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1.
Journal of Clinical Hepatology ; (12): 257-259, 2021.
Article in Chinese | WPRIM | ID: wpr-873391

ABSTRACT

Liver transplantation can completely remove the tumor and the diseased liver at the same time and is the best choice for patients with liver cancer and liver cirrhosis. With the advances in multimodality therapy for liver cancer in recent years, the concept of conversion therapy has been introduced into the fields of surgical treatment of liver cancer and liver transplantation, and successful conversion therapy is expected to help ineligible liver cancer patients to meet the criteria for liver transplantation and thus improve their prognosis. This article briefly introduces the advances in conversion therapy for liver transplantation for liver cancer.

2.
Article in Chinese | WPRIM | ID: wpr-921555

ABSTRACT

Objective To explore the feasibility of using ultrasound to evaluate stent placement for managing graft stenosis after Meso-rex bypass for cavernous transformation of the portal vein in adults. Methods This study enrolled the patients who underwent Meso-rex bypass due to cavernous transformation of the portal vein,were diagnosed graft stenosis by postoperative ultrasound,and then underwent percutaneous portal vein puncture portography and stent placement.We then compared the ultrasonic measurement indicators and sonographic manifestations before and after stent placement,and evaluated the alleviation of portal hypertension symptoms after stent placement and related clinical indexes. Results Finally,8 patients were enrolled in this study,including 5 males and 3 females,with an average age of(32.4±14.7)years.The median duration of follow-up was 26 months after stent placement.The mean diameter of graft stenosis was(2.74±0.23)mm after Meso-rex bypass and became wider[(7.23±0.68)mm]after stent placement(


Subject(s)
Adolescent , Adult , Constriction, Pathologic , Female , Humans , Hypertension, Portal , Male , Middle Aged , Portal Vein/surgery , Portasystemic Shunt, Surgical , Stents , Treatment Outcome , Young Adult
3.
Article in Chinese | WPRIM | ID: wpr-906768

ABSTRACT

@#Duchene muscular dystrophy (DMD) is a serious progressive muscular dystrophy.Reports in recent years about abnormal lipid in DMD patients have increased, yet little attention has been paid to liver lipid.This study aimed to explore the effect of dystrophin gene defect on liver lipid synthesis.7-week-old mdx male mice were used as DMD model.The conditions of liver function, liver lipid accumulation and liver lipid synthesis were determined through liver tissue morphological examination, blood biochemical examination, and detection of hepatic gene and protein expression.The results showed that lipid droplets in liver of mdx mice increased significantly.The contents of total cholesterol and triglyceride in liver, aspartate aminotransferase and alanine aminotransferase in serum increased.The gene and protein expression of hepatic lipid synthesis-related enzymes such as fatty acid synthase, acetyl CoA carboxylase, and sterol regulatory element binding protein 1-c were up-regulated.These results showed accumulation of liver lipid in 7-week-old mdx male mice.

