OBJECTIVETo discuss the safety line to avoid the post-hepatectomy hepatic insufficiency by combining indocyanine green test by pulse dye-densitometry (PDD-ICG) and standard remnant liver volume (SRLV).

METHODSSeventy-five hepatic cancer patients undergone hepatectomy from March 2007 to February 2008 were included. According to the liver function decompensatory grades after operation, the relationship between ICG retention rate at 15 min (ICGR15) and standard remnant liver volume by linear regression were analyzed.

RESULTSThere were 60 cases with slight hepatic insufficiency, 12 cases with moderate hepatic insufficiency, and 3 cases with severe hepatic insufficiency. There were no difference in age [(50 +/- 13) years old and (53 +/- 9) years old], prothrombin time [(13.6 +/- 1.0) s and (13.5 +/- 1.0) s], international normalized ratio (1.09 +/- 0.10 and 1.06 +/- 0.10) between slight hepatic insufficiency group and moderate and severe hepatic insufficiency group (P > 0.05). And there were difference in K value (0.20 +/- 0.04 and 0.17 +/- 0.03), ICGR15 (6 +/- 4 and 9 +/- 4), SRLV [(545 +/- 93) ml and (398 +/- 82) ml] between two groups (P < 0.05). Compared ICG test and standard remnant liver volume of the patients with moderate hepatic insufficiency after operation, the liner relationship was found (R = 0.640, P = 0.025), and the regression equation was: standard remnant liver volume (ml/m(2)) = 1594.6 x ICGR15 + 265.

CONCLUSIONSPDD-ICG test and standard remnant liver volume are effective to estimate hepatic function reserve of patient undergone hepatectomy.

Adult ; Female ; Hepatectomy ; methods ; Hepatic Insufficiency ; etiology ; Humans ; Indocyanine Green ; pharmacokinetics ; Liver ; pathology ; Liver Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology

OBJECTIVETo investigate the time trends of cancer mortality among residents in Kaifeng county, Henan province.

METHODSData on cancer mortality from the vital registration system in Kaifeng county from 1988 to 2005 was analyzed. A total of 9543 death records (5974 males and 3567 females) due to malignant tumors were studied. A two-year-period age-specified standardized mortality rates were directly adjusted by the world standard population, and the annual percentage change (APC) of mortality were estimated by a linear logarithm regression.

RESULTSThe crude cancer death rate for male was 95.09/100,000 and its age-standardized death rate was 117.41/100,000. While, the crude cancer death rate for female was 59.13/100,000 and the age-standardized death rate was 57.15/100,000. There was a significant growth tread for lung cancer (APC: 6.54%), liver cancer (5.07%) in males and breast cancer (7.04%) in females in the groups aged over 18. On the contrary, the decreasing treads for esophageal cancer in both of sexes (-7.09%, -13.53%) were also observed in this study. Meanwhile, there was no other significant changes in the trend, either in the tumor sites or mortality, was observed.

CONCLUSIONIn the past two decades, there has been a significant increasing trend for cancer mortality in Kaifeng county, of Henan Province. Hence, it is necessary to enhance epidemiological survey to identify risk factors at the earlier stages.

China ; epidemiology ; Death Certificates ; Female ; Humans ; Male ; Mortality ; trends ; Neoplasms ; mortality ; Rural Population

OBJECTIVETo investigate the association between genetic polymorphisms in methylenetetrahydrofolate reductase (MTHFR) and risk of breast cancer among women.

METHODSTwo hundred seventeen cases with breast cancer and 218 matched controls were genotyped for the MTHFR C677T and A1298C polymorphisms by PCR-RFLP methods. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression model.

RESULTSWe found that the frequency of the MTHFR C677TT genotype among cases was significantly different from that among controls (32.7% vs. 24.8%; P = 0.02). The MTHFR C677TT genotype had an increased risk of breast cancer compared with the 677CC genotype (95% CI, 1.09 - 3.14). No significant association between the MTHFR C677T or A1298C polymorphism and risk of the cancer was observed.

CONCLUSIONThese findings suggest that 677CT polymorphism in MTHFR may be a genetic susceptibility factor for breast cancer among Chinese women.

Asian Continental Ancestry Group ; Breast Neoplasms ; genetics ; China ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Methylenetetrahydrofolate Reductase (NADPH2) ; genetics ; Point Mutation ; Polymorphism, Restriction Fragment Length

OBJECTIVETo study the use of vein grafts in adult-to-adult (AA) living donor liver transplantation (LDLT), we transplanted recipient vena saphena magna grafts for drainage of the paramedian portion of the right lobe liver grafts without a middle hepatic vein in LDLT.

METHODSFrom January 2002 to March 2006, 26 patients underwent A-A LDLT, and recipient saphenous vein grafts were used for revascularization of veins and arteries such as: tributaries of the middle hepatic vein from V5, V8; right inferior hepatic vein; injured portal vein; and hepatic artery.

