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Objective To investigate the clinical efficacy of laparoscopic spleen-preserving distal pancreatectomy (Kimura method and Warshaw method) for benign lesions of pancreatic body and tail.Methods The retrospective cohort study was conducted.The clinicopathological data of 39 patients with benign lesions of pancreatic body and tail who underwent laparoscopic spleen-preserving distal pancreatectomy in the Second Affiliated Hospital of Nanchang University between March 2008 and January 2018 were collected.Of 39 patients,28 undergoing Kimura method (splenic artery and vein-preserving distal pancreatectomy) were allocated into the Kimura group,and 11 undergoing Warshaw method (cutting splenic vessels and preserving short gastric vessels)due to serious adhesion between pancreatic body and tail and splenic hilum were allocated into the Warshaw group.Observation indicators:(1) operation situations;(2) postoperative situations;(3) follow-up situations.Followup using outpatient examination and telephone interview was performed to detect blood glucose level and tumor recurrence of patients up to March 2018.Measurement data with normal distribution were represented as (x)±s and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range) and comparison between groups was done using nonparametric rank-sum test.Comparisons of count data were analyzed using chi-square test or Fisher exact probability.Results (1) Operation situations:39 patients received laparoscopic spleen-preserving distal pancreatectomy,operation time and volume of intraoperative blood loss of 39 patients were respectively (194 ±58)minutes and 100 mL (range,30-800 mL).The operation time and volume of intraoperative blood loss were respectively (197±56)minutes,100 mL (range,30-800 mL) in the Kimura group and (186±63)minutes,150 mL (range,30-450 mL) in the Warshaw group,with no statistically significant difference between groups (t =0.494,Z =-0.597,P＞ 0.05).(2) Postoperative situations:time to anal exsufflation and duration of hospital stay were respectively (2.6±0.8)days,(9.2±7.3)days in 39 patients and (2.4±0.6)days,(7.5±4.2)days in the Kimura group and (2.8±1.3)days,(13.5±11.1)days in the Warshaw group,with no statistically significant difference between groups (t=-0.720,-1.736,P＞0.05).Seven patients had postoperative complications.The incidence of complication was 2/28 in the Kimura group,1 patient with pancreatic leakage at 5 days postoperatively was cured by 15-day B ultrasound guided catheter drainage,and 1 who was diagnosed as pulmonary infection by chest CT examination at 5 days postoperatively was discharged from hospital after 8-day anti-infection and sputum-inductive treatments.The incidence of complication was 5/11 in the Warshaw group,3 patients with sustained fever at 5 and 7 days postoperatively who were diagnosed as grade 1 splenic infarction by epigastric enhanced CT examination were improved and discharged from hospital by antibiotic and low molecular weight heparin treatments,and then epigastric enhanced CT re-examination at 3 months postoperatively showed recovery of splenic perfusion;1 with pancreatic leakage at 7 days postoperatively was cured by 18-day conservative treatment;1 who was diagnosed as delayed gastric emptying by upper gastrointestinal contrast at 16 days postoperatively was improved and then discharged from hospital by 15-day placement of intestinal feeding tube and nutrition support therapy.There were statistically significant differences in the incidences of overall complication and splenic infarction between groups (x2 =5.485,4.878,P＜0.05) and no statistically significant difference in the incidence of other complications between groups (P＞0.05).(3) Follow-up situations:39 patients were followed up for 12 months (range,2-64 months).During the follow-up,six patients had normal blood glucose level,and all patients had good quality of life,without recurrence.Conclusions Laparoscopic spleen-preserving distal pancreatectomy for the benign lesions of pancreatic body and tail is satisfactory in short-and long-term curative effects.The incidences of complication and splenic infarction of Kimura method are lower than that of Warshaw method.