4.
Article in Chinese | WPRIM | ID: wpr-906180

ABSTRACT

Objective:To observe the clinical efficacy of Didangtang combined with gemcitabine chemotherapy in postoperative patients with non-muscle invasive bladder ctraditional chinese medicineancer (NMIBC). Method:A total of 100 patients with NMIBC in Jiangsu Provincial Second Chinese Medicine Hospital and Jiangsu Province Hospital of Chinese Medicine from January 2015 to September 2020 were randomly divided into control group and treatment group. 50 cases in the treatment group received Didangtang combined with intravesical infusion of gemcitabine, and 50 cases in the control group received placebo combined with intravesical infusion of gemcitabine. Before and after the treatment cycle, the blood biochemistry, immune cell subsets(CD3<sup>+</sup>,CD4<sup>+</sup> and CD4<sup>+</sup>/CD8<sup>+</sup>) were detected to assess the safety and immune function changes in treatment group. Quality of life scale for patients with bladder cancer prepared by European Organization for the Research and Treatment of Cancer (EORTC QLQ-C30) and Specificity scale for patients with superficial bladder cancer (EORTC QLQ-BLS24) were scored to assess the changes in physical, role, emotional and social functioning of the patients, symptomatic conditions such as fatigue, pain, nausea and vomiting, shortness of breath, insomnia, loss of appetite, diarrhea and constipation, as well as bladder cancer-specific symptoms such as treatment-generated problems, future concerns, bowel symptoms and urinary tract symptoms. Result:There were no differences in terms of age, sex, disease duration and tumor states. During the treatment period, both groups had no recurrence or adverse events. The traditional Chinese medicine(TCM) efficacy in the treatment group was significantly better than that in the control group(<italic>χ<sup>2</sup></italic><sup> </sup>= 7.23,<italic>P </italic>= 0.02). After treatment, the number of CD3<sup>+</sup>,CD4<sup>+</sup> ,CD8<sup>+</sup> cells and the CD4<sup>+</sup>/CD8<sup>+</sup> ratio in the treatment group were significantly higher than those in control group(<italic>P</italic><0.05). Both groups showed significant improvements in the domains of role functioning, social functioning, and general health after treatment (<italic>P</italic><0.05). In addition, fatigue, diarrhea, constipation, intestinal symptoms, and urinary tract symptoms in the treatment group were significantly better than those in the control group after treatment (<italic>P</italic><0.05). Conclusion:Didangtang can reduce adverse clinical symptoms during postoperative gemcitabine infusion chemotherapy in patients with NMIBC, reduce urethral and intestinal discomfort reactions, improve immune function and enhance quality of life for patients.

5.
Article in Chinese | WPRIM | ID: wpr-909332

ABSTRACT

In the 42 nd and 44 th workshops of CSPEN-nutritional risk-undernutrition-support-outcome-cost effectiveness ratio (NUSOC) multi-center database collaboration group, Jens Kondrup and Henrik Rasmussen described again the application of NRS 2002, the evidence-based basis of NRS 2002 development and the methodology for prospective validation of clinical effectiveness. There is no gold standard for validation. They both considered that malnutrition could be identified as a score of 3 or more for impaired nutritional status in NRS 2002. Although NRS 2002 is simple and easy to be applied, it is not comprehensive enough for malnutrition diagnosis. ASPEN and ESPEN on-line published the Global Leadership (nutritional) Initiative on Malnutrition(GLIM)diagnosis criteria in September 2018. With the gradual implementation of medicare payment based on diagnosis related groups(DRG)in China, the nutritional risk and the malnutrition diagnosis with Chinese version of ICD-10 (2016) code should be recorded in the first page of the medical records. In this terminology interpretations, the terms of nutritional risk screening(NRS 2002.01.016)and malnutrition diagnosis (GLIM-phenotypic criteria 01.028, etiologic criteria 01.029) published in Parenteral and Enteral Nutrition Terminology 2019 are discussed based on the reports given by Kondrup and Rasmussen in Beijing and Zhengzhou.

6.
Article in Chinese | WPRIM | ID: wpr-909317

ABSTRACT

Objective:To observe the changes of nutrition impact symptoms (NIS) and fat-free mass and analyze the relationship between them in patients with head and neck cancer (HNC) during radiotherapy.Methods:A convenient sampling method was adopted to select HNC patients who received radiotherapy in the outpatient clinic of department of radiotherapy for head and neck cancer in a cancer hospital in Beijing from March 2017 to January 2020. The nutrition impact symptoms (NIS) were assessed by a nutrition impact symptoms checklist and the fat free mass was assessed by bioelectrical impedance analysis at three time points: before radiotherapy (T1), during radiotherapy (T2) and at the end of radiotherapy (T3). The Generalized Estimating Equations (GEE) was used to analyze the relationship between them.Results:A total of 542 HNC patients were included in the analysis. During radiotherapy, the patients' NIS number and score presented an increasing trend, reaching the highest level and peaked at the end of radiotherapy. The change of fat-free mass showed a decreasing trend and reached the minimum at the end of radiotherapy. Patients with higher NIS scores had more percentage loss of fat-free mass.Conclusions:During radiotherapy, patients with HNC showed an increase in NIS score and lost fat-free mass. Patients with higher NIS score lost more percentage of fat-free mass, which suggested that clinical medical staff should pay attention to NIS management and take comprehensive intervention measures in time to reduce the loss of fat-free mass.

