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1.
Chinese Journal of Hepatobiliary Surgery ; (12): 615-621, 2023.
Article in Chinese | WPRIM | ID: wpr-993384

ABSTRACT

Objective:To observe the influence of NOD-like receptor thermal protein domain associated protein 6 (NLRP6) on hepatic ischemia-reperfusion injury (IRI), and elucidate the related mechanism.Methods:Thirty C57BL/6 mice with body weight of (18.80±1.99) g, were divided randomly into 5 groups, with 6 mice in each group: the mice that experienced only exploratory laparotomy were Sham group; that only underwent an operation to establish a hepatic IRI model were IRI group; that were treated with tail intravenous injection of clodronate (Clo) liposomes before the establishment of hepatic IRI model were Clo group; that received tail intravenous injection of clodronate liposomes and transfusion of bone marrow derived macrophages (BMDM) before the operation were Clo+ BMDM group; that received preoperative tail intravenous injection of clodronate liposomes and transfusion of BMDM with NLRP6 knockdown were Clo+ NLRP6-knockdown group. Real time quantitative polymerase chain reaction analysis (RT-PCR) and Western blot were performed to analyze the expressions of pyroptosis related proteins and factors. Simulate a hypoxia/reoxygenation (H/R) model in vitro, and set up experimental groups: lipopolysaccharide (LPS) + adenosine triphosphate (ATP), LPS+ ATP+ NLRP6-knockdown, H/R, and H/R+ NLRP6-knockdown. The changes of expressions of pyroptosis related proteins and factors were detected by RT-PCR and Western blot. Expression of NF-κB in vivo and in vitro was measured.Results:Compared with those in Sham group, protein expressions of NLRP6, NLRP3, Caspase-1, gasdermin D (GSDMD), IL-1β and IL-18 were remarkably increased in IRI group, but the levels of these proteins were dramatically decreased in Clo group with the exhaustion of macrophages in comparison with in IRI group, which were significantly different statistically (all P<0.05). The levels of these proteins were enhanced again in Clo+ BMDM group with the reconstruction of macrophages in contrast to those in Clo group, while the enhancements were more obvious in Clo+ NLRP6-knockdown group comparing to those in Clo+ BMDM group, with significant differences (all P<0.05). In vitro, pyroptosis rate for LPS+ ATP group was (16.39±1.06)%, which was lower than (27.34±2.79)% for LPS+ ATP+ NLRP6-knockdown group, with a statistical significance ( P<0.05). Meanwhile, pyroptosis rate for H/R group was (20.59±5.66)%, also much more reduced than (37.76±2.00)% for H/R+ NLRP6-knockdown group ( P<0.05). Expressions of NLRP3, Caspase-1, GSDMD, IL-1β, IL-18 and NF-κB p65 in LPS+ ATP+ NLRP6-knockdown group were more elevated than in LPS+ ATP group, and these indices were also more enhanced in H/R+ NLRP6-knockdown group than which in H/R group. Compared to the Sham group, expression of NF-κB p65 significantly increased in IRI group, which was reversed in Clo group, but enhanced again in Clo+ BMDM group and reached a peak in Clo+ NLRP6-knockdown group. Conclusions:Macrophage plays a critical role in immune response to hepatic IRI, wherein NLRP6 functions specifically. NLRP6 acts to suppress inflammation during hepatic IRI through regulating macrophage pyroptosis via inhibiting NF-κB.

