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A study on relationship of nitric oxide,oxidation,peroxidation,lipoperoxidation with chronic cholecystitis

World Journal of Gastroenterology 2000年第4期6卷 501-507页

作者： Jun Fu Zhou Dong Cai You Gen Zhu Jin Lu Yang cheng hong peng Yang Hai Yu The Second Affiliated Hospital of Medical College of Zhejiang University Hangzhou 310009ZhejiangChina The People’s Hospital of Jinhua City Jinhua 321000ZhejiangChina

AIM:To study relationship of injury induced by nitric oxide, oxidation, peroxidation,lipoperoxidation with chronic ***:The values of plasma nitric oxide (P-NO), plasma vitamin C (P-VC), plasma vitamin E (P-VE), plasma beta-carotene (P-beta-CAR), plasma lipoperoxides (P-LPO), erythrocyte superoxide dismutase (E-SOD), erythrocyte catalase (E-CAT), erythrocyte glutathione peroxidase (E-GSH-Px) activities and erythrocyte lipoperoxides (E-LPO) level in 77 patients with chronic cholecystitis and 80 healthy control subjects were determined, differences of the above average values between the patient group and the control group and differences of the average values between preoperative and postoperative patients were analyzed and compared, linear regression and correlation of the disease course with the above determination values as well as the stepwise regression and correlation of the course with the values were ***:Compared with the control group, the average values of P-NO, P-LPO, E-LPO were significantly increased (P<0.01), and of P-VC, P-VE, P-beta-CAR, E-SOD, E-CAT and E-GSH-Px decreased (P <0.01) in the patient group. The analysis of the linear regression and correlation showed that with prolonging of the course, the values of P-NO, P-LPO and E-LPO in the patients were gradually ascended and the values of P-VC,P-VE, P-beta-CAR, E-SOD, E-CAT and E-GSH-Px descended (P<0.01). The analysis of the stepwise regression and correlation indicated that the correlation of the course with P-NO, P-VE and P-beta-CAR values was the closest. Compared with the preoperative patients, the average values of P-NO, P-LPO and E-LPO were significantly decreased (P <0.01) and the average values of P-VC, E-SOD, E-CAT and E-GSH-Px in postoperative patients increased (P <0.01) in postoperative patients. But there was no significant difference in the average values of P-VE, P-beta-CAR preoperative and postoperative ***:Chronic cholec

关键词： nitric oxide oxidation peroxidation lipoperoxidation chronic cholecystitis

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Reasonable choice of surgical procedures for patients with portal hypertension

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Hepatobiliary & Pancreatic Diseases International 2003年第3期2卷 330-333页

作者： Guang-Wen Zhou Zong-Yuan Tao cheng-hong peng hong-Wei Li the Surgical Department and Shanghai Digestive Surgical Institute, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China Surgical Department and Shanghai Digestive Surgical Institute Ruijin Hospital Shanghai Second Medical University Shanghai 200025 China. gw_vrai@***

OBJECTIVE: To assess individualized therapeutic protocol for patients with portal hypertension on the basis of accumulated knowledge about the mechanism of portal hypertension. DATA SOURCES: Patients data on shunt and other surgical procedures from Ruijin Hospital, Shanghai, China and the published papers. RESULTS: The direction of blood flow of the collateral vessels in the gastro-splenic region is an important factor in deciding surgical strategy because there is a close relationship between surgical risk and the classification of liver function. Clinically it is confirmed that each patient needs an individualized surgical procedure and that prophylactic operation is suitable for patients with splenomegaly, splenism associated with serious esophageal varices and hemorrhagic tendency under endoscopy but acceptable liver function. The shunt diameter (SD) (SD=0.67×PVD) is determined in our patients according to individualized hemodynamics. The rehemorrhagic rate after shunt being higher than that in others may be related to lesioned gastric mucosa caused by portal hypertension or bleeding and temporary melena. This finding is good for prevention of hepatic encephalopathy. The life quality and labor ability of patients will be improved because of hepatopetal flow in the portal vein. With strict indications for reoperation, selective operation is performed as soon as possible when hemorrhage is controlled conservatively and liver function improved. Once the patient with cirrhosis associated with portal hypertension is scheduled for liver transplantation, treatment of hemorrhage should aim to keep the patient in good condition and to avoid the protocol that may be disadvantageous to liver transplantation in the future. CONCLUSION: Surgical procedures for patients with portal hypertension should follow the principle of individualization. To obtain the best outcome, the choice of reasonable surgical procedure is expected.

