BACKGROUND:Stem cel transplantation is a promising treatment of advanced liver disease, and adipose-derived mesenchymal stem cel s have become another kind of popular cel s fol owing bone marrow mesenchymal stem cel s.
OBJECTIVE:To investigate the influence of adipose-derived mesenchymal stem cel transplantation on blood biochemical indices of liver cirrhosis rats.
METHODS:Sixty rats were equal y randomized into normal control, model and cel transplantation groups. Model rats of liver cirrhosis were made in the latter two groups through intragastric administration of carbon tetrachloride. One week after successful modeling, rats were given intraperitoneal injection of adipose-derived mesenchymal stem cel suspension in the cel transplantation group, and given normal saline in the other two groups.
RESULTS AND CONCLUSION:Compared with the normal control group, the model group showed a significant increase in the levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin, total protein in liver tissues, serum level of malondialdehyde, 15-minute indocyanine green retention rate and degree of hepatic fibrosis, and a significant decrease in serum albumin level, serum albumin/globulin, levels of glutathione peroxidase and cyclic guanosine monophosphate in liver tissues. On the contrary, these indicators were al improved in the cel transplantation group compared with the model group.
Moreover, CM-Dil-positive cel s were visible in the liver tissue of rats undergoing adipose-derived mesenchymal stem cel transplantation. Al these findings indicate that adipose-derived mesenchymal stem cel transplantation can reduce liver cirrhosis in rats by acting on blood biochemistry levels.

Objective To discuss whether potassium sensitivity test(PST) is correlated with PUF in Interstitial Cystitis (IC). Methods The data of 14 IC patients (female 13, male 1) were an-alyzed. The mean age was 48 years (range 35-67 years). The clinical symptoms included urinary fre-quency, urgency, pelvic and peritoneal region pain after bladder filling. All the patients met the diag-nostic criteria of NIDDK for IC. Dilatations by hyponome were performed, medicine including heparin-sodium, lidocaine, NaHCO3 were used by intravesical instillation. PST and the pelvic pain and urgen-cy/frequency patient symptom (PUF) were used for evaluation. The relationship of the PST and PUF was assessed by statistics. Results PST median decreased from 4.0 to 1.0 (P<0.01). PUF medi-an decreased from 27.5 to 13.5(P<0.01). PST was directly correlated with PUF (rs=0. 868, t= 4.418, P= 0.001 before treatment, rs = 0.779, t=4.300, P = 0.001 after treatment). Conclusions PST and PUF are correlated. Both can be used as index in diagnosis, differential diagno-sis, symptom severity and treatment effectiveness evaluation of IC.

Objective To investigate the value of perfusion CT in the evaluation of neoadjuvant chemotherapy in locally advanced squamous cell carcinoma.Methods Sixty-seven patients with Ib2-IIb squamous cell carcinoma of the cervix underwent CT perfusion imaging before neoadjuvant chemotherapy to measure blood flow (BF),blood volume (BV),peak time (MTT),permeability sur-face (PMB),perfusion time to peak (TTP)and MIP(HU);and underwent routine enhancement CT after the two course of neoadju-vant chemotherapy treatment to measure tumor size,and evaluate the therapeutic effect.Results Among 67 patients,48 patents were effective (2 completely remission and 46 partial remission),and 1 9 patients were ineffective (1 5 stable and 4 progressed),with the overall response rate of 71.6%.The differences of PMB and BV value between effective and ineffective group were statistically significant before neoadjuvant chemotherapy (P <0.001).The BF,MTT,TTP value were no significant difference between effec-tive and ineffective group before neoadjuvant chemotherapy (P >0.05).The BV and PMB value were relatively higher in the patients with effective chemotherapy.Conclusion CT perfusion imaging could measure the BV and PMB value of the tumor before neoadju-vant chemotherapy to provide the basis for treatment selection.

Objective To explore the efficacy and safety of percutaneous transhepatic portal vein or transjugular intrahepatic portosystemie shunt (TIPS)to implant the portal vein metallic stent in treatment of cavernous transformation of portal vein (CTPV).Methods Clinical and imaging data of 8 patients with CTPV were retrospectively analyzed who were treated in our hospital.All patients were treated with metallic stent implantation in portal vein including 3 patients by TIPS and 5 by percutaneous transhepatic portal vein.Results All patients were successful in the stent implantation without any occurrence of serious complications such as intra-abdominal hemorrhage and so on.Intraoperative angiography showed blood circulated freely in these stents.1 day-2 weeks later,the patients symptoms of abdominal pain and gastrointestinal bleeding were obviously relieved or disappeared.Follow up 1 month-3 years,1 patient with stent occlusion after one year of operation,the blood flow recovery after stent reimplantation,and the remaining patients,color doppler ultrasound reflected patency of blood flows in their stents.No one suffered from gastrointestinal bleeding or abdominal pain again.Conclusion Implantation of portal vein metallic stent via percutaneous transhepatic portal vein or via TIPS in treatment of cavernous transformation of portal vein is safe and effective.