7.
Article in Chinese | WPRIM | ID: wpr-908468

ABSTRACT

Hepatic alveolar echinococcosis is a zoonotic parasitic disease caused by echinococcus multilocularis infection. The growth pattern of the lesions of hepatic alveolar echinococcosis is similar to that of liver malignant tumor showing invasive growth. Hepatic alveolar echinococcosis can not only directly invade the adjacent tissue structure, but also metastasize through the lymphatic tracts and blood vessels. Hepatic alveolar echinococcosis with intraperitoneal implantable metastasis is extremely rare. The authors introduce the diagnosis and treatment of 1 patient who had hepatic alveolar echinococcosis with intraperitoneal implantable metastasis.

8.
Article in Chinese | WPRIM | ID: wpr-865122

ABSTRACT

Objective:To investigate the clinical efficacy of ex vivo liver resection and autotransplantation (ELRA) for liver complex space-occupying lesions.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 50 patients with liver complex space-occupying lesions who underwent ELRA in the First Hospital Affiliated to Army Medical University between June 2009 and May 2017 were collected. There were 36 males and 14 females, aged from 13 to 69 years, with a median age of 51 years. All patients underwent ELRA. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted by outpatient examination or telephone interview. Patients were followed up according to the individual follow-up plan in the first 6 months after discharge, and then once every 3 to 6 months to detect tumor recurrence and survival up to May 2019. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M (range). Count data were expressed as absolute numbers or percentages. The Kaplan-Meier method was used to calculate survival rates and draw survival curves, and Log-rank test was used for survival analysis. Results:(1) Surgical situations: all the 50 patients underwent ELRA successfully, and postoperative pathological examination showed the R 0 resection rate was 100%(50/50). The operation time of the 50 patients were (630±186)minutes, of which 9 patients with liver benign occupation had the operation time of (684±168)minutes and 41 patients with liver malignant tumor had the operation time of (618±190)minutes. The operation time of temporary reconstruction of inferior vena cava and portacaval shunt, time of anhepatic phase, volume of intraoperative blood loss of the 50 patients were (35±9)minutes, (256±71)minutes, 2 000 mL(range, 400-10 000 mL), respectively. The remnant liver mass to standard liver mass ratio of the 50 patients was 65%±16%, of which 9 patients with liver benign occupation had the remnant liver mass to standard liver mass ratio of 63%±14% and 41 patients with liver malignant tumor had the remnant liver mass to standard liver mass ratio of 65%±17%. Of the 50 patients, 35 had vascular invasion (7 cases with liver benign occupation, 28 cases with liver malignant tumor), of which 24 (6 cases with liver benign occupation, 18 cases with liver malignant tumor) underwent in vitro vascular reconstruction, 12 (5 cases with liver benign occupation, 7 cases with liver malignant tumor) had bile duct invasion and underwent choledochojejunostomy due to the inability of the common bile duct to anastomose the ends. Two cases with liver metastasis of gastric cancer, one case with liver metastasis of colon cancer and one case with liver metastasis of pancreatic cancer underwent radical gastrectomy, radical resection of colon cancer, and pancreaticoduodenectomy, respectively. (2) Postoperative situations: the duration of postoperative hospital stay of the 50 patients were 25 days (range, 11-169 days). Of the 50 patients, 12 had pleural effusion who were treated with pleural puncture drainage, 10 had bile leakage who were treated with abdominal puncture drainage, 3 had bile duct anastomotic leakage who were treated with endoscopic nasobiliary drainage or biliary stent implantation, 6 underwent reoperation among which 4 underwent exploratory laparotomy due to abdominal hemorrhage, 1 underwent portal vein reconstruction due to abdominal hemorrhage combined with portal vein thrombosis, and 1 underwent salvage liver transplantation due to liver failure. Nine of the 50 patients died within 90 days after surgery, all of whom had liver malignant tumor. Among them, 3 died of multi-organ dysfunction syndrome caused by severe infection, 3 died of acute liver failure, 2 died of abdominal hemorrhage and 1 died pulmonary embolism. (3) Follow-up: all the 50 patients were followed up for 1 to 119 months. The overall survival time, 1-, 3-, 5-year overall and tumor-free survival rates of the 50 patients after operation were 17 months (range, 1-119 months), 68.0%, 45.9%, 41.1% and 41.9%, 33.4%, 30.8%, respectively. The overall survival time, 1-, 3-, 5-year overall and tumor-free survival rates of the 9 patients who with liver benign occupation after operation were 68 months (range, 10-114 months), 88.9%, 88.9%, 88.9% and 88.9%, 88.9%, 88.9%, respectively. The overall survival time, 1-, 3-, 5-year overall and tumor-free survival rates of the 41 patients who with liver malignant tumor after operation were 15 months (range, 1-119 months), 63.4%, 36.6%, 31.0% and 31.5%, 21.0%, 18.0%, respectively. There were significant differences in the overall and tumor-free survival rates between patients who with liver benign occupation and patients who with liver malignant tumor ( χ2=7.626, 11.766, P<0.05). Conclusions:ELRA can be applied in the treatment of liver complex space-occupying lesions. The selection criteria of patients with liver malignant tumor should be more rigorous to reduce perioperative mortality.

