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Progress in research of liver surgery in China

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World Journal of Gastroenterology 2000年第6期6卷 773-776页

作者： Wu MC Shen F Second Mil Med Univ Eastern Hepatobiliary Surg Hosp Shanghai 200438 Peoples R China

INTRODUCTIONLiver surgery,was started in the late 1950s in Chinaand has developed rapidly in the past 40 *** study on the diagnosis and treatment of primaryliver cancer in China underwent four stages:①Inthe 1950s,the... 详细信息

关键词： liver neoplasms/surgery liver transplantation liver neoplasms/diagnosis liver neoplasms/therapy biopsy needle genes suppressor tumor

Possible relationship between intestinal barrier function and formation of pigment gallstones in hamsters

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Hepatobiliary & Pancreatic Diseases International 2008年第5期7卷 529-532页

作者： Fan, Ying Wu, Shuo-Dong Sun, Lei Fu, Bei-Bei Su, Yang China Med Univ Shengjing Hosp Dept Gen Surg Shenyang 110004 Peoples R China

BACKGROUND: The presence of bacteria in bile is an important factor in the formation of pigment gallstones. The bile of healthy people is sterile and bacteria in the biliary system come from endogenous infection from the gut. Yet, the route of bacterial translocation into the bile duct is still unclear. Theoretically, two routes exist: one is through the intestinal barrier and the other is by direct reflux from the sphincter of Oddi. This study was undertaken to explore the relationship between the effectiveness of intestinal barrier and the formation of pigment gallstones in hamsters. METHODS: Thirty-two hamsters were divided into an experimental and a control group, with 16 hamsters in each group. A low protein and high cellulose diet was given for 6 weeks to induce the formation of pigment gallstones in the experimental group (PS) and a normal diet was given to the control group (CON). Morphological changes, changes in the levels of serum endotoxin and diamine oxidase, and changes in the numbers of B lymphocytes, plasma cells and secretory immunoglobin A (sIgA) in the intestinal mucosa were assessed after 6 weeks. RESULTS: Four hamsters died during lithogenesis and body weight decreased in the PS group. Pigment gallstones were found in 11 hamsters at the end of the experiment, giving a lithogenesis rate of 91.67%. The serum endotoxin level before and after gallstone formation in the PS group was 0.2960 +/- 0.1734 U/ml and 8.2964 +/- 4.6268 U/ml, respectively (P<0.05). The blood diamine oxidase level before and after gallstone formation in the PS group was 2.6333 +/- 0.8037 U/ml and 3.3642 +/- 0.9545 U/ml, respectively (P<0.05). The numbers of B lymphocytes, plasma cells and sIgA in the intestinal mucosa in the PS group were 71.56 +/- 2.89, 68.65 +/- 2.09 and 27.56 +/- 1.07, respectively, and were significantly decreased compared with the corresponding values in the CON group (94.25 +/- 3.69, 93.47 +/- 3.98 and 42.57 +/- 1.96, respectively, P<0.05). CONCLUSIONS: A

关键词： endotoxins diamine oxidase B lymphocytes plasma cells secretory immunoglobin A

Risks faced by donors of right lobe for living donor liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2009年第6期8卷 581-585页

作者： Ran, Shun Wen, Tian-Fu Yan, Lu-Nan Li, Bo Zeng, Yong Chen, Zhe-Yu Zhang, Yu Liao, Zhi-Xue Liang, Guan-Lin Li, Guo Zhang, Xian-Hua Sichuan Univ Dept Hepatobiliary Surg W China Hosp Chengdu 610041 Peoples R China