2.
Chinese Journal of Hepatobiliary Surgery ; (12): 522-527, 2023.
Article in Chinese | WPRIM | ID: wpr-993366

ABSTRACT

Objective:To investigate the value of the extrahepatic bile duct and main pancreatic duct segment patterns on magnetic resonance cholangiopancreatography (MRCP) for differentiating the periampullary carcinoma (PAC).Methods:The clinicopathologic data of 125 patients with PAC who were admitted to Wuxi No.2 People’s Hospital from June 2013 to December 2021 were retrospectively analyzed, including 72 males and 53 females, aged (64.9±8.6) years. According to its anatomy, the extrahepatic bile duct (B) was divided into suprapancreatic and intrapancreatic (including ampullary) segments, and the main pancreatic duct (P) was divided into tail-body and head segments. MRCP patterns: i. the extrahepatic bile duct or main pancreatic duct visible without dilatation, ii. cutoff of the distal extrahepatic bile duct or main pancreatic duct with upstream dilatation, iii. cutoff of the intrapancreatic or head segment with upstream dilatation and remnant intrapancreatic or head segments invisible, iv. cutoff of the intrapancreatic or head segment with upstream dilatation and nondilated remnant intrapancreatic or head segments, were represented as 0, 1, 2, and 3, respectively. Segment patterns of B1/P0+ B1/P1, B0/P2+ B0/P3+ B2/P2+ B2/P3+ B3/P3, B3/P0, and B0/P0+ B2/P0 on MRCP were compared in PAC patients.Results:Of the 125 patients, there were 57 (45.6%) with pancreatic head carcinoma, 36 (28.8%) with ampullary carcinoma, 20 (16.0%) with distal cholangiocarcinoma, and 12 (9.6%) with periampullary duodenal carcinoma. Segment patterns of B0/P2+ B0/P3+ B2/P2+ B2/P3+ B3/P3 were found in 52 patients with pancreatic head carcinoma (91.2%, 52/57), with a significant difference between PAC (χ 2=110.66, P<0.001). Segment patterns of B1/P0+ B1/P1were found in 36 patients with ampullary carcinoma (100.0%, 36/36), fallowed by 11 (91.7%, 11/12) with periampullary duodenal carcinoma, with a significant difference between PAC (χ 2=129.95, P<0.001). Segment pattern of B3/P0 presented in 16 patients with distal cholangiocarcinoma (80.0%, 16/20), with a significant difference between PAC (χ 2=62.45, P<0.001). The segment patterns of B0/P0+ B2/P0 were only seen in 3 of 57(5.3%) patients with pancreatic head carcinoma. Conclusion:On MRCP, cutoff of the head segment with upstream dilatation and remnant head segment invisible or nondilated indicates the pancreatic head carcinoma. Cutoff of the intrapancreatic segment with upstream dilatation, remnant intrapancreatic segment visible, and main pancreatic duct nondilated, indicates the distal cholangiocarcinoma. And cutoff of the distal extrahepatic segment with upstream dilatation and main pancreatic duct dilatation or not, indicates the ampullary or periampullary duodenal carcinoma.

