目的结合近期收治的1例肝脏血管周上皮样细胞肿瘤（perivascular epitheliod cell tumor，PEComa）的病例特点，总结该疾病的诊治体会。 方法回顾分析2013年9月笔者所在医院成功收治的1例肝脏原发PEComa的诊治过程，并结合既往文献报道，总结和复习该疾病的临床特点以及处理方法。 结果肝脏PEComa较为罕见，起病隐匿，症状缺乏特异性，临床诊断困难，多依赖病理学检查证实，手术切除是有效的治疗手段。 结论提高本病影像学特征的认识有助于术前肿瘤性质的判断，本病预后较好，但术后仍需要长期密切观察随访。
Objective To investigate the maximum tolerance limit of rats to hepatic inflow occlusion with portal vein blood bypss (PBB) in normothermia. Methods First. A new animal model was established, the animal survival rate were calculated following 7 days of reperfusion after hepatic inflow occlusion of 30, 60, 90, 100, 110, 120 min or portal triad clamping (PTC) of 30 min. And then, the hepatic energy metabolism (RCR, P/O, ATP, AKBR) was studied following 30, 90, 120 min of ischemia or 1, 6, and 24 hours of reperfusion after the ischemia. According to the reversibility of the hepatic motochondrial function injury and maximum as long as a period of liver warm ischemia of all animal postoperative 7 days survial, the safe limit of rat to hepatic inflow occlusion was evaluated. Results The survival rate on postoperative 7 days was one hundred percent subjected to 30, 60 and 90 min of hepatic inflow occlusion, and 50, 30, 20 percent in 100, 110, 120 min, respectively, the survival rate in rats with 30 min of portal triad champing was about 40 percent. The parameters of hepatic motochondrial function reflecting the degree of liver damage to ischemia showed significantly different as compared to sham group. The functional lesion was exacerbated during inital reperfusion, then was restored progressively in PBB-30 min and PBB-90 min groups, but was maintained low level in PBB-120 min and PTC-30 min groups.Conclusion The 90 minutes is the maximum limit of rats to hepatic inflow occlusion in normothermia.
Objective To study the efect of IH764-3 on ischemia-reperfusion (I/R) injury in rat liver. Methods Rats were divided into 3 groups, the control group was not subjected to ischemia and no treatment was given. I/R injury group was subjected to 40 minutes ischemia followed by reperfusion for 120 minutes. The IH7643 group (40mg/kg) was administred at ischemia and reperfusion. Results In the IH764-3 group, sereum levels of ALT, AST, AKP and γ-GT were significantly lower than those in the I/R group. Energy charge level recovery was significantly higher with IH7643 (P＜0.05), hepatic ultrastructure was better preserved with IH764-3. Conclusion IH764-3 may be useful in the treatment of hepatic ischemia reperfusion injury
【Abstract】Objective To study the liver injury and effects of aescin on liver in rats with acute pancreatitis. Methods The rats were divided into 3 groups (control group, AP group and aescin group). The serum alanine aminotransferase （ALT）, serum lactate dehydrogenase (LDH), hepatic cellular energy charge (EC) and adenosine triphosphate (ATP) were detected. The pathologic changes in pancreas and liver were also observed. Results The serum levels of ALT and LDH in aescin group were significantly lower than those of the AP group. The EC and ATP levels were significantly higher in aescin group than that of the AP group. Conclusion Introvenous injection of aescin can alleviate the liver injury in rats with acute pancreatitis.
目的 探讨大鼠离体肝脏保存再灌注后肝脏组织中细胞间黏附分子-1（ICAM-1） mRNA的表达变化及丹参对其表达的影响。 方法 选取健康Wistar雄性大鼠54只，用完全随机方法选6只大鼠作为正常组，切除肝脏后立即灌注；随机选24只大鼠作为对照组，切除肝脏后置入4 ℃UW液中分别保存8、16、24、32h后再行肝脏循环再灌注；余下的24只作为实验组，切除肝脏后置入含丹参的4 ℃UW液中分别保存8、16、24、32h后再行肝脏循环再灌注。应用 RT-PCR方法检测各组大鼠离体肝脏保存再灌注后肝脏组织中ICAM-1mRNA表达。 结果 正常组肝脏中的ICAM-1mRNA表达为3.61±1.56，对照组和实验组8、16、24、32h时肝脏中ICAM-1mRNA表达分别为15.71±1.78、33.70±3.35、45.83±4.37、66.98±5.89和11.69±1.25、16.55±1.37、24.73±2.74、32.65±3.39，对照组和实验组各时相均分别明显低于正常组（P＜0.05），且均随保存时间延长，ICAM-1mRNA 表达逐渐增加（P＜0.05），实验组16h后ICAM-1mRNA 表达均分别明显低于对照组相应时相（P＜0.05）。结论 丹参能够降低离体肝脏保存再灌注后肝脏组织中ICAM-1mRNA表达，对肝脏保存再灌注损伤可能具有防护作用。
【Abstract】Objective To investigate the injury of calcium on the liver. Methods By using collagenase-containing solution to perfuse the rat livers, the rat liver suspension with different viability was prepared, preserved hypothermically, and the cytosolic calcium comcentration was detected with Fura2/AM. Results ① The concentration of cytosolic calcium after 2-hour storage: Experiment group 1(viability 5%) (1055.0±30.79) nmol/L, experiment group 2(viability 10%) (853.0±20.42) nmol/L, experiment group 3(viability 30%) (616.0±13.20) nmol/L, experiment group 4(viability 50%) (562.0 ±26.06) nmol/L, experiment group 5(viability 70%-80%) (318.0±13.01) nmol/L, experiment group 6(viability 90%) (114.6±6.11) nmol/L. ②The concentration of cytosolic calcium after 24hour storage: Experiment group A(viability 10%) (1704.0±70.11) nmol/L, experiment group B(viability 50%) (1125.0±23.22) nmol/L. The results showed that the lower was the viability, the higher was the cytosolic calcium concentration.With the same viability the cytosolic calcium concentration elevated more than two times higher than the original concentration with the time lengthened. Conclusion Calcium overload is one of the main factors which attribute to the ischemiareperfusion injury of the hepatocytes.