BACKGROUND: Because of the shortage of deceased donors with livers fit for transplantation, living donor liver transplantation (LDLT) is becoming an attractive alternative. Attention should be paid to the donors, especially to those of the right lobe. In this study, we evaluated the risks faced by donors of the right lobe for adult-to-adult LDLT. METHODS: The perioperative data from 105 consecutive living donors of the right lobe performed in West China hospital from January 2002 to December 2007 were retrospectively studied. Preoperative evaluation included CT, MRCP, and intraoperative cholangiography, showing liver volume, hepatic vasculature and the biliary system. The standard liver volume (SLV) and the ratio of left lobe volume to SLV were calculated. The right lobe grafts were obtained by transecting the liver on the right side of the middle hepatic vein without inflow vascular occlusion, using an ultrasonic dissector. After operation the donors were monitored in the Intensive Care Unit for about three days. Each donor was followed up for at least 6 months. RESULTS: There was no donor mortality. Major complications occurred in 14 donors (13.3%), of whom 3 received conservative treatment, 8 required invasive paracentesis, and 3 required further surgery. All donors were recovered well and resumed their previous occupations. CONCLUSIONS: Donors of the right lobe face low risks. The preoperative evaluation, especially evaluation of the volume of the remnant liver, should be exact. During the operation, the patency of the remnant hepatic vasculature and bile duct must be preserved, and the extent of injury to the remnant liver should be limited as much as possible. The detection and treatment of postoperative complications should be diligently performed.

关键词： liver transplantation living donor right lobe risk safety

Predominant expression of Th1-type cytokines in primary hepatic cancer and adjacent liver tissues

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Hepatobiliary & Pancreatic Diseases International 2007年第1期6卷 63-66页

作者： Qiu, Fa-Bo Wu, Li-Qun Lu, Yun Zhang, Shun Zhang, Bing-Yuan Qingdao Univ Affiliated Hosp Dept Hepatobiliary Vasc Surg Qingdao 266003 Peoples R China

BACKGROUND: Research has revealed a shift towards Th2 in many types of malignant tumor, but the state of Th1/Th2 is not clear in patients with primary hepatic cancer (PHC). This study was designed to determine the expression of Th1- versus Th2-type cytokines in primary hepatic cancer and the adjacent liver tissue in order to provide evidence for treatment of the Th1/Th2 shift. METHODS: Samples were collected from 11 patients with PHC. The gene expression of Th1/Th2 cytokines was detected by reverse transcriptase polymerase chain reaction (RT-PCR) using IFN-gamma and IL-2 as Th1-type cytokine genes, and IL-4 and IL-10 as Th2-type cytokine genes. RESULTS: Th1-type cytokines were expressed in 7/11 PHCs and 9/11 adjacent liver tissues, while Th0 type cytokines occurred in 4/11 PHCs and 2/11 adjacent liver tissues. CONCLUSION: Th1-type cytokines are expressed predominantly in primary hepatic cancer and the adjacent liver tissue.

关键词： primary hepatic carcinoma cytokine gene expression reverse transcriptase polymerase chain reaction

Resection of hepatic caudate lobe hemangioma:experience with 11 patients

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Hepatobiliary & Pancreatic Diseases International 2010年第5期9卷 487-491页

作者： Xu, Li-Ning Huang, Zhi-Qiang Chinese Peoples Liberat Army Gen hosp Clin Div Surg Inst Hepatobiliary Surg Beijing 100853 Peoples R China Chinese Peoples Liberat Army Gen hosp Dept Gen Surg Beijing 100853 Peoples R China Chinese Peoples Liberat Army Gen hosp Intens Care Unit Clin Div S Bldg Beijing 100853 Peoples R China

