Abstract: Objective To investigate the expression of inhibitor of apoptosis gene Livin and its relationship with expression of P53,Bcl-2 in esophageal carcinoma tissues. Methods The expression of Livin messenger ribonucleic acid (mRNA) in 36 esophageal carcinoma tissues and 18 paracancerous tissues were measured by reverse transcriptionpolymerase chain reaction (RT-PCR) combined with silver staining technique. The expression of Livin, P53 and Bcl-2 proteins were detected by immunohistochemical method (streptavidin-peroxidase). Results RT-PCR results: Livin mRNA positive expression of esophageal carcinoma tissues was more evident than that of paracancerous tissues, the expression of both variants was simultaneous basically. Immunohistochemical results: the Livin protein positive expression rate of esophageal carcinoma tissues was higher evidently than that of paracancerous tissues(Plt;0.01). Livin protein positive expression rate of external coat of esophagus invaded by carcinoma was higher than that of tunica muscularis esophagi invaded by carcinoma(Plt;0.05); Livin protein positive expression rate of lymph node metastasis was higher than that of normal lymph node (Plt;0.05). The expression of Livin protein was not related to the expression of P53 protein（χ2=1.00,P=0.505）,but it was positively related to the expression of Bcl-2 protein（χ2=10.60，P=0.003）. Conclusion Aberrant expression of Livin may be a new target for diagnosis and gene treatment of esophageal carcinoma.The aberrant expression of Livinand apoptosis related gene Bcl-2 may play synergetic roles in process of carcinogenesis of esophageal carcinoma.
Objective To study the expressions of Livin, Caspase-3 and Bcl-2 in lung tissue of nonsmall cell lung cancer ( NSCLC) , and their relationship with the clinicopathological features and prognosis of NSCLC. Methods The expressions of Livin, Caspase-3 and Bcl-2 proteins were evaluated by immunohistochemical method in 87 NSCLC samples and 40 lung benign tissues. The relationship of their expressions with the clinicopathological features and prognosis of NSCLC were analyzed by Spearman’s Rank correlation and COX Regression. Results More NSCLC tissues showed expression of Livin than lung benign tissues( 72. 41% vs 0. 0% , P = 0. 000 ) , and the expression of Caspase-3 was significantly decreased ( 67. 82% vs 87. 5%, P lt; 0. 05 ) . The proteins of Livin, Caspase-3 and Bcl-2 were detected in the endochylema but none was detected in nucelus. There was no relationship between the expression of each of these proteins and the clinicopathological features of NSCLC such as histologic type, tumor differentiation,lymph node metastasis, TNM stage, the size of tumor, and tumor site. The expression of Livin was correlated with Caspase-3 and Bcl-2 expressions ( r1 = - 0. 260, P = 0. 015; r2 = 0. 351, P = 0. 001) . Livin, Caspase-3 and Bcl-2 were not independent prognostic factors of NSCLC. Conclusions The expression of Livin and Bcl-2 are up-regulated in NSCLC. The expression of Livin is positively correlated with that of Caspase-3 and Bcl-2, they might interact with each other in the carcinogenesis and development of NSCLC. The levels of Livin, BCl-2 and Caspase-3 proteins are not independent factors affecting the prognosis of lung cancer patients.
ObjectiveTo study the expression of inhibitor of apoptosis proteins (Livin) and aspartate-specific cysteine protease-3 (Caspase-3) in patients with middle ear cholesteatoma and its clinical significance. MethodWe selected 51 patients with cholesteatoma of the middle ear treated between April 2013 and March 2014 in our department to be our study subjects. Streptaridin-perosidase immunohistochemical method was adopted to detect the expression of Livin and Caspase-3 in the middle ear cholesteatoma epithelium and normal skin of external acoustic meatus. SPSS 17.0 software package was used for statistical analysis. ResultsThe expression of Livin in cholesteatoma epithelium was significantly higher than that in the normal skin tissue of the external auditory canal (P<0.05), and the expression of Caspase-3 in cholesteatoma epithelium was significantly higher than the normal skin tissue in the external auditory canal (P<0.05). The expression of Livin and Caspase-3 in cholesteatoma epithelium was positively correlated (r=0.49, P<0.05). ConclusionsThere is a balance between apoptosis and inhibition of apoptosis in normal tissues, and when there is abnormal expression of Livin and Caspase-3 in normal tissues, it will cause cell apoptosis and apoptosis-inhibitory balance disorders, which causes middle ear cholesteatoma.
