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Effect of perioperative fluid therapy on early phase prognosis after liver transplantation

Hepatobiliary & Pancreatic Diseases International 2008年第4期7卷 367-372页

作者： Jiang, Guo-Qing Peng, Min-Hao Yang, Ding-Hua Guangxi Med Univ Affiliated Hosp 1 Dept Hepatobiliary Surg Nanning 530021 Peoples R China peoples hosp subei Dept Hepatobiliary Surg Yangzhou 225001 Peoples R China

BACKGROUND: Although liver transplantation (LT) has made rapid progress, early pulmonary complications still occur. More attention should be paid to fluid therapy that may be an important factor leading to these complications. It is necessary to investigate the correlation between intraoperative and postoperative fluid therapy and early pulmonary complications after LT, then attempt to provide a reasonable fluid therapy in the perioperative period. METHODS: Sixty-two patients who had undergone Ff were enrolled and analyzed retrospectively. Based on early phase prognosis after LT, the 62 patients were divided into a non-pulmonary complication group and a pulmonary complication group. Twenty perioperative variables were analyzed in both groups to screen out several factors causing early pulmonary complications, then the parameters reflecting postoperative recovery were analyzed. RESULTS: The pulmonary complication group had 29 patients (46.77%), 3 (4.84%) of whom died during the perioperative period. Using monofactorial analysis for each variable, the two groups differed in the following variables: preoperative lung function, volume of intraoperative transfusion, volume of intraoperative bleeding, and volume of intraoperative net fluid retention and fluid balance (= 2 of the first 3 days after operation. Analysis of the relationship between multivariate factors and pulmonary complications after LT by logistic multivariate regression analysis showed that preoperative lung function, volume of intraoperative bleeding, and fluid balance (=-2 of the first 3 days after operation were influential factors. CONCLUSIONS: It is important to maintain fluid balance during the perioperative period of LT. If the hemodynamics are stable, appropriate negative fluid balance in the first 3 days after operation apparently decreases the incidence of early pulmonary complications after LT. These measures are associated with better postoperative recovery.

关键词： liver transplantation perioperative period fluid therapy fluid balance

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EZH2 and STAT6 expression profiles are correlated with colorectal cancer stage and prognosis

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World Journal of Gastroenterology 2010年第19期16卷 2421-2427页

作者： Wang, Cheng-Gang Ye, Ying-Jiang Yuan, Jing Liu, Fang-Fang Zhang, Hui Wang, Shan Beijing Univ Dept Surg Gastroenterol Surg Oncol Lab Peoples Hosp Beijing 100044 Peoples R China Chinese peoples Liberat Army hosp Dept Pathol Beijing 100036 Peoples R China Beijing Univ Peoples Hosp Dept Pathol Beijing 100044 Peoples R China

AIM: To investigate the role of enhancer of zeste homologue 2 (EZH2) and STAT6 immunohistochemistry in the evaluation of clinical stages and prognosis of colorectal cancer (CRC). METHODS: The expression patterns were examined by immunohistochemistry in both tumor and adjacent non-neoplastic tissues of 119 CRC patients who underwent operation during the time period from 2002 to 2004. RESULTS: The positive rates of EZH2 and STAT6 in CRC cases were 69.7% (83 of 119) and 60.5% (72 of 119), respectively, and there was signifi cant differ-ence when compared with tumor adjacent non-neoplastic tissues (P < 0.05). In all CRC cases, patientswith EZH2-positive, or STAT6-positive expression had lower survival rates than those with EZH2-negative or STAT6-negative expression (P = 0.002 and P = 0.005, respectively). Co-expression of EZH2 and STAT6 showed signifi cantly higher levels in CRC cases of high clinical TNM stages (P = 0.001), and the expression of STAT6 was also correlated with lymph node metastasis and distant metastasis (P = 0.001 and P = 0.016, respectively). Multivariate analysis revealed that EZH2 expression was an independent prognostic indicator of CRC (P = 0.039). CONCLUSION: EZH2 and STAT6 expressions have significant values in distinguishing clinical stages of CRC and predicting the prognosis of the patients.

