Renal transplantation is a standard procedure for endstage renal disease today. Due to immunosuppressive drugs and increasing survival time after renal transplantation, patients with transplanted kidneys carry an incr...Renal transplantation is a standard procedure for endstage renal disease today. Due to immunosuppressive drugs and increasing survival time after renal transplantation, patients with transplanted kidneys carry an increased risk of developing malignant tumors. In this case report, 3 patients with advanced rectal cancer after renal transplantation for renal failure were treated with anterior resection or abdominoperineal resection plus total mesorectal excision, followed by adjuvant chemotherapy. One patient eventually died of metastasized cancer 31 mo after therapy, although his organ grafts functioned well until his death. The other 2 patients were well during the 8 and 21 mo followup periods after rectal resection. We therefore strongly argue that patients with advanced rectal cancer should receive standard oncology treatment, including operation and adjuvant treatment after renal transplantation. Colorectal cancer screening in such patients appears justified.展开更多
AIM: To investigate pathological types and influential factors of chronic graft dysfunction (CGD) following liver transplantation (LT) in rats. METHODS: The whole experiment was divided into three groups: (1) Normal g...AIM: To investigate pathological types and influential factors of chronic graft dysfunction (CGD) following liver transplantation (LT) in rats. METHODS: The whole experiment was divided into three groups: (1) Normal group (n = 12): normal BN rats without any drug or operation; (2) SGT group (syngeneic transplant of BN-BN, n = 12): both donors and recipients were BN rats; and (3) AGT group (allogeneic transplant of LEW-BN, n = 12): Donors were Lewis and recipients were BN rats. In the AGT group, all recipients were subcutaneously injected by Cyclosporin A after LT. Survival time was observed for 1 year. All the dying rats were sampled, biliary tract tissues were performed bacterial culture and liver tissues for histological study. Twenty-one d after LT, 8 rats were selected randomly in each group for sampling. Blood samples from caudal veins were collected for measurements of plasma endotoxin, cytokines and metabonomic analysis, and faeces were analyzed for intestinal microflora. RESULTS: During the surgery of LT, no complications of blood vessels or bile duct happened, and all rats in each group were still alive in the next 2 wk. The long term observation revealed that a total of 8 rats in the SGT and AGT groups died of hepatic graft diseases, 5 rats in which died of chronic bile duct hyperplasia. Compared to the SGT and normal groups, survival ratio of rats significantly decreased in the AGT group (aP < 0.01, bP < 0.001, respectively). Moreover, liver necrosis, liver infection, and severe chronic bile duct hyperplasia were observed in the AGT group by H and E stain. On 21 d after LT, compared with the normal group (25.38 ± 7.09 ng/L) and SGT group (33.12 ± 10.26 ng/L), plasma endotoxin in the AGT group was remarkably increased (142.86 ± 30.85 ng/L) (both P < 0.01). Plasma tumor necrosis factor-α and interleukin-6 were also significantly elevated in the AGT group (593.6 ± 171.67 pg/mL, 323.8 ± 68.30 pg/mL) vs the normal (225.5 ± 72.07 pg/mL, 114.6 ± 36.67 pg/mL) and SGT groups (321.3 ± 88.47 pg/mL, 205.2 ± 53.06 pg/mL) (P < 0.01). Furthermore, Bacterial cultures of bile duct tissues revealed that the rats close to death from the SGT and AGT groups were strongly positive, while those from the normal group were negative. The analysis of intestinal microflora was performed. Compared to the normal group (7.98 ± 0.92, 8.90 ± 1.44) and SGT group (8.51 ± 0.46, 9.43 ± 0.69), the numbers of Enterococcus and Enterobacteria in the AGT group (8.76 ± 1.93, 10.18 ± 1.64) were significantly increased (both aP < 0.01, bP < 0.05, respectively). Meanwhile, compared to the normal group (9.62 ± 1.60, 9.93 ± 1.10) and SGT group (8.95 ± 0.04, 9.02 ± 1.14), the numbers of Bifidobacterium and Lactobacillus in the AGT group (7.83 ± 0.72, 8.87± 0.13) were remarkably reduced (both aP < 0.01, bP < 0.05, respectively). In addition, metabonomics analysis showed that metabolic profiles of plasma in rats in the AGT group were severe deviated from the normal and SGT groups. CONCLUSION: Chronic bile duct hyperplasia is a pathological type of CGD following LT in rats. The mechanism of this kind of CGD is associated with the alterations of inflammation, intestinal barrier function and microflora as well as plasma metabolic profiles.展开更多