Objective To explore the CT and MRI manifestations and diagnosis of elastofibroma dorsi(EFD).Methods CT or MRI findings of 20 cases (36 lesions)of EFD confirmed by surgical pathology were analyzed retrospectively.12 patients underwent plain chest CT,4 patients plain chest MRI,4 patients plain unilateral shoulder MRI.Results ① All of cases were located in the infrascapular region,between the thorax wall and serratus anterior,mainly shaped flat mound-like or semi-circular.CT densities and MRI signal intensities of the masses were similar to those of muscle with some interlaced fat-like areas within the lesions.The masses had irregular edges, with no clear boundary between the thorax wall and serratus anterior,with disappeared fat gaps.② Statistical difference were found in patients’incidence between men and women,incidence between unilateral and bilateral and lesion volume between the left and right (P <0.05),and the incidence in female was significantly higher than that in male,the incidence in bilateral was significantly higher than that in unilateral,the lesion volume in the right was bigger than that in the left.Conclusion ① EFD has its characteristic location and imaging findings,so a definite diagnosis can be made with CT and MRI.② The mechanical friction between the scapula and chest wall may be related to tumor growth.

Objective:To explore the safety and efficacy of Castor branched stent-graft exclusion in the treatment of aortic dissection and aneurysm involving left subclavian artery.Methods:The clinical and imaging data of 88 patients with aortic dissection or aneurysm involving left subclavian artery diagnosed by CTA or DSA in our hospital from December 2017 to December 2019 were collected retrospectively, including 67 aorta dissections, 7 thoracic aortic aneurysms and 14 aorta penetrating ulcer. All patients were treated with branched stent-graft under the guidance of DSA. The postoperative curative effect and complications were observed. The paired t test was used to compare the maximum aortic diameter of the lesion before and 6 months after the operation. Results:Eighty-eight patients were successfully treated with integrated stent, the success rate of operation was 100%, and the disease-related symptoms of all patients were basically or completely relieved. The mortality rate within 1 month after the operation was 2.7% (2/88). The two deaths were complicated with other serious diseases before the operation, and the cause of death was not related the operation. All patients were followed up except 4 patients who lost contact after discharge. During the follow-up, there were 1 case of retrograde type A dissection, 1 case of new aneurysm of aortic arch, 2 cases of in-stent stenosis of left subclavian artery branch, 3 cases of mild stroke, no persistent endoleak and no death or other serious complications. The mean maximum aortic diameter at 6 months after operation [(34±4)mm] was significantly lower than that before operation [(38±6 mm)] ( t=6.63, P<0.05). Conclusion:Castor branched stent-graft is simple, mini-invasive and effective in the treatment of aortic dissection and aneurysms involving the left subclavian artery.

Objective To evaluate the clinical therapeutic efficacy and adverse reactions of Coix Seed Extract combined with transcatheter arterial chemoembolization(TACE) in the treatment for hepatic metastases and to compare the levels of serum VEGF of the patients before and after the treatment.Methods FromJuly 2009 to July 2011, 62 patients with hepatomatic metastases were enrolled in this study and were randomized into combining group and control group.The combining group were treated by TACE combined with Coix Seed Extract, and the control group were treated with TACE only. Both groups underwent TACE at least twice.Before and after the treatment,the enzyme linked immunosorbentassay(ELISA)was used to examine the change of VEGF. Results Among 62 assessable patients, overall response rate was 61.3 ％(19/31) in combining group and 45.2 ％ (14/31)in control group respectively (P＞ 0.05).The disease control rate was 80.6 ％(25/31) in combining group and 54.8 ％ (17/31) in control group(P＜0.05).The 1-year survival rates were 67.7 ％(21/31) in combining group and 38.7 ％(12/31) in control group(P ＜ 0.05).The median PFS(progression free survival time) was 7.0 months in combining group and 5.1 months in control group (P＜ 0.05).The levels of serum VEGF in combining group were significantly decreased after treatment (P ＜ 0.05). There was no significant difference between the levels of serum VEGF before and after treatment in control group(P＞ 0.05).The levels of serum VEGF in combining group after treatment were lower than that in control group after treatment (P ＜ 0.05). Adverse reactions in both groups were grade Ⅰ to Ⅲ.The fatigue,anorexia and the right upper quadrant pain was significantly superior in combining group. Conclusion Coix Seed Extract combined with transcatheter arterial chemoembolization in the treatment of hepatomatic metastases can improve disease control rate,decrease the levels of serum VEGF,improve clinical symptoms,prolong the PFS and 1-year survival rate.

