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Objective To analyze the experience in diagnosis and surgical treatment for solid pseudopapillary neoplasm(SPN) of pancreas in children.Methods A retrospective study was performed in 12 pediatric patients with SPN who had been admitted to Affiliated Cancer Hospital of Zhengzhou University during January 2004 to December 2016,and their general data,demographic data,types of operations,postoperative complications and follow-up were analyzed.Results Among the 12 patients,3 cases were male and 8 cases were female,with average age 14.3 years old (11-17 years old).The main clinical manifestations included abdominal pain(4/12 cases,33.3％),abdominal mass (2/12 cases,16.7％) and trauma(2/12 cases,16.7％).In those 12 patients,33.3％ (4/12 cases) SPN was located at the head of the pancreas,and 66.7％ (8/12 cases) at the body and tail of it.The tumors were usually large,the largest diameter ranged from 4.0 to 15.3 cm(average largest diameter,8.2 cm).The color uhrasonography indicated heterogeneous echogenic mass and clear boundary.CT scanning indicated that the tumor was a low-density cystic mass with a clear boundary,with enhanced tumor real component and irregular reinforcement.No calcification was found in the patients.Dynamic enhanced magnetic resonance imaging scan revealed gradual strengthening solid components in tumor.All the patients received surgical resection,with distal pancreatectomy in 4 patients,pancreaticoduodenectomy in 4 patients,spleen-preserving distal pancreatectomy in 2 patients,Enucleation in 1 patient,and distal pancreatectomy and self-splenic slices transplantation in 1 patient.Lymphadenectomy was performed in 4 patients,and all the 21 removed lymph nodes were all negative.Pathological diagnosis confirmed the SPN in all the patients,among them 3 cases were malignant SPN,and one of them with tumor rupture and hemorrhage.The mean follow-up duration was 57.7 months(19-156 months) and no recurrence was found.Conclusion SPN is a rare neoplasm in children who go to see doctors because of clinical symptoms.Surgical resection,especially organs-preserving resection,may improve the long-term results.
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Objective:Preliminary study on therapeutic effects of adipose tissue derived stem cells (ADSCs) on MRL/lpr mice and the effect on imbalance of Th17/Treg.Methods:Fifteen 12-week-old MRL/lpr mice were randomly divided into 3 groups by using random number table,including ADSCs group,control group and cyclophosphamide (CTX) group,with 5 in each group.ADSCs group and control group were injected with 1 × 106ADSCs or phosphate buffered solution (PBS) via tail vein respectively,once a week,a total of eight times.CTX group was injected CTX at a dose of 15 mg/kg body weight,once a week for 2 weeks,and then repeated after 2 weeks' rest,a total of four times.The 24-hour proteinuria was measured before and after treatment.All the mice were sacrificed after treatment for 8 weeks.Th17 cells and Treg cells in splenic were examined by flow cytometry.Results:(1) The 24-hour proteinuria in the three groups had no significant difference before treatment (P ＞ 0.05).After therapy for 4 weeks,the 24-hour proteinuria in the ADSCs and CTX groups was much lower than those in control group,and the difference was significant [(5.02 ± 1.61) g/L vs.(7.10 ± 1.63) g/L,(4.90 ±0.71) g/L vs.(7.10 ± 1.63) g/L,P ＜ 0.05],and the longer the duration of treatment (8 weeks),the more obvious effect [(2.24 ± 0.73) g/L vs.(10.36 ± 1.64) g/L,(3.80 ± 1.45) g/L vs.(10.36 ± 1.64) g/L,P ＜0.01].There was no significant difference in 24-hour proteinuria between ADSCs group and CTX group (P ＞ 0.05).(2) Percentage of Treg cells/CD4 + T cells in the spleen lymphocytes:The percentages in ADSCs and CTX groups were higher than that in control group.The levels were 13.62％ ± 1.87％,14.14％ ± 1.29％,10.71％ ± 1.23％,respectively,but there was no significant difference (P ＞ 0.05).(3) Percentage of Th17 cells/CD4 +T cells in the spleen lymphocytes:The percentages in ADSCs and CTX groups were significantly lower than that in control group.The levels were 1.43％ ± 0.20％,1.63％ ± 0.65％,6.37％ ± 1.64％,respectively,with statistical significance (P ＜ 0.01).Conclusion:Transplantation of ADSCs can reduce the 24-hour proteinuria in MRL/lpr mice.To prolong the time of treatment,the effect is more significant.Transplantation of ADSCs can up-regulate Treg cells and down-regulate Th17 cells.ADSCs have the ability to regulate the immune balance of Th17/Treg in MRL/lpr mice,suggesting that ADSCs play the role of anti-inflammatory and immune regulation by regulating the Treg and Th17 cells.