ObjectiveTo evaluate donor safety in living donor liver transplantation. MethodsThe clinical data of 356 donors underwent living liver donation in our center from January 2001 to September 2015 were retrospectively analyzed. These patients were divided into pre-2008 group(before January 2008) and post-2008 group(after January 2008). The donor safety was evaluated with regard to three aspects, i.e. complications, liver function, and quality of life. Results①There was no donor death in our center.②The overall complications rate was 23.3%(83/356). The proportion of ClavienⅠ, Ⅱ, Ⅲ, andⅣcomplications was 50.6%(42/83), 26.5%(22/83), 21.7%(18/83), and 1.2%(1/83), respectively. In all the donors, the incidence of ClavienⅠ, Ⅱ, Ⅲ, andⅣcomplications was 11.8%(42/356), 6.2%(22/356), 5.1%(18/356), and 0.3%(1/356), respectively. The overall complications rate in the post-2008 group was significantly lower than that in the pre-2008 group〔18.1%(41/227) versus 32.6%(42/129), P < 0.01〕. The most common complication was the biliary complication with an incidence of 8.4%(30/356).③The postoperative liver dysfunction was transient and generally retur-ned to normal level within a week.④The donor's quality of life was generally satisfied as assessed by the SF-36 tool, and 94.8%(239/252) of them would donate again if necessary. ConclusionEver improving surgical and anesthetic techniques, together with strict donor selection and specialized perioperative management, could guarantee a low donor morbidity and a satisfactory long-term prognosis.
Objective To analyze the surgical techniques for the procurement and back-table surgery of the graft in living-related small bowel transplantation. Methods Eligible donor was chosen according to the donor selection criteria of living-related small bowel transplantation, and preoperative plan was designed. A segment of ileum of 120 cm was procured 20 cm proximal to the ileocecal valve which was preserved in the donor. The techniques for the procurement and back-table surgery of the graft were summarized, which included measurement of entire small bowel length from Treitz to ileocecal valve, palpation and transillumination to identify the distal branch of the superior mesenteric artery， and transient blockage of isolated blood vessels with vascular clamps in order to observe the influence on the blood circulation of graft and residual ileum. The detailed manipulation techniques in processing the graft blood vessels were discussed. Results The operations were successful both on the donor and the recipient. The functions of implanted segment of bowel were well. The donor had no other complications, such as mesenteric thrombi and anastomosis leakage of intestine, except for transient moderate diarrhea. She was discharged 14 days after operation. In the next 8 months of following-up, the donor has not experienced significant alteration in bowel habits or weight loss. Now she is in good appetite, without any changes in the habit and amount on diet. No changes have been found in lifestyle, work habits, or psychosocial conditions after the small bowel donation. Conclusion The procurement of a segment of ileum as graft and preservation of 20 cm proximal to the donor ileocecal valve may be ideal protocol. Using a standardized technique with attention presents little recent or long-term risks for the donor and brings satisfied effect for the recipient.