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Objective To explore the preparation and quality control of As2 O3 nanoparticle .Methods PEG‐PLA was used as the vector material to prepare As2 O3 nanoparticle with ultrasonic emulsification method ,and the VEGFR‐2 was coupled to obtain VEGFR‐2/As2 O3‐PEG‐PLA nanoparticle .The particle size distribution ,Zata potential ,loading efficiency (LE) ,encapsulation effi‐ciency(EE) ,drug release in vitro and stability was determined ,and morphological characteristics was observed by transmission elec‐tron microscope(TEM) .Tweety‐four hepatocellular carcinoma nude mices were randomly divided into VEGFR‐2/As2O3‐PEG‐PLA nanoparticles group and As2 O3‐PEG‐PLA nanoparticles group ,by tail vein injection of nanoparticles .High performance liquid chro‐matography was used to determine content of As2 O3 .After 21 d ,six nude mices in each group were killed ,and the immunohisto‐chemistry and western blot method was used to detect the expression of VEGFR‐2 .Results The particle size of VEGFR‐2/As2 O3‐PEG‐PLA was determined to be (141 .9 ± 13 .2)nm ,Zata potential was (10 .2 ± 1 .1)mV .It was found to spherical or oval shape , with uniform size and dispersibility under TEM .LE and EE was (5 .51 ± 1 .83)% and (62 .12 ± 5 .98)% ,respectively .Drug release in vitro showed that VEGFR‐2/As2 O3‐PEG‐PLA exhibited controlled release effect ,with half of the release time as 10 h .Besides , VEGFR‐2/As2 O3‐PEG‐PLA showed a good stability in 3 days .Compared with As2 O3‐PEG‐PLA nanoparticles group ,the concen‐tration of As2 O3 in tumor and liver tissue was high ,the concentration of As2 O3 in blood ,heart ,kidney tissue was low ,the expression of VEGFR‐2 in tumor tissue was low in VEGFR‐2/As2O3‐PEG‐PLA nanoparticles group(P< 0 .05) .Conclusion The prepared As2 O3 nanoparticle using PEG‐PLA as vector and VEGFR‐2 as target showed uniform size ,high EE and LE ,good stability .And it preliminarily proved that VEGFR‐2 could be targeted in nude mice .
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Objective To explore the clinical efficacy of laparoscopic left hemihepatectomy for the treatment of intrahepatic bile duct stones.Methods The clinical data of 30 patients with left intrahepatic bile duct stones who were admitted to the Second Affiliated Hospital of Nancbang University from June 2013 to June 2014 were retrospectively analyzed.All the patients underwent laparoscopic left hemihepatectomy by the Glisson intra-and extra-pedicles vascular inflow occlusion techniques together with the removal of choledocholithiasis and right bile duct stones,and T tube placement or laparoscopic primary suture of common bile duct were selected according to the condition of bile duct.All the 30 patients were readmitted to hospital and detected by color Doppler ultrasound (CDUS),computed tomography (CT) and T tube cholangiography at postoperative month 1,and then received CDUS reexamination every 3 months.CT and MRI reexaminations were applied to patients with complication of residual stones if necessary.All the patients were followed up till July 2014.Results All the 30 patients were treated by laparoscopic hepatectomy with left hemihepatic vascular inflow occlusion,including 5 with conversion to open surgery and 25 with successful operation.The Glisson extra-and intra-pedicel vascular inflow occlusion techniques were used in 11 and 14 patients,respectively.The operation time and volume of blood loss were (158 ± 85) minutes and (405 ± 215) mL.Two patients received intraoperative blood transfusion.There were no residual stones in the 8 patients with choledocholithiasis by intraoperative choledochoscope,and primary suture of bile duct and T tube placement were done in 5 and 3 patients,respectively.No patients died.After operation,there were 2 patients with bile leakage and 1 with pleural effusion,and they were cured though drainage.One patient with subphrenic effusion was cured by B ultrasound-guided puncture and drainage.One patient had bleeding with the volume of blood loss of 500 mL,and was cured by conservative treatment.The duration of hospital stay in all the patients was (8.5 ± 2.3)days.No bile leakage and abdomen infection were detected by outpatient examination.The time of followup was 1-12 months,without recurrence of stones.Conclusion Laparoscopic left hemihepatectomy for the treatment of left intrabepatic bile duct stones is safe and feasible with satisfactory outcome.
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Objective To prepare the immunoconjugate composed of Adriamycin nanoparticles and VEGFR 2 monoclonal antibody(conjugate of ADM-NP and VEGFR 2-MAb) and study its pharmacokinetics property. Methods Adriamycin nanoparticles were prepared by using double emulsion method, with PLA and O-CMC as materials. Conjugate of ADM-NP and VEGFR 2-MAb was prepared by using molecule conjugate technology. Immunoreactivity of the conjugate with type IV collagenase and H 22 cell were analyzed by using ELISA. Pharmacokinetics parameters of the immunoconjugate were obtained by using SD rats as study objects. Results The prepared ADM-NP was sphere particles under SEM, which diameters were (160±34) nm. The drug loading rate and entrapment rate were (30.15±3.5)% and (80.56±4.24)% respectively. Conjugate of ADM-NP and VEGFR 2-MAb was successfully prepared, which had immunoreactivity with type IV collagenase and H 22 cell. The immunoconjugate showed good ADM control-release ability and could prolong the retention time of ADM in vivo. Conclusion Conjugate of ADM-NP and VEGFR 2-MAb keeps the immunoreactivity of VEGFR 2-MAb and shows good ADM control-release ability.
