Objective To investigate the effect of standard remnant liver volume (SRLV) on liver insufficiency after hepatectomy in cirrhotic patients with hepatocellular carcinoma (HCC).Methods Sixty-seven HCC patients with liver cirrhosis were involved in this study.The following parameters were obtained in all cases:total liver volume (TLV),resected liver volume by surgery,body surface area (BSA),remnant liver volume (RLV)and SRLV.Compared analysis of relationship between liver insufficient and the parameters as well as the age of patients,duration of operation and blood lose etc.was carried out,in order to establish the security threshold of SRLV.Results According to the postoperative liver function,the patients were divided into 2 groups:Group A,52cases with mild liver dysfunction; Group B,15cases among them 12 with moderate and 3 with severe liver insufficiency.Statistical analysis showed that the difference of TLV,duration of operation,intra-operative blood lose and age between Group A and B were insignificant(P＞0.05).However,that of RLV and SRLV were significant(P＜0.05).The average SRLV in Group A was 562±89 ml/m2 and 410±87 ml/m2 in Group B (P＜＜0.01).The security threshold of SRLV was 438 ml/m2 calculated by receiver operating characteristic (ROC)in our patients.Then randomly selected sixty HCC patients,the incidences of moderate and severe liver insufficiency postoperative in the SRLV≤438 ml/m2 and SRLV＞438 ml/m2 patients were 92.3％and8.5％ (P＜0.01).Conclusions It is suggested from our present study that SRLV is a good predictor for post-operative liver function reserve in patients with cirrhotic HCC.Its security threshold is 438 ml/m2,and the risk of occurring hepatic failure will be high postoperatively when patient,s SRLV is less than this value.

BACKGROUND:The degradation of a col agen Ⅰ modified porous calcium sulfate scaffold in vivo is unclear, and its degradation product effects on human osteoblasts are rarely reported.
OBJECTIVE:To observe the biocompatibility of human osteoblasts with degradation products of calcium sulfate/col agen membrane composite porous scaffold.
METHODS:Passage 2 human osteoblasts were cultured in the extract of degradation products of calcium sulfate/col agen membrane composite porous scaffold and in Dulbecco’s modified Eagle’s medium containing 10%newborn calf serum. At days 1, 3, 5, 7, cellproliferative curves and total protein were determined using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method and Coomassie bril iant blue micro-plate method, respectively. And alkaline phosphatase activity was also detected.
RESULTS AND CONCLUSION:The proliferation rate of human osteoblasts in the extract of degradation products of calcium sulfate/col agen membrane composite porous scaffold was slightly higher than that in the Dulbecco’s modified Eagle’s medium containing 10%newborn calf serum, but there was no significant difference (P>0.05). Alkaline phosphatase activity, total protein synthesis and alkaline phosphatase/total protein were increased with time in the two groups, but there was no significant difference at different time (P>0.05). These findings indicate that the degradation products of calcium sulfate/col agen membrane composite porous scaffold cannot influence proliferation and growth of human osteoblasts as wel as their normal physiological functions, which have good biocompatibility.

AIM: To investigate the change of estrogen receptor (ER) in hippocampus, hypothalamus and pituitary of female rats exposed to psychological stress, and to illuminate the mechanism of dysfunction on ovarian reproductive endocrine function. METHODS: Sound, light and electricity were combined into a psychological stressful stimulus to induce female rat dysfunction on ovarian reproductive endocrine function. Immunohistochemical technique and image analysis were used to assess the expression levels of ER in hippocampus, hypothalamus and pituitary. RESULTS: When exposed to compound stressful stimulus of sound, light and electricity for 20 days in female rats, the expression levels of ER in hippocampus, hypothalamus and pituitary dropped. CONCLUSION: The decrease in estrogen receptor expression in hippocampus, hypothalamus and pituitary of female rats exposed to psychological stress may be one of the mechanisms of ovarian reproductive endocrine dysfunction.

