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Objective To study the expression and the clinical significance of cysteine rich transmembrane BMP regulator 1 (CRIM1) in hepatocellular carcinoma (HCC) and discuss the association between CRIM1 and epithelial-mesenchymal transition (EMT).Methods The cases were came from the Subei People's Hospital Affilated Hospital of Yangzhou University from January 2013 to December 2017.CRIM1 and EMT related proteins (E-cadherin,Vimentin) in parts of HCC tissues and their paired peritumoural tissues were tested by Western blotting.The gray value was test by t test.The observation indicators:(1) expression of CRIM1 protein and EMT-related protein (E-cadherin,Vimentin) in liver cancer tissues and paracancerous tissues.(2) The relationship between CRIM1 protein expression and clinicopathological factors in patients with liver cancer.The expression ofCRIM1 in HCC tissues and adjacent tissues was detected by immunohistochemistry(IHC),which was divided into high expression group and low expression group according to the histochemical score,and the relation between the expression of CRIM1 and the clinicopathological factors of the patients was analyzed by chi-square test and Spearman correlation analysis.Finally,the relation between CRIM1 and overall survival of HCC patients was analyzed by Kaplan Meier Plotter database.Results The expression of CRIM1 in tumor and matched paratumor specimens were 0.15 ± 0.03,0.8 ± 0.04,and E-cadherinin tumor and matched paratumor specimenswere 0.20 ±0.05,0.56 ± 0.06,their expression in paracancerous tissues was higher than HCC tissues (t =14.21,4.69,P ＜ 0.05),while the expression of Vimentin in tumor and matched paratumor specimens were 0.74 ± 0.08,0.45 ± 0.06,the expression in tumor tissues were significantly higher than adjacent tissues (t =2.87,P ＜ 0.05).The expression of CRIM1 in HCC tissues was further verified by immunohistochemistry,which shows that CRIM1 was overexpressed in paracancerous tissues.In 114 patients,46 cases of CRIM1 protein were highly expressed in liver cancer tissues,and 68 cases of CRIM1 protein were low expressed.The expression of CRIM1 obviously related with the level of αt-fetoprotein (AFP),tumor size and symptom(r =-0.43,-0.34,-0.24,x2 =9.381,5.248,8.117,P ＜ 0.05).However,other clinicopathological features were not correlated with CRIM 1 expression,including age,tumour differentiation,tumor number.Finally,the overall survival was different between CRIM1 high expression and low expression according to the Kaplan Meier Plotter database.Conclusions The expression of CRIM1 is negatively correlated with the EMT process in HCC.CRIM1 might be a potential molecular marker for prognosis.
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Metabolic deregulation is a major essential feature in the development of cancer,wbich also correlates with invasion and metastasis of tumor.Metabolic characteristic of tumor cells which deviate significantly from those of normal cells.In this review,we summarize the research about the relationship between cellular metabolic abnormalities and capability of tumor's invasion and metastasis.
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Objective To evaluate the feasibility and safety of modified laparoscopic pyloroplasty (LP) during laparoscopic splenectomy and azygoportal disconnection (LSD) for the prevention of postoperative gastroparesis.Methods A total of 31 cirrhotic patients with bleeding portal hypertension admitted to our department between Jan 2015 and Aug 2015 were retrospectively reviewed.Patients were divided into LP group (n =14) and non-LP group (n =17).Results One month postoperatively,the incidence of bloating was significantly lower in the LP group than in the non-LP group [21％ vs.88％,P ＜0.05].Three months postoperatively,the LP group had significantly lower incidences of nausea (0 vs.35％,P ＜ 0.05) and bloating (14 ％ vs.76％,P ＜ 0.05) than the non-LP group.The incidence of gastric retention confirmed by electronic gastroscopy at 3 and 6 months postoperatively in the LP group was significantly lower than that in the non-LP group (14％ vs.94％,P ＜ 0.01;14％ vs.88％,P ＜ 0.01,respectively).Conclusion It is safe,feasible and with good therapeutic effect for modified laparoscopic pyloroplasty during laparoscopic splenectomy and azygoportal disconnection for the prevention of postoperative gastroparesis.