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Aim To study the activation of Nrf2 in-duced by baicalein ( BAI ) , and its protection against carbon tetrachloride ( CCl4 ) , ethanol and acetamino-phen ( APAP )-induced hepatotoxicity. Methods A reporter gene assay was conducted in human normal liver L-02 cells to detect the activation of transcription factor Nrf2 induced by baicalein. APAP ( 10 mmol · L-1 ) , CCl4 (10 mmol·L-1 ) and Ethanol (100 mmol · L-1 ) were used to induce hepatotoxicity in L-02 cells. After the pre-incubation with Baicalein (0, 1, 10, 25, 50, 100 μmol·L-1 ) for 15 min, cells were administrated with or without those above hepatotoxins. 48 h later, cell viability was detected by 3-(4, 5-dim-ethylthiazol-2-yl ) 2 , 5-diphenyltetrazolium bromide (MTT) method. Results Baicalein (25, 50 μmol· L-1 ) induced the activation of Nrf2 ( P <0. 01 , P <0. 05) in the reporter gene assay. As compared with control, three hepatotoxins ( APAP, CCl4 , Ethanol ) all decreased cell viability ( P<0. 01 ) , and baicalein significantly reversed such decreases in a concentra-tion-dependent manner ( P<0. 01 ) . Conclusion Ba-icalein can induce the activation of transcription factor Nrf2 , which is probably one of the mechanisms con-tributing to the protection of baicalein against hepato-toxins (APAP, CCl4, Ethanol)-induced hepatotoxici-ty.
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Objective To evaluate the value of combined hepatectomy in radical resection for hilar cholangiocarinoma. Methods The clinical data and follow-up data of 67 patients of resection for hilar cholangiocarinoma in Henan Tumor Hospital from June 2005 to october 2008 were retrospectively analyzed. Results According to intraoperative exploration situation and bismuth types, tumor resection was combined performed with hepatectomy (n＝38)or non-hepatectomy (n＝29). The rate of R0 resection was 55.3% in hepatectomy group(n＝21) and 34.5% in non-hepatectomy group(n＝10), and the difference was significant（P＝0.024）. The incidence of complications were 39.5% in hepatectomy group(n＝15) and 13.4% in non-hepatectomy group(n＝4), and one patient with liver and kidney failure died in hospital. The 1, 3, 5 years of survival rate were 89.3%,53.6% and 32.1% respectively in R0 group (n＝31) and 69.7%,30% and 10% respectively in R1～R2 group(n＝36), there were significant differences in the postoperative survival rate between both groups（P＝0.018). The 1, 3, 5 years of survival rate were 81.8%,48.5% and 24.2% in hepatectomy group and 75%,32% and 16% in non-hepatectomy group respectively, and the differences were significant（P＝0.037). Conclusions Aggressive resection including combined hepatectomy for hilar cholangiocarcinoma can play an important role for curative effect and long term survival rate.
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<p><b>OBJECTIVE</b>To investigate the secondary operation methods and the effects on the prognosis of unexpected gallbladder cancer (UGC).</p><p><b>METHODS</b>A retrospective analysis on the clinical data was made for 41 patients who underwent extended radical excision from June 1995 to December 2002. Among the patients, 12 were male, 29 were female. The average age was 51 years old. The 41 patients had undergone gallbladder excision because of cholecystitis complicated lithiasis of gallbladder (32 cases), polypi of gallbladder or adenoma (9 cases). Postoperative pathology showed that 32 cases were adenocarcinoma of gallbladder, 6 cases were squamous carcinoma, 3 cases were squamous adenocarcinoma. Six cases were on the stage of Nevin I, 16 on Nevin II, 17 on Nevin III, 2 on Nevin IV. The second operation was performed after 6-30 d of the first operation. The second operation chose the improved method of Glenn excision of carcinoma of gallbladder.</p><p><b>RESULTS</b>On the second operation, 14 cases were with lymphatic metastasis, 14 with gallbladder metastasis, 6 with bile duct metastasis, 2 with pancreas metastasis. Fourteen cases were on the stage of Nevin IV, 9 on Nevin V, none on Nevin I, II and III. After the second operation, 1 year survival rate was 100% (41 cases); The three-year survival rate was 53.8% (22 cases); The five-year survival rate was 17.5% (7 cases).</p><p><b>CONCLUSION</b>Extended radical excision is one of the most important methods for the treatment of UGC.</p>