Objective To approach whether the postoperative recovery processes of the living donors and hepaticpatients after right hepatectomy is similar. Methods The clinical data of consecutive cases from 2009 to 2010 in our liver transplantation center was retrospectively analyzed， including 40 cases who donated the right lobe without the middlehepatic vein （living donor liver transpalntation-donor group， abbreviated as LDLT-D group） and 80 hepatic patients forright hepatectomy， in which 40 cases were hepatic patients without cirrhosis （liver disease-noncirrhosis group， abbreviatedas LD-NC group） and 40 cases were hepatic patients with cirrhosis （liver disease-with cirrhosis group， abbreviated asLD-WC group）. Preoperative liver function and general clinical data， intraoperative blood loss and transfusion， postoper-ative liver function， and complications were statistically analyzed in this study. Results The preoperative parameters of three groups were comparable. LDLT-D group experienced more intraoperative bleeding than LD-NC group 〔（765±411） mL vs. （584±242） mL， P=0.008〕， and was similar to LD-WC group 〔（666±224） mL， P=0.136〕. However， the average amount of blood transfusion products was similar among the 3 groups （P=0.108）. The levels of total bilirubin and INR of LDLT-D group were higher than LD-NC group and LD-WC group on the first and third day after operation （P＜0.05）. The levels of ALT and AST of LD-WC group were higher than LDLT-D group and LD-NC group （P＜0.05）. The overall postoperative surgical morbidity incidence of LDLT-D group， LD-NC group， and LD-WC group were 30.0%（12/40）， 27.5% （11/40）， and 37.5% （15/40） respectively， and were not statistically significant （P=0.606）. However， the ClavienⅢcomplication rate of LD-WC group was higher than LDLT-D group and LD-NC group 〔27.5% （11/40） vs. 7.5%（3/40） and 10.0% （4/40）， P=0.024〕. Conclusions Liver function of living donors is injured more seriously during the early postoperative period. The total complication rates after right hepatectomy are similar among the living liver donation and hepatic patients with or without cirrhosis. However， the serious complication rate of cirrhotic liver recipients is higher than living donors and patients without cirrhosis.
Objective To evaluate the effect of sensory disturbance after the sagittal split ramus osteotomy (SSRO）on quality of life. Methods From September2004 to September 2005, 21 patients undergoing SSRO were studied by using questionnaires. There were 12 males and 9 females, aging 1927 years(mean 22.6 years).The patients were followed up at 4 weeks and 24 weeks after operation. The subjective questionnaire was completed by patient to evaluate the degree of living quality descending. Results At 4 weeks,19(90.48%) patients’ living quality descended because of postoperative sensory disturbance. Among them, 7(33.33%) patients had severe descending of living quality. The average effecting time of living accounted for total time 26.9%(about 6.5 h/d). At 24 weeks, 12(6316%) patients’ living quality descended because of postoperative sensory disturbance, 7(36.84%) patients could achieve preoperative living quality. The average effecting time of living accounted for total time 15.5%(about 3.7 h/d). Conclusion Most patients have descending of living quality after SSRO because of sensory disturbance. However, this condition can be improved during the followup and more than 1/3 patients canachieve their preoperative living quality.
ObjectiveTo review the causes, prevention methods, and therapies of the small-for-size syndrome (SFSS) in living donor liver transplantation (LDLT). MethodsThe literatures about SFSS in recent years were reviewed and summarized. ResultsThe donor’s age, graft steatosis level, MELD score of the recipient, portal hypertension, low outflow, and graft size were risk factors of SFSS. Ideal donor, splenectomy, ligating splenic artery, keeping a satisfactory intraoperative outflow, early diagnosis and active therapy could obviously decrease the incidence of SFSS. ConclusionThe risk factors of SFSS can be predicted before operation, and the positive actions can be used to prevent or cure the SFSS.
