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Objective:To evaluate partial splenectomy (LPS) in the treatment of benign solid tumors of the spleen.Methods:The clinical data of patients with benign solid tumors of spleen treated by laparoscopy from Jan 2010 to Jun 2018 in the Third Affiliated Hospital of Soochow University was retrospectively analyzed. Patients were divided into LPS group and laparoscopic total splenectomy (LTS) group.Results:There were 21 cases in LPS group and 25 cases in LTS group. Differences between the two groups, operative time, blood loss, transfusion rate, maintenance of drain, postoperative hospital stay, costs, postoperative WBC and platelet count, and postoperative complications such as hemorrhage, fever, splenic fossa effusion, pancreatic fistula, venous thrombosis were statistically insignificant. However, the postoperative incidence of thrombocythemia in the LPS group were significantly lower compared to the LTS group (χ 2 =4.293, P<0.05). Conclusions:Patients with benign solid tumors of the spleen will benefit more from LPS compared to LTS.
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Objective To explore the safety,feasibility,clinical efficacy and prognosis of gallbladder carcinoma treated by laparoscopy.Methods The clinical data of 43 patients with gallbladder carcinoma treated by laparoscopy radical cholecystectomy from Jan 2010 to Oct 2017 in the Third Affiliated Hospital of Soochow University were retrospectively analyzed.Results 15 cases underwent simple laparoscopic cholecystectomy,13 cases underwent laparoscopic cholecystectomy + lymphadenectomy and 15 cases underwent laparoscopic cholecystectomy + liver wedge resection + lymphadenectomy.The average operation time was (64 ± 32) min,(100 ± 45) min,and (217 ± 74) min,respectively.The average intraoperative blood loss was (67 ± 83) ml,(58 ± 63) ml and (182 ± 165) ml.The average postoperative hospital stay was (4.3 ± 2.2) days,(5.2 ± 2.0) days,(7.0 ± 1.7) days.All patients were diagnosed as gallbladder carcinoma by postoperative pathology.The median follow-up time was 14.5 months (range from 3 to 97 months).The cumulative survival rates of Tis,T1b,T2 and T3 stage were 100％,90％,52.7％ and 0,respectively (x2 =25.333,P ＜ 0.05).Conclusions It is safe and feasible to treat early gallbladder carcinoma by laparoscopy.
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Objective@#To compare the clinical application of three-dimensional laparoscopic pancreatoduodenectomy (3D-LPD) with that of two-dimensional laparoscopic pancreatoduodenectomy (2D-LPD), and to explore the safety and feasibility of 3D-LPD.@*Methods@#A retrospective analysis was made from the data of 45 patients with 3D-LPD and 45 patients with 2D-LPD who underwent total laparoscopic pancreatoduodenectomy from March 2017 to August 2018 at Department of Hepato-Pancreato-Biliary Surgery, the First People′s Hospital of Changzhou.The differences of intraoperative conditions, postoperative complications and postoperative pathological findings between the two methods were compared.Measurement data were compared with independent sample t-test, enumeration data were statistically analyzed with Chi-square test or Fisher exact probability.@*Results@#The operation time of 3D-LPD group was shorter than that of 2D-LPD group ((335±95) min vs. (419±113) min, t=-3.817, P=0.000), which mainly showed that the time of digestive tract reconstruction was reduced ((92±26) min vs. (131±46) min, t=-4.951, P=0.000). The intraoperative blood loss in the 3D-LPD group was significantly less than that in the 2D-LPD group ((242±124) ml vs. (350±176) ml, t=-3.365, P=0.001), and the perioperative blood transfusion in the 3D-LPD group was significantly less than that in the 2D-LPD group (χ2=4.444, P=0.035). Postoperative hospitalization days and ICU stay time were not significantly different between the two groups(both P>0.05). Postoperative complications such as pancreatic fistula, biliary fistula, postoperative bleeding, gastric emptying disorders, abdominal infection, were not significantly different between the two groups(all P>0.05).@*Conclusions@#The operation time of 3D-LPD is shorter than that of 2D-LPD, and the amount of bleeding is less. Short-term clinical data showed that, 3D-LPD is effective, safe and worth popularizing.
