简介：Livertransplantation（LT）isalife-savingtreatmentforpatientswithend-stageliverdiseaseandforpatientswithlivercellcancerrelatedtoliverdisease.Acuteandchronicliverdiseasesrelatedtohepatitisvirusesarebetweenthemainindicationsforlivertransplantation.Theriskofviralreinfectionaftertransplantationisthemainlimitingfactorintheseindications.Beforetheavailabilityofantiviralprophylaxis,hepatitisBvirus（HBV）recurrencewasuniversalinpatientswhowereHBVDNA-positivebeforetransplantation.ThenaturalhistoryofrecurrentHBVwasacceleratedbyimmunosuppression,anditprogressedrapidlytograftfailureanddeath.Introductionofpost-transplantprophylaxiswithimmunoglobulinalonefirst,andassociatedtoantiviraldrugslater,drasticallyreducedHBVrecurrence,resultinginexcellentlong-termoutcomes.Onthecontrary,recurrenceofhepatitisCisthemaincauseofgraftlossinmosttransplantprograms.Overall,patientandgraftsurvivalafterLTforhepatitisCvirus（HCV）-associatedcirrhosisisinferiorcomparedwithotherindications.However,successfulpretransplantorposttransplantantiviraltherapyhasbeenassociatedwithincreasedgraftandoverallsurvival.Untilrecently,thecombinationofpegylatedinterferonandribavirinwasthestandardofcareforthetreatmentofpatientswithchronichepatitisC.Highlyactiveantiviralcompoundshavebeendevelopedoverthepastdecade,thankstonewinvitrosystemstostudyHCVentry,replication,assembly,andrelease.

简介：Alcoholicliverdiseaseisanestablished,yetcontroversial,indicationforlivertransplantation.Althoughanabstinenceperiodofupto6mopriortotransplantationismandatory,alcoholrelapseaftertransplantationisacommonevent.Incaseofrecurrenceofheavydrinking,graftsurvivalissignificantlyimpaired.Guidelinesondetectionandsurveillanceofalcoholconsumptioninthispatientcohortarelacking.Thisreviewsummarizesthechallengeofpatientselectionaswellasthecurrentknowledgeonestablishedandnovelalcoholbiomarkerswithspecialfocusonlivertransplantcandidatesandrecipients.

简介：Recentfindingsinthepathophysiologyandmonitoringofhemostasisinpatientswithendstageliverdiseasehavemajorimpactoncoagulationmanagementduringlivertransplantation.Thereisincreasingevidence,thatthechangesinbothcoagulationfactorsandplateletcountregularlyobservedinpatientswithlivercirrhosiscannotbeinterpretedasareliableindicatorofdiffusebleedingrisk.Instead,adifferentiatedviewonhemostasishasledtotheconceptofarebalancedcoagulationsystemWhileitisimportanttorecognizethatprocoagulantfactorsarereducedinlivercirrhosis,itisalsoevidentthatsynthesisofanticoagulantfactorsandfibrinolyticproteinsproducedintheliverisalsodiminished.Similarly,thedecreasedplateletcountmaybecounterbalancedbyincreasedplateletaggregabilitycausedbyhighlyactivevonWillebrandmultimeres.Thecoagulationsystemisthereforstatedtoberebalanced.Whileundernormal＂unstressed＂conditionsdiffusebleedingisrarelyobserved,howeverbothdiffusebleedingorthrombusformationmayoccurwhencompensationmechanismsareexhausted.Whilemostpatientspresentingforlivertransplantationhaveseverecirrhosis,liverfunctionandthusproductionofpro-andanticoagulantfactorscanbepreservedespeciallyincholestaticliverdisease.Duringlivertransplantation,profoundchangesinthehemostasissystemcanoccur.Surgicalbleedingcanleadtodiffusebleedingascoagulationfactorsandplateletsarealreadyreduced.Ischemiaandtissuetraumacanleadtoalterationsofhemostasiscomparabletotraumainducedcoagulopathy.Afurthercommondisturbanceoftenstartingwiththereperfusionofthetransplantedorganishyperfibrinolysiswhichcaneventuallyprecipitatecompleteconsumptionoffibrinogenandanendogenousheparinizationbyglycocalyxshedding.Moreover,thromboticeventsinlivertransplantationsarenotuncommonandcontributetoincreasedmortality.Besidesconventionallaboratorymethods,bed-sidemonitoringofhemostasis（e.g.,thrombelastography,thrombe

