Laparoscopic versus traditional open splenectomy for hepatocellular carcinoma with hypersplenism / 华中科技大学学报（医学）（英德文版）

This study aimed to examine the efficacy of the laparoscopic vs. traditional open splenectomy for hepatocellular carcinoma (HCC) with hypersplenism. Between 2002 and 2013, 51 Chinese HCC patients with hypersplenism underwent either simultaneous laparoscopic splenectomy plus anticancer therapies (Lap-S&A) (n=25) or traditional open splenectomy plus anti-cancer therapies (TOS&A) (n=26). The outcomes were reviewed during and after the operation. Anti-cancer therapies for HCC included laparoscopic hepatectomy (LH) and laparoscopic microwave ablation (LMA). The results showed that there was no significant difference in the operating time between the two groups, but the blood loss and blood transfusion were less, pain intensity after surgery was weaker, the time to first bowel movement, time to the first flatus and postoperative hospital stay were shorter, and the postoperative complication rate and the readmission rate were lower in the Lap-S&A group than in the TO-S&A group. Two patients in the Lap-S&A group and one patient in the TO-S&A group died 30 days after surgery. However, no significant difference in the mortality rate was noted between the two groups. It was concluded that simultaneous Lap-S&A holds the advantages of more extensive indications, lower complication incidence and less operative expenditure than conventional open approach and it is a feasible and safe approach for HCC with hypersplenism.

Synergistic suppressive effect of PARP-1 inhibitor PJ34 and HDAC inhibitor SAHA on proliferation of liver cancer cells / 华中科技大学学报（医学）（英德文版）

Poly (ADP-ribose) polymerase-1 (PARP-1) inhibitors and histone deacetylase (HDAC) inhibitors have recently emerged as promising anticancer drugs. The aim of this study was to investigate the effect of combination treatment with the PARP inhibitor PJ34 and HDAC inhibitor SAHA on the proliferation of liver cancer cells. Cell proliferation and apoptosis were assessed in three human liver cancer cell lines (HepG2, Hep3B and HCC-LM3) treated with PJ34 (8 μmol/L) and SAHA (1 μmol/L), alone or combined, by Cell Counting Kit-8 assay and flow cytometry, respectively. The nude mice bearing subcutaneous HepG2 tumors were administered different groups of drugs (10 mg/kg PJ34, 25 mg/kg SAHA, 10 mg/kg PJ34+25 mg/kg SAHA), and the inhibition rates of tumor growth were compared between groups. The results showed that combined use of PJ34 and SAHA could synergistically inhibit the proliferation of liver cancer cell lines HepG2, Hep3B and HCC-LM3. The apoptosis rate of HepG2 cells treated with PJ34+SAHA was significantly higher than that of HepG2 cells treated with PJ34 or SAHA alone (P<0.05). In vivo, the tumor inhibition rates were 53.5%, 61.4% and 82.6% in PJ34, SAHA and PJ34+SAHA groups, respectively. The combined use of PJ34 and SAHA could significantly inhibit the xenograft tumor growth when compared with use of PJ34 or SAHA alone (P<0.05). It was led to conclude that PJ34 and SAHA can synergistically suppress the proliferation of liver cancer cells.

Influence of cirrhosis on long-term outcomes after liver resection in patients with a single small hepatocellular carcinoma / 中华外科杂志