关键词： portal hypertension surgical strategies

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Surgical experience in splitting donor liver into left lateral and right extended lobes

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World Journal of Gastroenterology 2005年第27期11卷 4220-4224页

作者： Ji-Qi Yan Thomas Becker Michael Neipp cheng-hong peng Rainer Lueck Frank Lehner hong-Wei Li Juergen Klempnauer Department of Surgery Ruijin Hospital Affiliated to Shanghai Second Medical University Shanghai 200025 China Department of Abdominal and Transplant Surgery Medical School of Hannover Carl-NeubergStr. 1 Hannover 30625 Germany

AIM： To outline the surgical experience with donor liver splitting in split liver ***： From March 1 to September 1 in 2004, 10 donor livers were split ex situ into a left lateral lobe （segments Ⅱ and Ⅲ） and a right extended lobe （segments Ⅰ, Ⅳ-Ⅷ） in Medical School of Hannover, and thereafter split liver transplantation was performed successfully in 29 cases. The average age, weight and ICU slaying period of the donors were 32.7 years （25-52 years）, 64.5 kg（45-75 kg） and 2.4 d （2-8 d） ***： The average weight of the whole graft and the left lateral lobe was 2 322.6 g （956-2 665 g） and 282.8 g （298-373 g） respectively, and the average ratio of left lateral lobe to the whole graft was 0.225 （0.278-0.274）.The average graft to recipient weight ratio （GRWR） of the left lateral lobe and the right extended lobe reached 2.44% （2.22-5.42%） and 2.73% （2.32-2.30%） *** average it took approximately 205 min （85-235 rain）to split the donor liver. Five donor organs showed anatomic variation including the left hepatic vein variation in two cases, the left hepatic artery variation in two cases and the bile duct variation in one ***： Split liver transplantation has become a mature surgical technique to expand the donor pool with promising results. In the process of graft splitting, close attention needs to be paid to potential anatomic variations,especially to variations of the left hepatic vein, the left hepatic artery, and the bile duct.

关键词： Split Donor liver Anatomic variation

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Microencapsulated tumor assay:Evaluation of the nude mouse model of pancreatic cancer

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World Journal of Gastroenterology 2012年第3期18卷 257-267页

作者： Ming-Zhe Ma Dong-Feng cheng Jin-Hua Ye Yong Zhou Jia-Xiang Wang Min-Min Shi Bao-San Han cheng-hong peng Department of General Surgery Shanghai Institute of Digestive Surgery Ruijin Hospital affiliated with to Shanghai JiaoTong University School of Medicine Shanghai 200025 China Laboratory Animal Center Shanghai JiaoTong University School of Medicine Shanghai 200025 China

AIM: To establish a more stable and accurate nude mouse model of pancreatic cancer using cancer cell microencapsulation. METHODS: The assay is based on microencapsulation technology, wherein human tumor cells are encapsulated in small microcapsules (approximately 420 μm in diameter) constructed of semipermeable membranes. We implemented two kinds of subcutaneous implantation models in nude mice using the injection of single tumor cells and encapsulated pancreatic tumor cells. The size of subcutaneously implanted tumors was observed ona weekly basis using two methods, and growth curves were generated from these data. The growth and metastasis of orthotopically injected single tumor cells and encapsulated pancreatic tumor cells were evaluated at four and eight weeks postimplantation by positron emission tomography-computed tomography scan and necropsy. The pancreatic tumor samples obtained from each method were then sent for pathological examination. We evaluated differences in the rates of tumor incidence and the presence of metastasis and variations in tumor volume and tumor weight in the cancer microcapsules vs single-cell suspensions. RESULTS: Sequential in vitro observations of the microcapsules showed that the cancer cells in microcapsules proliferated well and formed spheroids at days 4 to 6. Further in vitro culture resulted in bursting of the membrane of the microcapsules and cells deviated outward and continued to grow in flasks. The optimum injection time was found to be 5 d after tumor encapsulation. In the subcutaneous implantation model, there were no significant differences in terms of tumor volume between the encapsulated pancreatic tumor cells and cells alone and rate of tumor incidence. There was a significant difference in the rate of successful im- plantation between the cancer cell microencapsulation group and the single tumor-cell suspension group (100% vs 71.43%, respectively, P = 0.0489) in the orthotropic implantation model. The former method