BACKGROUND: Heme oxygenase-1 (HO-1) plays an important role on preventing tissues and organs from oxidant stress injury, which remains currently one of the most active areas of investigation. OBJECTIVE: To study HO-1 over-expression on the survival and fiver function of rats after reduced-size liver transplantation by constructing recombinant adenovims Ad5-HO-1.DESIGN, TIME AND SETTING: Randomized controlled animal study was performed in the Institute of Pediatrics, Children Hospital Affiliated to Chongqing Medical University from September 2003 to March 2005. MATERIALS: Seventy-four SD rats were used to establish in situ reduced-sized liver transplantation models. METHODS: Recombinant adenoviral vector encoding Ha-1 gene (AdS-HO-1) was generatred by molecular biology method, wluch was administered to donors via voln at 48 hours before transplantation. All rats were randomly divided into control group(n=12),saline group(n=12), cobalt protoporphyrin (CoPP)group(n=13),Ad5-HO-1 group(n=13),Ad5-green fluorescent protein(GFP)group(n=12),and Ad5-HO-1+zinc protoporphyrin (ZnPP)group (n=12).Livers of donor wefe harvested and stored for 24 hours at 4℃ in HTK solution. Before it is implantedinto recipient. MA IN OUTCOME MEASURES: Survival rate and liver function; portal vein blood flow monitored 2 hours after transplantation by Color Doppler How Imaging; pathological changes of transplanted liver tissue observed by HE staining;HO-1 activity, tumor necrosis factor-alpha(TNF-α),Bcl-2 and Bax expression detected by immunohistoehemical staining; changes of HO-1,TNF-α,bcl-2 and bax mRNA detected by molecular viewpoint. RESULTS: Survival rate in the Ad5-HO-1 group was significantly higher than that in the saline group at al,7,and 21 days after liver transplantation(P＜0.05).Glutamic pyruvic transaminase decreased in the Ad5-HO-1 group as compared to that in the saline,Ad5-GFP,and Ad5-HO-1+ZnPP groups(P＜0.05);portal venous blood flow significantly increased 2 hours after transplantation(P＜0.05);HO-1 activity also significantly increased(P＜0.05).RT-PCR and immunohistochemical staining showed that HO-1 and bcl-2 expressions increased(P＜0.05),but bax and TNF-αexpressions decreased(P＜0.05).CONCLUSION:Ad5-HO-1 significantly induces high expression of HO-1 increases portal venous blood flow within 2 hours alter liver transplantation, and promotes liver functional recovery so as to prolong survival time of rats after liver transplantion.

Objective To compare the therapeutic effect and complication of immediate and selective interlocked intramedullary nailing in treatment of open tibial shaft fractures. Methods A total of 123 open tibial shaft fractures of 102 cases were treated with immediate fixation with interlocked intramedullary nailing after debridement (Group A) and with selective fixation with interlocking intramedullary nailing after debridement and closing the wound (Group B). Results The follow up for more than half a year showed that all fractures were healed, with excellent joint function of knee and ankle. Of all, 12 cases with skin necrosis and defect but without deep infection were healed after pedicle flap reconstruction. The result of Group A was much better than that of Group B in regard of total operation time, hospital stay, cost, amount of antibiotics used and partial weight bearing. No statistical difference in therapeutic effects and complications was found between two group. Conclusion Infection is not the contra-indication of interlocked intramedullary nailing in open tibial fractures. Immediate operation can be done after thorough debridement.

Objective To summarize complications and early clinical effect of less invasive stabilization system and the femoral condylar support plates in treatment of AO type C distal femoral fractures. Methods We reviewed 46 patients who had internal fixation of AO type C distal femoral fractures. Of all 46 patients, 25 were with less invasive stabilization sys-tem and 21 were with femoral condylar support plates fixation. Comparative analysis was performed using intraoperative in-dex, postoperative complications and the Evanich score at follow-up. Results All 46 patients were followed up with a mean time of 19.6 months after surgery. The difference in incision length, blood loss, fracture healing time was significant between the 2 groups(P＜0.05)but not in the duration of operations and hospital stays(P>0.05). The statistical signifi-cance was also found in the total incidence of postoperative complications and the Evanich score at the last follow-up(P＜0.05). Conclusion Patients with less invasive stabilization system fixation had the characteristics of less trauma, shorter fracture healing time, less postoperative complications and better functional recovery compared with femoral condylar sup-port plates. Less invasive stabilization system had became an ideal internal fixation in treatment of AO type C distal femoral fractures.

