1.Advances in human placenta-derived stem cells for liver regeneration
Jian WANG ; Zhengyan ZHU ; Zhi DU
Chinese Journal of Hepatobiliary Surgery 2013;(3):236-240
Human placenta-derived stem cells (hPD-SCs) are a mixed group of stem cells.Stem cell medicine has applications for organ damage or failure through regenerative,anti-apoptotic,anti-inflammatory and anti-tumor properties in addition to cell function recovery.Presently,human placenta mesenchymal stem cells (hPMSCs) have similar characteristics to the differentiation of hepatocyte-like cells by promoting hepatocyte regeneration,anti-hepatocyte apoptosis and anti-liver fibrosis,in vitro or in animal models.To further our investigation,a summary of the origin,sorting and biological properties of hPDSCs along with a narration of hPDSCs for liver disease therapy was written.This leads to a discussion for new ideas to further explore cell treatment for liver disease.
2.Analysis of complications after ultrasound-guided PTBD
Xiang JING ; Zhi DU ; Yijun WANG ; Jianmin DING ; Yandong WANG
Chinese Journal of Hepatobiliary Surgery 2010;16(8):600-603
Objective To investigate the reasons of complications after ultrasound-guided PTBD and explore measures for their management. Methods The clinical data of 753 patients with obstructive jaundice treated with ultrasound-guided PTBD in our hospital from January 2001 to June 2008were retrospectively analyzed. Results The 753 patients received a total of 791 treatments of PTBD.The occurring rates of severe, common, and long-term complications were 1.14 % (9/791), 11.88 %(94/791 ) and 4.3% (9/791), respectively. Only 1 patient died of manipulation-related complications.Conclusion Ultrasound-guided PTBD is an effective method for treatment of obstructive jaundice.
3.Relevant factors of portal vein thrombosis in patients after splenectomy for portal hypertension due to cirrhosis resulting from hepatitis
Qianzhe XING ; Yijun WANG ; Qiang YUAN ; Zhi DU
Chinese Journal of Hepatobiliary Surgery 2010;16(12):918-921
Objective To analyze the relevant factors of portal vein thrombosis in patients after splenectomy for portal hypertension due to cirrhosis resulting from hepatitis. Methods The clinical data of 226 patients with hypertension due to cirrhosis resulting from hepatitis receiving simple splenectomy or splenectomy and portal-azygous devascularization in our hospital from August 2000 to June 2007 were retrospectively analyzed. Effective results were found in 154 of the patients. The 154 cases were divided into the thrombosis group and non-thrombosis group. The relation of portal vein thrombosis to the descendent level of portal vein pressure after operation,the prothrombin ratio (PTR) and fibrinogen(FIB) before operation, platelet count before and 1, 7, 14 days after operation, diameter of main portal vein and bilirubin level before operation and blood loss in operation were determined by logistic regression analysis. Results Portal vein thrombosis occurred in 31 patients. Regression univariate analysis showed that portal vein thrombosis was related to the descendent level of portal vein pressure after operation but not to the PTR and FIB, platelet count, diameter of main portal vein, bilirubin level and blood loss. Multivariate analysis demonstrated the same results. Conclusion The descended level of portal vein pressure is an important factor in portal vein thrombosis in patients after splenectomy for portal hypertension due to cirrhosis resulting from hepatitis.
