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Xiu-jun Cai

Publications and source records attributed to Xiu-jun Cai.

At least 19 recordsLinked to original sources
PubMed2007

Hypertonic saline resuscitation maintains a more balanced profile of T-lymphocyte subpopulations in a rat model of hemorrhagic shock.

OBJECTIVE: To investigate the potential and early effect of hypertonic saline resuscitation on T-lymphocyte subpopulations in rats with hemorrhagic shock. METHODS: A model of rat with severe hemorrhagic shock was established in 18 Sprague-Dawley (SD) rats. The rats were randomly divided into Sham group, HTS group (hypertonic saline resuscitation group) and NS group (normal saline resuscitation group). Each group contained 6 rats. The CD4(+) and CD8(+) subpopulations of T-lymphocytes in peripheral blood were detected respectively before shock and after resuscitation by double antibody labelling and flow cytometry. RESULTS: In the early stage after hemorrhagic shock, fluid resuscitation and emergency treatment, the CD4(+) lymphocytes of peripheral blood in HTS and NS groups markedly increased. Small volume resuscitation with HTS also induced peripheral CD8(+) lymphocytes to a certain extent, whereas NS resuscitation showed no effect in this respect. Consequently, compared with Sham and HTS groups, CD4(+)/CD8(+) ratio of peripheral blood in NS group was obviously increased, and showed statistically differences. CONCLUSION: In this model of rat with severe hemorrhagic shock, small volume resuscitation with HTS is more effective than NS in reducing immunologic disorders and promoting a more balanced profile of T-lymphocyte subpopulations regulating network.

Animals↗
PubMed2007

[Apoptosis of circulating lymphocyte in surgical critically ill patients associated with poor outcome].

OBJECTIVE: To investigate the role and mechanism of lymphocyte apoptosis in post-operative critically ill patients and to determine the effects of lymphocyte apoptosis on the outcome of post-operative critically ill patients. METHODS: Thirty-nine consecutive post-operative patients admitted to the intensive care unit (ICU) were included in the prospective study. In addition, 30 healthy blood donors were involved for comparison. Early signs of apoptosis were investigated using flow cytometric measurement of Annexin-V binding to the cell surface of peripheral lymphocytes. In patients, absolute lymphocyte counts were measured on day 1, 3 and 5. The correlations of secondary infection and ICU stay duration with lymphocyte apoptosis and lymphocyte counts were determined. RESULTS: Post-operative critically ill patients exhibited higher rate of lymphocyte apoptosis than controls [(10.82+/-3.32)% vs. (2.89+/-1.17)%, P<0.01]. Meanwhile, lymphocyte counts were decreased significantly in patients compared with healthy individuals [(1.41+/-1.26) x 10(9)/L vs. (2.58+/-0.62) x 10(9)/L, P<0.01]. In patients group, rate of lymphocyte apoptosis was significantly higher in patients with secondary infection compared with those without secondary infection [(12.67+/-3.11)% vs. (9.24+/-2.63)%, P<0.01], and lymphocyte counts had no difference on day 1, while on day 3 and day 5 were decreased significantly in patients with secondary infection compared with those without secondary infection [(0.68+/-0.35) x 10(9)/L vs. (1.30+/-1.33) x 10(9)/L, (0.72+/-0.40) x 10(9)/L vs. (1.34+/-1.11) x 10(9)/L, respectively, stay duration of post-operative patients was positively correlated with rate of lymphocyte apoptosis (r=0.412, P=0.009) and negatively correlated with day 1, 3 and 5 lymphocyte counts, significantly correlated with day 1 and day 5 (r(1)=-0.333, r(5)=-0.361, both P<0.05). CONCLUSION: Lymphocyte apoptosis is enhanced in peripheral blood of post-operative critically ill patients and leads to a profound and persistent lymphopenia associated with poor outcome such as secondary infection and delay of ICU stay duration. Further studies are required to examine whether intervention to prevent lymphocyte apoptosis might alter the patients' outcome.

Apoptosis↗
PubMed2006

[The application of selective portal inflow occlusion in laparoscopic hepatectomy].

