Releases of Norepinephrine and Dopamine in Ventriculocisternal Perfusions in Hepatectomized and Laparotomized Rats

Abstract: The completely hepatectomized rat has frequently been used as a model to study changes in the economy of norepinephrine (NE) and dopamine (DA) in hepatic coma. Hypothermia characteristically develops in hepatectomized rats and also occurs in patients in hepatic coma and is associated with improved survival in both. The aims of the present study were to measure both release and uptake of NE and release of DA in brain in warm (37°C) and cool (30–32°C) rats at 3–5 h after laparotomy or hepatectomy. Ventriculocisternal perfusions of the brain were performed on rats under basal conditions and during releases evoked by 40 m M K⁺. Basal releases of NE and DA and evoked release of DA were greater in the warm hepatectomized rats than in all other groups. In some studies, 10⁻⁵ M amitriptyline was added to the perfusates to assess whether neuronal uptake was changed after hepatectomy. Uptake of released NE was equally robust in cool hepatectomized as in cool laparotomized rats but could not be measured in warm hepatectomized rats because of amitriptyline toxicity in these rats. Decreases in NE and increases in DA content were found in most areas of the brain after perfusion. Increased releases of NE and DA may contribute to the pathogenesis of hepatic encephalopathy.     

Effect of thioacetamide,growth hormone or partial hepatectomy on spermidine acetylase activity of rat liver cytosol

Rat liver cytosol extracts catalyzed the formation of monoacetylspermidine when incubated with acetyl-CoA and spermidine.This activity was enhanced 15-fold by administration of thioacetamide (150 mg/kg). The peak of activity occurred 18–24 h after treatment with the drug and then declined reaching control levels by 76 h. Previous studies have shown that ornithine decarboxylase activity was also greatly increased over this time period. Putrescine content in the liver was increased 80–90-fold at 18–24 h and then declined. Spermidine levels were decreased significantly over the period 12–24 h after thioacetamide treatment and then increased substantially at later times. These results are consistent with the hypothesis that, at early times after administration of thioacetamide, the increase in putrescine content is brought about both by decarboxylation of ornithine and by degradation of monoacetylspermidine.Spermidine acetylase activity was also measured in liver extracts prepared after two other physiological stimuli known to enhance ornithine decarboxylase activity were used. Both growth hormone treatment and partial hepatectomy produced an early 2–3-fold increase in the cytosolic spermidine acetylase activity.     

肝切除手术治疗肝包虫病的疗效及对患者预后和肝功能的影响

目的:探讨肝切除手术治疗肝包虫病的疗效及对患者预后和肝功能的影响。方法:选取2015年2月-2018年5月期间我院收治的肝包虫病患者103例为研究对象,所有患者根据手术方式的不同分为A组(n=51,行外膜内完整外囊摘除术)和B组(n=52,行肝切除手术),比较两组患者围术期临床指标、肝功能指标、并发症发生情况,随访半年,记录两组患者随访期间死亡及原位复发情况。结果:B组术中出血量少于A组,手术时间、术后拔管时间以及住院时间均短于A组,组间比较差异有统计学意义(P0.05)。与术前比较,两组患者术后3 d、术后7 d谷丙转氨酶、胆红素以及谷草转氨酶均升高,但B组低于A组(P0.05);与术前比较,两组患者术后3 d、术后7 d白蛋白降低,但B组高于A组(P0.05);与术后3 d比较,两组患者术后7d谷丙转氨酶、胆红素以及谷草转氨酶均降低,白蛋白升高(P0.05)。B组术后并发症总发生率为7.69%(4/52),低于A组的23.52%(12/51),组间比较差异有统计学意义(P0.05)。两组随访期间无患者死亡,原位复发率比较差异均无统计学意义(P0.05)。结论:肝切除手术治疗肝包虫病患者安全有效,可减少术中出血量,促进患者术后康复,减轻手术对肝功能的影响,且术后复发率较低,患者预后较好。     

晚期肝癌和复发性肝癌治疗的研究进展

肝细胞癌(HCC)是我国最常见的恶性肿瘤之一,70%继发于肝炎、肝硬变。虽然诊断技术的提高,使肝癌的早期发现成为可能,然而由于肝癌早期症状隐匿,大多数肝癌确诊时已处于中晚期。肝切除术是治疗肝细胞癌最常用的手段。对于一些不可切除的晚期肝细胞癌,可采用动脉化疗栓塞以及系统化疗等手段使肿瘤降期,当转变成可切除肝癌后,再行补救性肝切除延长患者的生存期。此外,对于剩余肝体积不足而无法行一期肝切除的患者,可以采用PVE、ALPPS等方法,在剩余肝脏体积增大后再行二期肝切除术。肝内肿瘤复发率高也是导致肝细胞癌预后差的重要因素。在局部治疗后,建议在保留肝功能的前提下重复治疗。相比局部消融和动脉化疗栓塞治疗等多种手段,肝切除术有最好的远期疗效。联合和重复不同的治疗手段可达到很好的总生存期。对于患有晚期不可切除肿瘤或复发癌的患者,应积极的发挥肝切除的作用,并联合其他非手术治疗手段以取得较好的预后。     

Effect of peroxisome proliferators on the methylation and protein level of the c-myc protooncogene in B6C3F1 mice liver

