Current status of surgery for portal hypertension in China: a national multi-center survey analysis / 中华器官移植杂志

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

Influence of the connotation of the prevention and treatment recommendations of the physical examination report on the intention of the medical examiner / 中华健康管理学杂志

Objective:To explore the influence on the willingness to seek medical treatment by revising the recommendations for prevention and treatment in the medical examination report.Methods:Revising the prevention and treatment recommendations for four diseases, including proteinuria, hyperuricemia, hydronephrosis and renal insufficiency to clearly inform the etiology and prognosis of them. Using a cross-sectional study method, pre-revision prevention and treatment recommendations (version A) and post-revision prevention and treatment recommendations (version B) questionnaires were randomly distributed to medical examiners and at the health management center of our hospital in Wuhan. An ordinal logistic regression model and a binary logistic regression model were used to analyze the correlation of the understanding of diseases and the willingness to seek medical treatment with different connotation of the prevention and treatment recommendations, respectively.Results:A total of 530 valid questionnaires were collected, of which 267 were from version A and 263 from version B. There was no significant difference in the socio-demographic profile of respondents between version A and version B. For the four high risk factors of kidney diseases mentioned above, version B was better than version A in terms of understanding and willingness to seek medical treatment ( P<0.001). The level of understanding OR(95% CI) were 3.691(2.570, 5.301), 2.238(1.511, 3.320), 4.293(6.353, 2.903) and 5.275(7.877, 3.529) respectively. The willingness to seek medical treatment OR(95% CI) were 3.554(2.441, 5.175), 2.850(1.975, 4.114), 5.144(3.457, 7.654) and 4.225(2.868, 6.224) respectively. All the P values were lower than 0.001. Conclusions:Improving the connotation of prevention and treatment recommendations in the medical examination report can help increase the willingness for early medical consultation.

Efficacy comparison of two minimally invasive operations on cholecystolithiasis combined with choledocholithiasis / 国际外科学杂志

Objective To compare the clinical efficacy of laparoscopic cholecystectomy(LC) + endoscopic sphincterotomy combined with balloon dilation(ESBD) with laparoscopic cholecystectomy(LC) + common bile duct exploration(LCBDE) on cholecystolithiasis combined with choledocholithiasis.Methods The clinical data of 102 patients with gallbladder stones with common bile duct stones from October 2015 to October 2017 were reviewed from the Second Affiliated Hospital of Chongqing Medical University.Forty eight patients received LC + ESBD and 54 patients subjected to LC ± LCBDE.The operation time,intraoperative blood loss,abdominal drainage time,antibiotic utilization rate,stone residue rate were compared between the two groups.Measurement data with normal distribution were represented as (Mean ± SD),and t test was used to compare between groups.Measurement data with skewed distribution were represented as M(P25,P75),Mann-whitney U test was used to compare between groups.Categorical variables were describedas counts and percentages and were compared using chi-square test.Results The operation time,intraoperative blood loss,postoperative abdominal drainage time,and antibiotic utilization rate in the LC + ESBD group were (108.0 ± 23.4) min,(18.0 ± 7.1) ml,(1.83 ± 1.57) d,and 47.9％(23/48).The LC +LCBDE groupa were (169.6±37.8) min,(86.4±37.0) ml,(4.80±2.02) d,and 87.0％ (47/54),respectively,there were statistically significant differences between the two groups(P ＜0.05).The stone residual rate of the LC + ESBD group was 0,and the LC + LCBDE group was 5.6％ (3/54),respectively.There was no significant difference between the two groups(P ＞ 0.05).Conclusions LC + ESBD and LC + LCBDE both are safe and effective methods to treat cholecystolithiasis combined with choledocholithiasis.However,some data of LC + ESBD group are better than the LC + LCBDE group,such as general anesthesia time,surgical trauma and recovery time.Therefore,compared with LC + LCBDE,LC + ESBD may be the more suitable operation type for patients who have cardiovascular diseases and poor tolerance.

