BACKGROUND Immune cells,including neutrophils,natural killer(NK)cells,T cells,NKT cells and macrophages,participate in the progression of acute liver injury and hepatic recovery.To date,there has been no systematic st...BACKGROUND Immune cells,including neutrophils,natural killer(NK)cells,T cells,NKT cells and macrophages,participate in the progression of acute liver injury and hepatic recovery.To date,there has been no systematic study on the quantitative changes in these different immune cells from initial injury to subsequent recovery.AIM To investigate the infiltration changes of various immune cells in acute liver injury models over time,and to study the relationship between the changes in leukocyte cellderived chemotaxin 2(LECT2)and the infiltration of several immune cells.METHODS Carbon tetrachloride-and concanavalin A-induced acute liver injury models were employed to mimic toxin-induced and autoimmune-mediated liver injury respectively.The quantitative changes in various immune cells were monitored at different time points.Serum samples were collected,and liver tissues were harvested.Ly6G,CD161,CD4,CD8 and F4/80 staining were used to indicate neutrophils,NK/NKT cells,CD4^(+)T cells,CD8^(+)T cells and macrophages,respectively.Lect2-KO mice were used to detect the function of LECT2.RESULTS During the injury and repair process,different types of immune cells began to increase,reached their peaks and fell into decline at different time points.Furthermore,when the serum alanine transaminase(ALT)and aspartate transaminase(AST)indices reverted to normal levels 7 d after the injury,the infiltration of immune cells still existed even 14 d after the injury,showing an obvious lag effect.We found that the expression of LECT2 was upregulated in acute liver injury mouse models,and the liver injuries of Lect2-KO mice were less severe than those of wild-type mice.Compared with wild-type mice,Lect2-KO mice had different immune cell infiltration.CONCLUSION The recovery time of immune cells was far behind that of serum ALT and AST during the process of liver repair.LECT2 could regulate monocyte/macrophage chemotaxis and might be used as a therapeutic target for acute liver injury.展开更多
AIM:To study the clinical efficacy of traditional Chinese medicine(TCM)intervention"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"("TTK...AIM:To study the clinical efficacy of traditional Chinese medicine(TCM)intervention"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"("TTK")for treating liver failure due to chronic hepatitis B.METHODS:We designed the study as a randomized controlled clinical trial.Registration number of Chinese Clinical Trial Registry is Chi CTR-TRC-12002961.A total of 144 patients with liver failure due to infection with chronic hepatitis B virus were enrolled in this randomized controlled clinical study.Participants were randomly assigned to the following three groups:(1)a modern medicine control group(MMC group,36patients);(2)a"tonifying qi and detoxification"("TQD")group(72 patients);and(3)a"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"("TTK")group(36patients).Patients in the MMC group received general internal medicine treatment;patients in the"TQD"group were given a TCM formula"tonifying qi and detoxification"and general internal medicine treatment;patients in the"TTK"group were given a TCM formula of"TTK"and general internal medicine treatment.All participants were treated for 8 wk and then followed at 48 wk following their final treatment.The primaryefficacy end point was the patient fatality rate in each group.Measurements of various virological and biochemical indicators served as secondary endpoints.The one-way analysis of variance and the t-test were used to compare patient outcomes in the different treatment groups.RESULTS:At the 48-wk post-treatment time point,the patient fatality rates in the MMC,"TQD",and"TTK"groups were 