4.Clinical observation of metallic intra-biliary stents for palliative management of 160 malignant obstructive jaundice patients
Chen YAO ; Zhi DU ; Yijun WANG ; Tong BAI ; Laiyuan LI
Clinical Medicine of China 2010;26(7):718-721
Objective To study clinical value of percutaneous intrabiliary expandable metallic biliary stenting (EMBS) for treatment of malignant obstructive jaundice. Methods One hundred and sixty patients with malignant obstructive jaundice were treated with EMBS ( EMBS group) . Thirty patients underwent only external drainage by PTCD were recruited as control. The patency rate of stent,decline of bilirubin and the complication were analyzed retrospectively. Both groups were followed up for three months. The Kaplan-Meier method (log-rank test) was used to compare the survival period between the two groups. Results Anorexia,skin pruritus and color of urine alleviated at a certain degree in both groups.In the EMBS group,plasma total bilirubin was(218. 78 ±2. 29) μmol/L pre-stent,and decreased to (134. 90 ±2. 34), (83. 18 ±2.40) , (40. 74 ±2. 29) μmol/L at the 7,14,21 days after the stenting, respectively; direct bilirubin was (128.82 ±2.40) μmol/L pre-stent, and decreased to (81.28 ± 2. 34), (51. 29 ±2. 45) and (25. 70 ±2.40)μmol/L at the 7,14,21 days after the stenting ( P =0. 000). In the PTCD group,plasma total bilirubin was (223. 57 ± 2. 58) μmol/L pe-stent, and decreased to ( 145. 68 ± 2. 57 ) ,(87.57 ±2.58) ,(38.65 ±2. 20) μmol/L at the 7,14,21 days after the stenting,respectively;direct bilirubin was (127. 6 ±2. 59)μmol/L pre-stent,and decreased to (79. 78 ±2. 70) ,(58. 36 ±2. 46) and (29.46 ±2. 20)μmol/L at the 7,14,21 days after the stenting,respectively ( P <0.001 ). No significant difference was found between the two groups at any time point ( P > 0. 05). Complications occurred in 34 patients in the EMBS group and the incidence rate was 20. 62% . Two or more complications occurred in 9 patients. In the PTCD group, complications occurred in 60.00% of the patients. In the EMBS group, 14 patients were failed to follow up, and 136 died. The median length was 214 days. In the PTCD group,all patients were followed up and all died,with a median length of survival of 75. 5 days. The survival analysis showed that the EMBS group survived longer than the PTCD group (P =0. 000). Conclusions EMBS placement showed better effect than PTCD. Compared to PTCD, internal drainage of metallic stents lead few complications and faster recover, and can improve the life quality and prolong survival time of patient with malignant obstructive jaundice. The placement of metallic stents is recommended as a preference for palliative therapy of malignant biliary obstruction.
5.Diagnosis and treatment of peliosis hepatis
Quan SUN ; Qiang YUAN ; Guangxing MENG ; Zhi DU ; Yijun WANG
Chinese Journal of Digestive Surgery 2015;14(2):167-169
Peliosis hepatis is a rare benign hepatic vascular disease.There is the lack of specific clinical features and preoperative diagnosis.A patient with intermittent liver area pain was admitted to the Third Central Hospital of Tianjin in April 2014.The patient with space-occupying lessions of the right lobe of liver was preliminarily diagnosed as with hepatocellular tumor or vasogenic tumor by computed tomography and B ultrasound examinations and then received liver resection combined with cholecystectomy.The result of postoperative pathological examination confirmed peliosis hepatis with adenomatous hyperplasia of liver cells.The patient was followed up till October 20,2014 without recurrence.
6.Analysing Factors Causing Pancreatic Fistula post Pancreaticoduodenectomy with External Drainage of Pancreatic Duct
Qiang YUAN ; Yijun WANG ; Qianzhe XING ; Zhi DU
Tianjin Medical Journal 2014;(4):374-377
Objective To analyze relevant factors causing pancreatic fistula post pancreaticoduodenectomy with ex-ternal drainage of pancreatic duct. Methods Altogether 133 patients who underwent pancreaticoduodenectomy with exter-nal drainage of pancreatic duct in our hospital from 1999 to 2011 were retrospectively analyzed. Logistic regression analysis was used to analyze the relevance of pancreatic fistula with age, gender, combined diseases, pancreatic duct diameter, patho-logical types, preoperative total bilirubin (TBIL), albumin (ALB) levels, drainage of the bile duct before operation, obstruc-tion of the pancreatic duct drainage and postoperative application of growth somatostatin. Then we also analyzed the relation-ship between those risk factors and the severity of pancreatic fistula. Results Postoperative pancreatic fistula occurred in 24 cases (3 cases were of grade A,13 cases were of grade B and 8 cases were of grade C) among the 133 patients. Logistic re-gression analysis showed that obstruction of the pancreatic duct drainage is a major risk factor of pancreatic fistula in these patients(OR=4.529,P=0.005). The patients whose pancreatic duct drainage was obstructed had a significantly higher pan-creatic fistula rate than the patients whose drainage was not obstructed (30.8%vs 12.8%, P<0.05). The occurrence of pan-creatic fistula has no significant correlation with age, gender, combined diseases, pancreatic duct diameter, pathological types, preoperative TBIL, ALB level, preoperative bile duct drainage and postoperative application of somatostatin. What’s more, in those pancreatic fistula patients, the pancreatic fistulas were more severe in the obstructed ones than those in the un-obstructed ones. Conclusion The obstruction of the pancreatic duct drainage is a major risk factor of pancreatic fistula post pancreaticoduodenectomy with external drainage of pancreatic duct. If adequate preventive measures were employed during operation , the incidence of pancreatic fistula and pancreatic fistula severity will be significantly reduced.