Genes, Recessive ; Humans ; Nephritis, Hereditary ; diagnosis ; Nephrotic Syndrome ; diagnosis

Objective:To study the role of NF- ?B in the mechanism of liver injury following intestinal perforations due to abdominal firearm wound. Methods:A total of 42 Chang-Bai piglets were assigned randomly into 7 groups: control group and wounded 1, 2, 4, 8, 12, 24 hours group.The model of intestinal perforations due to abdominal firearm wound was established in wounded groups. Hepatic NF-?B and TNF-? content was measured with immunohistochemical staining and image analysis in all groups. Hepatocyte apoptosis indexes and serum ALT levels were also determined at the same time. The alterations of hepatic tissue were observed under light microscope. Results: Levels of hepatic NF-?B activity in wounded groups were significantly elevated compared with control group, and two peaks appeared in 1 h group and 8 h group, respectively (P

Objective:To study the role of TNF-?in the mechanism of hepatocyte apoptosis induced by intestinal perforations due to abdominal firearm wound. Methods:A total of 42 Chang-Bai piglets were divided randomly into 7 groups: control group and wounded 1, 2 , 4, 8, 12, 24 hour groups.The model of intestinal perforations due to abdominal firearm wound were established in wounded groups. Levels of plasma endotoxin were measured using ehromogenic limulus amehoeyte lysate test.Hepatic TNF-? content was measured with immunohistochemical staining and image analysis in all groups. Hepatocyte apoptosis indexes and serum TNF-? levels were determined at the same time. Results: Levels of plasma endotoxin, serum TNF-?, hepatic TNF-? content and hepatocyte apoptosis indexes in wounded groups were all significantly elevated compared with control group(P

Objective To investigate the effect of Curcumin on rats with severe acute pancreatitis associated renal injury and explore the possible mechanisms.Methods A total of 72 rats were randomLy divided into sham-operated group(S group, n =24), severe acute panceratitis with renal injury group(M group, n =24) ,Curcumin-treated group(Cur group,n=24).The S and M groups were given 1.5 ml saline through intragastric administration 3 hours before operation,while the Cur group was fed with same amount of Curcumin diluent(200 mg/kg).The pancreas and pancreatic tail-segment was dissociated and the head of pancreas was occlused in rats to form the model,blood vessel forceps was loosed after 3 hours.All the rats were sacrificed at 12 h,24 h, 36 h and 48 h after modeling.The level of ascites, serum amylase, creatinine, blood urea nitrogen were detected and the pathological chang of pancreas was observed under light microscope.Take the right kidney for Superoxide Dismutase (SOD) determination and the expression of hypoxia inducible factor-1αmRNA in the right kidney was detected with realtime polymerase chain reaction (RT-PCR).Results Compared with Cur group, the level of ascites, serum amylase, creatinine, blood urea nitrogen in M group were significantly increased, but the activity of SOD, the express of hypoxia inducible factor-1αmRNA had a significant decline (P＜0.05).The tissue damage of pancreas and the kidneys became more serious.But a better performance was to be found in the function of the Cur group's kidney and pancreas, and the the difference was statistical significance (P ＜0.05).Conclusion Curcumin has a good protective effect on severe acute pancreatitis associated renal injury.It may be through up-regulation expression of HIF-1α mRNA and increase the activity of superoxidase dismutase, then reduce the cell apoptosis and necrosis of the kidney, improve the ability of the kidney to tolerate hypoxia.