[Clinical application of bipolar tweezers-clamp for hepatic parenchymal transection]

Objective: To investigate the clinical value of the bipolar tweezers-clamp for the hepatic parenchymal transection in the resection of hepatocellular carcinoma. Methods: From January 2020 to January 2021,63 patients with the hepatocellular carcinoma for hepatectomy at Department of Hepatopancreatobiliary Surgery,Yuebei People's Hospital Affiliated to Shantou University Medical College were analyzed retrospectively.According to the different instruments used in the hepatic parenchymal transection,the patients were divided into bipolar tweezers-clamp group and ultrasonic scalpel group.There were 32 patients in bipolar tweezers-clamp group,with age of (55.5±10.5)years(range:37 to 78 years),including 22 males and 10 females,tumor size was (6.0±3.4)cm(range:2.4 to 13.4 cm). There were 6 patients with portal vein tumor thrombus and 5 patients with portal hypertension. There were 31 patients in ultrasonic scalpel group,with aged(57.8±10.1)years(range:37 to 79 years),including 27males and 4 females,tumor size was(7.9±5.1)cm(range: 2.4 to 21.3 cm),3 patients with portal vein tumor thrombus and 2 patients with portal hypertension. The preoperative baseline data,operation time,blood loss,postoperative liver function and the complications were compared between two groups using t test,χ² test and Fisher exact probabilityrespectively. Results: The operation was successfully completed in both groups.Compared with the ultrasonic scalpel group,the operation time was significantly shorter((219.3±76.4)minutes vs.(294.0±100.8)minutes,t=-3.322,P=0.002),the blood loss was less((250(475)ml vs. 500(1 050)ml,t=-2.307,P=0.026),the concentrate red blood cells transfusion volume was less(0.92(0.88)U vs. 2.32(4.00)U,Z=-1.987,P=0.047) in the bipolar tweezers-clamp group.The postoperative serum ALB level was higher in the bipolar tweezers-clamp group than that in the ultrasonic scalpel group((33.5±6.1)g/L vs. (29.5±4.2)g/L,t=3.226,P=0.020) on postoperative day 1;((35.7±4.5)g/L vs.(30.1±3.2)g/L,t=5.575,P<0.01) on postoperative day 3;((33.2±3.7)g/L vs. (31.0±4.4)g/L,t=3.020,P=0.004) on postoperative day 7. There was no significant difference in serum ALT,TBIL and PT level between the two groups(all P>0.05).No postoperative bile leakage occurred in both groups.The postoperative complications occurred in 8 cases(25.0%)in the bipolar tweezers-clamp group,including liver failure in one,and in 11 cases(35.5%)in the ultrasonic scalpel group,including liver failure in two(P>0.05). Conclusion: The bipolar tweezers-clamp is a safe and reliable method for the hepatic parenchymal transaction,which is quick and less bleeding during the hepatic resection.

Protective role of selenium-enriched supplement on spinal cord injury through the up-regulation of CNTF and CNTF-Ralpha

OBJECTIVE

Spinal cord injury (SCI), as one of the common serious spine disorders, often leads to severe neurological dysfunction and even permanent disability, which will cause heavy economical burden for family and society. Currently, selenium-enriched products have an obvious role in the protection and recovery of SCI; however, its protective mechanism is still unclear.

MATERIALS AND METHODS

In order to explore the protective effect of selenium-enriched supplement (SES) on SCI, the adult rats were randomly divided into sham operation control (SC) group, ischemia-reperfusion model (IM) group and SES pretreatment (ST) group to investigate the change of ciliary neurotrophic factor (CNTF) and its receptor-alpha (CNTF-Ralpha) during SCI in the presence of SES. The rats in IM and ST groups were subjected to the blockage of their abdominal aorta to establish the model of SCI; but the rats in SC group were subjected to sham operation without the blockage of abdominal aorta. The rats in ST group were fed with foods containing SES at the dose of equivalent 5 mg/L selenium in water before blocking their abdominal aorta. After 7 days, the rats were sacrificed to observe the structure of nerve cells through HE staining and the expression of CNTF and CNTF-Ralpha by Western blot, immunohistochemical, and RT-PCR methods, respectively.

RESULTS

Both protein and mRNA of CNTF and CNTF-Ralpha were positively expressed in rats from SC group. The mRNA expression levels of CNTF and CNTF-Ralpha in ST group were much higher than SCI model group.

CONCLUSIONS

SES can execute a protective role in SCI through up-regulating the expression of CNTF and CNTF-Ralpha.