【Abstract】 Objective To investigate the expression and significance of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) receptors in pancreatic cancer. Methods Thirty-two samples of pancreatic cancer tissue were collected from year 2002 to 2004. All of them were verified by histopathology and there were 9 cases of well-differentiated, 12 of moderately differentiated, and 11 of poorly differentiated, in which 12 cases were in the stage of Ⅰor Ⅱand 20 in the stage of Ⅲ or Ⅳ according to the TNM staging method. Eighteen normal pancreatic tissues were used as control group. The expressions of TRAIL receptors (death receptor 4, death receptor 5, decoy receptor 4 and decoy receptor 5) mRNA were assayed by semi-quantitive reverse transcription polymerase chain reaction (RT-PCR) in the pancreatic cancer tissues and the normal pancreatic tissues. Results The expressions of death receptor 4 (DR4) and death receptor 5 (DR5) were detected in all the pancreatic cancer tissues and the normal pancreatic tissues and the levels of DR4 and DR5 were significantly higher than those of the normal pancreatic tissues (P＜0.01). Decoy receptor 1 (DcR1) and decoy receptor 2 (DcR2) were also expressed in normal pancreatic tissues, whereas DcR1 and DcR2 were only expressed in 18 and 20 pancreatic cancer tissues, respectively. However, there were no significant difference of the expression of DcR1 and DcR2 between the pancreatic cancer tissues and the normal pancreatic tissues （Pgt;0.05）. The expression level of DR5 in pancreatic cancer tissue was correlated with tumor differentiation and clinical stage, and the levels in stage Ⅲ and stage Ⅳwere significantly lower than those of stageⅠand stageⅡ(P＜0.05). The expressions of DR4, DcR1 and DcR2 were not correlated with tumor differentiation and clinical stage (Pgt;0.05). Conclusion ①The expression of TRAIL receptors in pancreatic cancer tissues is prevalent, but the types of receptors expressed in different tissues were also different. High expression of death receptors may play an important role in TRAIL recptors regulated pancreatic cancer apoptosis. ②The expression of DR5 is correlated with the differentiation degree of pancreatic cancer cell and clinical stage of tumor. The expressions of DR4, DcR1 and DcR2 should not be considered as related indexes of differentiation degree or clinical stage of pancreatic cancer.
Objective To investigate the effect of ABO-incompatible liver transplantation on patients with acute hepatic failure. Methods A retrospective review was undertaken on the clinical data of 3 cases （1 case of Budd-Chiari syndrome, 1 case of liver cancer and 1 case of severe hepatitis B were included） undergoing ABO-incompatible liver transplantation for acute hepatic failure. The patients were given quadruple immunosuppression after operation. Results Postoperative complications including pulmonary infection, central pontine myelionlysis and acute rejection was suffered from by the patient of Budd-Chiari syndrome who was then given a positive deal and had survived for more than 14 months. The patient of liver cancer was aggravated by severe infection who died of multiple organ failure on day 13 after operation. The patient with severe hepatitis B was made more severe by acute renal failure whose kidney function was restored with continuous renal replacement therapy. Conclusion The outcome of ABO-incompatible liver transplantation can be improved with refined peri-transplant management and better immunosuppressive strategies. ABO-incompatible liver transplantation should be viewed as an important option in patients with acute hepatic failure awaiting an emergency procedure.