原发性肝细胞癌细胞凋亡的研究

通过对原发性肝细胞癌细胞凋亡的研究，探讨其生物学及临床意义，采用细胞凋亡的原位末端标记技术，检测了 １７ 例正常肝组织（包括癌周边肝组织）及 １８ 例原发性肝细胞癌组织中的细胞凋亡情况。结果：正常肝组织及癌周边肝组织的细胞凋亡数平均值分别为 ２２±１３ 及 ２６±０７９，而肝细胞癌组织为 １２３±２６。本结果表明：正常肝组织及肝癌周围肝组织中有较低的细胞凋亡数，而肝癌组织中有较高的细胞凋亡数，二者相比具有显著性差异， Ｐ＜ ０００５。     

肝细胞肝癌组织中p34cdc2表达及其与细胞增殖和凋亡的关系

目的:探讨p34cdc2激酶在肝细胞肝癌(HCC)发生发展中的作用及与增殖和凋亡的关系. 方法:收集HCC(含癌旁组织42)标本47例,正常肝组织10例,采用免疫组织化学SP法显示p34cdc2激酶的表达并结合增殖与凋亡特征进行分析. 结果:在肝癌组织、癌旁肝组织及正常肝组织细胞中p34cdc2表达定位于胞质中,在癌组织中过表达,差异有统计学意义(P＜0.01). 肝癌、癌旁组织中的增殖指数(PI)分别为(30.34±4.46)%与(27.88±5.89)%,肝癌组织明显高于癌旁组织(P＜0.05);肝癌、癌旁组织中的凋亡指数(AI)分别为(8.62±2.28)%与(7.38±2.61)%,肝癌组织明显高于癌旁组织(P＜0.05);p34cdc2蛋白阳性组PI(49.26±4.81)%显著高于阴性表达组(23.07±4.15)%(P＜0.05),AI无明显差异(P＞0.05). 结论:HCC中增殖与凋亡均高于癌旁组织;p34cdc2和PCNA一样可作为反映HCC细胞分裂增殖能力的有效指标;p34cdc2并不是HCC凋亡所必须.     

慢性乙型病毒性肝炎、肝癌组织HLA Ⅰ类抗原的表达及意义

目的：探讨慢性乙型肝炎、肝癌组织中人类白细胞抗原I（HLA I）的表达和临床意义。方法:应用流式细胞仪对51例慢性乙型肝炎患者肝组织和43例原发性肝癌癌组织中的HLA I抗原进行检测。结果:肝癌组织中HLA I抗原表达为36.47±19.38，明显低于慢性乙肝的79.54±41.55和正常肝组织的81.86±46.53（P均＜0.01），而慢性乙型肝炎肝组织和正常肝组织HLA I类抗原表达无明显差异（P＞0.05），伴有肝内和(或)淋巴结转移的肝癌组织中HLA I抗原表达较无转移组明显降低（22.83±11.59 vs 46.28±23.16，P＜0.05);HLA I类抗原表达与血清AFP水平呈明显负相关（r=-0.741?1, P＜0.01）,但与肝癌组织分化程度呈明显正相关(r=0.805?1, P ?.05)。结论:HLA I抗原表达异常与肝癌的发生和转移密切相关。 ［关键词］HLA I类抗原;肝炎，乙型;癌，肝细胞     

肝细胞肝癌与癌旁肝组织胰岛素受体结合特性的对比研究

目的　研究肝细胞肝癌与癌旁肝组织胰岛素受体密度与亲和力的差异。方法　采用体外受体结合实验 ,通过 Scatchard分析 ,计算两种细胞膜的最大结合容量 (Bmax)与平衡解离常数 (Kd值 )。结果　肝癌细胞膜胰岛素受体 Bmax为 1.94± 0 .6 4pm ol/ mg蛋白 ,Kd值为 2 .12± 0 .6 2 nmol/ L;癌旁肝组织细胞膜胰岛素受体 Bmax为1.42± 0 .5 7pmol/ mg蛋白 ,Kd值为 2 .2 1± 0 .78nm ol/ L。肝癌细胞膜胰岛素受体 Bmax显著高于癌旁组织细胞膜 (P<0 .0 5 ) ,而肝细胞肝癌与癌旁肝组织细胞膜的胰岛素受体亲和力无显著性差异 (P>0 .0 5 )。结论　肝细胞肝癌较癌旁肝组织表达胰岛素受体增高 ,而受体亲和力无明显差异     

