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Objective To investigate the clinical efficacy of laparoscopic spleen-preserving distal pancreatectomy (Kimura method and Warshaw method) for benign lesions of pancreatic body and tail.Methods The retrospective cohort study was conducted.The clinicopathological data of 39 patients with benign lesions of pancreatic body and tail who underwent laparoscopic spleen-preserving distal pancreatectomy in the Second Affiliated Hospital of Nanchang University between March 2008 and January 2018 were collected.Of 39 patients,28 undergoing Kimura method (splenic artery and vein-preserving distal pancreatectomy) were allocated into the Kimura group,and 11 undergoing Warshaw method (cutting splenic vessels and preserving short gastric vessels)due to serious adhesion between pancreatic body and tail and splenic hilum were allocated into the Warshaw group.Observation indicators:(1) operation situations;(2) postoperative situations;(3) follow-up situations.Followup using outpatient examination and telephone interview was performed to detect blood glucose level and tumor recurrence of patients up to March 2018.Measurement data with normal distribution were represented as (x)±s and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range) and comparison between groups was done using nonparametric rank-sum test.Comparisons of count data were analyzed using chi-square test or Fisher exact probability.Results (1) Operation situations:39 patients received laparoscopic spleen-preserving distal pancreatectomy,operation time and volume of intraoperative blood loss of 39 patients were respectively (194 ±58)minutes and 100 mL (range,30-800 mL).The operation time and volume of intraoperative blood loss were respectively (197±56)minutes,100 mL (range,30-800 mL) in the Kimura group and (186±63)minutes,150 mL (range,30-450 mL) in the Warshaw group,with no statistically significant difference between groups (t =0.494,Z =-0.597,P＞ 0.05).(2) Postoperative situations:time to anal exsufflation and duration of hospital stay were respectively (2.6±0.8)days,(9.2±7.3)days in 39 patients and (2.4±0.6)days,(7.5±4.2)days in the Kimura group and (2.8±1.3)days,(13.5±11.1)days in the Warshaw group,with no statistically significant difference between groups (t=-0.720,-1.736,P＞0.05).Seven patients had postoperative complications.The incidence of complication was 2/28 in the Kimura group,1 patient with pancreatic leakage at 5 days postoperatively was cured by 15-day B ultrasound guided catheter drainage,and 1 who was diagnosed as pulmonary infection by chest CT examination at 5 days postoperatively was discharged from hospital after 8-day anti-infection and sputum-inductive treatments.The incidence of complication was 5/11 in the Warshaw group,3 patients with sustained fever at 5 and 7 days postoperatively who were diagnosed as grade 1 splenic infarction by epigastric enhanced CT examination were improved and discharged from hospital by antibiotic and low molecular weight heparin treatments,and then epigastric enhanced CT re-examination at 3 months postoperatively showed recovery of splenic perfusion;1 with pancreatic leakage at 7 days postoperatively was cured by 18-day conservative treatment;1 who was diagnosed as delayed gastric emptying by upper gastrointestinal contrast at 16 days postoperatively was improved and then discharged from hospital by 15-day placement of intestinal feeding tube and nutrition support therapy.There were statistically significant differences in the incidences of overall complication and splenic infarction between groups (x2 =5.485,4.878,P＜0.05) and no statistically significant difference in the incidence of other complications between groups (P＞0.05).(3) Follow-up situations:39 patients were followed up for 12 months (range,2-64 months).During the follow-up,six patients had normal blood glucose level,and all patients had good quality of life,without recurrence.Conclusions Laparoscopic spleen-preserving distal pancreatectomy for the benign lesions of pancreatic body and tail is satisfactory in short-and long-term curative effects.The incidences of complication and splenic infarction of Kimura method are lower than that of Warshaw method.