Effects of microRNA-145 on epithelial-mesenchymal transition of TGF-β1-induced human renal proximal tubular epithelial cells / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the effects of microRNA-145 (miR-145) on epithelial-mesenchymal transition (EMT) of TGF-β1-induced human renal proximal tubular epithelial (HK-2) cells.</p><p><b>METHODS</b>The gene sequence of miR-145 was synthesized and cloned into pCMV-myc to construct recombinant plasmid pCMV-miR-145. HK-2 cells were divided into four groups: control (untreated), TGF-β1 (treated with TGF-β1), blank+TGF-β1 (treated with TGF-β1 after HK-2 cells transfected with blank plasmid) and miR-145+TGF-β1 (treated with TGF-β1 after HK-2 cells transfected with pCMV-miR-145 recombinant plasmid). Expression of miR-145 was detected by real-time PCR (RT-PCR). TGF-β1, Smad3, Smad2/3, p-Smad2/3, α-SMA, FN and type I collagen (Col I) protein levels were detected by Western blot. Concentrations of fibronectin (FN) and Col I in cell culture supernatants were measured using ELISA.</p><p><b>RESULTS</b>pCMV-miR-145 recombinant plasmid was successfully transfected into HK-2 cells. Compared with the control group, the miR-145+TGF-β1 group showed a significant up-regulation in the expression level of miR-145 (P<0.01). However, the TGF-β1 and blank+TGF-β1 groups showed a significant down-regulation in the expression level of miR-145 compared with that in the control and miR-145+TGF-β1 groups (P<0.01). Compared with the TGF-β1 and blank+TGF-β1 groups, the miR-145+TGF-β1 group showed significantly reduced levels of the signal proteins TGF-β1, Smad3, Smad2/3 and p-Smad2/3 (P<0.05), as well as significantly reduced levels of the biomarkers α-SMA, FN and Col I (P<0.05). Meanwhile, concentrations of FN and Col I in cell culture supernatants also decreased (P<0.05).</p><p><b>CONCLUSIONS</b>miR-145 modulates the EMT of HK-2 cells treated with TGF-β1, possibly by inhibition of the activation of TGF-β-dependent Smad signaling pathway.</p>

The effect of HIFU combined with nanoscale ultrasound molecular probes with simple virus thymidine kinase gene on angiogenesis in the nude mouse tumor / 重庆医学

Objective To observe the change of the protein and gene expression of hypoxia inducing factor-1α(HIF-1a) and vascular endothelial growth factor (VEGF) in the nude mouse tumor,which has been treated by HIFU combined with nanoscale ultrasound molecular probes with HSV1-TK gene microvascular density.Methods Sixty nude mice were implanted with HepG2 Cells to establish subcutaneous transplanted tumor.Divided this mice into six groups at random after treated by HIFU:MB+ HSV-TK+ GPC3 (group A),MB + HSV-TK (group B),HSV-TK +GPC3 (group C),HSV-TK (group D),MB + GPC3 (group E),PBS (group F).They were injected into the tail vein every after 3 days.Mice in group A,B,D and E were exposed to ultrasound by 2 W/cm2,1 MHz,5 mintues and 0.2 mL ganciclovi(GCV) was intraperitoneally injected at the first 48 hours after injection.After the treatment,immunohistoche were used to detect the microvascular density(MVD),Western blot and immunohistoche was employed to test the protein change of the VEGF and HIF-1α,Q-PCR was used to test the mRNA gene transcription of VEGF and HIF-1α in the tumor tissues.Results After 14 days,the protein expression of HIF-1α and VEGF in group A was significantly lower than that in group B,C,D,E and F (P＜0.05),the MVD level in the tumor is also like this,and the difference is statistically significant.Conclusion Anoscale ultrasound molecular probes with HSV1-TK can reduce the the level of VEGF,MVD and HIF-1α in the tumor which has been treated by HIFU,so it can inhibit tumor growth and improve the therapeutic efficacy after HIFU treatment.

