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Atrial fibrillation (AF) is one of the most common clinical arrhythmias. As the population ages, there is an upward trend in its prevalence. The risk factors associated with increased risk of AF include old age, diabetes, hypertension, and cancer. Studies have shown that in all age groups, the risk of death, hospitalization expenses, and hospitalization time of cancer patients with AF were higher than that without AF. Thus, increased systemic inflammation, electrolyte abnormalities, and neurohormonal changes in patients with prostate cancer (PCa) lead to a significantly higher incidence of AF than other cancers. However, the treatment of prostate cancer, including surgery, chemotherapy and radiotherapy, may also increase the risk of AF. In this review, relevant literatures are collected to understand the mechanism of AF in patients with PCa, determine the relationship between PCa and AF and its effect on hospitalized prognosis, and provide strategies for the prevention and treatment of AF in patients with PCa.
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Tacrolimus (TAC), also called FK506, is one of the classical immunosuppressants to prevent allograft rejection after liver transplantation. However, it has been proved to be associated with post-transplant hyperlipemia. The mechanism behind this is unknown, and it is urgent to explore preventive strategies for hyperlipemia after transplantation. Therefore, we established a hyperlipemia mouse model to investigate the mechanism, by injecting TAC intraperitoneally for eight weeks. After TAC treatment, the mice developed hyperlipemia (manifested as elevated triglyceride (TG) and low-density lipoprotein cholesterol (LDL-c), as well as decreased high-density lipoprotein cholesterol (HDL-c)). Accumulation of lipid droplets was observed in the liver. In addition to lipid accumulation, TAC induced inhibition of the autophagy-lysosome pathway (microtubule-associated protein 1 light chain 3β (LC3B) II/I and LC3B II/actin ratios, transcription factor EB (TFEB), protein 62 (P62), and lysosomal-associated membrane protein 1 (LAMP1)) and downregulation of fibroblast growth factor 21 (FGF21) in vivo. Overexpression of FGF21 may reverse TAC-induced TG accumulation. In this mouse model, the recombinant FGF21 protein ameliorated hepatic lipid accumulation and hyperlipemia through repair of the autophagy-lysosome pathway. We conclude that TAC downregulates FGF21 and thus exacerbates lipid accumulation by impairing the autophagy-lysosome pathway. Recombinant FGF21 protein treatment could therefore reverse TAC-caused lipid accumulation and hypertriglyceridemia by enhancing autophagy.
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Animals , Mice , Tacrolimus , Liver , Cholesterol, LDL , Autophagy , Disease Models, AnimalABSTRACT
Compared with normal tissue, interstitial extracellular pH of tumor cells is acidic. The reverse transmembrane pH gradient around tumor cells is closely related to its uncontrolled progression, angiogenesis and metastasis. Changes in urinary pH have an impact on the occurrence, progression and treatment of bladder cancer by regulating the microenvironment of bladder cancer cells. Relevant studies have shown that urinary pH value is an important factor in predicting the final clinical efficacy of bladder cancer patients combined with alkalization agents, which helps to reflect the acid-base balance and immune defense system in the body. Continuous monitoring of urinary pH can provide guidance and decision-making for the prognosis of bladder cancer patients.