RESULTSTotal outflow reconstruction ratio of V5, V8 and right inferior hepatic vein was 76.9% (20/26), the ratio of one-vein reconstruction was 57.7%, and the ratio of two-vein reconstruction was 19.2%. Reconstruction patterns and cases were demonstrated as follows: V5 (n=3), V8 (n=2), V5 and V8 (n=3), V5 and right inferior hepatic vein (n=1), V8 and right inferior hepatic vein (n=1), right inferior hepatic vein (n=10), injured portal vein of the donor (n=1). Total ratio of hepatic artery bypass grafting was 11.5% (3/26), anastomosis between hepatic artery and abdominal aorta (n=2), and anastomosis between hepatic artery and hepatic artery (n=1). Doppler ultrasound showed no thrombosis and the blood flowed smoothly and without venous outflow obstruction during the 2 to 48 months follow-up period.

CONCLUSIONReconstruction of V5 or V8 outflow and hepatic artery bypass grafting using vena saphena magna of the recipients can provide sufficient venous outflow and prevent the small-for-size syndrome and solve hepatic artery complications. This approach can be recommended.

Adult ; Aged ; Female ; Graft Survival ; Humans ; Liver Transplantation ; methods ; Living Donors ; Male ; Middle Aged ; Saphenous Vein ; transplantation ; Young Adult

OBJECTIVETo establish a new model for liver transplantation recipients with hepatocellular carcinoma (HCC) and validate the feasibility of it.

METHODSFrom February 1999 to June 2005, clinical data of 130 liver cancer patients who accepted liver transplantation were collected. Screening the pretransplant factors correlated with post-transplant survival using COX proportional-hazards regression, and establishing the assessment model. Finally, the area under the receiver operating characteristic curve (AUC ROC) were used to compare the validity of the new model with MELD.

RESULTSScreened by the COX model, serum concentrations of alkaline phosphatase, alphafetoprotein, sodium and the number of tumor nodule were significantly related with post-transplant survival. The new model with these four variables had greater ability to assess post-transplant recipients' outcomes, however, the MELD had not evaluation capacity.

CONCLUSIONThe established new model has a better ability to assess the risk of post-transplant mortality.

Adult ; Aged ; Alkaline Phosphatase ; blood ; Carcinoma, Hepatocellular ; blood ; surgery ; China ; Feasibility Studies ; Female ; Humans ; Liver Neoplasms ; blood ; surgery ; Liver Transplantation ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; methods ; Proportional Hazards Models ; Reproducibility of Results ; Sodium ; blood ; Survival Analysis ; alpha-Fetoproteins ; analysis

OBJECTIVETo evaluate the predictive value of portal vein flow rate preoperative for portal vein thrombosis (PVT) after periesophagastric devascularization in hepatitis B cirrhosis-related portal hypertension.

METHODSFrom January 2007 to July 2008, 45 patients with portal hypertension caused by hepatitis B cirrhosis were performed splenectomy with peri-esophagogastric devascularization in the same medical group in West China Hospital of Sichuan University. The portal vein flow rate and the diameter of portal vein were measured with doppler sonography respectively before and after the operation. At the same time, the level of PT and PLT were detected. The weight of spleens were measured after operation.

RESULTSThirteen cases suffered from PVT postoperatively. Portal vein flow rate was significantly lower in patients with PVT postoperation than that in patients without PVT (P < 0.01). In patients with PVT (n = 13) postoperation, the preoperative portal vein flow rate was (19.5 +/- 5.3) cm/s. Among the 13 cases, there were 12 cases whose flow rate were lower than 25 cm/s, and 1 case whose flow rate was 32. 3 cm/s; In patients without PVT (n = 32), the preoperative portal vein flow rate was (9.6 +/- 8.0) cm/s. In patients with lower rate (n = 17), the incidence rate of PVT was 70.6%; in patients with higher rate (n = 28), the incidence rate of PVT was 3.6%. The incidence rate of PVT in patients with lower rate was significantly lower than patients with higher rate (P < 0.01). The diameter of portal vein in patients with PVT was significantly wider than patients without PVT. The diameter of portal vein was negative correlative with the portal vein flow rate. The value 25 cm/s was of diagnostic efficiency, the sensitivity was 92.3%, and specificity was 70.6%.

CONCLUSIONSThe portal vein flow rate preoperative can be used as an early predictor of portal vein thrombosis after periesophagastric devascularization in hepatitis B cirrhosis-related portal hypertension to give a guide to clinical work.

