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Objective:To evaluate extrathecal vs. intrathecal approach of Glisson's pedicle in laparoscopic hepatectomy of hepatocellular carcinoma (HCC). Methods:Clinical data of 96 HCC patients receiving laparoscopic hepatectomy at the Department of Hepatobiliary Surgery, the 900 Hospital of the United Logistics Force from Jan 2019 to Jun 2022 were retrospectively analyzed. Thrity-six cases were treated with extrathecal approach of Glisson's pedicle and 60 cases were by intrathecal approach.All those 60 undergoing intrathecal approach cases were matched by 1∶1 propensity score matching, and the caliper value was 0.02. The duration of surgery, blocking-time of hepatoduodenal ligament, intraoperative blood loss, indexes of the liver function and the prothrombin time on the 1st day of the postoperative period, rate of the postoperative complications, postoperative hospital stay, postoperative survival and recurrence were compared between the two groups.Results:After propensity score matching, 32 cases in each group were identified. The operation time of the extrathecal group was shorter than that of the intrathecal group [(207.5±77.4) minutes vs. (248.6±74.7) minutes, P=0.03], the intraoperative bleeding volume was less than that of the intrathecal group [(150.0(100.0, 300.0) ml vs. 250.0(150.0, 587.5) ml, P=0.01], and the albumin level was higher on the 1st day after the surgery [(36.5±3.2) g/L vs. (34.3±3.2) g/L, P<0.01]. There was no statistically significant difference in postoperative liver function, coagulation, complications, hospitalization time, all over survival rate between the two groups (all P>0.05). Conclusion:Extrathecal approach for Glisson's pedicle is safe and feasible in laparoscopic hepatectomy for HCC, with simpler surgical procedure, less intraoperative trauma.
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Objective To investigate the effects of celastrol on the cell growth and apoptosis of human gallbladder cancer NOZ cells,and explore its potential molecular mechanism.Methods NOZ cell were cultured in vitro.And CCK-8 assay,Annexin V-FITC/PI staining method,cell cycle analysis were conducted to investigate the effects of celastrol on the growth and apoptosis of NOZ cells after being treated with drugs.The mitochondrial membrane potential and Bax and Bcl-2 protein expression level were determined by Rhodamine 123 and Western blot,respectively.Results Celastrol could inhibit NOZ cell growth,and the IC50 value was 5.3 μmol/L.Annexin-V/PI staining showed that cell apoptosis of NOZ cells were induced as the celastrol concentration increased,and the apoptosis ratio of control group was 4.4％,while the apoptosis rates of the test groups (2,5,10 p mol/L) were 7.4％,27.1％ and 43.4％,respectively.In addition,cell cycle analysis revealed that celastrol could induce G1-phase arrest.The G1-phase rate of control group was 25.6％,while the G1-phase rates of the test groups (2,5,10 μmol/L) were 36.5％,45.7％ and 92.5％,respectively.The mitochondrial membrane potential was measured after treatment with celastrol and the results indicated that the mitochondrial membrane potential was significantly decreased.Western Blot showed that the protein expression of Bax increased and Bcl-2 decreased in a time-dependent manner after treatment with celastrol.Conclusions Celastrol may inhibit cell proliferation of human gallbladder cancer NOZ cells and induce cell apoptosis partly by inducing the loss of mitochondrial membrane potential.
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Objective To study the frequency of peripheral blood T helper 17(Th17)and regulatory T cells(Treg)and their as-sociated cytokines level in child chronic hepatitis B(CHB)and to investigate the balance characteristics of Th1 7/Treg under differ-ent progression status in child CHB.Methods Peripheral blood and serum of 60 children with CHB and 16 healthy controls were collected for detecting the frequency of peripheral blood Fox3+Treg and Th1 7 by the flow cytometry and serum levels of Th1 7/Treg differentiation associated cytokine IL-17A,TGF-β,IL-22,IL-23,IL-6 and IL-1βwere detected by the enzyme-linked immu-nosorbent assay(ELISA).Results The frequency of peripheral blood Th1 7 and Treg,and the ratio of Th1 7/Treg in the CHB group were significantly higher than those in the healthy controls,the frequency of Th1 7 was positively correlated with disease progres-sion.In addition,serum IL-17A,IL-22 and IL-23 levels in the CHB children were higher than those in the healthy controls(P<0. 05).Conclusion Th17 and Treg play the important role in the mechanism of child CHB.The imbalance of Th17/Treg exists in child CHB.
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Objective To investigate the effects of laparoscopic operation in treating type Ⅲ child biliary atresia and its influence on postoperative infections .Methods 85 children cases of type Ⅲ biliary atresia were randomly divided into the conventional sur-gery group(OP group ,n=42) and the laparoscopic surgery group(LP group ,n=43) .The operation situation ,postoperative changes of inflammatory factors ,changes of liver function indexes before and after operation and postoperative infection were compared be-tween the two groups .Results The operative time of the LP group was longer than that of the OP group (P0 .05) .Conclusion The laparoscopic operation and the conventional operation in treating type Ⅲ child biliary atresia have their own advantages and disadvantages .The appropriate operation mode should be selected according to the children′s actual situation .