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Objective:To investigate the expressions and clinical significance of tetraspanin CO-029 and integrin αv in intrahepatic cholangiocarcinoma (ICC ).Methods:Tissue microarray (TMA) was used to detect the expression of CO-029 and αv in 254 cases of intrahepatic cholangiocarcinoma. The relationship between the two factors and clinicopathological features, recurrence, metastasis and prognosis was analyzed.Spearman method was used to analyze their correlation.Relationship between αv and CO-029 was studied by mass spectrometry and database search,immunoprecipitation and Western blot were used to detect the coexistence.Results:Tissue microarray analysis showed that the positive expression rate of CO-029 was 51.6% (131/254), and the positive expression rate of αv was 61.4% (156/254). The expression of CO-029 and αv were closely correlated with tumor envelope, size, number and TNM stage ( P<0.05). According to the time of recurrence (TTR), the expressions of CO-029 and αv in early postoperative recurrence group (TTR <1 year) were significantly higher than those in non recurrence group (TTR ≥ 1 year). The patients with high CO-029 expression were more likely to relapse ( HR=2.01, 95% CI=1.45-2.79; P<0.001) and had shorter survival time ( HR=2.03, 95% CI=1.46-2.81; P<0.001). The patients with high expression of αv had shorter recurrence time ( HR=1.85, 95% CI=1.38-2.47; P<0.001) and shorter survival time ( HR=1.95, 95% CI=1.40-2.71; P<0.001). Co immunoprecipitation and Western blot confirmed that αv and CO-029 formed a complex. There was a positive correlation between CO-029 and αv in intrahepatic cholangiocarcinoma ( r=0.401, P<0.01). Conclusions:The differential expression of CO-029 and αv were closely related to the recurrence, metastasis and prognosis of intrahepatic cholangiocarcinoma, and CO-029 may couple with αv to form a complex to promote the invasion and metastasis of intrahepatic cholangiocarcinoma.
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Objective:To investigate the correlations between CO-029 expression and cholangiocarcinoma invasion and metastasis, and the further explore the potential mechanism involved.Methods:The constructed lentiviral vector of vshRNA-CO-029 (LV/GFP/CO-029) was used to transfect and screen the stable transfected cholangiocarcinoma cell line HCCC-9810-vshRNA-CO-029 as the silence group, HCCC-9810 cells transfected with the mock plasmid were used as the mock group, and the untransfected cells were used as the control group. Cell scratch assay, Transwell assay and in vivo implantation assay were used to detect the migration, invasion and metastasis of the three groups of cells. Immunoprecipitation and tumor necrosis factor (TNF)-α stimulation assay were used to detect the effect of CO-029 on the expression of EMT-related genes.Results:The scratch healing rate of the silence group was (27.11±4.58)%, which was lower than that in mock group (92.84±6.24)%, the number of cells passing through Matrigel in silence group was (57.15±6.10), which was significantly lower than that in mock group (108.20±9.21) and control group (112.00±10.45), the differences were statistically significant ( all P<0.01). The volume of liver tumors in the silence group of orthotopic xenograft mouse model was (2.17±0.54) cm 3, while the volume of liver tumors in the transplanted simulation group was (0.74±0.15) cm 3, the differences were statistically significant ( P<0.05). The incidence of lung metastasis and the number of lung metastases in the simulated group was 100%(6/6) and (214.17±35.64), respectively, while that in the silence group was 16.7% (1/6) and (41.56±14.15), respectively, the differences were statistically significant (all P<0.05). Co-immunoprecipitation showed that CO-029 can form a complex with TNF-αR1. TNF-α induced the down-regulation of E-cadherin and up-regulation of vimentin and N-cadherin in the mock group, but no significant changes were observed in the silence group. Conclusion:CO-029 expression is positively correlated with tumor invasion and metastasis of cholangiocarcinoma, and could couple with TNF-α to induce EMT, which is a novel well-established potential prognostic and therapeutic target for cholangiocarcinoma metastasis and prognosis intervention.
