1.Repairing sciatic nerve crush injury by transplantation of bone marrow mesenchymal stem cells
Guang YANG ; Weitian YIN ; Jinwei XUE ; Chunyu LI ; Dongyan FAN
Chinese Journal of Tissue Engineering Research 2008;12(25):4948-4951
BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) are conveniently cultured and separated in vitro because theirimmunogenicity is low. Therefore, BMSCs are suitable for cell transplantation. Research has shown that BMSCs are potential to repair neurological defect. OBJECTIVE: To determine whether in vitro cultured BMSCs can be transplanted to repair peripheral nerve injury or not, and to investigate its mechanisms. DESIGN, TIME AND SETTING: Randomized controlled animal study This study was performed in Department of Toxicology, Public Health College of Jilin University from March 2006 to March 2007.MATERIALS: Fifty healthy female Wistar rats aging 2 months and six 1-week-old female Wistar rats were used for extraction of BMSCs. Rabbit-anti-nerve growth factor (NGF) monoclonal antibody was provided by Santa Cruz Company. METHODS:BMSCs were separated and cultured with adherent method. In the 3rd generation, BMSCs were preiabeled with bromodeoxyuridine (BrdU) 48 hours before transplantation. Fifty healthy Wistar rats were selected to prepare sciatic nerve crush injury models with clamping method.Subsequently, rats were randomly divided into transplantation group and control group, with 25 rats in each group. Rats in the transplantation group underwent transplantation of BrdU-labeied BMSCs at nerve injured sites; while, the same volume DMEM was injected into rats in the control group. MAIN OUTCOME MEASURES: Injured nerve in the transplantation group suffered from anti-BrdU staining 1, 2, 4, and 6 weeks after surgery. Distal injured nerve in both groups suffered from NGF immunohistochemical staining 1, 2, 4, and 6 weeks after surgery. Image analysis system was adopted to analyze integrated absorbance of positive expression. Gait analysis was performed every week after surgery to measure sciatic nerve function index, and it was also adopted to measure regenerated nerve conduction velocity 6 weeks after surgery. Subsequently, amount and inner diameter of medullated nerve fibers were calculated after luxol fast blue staining, while wet weight of experimental-lateral gastrocnemius muscle and cross section area of muscle fiber were measured at the same time. RESULTS: Fifty rats were included in the final analysis. BrdU-labeled positive cells could be found at injured nerve in the transplantation group 1, 2, and 4 weeks after surgery. Integrated absorbance of NGF protein expression in the transplantation group was significantly higher than that in the control group 1 and 2 weeks after surgery (P < 0.01), but there were no significant differences between the two groups 4 and 6 weeks after surgery (P > 0.05). Sciatic nerve function index in the transplantation group superiorly recovered to that in the control group 3-6 weeks after surgery. Furthermore, 6 weeks after surgery, nerve conduction velocity, amount and diameter of medullated nerve fibers, wet weight and cross section area of gastrocnemius muscle in the transplantation group were significantly higher than those in the control group (P < 0.05-0.01). CONCLUSION: BMSCs can be transplantated into injuried nerve tissue, and promote the recovery of nerve function in the micro-enviroment, improve NGF expression in an early phase may be one of its mechanisms.
2.Exploration of development of the subjective role of students in regional anatomy experiment program
Shengwei GAN ; Jianhua RAN ; Weitian LU ; Juan HUANG ; Shujuan ZHU ; Jin XU ; Ping FAN ; Shanquan SUN
Chinese Journal of Medical Education Research 2015;(7):735-737
During the teaching activities, to stimulate students' subject awareness and encour-age them to play the main role in class activities are inevitable trends in the reform of college educa-tion. Students’ subjective activity is a key to the teaching effect of regional anatomy, a course mainly based on experimental program. Department of Human Anatomy in Chongqing Medical University lay-outs regional anatomy teaching program to develop the students' subjective activities in learning from the course specialty: in preview and review, to train students' image-thinking by drawing; in anatomi-cal operation link, to cultivate students' interest in learning and innovation by discussing the relation-ship of anatomical structure and clinical disease and identifying the variation of structure; in the eval-uation process, taking the formative evaluation system to promote the students' initiatives and ensure the objectiveness and fairness. The implementation of these measures promotes the regional anatomy teaching quality.