OBJECTIVE: To discuss the safety and the feasibility of laparoscopic selective portal inflow occlusion. METHODS: From January 2005 to February 2006, 7 patients were performed by laparoscopic hepatectomy with selective portal inflow occlusion. The patients included 1 male and 6 females, the mean age was 48.9 years, ranged from 31 to 70 years. Procedure included left lateral segmentectomies (4 patients), left hemihepatectomies (2 patients), and right hemihepatectomies (1 patient). Portal vein, hepatic artery and their branches were exposed by blunt dissection and performed selective portal occlusion with absorbable clips. RESULTS: There is no conversion, no mortality, and no postoperative complication. Seven selective portal inflow occlusions were performed successfully. The mean operating time was 188.7 min (range 70 min to 300 min), the mean intraoperative blood loss was 625 ml (range 350 ml to 1000 ml), and the mean postoperative hospital stay was 8.4 days. CONCLUSIONS: Laparoscopic selective portal inflow occlusion is a safe and feasible technique.

Adult↗
PubMed2006

[Surgical treatment of hepatocellular carcinoma with tumor thrombus in inferior vena cava].

OBJECTIVE: To review the experience for the management of hepatocellular carcinoma with tumor thrombus in inferior vena cava. METHODS: From July 2003 to May 2005, hepatectomy combined with thrombectomy were performed on 7 cases of hepatocellular carcinoma with tumor thrombus in inferior vena cava. In order to remove the tumor thrombus in inferior vena cava, total hepatic vascular exclusion were adopted on all cases to control the blood flow of IVC. According to the position of extension of tumor thrombus, 5 different procedures were adopted in the cases to control the suprahepatic IVC and extract the tumor thrombus out of IVC and atrium. Procedure 1: Median sternotomy, extracorporeal bypass, cardiac arrest, incision on right atrium and IVC were performed on 1 case for thrombectomy. Procedure 2: Median sternotomy, extracorporeal bypass without cardiac arrest, incision on IVC and (or without) incision on right atrium were performed on 2 cases for thrombectomy. Procedure 3: Abdominal approach to control intrapericardial IVC through an incision on diaphragm was performed on 1 case for thrombectomy. Procedure 4: Abdominal approach to control suprahepatic IVC above diaphragm through a small incision made on vena cava foramen for thrombectomy was performed on 1 case. Procedure 5: Abdominal approaches to control suprahepatic IVC below diaphragm for thrombectomy were performed on 2 cases. RESULTS: All operations were successfully performed. The postoperative complications included pleural effusion in 1 case, subphrenic fluid collection in 1 case and wound infection in 1 case. The average survival time of 7 cases was 9.8 month. The longest survival time was 26 months. CONCLUSION: Hepatectomy and thrombectomy can be safely performed on the case of HCC combined with tumor thrombus in IVC. Surgical treatment can relieve the patient from the risk of sudden death caused by heart failure and pulmonary.

Adult↗
PubMed2006

[Expression of RhoC protein in human primary hepatocellular carcinoma and its clinical significance].

OBJECTIVE: To detect the expression of RhoC protein in human primary hepatocellular carcinoma (HCC) and pericancerous liver (PCL) tissues and its relation to HCC prognosis. METHODS: Immunohistochemical method was used to detect the expression of RhoC protein in HCC, PCL of 43 patients. Thirty-six patients were followed up after they received radical resection. RESULT: The expression of RhoC protein in HCC was significantly higher than that in PCL. Rhoc expression was increased in cases with poor differentiation, portal vascular invasion, unintact envelope and multiple masses. The survival analysis showed that HCC with lower RhoC protein expression had better clinical outcomes. CONCLUSION: RhoC protein expression is correlated with infiltration and metastasis in HCC. RhoC protein can be used as a prognostic indicator for HCC.

Adult↗
PubMed2005

[Effects of different means of fluid resuscitation on apoptosis of visceral organs in rats with hemorrhagic shock].