3.
Chinese Journal of Digestive Surgery ; (12): 150-159, 2023.
Article in Chinese | WPRIM | ID: wpr-990622

ABSTRACT

Objective:To investigate the risk factor of hepatocellular carcinoma (HCC) with vessels encapsulating tumor clusters (VETC) and the application value of its risk scoring model.Methods:The retrospective cross-sectional study was conducted. The clinicopathological data of 149 patients with HCC who were admitted to two medical centers, including 97 cases in the Jiangnan University Medical Center and 52 cases in the Affiliated Xingtai People′s Hospital of Hebei Medical University, from January 2017 to April 2020 were collected. There were 116 males and 33 females, aged (58±12)years. There were 74 cases with VETC and 75 cases without VETC. Observation indica-tors: (1) clinical characteristics of patients with and without VETC; (2) imaging features of patients with and without VETC; (3) multivariable analysis of HCC patients with VETC; (4) construction of VETC related risk scoring model and its performance evaluation; (5) postoperative early tumor recurrence of patients with and without VETC who were confirmed by risk scoring model and histopathological examination. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Count data were described as absolutes, and comparison between groups was conducted using the chi-square test and continuous correction chi-square test. Variables of clinical and imaging characteristics with statistically signifi-cant were included in the multivariate analysis. Multivariate analysis was conducted using the Logistic regression model of backward stepwise selection. VETC related risk scoring model was constructed based on the results of Logistic regression model. The receiver operating characteristic (ROC) curve was drawn, and the area under curve (AUC), the sensitivity, specificity, accuracy and their 95% confidence interval ( CI) were calculated. The maximizing Youden index was the optimal cutoff value for VETC prediction. The Hosmer Lemeshow goodness of fit test was used to assess the consistency between VETC risk scoring model predicted VTEC status and the true VETC status. The Kaplan-Meier method was used to calculate survival rates and draw survival curves. The Log-rank test was used for survival analysis. Results:(1) Clinical characteristics of patients with and without VETC. Cases with postoperative albumin <36 g/L were 57 in patients with VETC, versus 68 in patients without VETC, respectively, showing a significant difference between them ( χ2=5.13, P<0.05). (2) Imaging features of patients with and without VETC. Cases with lesion imaging presence as nonperipheral washout, cases with lesion imaging presence as mosaic architecture, cases with lesion imaging presence as intratumoral hemorrhage, cases with lesion imaging presence as corona enhancement, cases with lesion imaging presence as non-smooth tumor margin, cases with lesion imaging presence as peritumoral enhancement in arterial phase, cases with lesion imaging presence as intratumoral arteries, cases with lesion imaging presence as peritumoral hypointensity in hepatobiliary phase, cases with lesion imaging enhancement type as uniform low enhancement, uniform high enhance-ment, heterogeneous enhancement with septations and heterogeneous enhancement with irregular ring-like structures, cases with intratumoral necrosis or ischemic, cases with tumor diameter >5 cm were 73, 35, 33, 15, 39, 28, 42, 27, 4, 5, 27, 38, 45, 46 in patients with VETC, versus 64, 16, 13, 3, 19, 15, 9, 13, 9, 35, 5, 26, 10, 10 in patients without VETC, respectively, showing significant differences in the above indicators between them ( χ2=8.92, 11.15, 12.97, 9.28, 11.74, 5.77, 33.14, 6.96, 41.79, 36.05, 37.86, P<0.05). (3) Multivariable analysis of patients with VETC. Results of multivariable analysis showed that lesion imaging enhancement as heterogeneous enhancement with septations, lesion imaging enhancement as heterogeneous enhancement with irregular ring-like structures, intratumoral necrosis or ischemia and tumor diameter >5 cm were independent risk factors influen-cing patients with VETC ( odds ratio=4.18, 7.62, 4.23, 4.08, 95% CI as 1.60?11.60, 2.00?31.70, 1.71?10.90, 1.60?10.80), P<0.05). (4) Construction of VETC related risk scoring model and its performance evaluation. The VETC related risk scoring model was constructed as (heterogeneous enhancement with septations, presence: 1.0, absence: 0)+(heterogeneous enhancement with irregular ring-like structures, presence: 1.5, absence: 0)+(intratumoral necrosis or ischemia, presence: 1.0, absence: 0)+(main tumor diameter >5 cm, presence: 1.0, absence: 0). The AUC, sensitivity, specificity, and accuracy of VETC related risk scoring model were 0.86 (95% CI as 0.80?0.92), 79.7% (95% CI as 69.2%?87.3%), 80.0% (95% CI as 69.6%?87.5%) and 79.9% (95% CI as 72.7%?85.5%), respectively. Results of Hosmer-Lemeshow goodness of fit test showed a good consistency between VETC risk scoring model predicted VETC status and true VETC status ( P>0.05). (5) Postoperative early tumor recurrence of patients with and without VETC who were confirmed by risk scoring model and histopathological examination. All 149 patients were followed up for 29(range, 26?35)months. The time to tumor recurrence and 2-year cumulative tumor recurrence rate of 149 patients were 29(range, 24?33)months and 43.0%, respectively. The 2-year tumor cumulative recurrence rate of patients with and without VETC predicted by risk scoring model was 47.8% and 37.9%, respectively, showing a significant difference between ( χ2=3.90, P<0.05). The 2-year cumulative tumor recurrence rate of patients with and without VETC confirmed by postoperative histopathological examination was 47.4% and 38.1%, respectively, showing a significant difference between ( χ2=4.20, P<0.05). Conclusions:Lesion imaging enhancement as heterogeneous enhancement with septations or irregular ring-like structures, intratumoral necrosis or ischemia and tumor diameter >5 cm are independent risk factors influen-cing HCC patients with VETC. The proposed risk scoring model based on those three risk factors achieves an optimal preoperative diagnostic performance.