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Objective To investigate the strategies in dealing with intraoperative CO2 embolizm during Laparoscopic hepatectomy (LH).Methods We collected and analyzed data from patients who underwent laparoscopic hepatectomy (LH) in our hospital from Jan.2013 to Aug.2017.There were 321 patients.The criteria for the diagnosis of CO2 embolism were rapid intraoperative decrease in petCO2 and SPO2 accompanied with tachyarrhythmia.Results 12 patients were diagnosed to have CO2 embolism.The rate was 3.7％.For these 12 patients,10 patients were dealt with laparoscopically and 2 patients were converted to open surgery.Conclusion CO2 embolism did not rarely occur in LH patients.Sophisticated operations and careful manipulation in LH are the only ways to prevent CO2 embolism.
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Objective@#To evaluate the clinical significance of C-reactive protein/albumin ratio in predicting the postoperative prognosis of pancreatic cancer patients.@*Methods@#The clinical date of 97 patients with resectable pancreatic cancers who treated at Department of Hepatobiliary and Pancreatic Surgery, the third Affiliated Hospital of Soochow University from January 2005 to December 2015 were analyzed retrospectively. The cut-off value of CRP/Alb ratio was determined by the receiver operating characteristic(ROC) curve. According to the CRP/Alb ratio, patients were respectively divided into two groups: the high group(CRP/Alb ratio≥0.109) and the low group(CRP/Alb<0.109). The relationships between CRP/Alb ratio and clinical characteristics were analyzed by χ2 test. Median survival and 1-year overall survival rate(OS) was calculated by Kaplan-Meier method.The risk factors of patients with poor prognosis were analyzed by univariate and multivariate Cox regression analysis model.@*Results@#Tumor TNM stage(χ2=4.280, P=0.039) and differentiation(χ2=6.635, P=0.010) had significant relationship with CRP/Alb ratio. The median survival of higher CRP/Alb ratio group and lower CRP/Alb ratio group was 15 months and 23 months respectively. Compared with lower CRP/Alb ratio group, the 1-year OS of higher CRP/Alb ratio group decreased remarkablely, and the difference was statistically(χ2=10.207, P=0.001). Moreover, median survival and OS were decreased in patients with advanced age(≥65 years old: χ2 =5.338, P=0.021), high TNM stage(ⅡB-Ⅲ: χ2 =10.529, P=0.001), poor tumor differentiation(χ2=5.380, P=0.020), vascular invasion(χ2 =7.856, P=0.005) and positive surgical margin(χ2=9.059, P=0.003). A high CRP/Alb ratio was identified as an independent risk factor of poor prognosis for patients with pancreatic cancer(HR=1.832, 95% CI: 1.067-3.144, P=0.028). Besides, old age(HR=1.684, P=0.014), high TNM stage(HR=1.666, P=0.031), vascular invasion(HR=1.834, P=0.024) and positive surgical margin(HR=2.205, P=0.023) were also included.@*Conclusion@#Preoperative CRP/Alb ratio can be an important clinical factor for assessing the prognosis of patients with resectable pancreatic cancers, and high CRP/Alb ratio suggests poor prognosis.
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Objective To explore the effects of different intrauterine adhesion (IUA) classification systems on predicting the IUA prognosis.Methods One hundred cases were selected as the subjects in present study from those diagnosed with IUA and underwent surgery in Zhujiang Hospital of Southern Medical University from Jan.2010 to Jan.2017,and were followed up for two years.According to the actual situation,all patients were scored by March,AFS,ESGE and Chinese classification for comparing the effects of different IUA classification systems on predicting the pregnancy rate,live birth rate and effective rate within 2 years after surgery.Results ESGE classification had a good effect on predicting the postoperative live birth rate and effective rate,and a certain predictive effect on pregnant rate,with the area under curve (AUC) of 0.722,0.754 and 0.635,respectively.March classification had a certain effect on predicting the postoperative live birth rate and effective rate with AUC of 0.635,0.754,respectively,but had a poor effect on predicting pregnant rate.AFS classification and China classification had poor effect on predicting the IUA prognosis.Conclusion ESGE classification system is better than the other systems including March,AFS and Chinese classification,on predicting the IUA prognosis,but further verification in large sample size is still required.