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Objective To compare the effectiveness of postoperative analgesia and early rehabil-itation between the wound infiltration combined with intravenous analgesia and epidural analgesia after hepatectomy.Methods Forty-eight patients with liver carcinoma,37 males and 1 1 females,aged 40-65 years,ASA physical status Ⅰ or Ⅱ,were randomly divided into two groups.Patients in group T were given 0.375% ropivacaine 30 ml for incision infiltration before closing the abdomen and intrave-nous analgesia.Patients in group E were given 0.2% ropivacaine 100 ml for epidural analgesia. Pareoxib sodium 40 mg was injected intravenously 30 min toward the end of the operation.Pain scores were assessed by VAS at postoperative 2,6,12,24 and 48 h.Postoperative activity distance was re-corded on 1st,2nd,3th day after surgery;the time first getting off bed and hospital stay were recor-ded.Finally,the complications were also recorded.Results Compared with group T,VAS scores at rest and in activity 12,24 and 48 h postoperatively were significantly lower (P <0.05 ).Compared with group E,postoperative activity distance on 1st,2nd and 3th day after surgery in group T were shorter.Furthermore,the time first getting off bed and the hospital stay in group T were shorter than those in group E (P <0.05).The incidence of adverse reactions between the two groups had no sta-tistical significance.Conclusion The wound infiltration combined with intravenous analgesia is benefi-cial to early recovery and shorter hospital stay.
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Interferon regulatory factor 7 is originally identified in the context of Epstein-Barr virus infection,and has play a key role in regulator of type Ⅰ interferons.Aberrant production of type Ⅰ interferons is associated with many types of diseases such as cancers and autoimmune disorders.Furthermore,mounting evidence has shed light on the importance of interferon regulatory factor 7,which is a multifuwtional transcription factor,not only regulate the response of inflammation and immune in body,but also regulate others biological funetions such as tumor formation,cell invasion and so on.The article has reviewed the progression of both interferon regulatory factor 7 and tumor.
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Objective To explore the preparation and quality control of As2 O3 nanoparticle .Methods PEG‐PLA was used as the vector material to prepare As2 O3 nanoparticle with ultrasonic emulsification method ,and the VEGFR‐2 was coupled to obtain VEGFR‐2/As2 O3‐PEG‐PLA nanoparticle .The particle size distribution ,Zata potential ,loading efficiency (LE) ,encapsulation effi‐ciency(EE) ,drug release in vitro and stability was determined ,and morphological characteristics was observed by transmission elec‐tron microscope(TEM) .Tweety‐four hepatocellular carcinoma nude mices were randomly divided into VEGFR‐2/As2O3‐PEG‐PLA nanoparticles group and As2 O3‐PEG‐PLA nanoparticles group ,by tail vein injection of nanoparticles .High performance liquid chro‐matography was used to determine content of As2 O3 .After 21 d ,six nude mices in each group were killed ,and the immunohisto‐chemistry and western blot method was used to detect the expression of VEGFR‐2 .Results The particle size of VEGFR‐2/As2 O3‐PEG‐PLA was determined to be (141 .9 ± 13 .2)nm ,Zata potential was (10 .2 ± 1 .1)mV .It was found to spherical or oval shape , with uniform size and dispersibility under TEM .LE and EE was (5 .51 ± 1 .83)% and (62 .12 ± 5 .98)% ,respectively .Drug release in vitro showed that VEGFR‐2/As2 O3‐PEG‐PLA exhibited controlled release effect ,with half of the release time as 10 h .Besides , VEGFR‐2/As2 O3‐PEG‐PLA showed a good stability in 3 days .Compared with As2 O3‐PEG‐PLA nanoparticles group ,the concen‐tration of As2 O3 in tumor and liver tissue was high ,the concentration of As2 O3 in blood ,heart ,kidney tissue was low ,the expression of VEGFR‐2 in tumor tissue was low in VEGFR‐2/As2O3‐PEG‐PLA nanoparticles group(P< 0 .05) .Conclusion The prepared As2 O3 nanoparticle using PEG‐PLA as vector and VEGFR‐2 as target showed uniform size ,high EE and LE ,good stability .And it preliminarily proved that VEGFR‐2 could be targeted in nude mice .