Antipyretic and anti-inflammatory activities of Thais luteostoma extracts and underlying mechanisms / 中国天然药物

Thais luteostoma has been utilized as a crude drug whose shell and soft tissue have been widely used for the treatment of heat syndrome in China for thousands of years. The present study was designed to investigate the antipyretic and anti-inflammatory activities of T. luteostoma. T. luteostoma was divided into shell (TLSH) and soft tissue (TLST) samples in the present study. The rat model of yeast-induced fever was used to investigate their antipyretic effects; and the rat model of hind paw edema induced by carrageenan was utilized to study their anti-inflammatory activities, and at the same time, the concentration variations of the central neurotransmitter [prostaglandin E2 (PGE2) and cyclic adenosine monophosphate (cAMP)], inflammatory mediators [tumor necrosis factor (TNFα), interleukin-1β (IL-1), interleukin-2 (IL-2) and interleukin-6 (IL-6)] and ion (Na(+) and Ca(2+)) were also tested. The results showed that TLSH and TLST extracts significantly inhibited yeast-induced pyrexia in rats (P < 0.05), and exhibited more lasting effects as compared to aspirin, and TLSH had the better antipyretic activity than TLST, and that TLSH and TLST could significantly prevent against carrageenan induced paw edema in rats (P < 0.05); and markedly reduced levels of PGE2, cAMP, TNFα, IL-1β, IL-2, IL-6, and Na(+)/Ca(2+). In fever model, TLST could significantly reduce the levels of PGE2 (P < 0.01) in rats' homogenate and TNFα (P < 0.05), IL-1β (P < 0.01) in the plasma than TLSH, whereas TLSH could reduce the content of IL-2 (P < 0.01) and IL-6 (P < 0.01) in plasma and increase the content of Ca(2+) (P < 0.01) in plasma and homogenate more significantly than TLST. In conclusion, T. luteostoma extract has antipyretic and anti-inflammatory activities, which may be mediated through the suppression of production of PGE2, cAMP, Na(+)/Ca(2+), TNFα, IL-1β, IL-2, and IL-6.

Advances in clinical diagnosis and treatment of bile duct injury caused by laparoscopic cholecystectomy / 国际外科学杂志

Bile dut injury (BDI) is one of the severe complications of laparoscopic cholecystectomy (LC).The classification,diagnosis and treatment of the BDI caused by LC are partly controversial.The most efficient classification of the BDI is Strasberg-Bismuth's classification and the three modes and four classes developed by the Biliary Surgery Group of Surgery Branch of Chinese Medical Association.Although the success rate of intraoperative diagnosis for the BDI is very low,in most cases,the BDI is diagnosed by clinical manifestations and assistant examinations.Accurate classification and early diagnosis could help us to make a specific one for each patient according to certain situation.In this review,we focus on the classification,diagnosis and treatment of the BDI caused by LC.

Establishment of method and modification of colorimetric judgment on HIV-1 virus detection by reverse transcription loop-mediated isothermal amplification / 中华预防医学杂志

<p><b>OBJECTIVE</b>To establish the reverse transcription loop-mediated isothermal amplification (RT-LAMP) methods for on-site HIV-1 detection.</p><p><b>METHODS</b>As for the real-time fluorescent RT-LAMP, we firstly tested the specificity and sensitivity, then explored its quantitative determination, and finally applied the method to the detection of 35 HIV-1 positive samples. For colorimetric judgment, after choosing different ameliorates to modify Hydroxynaphthol blue (HNB), we tested their real effects on coloration, and then picked out the modified dyes with obvious color change to test the sensitivity and the detection of the 35 HIV-1-positive samples.</p><p><b>RESULTS</b>The real-time fluorescent RT-LAMP showed great specificity of HIV-1, and the sensitivity to detect HIV-1 RNA was between 10 and 100 copies per reaction. On testing 35 HIV-1-positive samples, the method could reach 100 percent detection rate. However, for the quantitative determination, the quantitative relation was not observed regarding the HIV-1 RNA of below 10(3) copies per reaction. Three modified HNB dyes with clear color variation between the reaction tubes of the negative and the positive were got in the study, and their sensitivities equaled to the level of agarose gel electrophoresis. Similarly, 100% (35/35) detection rate was reached when the colorimetric RT-LAMP with the modified dyes was applied to detect 35 HIV-1-positive samples.</p><p><b>CONCLUSION</b>The established real-time fluorescence method and the modified color judgment of RT-LAMP could be helpful for truly achieving rapid, accurate, and sensitive on-site detection of HIV-1.</p>

Is there an association between advanced stage of renal cell carcinoma and paraneoplastic syndrome?