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Chemokines participate in many biological functions including immune inflammatory response,various metabolic reactions and damage stress response.Meanwhile,they also play a crucial role in the process of tumor progression including regulating tumor proliferation,invasion and metastasis,and mediating immune cells infiltration and angiogenesis in tumor tissue as well as the tolerance to antitumor treatment.Pancreatic cancer is one of the highly malignant digestive system neoplasms with relatively high risk of early local invasion and distant metastasis,resulting in high mortality.At present,the specific mechanism of the development of pancreatic cancer has not been clarified yet.In recent years,the role of chemokine CXC (chemokine subfamily) and its receptor CXCR (CXC chemokine receptors) in pancreatic cancer has become a hot research topic and great progress has been made in this field.This paper overviewed the recent research advance on the functions of chemokine CXC and their receptors in pancreatic cancer.
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Objective To investigate the effect of estrogen on the fibrosis process of intrauterine adhesions and the expression of forkhead box F2 (FoxF2).Methods Primary human endometrial stromal cells (HESCs) were obtained by separation with 0.2％ collagenase Ⅰ digestion-mesh filtration-differential adherence,and identified by immunocytochemistry.HESCs affected with 10ng/ml transforming growth factor β1 (TGF-β1) for 48 hours.HESCs in model group were affected with 0,10-6,10-8,10-10 and 10-12mol/L estrogen,the expressions of smooth muscle actin alpha (α-SMA),Collagen I (COL Ⅰ) and FoxF2 were detected by quantitative PCR (qPCR) and Western blotting.Results HESCs with high purity and good activity were obtained by using 0.2％ collagenase Ⅰ digestion-mesh filtration-differential adherence separation method.Immunocytochemistry showed positive vimentin and negative cytokeratin 18 in HESCs.The results of qPCR and Western blotting showed that the mRNA and protein expression levels of α-SMA,COL Ⅰ and FoxF2 were higher in model group than in control group (P＜0.05),the model was built successfully.qPCR revealed that the mRNA expression levels ofα-SMA,COL Ⅰ and FoxF2 were significantly lower in 10-6,10-8 and 10-10mol/L estrogen groups than in model group (P＞0.05 in 10-10mol/L estrogen group,P＜0.05 in other groups),while in 10-12mol/L estradiol group,the expression levels of FoxF2 mRNA significantly decreased (P＜0.05),and of α-SMA and COL Ⅰ mRNA increased,but no significant difference were found (P＞0.05).Compared with the model group,the protein expression levels of α-SMA,COL Ⅰ and FoxF2 in 10-6,10-8 and 10 10mol/L estrogen groups decreased,but no significant difference was found (P＜0.05),while in 10-12mol/L estradiol group,the expression levels ofα-SMA protein increased (P＞0.05),and of COL Ⅰ and FoxF2 proteins decreased (P＜0.05).Conclusions The expression of FoxF2 in intrauterine adhesions is increased.Estrogen can reverse the fibrosis process of intrauterine adhesions in a certain range and inhibit the expression of FoxF2.
