Objetive To summarize the mechanism and the application of the research on liver regeneration. Methods The related literatures about enteral liver regeneration in recent years were reviewed. Results Even though liver regeneration after liver resection has been widely studied, we can get better understanding from new clinical application. The process of regeneration induced liver injury rarely occurs in the normal liver. Many studies have focused on the mechanism of liver cell regeneration after liver injury. For example, the study of liver regeneration related factors and liver regenerative cells, but the specific mechanism is still not very clear. Recent techniques using the obvious progress in understanding liver regeneration are portal vein embolization and the associating liver partition and portal vein ligation for staged hepatectomy. Living donor liver transplantation is one of the most significant clinical outcomes of research on liver regeneration. Another involved in liver regeneration is the main field of stem cell therapy. Conclusion Great understanding liver regeneration should provide to the development of new treatment strategies and diagnostic procedures for various liver diseases.
Objective To explore complications of endoscopic thyroidectomy and conventional thyroidectomy and to analyze causes of them in order to reducing complications of endoscopic thyroidectomy. Methods A total of 1 112 patients with thyroid diseases from September 2008 to March 2017 in the Shanghai Tongren Hospital were collected, then were designed to endoscopic thyroidectomy group and conventional thyroidectomy group. The recurrent laryngeal nerve injury, hypoparathyroidism, postoperative bleeding, tracheoesophageal injury, poor healing of surgical wound, skin ecchymosis and subcutaneous effusion, neck discomfort, and CO2 related complications were observed. Results ① There were 582 cases in the endoscopic thyroidectomy group and 530 cases in the conventional thyroidectomy group, the baselines such as the gender, age, most diameter of tumor, diseases type, operative mode, operative time, and intraoperative bleeding had no significant differences between the endoscopic thyroidectomy group and the conventional thyroidectomy group (P>0.05). ② All the operations were performed successfully, none of patients was converted to the open operation. The rates of the recurrent laryngeal nerve injury, hypoparathyroidism, postoperative bleeding, and tracheoesophageal injury had no significant differences in these two groups (P>0.05). The rates of the poor healing of surgical wound and neck discomfort were significantly lower and the rate of the skin ecchymosis and subcutaneous effusion was significantly higher in the endoscopic thyroidectomy group as compared with the conventional thyroidectomy group (P<0.05). There were 32 cases of CO2 related complications in the endoscopic thyroidectomy group. Conclusion Results of this study show that endoscopic thyroidectomy is safe for thyroid diseases, it’s complications could be reduced by improving operation technique.
With the implementation of “Good Clinical Practice”, the quality of clinical trials in China has increased constantly and more importance has been attached to the protection of the subject. Large scale clinical trials are primarily featured by long-term intervention, large sample size, many participant organizations, different levels of investigators, long test periods, and lots of adverse events. Consequently, the protection of subject is full of extensive complexities and difficulties and currently there is little experience to refer to. Hence, the article introduces the subject’s protection method adopted in the National Program Subject of Secondary Prevention Clinical Trial about Effect of Qi Shen Tonifying Qi on Myocardial Infarction (MISPS-TCM).
ObjectiveTo investigate the expression of Lgr5 protein in regeneration tissue of remnant liver after associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and its significance.MethodsA total of 120 male SD rats (200–240 g) were randomly equally divided into sham operation (SO) group, portal vein ligation (PVL) group, and ALPPS group using random number table method. The liver regeneration rate (LRR), liver function (AST and ALT), and the expressions of Ki-67 and Lgr5 in the right middle lobe of the liver were observed at day 1, 2, 4, and 7 after surgery.ResultsCompared with SO group, the LRRs and the Ki-67 protein expression positive rates and Lgr5 related protein expression levels in the right middle lobe of liver tissue were increased in the PVL group and ALPPS group at day 1, 2, and 4 after surgery (P<0.05), and the LRR was still increased at day 7 after surgery (P<0.05). The LRRs at day 4 and 7 after surgery in the ALPPS group were higher than those in the PVL group (P<0.05), the Ki-67 protein expression positive rates and Lgr5 related protein expression levels at day 2 and 4 after surgery in the ALPPS group were higher than those in the PVL group (P<0.05). The AST and ALT levels at day 1 and 2 after surgery in the ALPPS group and PVL group were higher than those in the SO group (P<0.05), which at day 1 after surgery in the ALPPS group were higher than those in the PVL group (P<0.05), but which returned to normal on day 4 after surgery.ConclusionsALPPS could promote liver regeneration better. Lgr5 is closely related to liver regeneration after ALPPS. Liver stem cells might be involved in liver regeneration after ALPPS.