BACKGROUND: Caudate lobectomy is now considered to be the most appropriate surgical treatment for benign tumors in the caudate lobe. But how to resect the caudate lobe safely is a major challenge to current liver surgery and requires further study. This research aimed to analyze the perioperative factors and explore the surgical technique associated with liver resection in hepatic caudate lobe hemangioma. METHODS: Eleven consecutive patients with symptomatic hepatic hemangiomas undergoing caudate lobectomy from November 1990 to August 2009 at our hospital were investigated retrospectively. All patients were followed up to the present. RESULTS: In this series, 9 were subjected to isolated caudate lobectomy and 2 to additional caudate lobectomy (in addition to left lobe and right lobe resection, respectively). The average maximum diameter of tumors was 9.65+/-4.11 cm. The average operative time was 232.73+/-72.16 minutes. Five of the 11 patients required transfusion of blood or blood products during surgery. Ascites occurred in I patient, pleural effusion in the perioperative period in 1, and multiple organ failure in 1 on the 6th day after operation as a result of massive intraoperative blood loss, who had received multiple transcatheter hepatic arterial embolization preoperatively. The alternating left-right-left approach produced the best results for caudate lobe surgery in most of our cases. All patients who recovered from the operation are living well and asymptomatic. CONCLUSIONS: For large hemangioma of the caudate lobe, surgery is only recommended for symptomatic cases. Caudate lobectomy of hepatic hemangioma can be performed safely, provided it is carried out with optimized perioperative management and innovative surgical technique.

关键词： caudate lobe hemangioma hepatectomy perioperative surgical technique

Oncolytic adenovirus-mediated MDA-7/IL-24 overexpression enhances antitumor activity in hepatocellular carcinoma cell lines

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Hepatobiliary & Pancreatic Diseases International 2010年第6期9卷 615-621页

作者： Xiao, Chao-Wen Xue, Xin-Bo Zhang, Hui Gao, Wei Yu, Yuan Chen, Kun Zheng, Jian-Wei Wang, Cong-Jun Tongji Univ Sch Med Shanghai E Hosp Dept Gen Surg Shanghai 200120 Peoples R China Huazhong Univ Sci & Technol Tongji Med Coll Tongji Hosp Dept Biliary & Pancreat Surg Wuhan 430030 Peoples R China

BACKGROUND: Melanoma differentiation-associated gene-7 (MDA-7)/interleukin-24 (IL-24) is a novel tumor suppressor gene, which has suppressor activity in a broad spectrum of human cancer cells. We investigated the effect of the replication-competent oncolytic adenovirus SG600-IL24 and replication-incompetent adenovirus ***-24, both expressing human MDA-7/IL-24 on the hepatocellular carcinoma cell lines HepG2, Hep3B, SMMC-7721, HCCLM3, and the normal liver cell line L02. METHODS: Hepatocellular carcinoma cell lines and the normal liver cell line were infected with SG600-IL24 and ***-24. The mRNA and protein expression of MDA-7/IL-24 in infected cells was confirmed by RT-PCR, ELISA, and Western blotting. MTT assay was used to investigate the proliferation effect. Hoechst staining and Annexin-V and PI staining were performed to study the MDA-7/IL-24 gene expressed in HCC cell lines and the normal liver cell line. Flow cytometry was used to analyse the cell cycle. RESULTS: RT-PCR, ELISA and Western blotting confirmed that the exogenous MDA-7/IL-24 gene was highly expressed in cells infected with SG600-IL24. MTT and apoptosis detection indicated that SG600-IL24 induced growth suppression, promoted apoptosis, and blocked cancer cell lines in the G2/M phase in hepatocellular carcinoma cell lines but not in the normal liver cell line. CONCLUSIONS: SG600-IL24 selectively induces growth suppression and apoptosis in hepatocellular carcinoma cell lines in vitro but not in the normal liver cell line L02. Compared with ***-24, SG600-IL24 dramatically enhances antitumor activity in hepatocellular carcinoma cell lines. (Hepatobiliary Pancreat Dis Int 2010; 9:615-621)

关键词： melanoma differentiation-associated gene-7 interleukin-24 oncolytic adenovirus hepatocellular carcinoma gene therapy

Progress in laparoscopic anatomy research: A review of the Chinese literature

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World Journal of Gastroenterology 2010年第19期16卷 2341-2347页

作者： Li, Li-Jie Zheng, Xiang-Min Jiang, Dao-Zhen Zhang, Wei Shen, Hong-Liang Shan, Cheng-Xiang Liu, Sheng Qiu, Ming Second Mil Med Univ Changzheng Hosp Minimally Invas Surg Ctr 18 F Shanghai 200003 Peoples R China