<p><b>OBJECTIVES</b>To compare the outcomes after liver resection for a single small hepatocellular carcinoma (HCC) (≤ 5 cm) between non-cirrhotic patients and cirrhotic patients, and to explore the influence of liver cirrhosis on recurrence and overall survival after liver resection in patients with a single small HCC.</p><p><b>METHODS</b>A consecutive series of 256 patients with a single small HCC undergoing liver resection from April 2001 to October 2009 was retrospectively reviewed. Among the 256 patients, 227 patients were male, and 29 were female. The medium age was 49 years (ranged, 14 - 79 years); 224 (87.5%) patients were positive for hepatitis B surface antigen, 241 (94.1%) patients were with preoperative liver function of Child-Pugh grade A. The entire cohort were divided into non-cirrhosis group (n = 44) and cirrhosis group (n = 212). Univariate analysis and then multivariate analysis were performed to determine the prognostic factors of recurrence and overall survival after liver resection for all patients.</p><p><b>RESULTS</b>The 1-, 3-, 5-year recurrence-free survival rates after liver resection were 93.0%, 85.3%, and 68.5%, respectively, in non-cirrhosis group, while 81.1%, 58.6%, and 45.0%, respectively, in cirrhosis group. The 1-, 3-, 5-year overall survival rates after liver resection were 100%, 92.5%, and 92.5%, respectively, in non-cirrhosis group, while 93.8%, 78.7%, and 67.8%, respectively, in cirrhosis group. Both the recurrence-free survival and overall survival of non-cirrhosis group were significantly better than those of cirrhosis group (χ(2) = 8.756, P = 0.003; χ(2) = 8.603, P = 0.003). Cirrhosis, absence of tumor capsule, presence of microvascular invasion and moderate/poor tumor differentiation were the independent adverse prognostic factors for recurrence-free survival and overall survival in patients with a single small HCC after liver resection.</p><p><b>CONCLUSIONS</b>Cirrhosis is an important adverse prognostic factor for long-term survival in patients with a single small HCC after liver resection. Liver resection resulted in much worse survival for cirrhotic patients compared to non-cirrhotic patients.</p>

Correlation of casein kinase 2β overexpression to the metastatic ability of colorectal cancer cells in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the expression of casein kinase 2β (ck2β) in colorectal cancer in relation to the metastatic ability of the cancer cells.</p><p><b>METHODS</b>The expression of ck2β in 46 normal colorectal mucosa, 20 colorectal adenomas and 66 colorectal cancers were detected immunohistochemically. In colorectal cancer cells, Ck2β protein expression was knockdown by RNA interference using ck2β-specific small interfering RNA (siRNA) and the interference efficiency was assessed by Western blotting. The effect of ck2β gene knockdown on the proliferation of the colorectal cancer cells was tested with colony formation assay, and the changes in the invasive ability of the cells were observed using Transwell chamber assay.</p><p><b>RESULTS</b>Negative or weak ck2β expression was detected in normal colorectal mucosa, with nuclear positivity in 8.7% and cytoplasmic positivity in 13.0% of the cases. Colorectal adenomas showed moderate ck2β expression, with 60% cases showing positivity in the cell nuclei and 40% in the cytoplasm. In colorectal cancers, significantly stronger expression of ck2β was found than that in colorectal adenomas and normal colorectal mucosa (P<0.05), and 75.8% cases showed positivity in the cell nuclei and 62.1% showed cytoplasmic positivity; the expression of ck2β protein in colorectal cancers with lymph node metastasis was even higher (P<0.05). Ck2β knockdown obviously inhibited the proliferation and invasiveness of colorectal cancer cells in vitro.</p><p><b>CONCLUSION</b>The high expression of ck2β in colorectal cancer is closely correlated to the carcinogenesis and metastasis of the tumor.</p>

An outbreak of measles among unvaccinated migrant population in Zhejiang province, from June to August, 2010 / 中华流行病学杂志

Objective On July 6, 2010, the parents of a patient with confirmed measles reported several suspected measles patients with fever and rash in their village. An investigation was carried out to verify and understand the cause of the outbreak. Methods Several suspected cases had an onset of fever and rash in this and other neighboring villages during June 1 to August 3,2010. A confirmed case was a suspected case with measles-specific IgM identified in the serum. We conducted door-to-door visits and searched the Chinese Center for Disease Control and Prevention Information System to identify cases, also conducted a retrospective cohort study among migrant children aged 8 months-14 years to identify risk factors related to measles. Results We identified 19 measles cases (17 confirmed case, 2 suspected cases)in the village, and all of them were migrants. Children aged 1-2 years had the highest attack rate(13%). The primary case-patient had onset on the day she arrived in this village(June 4,2010). Caretakers from an unlicensed private clinic were providing service in the village but did not report the outbreak to the public health authority. The outbreak was identified only after receiving a report from the parents of one of the patients, by that time the outbreak had lasted for one month. The measles vaccine coverage rate was 81% among the 315 migrant children aged 8 months-14 years. Among the 61 unvaccinated children, those who reportedly being contacted a measles patient had a higher attack rate(14/16, 88%)than those who did not(2/45, 4.4%)(Relative risk=20, Fisher' s exact 95% confidence interval: 5.7-94). Conclusion The low measles vaccine coverage among migrant children and lack of measures taken on the incident, timely isolation diagnosis/reporting by the caretakers from the unlicensed private clinic etc. had contributed to this prolonged outbreak. Measures need to be taken to improve the immunization services for migrant populations and to enhance measles surveillance programs in the area.