关键词： Nude mice Model of pancreatic neoplasms Encapsulation Subcutaneous implantation model Ortho- topic implantation model

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Diagnosis and treatment of solidpseudopapillary tumors of the pancreas

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Hepatobiliary & Pancreatic Diseases International 2005年第3期4卷 456-459页

作者： Xi Chen, Guang-Wen Zhou, Hui-Jiang Zhou, cheng-hong peng and hong-Wei Li Department of Surgery, Shanghai Institute of Digestive Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China Department of Surgery Shanghai Institute of Digestive Surgery Ruijin Hospital Shanghai Second Medical University Shanghai 200025 China. cc_vrai@***

Solid-pseudopapillary tumors (SPTs) of the pancreas have been reported as rare lesions with' low malignant potential' occurring mainly in young women. This study was designed to define the clinicopathological characteristics and the effect of surgical intervention. METHODS:A retrospective clinical analysis was made of 21 patients with solid-pseudopapillary tumor of the pancreas admitted from June 1994 to December 2004. RESULTS:Abdominal pain as the major complaint was found in 13 patients, and palpable abdominal mass in 7. Imaging examination showed the abdominal mass clearly, but diagnosis was not defined. In 12 patients, tumors were located in the pancreatic head and in 9 patients, in the pancreatic tail. The average diameter of the tumor was 9.5 cm (range, 3-20 cm). One patient had liver metastasis. The diagnosis of the tumor was proved pathologically during operation in 14 patients, and other 3 patients who had been diagnosed as having insulinoma and other malignant tumors were confirmed by paraffin section and enzyme labeling after operation. Eighteen patients (85.7% ) were followed up with a median period of 24 months, 1-60 months without tumor recurrence. CONCLUSION:Huge pancreatic masses of the pancreas in young women are suggestive of solid-pseudopapillary tumors. Aggressive surgical therapy can result in good prognosis in these patients.

关键词： pancreatic neoplasms pancreaticoduodenectomy

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Liver regeneration after split liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2005年第4期4卷 519-523页

作者： Hui-Xing Chen, Guang-Wen Zhou,Lu Yin,cheng-hong peng and hong-Wei Li Shanghai, China Department of Surgery and Center of Organ Transplantation, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025,China Center of Organ Transplantation Ruijin Hospital Shanghai Second Medical University Shanghai 200025 China. huixingchen@***

BACKGROUND: The number of split liver transplantations (SLT) has increased in the last 5 years. Regeneration after the loss of hepatic tissue is a fundamental response to liver injury. Because partial-liver grafts may not be an optimal size for recipients, the purpose of this study was to investigate the regeneration of graft liver after SLT. METHODS: Four recipients have undergone SLT at our hospital since 2002. The graft liver volume (GLV) in the postoperative day ( POD) was measured by computed tomography (CT) and the serum levels of aspartate amino-transferase (AST) , alanine aminotransferase (ALT) , total bilirubin ( TB ), prealbumin ( PA ) and albumin ( ALB ) were monitored. The GLV at different postoperative times was compared to the recipient' s standard liver volume ( SLV) and the liver volume regeneration ratio ( LVRR) was calculated. In order to compare SLV in recipient 2, we measured the total liver volume including the graft and the residual native liver as the GLV. RESULTS: The GLV/SLV at POD120 and POD360 of recipient 1 was measured 114% (1159.32 cm3 71016.95 cm3) , 97% (986.44 cm371016.95 cm3 ) with the LVRR being -11.0%, -24.3%, respectively. For recipient 2, it was measured 96% (927.32 cm3 7965.96 cm3) and 100% (968. 98 cm37965. 96 cm3 ) , with the LVRR being 24. 4% , 30. 0% , respectively. The initial graft volume of segment Ⅱ ,Ⅲ was 265.36 cm3 and increased to 335.24 cm3 and 360.56 cm3 at POD120 and POD360, respectively, with the LVRR being 26.3% and 35.9%, respectively. The GLV/SLV at POD60 of recipient 3 was 86% (893. 04 cm3/ 1038. 42 cm3 ) and the LVRR was 12. 0%. For recipient 4, it was 90% (567. 48 cm3/630. 54 cm3 ) whereas the LVRR was 20. 0%. The serum levels of ALT, AST and TB in all recipients declined gradually and returned to normal while the serum levels of PA and ALB increased to normal. The serum levels of ALT and AST peaked within 3 days after SLT. The neurological symptoms of Wilson 's disease in recipient 2 were improved markedly

