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DNA methylation is an important epigenetic regulatory mechanism, including gene promoter methylation and gene body methylation. Abnormal DNA methylation is closely related to the development and progression of malignant tumors, and the correlation between promoter methylation and tumors has been more clearly described previously. However, with the in-depth study of genome-wide DNA methylation, it has been found that there are more extensive methylation levels in gene body regions, which also play an important role in tumor-related gene expression, cell differentiation and tumor development. In this paper, we review the effects of gene bodymethylation on tumors in recent years and provide clues for the research and application of gene body methylation in the field of tumors by elaborating the role and regulatory mechanism of gene body methylation on tumors.
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Portal pressure measurement plays an important role in the diagnosis and evaluation of portal hypertension, and at present, there is still no unified method for the assessment of portal vein pressure. With the wide application of endoscopic ultrasound in digestive system diseases, endoscopic ultrasound-guided portal pressure gradient (EUS-PPG) measurement was included in the research agenda of the 2021 Baveno-VII conference, thus attracting widespread attention of scholars. This article reviews portal pressure measurement techniques, the development of EUS-PPG measurement technique, and two commonly used methods for EUS-PPG measurement in China and globally and elaborates on the application prospect of EUS-PPG measurement technique. A number of studies around the world have shown that EUS-PPG measurement technique is a direct, minimally invasive, simple, accurate, and radiation-free technique with strong clinical operability, and it is an important supplement to portal pressure measurement methods and may gradually become one of the main methods for portal pressure measurement.
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Objective:To evaluate the excitation and identification of parathyroid autofluorescence in thyroid surgery by a fluorescence laparoscopic system.Methods:The clinical data of 6 patients with papillary thyroid carcinoma who underwent Laparoscopic thyroid surgery at the Second Affiliated Hospital of Guangxi Medical University from Mar. 2022 to Apr. 2022 were collected. The autofluorescence of the parathyroid glands was detected and identified by the OptoMedic fluorescence laparoscopic system during the operation. A rapid frozen sections pathological examination of possible parathyroid tissue with autofluorescence was performed to determine whether it was parathyroid tissue.Results:Parathyroid autofluorescence with different intensities was visualized intraoperatively in all 6 patients, and it was confirmed as parathyroid tissue by rapid frozen pathological section.Conclusions:The parathyroid gland has a unique autofluorescence feature. Using this feature to identify, locate and protect the parathyroid gland during surgery can help reduce the complications of parathyroid injury.
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【Objective】 To analyze the dynamic relationship between the setting up of plasmapheresis station and the volume of voluntary blood donation collected using panel vector autoregressive model, so as to provide scientific reference for the management policies of blood stations and plasmapheresis stations in China. 【Methods】 The data collected from blood stations in seven administrative regions of Guangyuan, Sichuan Province from 2011 to 2021, as well as plasma collection data from two plasmapheresis stations in the region within two years since their operation, were collected. A panel vector autoregressive model was constructed. Impulse response analysis and variance decomposition analysis were used to analyze the impact and time lag effects of simulated plasmapheresis station settings on the collection volume of voluntary blood donation. Covariance analysis was used to explore whether the establishment of plasmapheresis station had an impact on the volume of voluntary blood donation collected after excluding the impact of initial value differences. 【Results】 The pulse response results showed that after the plasmapheresis station was set up, there was a negative impact effect on the voluntary blood donation collection volume at the first stage, and its impact began to rise after the second stage, reached the highest value in the third stage, and then began to decline. After the seventh stage, it tended to be stable. However, within the 10 stage range, the confidence interval for the response strength of voluntary blood donation collection volume always included 0, indicating that the response of blood collection volume to the plasmapheresis station setting in the region was not statistically significant. The results of variance decomposition showed that the contribution of collection volume of voluntary blood donation to their own impact reached 94.3%. In terms of the contribution of plasmapheresis station factors, the number of plasma donors has a relatively greater impact on the volume of voluntary blood donation collected(2.2%). Covariance analysis showed that after removing the initial confounding factors, whether to establish a plasmapheresis station had no significant impact on blood donation volume in the two groups of regions (P>0.05). 【Conclusion】 The establishment of a new plasmapheresis station will have a certain impact on blood collection volume of blood stations in the region in a short term, but in the long term, it may not directly affect the voluntary blood donation collection in the region.