Clinical analysis of 118 patients with tympanosclerosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the incidence of tympanosclerosis (TS) and the major risk factors of hearing loss.</p><p><b>METHODS</b>A total of 118 TS patients (137 ears) were compared with 265 patients with chronic otitis media (COM) (311 ears) for gender, age and course of disease. The disease regions and hearing loss of the TS patients were analyzed.</p><p><b>RESULTS</b>TS showed higher prevalence in women of older ages. Sclerosis was seen most frequently in the tympanic membrane, followed by the malleus, incus, incudomalleolar joint, other regions, ariticulus incudostapedius and stapes. The patients with sclerosis or deterioration in the ossicular chain had worse hearing loss than the other patients. Carhart notch occurred in 45 ears (32.85%), an incidence similar to that of inverted "V"-shaped curve of air-conduction audiometry near 2 kHz (47 ears, 34.31%). The factors contributing to the hearing loss, listed in the order of their importance, included pathologies in the incus, malleus, incudomalleolar joint, ariticulus incudostapedius, stapes, other regions, tympanic membrane, and gender.</p><p><b>CONCLUSIONS</b>Female patients may had increased risk of TS. The presence of Carhart notch and inverted "V"-shaped curve in air-conduction audiograph may indicate myringosclerosis or ossicular chain sclerosis. Abnormal ossicular chain is the leading factor contributing to hearing loss.</p>

Predictive value of human fatty acid binding protein for myocardial ischemia and injury in perioperative period of cardiac surgery / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the value of human fatty acid binding protein (h-FABP) in predicting myocardial ischemia and injury in the perioperative period of cardiac surgery, we observed the dynamic changes of h-FABP in perioperative period of patients underwent coronary artery bypass grafting and ventricular septal defects repairing surgery, and evaluated the relationship of h-FABP and ischemia modified albumin (IMA), CK-MB, cTnI.</p><p><b>METHODS</b>Patients underwent coronary artery bypass grafting (n=30) and ventricular septal defect repairing (n=30) surgery between February 2008 and December 2008 were included in this study. Venous blood sample was obtained at preoperative, aortic clamping, aortic unclamping of 10 min, 2 h, 6 h, 12 h, 24 h for the measurements of h-FABP, IMA, cTnI and CK-MB.</p><p><b>RESULTS</b>h-FABP and IMA changed in the same way at various examined time points, h-FABP changes also paralleled cTnI and CK-MB changes, h-FABP peaked early during myocardial ischemia and injury and returned to baseline level at 2 h post myocardial ischemia and injury. Linear correlation analysis showed that the peak value of h-FABP was positively correlated with IMA, CK-MB and cTnI in both CABG group (r = 0.948, 0.964 and 0.961, P < 0.05) and in the VSD group (r = 0.986, 0.978 and 0.957).</p><p><b>CONCLUSIONS</b>h-FABP is an early diagnostic parameter reflecting perioperative myocardial ischemia and injury in cardiac surgery. Quantitative h-FABP monitoring could predict the severity of myocardial ischemia and injury early during cardiac surgery.</p>