To investigate any association between renal cell carcinoma [RCC] and paraneoplastic syndromes [PNS]. The retrospective analysis included 1,028 patients of Chinese Han nationality with resectable RCC and PNS. The PNS included elevated erythrocyte sedimentation rate [ESR], hypertension, cachexia, anemia, pyrexia, abnormal liver function, hypercalcemia, polycythemia, varicocele and neuromyopathy. Staging was categorized as local [T1-2N0M0] and locally advanced [T3-4NxM0]. Among patients with at least one PNS, elevated ESR [p = 0.008], cachexia [p = 0.000], varicocele [p = 0.000] and pyrexia [p = 0.021] were related to advanced stage of RCC. Among patients with only one PNS, hypertension [p = 0.012] and hypercalcemia [p = 0.000] were related to advanced stage. The remaining PNS were not associated with tumor stage. Pyrexia, elevated ESR, cachexia and varicocele were related to advanced RCC. Hypertension and hypercalcemia occurring as single PNS, although also correlated with advanced stage, require further investigation

Study of the effect and mechanism of spastic paraplegia 21 protein on the replication of hepatitis B virus / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the effect of human spastic paraplegia 21 protein (SPG21) on the replication of hepatitis B virus(HBV) and its regulatory mechanism.</p><p><b>METHODS</b>HBV infectious clone pHBV1.3 and its promoter pHBV-Luc were transfected respectively into HepG2 cells with SPG21 of different concentrations, HBsAg and HBeAg in the supernatants were measured by enzyme linked immunosorbent assay (ELISA), expression of HBV core mRNA and protein were detected by RT-PCR and western blot, covalently closed circular DNA(ccc DNA) levels were measured by real-time PCR, and HBV promoter activity was measured by luminometer fluorescence detector.</p><p><b>RESULTS</b>Expression of HBsAg, HBeAg, HBV core protein and cccDNA were upregulated by SPG21 as well as HBV promoter activity in a dose-dependent approach. The activity of HBV promoter increased to 1.63, 3.09 and 4.66 times in HepG2 cells treated with 50mug/ml, 100mug/ml and 200mug/ml SPG21 respectively during 48 hour-treated ( P less than 0.05), as compared to the control group.</p><p><b>CONCLUSIONS</b>SPG21 can enhance the replication of HBV in HepG2 cells.</p>

Role of XBP1 signal transduction pathway in the ischemia/reperfusion injury of graft liver in rats / 中华器官移植杂志

Objective To explore the regulation mechanism of X box binding protein 1 (XBP1)signal transduction pathway for TNF-α and effective approach in ischemia/reperfusion (I/R) injury of liver transplantation for short hairpin RNA (shRNA) interference used to gene therapy in liver graft.Methods Male Sprague-Dawley rats were divided into three groups: the cold ischemia transfection group (CIT), the in vivo transfection group (IVT) and the control group. Experiments of orthotopic liver transplantation were performed by two cuff method. The rats in CIT were perfused with XBP1-shRNA plasmid (pSIXBP1) during cold ischemia phase, those in IVT received the equivalent volume (2 ml) of pSIIRAK 4 after portal vein inoculation, and those in the control group were not subjected to any treatment. Rats were killed at 60 or 180 min after restoring reperfusion of hepatic portal vein.Histopathological damage degree of graft liver was observed by light microscope. The expression levels of XBP1 gene and protein were detected by RT-PCR and Western blotting. The activities of NF-κB and the serum TNF-α level were detected by ELISA. Results All the indexes including the degree of histopathological damage, the expression levels of XBP1 mRNA and protein and the TNF-α level were significantly decreased in CIT as compared with IVT and control group (P＜0. 05). However,there was no significant difference in NF-κB activity among the three groups (P＞0. 05). Conclusion The role of XBP1 pathway in TNF-α gene regulation and that of NF-κB pathway in rat liver I/R injury are two relatively independent aspects, and the depression of XBP1 expression with XBP1 shRNA through portal vein perfusion during cold ischemia phase could effectively alleviate graft hepatic I/R