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【Objective】 To analyze the characteristics and mobility of the overlapping population of voluntary blood donation and plasmapheresis donation, so as to provide a scientific basis for the formulation of recruitment and retention strategies for blood donation and plasmapheresis donation, and to further propose a scientific reference for the decision-making of blood banks and plasmapheresis station management in China. 【Methods】 The basic information of blood donors and plasmapheresis donors in two counties in Guangyuan, Sichuan Province, which carried out whole blood collection and plasmapheresis collection from the establishment of the station to July 31, 2021 was statistically compared and analzed using the chi-square test and Post hoc testing test. 【Results】 As of July 31, 2021, a total of 50 658 people participated in blood donation and 63 375 people participated in plasmapheresis donation in Jiange County and Cangxi County, with a total overlap of 6 189 people. In the two regions, 16 458 (35.2%) people aged 40 to 50, and 35 558 people (56.1%) were over 50 years old. Among the overlapping population, 2 496 (40.3%) were 40 to 50 years old, accounted for the largest proportion, and 3 146 (50.8%) were males. Significant differences were noticed in age (P<0.001) and gender (P<0.001). There was a shift in dontion in 5 183, including 2 072 people from plasma to blood and 3 111 people from blood to plasma, among which 2 671 (51.5%) were men and 3 632 (70.1%) were over 50 years old, with significant differences in gender (P<0.05) and age (P<0.001). 【Conclusion】 There were a small number of donors donating both blood and plasma in Jiange and Cangxi, and men aged 40 to 50 were the majority, and people over 50 years old were more likely to shift the donation goals. The vast majority of donors have a single and fixed donation goal (blood or plasma), and are not easy to change.
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Liver cancer is one of the common malignant tumors in clinic, and the incidence rate has been increasing year by year. Most patients are diagnosed at the advanced stage, and the prognosis is poor. The occurrence and development of hepatocellular carcinoma is closely associated with immune elimination, balance and escape. In recent years, checkpoint inhibitors have been used in clinic and immune checkpoint inhibitors have made extensive progress and application in clinical research, which has brought a significant opportunity to improve the survival rate of patients with advanced liver cancer. However, HCC patients develop immunotherapy resistance afterwords. The poor drug response to tumor cells is a serious problem affecting the clinical prognosis. This review briefly summarizes the potential mechanism of innate resistance and acquired resistance in immunotherapy of liver cancer.
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OBJECTIVE@#To analyze the clinical features of a Chinese pedigree affected with tuberculosis sclerosis and explore its molecular pathogenesis.@*METHODS@#Clinical data of the proband and members of his pedigree were collected. Whole exome sequencing was carried out to detect variants of the TSC1 and TSC2 genes. Candidate variants was verified by Sanger sequencing and bioinformatic analysis.@*RESULTS@#The proband and his mother, who also had mild features of tuberous sclerosis, were found to harbor a novel heterozygous c.4183C>T (p.Q1395X) variant of the TSC2 gene, which was absent in the 4 healthy relatives. Bioinformatic analysis suggested the variant to be likely pathogenic.@*CONCLUSION@#The heterozygous c.4183C>T (p.Q1395X) variant of the TSC2 gene probably underlay the disease in this pedigree. Above finding has expanded the spectrum of TSC2 gene variants. The more severe symptoms in the proband may be attributed to phenotypic heterogeneity of this disease.
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Humans , China , Mutation , Pedigree , Tuberous Sclerosis/genetics , Tuberous Sclerosis Complex 2 Protein/geneticsABSTRACT
Laparoscopic radical resection of hilar cholangiocarcinoma (LRRHC), due to the existing state of affairs of complexity of the surgery and the poor prognosis of hilar cholangiocarcinoma, is extremely challenging and full of controversy. LRRHC is seriously lagged behind compared with the application of laparoscopic operation in hepatic, pancreatic and gastrointestinal surgery. This article reviewed the history, minimally invasiveness, indications, technical difficulties and other key points of the current development of LRRHC.