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Objective To investigate the short-term therapeutic effect of warfarin in preventing portal vein thrombosis (PVT) after modified laparoscopic splenectomy combined with pericardial devascularization.Methods The retrospective cohort study was used to analyze the clinical data of 32 patients with cirrhotic portal hypertension who were admitted to the Clinical Medical College of Yangzhou University between January 2014 and August 2014.The characteristics of warfarin and aspirin regimens were introduced to the patients before operation for choosing postoperative therapeutic regimen.Based on the decisions, 17 and 15 patients receiving warfarin regimen and aspirin regimen were divided into the warfarin group and the aspirin group, respectively.All the patients underwent successful modified laparoscopic splenectomy and pericardial devascularization with intraoperative autologous blood salvage.The treatments were as follows : from postoperative day 3, patients in the warfarin group received 2.5 mg of oral warfarin once daily with titration of the dose to maintain a target international normalized ratio (INR) of 2.0-3.0 for 1 year;patients in the aspirin group received 100 mg aspirin enteric coated tablets for 1 year;and both groups received 50 mg of oral dipyridamole three times daily for 3 months and subcutaneous injection of 4 100 U of low-molecular-weight heparin (LMWH) once daily for 5 days.Blood cell analysis, liver function, coagulation function and Doppler ultrasound screening for the occurrence of PVT were performed at the first and third months.Postoperative electronic gastroscopy was performed at 3 months postoperatively for observing the change of the esophageal and gastric-fundus varices.The patients were followed up till February 2015.The incidences of PVT and the level of INR at the first week, the first month and the third month after operation were observed.Measurement data with normal distribution were presented as (x) ± s and analyzed by t test, and measurement data with skewed distribution were presented as M(range) and analyzed by the rank-sum test.Comparison of the mean INR at different time points between the 2 groups was analyzed by the repeated measures ANOVA.Comparison of count data was analyzed by the Fisher's Exact Probility.Results There were no gastrointestinal hemorrhage or perioperative death in the 2 groups.(1) The overall incidences of PVT at postoperative week 1 were 9/17 and 6/15 in the warfarin and the aspirin groups, respectively, with no significant difference (P ＞ 0.05).However, the overall incidences of PVT at postoperative month 1 and 3 were 7/17 and 3/17 in the warfarin group, which was significantly different from 12/15 and 12/15 in the aspirin group (P ＜ 0.05).(2)The incidences of main portal vein thrombosis (MPVT) at postoperative week 1 and postoperative month 1 were 5/17 and 6/17 in the warfarin group, 4/15 and 5/15 in the aspirin group, showing no significant difference (P ＞ 0.05).The incidence of MPVT at postoperative month 3 was 3/17 in the warfarin group, which was significantly different from 9/15 in the aspirin group (P ＜ 0.05).(3) The INR was changed from 1.30 ± 0.17 before operation to 1.55 ± 0.38 at postoperative month 3 in the warfarin group, and from 1.33 ±0.14 before operation to 1.21 ±0.11 at postoperative month 3 in the aspirin group, showing significant difference in the changing trend between the 2 groups (F =713.908, P ＜ 0.05).(4) All the 32 patients were followed up for a median time of 7 months (range, 3-11 months).The results of electronic gastroscopy at postoperative month 3 showed that the esophageal and gastric-fundus varices were obviously improved or disappeared.Conclusion Warfarin in preventing PVT after modified laparoscopic splenectomy combined with pericardial devascularization is safe and feasible, with a good short-term outcome.
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Many methods can by used for the quantitative determination of the three types of immu-noglobulin. On the basis of the single radial immuno-diffusion method used by John L. Fahey,certain modifications have been made on the methods of diluting standard solutions and theirconcentrations, and the standard concentration of the immunoglobulins and the antibody-con-taining agar diffusion plates. In order to find the optimum condition of cultivation, theeffects of various temperatures and various cultivation time given by G. Mancini et al havebeen checked, and satisfactory standard curves have been obtained. Therefore, the accuracyof the analytical results is guaranteed. According to the results obtained, there is no observable effect on the diameter of theprecipitating ring when the temperature in culture-box is 35?C to 40?C and the cultivationtime extends to 96 hrs.