51.61%,35.38%,and 16.67%,respectively,and the differences between groups were statistically significant(P<0.05).However,there were no significant differences in the levels of hepatitis B virus DNA or prothrombin activity among the three groups(P>0.05).Patients in the"TTK"group had significantly higher levels of serum total bilirubin compared to MMC subjects(339.40μmol/L±270.09μmol/L vs 176.13μmol/L±185.70μmol/L,P=0.014).Serum albumin levels were significantly increased in both the"TQD"group and"TTK"group as compared with the MMC group(31.30 g/L±4.77g/L,30.72 g/L±2.89 g/L vs 28.57 g/L±4.56 g/L,P<0.05).There were no significant differences in levels of alanine transaminase among the three groups(P>0.05).Safety data showed that there was one case of stomachache in the"TQD"group and one case of gastrointestinal side effect in the"TTK"group.CONCLUSION:Treatment with"TTK"improved the survival rates of patients with liver failure due to chronic hepatitis B.Additionally,liver tissue was regenerated and liver function was restored.展开更多
Umbilical hernia occurs in 20% of the patients with liver cirrhosis complicated with ascites. Due to the enormous intraabdominal pressure secondary to the ascites, umbilical hernia in these patients has a tendency to ...Umbilical hernia occurs in 20% of the patients with liver cirrhosis complicated with ascites. Due to the enormous intraabdominal pressure secondary to the ascites, umbilical hernia in these patients has a tendency to enlarge rapidly and to complicate. The treatment of umbilical hernia in these patients is a surgical challenge. Ascites control is the mainstay to reduce hernia recurrence and postoperative complications, such as wound infection, evisceration, ascites drainage, and peritonitis. Intermittent paracentesis, temporary peritoneal dialysis catheter or transjugular intrahepatic portosystemic shunt may be necessary to control ascites. Hernia repair is indicated in patients in whom medical treatment is effective in controlling ascites. Patients who have a good perspective to be transplanted within 3-6 mo, herniorrhaphy should be performed during transplantation. Hernia repair with mesh is associated with lower recurrence rate, but with higher surgical site infection when compared to hernia correction with conventional fascial suture. There is no consensus on the best abdominal wall layer in which the mesh should be placed: Onlay, sublay, or underlay. Many studies have demonstrated several advantages of the laparoscopic umbilical herniorrhaphy in cirrhotic patients compared with open surgical treatment.展开更多
AIM To investigate the effects of DNA repair synthesis induced by DNA polymerase β in hepatoma cells after γ ray irradiation. METHODS Cell nuclei were prepared from SMMC LTNM hepatoma which is a transplanted hu...AIM To investigate the effects of DNA repair synthesis induced by DNA polymerase β in hepatoma cells after γ ray irradiation. METHODS Cell nuclei were prepared from SMMC LTNM hepatoma which is a transplanted human liver cancer born on nude mice. Samples were irradiated with 60 Co γ rays at different doses or dose rates. N ethylmaleimide (NEM) and ddTTP were used as selective inhibitors to DNA polymerases. The reaction of DNA repair synthesis was carried out with the selective inhibitor test. RESULTS It was found that the 3H TTP incorporation in irradiated nuclei or calf thymus DNA was significantly higher than that in the non irradiated ones, under the conditions of DNA polymerase α or γ being inhibited. When NEM and ddTTP which selectively inhibits DNA polymerase β both existed in the DNA repair synthesis reaction mixture, the 3H TTP incorporation in irradiated DNA did not significantly increased. Furthermore, 3H TTP incorporation into DNA of SMMC LTNM hepatoma nuclei was higher than that of normal hepatocyte nuclei ( P <0 01). The DNA repair synthesis induced by DNA polymerase β reacted more fast in hepatoma nuclei than in hepatocyte nuclei. CONCLUSION The effects of DNA repair synthesis induced by DNA polymerase β in some tumor cells might be stronger than that in normal cells, which may facilitate the cells to repair DNA damages from radiation.展开更多
