1.A Meta analysis for 4250 portal hypertension cases undergoing surgery in Chinese literature
Zhengfeng WANG ; Guangwen ZHOU
Chinese Journal of General Surgery 2012;27(8):643-649
ObjectiveTo systematically evaluate the therapeutic effect of gastroesophageal devascularization( GD),portasystemic shunt( PSS),devascularization plus portasystemic shunt ( GD + PSS) for the treatment of 4250 cirrhotic portal hypertension cases reported in Chinese literature. MethodsThe literatures about the effect of gastroesophageal devascularization,portasystemic shunt,devascularization plus portasystemic shunt on portal hypertension were collected from Wanfang databases, China National Knowledge Infrastructure(CNKI) from 1980 to 2011.RevMan 4.2 and SPSS 13.0 were used for data analysis. ResultsIn this study 17 reports were enrolled into the meta-analysis.The results of the mta-analysis showed that long term survival rate in the group of GD plus PSS was higher than that in group of GD [OR=1.73,95%CI (1.23,2.44),P <0.01].That in group of PSS was similar with the group of GD [ OR =0.87,95 % CI (0.63,1.20),P =0.40 ].That of group GD plus PSS was similar with the group of PSS [ OR =1.73,95% CI (0.95,3.13),P =0.07 ].For recurrent variceal bleeding rate,that in group of PSS was lower than that in the group of GD[ OR =0.46,95% CI (0.35,0.61 ),P <0.01 ].That in the group of GD plus PSS was lower than that in the group of GD [ OR =0.25,95% CI (0.18,0.35),P < 0.01 ].The group of GD plus PSS was similar to that of group of PSS [ OR =0.72,95% CI ( 0.40,1.29 ),P =0.27 ].Encephalopathy rate was higher in the group of PSS than the group of GD [ OR =3.57,95% CI (2.43,5.23 ),P <0.01 ].That in group of GD plus PSS was lower than that in the group of PSS[ OR =0.37,95% CI (0.20,0.69),P <0.01 ],while that in GD plus PSS was similar to the group of GD[ OR =1.58,95% CI (1.02,2.43),P =0.04 ].ConclusionsThe only significant factor influencing the long term result in Chinese patients with portal hypertension is preoperative liver function.The three types of operation have different benefits and disadvantages.
2.Gastroesophageal devascularization for the treatment of cirrhotic portal hypertension
Zhengfeng WANG ; Guangwen ZHOU
Chinese Journal of General Surgery 2012;27(9):710-712
ObjectiveTo evaluate the therapeutic effect of gastroesophageal devasculariztion on cirrhotic portal hypertensive bleeding.MethodsClinical data of 85 cirrhotic patients with portal hypertentsive bleeding undergoing gastroesophageal devascularization were retrospectively analyzed. Results The following-up rate was 78%. The 1-yr,3-yr and 5-yr survival rate was 95%, 88%and 82%respectively.There was significant difference in survival time after devascularization between patients of Child-Pugh A and Child-Pugh B.For the whole group the 1-yr,3-yr and 5-yr recurrent bleeding rate was 6%,16% and 28% and postoperative hepatic encephalopathy was 7%.ALT,AST and ALB recovered to pre-operative level on post-operative day 7.ConclusionsGastroesophageal devascularization was an effective therapy in treating portal hypertensive variceal bleeding.Liver function remains a significant factor influencing long term survival.
3.Diagnosis and management of pancreatic regional portal hypertension
Zhengfeng WANG ; Guangwen ZHOU
Chinese Journal of General Surgery 2012;27(3):204-206
Objective To summarize clinical experience on the diagnosis and management of pancreatic regional portal hypertension. Methods The clinical manifestations,diagnostic methods and therapeutic modalities of 40 cases of pancreatic regional portal hypertension were analyzed retrospectively.Results Male:female =26: 14.The average age was (40 ± 10)yrs.Among these patients,16 patients (40%) were accompanied by upper gastrointestinal bleeding and 20 patients (50%) by hypersplenism.There were 16 patients (40%) suffering from benign lesions and 6 patients (15%) from malignancy at pancreatic body and tail respectively,and 8 patients(20% ) from severe necrotic pancreatitis accompanying pseudocyst and 10 patients (25%) from chronic pancreatitis. The average splenic venous pressure was (28.4±4.2) cm H2O(P <0.01 ).The average diameter and speed of splenic vein bloodflow by Doppler examination was ( 1.3 ± 0.2 ) cm ( P < 0.01 ) and ( 9.3 ± 0.5 ) cm/s ( P < 0.05 ).The follow-up rate was 100%.Splenectomy was effective for controlling gastrointestinal bleeding. Conclusions It is not difficult to diagnose pancreatic regional portal hypertension based on findings of US,CT and endoscopic examination,together with its clinical features. Therapy should be aimed at both regional portal hypertension and underlying diseases.