Treatment of femoral unstable intertrochanteric fractures in the elderly with uncemented long stem bipolar prosthetic prosthesis / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of cemented long stem bipolar prosthetic prosthesis in the management of unstable intertrochanteric fractures in the elderly.</p><p><b>METHODS</b>A retrospective analysis of 23 elderly cases of uncemented long-stem prosthetic replacement for unstable intertrochanteric fractures was conducted. Of the 23 elderly patients, 6 had type IIA fracture by Evans-Jenson classification, 11 had type IIB fractures, and 6 had type III fractures.</p><p><b>RESULTS</b>One patient died due to severe respiratory failure during the follow-up period. The patients were followed up for 6 to 10 months (mean 15 months), and no dislocation, infection, loosening or sinking of the prosthesis was found in the followed-up cases with a Harris score reaching 84.8.</p><p><b>CONCLUSION</b>Cemented long-stem bipolar prosthetic prosthesis replacement is effective for management of unstable intertrochanteric fractures in the elderly.</p>

Therapeutic effect of ossicular reconstruction with bioceramic or porous macromolecular polyethylene partial ossicular replacement prosthesis in patients with tympanosclerosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of ossicular reconstruction with partial ossicular replacement prosthesis (PORP) in patients with tympanosclerosis.</p><p><b>METHODS</b>The data of 31 cases of tympanosclerosis treated between 1992 and 2009 were reviewed. Of the 31 patients, 17 (17 ears) underwent ossicular reconstruction with porous macromolecular polyethylene PORP, and 14 (14 ears) with bioceramic PORP. All the patients were followed up for 3-24 months.</p><p><b>RESULTS</b>Significant improvement was found in postoperative speech frequency (500, 1000, 2000 Hz) pure tone average (PTA) and air-bone gap (ABG) (P < 0.05) after the treatments without statistically significant differences between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>Porous macromolecular polyethylene and bioceramic are valuable ossicular prosthesis for tympanosclerosis.</p>

Minor liver resection for hilar cholangiocarcinoma of Bismuth-Corlette type III / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate long-term outcomes of minor liver resection for hilar cholangiocarcinoma (HC) of Bismuth-Corlette type III.</p><p><b>METHODS</b>From January 1997 to December 2007, the clinical data of 91 patients with Bismuth-Corlette type III HC underwent hepatectomy were collected and analyzed retrospectively.</p><p><b>RESULTS</b>There were 60 patients underwent minor hepatectomy, and 31 undergoing major hepatectomy. Hepaticojejunostomy was made conventionally in an end-to-side fashion in the patients undergoing major liver resection, and a new technique of hepaticojejunostomy used in the patients undergoing minor liver resection. That was the anterior edges of bile duct stumps which were not sutured after suturing of posterior edges. Instead of, the anterior edge of jejunum loop to the remnant liver on the top of the bile duct stumps were sutured with intermittent "U" sutures. In all patients, in-hospital mortality rate was 0 and rate of bile leakage was only 2.1%. The actual 1-, 3- and 5-year survival rates were 91.6% and 87.0%, 61.6% and 62.0%, 31.6% and 33.0%, respectively (P > 0.05).</p><p><b>CONCLUSIONS</b>Minor liver resection for the selected patients with HC of Bismuth-Corlette type III according to our criteria achieved better long-term outcomes. A new hepaticojejunostomy used in the patients undergoing minor liver resection is a safe and effective method.</p>

Expressions of ATP binding cassette transporter genes in rat hepatic oval cells / 中华肝脏病杂志

<p><b>OBJECTIVE</b>Liver regeneration occurs through hepatocytes after acute liver injury. However, severe liver injury activates bipotential oval cells from canals of Hering which can differentiate into hepatocytes and biliary epithelial cells. Most models of oval cell activation have employed potential carcinogens to inhibit hepatocyte replication in the face of a regenerative stimulus. Oval cells must be able to withstand the toxic milieu of the damaged liver. ATP binding cassette transporters are cytoprotective efflux pumps that may contribute to the protection of these cells. The aim of this study was to determine the ABC transporter expressions in hepatic oval cells.</p><p><b>METHODS</b>A rat model was established by feeding 2-acetylaminofluorene combined with partial hepatectomy to activate hepatic oval cells. Oval cells were isolated and purified using selective enzymatic digestion and density gradient centrifugation from the heterogeneous hepatic cell population. The expressions of ABC transporter gene, including MDR1, MRP1 and Bcrp1, in isolated hepatic oval cells and hepatocytes were measured by quantitative real-time reverse transcription-polymerase chain reaction and those in rat liver tissues were measured by immunohistochemistry.</p><p><b>RESULTS</b>Compared to those in the rat hepatocytes, mRNA expressions of the genes encoding MDR1, MRP1 and Bcrp1 were increased up to 9-, 1.5- and 13.8-folds in hepatic oval cells. Immunohistochemical staining of rat liver slides demonstrated that the expression of MDR1 proteins was found around periportal areas, and Bcrp1 protein was found located on cell membranes.</p><p><b>CONCLUSION</b>Hepatic oval cells express high levels of the ABC transporter gene that may have cytoprotective functions during severe hepatotoxicity.</p>

