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Nucleotide excision repair was a complex biochemical process that involved in the repair of many kinds of DNA damage. Previous study suggested that xeroderma pigmentosum group C (XPC) gene played an important role in the process of DNA damage repair. This study aimed to explore the influence of XPC gene polymorphism on the prognosis of patients with colorectal cancer (CRC) who were treated with capecitabine-related adjuvant chemotherapy. METHODS: A total of 158 patients with CRC who received surgical resection and capecitabine-based adjuvant chemotherapy were included in this study consecutively. Baseline clinical characteristics of patients were collected and analyzed. Additionally, peripheral blood specimens of the patients were collected for polymorphism analysis of XPC gene and mRNA expression of XPC, respectively. The association analysis between XPC polymorphism and prognosis and mRNA expression was performed. Cox regression analysis was used for multivariate adjustment. RESULTS: Prognostic data in the 158 patients with CRC who received capecitabine-based adjuvant chemotherapy was collected retrospectively. The median follow-up duration of the patients was 5.0 years (range: 0.25-7.5 years). The median DFS and OS of the 158 patients with CRC was 4.5 years and 5.7 years, respectively. XPC polymorphism analysis suggested that rs2228001 was of clinical significance. The prevalence of rs2228001 polymorphism among CRC patients was: TT genotype 86 cases (54.4%), TG genotype 60 cases (38.0%) and GG genotype 12 cases (7.6%), resulting in a minor allele frequency of 0.27, which was in accordance with Hardy-Weinberg equilibrium (P=0.733). TG and GG genotypes were merged in the subsequent analysis. The prognostic results exhibited that the median DFS of patients with TT genotype and TG / GG genotype was 4.5 and 5.7 years, respectively (c
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Objective To evaluate the clinical effectiveness and safety of percutaneous transhepatic papillary balloon dilatation (PTBD) combined with laparoscopic cholecystectomy (LC) for concurrent gallstones and common bile duct stones.Methods From Sep 2010 to Dec 2016,23 patients undergoing PTBD + LC were retrospectively compared with 34 cases recieving laparascopic common bile duct exploration (LCBDE) + LC.Parameters included surgical success rate,postoperative complications,residual stone rate,operation time,postoperative anal exhaust time,postoperative hospital stay,and hospitalization expenses.Results In this study 23 patients received PTBD + LC,34 patients received LCBDE + LC.In PTBD + LC group:the operation success rate was 91.3％,postoperative complications (2 cases of pancreatitis,3 cases of pulmonary infection,1 case of incisional infection),and the postoperative residual stone rate was 4.3％.In LCBDE + LC group:surgery success rate was 88.2％,postoperative complications (bile leakage 2 cases,lung infection 2 cases,incisional infection 1 case),postoperative residual stone found in 2.9％;The success rate,postoperative complications and postoperative residual stone rate between the two groups were not statistically different (P ＞ 0.05),nor in operation time,postoperative anal exhaust time,and hospitalization cost (P ＞ 0.05).PTBD + LC group had shorter hospital stay (P ＜ 0.05).Conclusions PTBD combined with LC is effective and safe procedure for the treatment of gallstones and bile duct stones.
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Objective To compare the clinical results between laparoscopic assisted small incision biliary duct exploration with traditional biliary exploration for patients with recurrent extrahepatic bile duct stones who had undergone biliary surgery for ≥2 times.Methods The clinical data of patients with recurrent extrahepatic bile duct stones who had undergone biliary surgery for ≥2 times,and underwent laparoscopic assisted small incision biliary duct exploration or traditional biliary exploration from September 2011 to June 2016 were retrospectively studied.Results 23 patients underwent laparoscopic assisted small incision biliary duct exploration (Group A),and 24 patients underwent traditional biliary exploration (Group B).The time spent on abdominal adhesion separation in group A and group B was (74.7 ± 20.5) min and (90.8 ± 20.3) min (P ＜ 0.05),respectively.The amount of intraoperative blood loss were (67.4 ± 35.6)ml and (107.4±31.5) ml (P ＜0.05).The number of patients with intestinal injury were 0 and 4.The postoperative time to first pass flatus was (26.9 ± 3.8) h and (35.5 ± 6.5) h (P ＜ 0.05).The durations of postoperative hospital stay were (8.1 ± 1.4) d and (12.8 ± 2.9) d,respectively,(P ＜ 0.05).The numbers of patients who required postoperative analgesics were 10 and 19 cases (P ＜ 0.05).The number of patients with postoperative incisional wound infection were 1 and 6.There was no significant difference in the time spent on biliary exploration,incidences of biliary leakage,pulmonary infection rate,hospitalization cost and liver function status between the two groups of patients (P ＞ 0.05).Conclusions Laparoscopic assisted small incision biliary duct exploration was safe and effective for patients with recurrent extrahepatic bile duct stones who had undergone biliary surgery for ≥2 times.This operation can be used as a preferred procedure.