Objective To investigate the effects of buccal acupuncture on analgesia,immune indicators,and expression levels of Survivin and Livin proteins in patients with advanced-stage primary liver cancer.Methods Eighty patien...Objective To investigate the effects of buccal acupuncture on analgesia,immune indicators,and expression levels of Survivin and Livin proteins in patients with advanced-stage primary liver cancer.Methods Eighty patients with advanced-stage primary liver cancer were selected and divided into control and treatment groups according to the difference in treatment modalities,with 40 patients in each group.The control group received transcatheter arterial chemoembolization(TACE),and the treatment group received buccal acupuncture in addition to TACE.The recent efficacy,analgesic effect,liver function,serum tumor markers,Survivin and Livin protein expression levels in liver cancer tissue,and immune indexes were analyzed and compared between the two groups.Results The objective response rate(ORR)and disease control rate(DCR)of the treatment group were 37.5%and 77.5%,respectively,which were significantly higher than those of the control group(22.5%and 52.5%),and the recent efficacy of the treatment group was significantly better than that of the control group(P<0.05).The onset of analgesia in the treatment group was significantly faster than that in the control group(P<0.05),the duration of analgesia was significantly longer than that in the control group(P<0.05),and the numeric rating scale(NRS)score of pain after treatment was significantly lower than that in the control group(P<0.05).In the treatment group,the aspartate aminotransferase(AST),alanine aminotransferase(ALT),and albumin/globulin(A/G)were significantly lower than those in the control group(P<0.05),and the serum levels of alpha-fetoprotein(AFP),alpha-L-fucosidase(AFU),and carcinoembryonic antigen(CEA)were significantly lower than those in the control group(P<0.05),and the expression levels of Survivin and Livin in liver cancer tissue were significantly lower than those in the control group(P<0.05);CD4^(+)and CD4^(+)/CD8+in the treatment group were significantly higher than those in the control group,and CD8+was significantly lower than that in the control group after treatment(P<0.05).Conclusion Buccal acupuncture can reduce the degree of pain and liver function damage in patients with advanced-stage primary liver cancer and lower the serum tumor marker levels,and its mechanism of action may be related to the down-regulation of Survivin and Livin protein expression levels in the liver cancer tissue and the regulation of the immune function.展开更多
文摘Renal transplantation is a standard procedure for endstage renal disease today. Due to immunosuppressive drugs and increasing survival time after renal transplantation, patients with transplanted kidneys carry an increased risk of developing malignant tumors. In this case report, 3 patients with advanced rectal cancer after renal transplantation for renal failure were treated with anterior resection or abdominoperineal resection plus total mesorectal excision, followed by adjuvant chemotherapy. One patient eventually died of metastasized cancer 31 mo after therapy, although his organ grafts functioned well until his death. The other 2 patients were well during the 8 and 21 mo followup periods after rectal resection. We therefore strongly argue that patients with advanced rectal cancer should receive standard oncology treatment, including operation and adjuvant treatment after renal transplantation. Colorectal cancer screening in such patients appears justified.
