ObjectiveTo study the relationship between expression of p27KIP1 and progression of hepatocellular carcinoma(HCC).MethodsThe expression of p27KIP1 in 52 cases of HCC was detected by immunohistochemistry of strept avidinbiotin complex and mRNA in situ hybridization.ResultsThe positive cells of p27KIP1 protein were diffused in HCC.The positive signal was localized in nuclei.The labeling index (LI) of p27KIP1 protein was significantly higher in tumorsurrounding tissues than that in tumor tissues. p27KIP1 protein LI showed a positive correlation with the differentiation grade of HCC.The better differentiation of cancer cells, the higher LI of p27KIP1 protein (P＜0.01).The positive cells of p27KIP1 mRNA were also diffused in HCC.The positive signal was localized in nuclei and cytoplasm. As to the expression of p27KIP1 at the mRNA level,there was no significant correlation with tumorsurrounding tissues and stages of HCC.Conclusionp27KIP1 protein is associated with progression and differentiation grade of hepatocellular carcinoma.
Objective To investigate the inhibitory effect and its mechanisms of TLSFJM (JM acute T leukemia cell line derived suppressor factor) on allograf t rejection of small bowel t ransplantation in rat , and to compare the effect s and complications of TLSFJM with those of FK506. Methods One hundred male Brown Norway (BN) rats and 100 Lewis(L EW) rat s were t reated as donors and recipient s of small bowel t ransplantation , respectively. Then they were divided into five groups according to the dose of administ ration of TLSFJM and/ or FK506 : small bowel transplantation group (SBT group) ; large dose of FK506 〔0. 5 mg/ ( kg ·d) 〕group ; small dose of FK506 〔0. 25 mg/ (kg ·d) 〕group ; TLSFJM 〔10 U/ ( kg ·d) 〕group ; TL SFJM 〔10 U/ ( kg ·d) 〕associated with small dose of FK506 〔0. 25 mg/ (kg ·d) 〕group. FK506 and TLSFJM were administered through int ramuscular or int raperitoneal injection , respectively. Survival time , body weight , hepatic and renal function and histopathology of recipient s in each group were observed. Results TLSFJM took no damage effect on the recipient s’renal and hepatic functions 7 days after administ ration. When TLSFJM was administ rated associated with small dose of FK506 in small bowel transplantation , it could not only effectively suppress rejection reaction , extend recipient’s survival time , but also decreased the dosage of FK506 and prevented the side effect s. But TLSFJM may not be used as immunosuppressive agent alone for the prevention and treatment of rejection in rat small bowel t ransplantation because the rejection still existed. Conclusion As an effective immunosuppression agent , TLSFJM associated with small dose of FK506 can prolong the survival time of both recipients and graf ting small bowel , relieve intensity of rejection , and prevent the side effect s when high dosage FK506 is administ rated. TLSFJM may be used as a high-efficiency , low-toxicity immunosuppresive agent in small bowel transplantation.
Objective To explore the effects of recombinant human growth hormone （rhGH） on senile patients after pancreaticoduodenectomy. MethodsFortysix patients were divided into the therapeutic group (rhGH, n=17) and control group (n=29). Both were treated with parenteral nutrition. In the therapeutic group, rhGH (8 u/d) was given hypodermically for 7 days. After operation the levels of albumin, prealbumin, transferrin, and immunoglobulin were measured. Postoperative fatigue syndrome and the average length of stay in hospital were observed too. ResultsAfter operation the levels of albumin, prealbumin, transferrin, and immunoglobulin in the therapeutic group were significantly higher than those of control group. The degree of postoperative fatigue syndrome in the therapeutic group was less than that of control group. The average length of stay in hospital was significantly shortened. Conclusion The early application of rhGH in senile patients after pancreaticoduodenectomy can enhance immune function, reduce the incidence of infection, promote the postoperative recovery, shorten the average length of stay in hospital,decrease the mortality, increase the safety of operation and improve the postoperative life quality of senile patients.
Objective To evaluate clinical efficacy of four-claw Ti-planes for internal fixation of multiple rib fractures and flail chest. Methods Clinical data of 93 patients with multiple rib fractures and flail chest who were admittedto Shanghai Pudong Hospital from December 2011 to November 2012 were retrospectively analyzed. There were 78 male and 15 female patients with their age of 20-80 years. All the patients received internal fixation of rib fractures using four-clawTi-planes. Finite element modeling and analysis were performed to investigate biomechanical behaviors of rib fractures after internal fixation with four-claw Ti-planes. Results The average number of rib fractures of the 93 patients was 5.9±2.1，and each patient received 3.8±1.3 four-claw Ti-planes for internal fixation. The operations were performed 6.3±3.2 days after admission. After the rib fractures were fixed with four-claw Ti-planes，rib dislocations and chest-wall collapse of flail chest were restored，and patients’ pain was relieved. Postoperative CT image reconstruction of the chest showed no dislocationor displacement at the fixation areas of the four-claw Ti-planes. Rib fractures were stabilized well，and normal contours of the chest were restored. Finite element analysis showed that the maximum bearable stress of the rib fractures after internal fixation with four-claw Ti-planes was twice as large as normal ribs. Conclusion Clinical outcomes of four-claw Ti-planesfor internal fixation of rib fractures are satisfactory with small incisions and less muscle injury of the chest wall，so this technique deserves wide clinical use.