Adult ; Aged ; Blood Flow Velocity ; Female ; Humans ; Hypertension, Portal ; etiology ; physiopathology ; surgery ; Liver Cirrhosis ; complications ; Male ; Middle Aged ; Portal Vein ; diagnostic imaging ; physiopathology ; Postoperative Complications ; diagnosis ; etiology ; Preoperative Care ; Risk Factors ; Splenectomy ; Ultrasonography ; Venous Thrombosis ; diagnosis ; etiology

OBJECTIVEMajor histocompatibility complex class I C-related molecules A and B (MICA and MICB) are innate immune system ligands for the NKG2D receptor expressed by natural killer cells and activated CD8(+)T cells. Our previous study showed that 5-aza-2'-deoxycytidine (5-aza-dC), a DNA methyltransferase inhibitor, can induce the expression of MICB and sensitized cells to NKL-cell-mediated cytolysis. The aim of this study was to determine the expression level of MICA in HepG2 cells (an HCC cell line) and L02 cells ( a normal liver cell), and to investigate the effect of 5-aza-dC on MICA expression in HepG2 cells.

METHODSCells were treated with 5-aza-dC, caffeine and ATM-specific siRNA. The cell surface MICA protein on HepG2 cells and L02 cells was determined using flow cytometry. The mRNA level was detected using real time RT-PCR.

RESULTSMICA was undetectable on the surface of L02 cells, but was highly expressed on HepG2 cells. MICA expression was upregulated in response to 5-aza-dC treatment (P less than 0.05), and the upregulation of MICA was partially prevented by pharmacological or genetic inhibition of ataxia telangiectasia mutated (ATM) kinase (P less than 0.05).

CONCLUSIONOur data suggest that 5-aza-dC induces the expression of MICA by a DNA damage-dependent mechanism.

Ataxia Telangiectasia Mutated Proteins ; Azacitidine ; analogs & derivatives ; pharmacology ; Caffeine ; pharmacology ; Carcinoma, Hepatocellular ; metabolism ; Cell Cycle Proteins ; antagonists & inhibitors ; metabolism ; Cell Line ; Cell Membrane ; metabolism ; DNA Damage ; DNA-Binding Proteins ; antagonists & inhibitors ; metabolism ; Flow Cytometry ; Hep G2 Cells ; Hepatocytes ; metabolism ; Histocompatibility Antigens Class I ; genetics ; metabolism ; Humans ; Liver Neoplasms ; metabolism ; Protein-Serine-Threonine Kinases ; antagonists & inhibitors ; metabolism ; RNA, Messenger ; genetics ; metabolism ; RNA, Small Interfering ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Tumor Suppressor Proteins ; antagonists & inhibitors ; metabolism ; Up-Regulation

OBJECTIVETo assess the diagnosis and treatment of invasive lung aspergillosis after liver transplantation.

METHODSRoutine sputum culture was performed. Itraconazole and fluconazole were used to prevent fungal infection prophylactically. Amphyotericin B was only used on aspergillosis. In 54 patients receiving, liver transplantation, 3 patients with lung aspergillosis were reviewed.

RESULTSOf the 3 patients 2 died and 1 recovered.

CONCLUSIONSOver-immunosuppression is a main risk factor for aspergillosis. Amphotericin B is still the best choice for the treatment of aspergillosis and its gradual, interrupted, low concentration administration, cooperated with itraconazole can ease the side effects.

Adult ; Aspergillosis ; diagnosis ; drug therapy ; etiology ; Female ; Humans ; Liver Transplantation ; adverse effects ; Lung Diseases, Fungal ; diagnosis ; drug therapy ; etiology ; Male ; Middle Aged

OBJECTIVETo establish a favorable formula of estimation adult standard liver volume (SLV) based on the data of living donors for liver transplantation.

METHODSFrom March 2005 to December 2007, 90 Adult-to-Adult living donor liver transplantation were performed. The donors' anthropometric data of gender, year, body weight and body height was collected prospectively. The total liver volume (TLV) of 90 living donors was measured by computed tomography. The correlation between TLV and several factors including body weight index (BMI) and body surface area (BSA) were analyzed. Then multiple stepwise linear regression analysis was performed and a new equation predicting SLV to improve approximate TLV was determined. TLV was then compared with the estimation standard liver volume (ESLV) calculated using our formula and published formulas in literature previously.

RESULTSAll the subjects had a mean body weight of (62.4 +/- 8.7) kg. The mean total liver volume was (1319.1 +/- 167.0) ml. There were positively correlated between TLV and body weight (BW), which could be expressed in the equation: TLV (ml) = 12.5 x BW (kg) + 536.4 (r(2) = 0.43, P < 0.01). Compared TLV with ELSV, which were calculated using previously published formulas based on the anthropometric data of the 90 subjects, the difference was be statistically significant.

CONCLUSIONA new simple formula is established that might be a more suitable to calculate TLV in Chinese adults.

Adult ; Female ; Humans ; Linear Models ; Liver ; anatomy & histology ; diagnostic imaging ; Liver Transplantation ; Living Donors ; Male ; Middle Aged ; Organ Size ; Tomography, X-Ray Computed

Acute Disease ; Adult ; Female ; Hepatitis ; therapy ; Humans ; Liver Transplantation ; Liver, Artificial ; Male ; Middle Aged