Liver transplantation plays a pivotal role in the field of treating end-stage liver diseases. It is currently the only treatment method that can effectively save patients’ lives and has been fully verified as effective in clinical practice. However, the problem of postoperative infection has become one of the key factors impeding the favorable prognosis of patients. Among them, donor-derived infections, due to their uniqueness and complexity, are gradually becoming a research hotspot in both clinical and scientific research fields. Through a systematic and comprehensive analysis of a large number of existing studies, we deeply analyzed the overall current situation of infections after liver transplantation, clarified the specific types of donor-derived infections and their respective characteristics. On this basis, the potential risks of such infections were thoroughly explored, and preventive strategies such as the prophylactic use of antibiotics and vaccination were put forward in a targeted manner, aiming to improve the prognosis of patients after liver transplantation to the greatest extent and enhance the quality of life of patients.
Objective To investigate the value of a new double action MR contrast agent——Gd-BOPTA in the diagnosis of focal nodular hyperplasia (FNH) of the liver with correlation of pathology. Methods Dedicated MRI scans were performed for 5 patients suspected to have liver FNH on clinical and imaging basis (six lesions). The MR imaging protocol included axial T1W and T2W plain scan, coronal T2 weighted imaging, 3D MRCP, Gd-BOPTA enhanced LAVA dynamic tri-phasic acquisitions (scanning at 15 s, 55 s and 90 s respectively), enhanced 2D T1W scan, enhanced LAVA in delay phase (at 5 and 10 min) and in the hepatobiliary phase (at 40 and 80 min). The imaging features on each MR sequence were compared with surgical and pathological findings. Results Six lesions in 5 FNH patients were all correctly diagnosed (5 conformed by surgery and 1 by needle biopsy). ①The hemodynamic phase: The parenchyma of 5 lesions were markedly enhanced in the arterial phase, being isointense or slight hypointense in both the portal venous and delay phases, while 1 lesion was isointense in all phases except being slight hyperintense in the arterial phase; The central scar of 5 lesions were not enhanced in the dynamic phase, but showed delayed enhancement. ②The hepatobiliary (excretory) phase: The parenchyma of all 6 lesions were slight hyperintense or isointense, and tree-like bile ducts with hyperintensity were seen within one lesion. The scar showed no enhancement. ③Pathology: The parenchyma was consisted of disarranged normal hepatocytes but with cytoedema, lack of portal tracts and cholestatic change. The central scar showed rich fibrous tissue, a very thick-walled arteriole, proliferative bile ducts, infiltration of inflammatory cells and myxomatous changes. Conclusion As a dual-phase MR contrast agent capable of depicting both the hemodynamic attributes and hepatobiliary excretion, Gd-BOPTA enhanced MRI can reflect the pathological features of FNH and reach a high diagnostic accuracy.
In this paper, we propose a new active contour algorithm, i.e. hierarchical contextual active contour (HCAC), and apply it to automatic liver segmentation from three-dimensional CT (3D-CT) images. HCAC is a learning-based method and can be divided into two stages. At the first stage, i.e. the training stage, given a set of abdominal 3D-CT training images and the corresponding manual liver labels, we tried to establish a mapping between automatic segmentations (in each round) and manual reference segmentations via context features, and obtained a series of self-correcting classifiers. At the second stage, i.e. the segmentation stage, we firstly used the basic active contour to segment the image and subsequently used the contextual active contour (CAC) iteratively, which combines the image information and the current shape model, to improve the segmentation result. The current shape model is produced by the corresponding self-correcting classifier (the input is the previous automatic segmentation result). The proposed method was evaluated on the datasets of MICCAI 2007 liver segmentation challenge. The experimental results showed that we would get more and more accurate segmentation results by the iterative steps and the satisfied results would be obtained after about six rounds of iterations.