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Objective To perform an exploratory investigation on confocal laser endomicroscopy (CLE) in the diagnosis of malignant bladder tumour.Methods From June 10 to July 11,2017,6 male bladder cancer patients underwent white light cystoscopy (WLC) + CLE examination,aging 64-86 years (median 72 years).All patients received TURBT on suspected lesions.WLC and CLE imaging results were recorded and validated by pathologic specimens.Results Lesions confirmed by histopathology were 3 low grade non-invasive papillary urothelial carcinomas,1 high grade non-invasive papillary urothelial carcinoma,1 low grade invasive urothelial carcinoma,1 high grade invasive urothelial carcinoma,1 carcinoma in situ (CIS),1 high grade dysplasia,1 cystitis glandularis,1 chronic inflammation,and 1 scar tissue.For CLE images in the normal urothelium,three layers of cells with different presentation were observed,namely,the superficial umbrella cells,the intermediate cells smaller in size and uniformly shaped,and the capillary network in the lamina propria.For non-invasive urothelial carcinoma,tumour cells appeared as papillary lesions growing from fibrovascular cores,with low grade cells appearing monomorphic and more cohesively arranged,and high grade cells relatively pleomorphic,more disorganised and with tortuous blood vessels in the fibrovascular core.For invasive urothelial carcinoma,tumour cells invaded the lamina propria,with uniform appearances,poor cohesion and indistinct cellular borders,and high grade ones were more pleomorphic.CIS and inflammation both appeared as erythematous patch-like flat lesions under WLC and sometimes difficult to differentiate.Under CLE,the former appeared as dysplastic and disorganised cells with indistinct cellular borders,with intact lamina propria,and inflammatory cells were discovered as infiltrative clusters in the lamina propria that were uniformly shaped and loosely connected.Dysplasia appeared somewhat similar compared with CIS under WLC,but with lower cellular irregularity as confirmed with pathology.Cellular appearance and structure in scar tissue was similar to that in the normal urothelium,but superficial umbrella cells were more likely absent,with thinner cell layers,and inflammatory infiltration was sometimes discovered in the lamina propria.Conclusions CLE provides real-time cellular imaging of the urothelium,and shows promising potential for clinical diagnosis,especially in differentiating fiat urothelial lesions.Large prospective studies are required for further validation.
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Objective To investigate the diagnostic value of narrow-band imaging for flat bladder lesions.Methods Forty-nine patients with flat bladder lesions diagnosed by white light cystoscopy + narrow-band imaging followed by transurethral resection were included.The diagnostic value of narrow-band imaging was evaluated based on postoperative pathological results.Results A total of 59 flat lesions were identified,in which 8 were normal urothelium,3 were chronic inflammation,1 was papillary urothelial neoplasm of low malignant potential,1 were mild dysplasia,1 was moderate dysplasia,1 were severe dysplasia,3 were carcinoma in situ,16 were low-grade papillary urothelial carcinoma,16 were high-grade papillary urothelial carcinoma,and 8 were invasive papillary urothelial carcinoma.For narrow-band imaging,the sensitivity was 86.7 ％ (39/45),specificity was 57.1％ (8/14),diagnostic accuracy was 79.7 ％ (47/ 59),false-positive rate was 42.9％ (6/14),positive predictive value was 86.7％ (39/45),negative predictive value was 57.1％ (8/14),area under ROC curve was 0.719.Among these lesions,the sensitivity and specificity for postoperative recurrent lesions were 100％ (3/3) and 40％ (2/5),respectively,and those for erythematous patch-like lesions were 90％ (9/10) and 100％ (4/4),respectively.Conclusion Narrow-band imaging can improve the detection rate for flat bladder tumor lesions,and reduce the risk for missed diagnosis under white light cystoscopy,especially for otherwise indistinguishable erythematous patch-like lesions.
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Objective To investigate the clinic efficacy of two section and three leaves approach on laparoscopic radical cystectomy (LRC) or robot assisted radical cystectomy (RARC).Methods A retrospective statistical analysis collected a total of 103 cases with bladder cancer undergoing LRC or RARC,from Jan 2013 to Dec 2015 in our center.Those patients were divided into two groups,including two section and three leaves approach group (46 cases) and conventional group (57 cases).The two section,which means that to cut lateral prostate gland and lateral vesical gland respectively,the three leaves include lateral lobe of lateral vesical gland (superior vesical arteries and veins),medial lobe of lateral vesical gland and lateral prostate gland.In two groups,whose age ranged from 35 to 84 years,the