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Objective: To investigate the application of CD44 receptor-targeted nanoparticles HACDDP-DOX in the treatment of breast cancer, and to clarify its inhibitory effect on allograft breast cancer in the mice. Methods: Hyaluronic acid (HA) was used to construct a breast cancer targeted nanoparticle via green synthesis approach, and its particle size, stability and doxorubicin release profile at different pH conditions were measured. Then the breast cancer models were constructed by inoculating 4T1 cells into the mouse mammary fat pad. The model mice were randomly divided into control group, DOX/CDDP group and HACDDP-DOX group according to the tumor volumes and the body weights. PBS, free drug DOX/CDDP and HACDDP-DOX were intravenously injected into the allograft breast cancer models on the 1st, 5th and 9th days after the tumor volume reached about 80 mm5 The antitumor effect and biosafety of HACDDP-DOX were evaluated by detecting the tumor volume, mouse weight and immunohistopathology. Moreover, the biological distribution of HACDDP-DOX in the mice was studied by biofluorescence imaging. Results: The average particle size of HACDDP-DOX was (80.0 ± 17.4) nm, which was stable under pH 7.4. Under acidic condition, the particle size was increased and the DOX was effectively released. Compared with DOX/CDDP group, the body weight of the mice in HACDDP-DOX group was increased (P<0.05) and the tumor volume was decreased (P<0.05). The HE staining results showed that the liver of the mice in control group had tumor metastasis and the alveolar septum was widened. The tumor tissue of the mice in DOX/CDDP group and HACDDP-DOX group were all necrotic, while in HACDDP-DOX group the degree of necrosis was significantly higher than DOX/CDDP group. Compared with DOX/CDDP group, the activity of Caspase-3 in HACDDP-DOX group was significantly increased (P<0.01), while the Ki-67 activity was significantly decreased (P<0.01). The biofluorescence imaging showed that the nanoparticle HACDDPTXX could accumulate to the tumor site by targeting, and effectively release the drug. Conclusion: HACDDP-DOX nanoparticles can effectively target the breast cancer cells, reduce the toxicity of chemotherapy drugs, and enhance the therapeutic effect of breast cancer.
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Objective:To investigate the application of CD44 receptor-targeted nanoparticles HACDDP-DOX in the treatment of breast cancer, and to clarify its inhibitory effect on allograft breast cancer in the mice. Methods:Hyaluronic acid(HA)was used to construct a breast cancer targeted nanoparticle via green synthesis approach,and its particle size,stability and doxorubicin release profile at different pH conditions were measured. Then the breast cancer models were constructed by inoculating 4T1 cells into the mouse mammary fat pad.The model mice were randomly divided into control group,DOX/CDDP group and HACDDP-DOX group according to the tumor volumes and the body weights.PBS,free drug DOX/CDDP and HACDDP-DOX were intravenously injected into the allograft breast cancer models on the 1st,5th and 9th days after the tumor volume reached about 80 mm3. The antitumor effect and biosafety of HACDDP-DOX were evaluated by detecting the tumor volume,mouse weight and immunohistopathology.Moreover,the biological distribution of HACDDP-DOX in the mice was studied by biofluorescence imaging.Results:The average particle size of HACDDP-DOX was(80.0 ± 17.4)nm,which was stable under pH 7.4.Under acidic condition,the particle size was increased and the DOX was effectively released. Compared with DOX/CDDP group,the body weight of the mice in HACDDP-DOX group was increased(P<0.05) and the tumor volume was decreased(P<0.05).The HE staining results showed that the liver of the mice in control group had tumor metastasis and the alveolar septum was widened.The tumor tissue of the mice in DOX/CDDP group and HACDDP-DOX group were all necrotic,while in HACDDP-DOX group the degree of necrosis was significantly higher than DOX/CDDP group.Compared with DOX/CDDP group,the activity of Caspase-3 in HACDDP-DOX group was significantly increased(P<0.01),while the Ki-67 activity was significantly decreased (P<0.01).The biofluorescence imaging showed that the nanoparticle HACDDP-DOX could accumulate to the tumor site by targeting,and effectively release the drug.Conclusion:HACDDP-DOX nanoparticles can effectively target the breast cancer cells,reduce the toxicity of chemotherapy drugs,and enhance the therapeutic effect of breast cancer.
