1.The management of donor livers in living related donor liver transplantation
Chinese Journal of Organ Transplantation 1999;20(4):234-236
Objective To investigate the management of donor livers in partial living liver transplantation.Methods Nine cases of partial living related donor liver transplantation in Kyoto University served as subjects.The donor liver perfusion time and method,and preparation and preservation were studied.Results The donor livers in 9 cases were successfully removed with the liver removal accounting for 20%to 29%of the total livers.The recipients were alive well.Conclusion The donor liver perfusion time and method.and preparation and preservation were the keys in partial living related donor liver transplantation.
2.Meta analysis on the application of fast track surgery in gastrectomy for gastric cancer
Jie DING ; Hao WANG ; Wenxian GUAN
Chinese Journal of General Surgery 2015;30(10):808-812
Objective To review the safety and efficacy of fast track surgery in gastrectomy for gastric cancer.Methods The computer retrieved databases, including Pubmed, Medline, Cochrane library and Web of science, to collect randomized controlled trials (RCT) or controlled clinical trials (CCTS) on FTS was used in gastrectomy for gastric cancer between January 1994 and march 2014, and manual retrieval in Google.Using RevMan5.0 software analysis data that extract from collect literature.Results A total of five RCTs and two CCTs, involving 636 patients,were included, there were 309 cases in experimental group (FTS group) and 327 cases in control group.Meta-analysis showed: the FTS group had earlier postoperative flatus [WMD =-18.74, 95% CI (-34.31,-3.17), P < 0.05], shorter postoperative hospital stay [WMD =-2.46, 95% CI (-3.75,-1.17), P=0.000 2], and lower hospital charge [SMD =-0.67, 95% CI (-1.00,-0.34), P < 0.000 1].However, there were no statistically significant differences in operation time, intraoperative blood loss, the number of retrieved lymph node intraoperative, the time of catheter removal and postoperative complication rate (P > 0.05).Conclusion FTS in gastrectomy for gastric cancer can promote postoperative bowel function recovery, decrease postoperative hospital stay and reduce hospital charge.
3.Experience of donor hepatectomy in living-related liver transplantation
Desheng WANG ; Kefeng DOU ; Wenxian GUAN
Chinese Journal of Organ Transplantation 1996;0(02):-
Objective To sum up the experience of donor hepatectomy in living-related liver transplantation.Methods From 1997 to 2001, donor hepatectomy was performed on 3 cases of left lateral segmentectomy at Xijing Hospital, Xi'an. Two living-related liver transplantations and one living-related auxiliary partial orthotopic liver transplantation were carried out. The surgical technique of donor operations consisted of mobilization of the liver lobe, hilar dissection, transection of the liver using ultrasonic dissector without inflow or outflow vascular occlusion. Results The donor operation took 5.0?h to 6.5?h. The blood loss was 200?ml to 400?ml. No complication occurred in all donors. The function of the donor liver in all donors were normal. Conclusions Donor hepatectomy of left lateral segment can be a safe operation provided. Good surgical technique and appropriate preservation are key points to success of the liver transplantation.
4.Living-related auxiliary orthotopic partial liver transplantation: report of a case
Kefeng DOU ; Wenxian GUAN ; Kaizong LI
Chinese Journal of General Surgery 1997;0(04):-
ObjectiveTo investigate the feasibility of auxiliary orthotopic partial liver transplantation (APOLT) from a living donor for the treatment of Willson′s disease.MethodsThe patient was a 20-year-old girl with Willson′s disease, whose blood type was O. The donor was a man aged 21 and his blood type was A. The left lateral lobe (260?g) of patient′s liver was removed, the left lateral lobe (295?g) of donor′s liver was grafted to the patient in situ. Blood plasma exchange was carried out to the recipient before transplantation. FK506 adrenocortical hormones and cytoxan was administered after operation. ResultsThe recipient had a onset of hepatic artery thrombosis 15 days after operation, and ensuing intraabdominal hemorrhage caused by thrombolytic agent was successfully managed by laparotomy. Other postoperative complications such as hydroperitonia, pulmonary atelectasis and bile fistula were cured. Now the patient has survived 15 months with a normal copper-protein level, a mitigated extrapyramidal symptom and the grafted liver grows larger.ConclusionAPOLT is a feasible remedy for late-staged Willson′s disease.