基金Supported by National Basic Research Program (973) of China, No. 2007CB513005, No. 2009CB522401 and No. 2009CB522406
文摘AIM: To investigate pathological types and influential factors of chronic graft dysfunction (CGD) following liver transplantation (LT) in rats. METHODS: The whole experiment was divided into three groups: (1) Normal group (n = 12): normal BN rats without any drug or operation; (2) SGT group (syngeneic transplant of BN-BN, n = 12): both donors and recipients were BN rats; and (3) AGT group (allogeneic transplant of LEW-BN, n = 12): Donors were Lewis and recipients were BN rats. In the AGT group, all recipients were subcutaneously injected by Cyclosporin A after LT. Survival time was observed for 1 year. All the dying rats were sampled, biliary tract tissues were performed bacterial culture and liver tissues for histological study. Twenty-one d after LT, 8 rats were selected randomly in each group for sampling. Blood samples from caudal veins were collected for measurements of plasma endotoxin, cytokines and metabonomic analysis, and faeces were analyzed for intestinal microflora. RESULTS: During the surgery of LT, no complications of blood vessels or bile duct happened, and all rats in each group were still alive in the next 2 wk. The long term observation revealed that a total of 8 rats in the SGT and AGT groups died of hepatic graft diseases, 5 rats in which died of chronic bile duct hyperplasia. Compared to the SGT and normal groups, survival ratio of rats significantly decreased in the AGT group (aP < 0.01, bP < 0.001, respectively). Moreover, liver necrosis, liver infection, and severe chronic bile duct hyperplasia were observed in the AGT group by H and E stain. On 21 d after LT, compared with the normal group (25.38 ± 7.09 ng/L) and SGT group (33.12 ± 10.26 ng/L), plasma endotoxin in the AGT group was remarkably increased (142.86 ± 30.85 ng/L) (both P < 0.01). Plasma tumor necrosis factor-α and interleukin-6 were also significantly elevated in the AGT group (593.6 ± 171.67 pg/mL, 323.8 ± 68.30 pg/mL) vs the normal (225.5 ± 72.07 pg/mL, 114.6 ± 36.67 pg/mL) and SGT groups (321.3 ± 88.47 pg/mL, 205.2 ± 53.06 pg/mL) (P < 0.01). Furthermore, Bacterial cultures of bile duct tissues revealed that the rats close to death from the SGT and AGT groups were strongly positive, while those from the normal group were negative. The analysis of intestinal microflora was performed. Compared to the normal group (7.98 ± 0.92, 8.90 ± 1.44) and SGT group (8.51 ± 0.46, 9.43 ± 0.69), the numbers of Enterococcus and Enterobacteria in the AGT group (8.76 ± 1.93, 10.18 ± 1.64) were significantly increased (both aP < 0.01, bP < 0.05, respectively). Meanwhile, compared to the normal group (9.62 ± 1.60, 9.93 ± 1.10) and SGT group (8.95 ± 0.04, 9.02 ± 1.14), the numbers of Bifidobacterium and Lactobacillus in the AGT group (7.83 ± 0.72, 8.87± 0.13) were remarkably reduced (both aP < 0.01, bP < 0.05, respectively). In addition, metabonomics analysis showed that metabolic profiles of plasma in rats in the AGT group were severe deviated from the normal and SGT groups. CONCLUSION: Chronic bile duct hyperplasia is a pathological type of CGD following LT in rats. The mechanism of this kind of CGD is associated with the alterations of inflammation, intestinal barrier function and microflora as well as plasma metabolic profiles.
文摘Objective To investigate the effects of buccal acupuncture on analgesia,immune indicators,and expression levels of Survivin and Livin proteins in patients with advanced-stage primary liver cancer.Methods Eighty patients with advanced-stage primary liver cancer were selected and divided into control and treatment groups according to the difference in treatment modalities,with 40 patients in each group.The control group received transcatheter arterial chemoembolization(TACE),and the treatment group received buccal acupuncture in addition to TACE.The recent efficacy,analgesic effect,liver function,serum tumor markers,Survivin and Livin protein expression levels in liver cancer tissue,and immune indexes were analyzed and compared between the two groups.Results The objective response rate(ORR)and disease control rate(DCR)of the treatment group were 37.5%and 77.5%,respectively,which were significantly higher than those of the control group(22.5%and 52.5%),and the recent efficacy of the treatment group was significantly better than that of the control group(P<0.05).The onset of analgesia in the treatment group was significantly faster than that in the control group(P<0.05),the duration of analgesia was significantly longer than that in the control group(P<0.05),and the numeric rating scale(NRS)score of pain after treatment was significantly lower than that in the control group(P<0.05).In the treatment group,the aspartate aminotransferase(AST),alanine aminotransferase(ALT),and albumin/globulin(A/G)were significantly lower than those in the control group(P<0.05),and the serum levels of alpha-fetoprotein(AFP),alpha-L-fucosidase(AFU),and carcinoembryonic antigen(CEA)were significantly lower than those in the control group(P<0.05),and the expression levels of Survivin and Livin in liver cancer tissue were significantly lower than those in the control group(P<0.05);CD4^(+)and CD4^(+)/CD8+in the treatment group were significantly higher than those in the control group,and CD8+was significantly lower than that in the control group after treatment(P<0.05).Conclusion Buccal acupuncture can reduce the degree of pain and liver function damage in patients with advanced-stage primary liver cancer and lower the serum tumor marker levels,and its mechanism of action may be related to the down-regulation of Survivin and Livin protein expression levels in the liver cancer tissue and the regulation of the immune function.