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Objective To analyze the risk factors of pulmonary embolism complications following laparoscopic bile duct exploration.Methods The data of 201 cases undergoing laparoscopic bile duct exploration from June 2002 to December 2014 were retrospectively analyzed.Fourteen risk factors of pulmonary cmbolism complications were evaluated by univariate analysis using no conditional binary Logistic regression.Results 23 patients developed pulmonary embolism complications (11.4％).Age (≥60y),Diabetes mellitus,coronary heart disease,history of cerebral infarction,preoperative shock,time of operation,ambulation after operation (≥3 d) were significant risk factors of pulmonary embolism complications (P ＜0.05).Multivariate Logistic regression analysis identified diabetes mellitus,coronary heart disease,history of cerebral infarction,time of operation,ambulation after operation (≥ 3 d) as independent risk factors of pulmonary embolism complications (P ＜ 0.05).Conclusions Diabetes mellitus,coronary heart disease,history of cerebral infarction,time of operation,ambulation after operation (≥ 3 d) are independent risk factors for pulmonary embolism complications following laparoscopic bile duct exploration.
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Objective To study the expression of P57kip2 and its clinical significance in hilar bile duct adenocarcinoma.Methods The expressions of P57kip2 in hilar bile duct adenocarcinoma tissues (37 cases) and normal bile duct tissues (32 cases) were determined by immunohistochemical SP methods.The relations between the expression levels of P57kip2 with clinicopathologic parameters were analyzed.Results The positive rate of P57kip2 was 43.2％ (16/37) in bile duct adenocarcinoma,while it was 87.5％ (28/32) in normal duct tissues (P ＜0.01).The expression level of P57kip2 in adenocarcinoma showed no significant association with gender,age or CA19-9 level (P ＞0.05),but they were significantly related with lymph node metastasis,invasion and degree of differentiation (P ＜ 0.05).Conclusions P57kip2 is associated with the occurrence and development of hilar bile duct adenocarcinoma.It may play an important role in invasion and metastasis of hilar bile duct adenocarcinoma.The P57 protein can be used as an index to diagnose hilar bile duct adenocarcinoma.
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Objective To study the clinical efficacy of splenectomy plus porta-azygous devascularization in the treatment of portal hypertension using either the hand-assisted laparascopic (HALS) or the laparoscopic approaches.Methods The clinical data of 30 cases of portal hypertension treated between January 2008 and June 2012 were enrolled in this study.16 patients underwent HALS and 14 patients underwent traditional laparoscopy approach.Results All the operations were successfully accomplished.The mean operation time of the HALS group was significantly shorter than the traditional laparoscopic group (270 min vs 350 min,P＜0.05).Intra-operative blood loss of the HALS group was significantly less than the traditional laparoscopic group (250 ml vs 370 ml,P＜0.05).The median overall costs were significantly lower in the HALS group (30000 RMB vs 35000 RMB,P＜0.05).There were no significant differences in the time to return to oral diet,the length of hospital stay,and the time to passage of flatus.The complication rates between the two groups were similar.Conclusion Hand-assisted laparoscopic surgery had the advantages over conventional laparoscopic surgery in minimal invasiveness,safety,and quicker postoperative recovery.
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ObjectiveTo analysis the different types of bacteria in patients with a varying severity of acute cholangitis.Methods241 patients who presented with actue cholangitis between Jan 2008 to Oct 2011 to our hospital were retrospectively studied.These patients were divided into three groups according to the Tokyo Guideline.The bile specimens were obtained intraoperatively.The parameters were compared by SPSS 16.0 package program for statistical analysis.Results75.1 percent of the patients were positive for bacteria in the bile.There were 241 strains of bacterium which included 139 Gram-positive bacteria,99 Gram-negative bacteria and 6 strains of microzyme.Escherichia coli,Enterococcus faecalis,Enterococcus casseliflavus,Pseudomonas aeruginosa and Klebsiella species were the most frequently isolated bacteria.The positive rates for bacteria were significantly different between patients with mild and severe cholangitis (P＜0.05).There was no significant difference between patients with moderate and mild cholangits (P=0.141),or moderate and severe cholangitis (P=0.647).Gram-negative bacteria were more common than Gram- positive bacteria in patients with moderate and severe acute cholangitis (P＜0.05).In patients with moderate and severe acute cholangitis,there was more patients with multiple and mixed bacterial infection.ConclusionsEscherichia coli and Enterococcus species were more common in patients with acute cholangitis.The positive rate of bacteria in the bile in severe acute cholangitis was higher than that in mild acute cholangitis.In patients with moderate and severe cholangitis,Gram-negative bacterial infections and multiple and mixed bacterial infections were more common.
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Objective To evaluate the life quality in patients who underwent laparoscopic appendectomy resection and open appendectomy resection for choledocholithiasis.Methods A survey was made on 30 patients who underwent laparoscopic appendectomy resection and 30 patients who underwent open appendectomy resection.The quality of life was measured with the Gastrointestinal quality of life index (GIQLI) preoperation and 2,5,10,16 weeks after the operation.Results There were no significant difference in the GIQLI scores.The GIQLI scores were 121,115,126,131,and 133 respectively in preoperation and 2,5,10,and 16 weeks after laparoscopic appendectomy resection.The scores of GIQLI were 122,109,120,127,and 129 respectively in preoperation and 2,5,10,and 16 weeks after open appendectomy resection.Conclusion The GIQLI scores from laparoscopic appendectomy resection group is better than that from the open appendectomy resection group.