Screening of differentially expressed proteins from human esophageal cancer and esophageal tissues by two-dimensional difference gel electrophoresis and mass spectrometry / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish two-dimensional electrophoresis profiles from human esophageal cancer tissue and paired normal esophageal tissue and identify differentially expressed proteins to identify the molecular markers for early-stage diagnosis.</p><p><b>METHODS</b>The total proteins of human esophageal cancer tissue and paired normal esophageal tissue were separated by immobilized pH gradient-based two-dimensional gel electrophoresis (2-DE). The 6 differentially expressed proteins were analyzed by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS). The peptide mass fingerprintings (PMF) were identified by database searching. Six differentially expressed proteins were validated by RT-PCR.</p><p><b>RESULTS</b>The well-resolved, reproducible 2-DE patterns of esophageal cancer tissue and esophageal normal tissue were established. Using MALDI-TOF-MS technology, 6 differential protein spots were identified. Among them, the expressions of squamous cell carcinoma antigen 1 (SCCA1b), KRT4 and annexin A1 were downregulated and triosephosphate isomerase (TPI1), heat shock protein 27 (HSP27) and manganese superoxide dismutase (MnSOD) were upregulated in esophageal cancer tissues.</p><p><b>CONCLUSION</b>The identification of differential expressed proteins in human esophageal cancer and normal tissue will be helpful for screening the biomarker for early-stage diagnosis.</p>

A new Bayesian reconstruction algorithm for PET images based on correction of the detected sinogram data / 南方医科大学学报

<p><b>OBJECTIVE</b>To improve Bayesian reconstruction of positron-emission tomography (PET) images by devising a novel coupled feedback (CF) iterative model.</p><p><b>METHODS</b>The CF iterative algorithm was applied to update the noisy detected emission sinogram data using the latest reconstructed image in the iterative process of PET reconstruction. The relevant operations included linear filtering, wiener filtering, and projection of the reconstructed images. The sinogram data used in the study was obtained from simulated phantom data.</p><p><b>RESULTS</b>The experiments and corresponding visional and quantitative comparisons showed that the new method had better performance than the traditional Bayesian reconstruction of PET images for improvement of the PET images.</p><p><b>CONCLUSIONS</b>The proposed sinogram-correcting method allows improvement on the original measurement data, and is applicable for PET image reconstruction or other reconstruction tasks with high noise level.</p>

Chinese medicine Extractum trametes robiniophila murr augment tumor necrosis factor related apoptosis-inducing ligand induced apoptosis in human hepatic cancer cell lines / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of tumor necrosis factor related apoptosis-inducing ligand (TRAIL) combined with Chinese medicine, Extractum trametes robiniophila murr in human hepatic cancer cells.</p><p><b>METHODS</b>HepG2 cell line resistant to adriamycin (HepG2/ADR) was induced step by step. The effects of TRAIL (100 ng/L) combined with Extractum trametes robiniophila murr (1.0 g/L) promoting apoptosis in HepG2 or HepG2/ADM were analyzed. The proliferation was observed by MTT assay and the apoptosis of cells was also observed by flow cytometry.</p><p><b>RESULTS</b>HepG2/ADM was confirmed resisting to ADM. The treatment of TRAIL (100 ng/L) combined with Extractum trametes robiniophila murr (1.0 g/L) showed significant inhibitory effects on the growth of both HepG2 and HepG2/ADM, and the percentage of apoptosis was increased compared with other groups within 24 to 72 h.</p><p><b>CONCLUSIONS</b>Extractum trametes robiniophila murr dramatically augmented the sensitivity of both HepG2 and HepG2/ADM to TRAIL, but only has slightly killing effects on L02. TRAIL combined with Chinese medicine treatment could be a safe and attractive strategy to drug-resistant/TRAIL-resistant tumor cells.</p>