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Objective To investigate the effects of Krüppel like factor 4 (KLF4)on matrix metalloproteinase 9 (MMP9)ex-pression in hepatocellular carcinoma(HCC).Methods A total of 50 primary hepatocellular carcinoma samples and their correspond-ing adjacent tissues specimens were collected.The expression of KLF4 and MMP9 were detected by IHC,Western blot and qRT-PCR.After KLF4 gene was transfected into hepatocellular carcinoma cell line (HepG2 cell line),the expressions of KLF4 and MMP9 were conformed by qRT-PCR and Western blot.Migration and invasion of HepG2 cell line transfected by KLF4 were detec-ted by wound-healing assay and invasion assay.Results Compared to corresponding adjacent tissues,The expression of KLF4 was significantly lower in HCCs(P <0.05),and MMP9 expression was remarkably higher in HCCs(P <0.05).KLF4 over-expression inhibited the expression of MMP9 on the protein and mRNA levels.Wound-healing assay and invasion assay confirmed that KLF4 regulated cell invasion and migration through regulating MMP9 expression.Conclusion KLF4 showed low expression in HCCs,and MMP9 was overexpressed.Up-regulation of KLF4 could decrease the expression of MMP9 in HepG2 cell line,which inhibited inva-sion and migration.
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Interferon induced transmembrane protein (IFITM is a recently discovered antiviral protein family in the cell,which inhibit many with or without coated virus replication to have antiviral effects.At the same time,some recent studies show that IFITM3 plays an important role in migration of a variety of human tumor cells and stem cells.While the mechanism in human tumor occurrence,development and diffusion transfer of IFITM3 is still unclear.This paper is aim to summarize the research progress and direction of IFITM3 protein in human tumors.
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Objective To prepare the immunoconjugate composed of Adriamycin nanoparticles and VEGFR 2 monoclonal antibody(conjugate of ADM-NP and VEGFR 2-MAb) and study its pharmacokinetics property. Methods Adriamycin nanoparticles were prepared by using double emulsion method, with PLA and O-CMC as materials. Conjugate of ADM-NP and VEGFR 2-MAb was prepared by using molecule conjugate technology. Immunoreactivity of the conjugate with type IV collagenase and H 22 cell were analyzed by using ELISA. Pharmacokinetics parameters of the immunoconjugate were obtained by using SD rats as study objects. Results The prepared ADM-NP was sphere particles under SEM, which diameters were (160±34) nm. The drug loading rate and entrapment rate were (30.15±3.5)% and (80.56±4.24)% respectively. Conjugate of ADM-NP and VEGFR 2-MAb was successfully prepared, which had immunoreactivity with type IV collagenase and H 22 cell. The immunoconjugate showed good ADM control-release ability and could prolong the retention time of ADM in vivo. Conclusion Conjugate of ADM-NP and VEGFR 2-MAb keeps the immunoreactivity of VEGFR 2-MAb and shows good ADM control-release ability.
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Liver three-dimensional simulation technology is a cross-field study of hepatic surgery,anatomy,computer image technology and virtual three-dimensional technology.Compared to the two-dimensional images,the three-dimensional technology applied to the planning of liver surgery has obvious advantages and unique features.This technology not only can three-dimensional clarity of presentation and precise positioning of the important structures of the liver inside and outside,but also allow the surgeon independent dividing a interest region of liver inside and outside.Visualization of the liver and liver volume measurement preoperative planning,can effectively reduce the risk of postoperative liver failure,the remnant liver necrosis and postoperative bile leakage.
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ObjectiveTo study the application of three-dimensional simulated surgical technique in precise hepatectomy. MethodsFrom July 2009 to February 2010, 16 patients with primary liver cancer underwent preoperative simulated imaging and three-dimensional simulation of liver resection.The 3D extent of simulated hepatectomy and actual hepatectomy was compared and analyzed. ResultsThe shape and the extent of the liver resected were very similar in the simulated and the actual hepatectomies. The mean differences in the length, breadth and depth of the remnant livers were 0. 6118 cm,0. 4490 cm and 0. 3199 cm, respectively. ConclusionsSimulation hepatectomy could predict the extent of the actual liver resection, and provided accurate guidance and preoperative planning for precise hepatectomy.
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Hepatic surgery has got fast development during recent years. Hepatic anatomic complexity is not the fence of hepatic surgery development. The limit of liver function reserve controls hepatic operation and makes surgeons confused. The investigation of hepatic function reserve has made great prograsses recently. This article reviewed domestic and overseas documents to explain the contrilmtion of liww functional reselwe examination for hepatic surgery on the basis of hepateetomy quantity, tumor postoperative relapse, liver transplantation , liver function failure and liver function reserve detection.