Analysis of prognostic factors for hyperamylasemia following pancreaticoduodenectomy / 中华外科杂志

Objective@#To investigate the prognostic factors of hyperamylasemia following pancreaticoduodenectomy (PD) .@*Methods@#Clinical data of 359 patients were collected prospectively who underwent PD by the same group at Changhai Hospital of Navy Medical University from January 2017 to June 2018.There were 212 males and 147 females.The median age was 63 years old (range: 23 to 82 years old) .According to whether the patient′s serum amylase was greater than 120 U/L at 0 or 1 day after surgery,the patients were divided into hyperamylasemia group and non-hyperamylasemia group. Univariate analysis and multivariate analysis were used to find out the prognostic factors of hyperamylasemia after PD.@*Results@#Of the 359 patients, 238 cases (66.3%) developed hyperamylasemia.The incidence rate of clinically related pancreatic fistula (15.1% vs.2.5%, P<0.01) , grade B/C post pancreatectomy hemorrhage (8.8% vs. 2.5%, P<0.01) , and surgical site infection (9.2% vs. 3.3%, P=0.04) was significantly higher in the hyperamylasemia group.The severity of complications (CD grade≥Ⅲ: 11.3% vs.4.1%, P=0.023) and postoperative hospital stay (11 days vs. 9 days, P=0.001) were higher in the hyperamylasemia group.In the multivariate analysis, the main pancreatic duct diameter (MPD) ≤3 mm (OR=4.469, 95% CI: 2.563-7.793, P<0.01) , pathological type of disease (pancreatic cancer or pancreatitis) (OR=0.230, 95% CI: 0.122-0.436, P<0.01) and soft texture of pancreas (OR=3.297, 95%CI: 1.930-5.635, P<0.01) were independent prognostic factors for hyperamylasemia.@*Conclusions@#Post-PD hyperamylasemia increased the incidence and severity of postoperative complications after PD.MPD≤3 mm, soft texture of pancreas and pathological type of disease were independent prognostic factors of hyperamylasemia.

Characterization of human αβTCR repertoire and discovery of D-D fusion in TCRβ chains

The characterization of the human T-cell receptor (TCR) repertoire has made remarkable progress, with most of the work focusing on the TCRβ chains. Here, we analyzed the diversity and complexity of both the TCRα and TCRβ repertoires of three healthy donors. We found that the diversity of the TCRα repertoire is higher than that of the TCRβ repertoire, whereas the usages of the V and J genes tended to be preferential with similar TRAV and TRAJ patterns in all three donors. The V-J pairings, like the V and J gene usages, were slightly preferential. We also found that the TRDV1 gene rearranges with the majority of TRAJ genes, suggesting that TRDV1 is a shared TRAV/DV gene (TRAV42/DV1). Moreover, we uncovered the presence of tandem TRBD (TRB D gene) usage in ~2% of the productive human TCRβ CDR3 sequences.

Construction and characterization of a novel recombinant retroviral vector expressing mouse T-bet / 生物工程学报

In order to study T-bet function in mouse cells, a novel retroviral vector expressing mouse T-bet and reporter gene Thy1.1 was constructed. Retrovirus particles were then produced by transfection of the recombinant retroviral plasmid into a packaging cell line Platinum-E. The recombinant retrovirus played considerable infection ability. T-bet expression was then identified by FACS after infection of CD4+ primary T cells from T-bet knockout mouse with recombinant retrovirus. To determine if exogenous expressing T-bet has normal function, we checked the expression level of T-bet target gene, Ifng. IFN-y expression was upregulated in the T-bet knockout T cells infected with recombinant retrovirus. In conclusion, we successfully constructed an effective mouse T-bet recombinant retroviral vector.

Treatment of primary liver cancer with preoperative radiotherapy and postoperative brachy radiotherapy / 中国普通外科杂志

Objective To evaluate the effect of preoperative radiotherapy and postoperative brachy radiotherapy (POBRT) on patients with primary liver cancer(PLC). Methods 50 patients with PLC were randomly divided into 2 groups:(1)Radiotherapy group, 25 patients who underwent preoperative radiotherapy 14～17 days before hepatectomy and POBRT 3～10 days after hepatectomy ;(2)Control group,25 cases who underwent hepatectomy only. In radiotherapy group, before heptectomy, the single-dose 6Gy per time and 3 sessions were given to each patient. 3～6 ductus were placed for POBRT during operation,and 10Gy of POBRT per time and 2～4 sessions were given postoperatively. In control group,no radio cherapy was given before and after hepatectomy. Results In radiotherapy group, the cancer shrank significantly after preoperative radiotherapy (P

Rare type of hepatic benign tumor and tumor-like lesions / 中国普通外科杂志

Objective　To summarize the experience in diagnosis and treatment of rare type of hepatic benign tumor and tumor-like lesions.Methods　The clinical data of 58 cases of uncommon benign hepatic tumor and tumor-like lesions admitted to Changhai Hospital from January 1980 to June 2000 were retrospectively reviewed. Results　Of the 58 cases, 26 were inflammatory pseudotumors, 8 focal hyperplastic lesions, 7 hepatocellular adenomas, 7 lipomatous tumors, 5 cystadenomas, 3 tuberculosis, 1 harmatoma and 1 neurofibroma. 82.8% of the cases had symptoms, 17.2% without obvious symptoms. Single lesion was found in 93.1%, multiple lesions in 6.9%. Operative procedures as follows: 30 local resections of the lesion, 14 hepatic segmentectomies, 9 hepatic lobectomies, 2 hepatic artery ligations, 1 hepatic artery ligation plus drainage of cyst, 2 liver biopsies. No operative mortality and no serious morbidity were noted. Conclusions　With popularization of advanced imaging techniques, the incidences of the benign tumor and tumor-like lesions of the liver have been increased in recent years. However, current imaging studies lack specificity, and differential dignosis of these lesions remains difficult. So we should be familiar with the clinical behavior, presentation of imagings and management of the diseases mentioned above.

Comparison of p16 status in primary hepatocellular carcinoma and its metastasis / 中国普通外科杂志

Objective To compare the p16 dynamic status in primary hepatocellular carcinoma(HCC) and its metastatic lesions.Methods The exon 2 of p16 gene was examined by PCR SSCP analysis in 36 paraffin embedded samples in 18 primary HCC cases and its metastatic lessions. Results p16 alterations were found in 4 (22.2%) of the 18 patients . Among them, 2 patients had alterations only in the metastatic lesions (one was deletion;the other was mutation).The other 2 patients had alterations both in primary and metastatic loci (one was deletion;the other was mutation).The deletion rate of exon 2 was 11.1%(2/18) and the mutation rate was 11.1%(2/18). However,the four alterations of p16 gene were found in 7 patients whose metastasis was accompanied by HCC recurrence ( 57.1% ), which was significantly higher than that in patients with metastasis but without HCC recurrence (P