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Objective:To investigate the value of total laparoscopic simultaneous resection for left-sided colorectal cancer (CRC) and synchronous liver metastases (SLM).Methods:A retrospective analysis of the clinical data of patients with left-sided CRC and SLM who underwent simultaneous resection in the Shanghai Cancer Center, Fudan University from March 2014 to December 2017. The patients were divided into laparoscopy group, open surgery group and hybrid surgery group. The intraoperative information, postoperative short-term outcome and long-term survival were analyzed among the three groups.Results:A total of 96 patients were enrolled. The total laparoscopic group enrolled 29 patients, including 21 males and 8 females, aged (57.8±1.6) years old; the open surgery group enrolled 28 patients, including 18 males and 10 females, aged (57.3±2.0) years old; 39 cases were included in the hybrid surgery group, including 27 males and 12 females, aged (55.3±1.8) years old. The distribution ratio of the two lobes of liver metastases in the open surgery group was higher than that in the total laparoscopic group and hybrid surgery group (all P<0.05), and there was no significant difference in the other clinical baseline characteristics between the three groups (all P>0.05). In laparoscopy group, open surgery group and hybrid surgery group, the mean operative time was (241.5±12.9) min, (209.3±10.7) min and (234.9±12.4) min, respectively. The median intraoperative blood loss was 200.0 ml, 300.0 ml and 200.0 ml, respectively. The median postoperative hospital stay was 8.0 days, 9.0 days and 9.0 days, respectively. There were no statistical differences in these indicators (all P>0.05). The patients in the open surgery group had a longer initial defecation time than those in the other two groups ( P<0.05). The incidence of postoperative complications was 31.0% (9/29), 39.3% (11/28) and 35.9% (14/39), respectively, with no difference among the three groups ( P>0.05). In laparoscopy group, open surgery group and hybrid surgery group, 1-year overall survival were 93.0%, 85.0% and 94.0%; 3-year overall survival were 72.0%, 81.0% and 74.0%, respectively ( P>0.05). One-year disease free survival were 70.0%, 52.0% and 55.0%; 3-year disease free survival were 36.0%, 30.0% and 39.0%, respectively ( P>0.05). Conclusion:Laparoscopic simultaneous resection for left-sided CRC and SLM shows slight advantages in the safety and short-term outcome, and does not affect the long-term survival.
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Objective:To compare laparoscopic versus laparotomy in the treatment of colorectal cancer liver metastases (CRLM).Methods:The clinical data of 78 consecutive patients with CRLM operated at Department of Hepatic Surgery, Fudan University Shanghai Cancer Center from April 2015 to August 2016 were analyzed retrospectively. There were 52 males and 26 females. The average was (56.8±9.9) years. The patients were divided into the laparoscopic group ( n=26) and laparotomy groups ( n=52). The operation time, intraoperative blood loss, extent of hepatectomy, postoperative liver function and complications were compared between the two groups. The follow-up data was used to compare the long-term survival outcomes. Results:There were no significant differences between the two groups in operation time, intraoperative bleeding volume and extent of hepatectomy ( P>0.05). The percentage of patients who underwent preoperative neoadjuvant chemotherapy in the laparotomy group was significant higher, and the diameter of liver metastasis was significantly larger than that in the laparoscopic group ( P<0.05). On day 1 after operation, the alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in the laparoscopic group were (502.2±115.3) U/L and (570.4±132.4) U/L, respectively, which were significantly better than those in the laparotomy group (683.9±150.1) U/L and (739.5±230.2) U/L, respectively ( P<0.05). On day 3 after operation, the ALT and AST levels in the laparoscopic group were (263.3±83.3) U/L, (271.4±87.3) U/L, which were still significantly superior than those in the laparotomy group (410.8±128.4) U/L and (489.1±125.6) U/L ( P<0.05). Complications occurred in 4 patients (15.4%) in the laparoscopic group and 19 patients (36.5%) in the laparotomy group, the difference was significant ( P<0.05). The recurrence and extrahepatic metastasis rates of the laparoscopic group were better than those of the laparotomy group, and the survival outcomes were better than the laparotomy group. Conclusion:Laparoscopic surgery was better than laparotomy surgery in the treatment of CRLM. Laparoscopic surgery should be further promoted.