5.Establishment of models of pancreas transplantation alone with enteric drainage in rats
Xiaonan LIU ; Tingting HUO ; Weizhong WANG ; Wenxian GUAN
Chinese Journal of Tissue Engineering Research 2006;10(17):174-176
BACKGROUND: Pancreas transplantation alone (PTA) is an effective therapy for diabetic patients who do not occur chronic complications. It's important to establish the stable PTA animal models to investigate immunologic tolerance or ischemic/reperfusion injury.OBJECTIVE: To establish the model of pancreas transplantation alone (PTA) with enteric drainage in rat.DESIGN: Grouping and controlled animal experiment SETTING: Department of Gastrointestinal Surgery, Xijing Hospital,Fourth Military Medical University of Chinese PLA MATERIALS: Totally 90 SD male rats, with the body mass of 250-320 g,were chosen in this study. 58 rats were induced by intravenous administration of streptozotocin (STZ) at a dose of 65 mg/kg via penile vein and the rats whose fasting plasma glucose exceeded 19.4 mmol/L for more than 2weeks were selected, 22 rats was successful. Rats were randomly assigned to 2 groups: control group (10 healthy rats) and group PTA consisted of 22diabetic rats, which received PTA from 22 normal donors.METHODS: This experiment was conducted at the laboratory of Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA from January 1999 to July 2004. The blood vessels reconstruction of PTA were performed using end-to-side anastomosis between the donors' abdominal aorta segment (abdominal artery and splenic artery) and recipients' abdominal aorta, and end-to-end anastomosis between the donors' portal vein segment (splenic vein) and recipients'left renal vein (use a cuff). Pancreas exocrine drainage was made by pancreas intestine anastomosis (Roux-Y).MAIN OUTCOME MEASURES: Body mass, food intake, water intake and fasting blood glucose were monitored 2 days before operation and 1,3,7,14 and 30 days after operation, and the failure causes were analyzed.RESULTS: 22 rats in the model group and 10 rats in the normal control the vein of the rats , very severe diabetic symptoms appeared in 22 rats:Body mass, food intake, fasting blood glucose was increased than that of cipients operation was (32.2±12.7) minutes and (63.4±15.9) minutes respectively. And the mean time of warm and cold ischemic time was 0minute and (48.6±18.3) minutes, respectively. 11 of the 22 cases (50%)died or lost their function of the endocrine within 1 month in Group PTA.The main complications were secondary pancreatitis and pancreas leakage after transplantation (7 cases, 31.8%). All successful recipients' blood glucose lowed on the 1st and recovered to be normal on the 3nd after transplantation (P < 0.01), and their food intake, water intake and urine volume decreased and became stable 14 days later.CONCLUSION: This method can be used to establish relative stable animal model. Successful PTAs may improve the pancreatic endocrine function of the diabetic rats.
6.Application of liposome in cancer therapy and tracer study
Jie DING ; Lijiang HU ; Xing KANG ; Ke CAO ; Wenxian GUAN
Chinese Journal of Clinical Oncology 2014;(21):1403-1407
Liposome is an artificially prepared spherical vesicle that has a phospholipid bilayer. Given that the basic structure of its biological membrane is also a lipid bilayer membrane, liposome shares similar structures with body cells Therefore, liposome has good biocompatibility and advantages such as biodegradability, low immunogenicity, and subtle toxicity. Liposome has been widely ap-plied as an effective drug carrier. Studies on liposome-encapsulated fluorescent dye on tumor tracing have been reported in recent years. Liposome can become a more advantageous transport carrier with continuous development of surface modification materials and prepa-ration methods. The long cycle, targeted liposome-encapsulated drugs, and fluorescent dye have become the focus of interest for several researchers. This article mainly discusses the application and progress of long cycle and targeted liposome in cancer research.