关键词： liver transplantation liver regeneration computed tomography

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Surgical management in biliary restricture after Roux-en-Y hepaticojejunostomy for bile duct injury

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World Journal of Gastroenterology 2007年第48期13卷 6598-6602页

作者： Ji-Qi Yan cheng-hong peng Jia-Zeng Ding Wei-Ping Yang Guang-Wen Zhou Yong-Jun Chen Zong-Yuan Tao hong-Wei Li Department of Surgery Ruijin Hospital School of Medicine Shanghai Jiaotong University Shanghai 200025 China

AIM: To discuss the surgical method and skill of biliary restricture after Roux-en-Y hepaticojejunostomy for bile duct injury. METHODS: From November 2005 to December 2006, eight patients with biliary restricture after Roux-en-Y hepaticojejunostomy for bile duct injury were admitted to our hospital. Their clinical data were analyzed retrospectively. RESULTS: Bile duct injury was caused by cholecys- tectomy in the eight cases, including seven cases with laparoscopic cholecystectomy and one with mini- incision choleystectomy. According to the classification of Strasberg, type E1 injury was found in one patient, type E2 injury in three, type E3 injury in two and type E4 injury in two patients. Both of the type E4 injury patients also had a vascular lesion of the hepatic artery. Six patients received Roux-en-Y hepaticojejunostomy for the second time, and one of them who had type E4 injury with the right hepatic artery disruption received right hepatectomy afterward. One patient who had type E4 injury with the proper hepatic artery lesion underwent liver transplantation, and the remaining one with type E3 injury received external biliary drainage. All the patients recovered fairly well postoperatively. CONCLUSION: Roux-en-Y hepaticojejunostomy is still the main approach for such failed surgical cases with bile duct injury. Special attention should be paid to concomitant vascular injury in these cases. The optimal timing and meticulous and excellent skills are essential to the success in this surgery.

关键词： Bile duct injury Biliary stricture Roux-en-Y hepaticojejunostomy Hepatic artery injury

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Abdominal cluster transplantation and management of perioperative hemodynamic changes

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Hepatobiliary & Pancreatic Diseases International 2006年第1期5卷 28-33页

作者： Hui-Xing Chen, Lu Yin, cheng-hong peng, Guang-Wen Zhou, Bai-Yong Shen, Hao Chen, Chuan Shen and hong-Wei Li Department of Surgery and Center of Organ Transplantation, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China Department of Surgery and Center of Organ Transplantation Ruijin Hospital Shanghai Second Medical University Shanghai 200025 China.

BACKGROUND: Multivisceral transplantation (MTX, or cluster transplantation) is defined as the transplantation of three or more abdominal organs en bloc, namely the liver together with the pancreatoduodenal complex, the stomach as well as the small bowel with/without the right hemicolon. Up to May 1999, only 72 cases were reported to the Intestinal Transplant Registry. Organ cluster transplantation may carry with complex hemodynamic alterations. Based on our experience in two cases of abdominal cluster transplantation, we describe the technical details of multivisceral transplantation and the management of hemodynamic changes. METHODS: A Swan-Ganz catheter was placed to assist in monitoring the patients' hemodynamic status. After the transplantation, the 2 patients were closely observed in the intensive care unit in terms of vital signs; disseminated intravascular coagulation (DIC) including activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (Fg) and D-dimer, and arterial blood gas; and quantity and characteristics of drainage. Additionally, intra-abdominal hemorrhage was supervised by bedside B-ultrasonography or enhanced computed tomography (CT) examination. Whole blood viscosity was monitored 2 weeks after transplantation. The blood flow of the hepatic artery and portal vein and arterial resistant index were assessed routinely by Doppler ultrasonography. RESULTS: Hemodynamic changes were observed during perioperation. Liver and renal function recovered within one week after transplantation. Enteral feedings and oral intake were gradually increased with a reciprocal decrease in parenteral nutrition. Despite systemic antibiotics were given according to the results of frequent cultures, patient 1 died from cytomegalovirus (CMV) infection 4 months after transplantation and patient 2 died of a systemic sepsis 2 months after the operation. CONCLUSIONS: Many factors contribute to the success of multivisceral transplantatio

关键词： multivisceral transplantation hemodynamic change

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Pancreatectomy combined with superior mesenteric-portal vein resection: report of 32 cases

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Hepatobiliary & Pancreatic Diseases International 2005年第1期4卷 130-134页