9.
Article in Chinese | WPRIM | ID: wpr-873237

ABSTRACT

Objective:To investigate the targets and possible mechanism of Didangtang in the treatment of bladder cancer. Method:Based on multiple traditional Chinese medicine and disease databases, the network pharmacology was used to screen potential targets, analyze the biological functions of potential targets, and construct a network of "Chinese medicine-target-path-disease". Bioinformatics analysis was applied in population and gene databases, in order to explore the differential expressions of core targets in tissues, distribution in the population and the correlation with prognosis. The in vitro experiment was used to verify the biological function of Didangtang. The underlying mechanism of Didangtang on the candidate target was detected. Result:A total of 21 core target genes and 16 highly enriched pathways were screened out. A functional network of Didangtang was constructed systematically. At the same time, six targets, namely cadherin 1 (CDH1), CAMP responsive element binding protein 1 (CREB1), colony stimulating factor 2 (CSF2), AP-1 transcription factor (JUN), matrix metalloproteinase 2 (MMP2), and prostaglandin-endoperoxide synthase (PTGS2), were differentially expressed in bladder cancer tissues (P<0.05). Furthermore, JUN and MMP2 were also differentially distributed in population (P<0.05). At the same time, the expression level of JUN was correlated with the prognosis of patients with bladder cancer (P<0.05). The in vitro experiment revealed that Didangtang inhibited the proliferation of bladder cancer cells and decreased the expression of candidate target JUN (P<0.01). Conclusion:Didangtang has the characteristics of multiple targets and multiple pathways in treatment of bladder cancer. It is initially confirmed that Didangtang can affect the expression of target JUN and inhibit the proliferation of bladder cancer, which lays a good foundation for further studies on mechanism.

10.
Journal of Clinical Hepatology ; (12): 592-595, 2020.
Article in Chinese | WPRIM | ID: wpr-819217

ABSTRACT

ObjectiveTo investigate the effect of proteasome subunit beta type 4 (PSMB4) on the proliferation and viability of human liver cancer SMMC7721 cells and its possible mechanisms. MethodsThe specific short-hairpin RNA (shRNA) technique was used to construct SMMC7721 cells with knockdown expression of PSMB4, and these cells were selected as experimental group. MTT assay and colony-forming assay were used to observe the change in cell proliferation, flow cytometry was used to measure the change in cell apoptosis rate, and Western blot was used to measure the change in the expression of related proteins. The independent samples t-test was used for comparison of continuous data between two groups. ResultsSMMC7721 cells with knockdown expression of PSMB4 were successfully constructed (shRNA1: t=22.67, P<0.0001; shRNA2: t=30.88, P<0.0001; shRNA3: t=67.82, P<0.0001). The MTT assay showed that the experimental group had a significantly lower OD490 value than the control group on day 4 (0.4770±0.0135 vs 0.3237±0.0127, t=8286, P=0.0012) and day 5 (0.5893±0.0088 vs 0.3847±0.0090, t=16.220, P<0.0001). The colony-forming assay showed a significant reduction in the number of cell colonies in the experimental group. Flow cytometry showed that compared with the control group, the experimental group had significantly higher early apoptosis rate (5.5570%±0.2589% vs 3.8870%±0.3324%, t=3.964, P=00166), late apoptosis rate (12.6300%±0.4198% vs 5.3100%±0.3062%, t=14.080, P=0.0001), and total apoptosis rate (181800%±0.6785% vs 9.1970%±0.6313%, t=9.967, P=0.0006), as well as a significant reduction in the protein expression of nuclear factor-kappa B p65 (0.8015±0.0120 vs 0.2841±0.0110, t=31.830, P<0.0001) and a significant increase in the protein expression of nuclear factor-kappa B inhibitory protein α (0.4816±0.0112 vs 0.6583±0.0142, t=9.774, P=0.0006). ConclusionKnockdown of PSMB4 expression may reduce the proliferation and viability of liver cancer SMMC7721 cells by inhibiting the NF-κB signaling pathway.