Rel mRNA和NF-κB2 mRNA在人肝细胞癌中的表达及其临床意义

【目的】探讨Rel及NF-κB2的mRNA在人肝细胞癌(hepatocellularcarcinoma,HCC)组织中的表达及其临床意义。【方法】用逆转录聚合酶链反应检测55例HCC患者癌组织及癌旁肝组织中RelmRNA和NF-κB2mRNA的表达情况。【结果】RelmRNA及NF-κB2mRNA在肝癌组织中的表达水平均明显低于其癌旁组织(分别为0.315±0.142对0.505±0.225;0.273±0.141对0.491±0.242,均P<0.05)。这两种因子在肝癌组织中的表达水平与临床分期及肝外转移明显有关,而与门静脉癌栓、术后复发、肿瘤数目、肿瘤直径及血清AFP水平等无明显关系。【结论】提示Rel、NF-κB2可能与肝癌的发生、发展有关。     

肝细胞癌及肝癌旁组织中SMAD3蛋白的表达及其生物学意义

目的 :检测 Smad3蛋白在肝癌及癌旁肝组织中的表达 ,并探讨其生物学意义。方法 :采用 SABC免疫组织化学方法检测 Smad3蛋白在 2 1例肝癌及其紧邻癌旁肝组织、 7例正常肝组织中的表达。结果 :Smad3蛋白在正常肝组织、癌旁肝组织、肝癌组织中的表达分别为 0 .0 375± 0 .0 0 31、 0 .0 30 7± 0 .0 0 83、 0 .0 16 9± 0 .0 0 4 5 ,呈明显的逐级递减趋势 (组间比较分别为 P<0 .0 1、P<0 .0 5 )。结论 :Sm ad3蛋白表达水平的下调可能与 HCC发生的早期事件有关     

Plk1在肝癌组织中表达及意义

目的:探讨Plk1在原发性肝细胞性肝癌中的表达及其意义。方法:用半定量RT-PCR、Western blot的方法检测21例原发性肝细胞性肝癌中Plk1的表达情况,并分析其与肝癌临床病理因素的关系。同时取肝硬化及正常肝组织各7例做对照。结果:肝癌组织中Plk1mRNA表达比值(Plk1/β-actin)为0.572±0.144,明显高于肝硬化组织中的0.250±0.057和正常肝组织的0.218±0.073(P<0.01)。Plk1 mRNA表达水平在肿瘤直径大于5 cm组中为0.641±0.110,而在肿瘤直径小于5 cm组中为0.458±0.120,两组之间比较有统计学差异(P<0.01)。其在有门静脉癌栓患者中的表达为0.652±0.107,明显高于无门静脉癌栓者中的表达0.522±0.144(P<0.05)。而与有无包膜,肿瘤病理分级和AFP阳性与否无明显相关。肝癌组织Plk1蛋白表达明显高于肝硬化及正常肝组织中的Plk1蛋白表达量。结论:原发性肝癌组织中Plk1mRNA及蛋白表达均明显增加;Plk1的表达高低与原发性肝癌的肿瘤直径大小及脉管侵犯有明显相关,提示其在肝癌生长及侵袭中发挥重要作用,为进一步研究肝癌的生长侵袭机制提供了思路。     

肝癌细胞转铁蛋自受体的表达及WuT9单抗对肝癌细胞的抑制作用

应用间接免疫荧光法检测了正常人肝组织、肝癌组织及培养的肝癌细胞转铁蛋白受体表达情况。11例肝癌组织中,10例免疫荧光阳性;原代培养的肝癌细胞荧光阳性率为84.1±11.4％,远高于正常肝细胞的阳性率(5.1±2.6％)。WuT9、WuT9-阿霉素连接物在体外对肝癌细胞的生长有明显的抑制作用,对正常肝细胞的影响较小。     

肝癌病人血浆和癌组织中血栓调节蛋白的检测

目的　检测肝癌病人血浆和肝癌组织中血栓调节蛋白 (TM )的表达 ,探讨TM与肝癌临床病理特征的关系。方法　用酶联免疫吸附夹心法检测 45例肝癌和 6例肝良性占位病人手术前后的血浆TM水平 ;用免疫组织化学法检测肝癌及肝良性占位组织中的TM蛋白表达水平。结果　术前肝癌组血浆TM水平 ( 10 .2± 5 .7)ng/mL明显高于肝良性占位组 ( 6.1± 2 .2 )ng/mL和正常人对照组 ( 5 .7± 1.0 )ng/mL ,P <0 .0 5 ;术前TM血浆水平肝癌伴门静脉癌栓组 ( 6.9± 4.5 )ng/mL和多发肝癌结节组 ( 8.1± 4.6)ng/mL明显低于无门静脉癌栓组( 11.4± 5 .6)ng/mL和单发肝癌结节组 ( 11.5± 5 .9)ng/mL ,P <0 .0 5 ;40例肝癌病人肝癌切除术前TM水平( 10 .8± 5 .3 )ng/mL与肝癌切除术后 ( 7.6± 4.2 )ng/mL相比差异显著 ,P <0 .0 5。肝良性占位组术前与术后相比差异无显著性 ,P >0 .0 5。肝癌组织中TM蛋白表达阳性的病人术前血浆TM水平明显高于TM表达阴性者 ,P <0 .0 5 ;而术后血浆TM水平两者则无显著性差异 ,P >0 .0 5。结论　肝癌病人血浆中TM水平升高 ,TM水平的高低与门静脉癌栓的形成有关     