目的探讨局麻下无张力疝修补术治疗腹股沟疝伴肝硬化患者的疗效,总结应用经验。方法回顾性分析2007年1月-2015年12月在首都医科大学附属北京佑安医院行局麻下无张力疝修补的167例腹股沟疝伴肝硬化病例的临床资料。根据ChildPugh分级标准...目的探讨局麻下无张力疝修补术治疗腹股沟疝伴肝硬化患者的疗效,总结应用经验。方法回顾性分析2007年1月-2015年12月在首都医科大学附属北京佑安医院行局麻下无张力疝修补的167例腹股沟疝伴肝硬化病例的临床资料。根据ChildPugh分级标准,将所有病例分为Child-Pugh A/B级组和C级组,计量资料2组间比较采用t检验;计数资料2组间比较采用χ~2检验及Fisher确切概率法检验。结果所有局麻下无张力疝修补手术均顺利完成,平均手术时间为(55.22±21.67)min,术后平均住院时间为(3.14±1.86)d,术后有25例(14.97%)患者共计出现47种并发症。2组的平均术后住院时间[(2.72±1.25)d vs(4.43±3.11)d]以及术后并发症发生率(8.78%vs 63.10%)比较差异均有统计学意义(t=1.984,χ~2=2.861,P值均<0.05)。在C级组中,术前肝功能未改善者的术后并发生症发生率与改善病例差异无统计学意义(100%vs 86.7%,P>0.05),但术后住院时间差异统计学意义(6.85 d vs 3.80 d,P<0.05)。结论局麻下无张力疝修补术是一种简便易行、安全有效的治疗肝硬化并发腹股沟疝的方法,围手术期的肝功能评估与维护是保证手术实施和术后顺利恢复的重要条件。展开更多
目的介绍右半肝劈离式肝移植时采用的简化“All in one”的肝静脉重建手术方式,探讨该术式的临床适应证、操作方式和预后。方法回顾性分析2例完全右半肝劈离式肝移植的病例资料,就右半肝肝静脉采用简化“All in one”重建方式进行总结...目的介绍右半肝劈离式肝移植时采用的简化“All in one”的肝静脉重建手术方式,探讨该术式的临床适应证、操作方式和预后。方法回顾性分析2例完全右半肝劈离式肝移植的病例资料,就右半肝肝静脉采用简化“All in one”重建方式进行总结分析。2例右半肝均为在体劈离,例1采用劈离肝实质至第一、二肝门,离断右肝管后整体灌注获取,台下分割肝脏血管的方法。例2采用在体劈离时先行获取左半肝,右半肝行在体灌注后获取。2例供肝劈离时均将肝中静脉主干保留于左半肝,右半肝的S5、S8段肝静脉采用同一供者髂动脉重建,并直接吻合于下腔静脉上原肝左和肝中静脉离断后的缺口,重建了肝后下腔静脉的完整性。结果采用简化“All in one”右半肝肝静脉重建方式,2例肝移植无肝期分别为41、36 min。肝脏开放后供肝回流良好,搭桥的髂动脉血管充盈满意,无肝脏淤血肿胀等表现,术后肝功能恢复顺利。分别随访1年11个月和10个月,无肝静脉和下腔静脉等流出道相关并发症发生。结论完全右半肝劈离式肝移植时,采用“All in one”的肝静脉重建方式可以简化移植肝脏流出道重建步骤、缩短无肝期时间,减少术后肝静脉并发症的发生。展开更多
基金Supported by the National Key R&D Program of ChinaNo. 2018YFA0108200 and No. 2018YFC1106400+5 种基金the National Natural Science Foundation of ChinaNo. 31972926, No. 32000607, No. 82270645 and No. 92068206Guangdong Basic and Applied Basic Research FoundationNo. 2020A1515111111 and No. 2019A1515110145China Postdoctoral Science FoundationNo. 2019M660205
文摘BACKGROUND Immune cells,including neutrophils,natural killer(NK)cells,T cells,NKT cells and macrophages,participate in the progression of acute liver injury and hepatic recovery.To date,there has been no systematic study on the quantitative changes in these different immune cells from initial injury to subsequent recovery.AIM To investigate the infiltration changes of various immune cells in acute liver injury models over time,and to study the relationship between the changes in leukocyte cellderived chemotaxin 2(LECT2)and the infiltration of several immune cells.METHODS Carbon tetrachloride-and concanavalin A-induced acute liver injury models were employed to mimic toxin-induced and autoimmune-mediated liver injury respectively.The quantitative changes in various immune cells were monitored at different time points.Serum samples were collected,and liver tissues were harvested.Ly6G,CD161,CD4,CD8 and F4/80 staining were used to indicate neutrophils,NK/NKT cells,CD4^(+)T cells,CD8^(+)T cells and macrophages,respectively.Lect2-KO mice were used to detect the function of LECT2.RESULTS During the injury and repair process,different types of immune cells began to increase,reached their peaks and fell into decline at different time points.Furthermore,when the serum alanine transaminase(ALT)and aspartate transaminase(AST)indices reverted to normal levels 7 d after the injury,the infiltration of immune cells still existed even 14 d after the injury,showing an obvious lag effect.We found that the expression of LECT2 was upregulated in acute liver injury mouse models,and the liver injuries of Lect2-KO mice were less severe than those of wild-type mice.Compared with wild-type mice,Lect2-KO mice had different immune cell infiltration.CONCLUSION The recovery time of immune cells was far behind that of serum ALT and AST during the process of liver repair.LECT2 could regulate monocyte/macrophage chemotaxis and might be used as a therapeutic target for acute liver injury.