11.
Article in Chinese | WPRIM | ID: wpr-827804

ABSTRACT

To observe the effects of propofol on the activation of hepatic stellate cell line HSC2-T6 induced by transforming growth factor-beta 1 (TGF-β1) and explore its possible mechanism. The cells were divided into control group, TGF-β1 group, propofol group, TGF-β1 + propofol group, rapamycin group, TGF-β1 + propofol + rapamycin group. Cells were treated with rapamycin (5 μmol/L) for 1 hour, propofol (100 μmol/L) for 1 hour, then TGF-β1 (5 ng/ml) was added to co-culture for 24 hours. Cell proliferation was measured by MTT assay. The concentrations of hyaluronic acid (HA), collagen IV (IV-C) and laminin (LN) in the supernatant of cell culture medium were measured by ELISA. The ultrastructure of cells was observed by transmission electron microscopy. The expressions of alpha-smooth muscle actin (α-SMA), mammalian rapamycin target protein (mTOR), phosphorylated mTOR (p-mTOR) and the autophagy related gene Beclin 1, LC3 and p62 were measured by Western blot. Compared with control group, cell proliferation, the expression of α-SMA, the concentrations of HA, IV-C and LN in culture supernatant, the number of autophages, the expressions of Beclin-1 and LC3-II, the ratio of LC3-II/LC3-I in HSC2-T6 cells were increased significantly, while the expression of p-mTOR, the ratio of p-mTOR/mTOR and the expression of p62 protein were decreased significantly in TGF-β1 group (All P<0.05). Compared with TGF-β1 group, cell proliferation, the expression of α-SMA, the concentrations of HA, IV-C and LN in culture supernatant, the number of autophages, the expressions of Beclin-1 and LC3-II, the ratio of LC3-II/LC3-I in HSC2-T6 cells in TGF-β1 group were decreased significantly, and the expression of p-mTOR, the ratio of p-mTOR/mTOR and expression of p62 protein were increased significantly in TGF-β1 + propofol group (All P<0.05). Propofol inhibits the activation of hepatic stellate cells induced by TGF-beta 1, and its mechanism involves the mTOR-autophagy pathway.

12.
Chinese Journal of Biotechnology ; (12): 2657-2673, 2020.
Article in Chinese | WPRIM | ID: wpr-878519

ABSTRACT

To investigate the degradation of polycyclic aromatic hydrocarbons (PAHs) and the changes of rhizosphere microorganisms in the rhizosphere soil of Leymus chinensis during the remediation of PAHs contaminated soil by Comamonas testosteroni (C.t)-assisted Leymus chinensis, we evaluated the removal of PAHs in the rhizosphere of Leymus chinensis using gas chromatography-mass spectrometry (GC-MS), analyzed the bacterial community and the diversity in Leymus chinensis rhizosphere soil by high-throughput sequencing technology, characterized the correlation among PAHs degradation and bacterial community components performing redundancy analysis (RDA) and network analysis, and predicted PAHs degradation potential via PICRUSt software in this paper. The degradation of PAHs in the rhizosphere of Leymus chinensis was promoted, the abundance and diversity of bacteria and the correlation among bacteria and PAHs were changed, and the degradation potential of PAHs in Leymus chinensis rhizosphere soil was enhanced in the later stage of phytoremediation (60-120 d) due to the incorporation of C.t. The accelerated degradation of three PAHs (Nap, Phe, BaP) was accompanied by the differ abundance and correlation of Proteobacteria (Sphingomonas, MND1, Nordella), Actinomycetes (Rubrobacter, Gaiella), Acidobacteria (RB41) and Bacteroides (Flavobacterium) affected by C.t. The results provide new insight into the microorganism choices for microbial assisted plant remediation of soil PAHs and the mechanisms of enhanced PAHs degradation via the combination of Comamonas testosteroni engineering bacteria and plants.