Objective To investigate the dynamic changes of postoperative liver reserve function and laboratory liver function as well as liver volume regeneration, and their potential relationship with short-term clinical outcomes after adult-to-adult living donor liver transplantation (LDLT). Methods The data of 30 recipients underwent LDLT were prospectively collected. The plasma clearance (K) by indocyanine green (ICG) excretive test, liver function test by laboratory methods, liver volume by CT and shortterm (lt;3 months) complications were analyzed. Results The graft recipient body weight ratio (GRBW) was 0.63%-1.43%. The hepatic volume of the recipients in the operation was (638±103) ml, which was smaller than that day 7, 30, and 90 after operation (Plt;0.001), but the hepatic volume at subsequent time point was not different from that at the former time point (Pgt;0.05). The KICG values of recipients among the day 3 〔(0.177±0.056)/min〕, 7 〔(0.183±0.061)/min〕, 30 〔(0.200±0.049)/min〕, and 90 〔(0.209±0.050)/min〕 after operation gradually increased, which was respectively higher than that of recipients before operation (P=0.006, P=0.002, Plt;0.001, and Plt;0.001). Compared with the baseline KICG 〔(0.228±0.036)/min〕 of the donors, the KICG of recipients showed significant variation on day 3 and 7 after operation (P=0.004 and P=0.015), and the KICG of recipients on day 30 and 90 after operation approached the baseline KICG (P=0.355 and P=0.915). The recipients were divided into good liver function group (n=23) and poor liver function group (n=7) according to total serum bilirubin on day 14 after operation. The KICG significantly dropped compared with the recipients of good liver function group on day 3 after operation (P=0.001). Conclusions The liver volume regenerates dramatically on day 7 after operation for the recipients. The ICG excretivetest shows that volume recovery occurs much more gradually than the recovery of function in the recipients. The ICG excretive test is a more reliable indicator of graft function and subsequent graft outcome early after LDLT.
【摘要】 目的 探讨凋亡抑制蛋白Livin与凋亡蛋白Caspase-3在结直肠腺瘤-癌序列中的表达变化及其相关性。 方法 2006年7月—2009年12月，采用免疫组织化学染色链霉菌抗生物素蛋白-过氧化物酶链接法streptavidin-peroxidese，SP）法检测18例正常黏膜、84例结直肠腺瘤、72例结直肠癌中Livin及Caspase-3的表达情况。 结果 结直肠腺瘤组织中Livin蛋白的阳性表达率明显高于正常黏膜组织（Plt;0.05），而低于腺癌组（Plt;0.05）；腺瘤组内绒毛状腺瘤与管状腺瘤相比较，Livin蛋白表达率差异有统计学意义（Plt;0.05）。结直肠腺瘤组织中Caspase-3的阳性表达率明显高于正常黏膜组织（Plt;0.05）；而腺瘤组织与癌组织之间Caspase-3阳性表达率差异（Plt;0.05）；腺瘤组内绒毛状腺瘤与管状腺瘤相比较，Caspase-3蛋白阳性表达率差异无统计学意义（Pgt;0.05）。Livin表达与Caspase-3表达呈负相关（Plt;0.05）。 结论 凋亡抑制蛋白Livin参与了大肠肿瘤的发生，且在大肠腺瘤-腺癌阶段起到了重要作用；凋亡抑制蛋白Livin与Caspase-3表达呈负相关，抑制Caspase-3蛋白的活性可能是Livin促进结肠癌发生的途径之一。【Abstract】 Objective To investigate the expression of Livin and Caspase-3 among colorectal adenoma-carcinoma sequence, and to identify the relationship between Livin and Caspase-3 expression in colorectal adenoma-carcinoma sequence. Methods Formalin-fixed paraffin embedded colorectal tissues from 174 patients, including 84 adenomas, 72 carcinomas, and 18 normal mucosa, were examined for expression of Livin and Caspase-3 by streptavidin-peroxidase (SP) immunohistochemistry between July 2006 and December 2009. Results The positive rates of Livin protein expression in colorectal adenoma was significantly higher than that in normal mucosa (Plt;0.05), but lower than that in adenocarcinoma (Plt;0.05); the expression of Livin in tubular adenoma was significantly higher than that in villous adenoma (Plt;0.05). The positive rates of Caspase-3 protein expression in colorectal adenoma were significantly higher than that in normal mucosa and carcinoma (Plt;0.05), and the difference in positive rate of Caspase-3 expression was not significant between the villous adenoma and tubular adenoma (Pgt;0.05). Livin expression had negative correlation with the Caspase-3 expression (Pgt;0.05). Conclusion The difference in expression of Livin between adenoma and adenocarcinoma indicates the potential value of it in carcinogenesis of colorectal cancer, which suggestes that suppressing Caspase-3 protein activity is one of the channels by which livin promotes colorectal carcinogenesis.