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Background and purpose:Thyroid carcinoma is a common endocrine tumor with an incidence that has increased over recent decades. The aim of the present study was to investigate the effectiveness of carbon nano-par-ticles-labeled lymph nodes in neck dissection for papillary thyroid cancer (PTC), focusing on the protectiveness for the recurrent laryngeal nerve (RLN) and parathyroid glands.Methods:Forty-eight patients with PTC treated from Apr. to Aug. 2015 were randomly divided into two groups. Group A patients (24 patients) were treated with lobectomy/total thyroidectomy plus unilateral/bilateral central lymph node dissection by conventional meticulous capsular dissection technique; Group B patients (24 patients) were treated with the same surgical procedures as group A, 5 min after the injection of carbon nano-particles. The operative time, intra-operative blood loss, incidence of RLN injury, incidence of transient hypocalcemia, the number of total lymph nodes and the ratio of metastatic nodes were collected and analyzed. Results:For unilateral lobectomy, the number of lymph nodes in group B was signiifcantly greater than that in group A (P<0.05). For total thyroidectomy, the operative time, and the incidence of transient hypocalcemia in group B were both lower than those in group A (P<0.05), and the number of total lymph nodes was signiifcantly higher than that in group A (P<0.05). In group B, the ratio of metastatic nodes were 26.7% (unilateral) and 33.3% (bilateral) in stained lymphnodes, and 11.8% and 25.9% in non-stained lymph nodes.Conclusion:The carbon nano-particles-labeled lymph nodes in neck dissection could facilitate to protect parathyroids and increase the number of lymph nodes, especially in total thyroidectomy plus bilateral central lymph node dissection.
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<p><b>OBJECTIVE</b>To investigate the histomorphology and the expressions of the proliferation marker Ki-67 and estrogen receptor in the uterus of mice with autoimmune premature ovarian failure (POF) induced by zona pellucida 3 peptide (pZP3).</p><p><b>METHODS</b>Autoimmune POP models were established in 20 female BALB/c mice (7-8 weeks old) by immunization with pZP3 and another 20 mice served as the control group. The POP models were verified by vaginal cytology, serum sex hormones, ovary histomorphology and ZP3 antibody immunohistochemistry. The histomorphology and expressions of Ki-67, estrogen receptor α and estrogen receptor β in the uterus of the mice were detected.</p><p><b>RESULTS</b>Autoimmune POP models were established successfully in 80% of the mice at 8 weeks after the immunization. Compared with those in the control group, the mice in the model group showed a smaller volume of the uterus, thinner endometrium and a reduced number of glands. The luminal epithelial cells, glandular epithelial cells and stromal cells in the uterus of the model mice all presented with a lower expression of Ki-67 than those in the control group, and Ki-67 translocation from the nuclei to the cytoplasm was found in the model group. The luminal epithelial cells, glandular epithelial cells and stromal cells showed positive ERα immunoreactivity in the model group but not in the control group. No obvious ERβ expression was found in the uterus in either of the groups.</p><p><b>CONCLUSION</b>pZP3 can induce autoimmune POP, cause suppressed proliferation of the endometrial epithelial cells and stromal cells, and reduce the cellular expression of ERα in the uterus of mice.</p>
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Animals , Female , Mice , Autoimmune Diseases , Metabolism , Cell Nucleus , Egg Proteins , Endometrium , Epithelial Cells , Estrogen Receptor alpha , Metabolism , Estrogen Receptor beta , Metabolism , Immunohistochemistry , Ki-67 Antigen , Metabolism , Membrane Glycoproteins , Mice, Inbred BALB C , Primary Ovarian Insufficiency , Metabolism , Receptors, Cell Surface , Stromal Cells , Uterus , Metabolism , Zona Pellucida GlycoproteinsABSTRACT
Objective Interleukin-21(IL-21) is likely to contribute to the development of liver fibrosis, but up to now, no study has been reported on the relationship between IL-21 and intrauterine adhesions ( IUA) .This study aimed to establish a rat model of IUA induced by mechanical injury and lipopolysaccharide (LPS) infection (dual injury), determine the expression level of serum IL-21, and confirm the association of serum IL-21 with the formation of IUA. Methods Forty healthy female SD rats were randomly divided into four groups of equal number,control, mechanical injury, LPSinfection, and dual injury.At 7 days after IUA modeling,uterine tissue-swere collected from all the animals for observation of the endometrial glands,detection of the degree of IUA by Masson staining, measure-ment of the serum IL-21 level by radioimmunoassay, and analysis of the correlation between the number of endometrial glands and the de-gree of fibrosis. Results The number of endometrial glandswas significantly smallerin the dual injury group (3.59±1.20) than in the mechanical injury (11.66±2.34) and LPSinfection group(11.59±1.47)(P<0.05), while the proportion of fibrosis area wassignificantly higher in the former group(0.65±0.03) than in the lattertwo(0.30±0.07 and 0.32±0.08)(P<0.05).The level of serum IL-21 was signifi-cantly increased in the dual injury group ([286.21±27.80]pg/mL) as compared with those in the control ( [ 118.65 ±22.55 ] pg/mL ) , mechanical injury([176.20±19.05]pg/mL), and LPS infection group ([187.98±16.51]pg/mL) (P<0.05), with a positive correlation be-tween the IL-21 level and theproportion of fibrosis area ( r=0.271, P<0.05) . Conclusion A rat model ofIUAwas successfully established by mechanical injury and lipopolysaccharide (LPS) infection.The evi-dent increase of serum IL-21 in the IUA model was positively correlated with the percentage of fibrosis area, suggesting that IL-21 may be involved indirectly in the formation of IUA.