7.Clinical efficacy of navigation of sentinel lymph node combined with endoscopic submucosal dissection in laparoscopic surgery for non curative treatment of early gastric cancer
Wei REN ; Song ZHANG ; Meng WANG ; Wenxian GUAN ; Lei WANG
Chinese Journal of Digestive Endoscopy 2016;33(12):826-828
Objective To explore the clinical efficacy of navigation of sentinel lymph node (SLN) combined with endoscopic submucosal dissection (ESD) for non curative treatment of early gastric cancer.Methods Clinical data of 9 cases with early gastric cancer treated with ESD from August 2015 to December 2015 were enrolled.The SLNs were explored by laparoscopy after nano carbon or indocyanine green(ICG) was injected under endoscopy.Then all stained nodes were resected by laparoscopy.Results The mean number of SLN were 2.75±1.50 in ICG group,which was significantly smaller than the number in nano carbon group(8.40±4.93) according to the laparoscopic pathology,so the accuracy of ICG was higher than that of nano carbon.But ICG performed better in development.The postoperative complications such as postoperative intestinal obstruction,enteritis and gastric paralysis were found in 5 patients of nano carbon group.But no serious complications after operation were found in patients of ICG group.Conclusion Application of ICG can help avoid the excessive removal of tissue,and reduce the incidence of complications.ICG,as a new type of tracer for early gastric cancer,shows good application prospects.
8.Remedy radical gastrectomy after endoscopic submucosal dissection for early gastric cancer
Yutao YUAN ; Hao WANG ; Meng WANG ; Min FENG ; Wenxian GUAN
Chinese Journal of General Surgery 2016;31(6):460-462
Objective To explore the reason for remedy radical operation after endoscopic submucosal dissection (ESD) for early gastric cancer.Methods The clinical data of 26 early gastric cancer cases who received remedy radical gastrectomy after ESD between January 2012 to March 2015 in Nanjing Drum Tower Hospital were analyzed retrospectively.Results All cases were followed up and mid follow-up was 25 months.There was no death nor tumor reccurence cases during the follow-up.Three cases suffered from complications in radical surgery for gastric cancer including afferent jejunal loop obstruction,adhesive intestinal obstruction,stomach paralysis respectively,all were cured by conservative therapy.Postoperative pathology found lymph node metastasis in 3 cases.Conclusions En bloc resection and negative resection margin,as well as free lymphatic metastasis are two important factors determing the survival of early gastric cancer patients undergoing ESD treatment.
9.Advances in the enteral nutritional support treatment for patients after digestive tract reconstruction
Xiaojie BIAN ; Meng WANG ; Weihong GE ; Wenxian GUAN
Chinese Journal of Clinical Oncology 2014;(18):1150-1153
Postoperative patients who underwent digestive tract reconstruction have a high risk of malnutrition and absorbing bar-rier. Enteral nutrition support can effectively maintain and improve the nutritional status of the human body, shorten hospital stay, and reduce complications. Therefore, the enteral approach is the preferred postoperative means of nutrition support. This article retrospec-tively summarizes the appropriate time to start enteral nutrition support therapy after digestive tract reconstruction, the proper selection of the mode of enteral nutrition support, the different enteral nutrition preparations, and the treatment of postoperative complications.
10.A study on the mechanism of adriamycin-induced apoptosis of human hepatic carcinoma cells
Jianyong ZHENG ; Kaizong LI ; Weizhong WANG ; Wenxian GUAN ; Jun YI
Chinese Journal of General Surgery 2001;0(07):-
0.05). ConclusionsAdriamycin can induce apoptosis of cancer cells, and this is an important mechanism for its anticancer effect. This effect may be related to the down regulation of Bel-2 (expression).