简介：Primarysclerosingcholangitis（PSC）isachronicprogressiveinflammatorydiseaseaffectingthebileducts,leadingtofibrosisandeventuallycirrhosisinmostpatients.Itsetiologyisunknownandsofarnoeffectivemedicaltherapyisavailable.Livertransplantation（LTX）istheonlycurativetreatmentandatpresentPSCisthemainindicationforLTXintheScandinaviancountries.ClosetohalfofthePSCpatientsexperienceoneormoreepisodesofacutecellularrejection（ACR）followingtransplantationandapproximately1/5ofthetransplantedpatientsdeveloprecurrentdiseaseinthegraft.Inaddition,somereportsindicatethatACRearlyafterLTXforPSCcaninfluencetheriskforrecurrentdisease.Fortheseimportantpost-transplantationentitiesaffectingPSCpatients,wehavereviewedthecurrentliteratureonepidemiology,pathogenesis,treatmentandthepossibleinfluenceofrejectionontheriskofrecurrentdiseaseintheallograft.

简介：Neuroendocrinetumors(NET)areaheterogeneousgroupofcancers,withindolentbehavior.Themostcommonprimaryoriginisthegastro-intestinaltractbutcanalsoappearinthelungs,kidneys,adrenals,ovariesandotherorgans.Ingeneral,NETisusuallydiscoveredinthemetastaticphase(40%-80%).Theliveristhemostcommonorganinvolvedwhenmetastasesoccur(40%-93%),followedbybone(12%-20%)andlung(8%-10%).Anumberofdifferenttherapeuticoptionsareavailableforthetreatmentofhepaticmetastasesincludingsurgicalresection,transplantation,ablation,trans-arterialchemoembolization,chemotherapyandsomatostatinanalogues.Recently,moleculartargetedtherapieshavebeenused,usuallyincombinationwithothertreatmentoptions,toimproveoutcomesinpatientswithmetastases.ThisarticleemphasizesontheroleofsurgeryinthetreatmentoflivermetastasesfromNET.

简介：Onetosixpercentofpatientswithmicroscopiccolitisarerefractorytomedicaltreatment.Theeffectoffaecalmicrobiotatransplantation(FMT)inactivecollagenouscolitis(CC)has,tothebestofourknowledge,neverbeenreportedbefore.Here,wereporttheeffectofrepeatedFMTinapatientwithCC.Thepatientpresentedwithseveresymptomsincludingprofusediarrheaandprofoundweightloss.Althoughsherespondedtobudesonideinthebeginning,shebecamegraduallyrefractorytomedicaltreatment,andwasthereforetreatedwithFMT.Thepatientremainedinremissionfor11moafterthethirdfaecaltransplantation.Theimmunomodulatoryeffectofthetherapywasevaluatedusingflowcytometry,whichshowedalterationsintheprofileofintraepithelialandlaminaproprialymphocytesubsetsafterthesecondtransplantation.OurobservationsindicatethatFMTcanhaveaneffectinCC,whichsupportthehypothesisthatluminalfactors,influencingtheintestinalmicrobiota,areinvolvedinthepathogenesisofCC.