7.Effects of serum came from hepatectomized patient on proliferation of cultured hepatocytes
Qianzhe XING ; Yingtang GAO ; Ying LUO ; Yijun WANG ; Zhi DU
Tianjin Medical Journal 2016;44(8):1001-1004
Objective To observe the influence of peripheral serum came from patients with hepatectomy at different time points on hepatocyte proliferation in vitro. Methods According to the different types of cultured serum, cultured HL-7702 cells were divided into fetal bovine serum (FBS) group, preoperative serum group, 0.5 h, 3 h, 24 h and 72 h post operative serum groups. All groups of cells were cultured for 72 hours in the Cell-IQ unmarked living cell image analysis system, and the amplification curves of each group were mapped by continuous counting of cells. The cell amplification multiple was compared between all groups after culturing for 72 hours. BrdU immunofluorescence staining was performed and BrdU positive rate was calculated for comparing the cell proliferation of all groups. Results Amplification curves showed that HL-7702 cell proliferation rates of all human serum groups except for 72 h post operative group were higher than those of FBS group. Human serum 0.5 h and 3 h postoperative groups were more obvious. The amplification multiples of human serum groups, except for 72 h post operative group were all significantly higher than those of FBS group (P<0.01), and 0.5 h and 3 h post operative groups were both significantly higher than those of preoperative group (P < 0.05). BrdU positive rates of all human serum groups were significantly higher than those of FBS group (P < 0.01), which were significantly higher in 0.5 h and 3 h post operative groups than those of preoperative group (P < 0.05), but there were no statistical differences between 24 h and 72 h post operative groups and the preoperative group. Conclusion Human serum can promote the proliferation of hepatocytes compared with that of FBS. The influence of serum acquired post hepatectomy is closely associated with the post operative time.
8.Analysis of the efficacy of laparoscopic Toupet fundoplication treatment of hiatal hernia combined with gastroesophageal reflux disease
Zhi WANG ; Fuzeng SU ; Cheng ZHANG ; Huiling LI ; Yiliang LI ; Zhi DU
Journal of Chinese Physician 2016;18(8):1172-1175
Objective To explore the efficacy of laparoscopic Toupet fundoplication treatment of hiatal hernia combined with gastroesophageal reflux disease.Methods Forty one patients' medical record information of hiatal hernia combined with gastroesophageal reflux disease that underwent laparoscopic Toupet fundoplication were collected in Xinjiang Uygur Autonomous Region People's Hospital from October 2012 to October 2015.Thirty six cases were adopted pure hiatal hernia suture,2 cases were used biological patch repair,1 case used Johnson PHY patch repair,1 case used Bade patch repair,and 1 case used Tyco hiatal hernia dedicated anti-blocking patch repair.These patients were carried out 24 hours esophageal pH monitoring,esophageal manometry,gastroesophageal reflux disease questionnaire (GERDQ) score and postoperative complications before surgery and 6 months postoperative.The clinical efficacy of laparoscopic Floppy Nissen fundoplication treatment of hiatal hernia combined with gastroesophageal reflux disease was retrospectively analyzed.Results There was no perioperative deaths and serious complications during perioperation.The reflux symptoms were significantly improved postoperative.There was significantly lower in reflux time [(1.40 ± 2.10) h],the number of reflux (29.83 ± 19.71),acid reflux time percentage [(6.47 ± 8.79) %],and DeMeester score (7.28 ± 7.38) than the preoperative [(2.04 ± 1.91) h,(120.40 ±82.72),(9.90 ±9.27)%,and (28.23 ±42.16),respectively].GERD Q scale score (7.18 ± 1.33) was significantly lower than preoperative (10.91 ± 2.02) with statistically significant difference (P <0.05).lower esophagealsphincter (LES) pressure [minimum resting breathing (7.24 ± 6.86) mmHg,and mean resting breathing (12.91 ± 6.89) mmHg] was significantly increased than preoperative [(0.70 ±6.15) mmHg,and (7.33 ± 7.72) mmHg,respectively].Residual pressure [average (8.16 ± 3.82) mmHg,and maximum (16.10 ± 12.05)mmHg] was significantly increased than preoperative [(4.36 ±4.77) mmHg,and (7.49 ± 5.15) mmHg,respectively].Relaxation rate [(58.50 ± 25.47) %] was significantly reduced than preoperative [(62.27 ± 27.55) %].However,swallowing invalid [(11.25 ± 21.04) %]was increased than preoperative [(6.36 ± 10.26)%],with statistically significant difference (P <0.05).The median follow-up was 10 months,and there was no recurrence during follow-up.ConclusionsLaparoscopic Toupet fundoplication can effectively inhibit reflux symptoms,and increase LES pressure,which is worthy of promotion.However,there is slightly higher incidence of postoperative dysphagia.
9.Effect of ulinastatin on lung function in pediatric patients undergoing cardiopulmonary bypass:a meta-a-nalysis
Yun ZHANG ; Yan WANG ; Yu CAO ; Zhi WAN ; Xiaodong DU ; Zhi ZENG ; Hu NIE
The Journal of Clinical Anesthesiology 2016;(2):180-186
Objective To systemically review the effect of ulinastatin on lung function in pediatric patients undergoing cardiopulmonary bypass.Methods PubMed,Embase,Cochrane Controlled Trials Reg-istry,China National Knowledge infrastructure,China Biology Medicine disc,VIP and Wanfang databases were searched from their inception to October 2015.Articles regarding the use of ulinastatin on lung function in patients undergoing cardiopulmonary bypass were searched.Studies were screened by two independent re-viewers and then the data were extracted.The methodological quality was evaluated according to the inclusion and exclusion criteria.Meta-analysis was then performed using RevMan 5.1 software. Results Nineteen eligible studies (n = 657 patients)were identified.The results of meta analysis showed that ulinastatin could improve the oxygen partial pressure(SMD=0.90,95%CI 0.52-1.28,P <0.01)and oxygenation index (SMD=1.01,95%CI 0.45-1.56,P <0.01),decrease the PA-a O2 (SMD= -0.87, 95%CI -1.70--0.03,P =0.04),reduce the respiratory index (SMD=-0.81,95%CI -1.51--0.11, P =0.02),Lower the airway peak pressure (SMD=-0.83,95%CI -1.18--0.48,P <0.01),improve the dynamic compliance (Cd)(SMD=1.10,95%CI 0.57-1.62,P <0.01),and shorten the breathing ma-chine ventilation time (SMD=-0.98,95%CI -1.59--0.36,P <0.01).Conclusion This meta-analysis showed that ulinastatin treatment had a certain degree of protective effects on lung function in pediatric pa-tients undergoing cardiac surgery with CPB,but further research was needed for all these studies which were not multicenter,strictly controlled.
10.Clinical analysis of 99 patients with hand-foot-mouth disease.
Zhi-zhi XING ; Wen-jun DU ; Can WANG
Chinese Journal of Epidemiology 2008;29(8):847-848
Adolescent
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Adult
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Child
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Child, Preschool
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Female
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Hand, Foot and Mouth Disease
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epidemiology
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Humans
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Infant
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Infant, Newborn
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Male
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Young Adult