4.Anticancer effects of PPAR? agonists:recent progress
Yanming ZHOU ; Zhengfeng YIN ; Jiamei YANG
Academic Journal of Second Military Medical University 2000;0(11):-
Peroxisome proliferator-activated receptor(PPAR) belongs to the superfamily of nuclear hormone receptor.Three PPAR subtypes have been identified to date(PPAR?,PPAR? and PPAR?)and the relationship between PPAR? and tumor has drawn great attention.Current data showed that PPAR? agonists exert their antineoplastic effect through inhibiting cell growth and angiogenesis,inducing cell apoptosis and differentiation,and reducing tumor invasive ability.PPAR? agonists may be a promising tool for cancer chemotherapy.
5.Expression and purification of TAT/CT-1 and TAT/EGFP fusion proteins
Xingxin LI ; Yue ZHOU ; Zhengfeng ZHANG
Journal of Third Military Medical University 2003;0(07):-
Objective To construct a vector containing protein transduction domain (PTD) and cardiotrophin-1 and a vector containing PTD and EGFP, express them in E. coli. and purify them. To detect the distribution of the two fusion proteins in mice. Methods CT-1 and EGFP were cloned to GST-fusion expression vector pGEX-4T3 by PCR and cloning techniques respectively, and then TAT was cloned into the vectors respectively to give pGEX-TAT/CT-1, pGEX-TAT/EGFP. After induced by IPTG the soluble protein GST-TAT/CT-1 and GST-TAT/EGFP was purified by Glutathione Sepharose 4B. The purified fusion proteins were injected into mice through caudal vein and examined in tissue section by immunohistochemical staining. Results CT-1 and EGFP were effectively amplified and the TAT/CT-1 and TAT/EGFP gene sequencing showed the same sequence as scheduled. The fusion proteins was successfully expressed in E. coli. and purified. Conclusion TAT/CT-1 and TAT/EGFP fusion proteins were expressed and purified successfully. The two fusion proteins were all detected positively in mouse brain, spinal cord, heart and liver.
6.Study on the construction of training base and teaching model of minimally invasive spine surgery
Changqing LI ; Yue ZHOU ; Jian WANG ; Tongwei CHU ; Zhengfeng ZHANG ; Wenjie ZHENG ; Yong PAN
Chinese Journal of Medical Education Research 2012;(11):1139-1141
Based on the analysis of the current status and limited factors of MISS at home and aboard,this paper discussed on the importance of MISS training base construction and explored the construction from the aspects of infrastructure constructing,teaching staff training,teaching materials compiling and teaching practice(teaching forms,contents and evaluation)researching.
7.Relation between fractional anisotropy in the cerebral peduncles and changes in motor evoked potential after acute middle cerebral artery territory infarction
Zhibin SONG ; Suyue PAN ; Yanling ZHOU ; Yanjiang DONG ; Haimao LIANG ; Zhengfeng ZHU
International Journal of Cerebrovascular Diseases 2011;19(5):370-375
Objective To investigate the changing characteristics of the fractional anisotropy (FA) in cerebral peduncles and its relation with motor evoked potential (MEP) after acute cerebral infarction and to clear the clinical sigiificance of the low limit value of the FA in cerebral peduncles. Methods The low limit value of the FA in normal cerebral peduncles was determined based on mean - 1. 64 standard deviation. The patients with acute cerebral infarction (n = 58) were divided into MEP positive group and MEP negative group according to the absence and presence of MEP, in which the patients in the MEP positive group were redivided into the FA in cerebral peduncles < the low limit value and≥ the low limit value groups according to the FA in cerebral peduncles on the affected sides. Results The low limit value of the FA in normal cerebral peduncles was 0. 36. There was significant difference in the FA in cerebral peduncles on the affected sides between the MEP negtive and MEP positive groups. The MEP negative group was the lowest (P=0. 000). The FA in cerebral peduncles on the affected sides in the positive group was significantly lower than that on the unaffected sides (P=0. 000), and the latency on the affected sides was longer than that on the normal sides (P=0. 000). The FA in cerebral peduncles on the affected sides was negatively correlated with the MEP latency (r=-0.332,P=0. 042). The MEP latency in the FA<the low limit value group was significantly longer than that in the FA ≥ low limit value group (P=0. 002). There were no significant differences in the FA in cerebral peduncles on the normal sides and the MEP latency among an groups. The detection rate of the FA in cerebral peduncle<0. 36 on the affected sides was the highest (50%). Conclusions In the evaluation of the prognosis of the patients, the changes of the FA in cerebral peduncles on the affected sides in patients with acute cerebral infarction had correlation,consistency, and complementarity with MEP.The detection rate of the low limit value of the FA in normal cerebral peduncles was the highest in the MEP negative patients. When the FA in cerebral peduncles was<0.36 on the affected sides, particularly when MET was negative, it might predict that the prognosis was poor.
