Objective To investigate the protective effect of ischemic preconditioning (IP) on ischemicreperfusion injury of rat liver graft. MethodsMale Sprague Dawley rats were used as donors and recipients of orthotopic liver transplantation,the period of cold preservation and anhepatic phase were 100 min and 25 min respectively.Sixtyfour rats were randomly divided into 2 groups (n=32),control group: donor livers were flushed through the portal veins with physiological saline solution containing heparin only before harvested; IP group: before donor livers were harvested,the portal veins and hepatic arteries of them were interrupted for 10 min,and reflow was initiated for another 10 min,then did as control group.One half of each group were used to investigate 1 week survival rate of recipients,and another half of each group were used to take sample of blood and hepatic tissue after 2 hours of reperfusion of liver graft. ResultsOne week survival rate,amount of bile,serum NO and activity of antioxidase were higher in IP group than those in control group(P＜0.05),meanwhile,serum ALT,AST,LDH,TNF and superoxide in hepatic tissue were lower in IP group than those in control group (P＜0.05),and histological findings in IP group showed less injury than those in control group. Conclusion IP could increase production of serum NO,reduce the level of serum TNF and protect rat liver graft from ischemicreperfusion injury.
Cholangiocarcinoma; Vascular endothelial growth factor; c-myc gene
ObjectiveTo investigate target gene therapy for hepatocellular carcinoma (HCC). MethodsHerpes simplex virus thymidine kinase (HSVTK) gene was inserted into the gene of AFP enhancer/ALB promoter with adenoassociated virus (AAV) plasmid (WAV2) as a carrier, and a hybrid plasmid pWAV2/AFPALB/HYTK was constructed. Besides, plasmid pEGFP1/AFPALB was also constructed. Two kinds of plasmids were transferred into AFP positive cells HepG2 and AFP negative cells 7721, SPC and 7901.ResultsIt was found that enhance green fluorescence protein could only be seen in AFP positive cells HepG2. 710 bp DNA was amplified only in AFP positive HepG2 cells.ConclusionPlasmid pWAV2/AFPALB/HYTK for HCC demonstrates specificity in vitro.
Objective To study the expression and significance of multidrug resistance-associated protein (MRP) gene in hepatocellular carcinoma (HCC). Methods Reverse transcription polymerase chain reaction (RT-PCR) assay was used to detect the expression of MRP mRNA in 25 fresh specimens of the primary HCC and its surrounding liver tissues. Immunohistochemistry LSAB technique was adopted to test MRP in 60 HCC specimens. The drug sensitivity was also tested by flow cytometry.Results The positive expression rates of MRP mRNA and MRP protein in primary HCC were 44.00%(11/25) and 45.00%(27/60) respectively. All the intensity of expression was low, but significant higer than its surrouding liver tissues (P＜0.05). The intensity and expression rate of MRP protein in 5 recurrent HCC had a tendency to increase. There was a correlation between the expression of MRP mRNA and MRP protein in 25 patients using RT-PCR and immunohistochemistry assay (Plt;0.05). Detected by flow cytometry, the average sensitivity of drugs in vitro of 60 HCC sp-cimens were 5-FU （15.80±7.63）%，DDP（18.45±9.59）%，ADM（17.95±7.99）%，MMC（16.60±8.69）% and CTX（17.40±10.14）%. Only 5FU and ADM were significantly affected by the expression of MRP protein (Plt;0.05).Conclusion The expression of MRP in primary HCC may be one of the important mechanisms of the intrinsic and acquired drug resistance in HCC. To study the expression of MRP could give a predictive value in HCC chemotherapy.