ObjectiveTo explore risk factors of colorectal cancer with synchronous liver metastases and its prognosis. Methods From Aug 1994 to Feb 2004, 106 colorectal cancer patients with synchronous hepatic metastases were enrolled. Fifteen clinicopathological parameters were collected for mono-variable and multi-variable analysis. Treatment result was analyzed by Kaplan-Meier method and COX regression. Results Bowel obstruction, ascites, pelvic nodules, peritoneal invasion, serosal infiltration, organs involvement, tumor size, circumference of bowel invasion, depth of invasion were all individually relevant with synchronous hepatic metastasis. Logistic regression demonstrates depth of invasion, serosal infiltration, pelvic nodules and ascites were most important factors resulting in synchronous hepatic metastases. Radical resection(57 cases), palliative resection(39 cases) and laparotomy only(10 cases) resulted respectively in mean survival time and median survival time of 41.0 and 34.0 months,23.6 and 18.0 months,16.5 and 12.0 months,respectively (all P=0.0095).Surgery, location of tumor and pelvic nodules were independent prognostic factors. Conclusions Synchronous liver metastasis may present when primary tumor infiltrates serosa, or pelvic nodules and ascites are present. Radical excision significantly improves survival rate.

OBJECTIVETo compare thoracoscopic esophagectomy with traditional esophagectomy in radical mediastinal lymphadenectomy for esophageal cancer, and to explore the feasibility and safety of thoracoscopic mediastinal lymphadenectomy for esophagectomy.

METHODSClinical data associated with perioperation and mediastinal lymph nodes clearance of 304 patients undergoing radical operation of esophageal cancer via left neck-right chest-upper abdomen in our department from June 2009 to June 2011 were analyzed retrospectively. Among 304 cases, 199 received traditional open radical resection and 105 thoracoscopic esophagectomy. The intrathoracic mediastinal lymph node metastasis rate, extent of metastasis, time of operation, blood loss and complications between two groups were compared.

RESULTSAll the 304 cases completed their operations successfully. A total of 3724 mediastinal lymph nodes were removed, mean 12.3±7.0 per case, including 1065 in thoracoscopic group, mean 10.1±5.5 per case, and 2659 in open group, mean 13.3±7.5 per case, whose difference was significant. But further analysis according to the postoperative pathologic staging showed no significant difference of above lymph nodes removed between two groups. Mediastinal lymph node metastasis was found in 126 patients with a rate of 41.4%, which was 35.6% and 44.7% in thoracoscopic and open groups respectively without significant difference(P>0.05). The left laryngeal recurrent nerve lymph node metastasis rate in open group and thoracoscopic group was 16.1% and 6.7% respectively, and the difference was significant(P<0.05). Differences of lymph node metastasis rate in other regions were not significant between the two groups. There were 365 positive lymph nodes, and the lymph node metastasis degree was 9.8%. which was 8.2% and 10.5% in thoracoscopic group and open group respectively(P<0.05), besides metastasis degree of open group was much higher in right laryngeal recurrent nerve and subcarinal lymph node region. The overall complication rate was 36.8%, which was 28.6% in thoracoscopic group and 41.2% in open group respectively with significant difference(P<0.05). There were no significant differences in operative time and blood loss between the two groups(both P>0.05).

CONCLUSIONRadical mediastinal lymphadenectomy with thoracoscopic esophagectomy is technically safe and feasible for early to moderate stage esophageal cancer with similar lymph nodes removed and lower complication morbidity. In the early period of carrying out thoracoscopic radical mediastinal lymphadenectomy, laryngeal recurrent nerve and subcarinal lymph node region should be identified to prevent incidental injury.

Blood Loss, Surgical ; Esophageal Neoplasms ; pathology ; surgery ; Esophagectomy ; methods ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Mediastinum ; pathology ; Operative Time ; Retrospective Studies

BACKGROUNDThe prevalence of lung cancer in the elder increases gradually recently, and lung cancer has become the main cause of cancer-related death. The aim of this study is to analyse the operative indication, complication, perioperative management and surgical measures, results and specificity for lung cancer in the elderly patients.

METHODSOne hundred and thirty-seven elderly patients with lung can-cer, aged from 70 to 83 years old with mean age of 74 were analysed. Of the 137 cases, 13 patients were in the stage I, 76 in stage II, 48 in stage III. Surgical procedures included pneumonectomy for 4 patients, lobectomy for 122 patients, segmentectomy and wedge resection for 7 patients, sleeve lobectomy for 19 patients, bronchoplastic procedure and pulmonary artery reconstruction for 2 patients. Video-assisted thoracic surgery was performed in 13 cases for segmentectomy and wedge excision

RESULTSThere was no operative death. The resection rate was 97.1%, and postoperative complication rate was 29.9%. The follow-up rate was 88.3% . The 1-, 2-, 3-year survival rate was 62%, 35%, 28% respectively.

CONCLUSIONSElderly patients with lung cancer can obtain good therapeutic results and prognosis undergoing surgical therapy, but the operative indications will be limited. Exquisite surgical technique and application of respirator after operation may expand the operative indications.