AgNORs计数与肝硬化、增生结节和肝癌的关系

用核仁组成区相关嗜银蛋白(AgNORs)染色技术对肝硬化、增生结节和肝癌进行了AgNORs定量测定.结果表明,正常肝组织的AgNORs计数为1.48±0.63,肝硬化为1.73±0.75,嗜酸性细胞结节为2.44±1.08,Ⅰ级肝癌为2.77±1.22,Ⅱ级肝癌为4.37±1.64,Ⅲ级肝癌为5.57±2.10;嗜酸性细胞结节属活跃增殖性病变,其AgNORs计数与正常肝组织有明显差异(P<0.05),与Ⅰ级肝癌相近(P>0.05).提示AgNORs计数与肝癌分级有一定关系,嗜酸性细胞结节为癌前期病变且与肝硬化结节为两种不同的病变.     

Liver

Alleviation of ischemia-reperfusion injury in rat liver donors by induction of exogenous hTERT gene;Effects of surgical technique on acute renal failure after orthotopic liver transplantation in patients with end-stage liver disease at high risk： a report of 90 eases;Timing for liver transplantation for chronic severe hepatitis;Analysis of bacterial variance and drug resistance after orthotopic liver transplantation;The influence of splenectomy on orthotopic liver transplantation and its management     

Liver

<正>209461 Intraoperative ligation of recipient’s portasystemic shunt in liver transplantation/Chen Litian(,Organ Transplant Center,Tianjin 1st Centr Hosp Tianjin 300192)…∥Chin J Gen Surg.-2009,25(4).-489～491Objective To investigate the clinical significance of ligating the portasystemic shunt confirmed by preoperative CT evaluation during orthotopic liver transplantation.Methods From January 2007 to August 2008,35 patients in Tianjin First Central Hospital underwent preoperative three-dimensional CT scan,among them 23 patients had spontaneous major portasystemic shunts,the other 12 patients did not have portasystemic shunts.16 out of the 23 cases with significant shunts underwent shunt ligation based on portal blood flow volume measured by intraoperative portal vein flowmetry.The shunt of the other 7 patients were left untreated.Results The portal blood flow in the 12 patients without portasystemic shunt judged by preoperative CT scanning were(1 101±70)ml/min.The shunts in 7 patients with portal blood flow greater than 1 000 ml/min were not ligated,that of the 16 patients with portal blood flow volume lower than 1 000 ml/min were ligated.The portal blood flow volume in those 16 patients before and after ligating the shunt were(657±112)ml/min and(1 136±161)ml/min,respectively(P<0.05).Postoperatively 2 patients suffered from portal vein thrombosis,among them 1 patients suffered from intermittent disturbance of consciousness,2 patients died within 3 months,with one died of respiratory failure from pulmonary aspergillus infection,one died of hepatic failure in 2 months after operation because of graft dysfunction.The other 19 patients with normal blood flow and well-functioning graft were alive.Conclusion The ligation of portasytemic shunt is mandatory in patients when pretransplant CT evaluation showing a major porto-systemic shunts and portal blood flow volume was less than 1 000 ml/min.5 refs,2 figs.     

Liver

<正>209293 Probing into indication of living-related Liver Transplantation for Wilson’s disease/Cheng Feng(Liver Transplant Center,1st Hosp Nanjing Med Univ,Key Lab Living Donor Liver Transplant,Minist Public Health,Nangjing 210029)…∥Chin J Surg.-2009,47(6).-437~440Objective To probe into indication of living-related liver transplantation(LRLT)for Wilson’s Disease.Methods From January 2001 to February 2007,thirty-seven living-related liver transplants were performed.A retrospective analysis was carried on outcome of those patients.The indications for LRLT were acute hepatic failure in 3 patients and chronic advanced liver disease in 32 patients including 13 patients with Wilsonian neurological manifestations.Two patients presented with severe Wilsoian neurological manifestations even though their liver functions were stable.According to the scoring system for evaluation of the neurological impairment in Wilsion disease based on neurological signs and functions(total score was 30),the pre-transplantation score of those patients with neurological manifestations was 15.9±4.3(n=15).Results Thirty-seven patients were followed up for 20-93 months.The survival rates of post-transplant patients and grafts at 1,3,and 5 year were 91.9%,83.8%,75.7%,and 86.5%,78.4%,75.7%,respectivly.Postoperative surgical complications occurred in 2 donors with bile leakage required drainage,in 2 recipients with hepatic thormbosis underwent retransplantation of cadeveric liver and in 1 recipient with hepatic stenosis required balloon dilatation.Neurological function was improved in all recipients and the score of posttransplantation at 6,12,18,24,and 30 months was 17.5±3.7(n=13);21.0±4.3(n=12);23.9±3.9(n=10);26.6±2.2(n=10)and 28.1±1.9(n=7)respectively.Conclusion Patients with acute hepatic failure or patients with severe liver disease unresponsive to chelation tratment should be treated with LRLT.Early transplantation in patients with an unsatisfactory response medical tratment may prevent irreversible neurologica     