4.
Chinese Journal of Hepatobiliary Surgery ; (12): 525-530, 2022.
Article in Chinese | WPRIM | ID: wpr-956997

ABSTRACT

Objective:To investigate the value of machine learning-based computed tomography (CT) images radiomics analysis in preoperative evaluation of surgical portal vein-superior mesenteric vein (PV-SMV) invasion in patients with pancreatic ductal adenocarcinoma (PDAC).Methods:The retrospective study was conducted with 156 consecutive PDAC patients who were underwent surgery at the Affiliated Wuxi No.2 People's Hospital of Nanjing Medical University between January 2010 and July 2021. There were 95 males and 61 females, with the age of (65.7±8.2) years. Patients were randomly split into training set and validation set by a ratio of 3∶2. Minimum redundancy maximum relevance was used to select radiomic features, which were extracted from contrast-enhanced CT images. Five machine learning classifiers were developed, and those models' area under the curve (AUC) values were compared with the conventional radiologic-feature-based evaluation.Results:Ninety-four and 52 patients were included into the training set and validation set, respectively. Their PV-SMV invasion rates were confirmed by intraoperative exploration with 31.9%(30/94) and 40.3%(25/61), respectively. Five models: LASSO regression, random forest, support vector machine, k-nearest neighbor and Naive Bayesian, were established based on ten features from CT images radiomics, and LASSO regression model achieved the highest AUC value compared with the other four models (all P<0.05). Compared with the conventional radiologic evaluation, the LASSO regression model had higher AUC (0.920 vs. 0.752) and sensitivity (92.0% vs. 86.5%)(both P<0.05). Conclusion:Machine learning-based CT images radiomics analysis can be used to evaluate PV-SMV invasion status preoperatively in PDAC. The LASSO regression model showed better performance than the conventional radiologic evaluation.

5.
Chinese Journal of Hepatobiliary Surgery ; (12): 277-282, 2019.
Article in Chinese | WPRIM | ID: wpr-745378

ABSTRACT

Objective To study the role of MDCT with 3D fusion images in the preoperative evaluation of pancreaticoduodenectomy.Methods 37 patients who underwent pancreaticoduodenectomy from March 2016 to May 2018 in the Affiliated Wuxi No.2 People's Hospital of Nanjing Medical University were included in this retrospective study.All patients underwent a dual-phase enhanced MDCT before operation.The volume data of enhanced MDCT were transmitted to a dedicated CT post-processing workstation.The 3D images,including the tumor,pancreas,portal vein system,arterial system,pancreatic and biliary tract,were reformatted respectively before the fusion imaging.Two reviewers analyzed the tumor location and its spatial relations with the pancreaticobiliary system,peripancreatic vessels and vascular variations by means of zooming,rotating,splitting and transparent displaying on fusion images.Then,the assessed items were compared to the surgical and pathological findings.Results The 3D fusion images of 37 patients in this study depicted the tumor,pancreas,peripancreatic vessels and pancreatic and biliary tract clearly.Compared with the intraoperative and pathological findings,the accuracy of both tumor detection and localization with the 3D fusion images was 100%.To compare the intraoperative findings,visualization and variation detection of the celiac,splenic,common hepatic,gastroduodenal,hepatic,and superior mesenteric arteries,and the superior mesenteric and portal veins were all 100%.Visualizations of the anterior superior pancreaticoduodenal artery (ASPDA),posterior superior pancreaticoduodenal artery (PSPDA),inferior pancreaticoduodenal artery (IPA) and dorsal pancreatic artery (DPA) were 85.7%,82.8%,72.2% and 75.8%,respectively.Conclusion The MDCT 3D fusion imaging technology allowed one stop preoperative assessment of pancreaticoduodenectomy,especially in clearly outlining the tumor location and its spatial relations with the surrounding surgical anatomies before surgery.