median age were (63.3 ± 9.8) years and (63.7 ± 9.1) years,respectively.The median BMI values were (23.2 ± 2.9) kg/m2 and (23.0 ± 2.2) kg/m2,respectively.The occurrence of history of abdominal surgery were 4 (8.7％) cases and 9(15.8％) cases,respectively.In two section and three leaves approach,the ASA scores of 1,2,3 were found in 5,35,6 cases,respectively.In conventional group,the ASA scores of 1,2,3 were found in 12,38,7 cases,respectively.The difference between two groups in age distribution,BMI value,ASA score,history of abdominal surgery,urinary diversion,surgical methods,pathological staging and grading had no statistical significance (P ＞ 0.05).Then,the operation time,the blood loss and the time to remove drainage tube,et al of the above two groups were compared.Patients with BMI≥24 kg/m2 in the two groups were 24 cases and 20 cases,respectively,following the strategy based on BMI ≥24 kg/m2 and BMI ＜ 24 kg/m2 to compare the difference of subgroups in the operation time and the bleeding amount,for the purpose of corroborating the applied effectiveness of two section and three leaves approach compared with the conventional measure on LRC or RARC for patients with BMI ≥ 24 kg/m2.Results All endoscopic operations were completed successfully.No conversion was recorded.In two groups,the median operation time were (255.1 ± 99.3) min and (284.2 ± 171.3) min,respectively,the difference was statistically significant (P =0.011).The blood loss was (233.1 ± 196.9)ml and (272.0 ±268.8) ml,respectively(P =0.009).The time to remove drainage tube were (10.6 ± 5.0) d and (9.9 ± 4.4) d,respectively (P =0.880).In addition,the difference in the intraoperative blood transfusion rate(10.9％ vs.21.1％),occurrence of lymph fistula (13.0％ vs.17.5％),gastric extubation time [(4.3 ± 1.9) d vs.(4.0 ± 1.9) d],time for flatus recovery [(3.9 ±1.2) d vs.(3.7 ± 1.7) d],the incidence of perioperative complications (26.1％ vs.36.8％) and postoperative hospital stay [(13.3 ± 5.5) d vs.(13.5 ± 4.8) d] were no statistical significance (P ＞0.05).The results of comparisons for patients with BMI ≥ 24 kg/m2 between subgroups included the operation time were (264.3 ± 68.1) min and (298.5 ± 80.2) min,respectively.The blood loss were (247.8 ± 199.4) ml and (295.3 ± 204.5) ml,respectively,both of them were statistical significance (P ＜0.05).The two section and three leaves approach was significantly better than those patients operated by conventional method.Conclusions Compared with conventional method undergoing LRC or RARC,two section and three leaves approach could shorten operative time and reduce the blood loss markedly,especially for patients with BMI≥24 kg/m2.
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Objective To investigate the effect of occult HBV infection (OBI) on carcinogenesis of cryptogenic hepatocellular carcinoma.Methods Samples of hepatocellular carcinoma (HCC) and pericarcinomatous tissues obtained after hepatectomy from January 2011 to November 2013 at the Third Affiliated Hospital of Sun Yat-Sen University were collected.They were divided into two groups:the cryptogenic HCC group (the CH group,n =26) and the HBV related HCC group (the HH group,n =40).These samples were compared with the normal liver tissues obtained in 30 patients.HBV DNA was identified by the nested polymerase chain reaction and the immunohistochemical method was taken to examine the hepatitis B virus X protein (HBx) and Yes-associated protein (YAP) expressions.Results OBI was identified in 20 (77.8％) cryptogenic HCC patients and 8 (26.7％) in the control group.There was a significant difference between the two groups (x2 =14.072,P ＜ 0.05).HBV DNA was detected in all the HBV-related HCC patients.The HBx protein expression was mainly located in the cytoplasm of liver cells and liver cancer cells,but YAP was expressed in the nucleus.Both of them showed diffuse brown or tan particles.In the HH group and the CH group,the positive expression rates of HBx protein in the tumorous tissues were 80.0％ and 90.0％,respectively,and 85.0％ and 82.5％ in the nontumorous tissues,but only in 40.0％ in the control group.The positive expression rates of YAP in the tumorous tissues were 65.0％ and 67.5％,respectively,15.0％ and 20.0％ in the nontumorous tissues,respectively,but only in 12.5％ in the control group.The HBx expression in the cancerous tissues and para-cancerous tissues of the HH group and the CH group showed no significant difference (P ＞ 0.05),but the YAP expression in the tumor tissues was significantly higher than that in the nontumorous tissues (P ＜ 0.05).The HBx and YAP expressions in the HH group were comparable to the CH group (P ＞ 0.05).However,their expressions in the cancerous tissue of the HH group and the CH group were significantly higher than in the normal liver tissues (P ＜ 0.05).Conclusion A high prevalence of HBV infection was observed in HBsAg-negative HCC and the high expressions of HBx and YAP might be involved in the process of cryptogenic hepatocellular carcinoma.