简介：瞄准：调查怎么在老鼠orthotopic肝移植减少胆汁的复杂并发症的发生。方法：165只男Wistar老鼠的一个总数随机被划分成三个组：组A，有修改二手铐的技术的orthotropic肝移植；组B，没有移植，胆汁管被切并且重建；并且组织C，仅仅剖腹术被执行。基于为胆汁的重建使用的途径，组A被划分成二亚群:A1(n=30)，管管重建，和A2(n=30)，管十二指肠重建。在胆汁管复杂并发症上学习动脉重建的影响，组B被划分成四亚群：B1(n=10)，有肝的动脉结扎的管管重建，B2(n=10)，没有肝的动脉结扎的管管重建，B3(n=10)，有肝的动脉结扎的管十二指肠重建，和B4(n=10)，没有肝的动脉结扎的管十二指肠重建。样品被收获在操作以后或在重要胆汁的复杂并发症被发现的时间的14d。结果：在组A，anhepatic阶段是13.7??€?‥吗？？

简介：

简介：Thisreviewaimsatevaluatingtheexistingevidenceregardingpostreperfusionsyndrome,providingadescriptionofthepathophysiologicmechanismsinvolvedandpossiblemanagementandpreventivestrategies.APubMedsearchwasconductedusingtheMeSHdatabase,＂Reperfusion＂AND＂livertransplantation＂werethecombinedMeSHheadings;EMBASEandtheCochranelibrarywerealsosearchedusingthesameterms.52relevantstudiesandoneongoingtrialwerefound.Theconceptofpostreperfusionsyndromehasevolvedthroughyearstoamultisystemicdisorder.Theimplicationsofthemainorgan,recipientandprocedurerelatedfactorsinthegenesisofthiscomplexsyndromearediscussedinthetextasthenovelpharmacologicandtechnicalapproachestoreduceitsincidence.Howevertheavailableevidenceaboutriskfactors,physiopathologyandpreventivemeasuresisstillconfusing,thepresenceoftwomaindefinitionsandthenumerosityofpossibleconfoundingfactorsgreatlycomplicatestheinterpretationofthestudies.

简介：Enterovesicalfistulasarenotuncommoninpatientswithinflammatoryormalignantcolonicdisease,however,fistulassecondarytoprimarybladdercarcinomasareextremelyrare.Wehereinreportedapatientpresentingwithintractableurinarytractinfectionduetoenterovesicalfistulaformationcausedbyasquamouscellcarcinomaoftheurinarybladder.Thispatientunderwentenblocresectionofthebladderdomeandinvolvedileum,andrecovereduneventfullywithouturinarycomplaint.Tothebestofourknowledge,thisisthefirstcasereportedintheliterature.

简介：AIM:Heatshockprotein(HSP)70isover-expressedinhumangastriccancerandplaysanimportantroleintheprogressionofthiscancer.WeinvestigatedtheeffectsofantisenseHSP70oligomeronhumangastriccancercelllineSGC-7901,anditspotentialroleingenetherapyforthiscancer.METHODS:HumangastriccancercelllineSGC-7901wastreatedinvitrowithvariousconcentrationsofantisenseHSP70oligonucleotidesatdifferentintervals.Growthinhibitionwasdeterminedaspercentagebytrypanbluedyeexclusiontest.ExtractedDNAwaselectrophoresedonagarosegel,anddistributionofcellcycleandkineticsofapoptosisinductionwereanalyzedbypropidiumiodideDNAincorporationusingflowcytometry,whichwasalsousedtodetecttheeffectsofantisenseoligomerpretreatmentonthesubsequentapoptosisinducedbyheatshockinSGC-7901cells.ProteinswereextractedforsimultaneousmeasurementofHSP70expressionlevelbySDS-PAGEWesternblotting.RESULTS:Thenumberofviablecellsdecreasedinadoseandtime-dependentmanner,andladder-likepatternsofDNAfragmentswereobservedinSGC-7901cellstreatedwithantisenseHSP70oligomersataconcentrationof10μmol/Lfor48hor8μmol/Lfor72h,whichwereconsistentwithinter-nucleosomalDNAfragmentation.Flowcytometricanalysisshowedadose-andtime-dependentincreaseinapoptoticratebyHSP70antisenseoligomers.ThisresponsewasaccompaniedwithadecreaseinthepercentageofcellsintheG1andSphasesofthecellcycle,suggestinginhibitionofcellproliferation.Inaddition,flowcytometryalsoshowedthatpretreatmentofSGC-7901cellswithHSP70antisenseoligomersenhancedthesubsequentapoptosisinducedbyheatshocktreatment.WesternblottingdemonstratedthatHSP70antisenseoligomersinhibitedHSP70expression,whichprecededapoptosis,andHSP70wasundetectableattheconcentrationof10μmol/Lfor48hor8μmol/Lfor72h.CONCLUSION:AntisenseHSP70oligomerscanabrogateHSP70expressioninSGC-7901cells,wh