6.
Chinese Journal of Hepatobiliary Surgery ; (12): 381-385, 2018.
Article in Chinese | WPRIM | ID: wpr-708423

ABSTRACT

Objective To detect the expression of miR-122 in hepatocellular carcinoma (HCC) cells and tissues,and to explore the role and the underlying mechanisms of miR-122 in HCC cells on invasion and migration.Methods Real-time quantitative polymerase chain reaction of analysis was used to examine the expression of miR-132 in HCC cell lines,a normal liver cell line,HCC tissues and adjacent non-tumor tissues.Over express or inhibit miR-122 by transfection.The invasion and migration of HCC cells were analyzed by Transwell assays.Meanwhile,related mechanism proteins were detected by western blot,including insulin like growth factor 1 receptor(IGF-1 R),E-cadherin,vimentin.Results The expression of miR-122 was decreased in HCC tissue samples compared with the adjacent non-tumor tissues[(20.5 ± 4.2) × 10-4 vs.(30.3 ± 5.6) × 10-4],especially in HCC tissue samples with HBV [(25.6 ± 3.5) × 10-4 vs.(19.1 ±3.2) × 10-4].The same results were observed in HCC cell lines.MHCC-97H cells exhibited lowest level of miR-122 expression[(33.7 ± 1.3) × 10-3],whereas SMMC-7721 exhibited the highest level of miR-122 expression [(65.3 ± 1.3) × 10-3].MiR-122 over-expression suppressed the invasion and migration of MHCC-97H[(218.7±24.0) vs.(418.0 ±23.4),(392.7±12.8) vs.(706.6±19.8)].Knocking down miR-122 promoted the invasion and migration of SMMC-7721 [(233.0 ± 14.4) vs.(145.0-±8.0),(561.3 ±9.6) vs.(218.0 ± 11.3)].Western blot revealed that miR-122 suppressed the expression of IGF-1R,Vimentin and facilitated the expression of E-cadherin.Conclusions The study indicates that miR-122 is downregulated in HCC,especially in HCC tissue samples with HBV.MiR-122 can suppress invasion and migration of hepatocellular carcinoma by regulating IGF-1R and epithelial mesenchymal transition,and may provide a new therapeutic option for HCC.