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Objective@#To discuss the clinical pathology characteristics, strategies of diagnosis and therapy, and related prognosis factors of pancreatic neuroendocrine tumors(pNET).@*Methods@#Clinical data of 103 pNET cases in Department of Pancreatic Surgery, Changhai Hospital of Second Military Medical University were collected from January 2006 to December 2015. There were 44 males and 59 females, aged from 21 to 77 years with mean age of 48 years.Of the 103 patients, there were functional type in 21 cases and no functional type in 82 cases. Related factors on diagnosis and treatment were summarized. Moreover, univariate survival analysis was performed by Kaplan-Meier method, and COX proportional hazards model was used for multivariate survival analysis.@*Results@#The detection rates of the B-ultrasound, CT, MRI were 60.2%, 84.6% and 91.3%, respectively, and there were 44 cases located in pancreatic head, 18 cases in pancreatic neck and 41 cases in pancreatic body and tail.G1 was the most common pathological grade, and the positive rates of Chromogranin A, Syn, neuron-specific enolase and CAM5.2 were 97.1%, 97.1%, 91.3% and 93.2%, respectively. The results of statistical analysis showed that tumor grade(χ2=26.077, P<0.05), Ki-67 index(χ2=25.427, P<0.05), ENETS stage(χ2=5.915, P<0.05), AJCC stage(χ2=8.411, P<0.05), lymph node metastasis(χ2=4.770, P<0.05) and distant metastasis(χ2=8.411, P<0.05) were associated with the prognosis of pNET, and the tumor grade was an independent risk factor of the pNET′ overall prognositic factors (HR=3.085, P<0.01).@*Conclusions@#The pNET can be located in any part of pancreas, and the combination of laboratory and various imaging examinations can help make early diagnosis. In addition, tumor grade, Ki-67 index, ENETS stage, AJCC stage, lymph node metastasis and distant metastasis were closely related to the prognosis of pNET, and the higher the tumor grade, the worse the prognosis.
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Objective To investigate the application value of double-layer continuous suture in pancreatic jejunum anastomosis of pancreatoduodenectomy (PD).Methods A retrospective analysis of 114 consecutive patients (67 men and 47 women) who underwent PD from June 2012 to July 2013 were conducted. There were 79 patients who were treated by double-layer continuous suture technique and 35 patients by double-layer interrupted suture technique .The incidence of pancreatic fistula and other complications after PD with two different suture techniques were compared .Results The operation time of double-layer continuous suture group and double-layer interrupted suture group is respectively ( 284 ±5 ) and ( 288 ±7 ) mins, the intraoperative bleeding volume is respectively (236 ±29) and (282 ±49) ml, the differences between two groups were no statistical significance .The postoperative fasting time in two group was respectively (7.8 ± 0.5) and (9.7 ±0.5) days, the length of hospital stay time was respectively (14.0 ±1.0) and (17.2 ± 10.0) days, the incidence of postoperative pancreatic fistula ( POPF) was respectively 17.1%(6/35) and 39.2%(317/9 ), the differences between two groups were statistically significant (all P<0.05).Grade A POPF was found in 4 patients ( 11.4%) from the double-layer continuous suture group and in 5 patients (6.3%) from the double-layer interrupted suture group.Grade B POPF was identified only in 1 patients (2.9%) from the double-layer continuous suture group and in 23 patients (29.1%) from the double-layer interrupted suture group .The presence of Grade C POPF was only documented in 1 patient from the double-layer continuous suture group and in 3 patients from the interrupted suture group .Conclusions Continuous suture can be safely used in the duct-to-mucosa pancreatojejunostomy .The double-layer continuous suture can be more effective in reducing pancreatic fistula , improving the feeding time , and reducing the length of hospital stay, and it is worthy of clinical popularization and application .