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Objective To investigate the effective administration model for gestational diabetes mellitus (GDM) in the community. Methods In a prospective study, the 75 g oral glucose tolerance test (OGTT) was performed in 4 713 resident pregnant women over 20 years old who received antenatal care in a general hospital or a special hospital from Sep. 2011 to Aug. 2012. Five hundred and thirty-three pregnant women were diagnosed as GDM, 198 patients who labored in a general hospital were enrolled in thegroup A , and the rest who labored in a special hospital were enrolled in the group B. 198 cases with non-GDM were enrolled in the group C. Results The incidence of GDM during this study period was 11.3%. The maternal age , gestationl weeks and OGTT results of patients in the three groups were significantly different (P 0.05). However, significant differences were found in the incidence of postpartum hemorrhage and cesarean section. The incidence of postpartum hemorrhage increased significantly in the patients of group B (χ2= 7.156, v = 2, P = 0.028). The incidence of cesarean section increased significantly in the patients of group A (χ2= 63.592, v = 2, P = 0.000). Conclusion Establishing an effective administration model for gestational diabetes mellitus in the community could control the incidence of GDM associated complications.
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ObjectiveTo investigate the methylation of the promoter region in miRNA in pancreatic cancer cell line PANC1 and normal pancreatic tissue,to discover the miRNA with hypermethylation associated with pancreatic cancer.MethodsThe genomic DNA of PANC1 and normal pancreatic tissue was extracted,and fractured by ultrasound.Methylation DNA fragments were obtained by 5-methyl of pyrimidine nucleoside antibodies and immunomagnetic beads.The hypermethylation miRNA differentially expressed between PANC1 and normal pancreatic tissue was selected by using methylation DNA chip.BSP ( bisulfite genomic sequencing PCR) and TA clone sequencing was performed for further validation.The genomic DNA of pancreatic cancer cell lines BXPC3,CFPAC1,PANC1 and SW1990 was extracted.The COBRA (combined bisulfite restriction analysis) was used to validate differentially expressed hypermethylation miRNA.ResultsEight differentially expressed hypermethylation miRNAs were screened from the DNA methylation chips,then five of them were selected for sequencing.The methylation status of miRNA-615,-663,-663b was significantly higher in the PANC1 than in normal tissues (60.6％ vs 7.6％,88.8％ vs 22.2％,94.4％ vs 13.0％ ) ; the methylation status of miRNA-675 was not significantly different between PANC1 and normal pancreatic tissue (76.0％ vs 100％ ).Due to large error in sequencing,miRNA1826 was excluded.The results of COBRA confirmed all the 4 miRNAs were highly methylated in PANC1 ; except for miRNA-675,other 3 miRNAs were highly methylated in BxPC,miRNA-663,miRNA-663b were highly methylated in CFPAC1,while miRNA-615,miRNA-663 were highly methylated in SW1990.ConclusionsHypermethylation miRNAs were differentially expressed between pancreatic cancer cell lines and normal pancreatic tissue,among them,highly methylated miRNA-663 was possibly associated with pancreatic cancer.