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【Objective】 To explore the establishment methods of transgenic human umbilical cord mesenchymal stem cells (hUC-MSCs) overexpressing tumor necrosis factor(TNF)-related apoptosis-inducing ligand (TRAIL) based on the transposons, and attempt to apply it on the nude mice mode with glioma. 【Methods】 PiggyBac transposon system specially designed by us was used to prepare non-targeting and Her2-targeting hUC-MSCs that can stably express TRAIL through puromycin screening. The glioma cells expressing firefly luciferase (U87MG-LUC) were injected into the skull of the immunodeficient mice (BALB/c-nu/nu) with 1×106 cells per mouse. After 7 days of injection, the mice transplanted with U87MG were detected with a small animal living imager to determine the size and location of the tumors in skull. Then we injected the glioma-transplantation nude mouse with two kinds of transgenic hUC-MSCs expressing TRAIL (named as untarget-TRAIL and target-TRAIL, respectively), or the non-transgenic hUC-MSCs (all 1×106 cells per mouse) or PBS (named as WT-MSCs and PBS for negative control) respectively, and then monitored the changes of tumor signals by a small animal living imager every week for 3~4 weeks. 【Results】 After six passages to expand the cells, the both transgenic cell lines can stably express TRAIL gene. Their ratio of green fluorescent protein (GFP) positive cells can reach 93%-97%, and the positive ratio of their MSC-specific surface markers still maintained normal (CD34+, CD45+, and HLA-DR+ all <0.1%, CD90>99%, CD73>88%, and CD105 >60%). The median survival time (d) of U87MG-transplanted nude mice in the groups of untarget-TRAIL, target-TRAIL, WT-MSCs, and PBS was 41 vs 39 vs 24 vs 23(P<0.05). 【Conclusion】 The transgenic hUC-MSCs overexpressing TRAIL gene can significantly prolong the survival time of nude mice with brain glioma.
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The research on the pathogenesis of Alzheimer′s disease (AD) is constantly updated nowadays. The amyloid cascade hypothesis and the theory of tau protein are the mainstream theory of the pathogenesis of AD. The theory that pathogen infection, including intestinal flora, increases the incidence of AD has gradually gained attention and fully supplements existing doctrines. By reviewing the literature on the pathogenesis of AD in the past 10 years, the possible mechanisms by which pathogens increase the incidence of AD were summarized and early interventions were proposed.
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The research on the pathogenesis of Alzheimer's disease (AD) is constantly updated nowadays.The amyloid cascade hypothesis and the theory of tau protein are the mainstream theory of the pathogenesis of AD.The theory that pathogen infection,including intestinal flora,increases the incidence of AD has gradually gained attention and fully supplements existing doctrines.By reviewing the literature on the pathogenesis of AD in the past 10 years,the possible mechanisms by which pathogens increase the incidence of AD were summarized and early interventions were proposed.
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Objective To explore the laboratory culture and identification of Mycobacterium tuberculosis L forms (MTB-L),isolation rate and drug resistance in smear-positive tuberculosis patients,and to improve clinical attention to MTB-L.Methods 222 smear-positive pulmonary tuberculosis patients treated in our hospital from September 2017 to December 2017 were randomly selected for MGIT 960 and 92-3TB-L liquid culture.After MGIT 960 was reported positive,acid-fast staining was performed on the precipitated smears of 92-3TB-L liquid medium for preliminary screening.The suspected L-positive strain culture was transformed into improved TSA-L solid medium to observe the colony characteristics and microscopic characteristics.The properties of the strain were confirmed by acid-fast staining and tuberculosis DNA amplification.Drug susceptibility and mutation sites of drug resistance genes were analyzed in MTB-L.Results Ⅰ-dentification of MTB-L:after the positive strain has been cultured,the colonies have the characteristics of "fried egg sample","particle-like" and " filament-like".MTB confirmed by tubercle DNA amplification experiments.Isolation rate:after cultured by MGIT 960 and Modified 92-3TB-L medium,the positive rate of single bacterial type was 50.90％,(113/222) the positive rate of both bacterial type and L type was 15.32％ (34/222),and the positive rate of MTB-L type was 2.25％ (5/222).Drug resistance:MTB-L was resistant to Streptomycin,Isoniazid,Rifampin,and Ethanol butylamine.No mutation was found in the drug resistance gene loci.Conclusions Clinical laboratory should routinely develop the culture of L-form of Mycobacterium tuberculosis bacteria,and increase the clinical attention to MTB-L.