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Objective To investigate the portal vein embolization (PVE) and portal vein ligation (PVL) in liver regeneration of rats with hepatic fibrosis.Methods Fifty rats with liver fibrosis were prepared,including 10 rats were randomly chosen as pre-operative control group.The other 40 rats were divided into two groups:PVE group (A1,n =20) and PVL group (A2,n =20).We chose to embolize and ligate the right portal vein,respectively.The blood samples were obtained at different end points for measuring ALT and AST levels.Each liver lobes and whole liver were weighed,and non-embolized liver lobe/whole liver weight ratio,non-ligated liver lobe/whole liver weight were caculated at different end points.The samples from liver with/without embolization or ligation were were stained with hematoxylin-eosin,and the changes of microstructure of liver were observed.Immunostained for PCNA and Ki-67 were performed.Results Transient elevation of postoperative ALT and AST levels were noted in each group.Serum ALT and AST reached the peak on the first day in both of PVE and PVL groups [ALT,A1 (66.5 ±6.3) U/L vs(491.5 ± 48.0) U/L,A2 group(62.8 ±5.7) U/L vs(433.7 ±41.0) U/L;AST,A1group (113.4 ± 12.5) U/L vs (685.2 ±65.7) U/L,A2 group (110.4 ± 11.1) U/L vs(623.9 ±75.2) U/L,P＜0.05),and started to decrease on the third day,recovered to the pre-operative level on the fourteenth day (P ＞ 0.05).The weight percentage of non-embolized and non-ligated liver lobes/whole liver after PVE and PVL increased.There was no significant difference between the first day and pre-operative levels (P ＞ 0.05).Nevertheless,there were significant differences observed from the third,seventh,fourteenth days (A1 group,50.2 ± 5.0,57.7 ±5.7,61.8 ±6.6;A2group,49.6 ±3.5,55.7 ±6.9,63.0±5.1,respectively)compared with preoperative groups (A1 group,34.4 ± 4.0;A2 group,34.4 ± 4.0) (P ＜ 0.05).There was no significant difference between group A1 and A2 in each time point (P ＞0.05).The PCNA and Ki-67 were positive in hepatocytes and increased after operation,reached the peak in the third day (P ＜ 0.05),decreased slowly and restored to the normal level in the fourteenth day after operation,meanwhile,there was no significant difference between group A1 and A2 (P ＞ 0.05).Conclusions Fibrosis rats had the ability of regeneration in the contralateral part of the liver after selective PVE and PVL and there was no significant difference on the proliferative degree.Therefore,the safety and reliability of PVE and PVL in inducing liver regeneration in rats with liver fibrosis were confirmed.
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Objective To summarize the surgical experience and primary follow-up results for robotic assisted radical cystectomy ( RARC ) , as well as to evaluate the safety and feasibility of this procedure.Methods From Jan 2013 to Oct 2015, we retrospectively analysis the perioperative data and primary follow-up data from 35 patients who underwent radical cystectomy with Da VinCi robotic laparoscopic in urological institution of Changhai Hospital.The median age was 65 (ranging from 46 to 78) years.The amount of male cases were 34, the female case were 1.There were three kinds of urinary diversion, ureterocutaneostomy, Bricker operation and orthotopic neobladder, were 2, 26 and 7 respectively.We collected the parameters including operating time, estimated blood loss, blood transfusion volume, time to flatus,length of hospital stay,perioperative complication,time of recurrence,time of death and the reason of death.Results All of the related operations had been accomplished successfully, none of which had been converted to the open procedure.The estimated operating time of ureterostomy was (315.0 ±106.1) min, Ideal conduit was ( 443.2 ±93.2 ) min, Orthotopic bladder was ( 488.3 ±80.6 ) min.The estimated intraoperative blood loss was 260.0 ±108.6(100 to 500 )ml.5 cases of all patients were transfused 400ml red cell suspension, the transfusion rate was 14.2%.The mean time to flatus was 3.1 ±1.6(1 to 7) d.The estimated time to remove the gastric tube and the drainage tube was 4.2 ±2.2d(2-10d),10.8 ±5.1d(4-25d),respectively.The length of hospital stay after surgery was 12.4 ±5.17(6 to 25) d.Overall,17,8, 10,31 and 4 of these patients had