基金Supported by National Science and Technology Key Projects on"Major Infectious Diseases such as HIV/AIDS,Viral Hepatitis Prevention and Treatment",No.2008ZX10005-007Research Projects of Key Disease of National Traditional Chinese Medicine(Hepatopathy)Clinical Research Center(Hubei Province),No.JDZX2012054+3 种基金National Natural Science Foundation of China,No.81373513,No.90709041,No.30672590,No.30271562,No.30371787,No.81102531 and No.81274147Key Projects of Natural Science Foundation of Hubei Province,No.2011CDB463Specialized Research Fund for the Doctoral Programs in Institution of Higher Education,No.20124230110001Key Subjects of Department of Science and Technology of Wuhan City,No.201260523199
文摘AIM:To study the clinical efficacy of traditional Chinese medicine(TCM)intervention"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"("TTK")for treating liver failure due to chronic hepatitis B.METHODS:We designed the study as a randomized controlled clinical trial.Registration number of Chinese Clinical Trial Registry is Chi CTR-TRC-12002961.A total of 144 patients with liver failure due to infection with chronic hepatitis B virus were enrolled in this randomized controlled clinical study.Participants were randomly assigned to the following three groups:(1)a modern medicine control group(MMC group,36patients);(2)a"tonifying qi and detoxification"("TQD")group(72 patients);and(3)a"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"("TTK")group(36patients).Patients in the MMC group received general internal medicine treatment;patients in the"TQD"group were given a TCM formula"tonifying qi and detoxification"and general internal medicine treatment;patients in the"TTK"group were given a TCM formula of"TTK"and general internal medicine treatment.All participants were treated for 8 wk and then followed at 48 wk following their final treatment.The primaryefficacy end point was the patient fatality rate in each group.Measurements of various virological and biochemical indicators served as secondary endpoints.The one-way analysis of variance and the t-test were used to compare patient outcomes in the different treatment groups.RESULTS:At the 48-wk post-treatment time point,the patient fatality rates in the MMC,"TQD",and"TTK"groups were 51.61%,35.38%,and 16.67%,respectively,and the differences between groups were statistically significant(P<0.05).However,there were no significant differences in the levels of hepatitis B virus DNA or prothrombin activity among the three groups(P>0.05).Patients in the"TTK"group had significantly higher levels of serum total bilirubin compared to MMC subjects(339.40μmol/L±270.09μmol/L vs 176.13μmol/L±185.70μmol/L,P=0.014).Serum albumin levels were significantly increased in both the"TQD"group and"TTK"group as compared with the MMC group(31.30 g/L±4.77g/L,30.72 g/L±2.89 g/L vs 28.57 g/L±4.56 g/L,P<0.05).There were no significant differences in levels of alanine transaminase among the three groups(P>0.05).Safety data showed that there was one case of stomachache in the"TQD"group and one case of gastrointestinal side effect in the"TTK"group.CONCLUSION:Treatment with"TTK"improved the survival rates of patients with liver failure due to chronic hepatitis B.Additionally,liver tissue was regenerated and liver function was restored.
文摘Umbilical hernia occurs in 20% of the patients with liver cirrhosis complicated with ascites. Due to the enormous intraabdominal pressure secondary to the ascites, umbilical hernia in these patients has a tendency to enlarge rapidly and to complicate. The treatment of umbilical hernia in these patients is a surgical challenge. Ascites control is the mainstay to reduce hernia recurrence and postoperative complications, such as wound infection, evisceration, ascites drainage, and peritonitis. Intermittent paracentesis, temporary peritoneal dialysis catheter or transjugular intrahepatic portosystemic shunt may be necessary to control ascites. Hernia repair is indicated in patients in whom medical treatment is effective in controlling ascites. Patients who have a good perspective to be transplanted within 3-6 mo, herniorrhaphy should be performed during transplantation. Hernia repair with mesh is associated with lower recurrence rate, but with higher surgical site infection when compared to hernia correction with conventional fascial suture. There is no consensus on the best abdominal wall layer in which the mesh should be placed: Onlay, sublay, or underlay. Many studies have demonstrated several advantages of the laparoscopic umbilical herniorrhaphy in cirrhotic patients compared with open surgical treatment.