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Activation of inflammatory responses regulates the transmission of pain pathways through an integrated network in the peripheral and central nervous systems. The immunopotentiator thymosin alpha-1 (Tα1) has recently been reported to have anti-inflammatory and neuroprotective functions in rodents. However, how Tα1 affects inflammatory pain remains unclear. In the present study, intraperitoneal injection of Tα1 attenuated complete Freund's adjuvant (CFA)-induced pain hypersensitivity, and decreased the up-regulation of pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6) in inflamed skin and the spinal cord. We found that CFA-induced peripheral inflammation evoked strong microglial activation, but the effect was reversed by Tα1. Notably, Tα1 reversed the CFA-induced up-regulation of vesicular glutamate transporter (VGLUT) and down-regulated the vesicular γ-aminobutyric acid transporter (VGAT) in the spinal cord. Taken together, these results suggest that Tα1 plays a therapeutic role in inflammatory pain and in the modulation of microglia-induced pro-inflammatory cytokine production in addition to mediation of VGLUT and VGAT expression in the spinal cord.
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Rho-associated kinases (ROCKs) are serine-threonine protein kinases that act downstream of small Rho GTPases to regulate the dynamics of the actin cytoskeleton. Two ROCK isoforms (ROCK1 and ROCK2) are expressed in the mammalian central nervous system. Although ROCK activity has been implicated in synapse formation, whether the distinct ROCK isoforms have different roles in synapse formation and function in vivo is not clear. Here, we used a genetic approach to address this long-standing question. Both Rock1 and Rock2 mice had impaired glutamatergic transmission, reduced spine density, and fewer excitatory synapses in hippocampal CA1 pyramidal neurons. In addition, both Rock1 and Rock2 mice showed deficits in long-term potentiation at hippocampal CA1 synapses and were impaired in spatial learning and memory based on the water maze and contextual fear conditioning tests. However, the spine morphology of CA1 pyramidal neurons was altered only in Rock2 but not Rock1 mice. In this study we compared the roles of ROCK1 and ROCK2 in synapse formation and function in vivo for the first time. Our results provide a better understanding of the functions of distinct ROCK isoforms in synapse formation and function.
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Objective@#To evaluate clinical efficacy and safety of microneedle-mediated intradermal injection with hyaluronic acid for the treatment of sensitive skin.@*Methods@#A total of 53 female patients aged 21-54 years and diagnosed with sensitive skin were enrolled from Department of Cosmetic Dermatology, Dermatology Hospital of Southern Medical University from January to June in 2018, and were divided into 3 groups by using a random number generator and a residue-based method: high-pressure jet injection group (n = 23) receiving high-pressure jet injection with hyaluronic acid on the right side of the face (treatment side) and high-pressure jet injection with 0.9% sodium chloride solution on the left side of the face (control side) once every 2 weeks, microneedle injection group (n = 15) receiving microneedle-mediated injection with hyaluronic acid on the right side of the face (treatment side) and microneedle-mediated injection with 0.9% sodium chloride solution on the left side of the face (control side) once every 4 weeks, combination group (n = 15) receiving microneedle-mediated injection with hyaluronic acid on the right side of the face (treatment side) and high-pressure jet injection with hyaluronic acid on the left side of the face (control side) once every 4 weeks. All the patients in the above 3 groups received 4 consecutive sessions of treatment. Before the initial treatment and 2 weeks after the final treatment, erythema and skin pore scores were determined on the right and left sides of the face by using VISIA facial imaging system, lactic acid stinging test was performed, and skin sensitivity including severity of itching, dryness, erythema and scaling was evaluated. Two weeks after the final treatment, the overall improvement was evaluated with the Global Aesthetic Improvement Scale (GAIS) by clinicians and patients. Adverse reactions were recorded during and after treatment. Statistical analysis was carried out by using paired t test, Wilcoxon sign rank sum test and chi-square test.@*Results@#Two weeks after the final treatment, the improvement of skin pore score in the treatment side was superior to that in the control side in the high-pressure jet injection group (t = 2.19, P = 0.03) , while no significant difference in the improvement of erythema score was observed between the treatment side and control side (t = 1.10, P = 0.27) ; in the microneedle injection group, the improvement of erythema and skin pore scores was greater in the treatment side than in the control side (t = 2.47, 3.02, both P = 0.01) ; in the combination group, the VISIA erythema score in the treatment and control sides was 0.59 ± 0.25 and 0.85 ± 0.31 respectively, the improvement of erythema score in the treatment side was superior to that in the control side (t = 5.02, P < 0.01) , while there was no significant difference in the improvement of skin pore score between the treatment side and control side (P > 0.05) . Two weeks after the final treatment, the severity of itching, dryness and scaling was significantly improved in both the treatment and control sides in the 3 groups compared with those before the initial treatment (P < 0.05) , while the severity of erythema was significantly improved only in the treatment side in the microneedle injection group and combination group when compared with that before the initial treatment (Z = -2.236, -2.887, respectively, both P < 0.05) . Moreover, both the microneedle injection group and combination group showed significantly decreased severity of erythema in the treatment side compared with that in the control side two weeks after the final treatment (Z = -2.646, -2.887, respectively, both P < 0.05) . Two weeks after the final treatment, the positive rate of the lactic acid stinging test significantly decreased in the treatment side compared with that before the initial treatment in the microneedle injection group (χ2 = 4.821, P = 0.028) , but showed no significant changes in the other groups (all P > 0.05) . No severe adverse reactions were observed during or after the treatment.@*Conclusion@#Microneedle intradermal injection with hyaluronic acid can effectively and safely improve erythema, skin pore and sensitive symptoms in patients with sensitive skin.