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Tumor associated macrophage (TAM), as the main type of immune cells in tumor microenvironment, becomes an active participant in the development of breast cancer. MicroRNA (miRNA) can regulate post-transcriptional gene expression, modulation of macrophage function by affecting its polarization typing and transformation, and ultimately contribute to the occurrence and development of breast cancer. It could provide a new diagnosis and clinical treatment strategy for the treatment of breast cancer by summarizing the mechanisms of miRNA in the polarization of TAM.
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Objective@#To investigate the effects of different expression of monoacylglycerol lipase (MAGL) in tumor-associated macrophages (TAMs) with the proliferation of MHCC97H human liver cancer cells in vivo and its mechanism.@*Methods@#Human peripheral blood-derived monocyte was induced to differentiate into M2-type TAMs and was identified by flow cytometry. The co-culture model of TAMs and MHCC97H human liver cancer cells was established, and the expression of MAGL in TAMs cells was detected by qRT-PCR. The expression of MAGL in TAMs cells was detected by plasmid transfection. ELISA and qRT-PCR was used to detect the mRNA expression levels and secretion levels of inflammatory factors in TAMs cells. The subcutaneous tumor model of MHCC97H mice was constructed to observe the effect of different expression of MAGL in TAMs cells with the proliferation of MHCC97H human liver cancer cells in vivo. F-test was used for the measurement of homogeneity of variance between two independent samples. A t-test was used for homogeneity of variance, and the corrected t-test was used for non-homogeneity of variance.@*Results@#Human peripheral blood-derived monocytes were successfully induced to differentiate into M2-type TAMs. An in vitro co-culture model was established. qRT-PCR showed that MHCC97H human liver cancer cells significantly down-regulated the expressional level of MAGL in TAMs cells. The constructed subcutaneous tumor model of mice demonstrated that up-regulation up-regulation of MAGL expression in M2-type TAMs inhibited the proliferation of MHCC97H human liver cancer cells in vivo. Furthermore, the mechanistic study illustrated that the high expression of MAGL promoted the transcription and secretion of inflammatory factors such as interleukin-1 beta, interleukin-6 and tumor necrosis factor-alpha in M2-type TAMs cells.@*Conclusion@#The overexpression of MAGL inhibits the proliferation of MHCC97H hepatocellular carcinoma cells in vivo, and its mechanism may be associated to the release of inflammatory factors that from TAMs cells.
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Background and purpose: With the application of laparoscopy in the liver surgery increasingly widely used, the safety and feasibility of laparoscopic liver resection is gaining recognition gradually. This study aimed to explore the laparoscopic liver resection for the tumor and the feasibility of open liver tumor resection and clinical curative effect. Methods: We retrospectively analysed the clinical data from 37 cases of laparoscopic hepatectomy and 74 patients with open liver resection from Mar. 2015 to Mar. 2016. Measurement data by covariance analysis were obtained, and comparison between groups were made using independent sample with Wilcoxon rank test and statistical value of Z. We collected data including operation time, intra-operative blood loss, post-operative recovery time of gastrointestinal tract, surgical drainage tube after extubation time, length of hospital stay, postoperative complications, hospitalization expenses and other clinical data. Laparoscopic group had 20 males and 17 female aged 18 to 76 (median age 55). Open group had 42 males and 32 females aged 26 to 74 (median age 54). The hepatectomy included ultrasonic knife + unipolar electric coagulation, combined with laparoscopic incision suture. Surgery procedures included 13 cases of local excision in laparoscopic group and 24 cases of liver segment or lobe anatomical resection. Open group had 33 cases of local excision and 41 cases of liver segment or lobe anatomical resection. Results: The average duration of laparoscopic hepatectomy was 149 min (40-204 min). The average duration of open hepatectomy was 142 min (45-190 min). The average intra-operative blood loss was 220 mL (30-570 mL) in laparoscopic group and 360 mL (90-970 mL) in open group. The average length of hospital stay was 4.9 d (3-6 d) in laparoscopic group and 6.8 d (5-9 d) in open group. Gastrointestinal average recovery time was 1.1 days in laparoscopic group and 2.3 days in open group. The average hospitalization expenses were 38760 yuan in laparoscopic group and 39145 yuan in open group. Conclusion:Laparoscopic hepatectomy is a safe, effective and minimally invasive surgery, can be safely used in local, liver segment and half liver resection, worthy of promotion.