关键词： Colorectal Neoplasms Enhancer of zeste homologue 2 STAT6 Immunohistochemistry

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Neurogenic nitric oxide facilitates the central nociceptive transmission of migraine attacks

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Neural Regeneration Research 2011年第3期6卷 213-218页

作者： Wang, Hebo Qi, Huijun Yu, Shengyuan Yang, Sumian Liu, Ruozhuo Hebei Gen hosp Dept Neurol Shijiazhuang 050051 Hebei Peoples R China Hebei Gen hosp Dept Emergency Shijiazhuang 050051 Hebei Peoples R China Chinese peoples Liberat Army Gen hosp Dept Neurol Beijing 100853 Peoples R China

Recent studies have shown that nitric oxide （NO） can induce migraine attacks at three possible sites of action： nitroxidergic nerves, the vascular endothelium, and the central nervous system. Most previous studies have focused on the former two sites of action. Several experiments using exogenic NO donors have suggested that nitroglycerin may induce migraine via central mechanisms. However, few studies have investigated the source of the NO involved in the central mechanisms of migraine. The present study used a cat model of migraine to represent migraine attacks in humans. We performed immunochemical staining of successive frozen sections of the brainstem and upper cervical spinal cord, and then used c-Fos protein expression to label nerve cell activation. We observed the effects of N^ω-nitro-L-arginine methyl ester （L-NAME）, a non-selective nitric oxide synthase （NOS） inhibitor, and 7-nitroindozole （7-NI）, a selective neuronal NOS inhibitor, on c-Fos and nNOS expression, which were induced by electrical stimulation to the dura mater near the superior sagittal sinus. The results demonstrated that c-Fos or nNOS immunoreactive cells was concentrated in the superficial layers （laminae Ⅰ and Ⅱ） of the spinal nucleus of trigeminal nerve. L-NAME and 7-NI pre-treatment significantly decreased c-Fos and neurogenic NOS expression; and there was a significant linear correlation between c-Fos and NOS expression （r = 0.858 2, P 〈 0.01）. These findings suggest that neurogenic NO could facilitate migraine nociceptive transmission to second-order neurons of the trigeminal nerve. However, L-NAME and 7-NI may block the activation of neurons in the spinal nucleus of the trigeminal nerve by inhibiting NO synthesis, and thereby attenuate acute migraine attacks.

关键词： migraine c-Fos nitric oxide dura mater neurogenic superior sagittal sinus

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Tissue microarrays in pathological examination of apoptotic acinar cells induced by dexamethasone in the pancreas of rats with severe acute pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2007年第5期6卷 527-536页

作者： Zhang, Xi-Ping Tian, Hua Lu, Bei Chen, Li Xu, Ru-Jun Wang, Ke-Yi Wang, Zhi-Wei Cheng, Qi-Hui Shen, Hai-Ping Hangzhou First peoples hosp Dept Gen Surg Hangzhou 310006 Peoples R China Hangzhou First peoples hosp Dept Pathol Hangzhou 310006 Peoples R China Hangzhou First peoples hosp Cent Lab Hangzhou 310006 Peoples R China Hangzhou First peoples hosp Dept Obstet & Gynaecol Hangzhou 310006 Peoples R China Zhejiang Univ Sch Med Affiliated Hosp 2 Dept Gen Surg Hangzhou 310003 Peoples R China