简介：AIM:ToinvestigatehowweightgainafterOLTaffectsthespeedoffibrosisprogression(SFP)duringrecurrenthepatitisCvirus(HCV)infectionofthegraft.METHODS:Ninetyconsecutivepatients(63males,medianage53years;55withHCV-relatedliverdisease),transplantedatasingleinstitution,werestudied.Allwerefollowedforatleast2yearsafterOLTandhadatleastonefollow-upgraftbiopsy,performednotearlierthan1yearafterthetransplantoperation.Foreachbiopsy,asingle,experiencedpathologistgaveanestimateofboththestagingaccordingtoIshakandthedegreeofhepaticsteatosis.TheSFPwasquantifiedinfibrosisunits/month(FU/mo).Thelipidmetabolismstatusofpatientswassummarizedbytheplasmatriglycerides/cholesterol(T/C)ratio.Bodymassindex(BMI)wasmeasuredbeforeOLT,and1and2yearsafterit.RESULTS:IntheHCVpositivegroup,thehighestSFPwasobservedinthefirstpost-OLTyear.Atthattimepoint,aSFP≤0.100FU/mowasobservedmorefrequentlyamongrecipientswhohadreceivedtheirgraftfromayoungdonorandhadapre-transplantBMIvalue＞26.0kg/m2.Atcompletionofthefirstpost-transplantyear,aBMIvalue＞26.5kg/m2wasassociatedwithaT/Cratio≤1.TheproportionofpatientswithSFP＞0.100FU/modescendedinthefollowingorder:femalerecipientswithahighT/Cratio,malerecipientswithhighT/Cratio,andrecipientsofeithergenderwithlowT/Cratio.Hepaticsteatosiswasobservedmorefrequentlyinrecipientswho,inthefirstpost-transplantyear,hadincreasedtheirBMI≥1.5kg/m2incomparisontothepre-transplantvalue.Hepaticsteatosiswasinverselyassociatedwiththestagingscore.CONCLUSION:AmongHCVpositiverecipients,excessweightgainpost-OLTdoesnotrepresentafactorfavoringearlyliverfibrosisdevelopmentandmightevenbeprotectiveagainstit.

简介：AIM:ToassesstheutilityofanautologousCD34+andCD133+stemcellsinfusionasapossibletherapeuticmodalityinpatientswithend-stageliverdiseases.METHODS:Onehundredandfortypatientswithendstageliverdiseaseswererandomizedintotwogroups.Group1,comprising90patients,receivedgranulocytecolonystimulatingfactorforfivedaysfollowedbyautologousCD34+andCD133+stemcellinfusionintheportalvein.Group2,comprising50patients,receivedregularlivertreatmentonlyandserveda...

简介：瞄准：在食道的有鳞的房间癌(ESCC)调查midkine的表示并且与clinicopathological特征分析它的关系。方法：RT-PCR和免疫细胞化学的染色被用来分别地在EC109房间检测midkinemRNA和蛋白质的表示。然后，在ESCC样品的66种情况中的midkine的表示被免疫组织化学对人的midkine用单音的同种细胞的抗体检测。结果：Midkine被RT-PCR和免疫细胞化学在EC109房间表示。免疫反应在56.1%被检测(37/66)ESCC样品。midkine的表示在肿瘤房间的细胞质被发现。尤其是，midkine的紧张在充满容器和肿瘤的入侵的边阶的区域是更强壮的。Midkine更强烈地比在中等并且糟糕区分的肿瘤在很好区分的肿瘤(76.9%)被表示(43.1%和41.2%，分别地)(P<0.05)。在midkine之间没有统计上重要的关联在ESCC的表示和性，年龄，临床的阶段，淋巴节点转移或幸存。结论：Midkine完了在ESCC表示了。它可以在肿瘤血管生成和侵略起一个作用。midkine的表示在ESCC与肿瘤细胞分化被相关。肿瘤房间区分越多糟糕，midkine表示越多weaker。