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<p><b>OBJECTIVE</b>To raise the awareness of adenosquamous carcinoma of pancreas and discuss the treatment of it.</p><p><b>METHODS</b>Clinical data of 80 cases of pancreas adenosquamous carcinoma patients in the Department of Pancreas Surgery of Changhai Hospital of Second Military Medical University from December 2003 to October 2011 were analyzed. The diagnose and treatment methods were discussed. There were 61 male cases and 19 female cases who aged from 28 to 81 years, with an average age of 60 years. The primary symptoms included 46 cases (57.5%) of abdominal malaise, 6 cases (7.5%) of low back pain, 4 cases (5.0%) of abdominal swelling pain with low back pain, 15 cases (18.8%) of abdominal swelling pain with jaundice, 5 cases (6.3%) of painless jaundice, 3 cases (3.8%) of significantly decreased body-weight and 1 case (1.3%) of no symptom. All the patients had been identified as pancreas tumor suffers by ultrasound, enhanced CT scan or MRI. Totally there were 43 cases of head/unciform process tumors, 15 cases of pancreas body tumors and 22 pancreas tail cases.Health situation of all cases were follow-up observed in the outpatient department or telephoned every 3 months till 24 months after the surgery.</p><p><b>RESULTS</b>Among the 80 patients, 19 patients underwent pancreaticoduodenectomy (PD) , 19 patients received pylorus-preserving PD, with 4 cases of palliative resection and 1 case of total pancreatectomy. The volume of bleeding during the surgery varied from 50 to 3 500 ml with a blood transfusion volume varied from 0 to 4 000 ml. Consumed time for PD procedures was 90 to 260 min with 60 to 150 min for body and (or) tail resection with or without lienectomy. The mean diameter of tumor was (4.9 ± 2.2) cm. Pathological tests showed 35 cases of positive lymph nodes, adjacent organ invasion happened in 35 patients, however, nerve invasion were found in 68 cases.Eighteen cases occurred postoperative complications, including bleeding, pancreatic fistula, gastric emptying, incision fat liquefaction and infection, pleural effusion, ascites and nervous diarrhea. There were only 48 effective follow-up patients, with a loss ratio of follow-up by 40.0%, reasons for the loss includes change of contact information, refuse or unable to provide useful information by the relatives of the patients.Sixteen patients received chemotherapy, and 8 patients received radiotherapy after operation. All patients were dead in the effective follow-ups. The postoperative median survival time was 6 months (0.1 to 23.0 months).</p><p><b>CONCLUSIONS</b>Adenosquamous carcinoma of pancreas is a rare kind of malignant tumor, nerve invasion can be found in almost all the cases. Patients with adenosquamous carcinoma of pancreas have an unfavorable prognosis. The principle treatments are surgery, radiotherapy and chemotherapy.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Carcinoma, Adenosquamous , Mortality , Pathology , General Surgery , Pancreas , Pathology , Pancreatectomy , Methods , Pancreatic Neoplasms , Mortality , Pathology , General Surgery , Pancreaticoduodenectomy , Methods , Postoperative Complications , Mortality , PrognosisABSTRACT
To study and analyze the causes of chylous leakage after pancreaticoduodenectomy. We retrospectively analyzed 381 patients who underwent pancreaticoduodenectomy [including pylorus-preserving pancreaticoduodenectomy] in Shanghai Chang Hai Hospital Affiliated to the Second Military Medical University, Shanghai, China between January 2010 and December 2012. We also studied the relationship between postoperative chylous leakage and age, gender, surgical approach, and the tumor nature. The chylous leak was placed in 23 patients and the incidence of chylous leakage in patients was 0.6%. There was no significant difference in gender, age and tumor pathological pattern between the chylous leakage group and non-chylous leakage group. The incidence of chylous leakage in patients with N1 grade cancer was significantly higher than that in patients with N0 grade cancer [p=0.001]. The incidence of chylous leakage in patients suffering R0 resection was significantly higher than that in patients suffering non-R0 resection [p=0.008]. All patients were successfully treated conservatively. The incidence of chylous leakage was 0.6% and the chylous leakage was closely linked with the tumor's grade malignancy and the range of radical resection