BACKGROUND: The good therapeutic effects of large dose of dexamethasone on severe acute pancreatitis (SAP) patients have been proved. This study was designed to investigate the influence of dexamethasone on apoptosis of acinar cells in the pancreas of rats with SAP and the protein expression of the apoptosis-regulating genes Bax and Bcl-2. METHODS: Ninety Sprague-Dawley rats with SAP were randomly divided into a model group and a dexamethasone treated group (45 rats in each group), and another 45 rats formed the sham operation group. Survival rates were calculated and gross pathological changes in the pancreas of each group were observed under a light microscope 3, 6 and 12 hours after operation. Tissue microarray technology was applied to prepare pancreatic tissue sections. The changes in Bax and Bcl-2 protein expression levels of pancreatic tissues from each group were assessed by immunohistochemical staining, and TUNEL staining was used to evaluate changes in apoptosis index. RESULTS: The model and treated groups did not differ in mortality at each time point. The pathological score for the pancreas in the treated group was significantly lower than that in the model group at 3 and 6 hours. The positive rates of Bax protein expression in the head and tail of the pancreas in the treated group at all time points were all markedly higher than those of the model group. The positive rate of Bcl-2 protein expression in the head of the pancreas in the treated group was significantly higher than that of the model group at 3 hours. TUNEL staining showed that the pancreas head and tail apoptosis indices of the treated group were markedly higher than those of the model group after 6 hours. CONCLUSIONS: Apoptosis may be a protective response. to pancreatic cell injury. The mechanism of action of dexamethasone in treating SAP may be related to the apoptosis of acinar cells in the pancreas induced by apoptosis-regulating genes such as Bax and Bcl-2. The advantages of tissue mic

关键词： tissue microarrays severe acute pancreatitis dexamethasone apoptosis pancreas

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Clinical value of contrast-enhanced ultrasonography in the characterization of focal liver lesions:a prospective multicenter trial

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Hepatobiliary & Pancreatic Diseases International 2009年第4期8卷 370-376页

作者： Wang, Wen-Ping Wu, Ying Luo, Yan Li, Rui Zhou, Xiao-Dong Zhang, Jun Qian, Chao-Wen Tan, Xu-Yan Xu, Qing-Hua Wang, Yan Yuan, Jian-Jun Fudan Univ Zhongshan Hosp Dept Diagnost Ultrasound Shanghai 200032 Peoples R China Shenzhen peoples hosp Dept Ultrasound Shenzhen 518020 Peoples R China Sichuan Univ Dept Ultrasound W China Hosp Chengdu 610041 Peoples R China Chongqing SW hosp Dept Ultrasound Chongqing 400038 Peoples R China Fourth Mil Med Univ Dept Diagnost Ultrasound Xijing Hosp Xian 710032 Peoples R China Jilin Prov Canc hosp Dept Electrodiag Changchun 130012 Peoples R China Zhejiang Prov Canc hosp Dept Ultrasound Hangzhou 310022 Zhejiang Peoples R China Jiangsu Prov Canc hosp Dept Ultrasound Nanjing 210009 Peoples R China First peoples hosp Foshan Dept Diagnost Ultrasound Foshan 528000 Peoples R China Henan Prov Canc hosp Dept Ultrasound Zhengzhou 450003 Peoples R China peoples hosp Henan Prov Dept Diagnost Ultrasound Zhengzhou 450003 Peoples R China

BACKGROUND: Contrast-enhanced ultrasonography (CEUS) is increasingly accepted in clinical settings for diagnostic imaging of focal liver lesions (FLLs). This study aimed to assess the efficacy of CEUS in the characterization of FLLs in comparison with final diagnosis based on gold standard assessment. METHODS: The study was approved by the local ethics committee and participating patients provided written informed consent. A total of 148 patients with 164 FLLs were studied. Unenhanced ultrasonography (US) and CEUS were performed using fundamental and harmonic imaging, respectively. Contrast enhancement was assessed during the arterial, portal and late vascular phases after intravenous administration of contrast (SonoVue (R), Bracco, Italy). Sensitivity, specificity and diagnostic accuracy of US and CEUS were compared in identifying the lesion as benign, malignant or indeterminate and its actual tumor type. Final diagnosis was established by biopsy (129/164), MR imaging (11/164) or medical history (24/164). RESULTS: When compared to the gold standard, the number of indeterminate diagnoses was reduced from 56.7% (93/164) as assessed by fundamental imaging to 6.1% (10/164) after SonoVue (R) enhanced US examination. Sensitivity and specificity improved from 49% and 25% at baseline US to 93% and 75% with CEUS, respectively (P<0.01). Diagnostic accuracy of CEUS was 88% in contrast to 41% of baseline US. CONCLUSION: SonoVue (R) enhanced US improves the characterization of FLLs and may limit the need for further investigations.