简介：AIM.Toinvestigatetheeffectofpyrrolidinedithiocarbamate(PDTC),anovelnuclearfactor-κB(NF-κB)inhibitor,onexpressionofmultipleinflammatorymediatorsandneutrophilicinflammationofcoldpreservedgraftsafterratlivertransplantationanditssignificance.METHODS:Orthotopiclivertransplantation(OLT)wasperformedafter24hofcoldstorageusingUniversityofWisconsinsolutionwithvariedconcentrationsofPDTC.WedeterminedthetimecourseofNF-κBactivationandexpressionofmultipleinflammatorysignals,suchastumornecrosisfactor-α(TNF-α),cytokine-inducibleneutrophilchemoattractant(CINC),andintercellularadhesionmolecule-1(ICAM-1)byELISAmethods.Serumalanineaminotransferase(ALT),intrahepaticmyeloperoxidase(MPO)/WBC(ameasureofneutrophilaccumulation)andMac-1expression(ameasureofcirculatingneutrophilactivity)werealsoevaluated.RESULTS:PDTCdecreasedNF-κBactivationinducedbyprolongedcoldpreservationinadosedependentmanner(from20mmol/Lto60mmol/L),diminishedTNF-α,CINC,ICAM-1proteinsinthegrafts,andreducedtheexpressionfincreasesinplasmaTNF-αlevelsinducedbyprolongedoldpreservation.NeutrophilicinflammationofthegraftwassignificantlysuppressedafterpreservationwithPDTC(P<0.05).ThetotalneutrophilaccumulationinPDTC(40mmol/L)group(7.04±0.97)wasmarkedlyreducedcomparedtocontrolgroup(14.07±1.31)(P<0.05).Mac-1expressionwassignificantlyreducedinPDTC(40retool/L)group(181±11.3%)comparedwiththecontrolgroup(281±13.2%)(P<0.05)at6hafterreperfusion.Furthermore,PDTCinhibitedtheincreasedserumALTlevelsafterlivertransplantation.CONCLUSION:PDTCcaninhibitBNF-κBactivationandexpressionoftheinflammatorymediators,whichareassociatedwithimprovedgraftviabilityviainhibitingintrahepaticneutrophilicinflammation.OurstudysuggeststhatatherapeuticstrategydirectedatinhibitionofNF-κBactivationinthetransplantedlivermightbeeffectiveinreducing

简介：AIM:Tostudytheblockingeffectsofgenisteinoncellproliferationcycleinhumangastriccarcinomacells(SGC-7901)andthepossiblemechanism.METHODS:MTTassaywasappliedinthedetectionoftheinhibitoryeffectsofgenisteinoncellproliferation.Flowcytometrywasusedtoanalyzethecellcycledistribution.ImmunocytochemicaltechniqueandWesternblottingwereperformedtodetecttheproteinexpressionofcyclinD1,cyclinB1andp21waf1/cip1.RESULTS:Genisteinsignificantlyinhibitedthegrowthandproliferationofhumangastriccarcinomacells(SGC-7901).Sevendaysaftertreatmentwithdifferentconcentrationsofgenistein(2.5,5.0,10.0,20.0μg/mL),thegrowthinhibitoryrateswere11.2%,28.8%,55.3%,84.7%respectivelyandcellcycleswerearrestedattheG(2)/Mphase.GenisteindecreasedcyclinD1proteinexpressionandenhancedcyclinB1andp21waf/cip1proteinexpressioninaconcentration-dependentmanner.CONCLUSION:ThegrowthandproliferationofSGC-7901cellscanbeinhibitedbygenisteinviablockingthecellcycle,withreducedexpressionofcyclinD1andenhancedexpressionofcyclinB1andp21waf/cip1proteinintheconcentrationrangeof0-20μg/mL.