文摘AIM To investigate the effects of DNA repair synthesis induced by DNA polymerase β in hepatoma cells after γ ray irradiation. METHODS Cell nuclei were prepared from SMMC LTNM hepatoma which is a transplanted human liver cancer born on nude mice. Samples were irradiated with 60 Co γ rays at different doses or dose rates. N ethylmaleimide (NEM) and ddTTP were used as selective inhibitors to DNA polymerases. The reaction of DNA repair synthesis was carried out with the selective inhibitor test. RESULTS It was found that the 3H TTP incorporation in irradiated nuclei or calf thymus DNA was significantly higher than that in the non irradiated ones, under the conditions of DNA polymerase α or γ being inhibited. When NEM and ddTTP which selectively inhibits DNA polymerase β both existed in the DNA repair synthesis reaction mixture, the 3H TTP incorporation in irradiated DNA did not significantly increased. Furthermore, 3H TTP incorporation into DNA of SMMC LTNM hepatoma nuclei was higher than that of normal hepatocyte nuclei ( P <0 01). The DNA repair synthesis induced by DNA polymerase β reacted more fast in hepatoma nuclei than in hepatocyte nuclei. CONCLUSION The effects of DNA repair synthesis induced by DNA polymerase β in some tumor cells might be stronger than that in normal cells, which may facilitate the cells to repair DNA damages from radiation.
文摘目的探讨局麻下无张力疝修补术治疗腹股沟疝伴肝硬化患者的疗效,总结应用经验。方法回顾性分析2007年1月-2015年12月在首都医科大学附属北京佑安医院行局麻下无张力疝修补的167例腹股沟疝伴肝硬化病例的临床资料。根据ChildPugh分级标准,将所有病例分为Child-Pugh A/B级组和C级组,计量资料2组间比较采用t检验;计数资料2组间比较采用χ~2检验及Fisher确切概率法检验。结果所有局麻下无张力疝修补手术均顺利完成,平均手术时间为(55.22±21.67)min,术后平均住院时间为(3.14±1.86)d,术后有25例(14.97%)患者共计出现47种并发症。2组的平均术后住院时间[(2.72±1.25)d vs(4.43±3.11)d]以及术后并发症发生率(8.78%vs 63.10%)比较差异均有统计学意义(t=1.984,χ~2=2.861,P值均<0.05)。在C级组中,术前肝功能未改善者的术后并发生症发生率与改善病例差异无统计学意义(100%vs 86.7%,P>0.05),但术后住院时间差异统计学意义(6.85 d vs 3.80 d,P<0.05)。结论局麻下无张力疝修补术是一种简便易行、安全有效的治疗肝硬化并发腹股沟疝的方法,围手术期的肝功能评估与维护是保证手术实施和术后顺利恢复的重要条件。
文摘目的介绍右半肝劈离式肝移植时采用的简化“All in one”的肝静脉重建手术方式,探讨该术式的临床适应证、操作方式和预后。方法回顾性分析2例完全右半肝劈离式肝移植的病例资料,就右半肝肝静脉采用简化“All in one”重建方式进行总结分析。2例右半肝均为在体劈离,例1采用劈离肝实质至第一、二肝门,离断右肝管后整体灌注获取,台下分割肝脏血管的方法。例2采用在体劈离时先行获取左半肝,右半肝行在体灌注后获取。2例供肝劈离时均将肝中静脉主干保留于左半肝,右半肝的S5、S8段肝静脉采用同一供者髂动脉重建,并直接吻合于下腔静脉上原肝左和肝中静脉离断后的缺口,重建了肝后下腔静脉的完整性。结果采用简化“All in one”右半肝肝静脉重建方式,2例肝移植无肝期分别为41、36 min。肝脏开放后供肝回流良好,搭桥的髂动脉血管充盈满意,无肝脏淤血肿胀等表现,术后肝功能恢复顺利。分别随访1年11个月和10个月,无肝静脉和下腔静脉等流出道相关并发症发生。结论完全右半肝劈离式肝移植时,采用“All in one”的肝静脉重建方式可以简化移植肝脏流出道重建步骤、缩短无肝期时间,减少术后肝静脉并发症的发生。