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Objective To evaluate clinical efficacy and safety of microneedle-mediated intradermal injection with hyaluronic acid for the treatment of sensitive skin.Methods A total of 53 female patients aged 21-54 years and diagnosed with sensitive skin were enrolled from Department of Cosmetic Dermatology,Dermatology Hospital of Southern Medical University from January to June in 2018,and were divided into 3 groups by using a random number generator and a residue-based method:high-pressure jet injection group (n =23) receiving high-pressure jet injection with hyaluronic acid on the right side of the face (treatment side) and high-pressure jet injection with 0.9％ sodium chloride solution on the left side of the face (control side) once every 2 weeks,microneedle injection group (n =15) receiving microneedle-mediated injection with hyaluronic acid on the right side of the face (treatment side)and microneedle-mediated injection with 0.9％ sodium chloride solution on the left side of the face (control side) once every 4 weeks,combination group (n =15) receiving microneedle-mediated injection with hyaluronic acid on the right side of the face (treatment side) and high-pressure jet injection with hyaluronic acid on the left side of the face (control side) once every 4 weeks.All the patients in the above 3 groups received 4 consecutive sessions of treatment.Before the initial treatment and 2 weeks after the final treatment,erythema and skin pore scores were determined on the right and left sides of the face by using VISIA facial imaging system,lactic acid stinging test was performed,and skin sensitivity including severity of itching,dryness,erythema and scaling was evaluated.Two weeks after the final treatment,the overall improvement was evaluated with the Global Aesthetic Improvement Scale (GAIS)by clinicians and patients.Adverse reactions were recorded during and after treatment.Statistical analysis was carried out by using paired t test,Wilcoxon sign rank sum test and chi-square test.Results Two weeks after the final treatment,the improvement of skin pore score in the treatment side was superior to that in the control side in the high-pressure jet injection group (t =2.19,P =0.03),while no significant difference in the improvement of erythema score was observed between the treatment side and control side (t =1.10,P =0.27);in the microneedle injection group,the improvement of erythema and skin pore scores was greater in the treatment side than in the control side (t =2.47,3.02,both P =0.01);in the combination group,the VISIA erythema score in the treatment and control sides was 0.59 ± 0.25 and 0.85 ± 0.31 respectively,the improvement of erythema score in the treatment side was superior to that in the control side (t =5.02,P ＜ 0.01),while there was no significant difference in the improvement of skin pore score between the treatment side and control side (P ＞ 0.05).Two weeks after the final treatment,the severity of itching,dryness and scaling was significantly improved in both the treatment and control sides in the 3 groups compared with those before the initial treatment (P ＜ 0.05),while the severity of erythema was significantly improved only in the treatment side in the microneedle injection group and combination group when compared with that before the initial treatment (Z =-2.236,-2.887,respectively,both P ＜ 0.05).Moreover,both the microneedle injection group and combination group showed significantly decreased severity of erythema in the treatment side compared with that in the control side two weeks after the final treatment (Z =-2.646,-2.887,respectively,both P ＜ 0.05).Two weeks after the final treatment,the positive rate of the lactic acid stinging test significantly decreased in the treatment side compared with that before the initial treatment in the microneedle injection group (x2 =4.821,P =0.028),but showed no significant changes in the other groups (all P ＞ 0.05).No severe adverse reactions were observed during or after the treatment.Conclusion Microneedle intradermal injection with hyaluronic acid can effectively and safely improve erythema,skin pore and sensitive symptoms in patients with sensitive skin.