ObjectivesTo explore the mechanisms by which ischmic preconditioning (IPC), ischemic postconditioning (IPO) and IPCIPO exert influence on ischemic reperfusion injury (IRI) of the graft of SD rat after pancreas transplantation. MethodsAfter the establishment of diabetic SD rats model by using streptozotocin, 24 rats suffered from pancreas transplantation and were randomly averagely divided into four groups: I/R group, IPC group, IPO group, and IPC-IPO group. Six diabetic SD rats suffered with sham operation were served as SO group. The blood glucose level of rats in each group was detected before and after reperfusion, the contents of malonaldehyde (MDA) and super oxide dismutase (SOD) of pancreas allograft were tested at 2 h after reperfusion, and the apoptosis index (AI) of pancreas allograft was monitored by using TUNEL method. ResultsThe blood glucose level of rats in each group was not significantly different (Pgt;0.05). In SO group, the blood glucose level of rats was significantly higher than other groups (Plt;0.01). The blood glucose levels of rats after reperfusion decreased from the levels before reperfusion in I/R group, IPC group, IPO group, and IPC-IPO group (Plt;0.05 or Plt;0.01), furthermore the blood glucose level of rats in I/R group was significantly higher than that in abovementioned three groups (Plt;0.01), although among which the difference was not markedly (Pgt;0.05). When compared with I/R group, the MDA contents of rats after reperfusion in IPC group, IPO group， and IPC-IPO group decreased (Plt;0.01), while the SOD contents of rats after reperfusion increased (Plt;0.01). In rats of SO group, the MDA and SOD contents were significantly higher and lower than other groups, respectively (Plt;0.01). The MDA and SOD contents in IPC group, IPO group, and IPC-IPO group were not different (Pgt;0.05). The AI of pancreas allograft at 2 h after reperfusion in I/R group 〔(47.31±4.52)%〕, IPC group 〔(26.25±3.17)%〕, IPO group 〔(24.73±3.62)%〕, and IPC-IPO group 〔(25.5±4.15)%〕 were higher than that in SO group 〔(3.16±0.53)%〕, Plt;0.01. The AI of pancreas allograft in IPC group, IPO group, and IPC-IPO group were not different (Pgt;0.05), but they were lower than that in I/R group (Plt;0.01). Pathological results showed that injury of pancreas allograft in I/R group was most severe. ConclusionsIPO and IPC are associated with comparable effectiveness to protect graft from IRI during pancreas transplantation. The combined protective effects of IPC and IPO do not appear to be additive, which is equal to IPC or IPO alone.
Objective To observe the expressions of P53 and CD34 in rectal cancer and distal mucosa and to explore the safe distal margin of radical surgery for rectal cancer at molecular pathologic level. Methods Forty-five cases of rectal cancer were marked before operation， and then the cases were detected by PET/CT. P53 and CD34 expressions in rectal tissues were detected by immunohistochemistry technique. Results P53 expression and microvessel density (MVD) in rectal cancer were significantly higher than those in distal mucosa， which in distal mucosa were decreased along the anal direction. P53 and CD34 were still found in the normal rectal tissue. P53 expression and MVD were not significantly different between in more than 1.5 cm distal rectal mucosa and in normal rectal tissue. Besides MVD was related to size of tumor in rectal cancer and distal 0.5 cm rectal mucosa tissue, P53 and CD34 in rectal cancer and distal mucosa rectal tissue were not associated with tumor diameter, stage and differentiation of rectal cancer. Conclusion From the molecular pathologic view, the resection of 2.0 cm rectal distal tissue should be safe for excision of rectal cancer.
【Abstract】ObjectiveTo discuss the technique for pancreas transplantation alone(PTA). MethodsEighty-eight SD rats were used as donors and recipients. The PTA was performed with enteric drainage（E-D group, n=22） or bladder drainage（B-D group, n=22）. The donor’s abdominal aorta(splenic artery) and portal vein(splenic vein) were anastomozed with the recipient’s abdominal aorta(end-to-side) and left renal vein(end-to-end). Blood glucose, food intake, water intake and urine volume were recorded before transplantation and on the 1st day, 3rd day, 7th day, 14th day and 30th day after transplantation. Results The mean PTA time was (33.1±11.1) min (donors) and (51.7±14.7) min(recipients). The grafts experienced no warm ischemia and the mean cold ischemia time was (46.5±17.1) min. After the successful PTA, the recipients’ blood glucose decreased on the first day after transplantation and reached normal on the third day. Their food intake, water intake and urine volume decreased and became stable 14 days later. ConclusionSuccessful PTA can restore the pancreatic endocrine function in diabetic rats. It is very important to master the technique for the operation.
目的 探讨经转化生长因子-β1 ( TGF-β1) 基因修饰的未成熟树突状细胞(imDC) 预处理大鼠小肠移植受体后的外周血及移植肠浸润T 细胞的变化及意义。方法 选用近交系F344/ N 和BN 大鼠建立全小肠异位移植模型,实验分4 组(每组24 只) : 同基因移植组(BN-BN 组) 、异基因移植组( F344/ N-BN 组) 、异基因移植+ TGF-β1 基因转染imDC 组( F344/ N-BN + TGF2β1 组) 和异基因移植+ TGF-β1 基因转染imDC + FK506 组( F344/ N-BN + TGF-β1 + FK506 组) 。各组大鼠分别于术后3 、5 、7 d 各处死6 只,获取大鼠静脉血和移植肠。应用免疫组化SABC 法检测受体鼠外周血及移植肠CD4 + 、CD8 + 、CD25 + 细胞和IL-4 的表达。同时行移植肠组织病理学检查并观察大鼠生存情况。结果 TGF-β1 修饰的DC 细胞能显著抑制外周血及移植肠浸润淋巴细胞CD4 + 、CD8 + 及CD25 + 的表达,并提高IL-4 的表达; 显著延长受体大鼠的生存时间,但移植肠仍有排斥反应的病理组织学征象。结论 TGF-β1 修饰的DC 通过影响受体外周血及移植肠浸润T 细胞对大鼠小肠移植发挥免疫抑制作用。