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Objective To separate the CD133 + subpopulation in human hepatocellular carcinoma (HCC) and investigate the tumorigenicity.Methods The human liver cancer tissues were subcutaneously transplanted into nude mice to generate xenograft tumors which were then isolated to prepare single cell suspension.The expression of CD133 + subpopulation was further detected using flow cytometry.The CD133 + subpopulations were separated and depurated with magnetic-activated cell sorting system.Immunofluorescence was performed to identify the histological phenotype of CD133 + subpopulation.The in vitro and in vivo clone formation assay and in vivo xenograft formation assay were performed, respectively.Results Flow cytometry analysis revealed that a percentage of (4.1 ± 0.6) ％ CD133 + cells were detected in xenografts.Immunofluorescence studies showed that (86.8 ± 7.5) ％ of the isolated cells were CD133 +.Compared with CD133-population, CD133 + cells showed a higher capability to generate clone sphere in vitro and a higher tumorigenicity in nude mice (P ＜ 0.05).Conclusion The CD133 + subpopulation in human hepatocellular carcinoma had a potent tumorigenicity and was enriched in cancer stem cells.
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Objective To investigate feasibility and early stage postoperative complications of lapa-roscopic radical cystectomy ( LRC) . Methods We retrospectively analyzed the data of 63 consecutive pa-tents (58 males and 5 females) who underwent LRC from Oct .2011 to Oct.2013 in our institute.Of these patients, 46 patients underwent ileal conduit , 9 patients underwent ureterocutaneostomy , and 8 patients un-derwent orthotopic ileal neobladder urinary diversion .The average age and body mass index of patients were 67.7±11.1 (33-84) years and 23.3±2.1 (18.8-28.7) kg/m2, respectively.The mean hemoglobin and al-bumin of patients were (130.7±20.3) g/L and (38.9±4.1) g/L, respectively.Comorbidities of hyperten-sion, diabetes, coronary heart disease and decompensated liver cirrhosis were found in 10, 6, 2 and 1 pa-tient, respectively.10 of 61 patients had a history of abdominal surgery .The indications for cystectomy were classified as muscle invasive bladder cancer for 30 patients, unresectable superficial bladder cancer for 19 patients and recurrent bladder cancer for 14 patients.Postoperative data and early stage postoperative compli-cations within 3 months after surgery were collected . Results The median operative time for LRC and uri-nary diversion was 390 (260-480) min, with a median estimated blood loss of 400 (100-1 500) ml.This was one patient converted to open surgery .The mean postoperative hemoglobin and albumin of patients was 108.5±14.7 g/L and 29.5±3.7 g/L, respectively, both of which significantly reduced compared with pre-operative data (P<0.01).The median duration of hospital stay was 15 days.The median time for liquid in-take, abdominal drainage removal and ureteral stent removal was 4 days, 9 days and 2 months after surgery , respectively.Catheter was removed 2 weeks after laparoscopic orthotopic cystectomy .21 (33.3%) of 63 pa-tients suffered from perioperative complications .15 of 46 patients (32.6%) in ileal conduit group had com-plications including ileus ( 5, 1 of 5 need re-operation ) , lymphatic fistulas ( 5) , pulmonary infection ( 1) , pyelonephritis (1), delirium (1), anastomotic leak (1, re-operation was needed) and pneumothorax (1). 2 of 9 patients (22.2%) in ureterocutaneostomy group had complications such as ileus (1) and lymphatic fistulas (1).4 of 8 patients (50.0%) in orthotopic ileal neobladder group suffered from complications like ileus (2, 1 of 2 required re-operation), lymphatic fistulas (1) and arrhythmia (1). Conclusions LRC is technically feasible and safe .It reduces the estimated blood loss and postoperative complications .It is noteworthy to surgeons that serum albumin significantly reduced after LRC , nutrition should be kept balanced after surgery.