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ObjectiveTo explore the feasibility, safety and clinical value of laparoscopic Rouxen-Y cystojejunostomy in the treatment of pancreatic pseudocyst. Method Four patients with pancreatic pseudocyst received totally laparoscopic pancreatic pseudocystojejunostomy. The data on intraoperative bleeding, operative time, postoperative time to get out of bed, time of first flatus/bowel motion, complication and duration of hospital stay were collected and analyzed retrospectively. ResultsAll operations were carried out successfully with laparoscopic surgery. The mean operative time was 90 min. The average intraoperative blood loss was 40 ml. The mean postoperative time to get out of bed was 1.5 d, and the mean time of first flatus/bowel motion was 2. 3 d. All patients recovered smoothly without any pancreatic fistula. The average hospital stay was 7 days. Fever, pancreatitis,adhesive intestinal obstruction and other complications did not occur. ConclusionsTotally laparoscopic Roux-en-Y pancreatic pseudocystojejunostomy was an efficacious, safe, and minimally invasive procedure.
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Objective To determine the methylation status and expression of Ras association domain family 1A (RASSF1A), and the possible effect between promoter aberrant methylation and pathogenesis of pancreatic cancer. Methods The methylation status of RASSF1A promoter CpG island (CGI) pancreatic cancer cell line BxPC3 was detected in 5 cases of normal pancreatic tissue and 13 pairs of pancreatic cancer tissues (tumor and peri-tumor) by using COBRA (combined bisulfite restriction analysis) and the methylation rate was calculated. The RASSF1A mRNA expression of BxPC3 was compared between pre- and post-treatment of the inhibitor of DNA methyltransferase (5-Aza-2-deoxycitydine, 5-Aza-dC). Results The average methylation rate of RASSF1A promoter CGI was 62.90% in BXPC3, 9.14% in normal pancreas, 53.79% in peri-tumors (TP), and 55.82% in tumors. The methylation rates in port-tumors and tumors were significantly increased when compared with that of normal pancreas (P < 0.01), while there was no significant difference between in peri-tumors and tumors (P > 0.05). After 5-Aza-dC treatting BxPC3 cells, the methylation rates decreased to 42.5% (P < 0. 05) and RASSF1A mRNA expression was enhanced. Conclusions Aberrant hypermethylation of RASSF1A promoter CGI could be considered as an early event in the process of pancreatic cancer and participates in the pathogenesis of pancreatic cancer.
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Objective To investigate the expression and methylation status of HOXA7 gene in human pancreatic cancer cell lines, and to explore the relationship between them.Methods HOXA7 mRNA expression of human pancreatic cancer cell lines BxPC3, CFPAC1, PANC1 and SW1990was detected by RT PCR.Bisulfite sequencing PCR (BSP) and combined bisulfite restriction analysis (COBRA) was used to test promoter methylation status.All the cell lines were treated by 5-aza-2-deoxycytidine (5-aza-dC), and HOXA7mRNA expression, methylation status was detected before and after this treatment.Results HOXA7 mRNA was expressed in BxPC3, CFPAC1 and SW1990, while there was no expression of HOXA7 mRNA in PANC1.HOXA7 promoter methylation rates of CFPAC1, BxPC3, PANC1 and SW1990 were 93.16%, 90.65%,90.09% ,52.30%.HOXA7 promoter methylation rate of SW1990 was significantly lower than those in other 3cell lines ( P ＜0.01 ).After 5-aza-dC treatment, HOXA7 mRNA of PANC1 was expressed again, and HOXA7mRNA of BxPC3 was increasingly expressed;while the expression of HOXA7 mRNA in CFPAC1 and SW1990was not significantly changed after 5-aza-dC treatment.Conclusions The expression of HOXA7 mRNA in BxPC3 and PANC1 was closely correlated with promoter hypermethylation, while there was no obvious relation in CFPAC 1 and SW1990.