Combination of transcatheter arterial chemoembiolization and antitumor drugs in the treatment of Hepatocellular carcinoma / 国际外科学杂志

Hepatocellular carcinoma(HCC)is a common world wide disease.Transcatheter arterial chemoembolization(TACE)has been the first choice for the unresectable midadvanced ones.However, TACE has its own limitation such as high recurrence rate and many complications, what's more, recurrence induced by neovascularization which is stimulated by activation of vascular endothelial growth factors promoted by ischemia and hypoxia in local tissues after the embolization always reduce the effect of treatment.And combination of TACE and anti-angiogenesis therapy is capable to make up the shortage of each other and reduce the recurrence rate, which has been a hot issue for non-surgical treatment of HCC.

Effect of hepatitis B virus X gene on the expression of spastic paraplegia 21 / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effect of hepatitis B virus(HBV) X gene on the expression of SPG21.</p><p><b>METHODS</b>The expressions of SPG21 mRNA and protein in HepG2 and HepG2.2.15 cells were tested by RT-PCR and western blot. HepG2 cells were co-transfected with reporter plasmid pGL3-SPG21 and plasmids carrying individual genes of HBV, the luciferase activity was measured and the expressions of SPG21 were detected by RT-PCR and western blot.</p><p><b>RESULTS</b>The expressions of SPG21 mRNA and protein were higher in HepG2.2.15 cells than in HepG2 cells (0.36+/-0.06 vs 0.21+/-0.05, P value is less than 0.05). The activity of SPG21 in HepG2 cells transfected with pCMV-X was higher (875+/-27 vs 67+/-12, P value is less than 0.01) as compared to blank control group (transfected with pCMV-tag2B). HBV X gene enhanced SPG21 gene promoter activity, SPG21 mRNA expression and SPG21 protein production in HepG2 cells in a dose-dependent manner.</p><p><b>CONCLUSION</b>HBV X gene can specially activate SPG21 expression.</p>

Reversal of multidrug resistance in hepatocellular cell line HepG2R by mdr1-antisense RNA / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate whether multidrug resistance gene 1(mdr1) could reverse multidrug resistance (MDR) in HepG2R cells.</p><p><b>METHODS</b>An adenovirus vector, Adeno-asmdr, containing the antisense RNA driven by AFP promoter, was construct. Adeno-EGFP was transfected into HepG2, an AFP producing cell line, L02, a normal human liver cell line, and HeLa, a human cervical cancer cell line, the EGFP transcription level was detected by RT-PCR. Adeno-asmdr was transfected into HepG2R cells, the expression of P-gp170 was detected by western blotting, apoptosis was detected using TUNEL and flow cytometry, cell cycle was analyzed by flow cytometry.</p><p><b>RESULTS</b>EGFP was highly expressed in HepG2 cells, however, its expression in L02 or HeLa cells was very weak. Western blot showed that the P-gp170 was marked down-regulated 48h after transfection with Adeno-asmdr, and the expression of P-gp170 was detectable at least 7d post-transfection. Compared with control cells, Adeno-asmdr transfected HepG2R cells were more sensitive to different chemicals, as indicated by TUNEL staining and flow cytometry. Chemical treatment arrested the cells in S and G0/M phase.</p><p><b>CONCLUSION</b>The recombinant adenoviral vector, Adeno-asmdr, can block the expression of mdr1, and reverse MDR in HepG2R cells.</p>