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Objective To investigate the association between the rs769236 polymorphism at the 5′-UTR region of CyclinA2 gene and the susceptibility of colorectal cancer (CRC) .Methods A case-control study was carried out on the Chinese Han population , the rs769236 polymorphism of CyclinA2 were analyzed by PCR restriction fragment length polymorphism (PCR-RFLP)in 150 CRC cases and 150 healthy controls .The association between CRC risk and the SNP (rs769236) was estimated by an unconditional logis-tic regression model .Results Compared with GG wild genotype ,variant genotypes(GA+AA) carriers had a significantly increased risk of CRC[adjusted odds ratio (OR)=1 .92 ,95% confidence interval(CI)=1 .10 -3 .36] .Conclusion The current results sug-gested that the SNP(rs769236) of CyclinA2 is significantly associated with the increased risk of CRC ,the variant genotypes(GA+AA) are the independent risk factors of CRC in Chinese Han population .
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The glucose-regulated protein78 (GRP78) is a member of the heat-shock protein 70 (HSP70) family and responsible for cellular homeostasis. GRP78 is highly expressed in various tumors. It plays an im-portant role in tumor proliferation, survival, metastasis, and drug resistance. Suppression of GRP78 in tumors could enhance cancer treatment. Inhibition of GRP78 in tumors may provide a noval approach toward cancer therapy.
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<p><b>OBJECTIVE</b>To assess the effect of cholesterol in bile on cholecystokinin receptor (CCK-R) in the gallbladder.</p><p><b>METHODS</b>One hundred Guinea pigs were randomly divided into four groups, 25 animals for each. The control group was fed a standard diet, and the cholesterol group fed a diet containing 2% cholesterol. After taking the 2% cholesterol diet for two weeks, the natural group persisted on the standard diet, and the treated group was perfused by traditional Chinese medicine. Serum cholecystokinin (CCK) level in the portal vein and maximal binding capacity (B(max)) and Kd of CCK-R in the gallbladder were measured in the four groups by RIA and RBA, and the concentrations of cholesterol in bile were also observed.</p><p><b>RESULTS</b>Compared with the control group, after high-cholesterol feeding for two weeks, the gallbladder emptying rate [(65.83 +/- 7.32)% approximately (47.22 +/- 5.24)%] and B(max) of CCK-R [(60 +/- 27) approximately (32 +/- 13) fmol/mg protein] and in decreased fasting gallbladder volume (FV) [(0.89 +/- 0.26) approximately (1.34 +/- 0.61) cm(3)] and concentration of cholesterol [(0.44 +/- 0.11) approximately (0.60 +/- 0.13) mmol/L] in bile increased, but no change was in the serum CCK level and Kd of CCK-R in the cholesterol group. Compared with the natural group, after two-week in take of herb decoction of qingre lidan and liqi huoxue, FV [(1.27 +/- 0.60) approximately (0.90 +/- 0.27) cm(3)], RV [(0.85 +/- 0.45) approximately (0.32 +/- 0.12) cm(3)], FB [(0.92 +/- 0.35) approximately (0.73 +/- 0.21) cm(3)], RB [(0.76 +/- 0.34) approximately (0.29 +/- 0.08) cm(3)] in the treated group decreased significantly; but gallbladder emptying rate [(43.06 +/- 4.27)% approximately (67.01 +/- 6.82)%] increased significantly. The concentration of cholesterol in bile was lower in the treated group than in the natural group [(0.59 +/- 0.14) approximately (0.43 +/- 0.10) mmol/L], but no change was found in the serum CCK level. Bmax of CCK-R in the treated group increased significantly [(39 +/- 19) approximately (59 +/- 11) fmol/mg protein], Kd of CCK-R showed no significant changes between the treated group and natural group.</p><p><b>CONCLUSION</b>High cholesterol in gallbladder bile causes defective muscle contraction by down-regulating CCK-R in the gallbladder, so the reduction of cholesterol concentration of bile may contribute to gallbladder contraction.</p>