OBJECTIVE: To observe the effects of different means of fluid resuscitation on apoptosis of visceral organs in rats with hemorrhagic shock. METHODS: The tails of 8 male SD rats were cut to cause active bleeding. Blood was collected from the carotid arteries of another 24 male SD rats and heparinized, then the 24 rats were randomly divided into 3 equal groups: no fluid resuscitation group (NF group, carotid blood was collected as described above, the tail was cut and the blood from the tail was collected in container with heparin 30 min after, and hemostasis and heparin blood transfusion were performed 60 min after cutting of the tail), controlled fluid resuscitation group [NS40 group: isosmotic saline was infused during the period of 30 to 60 min after the tail cutting to maintain the mean arterial pressure (MAP) at about 40 mm Hg and then hemostasis and heparin blood transfusion were performed 60 min after cutting of the tail], and great quantity fluid rapid resuscitation group [NS80 group: a great quantity of isosmotic saline was infused during the period of 30 to 60 min after the tail cutting to maintain the MAP at about 80 mm Hg and then hemostasis and heparin blood transfusion were performed 60 min after cutting of the tail]. Blood specimens were collected at the time points 0, 120, and 150 min to undergo blood routine examination. Another blood specimens were collected at the time points 0, 30, 60, and 90 min to undergo lactic acid examination. The surviving rats were killed and their livers, kidneys, lungs, and small intestines were taken out to undergo pathology. Cell apoptosis was examined by flow cytometry and TUNEL. RESULTS: The survival rates of the NS40 and NS80 groups were significantly higher than that of the NF group (both P < 0.05). The blood lactic acid levels of the NS40 and NS80 groups at the time points 60 and 90 min were all significantly lower than those of the NF and control groups (all P < 0.05). Apoptosis in the liver, kidney, and small intestine mucosa of the NS80 group was significantly marked than in the NF and NS40 groups (all P < 0.01). CONCLUSION: Controlled fluid resuscitation obviously reduces the early death rate of rats with severe hemorrhagic shock and apoptosis in the liver, kidney, and small intestine mucosa thereof and may benefit the prognosis.

Animals↗
PubMed2005

[Clinical study on primary repair for bile duct injury during laparoscopic cholecystectomy].

OBJECTIVE: To evaluate the place of primary repair of bile duct injury during laparoscopic cholecystectomy (LC). METHODS: Between 1994 and 2004, 53 of a total 14 302 cases were identified with bile duct injury. The indication, methods and outcome of primary repair for 17 cases of bile duct injury were analyzed. RESULTS: Forty-Two of 53 cases of bile duct injury were identified at the time of operation, thirty three involved a tear of the common, hepatic or right hepatic bile duct, and 17 cases received primary repair. Drainage tubes were placed in 7 cases, and biliary drainage through the cystic duct was performed in 10 cases. All patients recovered well and got out of bed within 6 hours postoperatively. The alimentary tract recovered in 24 hours after operation in all cases, and their mean hospitalization was 4.6 days. Sixteen patients were followed up, and no stricture of bile duct was found. CONCLUSION: Repair of bile duct injury during LC is safe and effective in selected cases.

Adult↗
PubMed2005

[Laparoscopic treatment of esophageal hiatal hernia: analysis of 11 cases].

OBJECTIVE: To investigate the effect and safety of laparoscopic treatment in patients with esophageal hiatal hernia. METHODS: Eleven patients with esophageal hiatal hernia, 9 males and 2 females, with the mean age of 56, accepted laparoscopic treatment. Two cases were treated by hernia repair merely and 9 cases were treated by hernia repair and fundoplication (Nissen's operation) one of which accepted laparoscopic cholecystoectomy at the same time. RESULTS: All patients were treated successfully. The operation time was 2.5 hours (1.5 - 5 hours) and the blood loss was between 20 - 200 ml. The patients began to accept liquid diet 24 - 36 hours after operation. There was no postoperative complication and all the clinic symptoms disappeared. The mean hospitalization time was 8 days (6 - 15d). CONCLUSION: Laparoscopic treatment of esophageal hiatal hernia provides a safe and minimal invasive procedure.

Adult↗
PubMed2005

[Laparoscopic hepatectomy by curettage and aspiration: 54 cases reported].

OBJECTIVE: Introduce the experience on 54 cases of laparoscopic hepatectomy-liver transection by curettage and aspiration (LTCA). METHODS: We used Peng multifunctional operative dissector (PMOD) to perform laparoscopic liver transection by curettage and aspiration. RESULTS: 52 patients underwent laparoscopic hepatectomy successfully. 2 patients were converted to an open hepatectomy for raw surface hemorrhage or severe abdominal cavity adherence. Mean operative time was 146.5 minutes, the mean bleeding volume was 460 mL, the largest excised liver size was 20 cm x 7 cm x 4 cm. Bile leakage and pneumothorax occurred in 2 patients. Patients could walk one day after operation and were discharged one week postoperatively. CONCLUSION: Laparoscopic hepatectomy by curettage and aspiration is a safe and effective technique. PMOD is an optimal tool to perform laparoscopic hepatectomy.