7.
Chinese Journal of Digestive Surgery ; (12): 752-758, 2018.
Article in Chinese | WPRIM | ID: wpr-699194

ABSTRACT

Objective To investigate the application value of multiple imaging techniques in the multidetector computed tomography (MDCT) combined with assessment of vascular invasion using a tumor-to-vessel contact (TVC) computed tomography grading system in preoperative evaluation of pancreatic cancer.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 66 patients with pancreatic cancer who were admitted to the Wuxi No.2 People's Hospital of Nanjing Medical University between February 2012 and July 2017 were collected.Surgical results of 66 patients showed that tumors of 48 and 18 patients were respectively located in head or uncinate process of the pancreas and body and tail of pancreas.The 317 vessels of 66 patients were detected.Fifty patients underwent radical resection and 250 vessels were detected,resected tumor diameter was (2.7± 1.4) cm (range,1.3-7.7 cm);16 underwent palliative operation and 67 vessels were detected.Patients received enhanced scans of MDCT,and multiplanar reformatted (MPR),curved planar reconstructions (CPR),CT angiography (CTA),arterial and venous images of three-dimensional (3D) CT and negative-contrast CT cholangiopancreatography (nCTCP) were build.The morphology evaluation of pancreatic tumor was done by a senior radiology physician.The peripancreatic vascular invasion was evaluated using a TVC computed tomography grading system by two senior radiology physicians.Two physicians read collectively films and then achieved consistent results if there was a disputed result.Observation indicators:(1) tumor detection and morphology evaluation by MDCT;(2) detection of processing images on vascular invasion signs and vascular anatomical variations after MDCT;(3) TVC grading results of peripancreatic vascular invasion by MDCT;(4) correlation between TVC grading results of peripancreatic vascular invasion by MDCT and surgical grading results;(5) follow-up and survival situations.The follow-up using outpatient examination and telephone interview was per-formed to detect postoperative survival up February 2018.Measurement data with normal distribution were represented as x±s.Measurement data with skewed distribution were described as M (range).The measured values of tumor diameter by MDCT and surgical resection were done by Pearson correlation analysis.The Spearman analysis was used to analyze the correlation in the consistency of the vascular invasion results evaluated by two viewers and between TVC grading evaluation results and surgical grading results.Results (1) Tumor detection and morphology evaluation by MDCT:66 patients underwent MDCT,nCTCP combined with MPR images showed that there were 63 low-density tumors and 3 isopycnic tumors.The nCTCP images of 66 patients showed that 42 had biliary system dilatation and pancreatic duct dilatation,11 had pancreatic duct dilatation,5 had pancreatic duct break and 8 didn't have obvious signs of biliary and pancreatic duct dilatation and break.Results of MDCT of 66 patients showed that 48 tumors were located in head or uncinate process of pancreas,18 in the body and tail of pancreas,showing a consistency with surgical results.Pearson correlation analysis showed that measured values of tumor diameter was (2.7± 1.4) cm (range,1.3-7.2 cm) in 50 patients with radical resection,with a correlation with measured values of tumor diameter of surgical resection (r =0.904,P<0.05).(2) Detection of processing images on vascular invasion signs and vascular anatomical variations after MDCT:results of MDCT in 2 patients with radical resection showed that vascular variations were confirmed intraoperatively;left gastric artery directly started with celiac axis in 1 patient,common hepatic artery started with superior mesenteric artery,and celiac axis was invaded by tumor tissues,with grading 2 of TVC grading evaluation;accessory left hepatic artery in 1 patient started with gastroduodenal artery and was invaded by tumor tissues,with grading 2 of TVC grading evaluation.Results of MDCT in 2 patients with palliative operation showed peripancreatic vascular invasion,tumor of 1 patient invaded inferior vena cava,and tumor of other patient invaded superior mesenteric artery and involved the first branch of superior mesenteric artery.(3) TVC grading results of peripancreatic vascular invasion by MDCT:there was an overall positive correlation of TVC grading evaluation results in 317 peripancreatic vessels invasion of 66 patients between two physicians (r =0.827,P<0.05).There was a positive correlation of TVC grading evaluation results in celiac axis,common hepatic artery,superior mesenteric artery,superior mesenteric vein and portal vein between two physicians (r=0.661,0.911,0.809,0.911,0.614,P<0.05).(4) Correlation between TVC grading results of peripancreatic vascular invasion by MDCT and surgical grading results:there was an overall positive correlation in 317 peripancreatic vessels invasion of 66 patients between TVC grading evaluation results and surgical grading results (r=0.806,P<0.05).There were positive correlations between TVC grading evaluation results and surgical grading results in the artery group (celiac axis,common hepatic artery and superior mesenteric artery) and vein group (superior mesenteric vein and portal vein) (r=0.703,0.823,P< 0.05).There were positive correlations between TVC grading evaluation results and surgical grading results in the celiac axis,common hepatic artery,superior mesenteric artery,superior mesenteric vein and portal vein (r =0.792,0.464,0.823,0.809,0.812,P<0.05).(5) Follow-up and survival situations:56 of 66 patients were followed up for 3-18 months,with a median time of 7 months.During the follow-up,53 patients had tumor metastases,including 50 deaths and 3 survivors with tumor;3 patients had tumor-free survival.Conclusion Multiple imaging techniques in the MDCT combined with assessment of vascular invasion using a TVC computed tomography grading system can accurately evaluate morphology of pancreatic tumor and peripancreatic vascular invasion,and increase accuracy of preoperative assessment of pancreatic cancer.