Subject(s)
Biodegradation, Environmental , Comamonas testosteroni/genetics , Polycyclic Aromatic Hydrocarbons/analysis , Rhizosphere , Soil , Soil Microbiology , Soil Pollutants
13.
Article in Chinese | WPRIM | ID: wpr-866738

ABSTRACT

The three steps of nutritional care in Europe, the United States and China were basically same as [Nutritional screening-assessment-intervention]. This review article discussed the second step of GLIM for diagnosis of malnutrition, when the diagnosis of malnutrition being needed. No normal range in healthy volunteer and no cut-off point based on clinical studies for FFMI in China now.

14.
Article in Chinese | WPRIM | ID: wpr-824190

ABSTRACT

Objective To describe the characteristics of radiation induced mucositis in patients withhead and neck cancer ( HNC) during radiotherapy, and analyze the effect of radiation induced mucositis on diet patterns and weight change and the influencing factors for radiation induced mucositis. Methods Patients with HNC treated with radiotherapy in one cancer hospital were recruited. Data were collected before, during and at the end of the radiotherapy, which included radiation induced oral and pharyngeal mucositis, pain during eat-ing, diet patterns and weight. Results Two hundred and two patients were completely investigated and 43.5%and 34. 2% of the patients suffered from moderate to severe (≥grade 2) oral mucositis and pharyngeal mucosi-tis, respectively during the radiotherapy. At the end of radiotherapy, 53. 5% and 51. 5% of the patients suffered from moderate to severe oral mucositis and pharyngeal mucositis (≥grade 2 ) , respectively. Oral and pharyngeal mucositis were significantly correlated with pain during eating, diet patterns and weight ( P<0. 05) . Tumor site was the main reason that affected the severity of mucositis ( Wald χ2 =26. 033, 14. 216;P<0.001). Conclusion Radiation induced mucositis was gradually aggravated with radiotherapy progress, which is closely related to pain during eating, change of diet patterns and weight loss. The severity of mucositis is re-lated to the tumor site. Measures should be taken to strengthen the management of adverse reactions and nutri-tional status of patients.

15.
Article in Chinese | WPRIM | ID: wpr-824173

ABSTRACT

The ultimate goal of the development of parenteral and enteral nutrition is to achieve T3 transfer of translational medicine in this field. This study is an international cooperative, multicenter and observational clinical study conducted by CSPEN-NUSOC cooperative group for 15 years which is aimed to observe the effect of standardized nutritional support on clinical outcome and cost/ effect and verify the clinical value parenteral and enteral nutrition through investigating the prevalence of nutritional risk and malnutrition and the application of nutritional support in adult in-patients.

16.
Journal of Medical Postgraduates ; (12): 624-628, 2019.
Article in Chinese | WPRIM | ID: wpr-818292

ABSTRACT

Objective Dangerous placenta previa(PPP) combined with placenta implantation seriously threatens maternal life safety. This paper aim to explore the changes of MnSOD and SIRT3,the expression of SIRT3 in maternal placenta PPP combined with placenta implantation, and the relationship between trophoblast invasion and placental implantation. Methods 90 cases with placenta implantation of pernicious placenta previa were collected from January 2014 to June 2018 in Anhui Maternal and Child Health Hospital. According to the depth of placental villus invading uterine myometrium, 30 cases of placenta adhesion, 30 cases of placental implantation, and 30 cases of placenta penetration, 30 cases of normal control group.Immunohistochemical SP and Western blot were used to detect the expression of MnSOD and SIRT3 in placental tissues of the study group and the control group, then compared and analyzed. Results Compared with the control group, the expression of MnSOD and SIRT3 in the placental implantation group were increased. With the increasing of placental implantation degree, the level of MnSOD and SIRT3 decreased significantly (P<0.05). Western blot showed that , the relative protein expressions of MnSOD/β-actin and SIRT3/β-actin in the control group were (0.39±0.05) and (0.41±0.08), which were higher than those in the adhesion group[(0.35±0.04), (0.32±0.02)], the implantion group[(0.28±0.02), (0.20±0.03)], and the penetration group[(0.23±0.01), (0.17±0.02)]. The difference was statistically significant(P<0.05). Conclusion The expressions of MnSOD and SIRT3 incytoplasm or nucleus of invasive trophoblasts and placental tissues of pregnant women with placental implantation is significantly decreased, both of which are involved in the occurrence and development of placental implantation, but the specific pathogenesis still needs to be further explored.