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Objective To investigate the therapeutic effects of varied operative for the treatment of intrahepatic bile duct stones.Methods The clinical data of 176 consecutive cases of hepatolithiasis surgically treated in the past 3 years in our hospital were retrospectively analyzed.There were 45 type Ⅰ patients,25 type Ⅱ a patients,25 type Ⅱ b patients,3 type Ⅱ c patients,52 type Ea patients,19 type Eb patients,and 7 type Ec patients.These 176 patients were divided into 4 groups according to modus operandi:choledocholithotomy and T-tube drainage in 71 patients (type Ea 31 patients,type Ⅰ 15 patients,type Ⅱ a 25 patients) ; choledocholithotomy and choledochojejunostomy in 25 patients (type Ea 14 patients,type Eb 7 patients,type Ec 4 patients) ; choledocholithotomy and hepaticojejunostomy in 10 patients (type Ⅱb 5 patients,type Ⅱ c 3 patients,type Ea 2 patients) ; hepatectomy plus T-tube drainage or choledochojejunostomy in 70 patients (type Ⅰ 30 patients,type Ⅱ b 20 patients,type Ea 5 patients,type Eb 12 patients,type Ec 3 patients).The postoperative residual stone rate,perioperative complications and long term results were compared between groups.Results Patients undergoing hepatectomy have less postoperative residual stone rate,higher rate of good long term efficacy as compared with those who did not undergo hepatectomy (17.1％ (12/70) vs 43.4％ (46/106),91.4％ (53/58) vs 77.0％ (67/87)).Though patients undergoing hepatectomy had higher rate of perioperative complications (37.1％ (26/70) vs 14.2％ (15/106)).Conclusions Hepatectomy is the most effective procedure for the treatment of type Ⅰ and type Ⅱ b hepatolithiasis.Hepaticojejunostomy is the main procedure for the treatment of type Ⅱ c hepatolithiasis.
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Objective To innovate and improve the feasibility of flexible ultrasonic cystoscopy (FUCS) in the diagnosis and treatment for urinary tract diseases in vivo by using female pigs as animal model.Methods Endobronchial ultrasonography was took as a substitute for FUCS and the operating skills and experience of FUCS in vivo by using female pigs as animal model were summarized,in order to testify the efficacy and safety of needle biopsy guided by FUCS.Results FUCS could simultaneously display the endoscopic images and ultrasonic images.Ninety ml was suitable in pig bladder for FUCS when the layers of bladder wall were clear.The mucosa,submucosa,muscularis and serosa layers were legible,which contributed to the needle positioning biopsy.Doppler ultrasound mode could distinguish the vessels,which could guide the puncture and avoid accidental injury of blood vessels and surrounding organs.Pathological results of positioning biopsy were consistent with FUCS evaluation for the three major layers of bladder wall.Conclusion Studies in vivo show that application of FUCS in the diagnosis and treatment for bladder disease is feasible,and further improvement of the FUCS equipment and clinical practice should be made.
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Objective To study the effect of Tspan 8 on metastasis and invasion of human hepatocellular carcinomas(HCC).Methods RT-PCR and western blot were used to detect the expressions of Tspan 8 in HCC cell lines,HCC and matched nontumorous tissues.The expression of Tspan 8 was then down-regulated by LV/GFP/Tspan 8 in HCC cells.The expressions of Tspan 8 mRNA and protein were determined by RT-PCR and Western blot assay,respectively.The proliferation was examined by MTT,the expression of AMDM12 was assessed by Western blot,and the invasion ability of HCC cells was evaluated by transwells.Results A high level of Tspan 8 was found in high metastatic potential HCC cells,and the expression of Tspan 8 in HCC tissues was much higher than that in the matched nontumorous tissues. Down-regulation of Tspan 8 had no influence on the proliferation of HCC cells (P＞0.05),while it inhibited the expression of ADAM12 and the invasive ability of HCC cells (P＜0.01,P＜0.01 respectively).Conclusion Tspan 8 played an important role in invasion and metastasis of human hepatocellular carcinomas and down-regulation by LV/GFP/Tspan 8 inhibited the invasiveness of human hepatocellular carcinoma cells.