Reversal of adriamycin resistance of hepatocellular carcinoma by targeting it with recombined adenovirus carrying antisense multidrug resistance gene 1 RNA / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate if an adenovirus vector carrying antisense multidrug resistance gene 1 (MDR1) could reverse multidrug resistance (MDR) of HepG2/ adriamycin (ADM) cells in tumors transplanted in athymic mice.</p><p><b>METHODS</b>An adenovirus vector carrying AFP promoter and antisense MDR1 was constructed. HepG2 MDR cells (HepG2/ADM) were induced by graded resistance to ADM and were subcutaneously inoculated into athymic mice to construct the transplanted tumor. After adeno-asmdr1 was injected, the volume of the transplanted tumor and the apoptotic body in the xenograft tumor cells were observed and reverse transcriptase polymerase chain reaction was employed to investigate the expression of the mdr1-mRNA from the mouse transplanted tumor cells.</p><p><b>RESULTS</b>Following injection with adeno-asmdr1, the tumor volumes in this mice group did not increase. However the tumor volume in the PBS plus ADM group did increase significantly (P less than 0.05). In the tumor xenograft cells, mdr1 mRNA in the xenografts was assessed by RT-PCR and found to be reduced at week 1, and at week 4 in the ADM+asmdr1 group, but it was stable in the ADM group. It was only 20% in the ADM+asmdr1 group compared to the ADM group at the 4th week. Evidence of apoptosis was observed in the tumor xenograft cells treated with adeno-asmdr1, but there was rarely any apoptosis in the group treated with ADM and PBS.</p><p><b>CONCLUSION</b>Adenovirus carrying antisense mdr1 RNA can partially reverse the MDR of HepG2/ADM cells and inhibit tumor growth by down-regulating mdr1 mRNA resulting in tumor cell apoptosis.</p>

The cause of impairment of gallbladder emptyingin patients with gallstone and diabetes mellitus / 重庆医科大学学报

Objective:To investigate the abnormity of arterioles in gallbladder and its relation with gallbladder hypomotility in patients with gallstone and diabetes mellitus.Methods:30 patients with simple gallstone and 30 patients with gallstone accompanied with diabetes mellitus were analyzed.Their gallbladder emptying function was measured with B ultrasound before operation.After operation,the arterioles of gallbladder rinsed with PAS reagent in photos were analyzed in tubular area and stereo system with BEIHANG CM-2000B biological and medical photo system.Results:The gallbladder volumes of fasting(V 0),two hours after eating(V 2) increased (59.3?0.6 vs 37.9?5.4,44.7?6.6 vs 14.3?4.9 respectively),whilethe ejective volume of bile(EV) and the ejective rate of gallbladder two hours after eating[GBEF 2 (%)] decreased in patients with diabetes mellitus(14.5?7.1 vs 23.4?9.3,24.9?12.7 vs 61.5?8.5,respectively).In patients with gallstone and diabetes mellitus,the area ratio of arterioles wall to whole arterioles in cross section was significantly higher than in the patients with simple gallstone(0.81 ?0.09 vs 0.58?0.15, P 0.05).Conclusion:The emptying function is significantly impaired in patients with gallstone and diabetes mellitus.The sedimentation of PAS positive material in the wall of arterioles lead to the stenosis of arterioles,and it is probably the cause for gallbladder hypomotility.

Juxtaglomerular cell tumor(report of 2 cases and review of the literature) / 中华泌尿外科杂志

