ObjectiveTo assess the effectiveness of hemihepatic vascular occlusion (HHO) and total hepatic inflow occlusion (THO) which were applied in the liver resection. MethodsRandomized controlled trials (RCTs) comparing HHO and THO in hepatectomy were electro-nically searched from CENTRAL (Issue 1, 2013), PubMed, EMbase, CBM, CNKI and Digital Journals of Chinese Medical System. The English or Chinese version of relevant published and unpublished data and their references were also retrieved by hand. The last retrieval date was in May 2013. The data were extracted and the quality was evaluated by two reviewers independently, and then RevMan 5.2 software was used for data analysis. ResultsTen RCTs involving 788 patients were finally included. The results of meta-analysis showed that, HHO reduced the levels of aspartate transaminase (AST) (WMD=-235.84, 95%CI-411.28 to-60.40, P=0.008) and alanine aminotransferase (ALT) (WMD=-195.52, 95%CI-351.87 to-39.16, P=0.01) in 1 day postoperatively. HHO also shortened the recovery time of AST (WMD=-3.83, 95%CI-4.52 to-3.15, P < 0.000 01) and ALT (WMD=-4.29, 95%CI-5.75 to-2.84, P < 0.000 01) postoperatively, and shortened the recovery time of gastrointestinal function (WMD=-1.52, 95%CI-2.75 to-0.29, P=0.02). However, HHO was the same as THO in intraoperative haemorrhage and postoperative transfusion and hospital stay. ConclusionHHO applied in liver resection could relieve the damage of liver function, and shorten the recovery time of gastrointestinal function postoperatively. Due to the poor quality of the included studies, more high quality RCTs with longer follow-up are required to further verify the aforementioned conclusion.
ObjectiveTo observe effect of echinococcus cyst fluid on proliferation and cell cycle progression of rat hepatic stellate cells (HSC-T6), and to preliminarily reveal a new mechanisms of pro-fibrogenic effect of alveolar echinococcosis. MethodsHSC-T6 cells were treated with different concentrations (0.00-0.90 mg/mL) of echinococcus cyst fluid. Then, the morphological changes were observed under the inverted microscope, the impacts on proliferation and cell cycle were tested by the CCK-8 assay and flow cytometry respectively. ResultsAfter treated by echinococcus cyst fluids with different concentrations (0.00-0.90 mg/mL) for 24 h, the most cells shrinked fusiform shape with more slender synapses, and the proliferation activities were increased with the concentration of echinococcus cyst fluid increasing when it was higher than 0.05 mg/mL (P<0.05), the proportion of G0/G1 was decreased (P<0.05) and those of S and G2/M were increased (P<0.05) with the concentration of echinococcus cyst fluid increasing. ConclusionsEchinococcus cyst fluid could promote proliferation of HSC-T6 cells in a dose-dependent manner, which might due to its impact on cell cycle progression. Therefore, alveolar echinococcosis might promote hepatic fibrosis through regulating hepatic stellate cells, but further research on detail needs to be done in future.
ObjectiveTo summarize clinical treatments of hepatic alveolar echinococcosis in recent years and provide a new basis for guiding clinical practice. MethodsThe relevant literatures about treating hepatic alveolar echinococcosis at home and abroad were reviewed. The clinical curative effect and advantages or disadvantages among various treatments were analyzed. ResultsThe radical surgery was still the primary treatment of hepatic alveolar echinococcosis, liver transplantation was more used in the treatment of the late hepatic alveolar echinococcosis. surgery combined with chemical therapy had an obvously clinical curative effect. ConclusionsWith a high incidence and poor prognosis of hepatic alveolar echinococcosis, it is difficult to cure. Radical surgery, liver transplantation, chemotherapy and radiation therapy have been used in clinical treatment of hepatic alveolar echinococcosis. It is essential to fully acknowledge indications of various treatments. At the same time, if occurrence and development of this disease could be further researched, it might bring us a new hope of curing hepatic alveolar echinococcosis.
The high incidence of hydatid disease in seven northwestern provinces, is one of the reason of "Poverty due to illness, and return poverty due to illness" in China. The incidence of chest hydatid disease in China after hepatic hydatid disease ranks second. Department of thoracic surgery in the First Affiliated Hospital of Xinjiang Medical University is on the domestic leading position of the treatment of chest hydatid disease. Since 1956 the first case of pulmonary hydatid cyst were completed, we have successfully finished the surgical treatment of pediatric chest hydatid disease, chest hydatid disease complex, huge pulmonary hydatid cyst, mediastinal and pleural hydatid cyst, and rib hydatid in our department. To further standardize the treatment of chest hydatid disease, a special formulation of "technical specification for chest hydatid disease diagnosis expert consensus" by our department were produced, in order to help clinicians treat chest hydatid disease by more suitable strategies. This consensus was released in July 2015, for the original version. The definition, diagnosis, treatment principle, and prevention of chest hydatid disease were elaborated and clinical experiences of 60 years were combined with in this consensus, in order to help the clinicians for diagnosis, treatment, and prevention of hydatid disease.
ObjectiveTo investigate the expressions of type Ⅰ and type Ⅲ collagen protein in hepatic alveolar echinococcosis tissues, and to explore its relationship with the biological behavior in progress of hepatic alveolar echinococcosis (HAE). MethodsTwenty samples of normal liver tissues and liver tissues at the edge of the lesion with HAE in our hospital from Jan. 2012 to Dec. 2014 were collected, and HE and Masson staining were performed. The pathological changes and the degree of fibrosis of liver tissues around HAE lesion were observed under light microscope. The expressions of type Ⅰ and type Ⅲ collagen protein in liver tissues were detected by immunohistochemical staining. ResultsThe degree of liver fibrosis of liver tissues at the edge of the lesion with HAE was grade Ⅱ, and the degree of fibrosis of normal liver tissues was grade 0, the difference between the two was statistically significant (P < 0.05). The color index of type Ⅰand type Ⅲ collagen protein in the liver tissues at the edge of the lesion with HAE was 7.45±1.85 and 8.00±1.62, respectively, which were higher than those of normal liver tissues (3.10±1.02 and 3.50±0.89), the difference were statistically significant (t=-9.21, P=0.001;t=-10.88, P=0.001). ConclusionsThere is liver fibrosis around the lesion in the patients with HAE. HAE may promote the expressions of type Ⅰ and type Ⅲ collagen and then induce the occurrence of liver fibrosis.