关键词： contrast-enhanced ultrasonography characterization focal liver lesions

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Effect of preoperative regional artery chemotherapy on proliferation and apoptosis of gastric carcinoma cells

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World Journal of Gastroenterology 2002年第3期8卷 451-454页

作者： Tao, HQ Zou, SC Zhejiang Prov peoples hosp Dept Surg Hangzhou 310014 Zhejiang Peoples R China

AIM: To study the effects of preoperative regional arterychemotherapy (PRACT) in inducing growth inhibition andapoptosis of gastric carcinorna (GC) ***: TUNEL ( terminal-deoxynucleotidyl-transferaseTdT-mediated dUTP-fluorescein and labeling) method andimmunohistochemical techniques were used to detect thestate of apoptosis and proliferation of GC cells inhistopathologic sections. A total of 110 cases of GC and 68cases of metastatic lymph node with or without PRACT wereadopted. Correlations between apoptosis index (Al),proliferation index (PI) and PRACT and prognosis ***: The apoptosis index (Al) was significantly higherin the PRACT group (12.5 ‰ + 4.33‰) than in the untreatedgroup (7. 1‰ + 3. 43 ‰, P ＜ 0. 001 ), whereas theproliferation index (PI) in the PRACT group (33.8 % ± 8.8% ) was eignificantly lower than that in untreated group (43.6 % + 12.8 %, P＜0.01). Both Al and PI were correlated tothe differentiation degree of GC in PRACT group, the Al inthe differentiated group was higher than that inundifferentiated group (P＜0.001), but the PI was lower inthe differentiated group than that of the undifferentiatedgroup ( P ＜ 0.01 ). The Al of GC cells in metastatic lymphnode was also significantly higher in the PRACT group (7.9‰+ 3.41‰) than in the untreated group (3.6 ‰ + 2.93 ‰,P ＜ 0.01 ), though the PI of GC cells in metastatic lymphnodes in the PRACT group (17. 2 % + 6. 8 % ) wassignificantly lower than that in the untreated group (26.7 %+ 9. 3 %, P ＜ 0. 01 ). The severity of histopathologicchanges was significantly higher in the PRACT group than inthe untreated group ( P ＜ 0.05). In addition, postoperativesurveys demonstrated that the 5-year survival rate of GCpatients in the PRACT group was significantly higher than thatof patients in the untreated group (P＜0.01).CONCLUSION: Preoperative regional artery chemotherapy(PRACT) showed inhibitory action on the growth of GC cellsmainly through inhibiting proliferation and inducing theapoptosis

关键词：胃癌细胞增殖凋亡局部动脉化疗

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Measurement of liver volume and its clinical significance in cirrhotic portal hypertensive patients

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World Journal of Gastroenterology 1999年第6期5卷 525-526页

作者： Zhu JY Leng XS Dong N Qi GY Du RY Beijing Med Univ Peoples Hosp Dept Surg Beijing 100044 Peoples R China

INTRODUCTIONAccurate assessment of hepatic reserve function in cirrhotic portal hypertensive patients is important for selection of surgical procedure and evaluation of prognosis. The measurement of liver volume has been applied in clinic as widely as Child's class[1,2]. Limited by technical condition, measurement of liver volume in vivo has seldom been reported in China. Using double helix-spiral CT (Elscint CT Twin), the liver volume of 25 cirrhotic patients and 30 patients in controls was assessed, and a correlation analysis was made between the liver volume and preoperative natural shunting rate, portal vein flow, portal pressure and prognosis of cirrhotic patients.