8.
Chinese Journal of Hepatobiliary Surgery ; (12): 832-835, 2017.
Article in Chinese | WPRIM | ID: wpr-708341

ABSTRACT

Objective To study the expression of the long non-coding RNA-BC043614 in pancreatic ductal adenocarcinoma (PDAC) and to analyse the relationship between the clinical pathological data and the prognosis of PDAC.Methods The clinical data of 42 patients who had PDAC treated from June 2013 to June 2014 were retrospectively analyzed.Real-time fluorescence quantitative PCR (qRT-PCR) was performed to detect the difference in expression of lncRNA-BC043614 between PDAC and its adjacent normal tissues.Correlation between the expression of lncRNA-BC043614 in PDAC and the clinical pathological characteristics was analyzed by the x2 test.The potential of lncRNA-BC043614 in predicting prognosis in patient with PDAC after operation was assessed using the Log-rank test and the Cox's proportional hazards regression model.Results The expression of lncRNA-BC043614 was markedly higher in PDAC than in its adjacent normal tissues (P <0.05).The expression of lncRNA-BC043614 in PDAC was significantly correlated with tumor size,tumor differentiation,vascular carcinoma,and CA19-9 serum levels (P < 0.05).Patients with a higher expression of lncRNA-BC043614 in PDAC had a significantly shorter tumor-free survival (P <0.05).A high expression of lncRNA-BC043614 in PDAC was an independent risk factor of tumor-free survival in patients with PDAC after operation (P < 0.05).Conclusions lncRNA-BC043614 was highly expressed in pancreatic cancer tissue and it correlated with the patient's tumor-free survival.lncRNA-BC043614 can be used as a new prognostic biomarker.

9.
Chinese Journal of Hepatobiliary Surgery ; (12): 320-322, 2017.
Article in Chinese | WPRIM | ID: wpr-618700

ABSTRACT

Objective To study enhanced recovery after surgery (ERAS) in pancreaticoduodenectomy.Methods A case-control study was conducted on 56 patients who underwent pancreaticoduodenectomy in our hospital from May 2012 to December 2016.These patients were divided into two groups:25 patients received ERAS management (the ERAS group) and 31 patients traditional perioperative management (the control group).The data on postoperative pancreatic leakage,bile leakage,postoperative bleeding,delayed gastric emptying,postoperative intestinal function recovery,hospitalization stay,medical cost and readmission rate within 90 days between the two groups were compared.Results The rate of delayed gastric emptying,postoperative intestinal function recovery,hospitalization stay and medical cost were significantly better in the ERAS group than the control group (all P < 0.05).There were no significant differences in the rates of pancreatic leakage,bile leakage,postoperative bleeding,and readmission within 90 days between the two groups (all P > 0.05).Conclusions Perioperative ERAS in pancreaticoduodenectomy was safe and efficacious.It improved recovery of patients and reduced hospital stay and expenses.

10.
Chinese Journal of Sports Medicine ; (6)1983.
Article in Chinese | WPRIM | ID: wpr-581560

ABSTRACT

Forty-six male SD rats were randomly divided into 3 groups:control group(Grp 1), exhaustive swimming group(Grp 2) and recovery from swimminggroup (Grp 3). The lipid peroxidase (LPO) content and superoxide dismutase(SOD) activity of kidney, the excretion rate of total urinary protein (TUP)and the plasma angiotensin II(AII) content were measured. Their ultrastructuralchanges of kidney were investigated. It was shown that after exhaustive swimming,the LPO contents of kidney,the AII and the excretion rate of TUP increased significantly (p0.05). In Grp 3,the LPO and theexcretion rate of TP were significantly higher than Grp 2 (p

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