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ObjectiveTo evaluate the safety and efficacy of submucosa dilation assisted laser resection of bladder tumor for the treatment of solitary non-muscle invasive bladder cancer. MethodsA total of 12 patients with solitary non-muscle invasive bladder tumor were treated with the procedure of submucosa dilation assisted laser resection under total intravenous anesthesia or epidural anesthesia.lntravesical instillation chemotherapy was performed according to CUA 2007 guidelines.Patients were followed up for 4 - 36 months after the operation. ResultsThe diameter range of the tumors was 0.5 - 2.3 cm with the clinical stage Ta - T1 and low pathology grade.Submucosa dilation assisted laser resection of bladder tumor was successfully performed on all patients.The average operation time was 25 min (range,20 -45 min ),and the catheter time was 3 d ( range,1 -4 d).The mean volume of bleeding was less than 5 ml,no patient required blood transfusion.No complications such as obturator nerve reflex,bladder perforation and over-hydration occurred.No recurrence occurred during the follow-up. ConclusionsSubmucosa dilation assisted laser resection of bladder tumor could be an effective,safe,and excellent alternative procedure for the treatment of solitary non-muscle invasive bladder cancer,with few complications and a low recurrence rate.More studies and long-term follow-up should be warranted to ultimately evaluate this procedure.
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Objective To summarize the experience in the diagnosis and treatment of hepatic trauma. Methods The clinical data of 260 patients with hepatic trauma admitted from January 1988 to December 2007 were retrospectively reviewed with regard to degree of trauma, treatment methods, therapeutical effects, complications and SO on. Results One hundred and fifty-three eases were treated by operative management,1 07 cases by nonoperative management.236 cases were cured,24 cases died,and the case fatality rate was 10.2%.There were no death among 139 patients with hepatic trauma grades Ⅰ～Ⅱ,22 death among 119 grades Ⅲ～Ⅴ patients, all death of 2 in grade VI, which demonstrated the correlation between death and hepatic trauma grade was statistically significant. Complications appeared in 82 eases, mainly including Secondary hemorrhage, abdominal infection and so on. Conclusions Nonoperative management is suitable for hepatic trauma with stable hemodynamics. Operative management is rapidly selected when the hemodynamics aren't stable. The cooperation of many specialities can enlarge the application of nonoperative management and decrease complications.
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Objective To detect the expression of genes Her-2/neu,DPC4 and P16 in pancreatic carcinomas and to investigate the role of their alterations in tumorigenesis and progression of pancreatic carcinomas.Methods We studied the immunohistochemical markers Her-2/neu,DPC4 and P16 in 34 adenocarcinomas and 12 nonmalignant specimens of the pancreas,and the relationship between DPC4 alterations and various clinicopathological parameters was evaluated.Results There was a significant difference between normal pancreatic tissues and benign pancreatic lesions and primary pancreatic carcinomas for frequency of Her-2/neu expression and loss of P16 expression(P
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Objective To study the management of vascular injury.Methods Retrospective analysis was made on the clinical data of 59 cases of vascular injury,including 55 cases of vascular injury in neck and(extremity) and 4 cases of portal vein and vena cava injury.Among them,21 cases had femoral artery injury with infection and 4 cases had vascular injury due to intervention therapy.All patients with vascular wound of extremity or neck had undergone hemostasis by compression and antishock treament before hospital admission.All cases of femoral artery injury with infection underwent hemostasis by arterial ligation and incision and(drainage) of abscess.Vascular anastomosis was performed in 11 cases,vascular grafting in 12 cases,and(vascular) repair in 14 cases.Results There were 2 deaths.5 cases had amputation(including a case of(femoral) embolism due to intervention trerapy).Postoperative intermittent claudication,decreased skin(temperature) and other signs of ischemia occurred in 21 cases of femoral artery injury with infection,but none developed limb gangrene. The other cases were discharged in good health.Conclusions In the treatment of vascular injury,wound hemostasis and antishock treatment should be done first to save the patient′s life and the management of the vascular injury depends on the situation,with the aim to try by all means to save the extremity.Vascular reconstruction is the main method for treatment of vassular injury.Vascular ligation can be done in cases of femoral artery injury with infection.