关键词： liver volume hypertension, portal liver cirrhosis prognosis

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Treatment of Helicobactor pylori infection:analysis of Chinese clinical trials

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World Journal of Gastroenterology 2000年第3期6卷 324-325页

作者： Li YY Sha WH First Municipal peoples hosp Guangzhou Dept Gastroenterol Guangzhou 510180 Peoples R China

INTRODUCTION E radication of Helicobacter pylori(Hp)infection isgenerally not *** clinical regimens havebeen recommended in the *** theexperience from the other countries and the practicein China,Chinese doctors have tried *** this study,we collected and pooled thedata from Chinese literature to evaluate the effectof different regimens in Chinese patients infectedwith Hp.

关键词： Helicobacter infection/therapy clinical trials evaluating studies Helicobacter pylori

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Diagnosis of bacterial hepatic abscess by CT

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Hepatobiliary & Pancreatic Diseases International 2007年第3期6卷 271-275页

作者： Wang, Cheng-Lin Guo, Xue-Jun Qiu, Shui-Bo Lei, Yi Yuan, Zhi-Dong Dong, Han-Bin Liu, Hui-An Peking Univ Shenzhen Hosp Dept Imaging Shenzhen 518036 Peoples R China peoples hosp Shenzhen 4 Dept Imaging Shenzhen 518036 Peoples R China Buji peoples hosp Shenzhen Dept Imaging Shenzhen 518036 Peoples R China

BACKGROUND: Bacterial hepatic abscess usually is acute and progressive, often resulting in sepsis, impairment of liver function and disseminated intravascular coagulation. The mortality rate was as high as 80% in the past. For the purpose of early diagnosis and differential diagnosis of this disease, we probed the imaging manifestations and their characteristics in bacterial hepatic abscesses by CT scan. METHODS: Twenty-four lesions from 21 patients with bacterial hepatic abscesses that were confirmed by clinical features, puncture and culture were reviewed for CT manifestations. Fourteen patients were male and 7 were female, with an average age of 56.2 years. All lesions underwent CT plain scan and three-phase enhanced scan and 15 patients underwent delayed-phase imaging. Three senior radiologists read the films in accordance with a standard. RESULTS: Among 24 lesions, 18 (75%) were situated in the right liver with diameters of 1.4-9.3 cm (average 4.5 cm). Nineteen (79.2%) lesions were round or sub-round in shape, and 22 (91.7%) had smooth, uninterrupted and sharp edges. All lesions showed low attenuation of less than 20 Hu. Twenty-two enhanced lesions (91.7%) had rim-shaped enhancement in the abscess wall, and 13 (54.2%) showed single or double-ring signs. Eighteen (75%) displayed honeycomb-like, grid-like or strip-like enhancement. Eighteen (75%) were regionally enhanced in the surroundings or upper or lower layers. Only 2 (8.3%) displayed a gas-liquid surface sign. CONCLUSIONS: The CT findings of bacterial hepatic abscess are usually typical, and the diagnosis of the abscess is not difficult. To precisely diagnose atypical cases, it is necessary to combine CT with clinical observations and follow-up.

关键词： hepatic abscess bacterial CT imaging characteristics

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A clinical and long-term follow-up study of perioperative sequential triple therapy for gastric cancer

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World Journal of Gastroenterology 2000年第2期6卷 284-286页

作者： Zou SC Qiu HS Zhang CW Tao HQ Zhejiang Prov peoples hosp Dept Surg Hangzhou 310014 Zhejiang Peoples R China

INTRODUCTIONAlthough the long-term postoperative survival rateof gastric cancer(GC) patients has been improvedsignificantly since the local dissection of lymph nodewas widely used in China,yet the low curativeresection rate and the high recurrence rate fromperitoneal and hepatic metastases hinder it fromfurther *** alter the currentunsatisfactory status of GC treatment,a

关键词： stomach neoplasms/surgery stomach neoplasms/drug therapy intra-arterial chemotherapy intra-peritoneal chemotherapy curative resection survival rate

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