17.
Article in Chinese | WPRIM | ID: wpr-816491

ABSTRACT

OBJECTIVE: To explore the feasibility of using optical coherence tomography(OCT)technique to determine the tumor invasive front of hepatic hilar cholangiocarcinoma.METHODS: Two patients were diagnosed in Beijing Tsinghua Changgung Hospital as type Bismuth Ⅳ and type Ⅲ b hilar cholangiocarcinoma respectively and both underwent perihilar and left trihepatectomy.The common bile duct-common hepatic duct,right anterior hepatic duct and left hepatic duct were all opened along the axial direction of the bile duct after the two specimens were excised.OCT equipment was used to scan the three branches to determine the dividing point between cancer and normal bile duct.Suture markers were performed of the 6 positions,and pathological examination was carried out.RESULTS: Pathologically,both 2 cases were confirmed as hilar cholangiocarcinoma.Under OCT scan,normal bile ducts showed the inner single layer of epithelial cells was visible as a superficial,hypo-reflective layer.The intermediate connective fibromuscular layer was visible as a hyper-reflective layer and the outer connective layer was visible as a hypo-reflective layer.Malignancies showed unrecognizable layer architecture and multiple presence of nonreflective areas,with or without papillary architecture.Among 6 marker-positions determined by OCT in the 2 specimens,4 sites were less than 1 mm,1 site was about 2 mm and 1 site was about 7 mm apart from pathological tumor invasive front.CONCLUSION: OCT as a fast-real-time imaging technique has the potential to determine the tumor invasive front of hilar cholangiocarcinoma.

18.
Article in Chinese | WPRIM | ID: wpr-816416

ABSTRACT

OBJECTIVE:To study the effect of modified meso-rex surgery combined with umbilical vein recanalization and primary stent implantation in the treatment of portal vein portal vein cavernous transformation.METHODS:A retrospective study was conducted in Beijing Tsinghua Changgung Hospital. A patient underwent classic or thotopic total liver transplantation for more than 9 years, admitted in February 2018 was selected.Her main portal vein occlusion and portal vein cavernous transformation were followed by portal hypertension, esophageal and gastric varices, and gastrointestinal bleeding. Surgical treatment of Meso-rex bypass were performed. During operation, hyperplasia of the left liver was noted. After wedge resection of part of the left liver parenchyma, the stump of ligamentum teres hepatis was exposed. Left portal vein was difficult to be dissected and exposed. After the umbilical vein was recanalized to the left branch of the portal vein, vascular anastomosis and stent implantation were completed. Postoperative anticoagulant therapy was given,and the blood flow was monitored.RESULTS:The shunt procedure was successful. The bypass patent, and blood flow was unobstructed 1-year post-operation. No gastrointestinal bleeding occurred ever.CONCLUSION:Meso-rex bypass combined with umbilical vein recanalization and primary stent implantation can be used to treat patients with portal vein cavernous transformation whose left portal vein is patent but difficult to be exposed.The long-term effect is worth expecting and more cases are needed for further verification.