简介：AIM:Toevaluatetheroleofsurvivinandcaspase-3inapoptosisofgastriccarcinoma,aswellasinprognosisofpatientswithgastriccarcinoma.METHODS:Expressionsofsurvivinandcaspase-3wereinvestigatedimmunohistochemicallyin80gastriccarcinomapatientswithoutahistoryofchemo-radiationtherapy.TumorcellapoptosiswasexaminedbyTUNELmethod.RESULTS:Immunohistochemicalanalysisshowedthatsurvivinexpressionwaspositivein61of80patients(76%)withgastriccarcinoma.Incontrast,noexpressionofsurvivininadjacentnormaltissueswasdetected.Expressionlevelofcaspase-3washigherinnormaltissuesthanincarcinoma.Patientswithhigherexpressionofsurvivinhadworsehistologicalgradesandpathologicalstages.Expressionofcaspase-3wassignificantlyassociatedwithhistologicalstages,butnotwiththepathologicalstages.Althoughsurvivinexpressionincarcinomawasnotinverselyrelatedtocaspase-3,patientswithsurvivin(-)andcaspase-3(+)hadthemaximumapoptosisindex.CONCLUSION:Expressionlevelofsurvivinwasassociatedwithhistologicalgradesandpathologicalstagesofthetumor,indicatingthatsurvivinmaybeapoorprognosisfactorforgastriccarcinoma.Unlikecaspase-3,survivin(anapoptosisinhibitor)canmarkedlyinhibittheapoptosisoftumorcells.

简介：Perivascularepithelioidcelltumor(PEComa)ofthepancreasisanunusualtumorderivingfrommesenchyma.ThispaperdescribedacaseofpancreaticPEComa,whichwasinitiallysuspectedasneuroendocrinecarcinomabybiopsy,andthereforesurgicaltreatmentwasrecommendedduetoundetermineddiagnosis.Examinationofthesurgicalspecimenunderamicroscopeshowedthatthetumorcell’smorphologywasepithelioidorspindle-shaped,andrangedinanestedpattern.Additionally,thesecellshadalargeextentofacidophiliccytoplasm,nomitoticfigures,andexpressedHMB-45,melan-p,andsmoothmuscleactinimmunohistochemically.PathologicalexaminationindicatedthatPEComaoriginatedfromthepancreas,butsymptomsrelatedtotuberoussclerosiswereabsent.SincePEComaisextremelyrareinthepancreas,itislikelytobeignoredindifferentialdiagnosis.Inconclusion,ourarticlehighlightedtheclinicopathologicalfeaturesofPEComa,andweconductedaliteraturereviewfocusingonPEComasoastodeepentheunderstandingofthistumortype.

简介：

简介：AIMToevaluatetheclinicaloutcomesofpatientswhounderwentendoscopicsubmucosaltunneldissection(ESTD)foresophagealsquamouscellcarcinoma(ESCC)andprecancerouslesions.METHODSESTDwasperformedin289patients.Theclinicaloutcomesofthepatientsandpathologicalfeaturesofthelesionswereretrospectivelyreviewed.RESULTSAtotalof311lesionswereincludedintheanalysis.Theenblocrate,completeresectionrate,andcurativeresectionratewere99.04%,81.28%,and78.46%,respectively.TheESTDproceduretimewas102.4±35.1min,themeanhospitalizationtimewas10.3±2.8d,andtheaverageexpenditurewas3766.5±846.5dollars.Theintraoperativebleedingratewas6.43%,thepostoperativebleedingratewas1.61%,theperforationratewas1.93%,andthepostoperativeinfectionratewas9.65%.Esophagealstrictureandpositivemarginweresevereadverseevents,withanincidencerateof14.79%and15.76%,respectively.Notumorrecurrenceoccurredduringthefollow-upperiod.CONCLUSIONESTDforESCCandprecancerouslesionsisfeasibleandrelativelysafe,butforlargemucosallesions,therateofesophagealstrictureandpositivemarginishigh.