作者： Guang-Wen Zhou, Wei-Ding Wu, Wei-Dong Xiao, hong-Wei Li and cheng-hong peng Shanghai, China Department of Surgery, Shanghai Institute of Diges- tive Surgery, Ruijin Hospital, Shanghai Second Medical University, Shang- hai 200025, China Department of Surgery Shanghai Institute of Digestive Surgery Ruijin Hospital Shanghai Second Medical University Shanghai 200025 China. gw_vrai@***

BACKGROUND: Resection of the superior mesenteric- portal vein (SMPV) during pancreatoduodenectomy is dis- puted. Although the morbidity and mortality of patients af- ter this operation are acceptable, survival is limited. In this study, we evaluated the morbidity, mortality and survival of patients with ductal adenocarcinoma of the pancreas who had undergone pancreatectomy with en bloc portal vein re- section. METHODS: A total of 32 patients with ductal adenocarci- noma of the pancreas who had undergone pancreatectomy with SMPV resection between 1999 and 2003 were retro- spectively analyzed. In addition, they were categorized in- to two groups according to the invasion of the wall of the portal vein: group A (n =12), extended compression of the wall of the portal vein by surrounding carcinoma without true invasion and group B (n =20), true invasion including intramural and transmural invasion. RESULTS; The morbidity of the 32 patients was 31.25%. There was no operative death, and the overall 1-,3-year survival rates were 59% and 16%, respectively. The mean survival time of patients with microscopically positive mar- gin was only 5. 6 months as compared with 20 months in patients with microscopically negative margin. No diffe- rences in tumor size, margin positivity, nodal positivity, and 1-, 3-year survival rates were observed between the two groups. CONCLUSIONS; If selected carefully, pancreatectomy combined with SMPV resection can be performed safely, without increase in the morbidity and mortality. SMPV re- section should be performed only when a margin-negative resection is expected to be achieved. SMPV invasion is notassociated with histologic parameters suggesting a poor prognosis.

关键词： pancreatic carcinoma pancreaticoduoenectomy superior mesenteric-portal vein resection

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Preparation and characterization of chitosan porous microcarriers for hepatocyte culture

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Hepatobiliary & Pancreatic Diseases International 2011年第5期10卷 509-515页

作者： Xu-Bo Wu, cheng-hong peng, Fang Huang, Jie Kuang, Song-Lin Yu, Ya-Dong Dong and Bao-San Han Center of Organ Transplantation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China Department of General Surgery, Central Hospital, Minhang District, Shanghai 201100, China [a] Center of Organ Transplantation Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai 200025 China [b] Department of General Surgery Central Hospital Minhang District Shanghai 201100 China

BACKGROUND: The bioartificial liver (BAL) is considered a possible alternative method for treating liver failure. The core of the BAL system is culturing liver cells in vitro with high density and activity. Microcarrier culture is a mode of high-density culture. We set out to prepare a novel porous microcarrier to improve the activity of liver cells in vitro. METHODS: Chitosan was used to prepare a novel porous spherical microcarrier with interconnected structure. The chitosan porous microcarriers (CPMs) were modified with gelatin to improve their biocompatibility. CPMs were co-cultured with liver cells, HL-7702 (L-02), to evaluate their effect on cell culture. RESULTS: The average size of the CPMs was about 400 μm in diameter and their apertures were less than 30 μm. The pores of the microcarrier were interconnected. After fixation by sodium tripolyphosphate, the structure of the first freeze-dried CPMs was stable. To further improve the biocompatibility, the surface of CPMs was modified with gelatin through chemical crosslinking (GM-CPMs). Comparing the proliferation curves of L-02 cells cultured on simple CPMs, GM-CPMs and tissue culture polystyrene (TCPS, a mode of planar cell culture), the proliferation rates were similar in the first 5 days and the cells proliferated until day 8 in culture with microcarriers. The OD value of liver cells cultured on GM-CPMs was 1.97-fold higher than that on TCPS culture at day 8. Levels of urea and albumin in supernatants of cells cultured on GM-CPMs increased steadily for 8 days, and were clearly higher than those of cells cultured on TCPS (P<0.05).CONCLUSIONS: The novel CPMs were promising microcarriers for hepatocyte culture and the GM-CPM seemed better. Porous microcarrier culture was beneficial for hepatocyte function and activity.

关键词： porous microcarrier chitosan gelatin, liver cells cell culture

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