3.Strategy on timing of ALPPS stageⅡbased on increase in remnant liver volume
Ren JI ; Chunhong LIU ; Weitian FAN ; Mingwu DENG ; Siyuan QIU ; Bangren XU ; Wong Tiffany Cho Lam ; To Tan CHEUNG ; AC Albert CHAN ; Mau Chung LO
Chinese Journal of Hepatobiliary Surgery 2021;27(11):815-818
Objective:To study the safety and efficacy on timing of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) stageⅡbased on increase in remnant liver volume.Methods:19 patients (male: female 13: 6; average age 53 years) with liver tumors treated by ALPPS from April 2014 to December 2020 were retrospectively studied. Patients with FLV/ESLV (future liver volume/ estimated standard liver volume) increase of more than 50% within 1 week followed by stageⅡALPPS were included into the rapid group ( n=8). Those who failed to have 50% increase in FLV/ESLV within 1 week were included into the control group ( n=11). The two groups were compared in the ALPPS stage II in operating time, blood loss, postoperative complications, mortality rate and hospital stay. Results:All 19 patients underwent ALPPS stage II uneventfully. One patient in the control group died from liver failure within 30 days of operation. The operation time (3.2±1.8)h, blood loss (554±227) ml and postoperative hospital stay (12.6±2.4) d in the rapid group were significantly better than those in the control group (4.7±2.2) h, [(760±314) ml, (18.2±6.4) d (all P<0.05)]. The two groups had similar complication rates in both post stageⅠ[37.5%(3/8) vs. 45.4%(5/11)] , or stageⅡ [37.5%(3/8) vs. 36.4%(4/11)] (both P>0.05). Conclusion:Rapid increase in FLR volume of more than 50% within a week was safe and feasible to proceed to ALPPS stage II. This conclusion needs to be confirmed by further studies using large sample sizes.
4.Prognosis of associating liver partition and portal vein ligation for staged hepatectomy to treat patients with hepatocellular carcinoma
Chunhong LIU ; Ren JI ; Weitian FAN ; Xiaoming HONG ; Zhiren CHEN ; Chulin HUANG ; Dantu ZHANG
Chinese Journal of Hepatobiliary Surgery 2022;28(10):731-734
Objective:To investigate the safety and outcomes of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in hepatocellular carcinoma (HCC).Methods:The clinical data of HCC patients who underwent hepatectomy at the University of Hongkong-Shenzhen Hospital from April 2014 to December 2020 were retrospectively analyzed. Of 57 HCC patients who were enrolled, there were 43 males and 14 females, aged (51±14) years old. According to the surgical method, the patients were divided into two groups: patients with pre-operative residual liver volume/standard liver volume <30% who underwent ALPPS procedure by anterior approach formed the study group ( n=20), and patients who underwent right hepatectomy with residual liver volume/standard liver volume ≥35% formed the control group ( n=37). Clinicopathological data and prognosis were reviewed and compared between the two groups. The patients were followed up via outpatient service and telephone. Results:There were more patients with well-moderately differentiated HCC in the study group than in the control group, and the difference was statistically significant ( P<0.05). All patients in the study group successfully completed two-step hepatectomy. Compared with the control group, the operative duration [644(535, 780) vs. 352 (269, 401) min], intraoperative blood loss [1 650 (1 338, 2 200) vs. 650 (500, 925) ml], and proportion of patients requiring blood transfusion (60.0% vs. 29.7%) were increased in the study group. The difference was statistically significant ( P<0.05). There was no significant difference in the incidence of grade III or higher complications between the study group and the control group [30.0% (6/20) vs. 18.9% (7/37), χ 2=0.91, P=0.341]. The 1-, 2- and 3-year overall survival rates were 90.0%, 63.8% and 46.4% respectively, and the corresponding tumor-free survival rates were 53.3%, 35.6%, and 35.6% respectively for the study group. The 1-, 2-, and 3-year overall survival rates were 71.4%, 63.4%, 51.7%, and tumor-free survival rates were 39.0%, 18.5%, 9.3% in the control group respectively. There was no significant difference in the postoperative survival rate and tumor-free survival rate between the two groups ( P>0.05). Conclusion:ALPPS was safe and feasible for treatment of right hepatocellular carcinoma with insufficient residual liver volume, and its survival outcomes was similar with one-stage right hepatectomy for HCC patients.