Résumé
Objective To compare the clinical value of early enteral nutrition and parenteral nutrition therapy in postoperative patients of cholangiocarcinoma.Methods 56 cases of cholangiocarcinoma patients were randomly divided into early enteral nutrition group (EPN group) and parenteral nutrition group (PN group).All patients received nutritional support on the basis of metabolic support.Leukocyte count and neutrophil percentage decrease rate,total bilirubin decrease rate and hepatase (valley-C conversion) were counted at 3 and 7 days after operation.The decrease rate of aminase and glutamic oxaloacetic transaminase,recovery time of intestinal function (anal exhaust and defecation),incidence rate of surgical site infection (abdominal cavity and wound),hospitalization time after operation,incidence rate of bile leakage and hospitalization cost were compared between the two groups.Results The recovery time of intestinal function [(51.2 ±4.4) h],the decrease rate of leukocyte count (0.438 7 ±0.191 5) and neutrophil ratio (0.179 5 ± 0.046 1),the decrease rate of bilirubin (0.502 5 ± 0.153 5),alanine aminotransferase (ALT) (0.688 1 ±0.113 3),aspartate aminotransferase (AST) (0.617 0 ± 0.178 8) and hospitalization expenses [(87 852.37 ±9 127.04)yuan] in EPN group were better than those in PN group [(72.0 ± 12.9)h,0.090 5 ±0.120 3,0.083 4 ±0.036 8,0.201 5 ±0.077 8,0.251 6 ±0.419 0,0.230 9 ± 0.437,(109 036.69 ± 7 949.71) yuan,P ＜ 0.05].However,the incidence of abdominal distension (42.31％) was higher than that of PN group (13.33％,P ＜ 0.05).The incidence of bile leakage (7.69％) was not significantly different from that of PN group (13.33％,P ＞0.05).Conclusions Early enteral nutrition has obvious advantages in postoperative recovery of patients with cholangiocarcinoma.
Résumé
Objective To evaluate the effect of liver transplantation(LT)on the prognosis in patients with intrahepatic cholangiocarcinoma(ICC).Methods A retrospective analysis was performed on 11 consecutive patients with ICC who underwent LT between October 2003 and November 2008 at our institution.The overall and disease-free survival rates were calculated by the Kaplan-Mayer method.Results The median survival time Was 9.0 months(2.5-53 months).The 1-,2-,3-and 4-year disease-free survival rate and overall survival rate of all the patients were 51.9%、51.9%、51.9%、51.9%and 50.5%、50.5%、50.5%、50.5%,respectively.The perioperative mortality and the recurrence rate were 0 and 43.5%,respectively.The survival rate and disease-free survival time of patients with recurrence were 2.5-10 months(mean 7.5 months)and 1-8 months(mean 3.8 months).Conclusions The prognosis of LT for ICC is rather poor.ICC patients with lymph node metastasis.vascular or bile duct invasion is contraindicated for LT.
Résumé
Objective To investigate the effect of antisense oligodeoxynueleotide targeting sur-vivin (survivin ASODN) on hilar cholangioearcinoma cell line FRH-0201 depressing the expression of survivin. Methods Survivin ASODN was transfected into hilar eholangiocarcinoma cell line FRH-0201by liposome. Morphologieal changes were observed by inverted phase contrast microscope. RT-PCR and Western blot methods were performed to detect the expressions of survivin mRNA and protein re-spectively. The changes in cell apoptosis were detected by flow cytometry. Results The expression of survivin mRNA and protein was significantly decreased in survivin ASODN group than that in the con-trol group(mRNA: 0.51-t-0. 03 vs 0. 82-t-0.02,P%0. 05～protein: 1.82-t-0.16 vs 3. 08--t-_0. 27, P-Q 0.05). The morphologieal apoptotic changes were observed and the apoptosis rate was increased (11.50+1.49% vs 0.39-+-0.08～, P%0.05). Conclusion Survivin AS()DN can induce hilar cholan-gioeareinoma cell line FRH-0201 into apoptosis by decreasing the expression of survivin.
Résumé
Objective To investigate the significance of tamoxifen in the combination chemotherapy of human multidrug-resistant bile duct carcinoma cell line (QBC939/ADM) and its mechanism. Methods The QBC939/AI)M was established, through exposure to gradually increased and the high and low alternated concentration of ADM persistently. The QBC939 and the QBC939/ADM were effected by single ADM, MMC, VDS or jointly with TAM. Drug sensitivity was measured by MTT. Growth cycle and apoptosis were performed by FCM. The level of their P-gp was detected by IHC. The content of ADM in the human cholangiocarcinoma cell line QBC939 was observed by FCM. Results The inhibitive rate of ADM, MMC, VDS to QBC939/ADM was rather lower than to QBC939. With the use of TAM, their chemotherapy effects were apparently enhanced and the apoptosis ratio increased comparably. The IHC results showed that the level of P-gp on the QBC939/ ADM was overexpressed, and the content of ADM in the QBC939/ADM group was much lower. Effected with the high content of TAM(10 μmol/L), the level of P-gp on the QBC939/ADM was decreased, with the content of ADM in the QBC939/ADM group increased comparably. TAM could both improve the chemotherapy effects of the two types of the cell, but the effect of the QBC939/ADM group was more apparent. Conclusion TAM can enhance the depressant effect of chemotherapy to both the two types of the cell, and increase the content of ADM in the QBC939/ADM group. TAM can be combined with the overexpressed P-gp.