Inhibitory effect of cyclin D1 antisense cDNA on human hepatocarcinoma cell line HepG2 / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effect of antisense cDNA of cyclin D1 on the cyclin D1 gene expression and cell proliferation of human hepatocarcinoma HepG2 cells in vitro.</p><p><b>METHODS</b>Plasmids containing cyclin D1 antisense cDNA were constructed and transfected into HepG2 cells. Their effects on cell proliferation were examined by MTT method, RT-PCR, immunohistochemical means, and flow cytometry.</p><p><b>RESULTS</b>Cyclin D1 antisense cDNA significantly inhibited the growth of HepG2 cells. The inhibition peaked at 48 hour after transfection by MTT method. RT-PCR analysis showed that cyclin D1 antisense cDNA down-regulated cyclin D1 at the mRNA levels. Expression level of cyclin D1 protein was also decreased as shown by immunohistochemical studies. Cell-cycle analysis by flow cytometry showed that transfected HepG2 cells were arrested at the G1 phase of the cell cycle.</p><p><b>CONCLUSIONS</b>Our data suggest that cyclin D1 antisense cDNA could specifically inhibit the expression of cyclin D1 mRNA and protein and regulate cell cycle and cell proliferation of HepG2 cells. Cyclin D1 antisense cDNA may serve as a potential antitumor strategy in regulating cell-cyclin treating advanced HCCs.</p>

Preparation and characterization of Radix Salvia reference material for heavy metals under GAP control / 中国中药杂志

<p><b>OBJECTIVE</b>To prepare and characterize the heavy metal reference material of radix salvia planted in Zhongjiang, Sichuan province under the good agricultural procedure (GAP).</p><p><b>METHOD</b>After being prepared, the reference material was digested with 65% HNO3 and H2O2 by microwave-assisted oven systems, and the heavy metals in Radix salvia reference material were accurately determined by inductively coupled plasma mass spectrometry (ICP-MS).</p><p><b>RESULT</b>The measuring method was validated by running certificated reference materials, including bush twigs and leaves (GBW07602) and tea twigs and leaves (GBW07605) under the same conditions. The recoveries of the elements mostly ranged from 90% to 110%, and the RSD was within 5%. The measurement of radix salvia reference material was carried out by different laboratories with ICP-MS and by several time intervals in one year for the stability. The results showed that the concentration of the heavy metals provided were accurate and the reference material was stable.</p><p><b>CONCLUSION</b>The reference material is suitable to be the criterions of heavy metals for radix salvia in the qualities controlling, and is also suitable to be the criterion of poisonous heavy metals of other herbs in the administration of GAP.</p>

The diagnosis and treatment of pancreatic duct stones in 29 cases / 中国普通外科杂志

Objective To explore the diagnosis and treatment of pancreatic duct stones. MethodsClinical data of 29 cases of pancreatic duct stones were analyzed retrospectively. ResultsChronic pancreatitis was complicated in 21 cases, cholelithiasis in 12, pancreatic cancer in 2 . The correct diagnosis rate of ultrosonography, CT, ERCP and MRCP was 89.7%(26/29), 65.0%( 13/20 ),100%(6/6) and 100%(4/4) respectively. Six cases underwent EST,16 cases did transpancreatic duct lithotomy plus Roux-en-Y pancreaticojejunostomy, Three cases did sphincteroplasty, pancreaticoduodenectomy and exploratory laparotomy were performed in one each. ConclusionsChronic panreatitis cholelithiasis is the main causes of pancreatic duct stones. Imaging examinations help to make diagnosis preoperatively. Transpancreatic duct lithotomy plus Roux-en-Y pancreaticojejunostomy is the therapy of choices for patients with pancreatic duct stones.