The development of laparoscopic surgery has generated the new field of study, laparoscopic anatomy. This article reviews the reported literature on laparoscopic anatomy and explores how it has evolved along with advances in abdominal surgery. In addition, the principal concerns in current laparoscopic anatomy research are discussed, including: (1) types of special adjacent anatomical structures; and (2) special surgical planes and anatomical landmarks. Understanding of systematic laparoscopic anatomy can provide the junior surgeons a clear procedural approach, and would benefit laparoscopic surgeons in training.

关键词： Anatomy Landmark Laparoscopy Minimally invasive surgical plane

High-dose vs low-dose proton pump inhibitors for upper gastrointestinal bleeding:A meta-analysis

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World Journal of Gastroenterology 2010年第20期16卷 2558-2565页

作者： Wu, Liu-Cheng Cao, Yun-Fei Huang, Jia-Hao Liao, Cun Gao, Feng Guangxi Med Univ Dept Colorectal & Anal Surg Affiliated Hosp 1 Nanning 530021 Guangxi Zhuang Peoples R China

AIM:To evaluate the efficacy of high-dose proton pump inhibitors(PPIs)vs low-dose PPIs for patients with upper gastrointestinal ***:PubMed,Embase,the Cochrane Library,and Web of Science were searched to identify relevant randomized controlled trials(RCTs).Eligible trials were RCTs that compared high-dose PPI with low-dose PPI following endoscopic *** primary endpoint was rebleeding;secondary endpoints were patient numbers that needed surgery,and *** meta-analysis was performed with a fixed effects model or random effects ***:Nine eligible RCTs including 1342 patients were *** results showed that high-dose intravenous PPI was not superior to low-dose intra-venous PPI in reducing rebleeding[odds ratio(OR)= 1.091,95%confidential interval(CI):0.777-1.532],need for surgery(OR=1.522,95%CI:0.643-3.605) and mortality(OR=1.022,95%CI:0.476-2.196).Subgroup analysis according to different region revealed no difference in rebleeding rate between Asian patients(OR=0.831,95%CI,0.467-1.480)and European patients(OR=1.263,95%CI:0.827-1.929).CONCLUSION:Low-dose intravenous PPI can achieve the same efficacy as high-dose PPI following endoscopic hemostasis.

关键词： Meta-analysis High-dose Low-dose Proton pump inhibitors Gastrointestinal bleeding

A successful pregnancy following liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2007年第1期6卷 98-100页

作者： Pan, Guang-Dong Yan, Lu-Nan Li, Bo Zeng, Yong Wen, Tian-Fu Zhao, Ji-Chun Wang, Wen-Tao Yang, Jia-Yin Sichuan Univ W China Hosp Ctr Liver Transplantat Dept Gen Surg Chengdu 610041 Peoples R China Guangxi Med Sci Univ Affiliated Hosp 5 Dept Gen Surg Liuzhou 545051 Peoples R China

BACKGROUND: The safety and possibility of pregnancy following liver transplantation has been the hot topic in transplant. A case is reported with a review the of literature. METHOD: The data of a 22-year-old pregnant patient with end-stage liver disease who had undergone orthotopic liver transplantation in September 28, 2000 were analyzed retrospectively. RESULTS: After surgery, the patient was uneventfully recovered and was pregnant at the time of the 33rd month postoperation. The patient experienced a rejection on the 8th week of pregnancy and was successfully treated at this hospital. The patient was closely monitored throughout her pregnancy, and received routine antenatal care with respect to sonographic screening. Caesarean section was performed in March 18, 2004, and a health live-born infant weighing 2000 g was delivered at full-term. After the delivery, the patient was satisfactory with, her health and the baby was healthy. CONCLUSION: Under close monitoring, successful pregnancy following liver transplantation is possible and safe in women with end-stage liver diseases.

关键词： pregnancy liver transplantation