Liver

<正>209604 The suppressive effect of CD8+ CD28-regulatory T cells from spontaneous tolerance models on the acute rejection responses in rat liver transplantation/Chen Ning(陈宁,Dept Gastroenterol,Peking Univ Peop Hosp,Beijing 100044)…∥Chin J Organ Trans-plant. -2009,30(9). -524 ～526     

探讨脂肪肝供肝在肝脏移植中的价值

目的探讨应用不同脂肪沉着程度供肝对肝移植患者预后的影响。方法选取64例进行肝移植术患者,依据供肝浸润程度,随机分为轻度脂肪肝组、中度脂肪肝组、重度脂肪肝组、无脂肪肝组共四组,每组各16例,比较四组患者肝功能(主要观察ALT、AST指标)、入住ICU的平均时间、1年移植物成活率、移植物原发无功发生率。结果轻度脂肪肝组入住ICU的平均时间、ALT和AST水平、移植物原发无功发生率与无脂肪肝组接近;中度脂肪肝组入住ICU平均时间、ALT和AST水平均较轻度组和无脂肪肝组明显增高,P0.05;重度脂肪肝组入住ICU平均时间、ALT和AST水平、移植物原发无功发生率明显较前三组为高,P0.05。结论轻、中度肝脏脂肪浸入可作为肝移植供肝,重度脂肪肝不能作为供肝的选择目标。     

Liver

<正>209087 Clinical analysis of outcome of invasive fungal infection after kidney transplantation/Chen Guodong(陈国栋,Dept Transplant Surg,1st Hosp,Sun Yat sen Univ, Guangzhou 510080)…∥Chin J Organ Transplant. -2009, 30(10). -616～619 Objective To explore the outcome of invasive fungal infection in kidney transplantation and the influencing factors.     

Liver

Prevention and treatment of artery complication after liver transplantation by HBO , Clincal feature of cytomegabvirus pneumonia in orthtopic liver-transplantation and treatments, Risk factors of diabetes mellitus following orthotopic liver transplantation , Re-infection of hepatitis B virus after liver transplantation , Diagnosis and treatment of fungal infection after orthotopic liver transplantation , Two successful adult-to-adult living donor liver transplantation using dual grafts     

Microenvironment of Liver Regeneration in Liver Cancer

The occurrence and development of liver cancer are essentially the most serious outcomes of uncontrolled liver regeneration. The progression of liver cancer is inevitably related to the abnormal microenvironment of liver regeneration. The deterioration observed in the microenvironment of liver regeneration is a necessary condition for the occurrence, development and metastasis of cancer. Therefore, the use of a technique to prevent and treat liver cancer via changes in the microenvironment of liver regeneration is a novel strategy. This strategy would be an effective way to delay, prevent or even reverse cancer occurrence, development and metastasis through an improvement in the liver regeneration microenvironment along with the integrated regulation of multiple components, targets, levels, channels and time sequences. In addition, the treatment of "tonifying Shen (Kidney) to regulate liver regeneration and repair by affecting stem cells and their microenvironment" can regulate "the dynamic imbalance between the normal liver regeneration and the abnormal liver regeneration"; this would improve the microenvironment of liver regeneration, which is also a mechanism by which liver cancer may be prevented or treated.     

化肝汤1号治疗酒精性肝纤维化症状及肝功能改变

目的观察活血化瘀、软坚散结药配伍治疗肝纤维化时对患者主、次症状改变及肝功能的影响。方法将确诊为酒精性肝纤维化患者90例,随机分为三组,治疗组采用自制方剂化肝汤1号(醋鳖甲、黄芩、柴胡、赤芍等),对照组1采用凯西莱治疗,对照组2采用化肝汤1号和凯西莱联合治疗,疗程3个月。观察三组患者治疗前后主、次症状改善情况,血清天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、γ谷氨酰转肽酶(γ-GT)变化。结果三组治疗后的临床疗效比较差异无统计学意义(H=2.5897,P>0.05)。三组治疗后肝功能指标均有改善,与治疗前比较,差异有统计学意义(P<0.05)。结论化肝汤1号可有效地降低肝细胞的损害程度,促进受损细胞修复,从而改善肝功能。