Objective To improve the diagnosis accuracy and treatment quality of juxtaglomerular cell tumor.Methods The clinical data of 2 female patients(20 and 36 years,respectively)with juxtaglo- merular cell tumor were presented and discussed in combination with review of the literature,including the onset characteristics,imaging features,treatment,pathology and prognosis.Case 1 presented with hyperten- sion of 180/110 mm Hg.The laboratory examinations showed that in decubitus and standing position,the plasma rennin activity(PRA)was 3.2?g - L~(-1)?h~(-1)and 36.5?g?L~(-1)?h~(-1);angiotensinⅡwas 54.3 pg/ml and 183.5 pg/ml;aldosterone was 193.5 prnol/L and 489.4 pmol/L,respectively;serum kalium was 2.6 mmol/L.Case 2 presented with hypertension of 210/120 mm Hg.The laboratory examination results were as follows:in decubitus and standing position,PRA was 4.3?g?L~(-1)?h~(-1)and 37.0?g?L~(-1)?h~(-1);angio- teusinⅡwas 55.6 pg/ml and 200.4 pg/ml;aldosterone was 162.4 pmol/L and 506.3 pmol/L,respectively; serum kalium was 3.0 mmol/L.On CT scan,both cases had renal tumor,with the diameter of 3.0 cm and 3. 5 cm,respectively.Results Case 1 underwent laparoscopic partial nephrectomy.Case 2 who had artery stricture and severe functional injure of the right kidney underwent laparoscopic right nephrectomy.The oper- ative time was 3.0 h and 2.0 h,and the blood loss was 175 ml and 112 ml,respectively.There was no mor- tality or postoperative complication.In 1 or 2 postoperative weeks,Case 1 had blood pressure(BP)of 120/70 mm Hg;in deeubitus and standing position,PRA was 1.5?g ~ L~(-1)?b~(-1)and 12.8?g?L~(-1)?h~(-1);angio- tensinⅡwas 30.6 pg/ml and 97.5 pg/ml;aldosterone was 78.5 pmol/L and 192.2 pmol/L,respectively ;se- rum kalium was 4.2 mmol/L.Case 2 had BP of 125/75 mm Hg;in decubitus and standing position,PRA was 1.6?g.L~(-1)?h~(-1)and 12.3?g.L~(-1)?h(-1);angiotensinⅡwas 34.3 pg/ml and 83.5 pg/ml;aldoste- rone was 62.6 pmol/L and 292.5 pmol/L,respectively;serum kalium was 4.8 mmol/L.Pathology showed that the juxtaglomerular cell tumor had intact envelop.Light microscopically,the tumor was very much like a hemangiopericytoma,showing active proliferation and nuclear atypia.The immunohistochemical staining showed positive Vimentin,CD_(34)expression,and negative MSA,EMA,Bcl-2,?-SmA,AG/AG3,34?En, CD_(117),CD_(31),Iv glue,Ki-G~-(＜2%)expression.Ultrastructural changes of the nuclei and some organelles in the cytoplasm were observed under electron microscope.The conspicuous ultrastructural feature was the pres- ence of secretion granules and rhomboid-shaped,crystal-like structures in the dilated cisternae of rough endo- plasmic reticulum and vesicles of Golgi complex.The follow-up was 14 and 6 months,respectively;the renal function was normal and no tumor recurrence was found.Conelusions Juxtaglomerular cell tumor is a rare tumor which can produce renin.It is characterized by severe hypertension and low serum potassium.La- boratory examination results are helpful for the diagnosis:PRA and angiotensinⅡincrease obviously ;aldoste- rone is 1-10 times more than normal;serum kalium is commonly between 2.1-3.5 mmol/L.The definite diagnosis depends on clinical presentations,immunohistochemistry,light and electron microscopic examina- tions.Laparoscopie operation is the first choice of surgical treatment.

Effect of gadolinium chloride pretreatment on experimental hepatocarcinogenesis of H_(22) cells in mice / 第三军医大学学报

Objective To investigate the effect of gadolinium chloride (GdCl3) on the H22 experimental hepatocarcinogenesis in mice. Methods Totally 80 mice were inflicted to experimental hepatoma by implanting H22 cells to their liver lobes, and then equally and randomly divided into experimental hepatoma group (B) and GdCl3 pretreatment group (10 mg/kg, C). Another 40 mice served as normal control group (A). Ten mice from every group were killed respectively 7, 14, and 28 d after implantation. The left 10 mice were used for recording survival time and measuring the mass weight. Hepatic pathological histology was observed, and the expression of TNF-? was detected by ELISA and RT-PCR. Results ①Survival time was obviously higher in group B than in group C (P