Adult↗
PubMed2005

[Surgical treatment of hepatocellular carcinoma originating from caudate lobe].

OBJECTIVE: To explore the significance of surgical treatment of HCC originating from caudate lobe. METHODS: From 1995 to 2003, caudate lobectomy, including 19 cases of isolated lobectomy and 20 cases of combined lobectomy, were performed in 39 patients with HCC originating from caudate lobe, and the factors that might influence postoperative liver function were compared between the two groups. RESULTS: All tumors were resected successfully. One patient died of postoperative renal failure. Hydrothorax occurred in 3 patients, ascites in 4 patients, and bile leakage in 1 patient. The survival rates of 1, 3, 5 year were 53%, 50%, 39% respectively. CONCLUSIONS: Caudate lobectomy is a effective method for HCC originating from caudate lobe.

Adult↗
PubMed2004

[Outcome and efficacy of laparoscopic splenectomy in treatment of idiopathic thrombocytopenic purpura].

OBJECTIVE: To investigate the safety and efficacy of laparoscopic splenectomy (LS) in treatment of idiopathic thrombocytopenic purpura (ITP). METHODS: Twenty-one patients with ITP underwent LS. The data of preoperative and postoperative platelet counts, intraoperative blood loss, recovery time, hospital stay time, and complications were analyzed prospectively. RESULTS: The platelet count was elevated rapidly in one week, and peristalsis of alimentary tract was recovered in 24 hours after operation in all cases. All patients got out of bed within 6 hours postoperatively. Their mean hospitalization time was 4 days. Complications were seen in 4 cases, of which one case underwent laparotomy, one case underwent laparoscopy once more to stop bleeding, one case developed subdiaphragmatic infection, and one case developed subcutaneous emphysema. Sixteen patients were followed up, and 2 patients relapsed. CONCLUSION: LS is a relatively safe and effective measure for treatment of ITP.

Adolescent↗
PubMed2004

[Role and significance of extrahepatic control of hepatic vein and inferior vena cava in difficult hepatectomies for patients with liver tumors].

OBJECTIVE: To explore the role of extrahepatic control on blood flow of hepatic vein and inferior vena cava in hepatectomy, and observe its effect on minimizing hemorrhage. METHODS: From 2001 to April 2003, 33 patients who had liver tumors involving segment IV, VII, VIII or half liver underwent major hepatectomies that required exposure of the inferior vena cava and main trunks of hepatic veins, during which the major hepatic veins and inferior vena cava were isolated and taped to control blood flow when necessary. RESULTS: In 33 attempts, 32 were successful and all tumors were resected successfully. The placement of occlusion tape was unsuccessful in 1 case. 7 cases did not need blood transfusion during operation. The amount of blood transfusion for other cases were form 0 to 1 600 ml. there was no operative mortality. CONCLUSIONS: Appropriate control of main truck of hepatic vein and inferior vena cava is effective in reducing blood loss during hepatectomies. It is also very helpful for performing difficult hepatectomies.

Adult↗
PubMed2004

Ciliated hepatic foregut cyst: report of first case in China and review of literature.

OBJECTIVE: To report the first case of ciliated hepatic foregut cyst in China, and review of literature to introduce the characteristics of this disease for doctors to recognize this disease. METHOD: Report the clinical procedure of diagnosis and treatment for the first case of ciliated hepatic foregut cyst in China, and to review the embryologic genesis, incidence, clinical manifestation, radiologic features and therapeutic principle of this disease. RESULTS: We performed the resection for ciliated hepatic foregut cyst under laparoscopy; the patient recovered well after the procedure. CONCLUSION: Ciliated hepatic foregut cyst is quite rare clinically, belongs to non-parasitic, solitary and unilocular cystic lesion, is always less than 4 cm in diameter, mostly seen in the left lobe, and has the tendency of malignant change. It should be removed as soon as diagnosed.

Adult↗