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Objective To evaluate the dynamic changes of left ventricular mechanical synchrony in the early period after acute myocardial infarction (AMI) by two-dimensional speckle tracking imaging (2D-STI) and real time three-dimensional echocardiography (RT-3DE),and analyze the correlation with phase analysis of single photo emission computed tomography gated myocardial perfusion imaging (SPECT GMPI) in porcine models,and further to investigate the clinical significance of left ventricular mechanical dyssynchrony in patients with AMI.Methods Bama minipigs(n =11) were subjected to left anterior descending (LAD) occlusion by balloon to introduce AMI porcine models.All animals underwent 2D-STI and RT-3DE at the baseline (before AMI),1 day,1 week and 4 weeks after LAD occlusion,respectively.In addition,SPECT GMPI was measured at baseline and 1 day after AMI.Data was analyzed and compared the dynamic changes of left ventricular mechanical synchrony before and after AMI.Then the correlation between echocardiography and SPECT GMPI in evaluating left ventricular mechanical synchrony before and after AMI were calculated.Results Eight pigs were successfully established as AMI models and complete the study.SPECT GMPI,2D-STI and RT-3DE showed that the left ventricular mechanical synchrony indexes were significantly higher at 1 day after AMI than those before AMI,which means the appearance of left ventricular mechanical dyssynchrony.Compared with those 1 day after AMI,GLS,Time SD,Tmsv16-SD％ and Tmsv16-Dif％ did not change significantly at 1 week after AMI,but they significantly increased at4 weeks after AMI (all P ＜0.05).At baseline and 1 day after AMI,the GLS measured by 2D-STI and the SPECT GMPI parameter phase bandwidth (BW) showed good correlation(r =0.708-0.719,P ＜0.05),Time SD was significantly correlated with the SPECT GMPI parameter phase standard deviation (SD)(r =0.717-0.830,P ＜0.05),while Tmsv16-Dif％ derived from RT-3DE had a better positive correlation with BW (r =0.713-0.857,P ＜0.05),as similar as Tmsv16-SD％ with SD(r =0.803-0.957,P ＜0.05).Conclusions Left ventricular mechanical dyssynchrony is present 1 day after AMI.Compared with that 1 day after AMI,left ventricular mechanical dyssynchrony doesn't change significantly at 1week after AMI,but further aggravates at 4 weeks after AMI.The parameters of 2D-STI and RT-3DE have good correlation with the mechanical synchrony parameters measured by SPECT GMPI.2D-STI and RT-3DE can be used as reliable methods to evaluate left ventricle mechanical dyssynchrony early after AMI.
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Objective To explore the influence of preoperative transarterial chemoembolization on short-term prognosis in patients with hepatocellular carcinoma after liver transplantation Methods From Jan 2006 to Sep 2016 in Ruijin Hospital 21 patients received preoperative hepatic transarterial chemoembolization (TACE) before liver transplantation,the other 30 patients undergoing upfront liver transplantation served as control group.Results No statistical difference was found in the total operation time (401 ± 72) min vs.(377 ± 100) min,blood loss (2 785 ± 25 56) ml vs.(4 199 ± 3 748) ml and length of hospital stay (32-± 16) d vs.(28 ± 17) d between two groups,and the occurrence rate of vascular complications (14.3％ vs.0) or biliary complications (9.5％ vs.6.7％) also showed no difference (P ＞ 0.05).Although more patients were diagnosed with postoperative infection in the observation group (81％ vs.40％) (P ＜ 0.05),there was no statistically significant difference in complication grade and perioperative mortality between two groups (P ＞ 0.05).There's no remarkable difference in the liver function recovery level between two groups in terms of postoperative indexs of liver function such as TBL,ALT,AST,and there was also no statistical difference between two groups in 1-year,2-year and 3-year overall survival (P ＞ 0.05).The waiting time in the study group was significantly longer than that in the control group (P ＜ 0.05),and the incidence of postoperative immune dysfunction was lower than that of the control group (P ＜ 0.05).Conclusion Preoperative TACE does not affect liver function recovery and perioperative safety after liver transplantation.