19.
Article in Chinese | WPRIM | ID: wpr-796801

ABSTRACT

Objective@#To investigate the application value of augmented reality (AR) technology in pancreatoduodenectomy (PD).@*Methods@#The retrospective and descriptive study was conducted. The clinicopathological data of 3 male patients who underwent PD in Tsinghua University Affiliated Beijing Tsinghua Changgung Hospital from June 2018 to February 2019 were collected. The 3 patients were aged from 52 to 63 years, with a median age of 57 years. Digital imaging and communication standard format data of enhanced computed tomography (CT) scan were collected, the three-dimensional (3D) images of abdominal arteries, portal vein, descending duodenum, pancreatic body and tail, pancreatic head, common bile duct, and pancreatic duct were reconstructed. The results were imported into the AR software. Optical tracking based on two-dimensional codes and manual interactive rigid registration were adopted for intraoperative navigation. Observation indicators: (1) surgical and postoperative conditions; (2) postoperative pathological examination; (3) follow-up. Follow-up using outpatient examination or telephone interview was conducted to detect survival of patients and tumor metastasis and recurrence up to June 2019. The measurement data with skewed distribution were expressed as M (range). Count data were expressed as absolute numbers.@*Results@#(1) Surgical and postoperative conditions: all the 3 patients underwent PD with AR technology as intraoperative navigation successfully. The operation time, volume of intraoperative blood loss, and duration of postoperative hospital stay were 6 hours (range, 5-8 hours), 700 mL (range, 300-900 mL), 11 days (range, 9-12 days). There was no perioperative death or complication occured. After surgery, the patients who underwent PD combined with superior mesenteric vein (SMV) resection and reconstruction had patent SMV on the enhanced computed tomography examination. (2) Postoperative pathological examination: results of pathological examination showed 1 case of intraductal papillary mucinous neoplasm (IPMN) of the pancreas with invasive adenocarcinoma (neoplasm invading SMV), 1 case of insulinoma, and 1 case of periampullary neuroendocrine carcinoma, respectively. (3) Follow-up: 3 patients were followed up for 4-12 months, with a median follow-up time of 6 months. During the follow-up, the patient with IPMN of the pancreas and invasive adenocarcinoma had liver metastasis at 3 months after surgery, and received chemotherapy at other hospital. After 4 cycles of chemotherapy, the metastatic nodule shrank, and the patient was still in follow-up up to deadline of follow-up. Other 2 patients had no recurrence or metastasis.@*Conclusion@#AR technique assisted PD is safe and feasible, which is helpful to indentify vascular branches and tracks.

20.
Article in Chinese | WPRIM | ID: wpr-790108

ABSTRACT

Objective To investigate the application value of augmented reality (AR) technology in pancreatoduodenectomy (PD).Methods The retrospective and descriptive study was conducted.The clinicopathological data of 3 male patients who underwent PD in Tsinghua University Affiliated Beijing Tsinghua Changgung Hospital from June 2018 to February 2019 were collected.The 3 patients were aged from 52 to 63 years,with a median age of 57 years.Digital imaging and communication standard format data of enhanced computed tomography (CT) scan were collected,the three-dimensional (3D) images of abdominal arteries,portal vein,descending duodenum,pancreatic body and tail,pancreatic head,common bile duct,and pancreatic duct were reconstructed.The results were imported into the AR software.Optical tracking based on two-dimensional codes and manual interactive rigid registration were adopted for intraoperative navigation.Observation indicators:(1) surgical and postoperative conditions;(2) postoperative pathological examination;(3) follow-up.Follow-up using outpatient examination or telephone interview was conducted to detect survival of patients and tumor metastasis and recurrence up to June 2019.The measurement data with skewed distribution were expressed as M (range).Count data were expressed as absolute numbers.Results (1) Surgical and postoperative conditions:all the 3 patients underwent PD with AR technology as intraoperative navigation successfully.The operation time,volume of intraoperative blood loss,and duration of postoperative hospital stay were 6 hours (range,5-8 hours),700 mL (range,300-900 mL),11 days (range,9-12 days).There was no perioperative death or complication occured.After surgery,the patients who underwent PD combined with superior mesenteric vein (SMV) resection and reconstruction had patent SMV on the enhanced computed tomography examination.(2) Postoperative pathological examination:results of pathological examination showed 1 case of intraductal papillary mueinous neoplasm (IPMN) of the pancreas with invasive adenocarcinoma (neoplasm invading SMV),1 case of insulinoma,and 1 case of periampullary neuroendocrine carcinoma,respectively.(3) Follow-up:3 patients were followed up for 4-12 months,with a median follow-up time of 6 months.During the follow-up,the patient with IPMN of the pancreas and invasive adenocarcinoma had liver metastasis at 3 months after surgery,and received chemotherapy at other hospital.After 4 cycles of chemotherapy,the metastatic nodule shrank,and the patient was still in follow-up up to deadline of follow-up.Other 2 patients had no recurrence or metastasis.Conclusion AR technique assisted PD is safe and feasible,which is helpful to indentify vascular branches and tracks.

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