Peroxisome proliferators in general are nongenotoxic mouse liver carcinogens for which DNA hypomethylation and altered gene expression are proposed mechanisms. Therefore, the peroxisome proliferators 2,4-dichlorophenoxyacetic acid (2,4-D), dibutyl phthalate (DBP), gemfibrozil, and Wy-14,643 were evaluated for the ability to alter the methylation and expression of the c-myc protooncogene. Male B6C3F1 mice were administered for 6 days in their diet Wy-14,643 (5-500 ppm), 2,4-D (1,680 ppm), DBP (20,000 ppm), or gemfibrozil (8,000 ppm). All four peroxisome proliferators caused hypomethylation of the c-myc gene in the liver. Wy-14,643 appeared to be the most efficacious with a threshold between 10 and 50 ppm. The level of the c-myc protein was increased by Wy-14,643, but not the other peroxisome proliferators. When female B6C3F1 mice received a two-thirds partially hepatectomy and 16 h later were administered 50 mg/kg Wy-14,643 by gavage, hypomethylation of the gene occurred 24 h later. Hypomethylation was not found in mice that received Wy-14,643 following a sham operation. Hypomethylation of the c-myc gene within 24 h of administering Wy-14,643 after a partial hepatectomy but not after a sham operation supports the hypothesis that the peroxisome proliferators prevent methylation of hemimethylated sites formed by DNA replication.     

Keratinocyte growth factor: effects on keratinocytes and mechanisms of action

Keratinocyte growth factor (KGF) is a potent and specific mitogen for different types of epithelial cells, and it can protect these cells from various insults. Due to these properties, it is of particular importance for the repair of injured epithelial tissues, and it is currently therapeutically explored for the treatment of radiation- and chemotherapy-induced mucosal epithelial damage in cancer patients. In this review we summarize the current knowledge on the role of KGF in tissue repair and cytoprotection, and we report on its mechanisms of action in keratinocytes.     

富含BCAA 的PN 对肝硬化大鼠肝部分切除术后肝脏NK 的影响

目的:探讨富含支链氨基酸的肠外营养对肝硬化大鼠肝部分切除术后肝脏自然杀伤细胞(NK细胞)的影响。方法:20只肝硬化大鼠随机分为肝部分切除术后行8.5%Novamin的肠外营养5 d组10只,肝部分切除术后行10%Hepa的肠外营养5 d组10只。应用流式细胞仪测定大鼠肝脏NK细胞的百分率;应用4小时51Cr释放法测定肝脏NK细胞的杀伤活性。结果:与8.5%Novamin的肠外营养5 d组比较,10%Hepa的肠外营养5 d组肝脏NK细胞占全部淋巴细胞的百分比和肝脏NK细胞杀伤活性明显升高(P<0.05)。结论:富含支链氨基酸的肠外营养可以增加肝脏NK细胞的百分率和肝脏NK细胞的杀伤活性。     

Partial hepatectomy hemodynamics changes: Experimental data explained by closed-loop lumped modeling

The liver function may be degraded after partial liver ablation surgery. Adverse liver hemodynamics have been shown to be associated to liver failure. The link between these hemodynamics changes and ablation size is however poorly understood. This article proposes to explain with a closed-loop lumped model the hemodynamics changes observed during twelve surgeries in pigs. The portal venous tree is modeled with a pressure-dependent variable resistor. The variables measured, before liver ablation, are used to tune the model parameters. Then, the liver partial ablation is simulated with the model and the simulated pressures and flows are compared with post-operative measurements. Fluid infusion and blood losses occur during the surgery. The closed-loop model presented accounts for these blood volume changes. Moreover, the impact of blood volume changes and the liver lobe mass estimations on the simulated variables is studied. The typical increase of portal pressure, increase of liver pressure loss, slight decrease of portal flow and major decrease in arterial flow are quantitatively captured by the model for a 75% hepatectomy. It appears that the 75% decrease in hepatic arterial flow can be explained by the resistance increase induced by the surgery, and that no hepatic arterial buffer response (HABR) mechanism is needed to account for this change. The different post-operative states, observed in experiments, are reproduced with the proposed model. Thus, an explanation for inter-subjects post-operative variability is proposed. The presented framework can easily be adapted to other species circulations and to different pathologies for clinical hepatic applications.     

罗哌卡因切口浸润联合静脉自控镇痛对肝癌肝切除术患者术后镇痛镇静效果及肝功能的影响

摘要 目的：探讨静脉自控镇痛（PCIA）联合罗哌卡因切口浸润对肝癌肝切除术患者术后的镇痛镇静效果及肝功能的影响。方法：选取2017年2月~2019年4月期间我院收治的119例行肝切除术的肝癌患者,根据随机数字表法分为对照组（n=59）和研究组（n=60）,对照组患者术后给予生理盐水联合 PCIA,研究组患者术后给予罗哌卡因切口浸润联合PCIA。比较两组患者术后指标、镇痛镇静效果、肝功能及不良反应。结果：研究组腹腔引流管拔出时间、术后首次下床活动时间、术后住院时间较对照组更短（P<0.05）,术后 PCIA 药物使用量少于对照组（P<0.05）。两组患者术后4 h~术后48 h视觉模拟疼痛评分量表（VAS）评分均呈先升高后降低趋势,且术后12 h、术后24 h、术后48 h研究组VAS评分均低于对照组（P<0.05）;研究组术后12 h、术后24 h、术后48 h Ramsay镇静评分均高于对照组（P<0.05）。两组患者术后3 d丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)水平均升高（P<0.05）。两组患者不良反应发生率比较无统计学差异（P>0.05）。结论：罗哌卡因切口浸润联合PCIA应用于肝癌肝切除术患者术后镇痛,镇静镇痛效果确切,可有效改善术后指标,且不增加肝功能损害,不良反应发生率较低。