Objective To explore and establish a more precise and reasonable classification method which is suitable for clinical treatment and scientific research of SARS patients. Methods ① Establishing a computerized classification method: Analyzing the relationship between variable items on the front page of medical records and severity of disease; Identifying the variable items related to patient’s condition by stepwise identification analysis; Creating a function equation and computerized classification system. ② Comparing and analyzing the difference between computerized and clinical classifications regarding to the general condition of patients, clinical manifestations, laboratorial test results, prognosis, period of hospitalization and medical expenditure, etc. Results ① Clinical classification: general cases 642 (94.41%), critical cases 38 (5.59%); Computerized classification: type A 436 (64.12%), type C 237 (34.85%), type D 7 (1.03%), no type B. ② There were statistical significance among groups between two classifications regarding the items of general condition (age, cure rate, mortality and average length of hospitalization), total protein , Alb, BUN and medical expenditure. ③ Comparative analysis of the two classifications: 99.77% of type A cases (general type) by computerized classification were general cases by clinical classification; 97.36% of critical cases by clinical classification were type Camp;D by computerized classification. Conclusions The results are conformity between two classifications and the differences are analogical among thegroups. The statistical difference is significant between general and critical cases with the number of critical cases by computerized classification 6.42 times more than that by clinical classification; Compared with clinical classification, computerized classification has advantages that there is significant difference between the groups while no difference within the groups. With more critical cases and more objective and logic results, the compauterized classification is suitable for study and application in the fields of health service quality management, health economy management and pharmaceutical economics, etc.
Objective This study analyzed the medical expenditure and its influential factors, and compared the clinical effectiveness and medical expenditure of three major drugs. Methods We designed the cohort study to compare the difference of medical and pharmaceutical expenditures between patients with and without underlying diseases. Multi-linear regression was applied to analyze the influential factors. Incremental expenditure-effectiveness ratio was applied to study three clinically important drugs. Results The curing rate of non-critical patients was statistically significant than critical patients (73.68%, 99.38%, P=0.000) .The curing rate of non-critical patients without underlying diseases was statistically significant than those with underlying diseases in the cohort (96%, 99.66%, P=0.001 6). No significance was identified in the critical patients cohort. The medical expenditure of non-critical patients with and without underlying diseases were 7 879.22 and 7 172.23 RMB per capita, respectively. Accordingly, the medical expenditure in critical patients was 24 912.89 and 26 433.53 RMB per capita. No significance was identified in the two cohorts. Medical expenditure was positively correlated with age and disease severity, with its equation y=4585.71+79.04X1+17188.87X2 (X1: age, X2: disease severity). Regarding the clinical effectiveness and medical expenditure, no significance was identified in critical patients who administered small and medium dose of Methylprednisolone. The expenditure-effectiveness ratios of Ribavirin that was administered by non-critical patients without underlying dissuades were 6 107 and 4 225 RMB, respectively. Accordingly, the expenditure-effectiveness ratios of Thymosin were 11 651 and 6 107 RMB. Conclusions The curing rate of non-critical patients without underlying diseases was higher than the counterpart in the cohort. No influence of underlying diseases was found in the critical patient cohort. Medical expenditure was positively correlated with age and disease severity. Small-and-medium dose of Methylprednisolone might not influence the curing rate and medical expenditure in critical patients. The effectiveness of Thymosin for non-critical patients with and without underlying diseases was not significantly different. However, additional 5 877 RMB occurred if Thymosin was administrated. Likewise, the effectiveness of Ribavirin for non-critical patients remains the same. However, additional 1 082 RMB was consumed in Ribavirin-administrated patient.
Objective To summarize primary clinical data from Xiao Tang Shan Hospital (XTSH) Information System, to provide evidence for clinical data of emerging diseases. Method The primary data were extracted from XTSH information system, which related to demographic and background information, case history, prescriptions, laboratory tests, physical examination, vital sign, surgery, diagnostics and expenditures. The software for data verification was developed by Delphi language program. The information of SARS management was developed by Oracle Developer. Results XTSH information system for SARS management collected 1.09 million pieces of information covering 680 SARS cases. The database was functionally divided into inquiry window, conditional case list window and case details spread window, which provided information of SARS management and shaped a platform for further investigation. Quality control of clinical data was done by the software of SARS Information Real Control.Conclusions XTSH information system collected complete data of SARS management, which made healthcare, research and policy-making on SARS accessible, and made it possible to share resources and train the professionals.