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For the characteristics including minimal invasion,low incidence of complication and better postoperative prognosis,endoscopic therapy is widely accepted to be the first line therapy for most biliary strictures.At present,repeated progressive dilation combined with multiple plastic stents placement is the main therapy for benign biliary strictures.The long-term effective rate is relatively high in surgery related strictures,but in the non-surgery related strictures,its long-term effective rate is limited and the optimal therapy should be chosen cautiously according to patients' condition.In malignent biliary stricutes,dilation combined with metallic stents placement is recommended to treat both of preoperative long-term drainage in patients with resectable tumor and palliative treatment in patients with unresectable tumor,while nosobiliary drainage is recommended in preoperative short-term drainage. The choice of unilateral or bilateral drainage depends on patients' conditons in malignent hilar biliary strictures.The merits and demerits of stents should be mastered before they are placed in stricture sections.Recently,a lot of new endoscopic technologies and methods are applied in clinical practice,but their curative effect should be tested.Therefore,accumulative evidence-based data are needed to make them more rational and more standard.
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<p><b>OBJECTIVE</b>To find out the optimal nitrogen application level of Desmodium styracifolium.</p><p><b>METHOD</b>A field experiment using randomized block design was carried out to study the effects of 5 nitrogen application levels (150, 187.5, 225.0, 262.5 and 300.0 kg x hm(-2)) on yield and active component content of D. styracifolium.</p><p><b>RESULT</b>Nitrogen application could increase the yield and contents of polysaccharide, total flavonoides and total saponins of D. styracifolium. However, the enhancing extent of the active component content and the yield were not always significant with the increase of nitrogen level. In which, the yield were not significantly different among the nitrogen application levels of 225.0, 262.5, 300.0 kg x hm(-2) the polysaccharide content was no significantly difference among the nitrogen application levels of 225.0, 262. 5 and 300.0 kg x hm(-2), the total flavonoides content under the nitrogen level of 300.0 kg x hm(-2) was significantly lower than that of 150.0 kg hm(-2) (P < 0.01), and the total saponins content under the nitrogen level of 300.0 kg x hm(-2) was no significant difference compared with that of 262.5 kg x hm(-2).</p><p><b>CONCLUSION</b>The optimal nitrogen application level of D. styracifolium was 225.0-262.5 kg x hm(-2).</p>
Subject(s)
Fabaceae , Chemistry , Metabolism , Fertilizers , Flavonoids , Metabolism , Nitrogen , Metabolism , Plant Extracts , Metabolism , Polysaccharides , Metabolism , SoilABSTRACT
A new solid-phase BA-ELISA-spot assay is described for detection and enumera-tion of antigen specific antibody secreting cells.Spleen cells from immunized mice areincubated in plstic wells precoated with specific an tigen.After removal of the cells,immobilized antibodies at the point of release from single cell are demonstrated bymeans of an immunenzyme procedure in which.enzyme-substrate(HRP-TMB)reactionsare performed.Blue spots are thus produced and counted with naked eye.