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Comprehensive treatment of biliary tract cancer has evolved rapidly, thereby improving disease control and long-term survival. The authors focus on the update of this emerging field and its impacts on surgical treatment to explore the development of surgery in the treatment of biliary tract cancer in the future. With the goal of medium- and long-term benefits, a comprehensive treat-ment based on multidisciplinary team and surgery-centered approach is recommended throughout treatment of biliary tract cancer. In the era of multidesciplinary team, surgical treatment of biliary tract cancer will develop toward precision, limited surgical scope, and minimally invasive technique.
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Hepatocellular carcinoma (HCC) has the features of high incidence rate, low survival rate, poor treatment outcome, and complex pathogenesis. In recent years, many studies have shown that long non-coding RNA (lncRNA) MALAT1 is upregulated in HCC and can promote the proliferation, invasion, and metastasis of HCC cells, and it can also guide the diagnosis, prognostic evaluation, and treatment of HCC in clinical practice. This article reviews the current status of research on lncRNA MALAT1 in HCC and discusses its expression pattern, mechanism of action, and clinical significance in predicting and monitoring the progression of HCC, so as to gain a deep understanding of the role of lncRNA MALAT1 in the progression of HCC. It is pointed out that lncRNA MALAT1 is expected to become a potential biomarker for the diagnosis and prognostic evaluation of HCC and may be used as a therapeutic target in clinical practice.
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MicroRNA-223 (miR-223) is located on chromosome X, and is highly conserved in the process of evolution. In recent years, many studies have shown that miR-223 is abnormally expressed in a variety of digestive system tumors, such as esophageal cancer, gastric cancer, liver cancer, pancreatic cancer and colorectal cancer. MiR-223 can participate in the proliferation, apoptosis and invasion of tumor cells through a variety of signal pathways, which is expected to become a marker for the diagnosis and prognosis of digestive system tumors.
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Objective:To investigate the expression level of C-type lectin domain family 4 member G ( CLEC4 G) in liver disease tissues and its correlation with the clinicopathological characteristics of hepatocellular carcinoma (HCC) patients. Methods:The cancer tissue and the corresponding adjacent tissues (at least 2 cm from the edge of the cancer tissue), cut in surgeries from January to December in 2019, of 40 HCC patients in Zhuzhou Central Hospital, as well as 10 normal liver tissue samples (seen as far away as possible from the edge of the cancer tissue with naked eyes) and 10 liver cirrhosis samples were analyzed retrospectively. The tumor genome atlas (TCGA) database was used to screen the HCC transcriptome data sets, and bioinformatics methods were used to make expression heat maps and box maps which can help analyze the difference of CLEC4 G in cancer and adjacent tissues. The mRNA expression level of CLEC4 G was detected by conducting real-time fluorescence quantitative PCR (qRT-PCR), and the protein expression level of CLEC4G was detected by immunohistochemistry (IHC). The measurement data were expressed as mean±standard deviation ( Mean± SD). Group t test was used for inter-group comparison. The counting information was expressed as a percentage (%). The χ2 test was adopted to analyze the correlation between CLEC4 G expression level and the clinicopathological features of patients. Results:The expression level of CLEC4 G in cancer tissues was significantly decreased in heat map compared with that in adjacent tissues. In the box figure, the relative expression of CLEC4 G mRNA in the cancer tissues was (82.5±18.9) and (3 354.4±296.2) in paracancer tissues, with statistically significant difference ( P<0.001). Respectively, qRT-PCR and IHC showed that mRNA of CLEC4 G were abundant in normal liver tissues (3 301.3±286.4), while they were very little in liver cancer tissues (63.6±32.9), significantly decreasing in liver cirrhosis (1 742.6±208.7) and paracancer tissues (1 553.2±249.9), with statistically significant difference ( P<0.001). Moreover, low CLEC4 G expression level was associated with tumor vascular metastasis in HCC patients. Conclusions:CLEC4 G is highly expressed in normal liver tissue, but with the progression of malignant liver disease, it is significantly decreased with little expression in HCC tissue. It can be expected to be a good marker for the pathological diagnosis of HCC.
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Severe acute pancreatitis is a common clinical acute abdominal disease, characterized by acute onset, rapid progression, high risk, poor prognosis and so on. Due to the high mortality of this disease, it has been the focus and difficulty of clinical research. The traditional treatment of severe acute pancreatitis mainly include fasting and parenteral nutrition. However, recently, international and national consensus suggest that early enteral nutrition is fit for severe acute pancreatitis, although the timing of early enteral nutrition has been controversial. The article summarizes the optimal timing of early enteral nutrition for severe acute pancreatitis.
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Objective@#To investigate the safety and feasibility of emergency transcatheter arterial embolization in the treatment with spontaneous rupture of hepatocellular carcinoma.@*Methods@#The data of 42 patients with spontaneous rupture of hepatocellular carcinoma who were treated by emergency transcatheter arterial embolization from January 2015 to December 2018 in Department of Hepatobiliary Surgery of Chongqing Emergency Medical Center were collected. There were 35 males and 7 females, aged 28-78 years, with an average age of 51 years. The success rate of intubation, postoperative mortality and postoperative complications were observed.@*Results@#All patients were successfully intubated, 40 cases improved and discharged, 1case died within 1 month after operation, who with large amount of bleeding, 1 case died after 1 month, who with diffused liver cancer and liver failure, 3 cases were complicated liver or kidney failure, in whom 2 cases improved after active treatment.@*Conclusion@#Emergency transcatheter arterial embolization has the advantages of less trauma, short operation time, less postoperative complications and good hemostatic effect, which can increase the survival rate of patients under emergency conditions and lay a foundation for subsequent tumor treatment, it should be popularized in clinical work.
ABSTRACT
Severe acute pancreatitis is a common clinical acute abdominal disease,characterized by acute onset,rapid progression,high risk,poor prognosis and so on.Due to the high mortality of this disease,it has been the focus and difficulty of clinical research.The traditional treatment of severe acute pancreatitis mainly include fasting and parenteral nutrition.However,recently,international and national consensus suggest that eady enteral nutrition is fit for severe acute pancreatitis,although the timing of early enteral nutrition has been controversial.The article summarizes the optimal timing of early enteral nutrition for severe acute pancreatitis.
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Objective To investigate the safety and feasibility of emergency transcatheter arterial embolization in the treatment with spontaneous rupture of hepatocellular carcinoma.Methods The data of 42 patients with spontaneous rupture of hepatocellular carcinoma who were treated by emergency transcatheter arterial embolization from January 2015 to December 2018 in Department of Hepatobiliary Surgery of Chongqing Emergency Medical Center were collected.There were 35 males and 7 females,aged 28-78 years,with an average age of 51 years.The success rate of intubation,postoperative mortality and postoperative complications were observed.Results All patients were successfully intubated,40 cases improved and discharged,1case died within 1 month after operation,who with large amount of bleeding,1 case died after 1 month,who with diffused liver cancer and liver failure,3 cases were complicated liver or kidney failure,in whom 2 cases improved after active treatment.Conclusion Emergency transcatheter arterial embolization has the advantages of less trauma,short operation time,less postoperative complications and good hemostatic effect,which can increase the survival rate of patients under emergency conditions and lay a foundation for subsequent tumor treatment,it should be popularized in clinical work.