8.Essential status of teachers in bilingual teaching for clinical courses
Min WANG ; Xia ZHANG ; Yong HAO ; Yue ZHOU ; Zhengfeng ZHANG ; Changqing LI
Chinese Journal of Medical Education Research 2011;10(4):510-512
Objective to research into the essential status of teachers in bilingual teaching for clinical coulses and its effects on the fields.Methods we have investigated the 46 teachers in resent three years for their interesting,attitude,reasons of negative,methods of the teaching and level of English in bilingual teaching Results 6 teachers expressed their interesting in bilingual teaching,which accounts for 13%.and 100% of the teachers hold the negative attitude because it has nothing to do with the evaluation of their professional title,43 teachers think it is not related to bonus(93.47%),and to Periodical Evaluation(45,97.82%)Conclusion The status of bilingual teaching is not satisfiing and improving the level of Enghsh of teaehers is essential for it.
9.Effects of troglitazone on the proliferation and differentiation of HepG2 cells
Yanming ZHOU ; Yinghao WEN ; Xiaoyan KANG ; Haihua QIAN ; Dianqi LI ; Jiamei YANG ; Zhengfeng YIN
Chinese Journal of Digestive Surgery 2008;7(3):200-202
Objective To examine the effects of a peroxisome proliferator-activated receptor γ ligand troglitazone on the proliferation and differentiation of HepG2 cells. Methods After the pretreatment of HepG2 cells with troglitazone, MTT and flow cytometry were used to analyze the proliferation and cell cycle of HepG2 cells, respectively. Immunocytochemistry, bromocresol green dye-binding method and chemiluminessence immunosorbent assay was used to determine E-cadherin, albumin and AFP, respectively. The expression of cyclin D1 and c-myc protein were detected by Western blot. Results Troglitazone inhibited the proliferation of HepG2 cells in a concentration-dependent manner and arrested HepG2 ceils at the G0>/G1> phase. After pretreated with troglitazone, HepG2 cells showed E-cadherin expression, a decreased expression of cyclin D1 and c-myc protein, a reduction of AFP level and a dramatic increase of albumin level. Conclusions Troglitazone inhibits proliferation and induces differentiation of HepG2 cells, the mechanism of which might be attributable to the down-regulation of cyclin D1 and c-myc expression.
10.The correlation between hepatitis virus infection and p53 expression in cholangiocarcinoma tissues
Yanming ZHOU ; Jiamei YANG ; Bin LI ; Zhengfeng YIN ; Feng XU ; Dianqi LI
Chinese Journal of General Surgery 2008;23(3):216-218
Objective To assess hepatitis B virus(HBV)and hepatitis C virus(HCV)infections in different anatomic location of cholangiocarcinoma(CC)and relationship with abnormal p53 expression.Methods A total of 411 CC samples including intrahepatic cholangiocarcinoma(ICC 312 cases);perihilar cholangiocarcinoma(PHC,73 cases)and distal cholangiocarcinoma(DC,26 cases)underwent serologic test for HBsAg and anti-HCV using microparticle enzyme immunoassay.Abnormal p53 expression was detected in formalin-fixed.paraffin-embedded CC tissues by immunohistochemistry.Results Seropositivity for HBsAg and anti-HCV were found in 48.4%(151/312)and 2.9%(9/312)of ICC cases,and in 10.9%(8/73)and zero of PHC,and in 7.7%(2/26)and zero of DC,respectively.Abnormal p53 expression was detected in 30.1%(94/312)of ICC cases.23.3%(17/73)of PHC cases and 19.2%(5/26)of DC cases.There was no correlation between seropositivity of HBsAg and anti-HCV and p53 overexpression among three groups of CC. Conclusions HBV but not HCV infection may be associated with the development of ICC.p53 abnormality may not play a significant role in HBV-associated carcinogenesis of ICC.