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Objective To assess left ventricular remodeling (LVRM) after acute myocardial in-farction (AMI) quantitatively by SPECT gated myocardial perfusion imaging (GMPI), and further explore its influencing factors. Methods Twelve Ba-Ma miniature swine were used to establish AMI model. GMPI was performed at the baseline (before AMI), 24 h, 1 and 4 weeks after AMI. Infarct expansion index, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction ( LVEF) and myocardial perfusion defect were measured. Meanwhile, creatine kinase isozyme MB (CK-MB) and hypersensitive cardiac troponin I (hs-cTn I) were detected. The changes of LVEDV and LVESV before and after AMI (ΔLVEDV and ΔLVESV) were calculated. Repeated measurement analy-sis of variance, the least significant difference t test and Pearson correlation analysis were performed. Re?sults Nine AMI swine were successfully created. LVRM was present 24 h after AMI. LVEDV and LVESV were significantly greater than those before AMI and aggravated within 1 week after AMI, then were down-wards at 4 weeks after AMI. Before AMI, 24 h, 1 and 4 weeks after AMI, the LVEDV was (34.44±7. 90), (47.56±22.66), (71.89±14.90) and (70.33±19.47) ml (F = 28.836, P<0.001), and the LVESV was (10.11±5.49), (25.33±11.62), (40.89±15.88) and (35.44±17.11) ml (F = 22.450, P<0. 001). In-farct expansion index increased progressively within 4 weeks after AMI (F= 16.054, P<0.001). LVEF was significantly lower after AMI than that before AMI (F = 18.267, P<0.001) and improved at 4 weeks after AMI compared to that at 1 week ((52.56±14.96)％ vs (45.11±15.80)％; t= 2.440, P<0. 05). There was a significant correlation between the change in perfusion defect and the ΔLVEDV or ΔLVESV (r values:0. 731 and 0.700, both P<0.05) at 1 week after AMI. In addition, hs-cTn I at 24 h was correlated withΔLVEDV at 24 h and 4 weeks after AMI, respectively (r values: 0.669 and 0.693, both P<0.05). Conclu?sions LVRM and cardiac dysfunction occur in the early period after AMI. LVRM and cardiac dysfunction are most severe at 1 week after AMI, and recover at 4 weeks after AMI, whereas infarct expansion is aggra-vated within 4 weeks. Infarct size and hs-cTn I are closely related to the degree of LVRM.
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Objective To systematically evaluate the effect of preoperative transarterial chemoembolization (TACE) on perioperative safety of patients with resectable hepatocellular carcinoma (HCC).Methods Literatures were researched using Chinese Journal Full-text Database,Wanfang database,VIP database,PubMed,Medline from December 1,1994 to May 30,2016 with the key words including “肝细胞癌,肝切除,术前化疗栓塞,经动脉化疗栓塞,liver cancer,hepatocellular carcinoma,liver resection,hepatectomy,transcatheter arterial chemoembolization,transarterial chemoembolization,preoperative” Manual retrieval was also conducted simultaneously.The randomized controlled trials (RCTs) about TACE on perioperative safety of patients with resectable HCC were received and enrolled.Patients undergoing surgery after preoperative TACE were allocated into the case group and patients undergoing first-stage resection were allocated into the control group.Two reviewers independently screened literatures,extracted data and assessed the risk of bias.Count data were described as relative risk (RR) and 95％ confidence interval (CI).Measurement data were represented as standardized mean difference (SMD) and 95％CI.The heterogeneity of the studies was analyzed using the I2 test.Results Five RCTs were enrolled in the Meta analysis,and the total sample size was 430 cases including 212 in the case group and 218 in the control group.Results of Meta analysis showed that there was no statistically significant difference in the hemihepatic resection rate between the 2 groups (RR=0.99,95％CI:0.81～ 1.20,P＞0.05).The combined resection rate of perihepatic organs in the case group was significantly higher than that in the control group (RR=3.42,95％CI:1.91-6.12,P＜0.05).Results of subgroup analysis showed that operation time and incidence of postoperative complications of patients with an average tumor diameter ＞5 cm in the case group were respectively longer and higher than these in the control group (SMD=0.31,RR=1.65,95％CI:0.06-0.57,1.01-2.69,P＜0.05).Conclusion There is no obvious effect of preoperative TACE on resectable HCC,and it can evaluated combined resection rate of perihepatic organs,operation time and incidence of postoperative complications of patients with resectable HCC and an average tumor diameter ＞ 5 cm,and also reduce the perioperative safety.