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Objective:To systematically review the profile of lymph node dissection (LND) for patients with intrahepatic cholangiocarcinoma (ICC) in China.Methods:Using the key words "intrahepatic cholangiocarcinoma" "intrahepatic cholangiocellular carcinoma" "lymph node dissection" "lymphadenec-tomy" "lymph node metastasis", the databases including China Zhiwang, Wanfang, Weipu, Sinomed, PubMed, Embase, Web of Science, Scopus, Cochrane Library were systematically searched. Cohort studies or randomized controlled clinical trials with intraoperative LND documentation and with analysis on the clinicopathologic characteristics or prognostic influences on patients with ICC were included into this meta-analysis from the date of database creation to April 20, 2022. The risk of bias in non-randomized controlled trials was evaluated using the Newcastle-Ottawa scale. A meta-analysis of preoperative imaging lymph node enlargement rates, LND rates, and pathological lymph node metastasis rates were performed using R software.Results:Thirty-three relevant studies that met the systematic evaluation criteria were included, all of which were retrospective cohort studies. All these publications were of medium to high quality. Patients’ enrollment ranged from 1993 to 2020. Patients were enrolled from 20 provinces/autonomous regions/municipalities with a total of 39 medical centers and 4 278 patients. The meta-analysis indicated that the LND rate, preoperative imaging lymph node enlargement rate, pathological lymph node metastasis rate were 47.8%(95% CI: 41.3%-54.3%), 18.5%(95% CI: 7.5%-29.6%) and 51.2%(95% CI: 43.8%-58.6%), respectively. Subgroup analysis showed the LND rate was 36.0%(95% CI: 27.0%-45.0%) in studies with a median year of enrollment before 2010, 48.3% (95% CI: 38.1%-58.6%) in studies from 2010 to 2017, and 53.3%(95% CI: 43.3%-63.2%) in studies after 2017. The LND rates were statistically different in the studies in the different periods of patient enrollment ( P=0.032). Conclusion:The meta-analysis indicated that the overall LND rate for ICC in China was not high but showed an increasing tendency.
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Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world,and its incidence is on the rise.Surgical resection is the standard method for the treatment of primary or metastatic HCC.In the past ten years,the local ablation of liver tumor has become more and more mature,and it has been proved to be an effective method for the treatment of malignant liver diseases.Whether used alone or in combination,it can control the growth of the tumor to a certain extent and prolong the survival time.It also improves the quality of life.This article begins with the mechanism of radiofrequency ablation in the treatment of liver cancer,and introduces in detail the research progress in the treatment of small liver cancer,large liver cancer,huge liver cancer and metastatic liver cancer by radio frequency ablation and the evaluation of the curative effect after operation.
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Objective To investigate curative efficacy of tetramethylpyrazine in combination with chemotherapy in treatment of medium and advanced liver cancer and its effects on level of brain-derived neurotrophic factor ( BDNF).Methods 90 patients of medium and advanced liver cancer who received therapy from January 2011 to June 2012 were selected as research objects.According to therapeutic schemes, those patients were divided into the control group (n=42) and the observation group (n=48).The control group was treated with transcatheter hepatic arterial chemoembolization ( TACE) , while the observation group was treated with tetramethylpyrazine in combination with TACE.Then, the short-term curative efficacy, long-term curative efficacy, level of BDNF and adverse reactions were compared.Results The total short-term therapeutic efficacy ratio in the observation group was statistically higher than that in the control group ( 83.3% vs 64.3%, P <0.05 ).During the three-year follow-up, the one-year and two-year survival rate in the observation group was statistically same with that in the control group respectively (75.0% vs 66.7%, 66.7% vs 59.5%), while the three-year survival rate was statistically higher than that in the control group (52.1%vs 30.9%, P<0.05).After treatment, in comparison with the control group, level of BDNF in the observation group was statistically lower(P<0.05).During treatment, incidences of liver function deterioration, abdo minal pain and diarrhea, nausea and vomiting, fever and headache in two groups were statistically same.Conclusion Tetramethylpyrazine in combination with TACE is effective for medium and advanced liver cancer, which can increase short-term and survival rate to some extent, significantly reduce level of BDNF with not increasing incidence of adverse reactions.
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Objective To examine the effect of carbon dioxide pneumoperitoneum on local pancreas pathological changes, serum levels of amylase, IL-6, E-selectin and P-selectin in rats with severe acute pancreatitis (SAP). Methods Fifty healthy male SD rats were randomly divided into 3 groups: CO2 experiment group ( n =20): SAP was induced by injecting 5% sodium taurocholate through retrogradely common biliopancreatic ducts via duodenal papilla,and then CO2 pneumoperitoneum was established at a pressure of 12 mmHg for 30 min; SAP group ( n = 20): The rats were treated as same as CO2 experiment group, excepting CO2 pneumoperitoneum; Control group (n = 10): Abdomen was incised and nothing was done to duodenum and pancreas except for moving them softly. The blood samples were gathered for examining serum levels of amylase, IL-6, E-selectin and P-selectin, and histopathologic examination of pancreas was done.Results Compared with control group, the pancreatic pathologic histology score, serum levels of amylase,IL-6, E-selectin and P-selectin were significantly higher in the CO2 experiment group and SAP group (P =0.000). The levels of IL-6 were significantly lower in CO2 experiment group compared to SAP group (P =0. 000). There was no significant difference between CO2 experiment group and SAP group in pancreatic pathologic histology score( P =- 0.294), the levels of serum amylase ( P = 0.073 ), E-selectin and P-selectin. Conclusions CO2 pneumoperitoneum has no adverse effect on the changes of pathological histopathology and the levels of IL-6, E-selectin and P-selectin in SD rats with SAP.
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Objective To explore the effect of nitroglycerin on ET/NO, TXA2/PGI2 and pancreas pathomorphology changes in severe acute pancreatitis (SAP) rats. Methods Sixty SD rats were random divided into five groups, including control group (A group, n = 12) and experimental group(B,C,D and E group, n = 12). The SAP was induced by injection of 5% sodium taurocholate through retrograde common biliopancreatic ducts via duodenal papilla with epidural catheter. Group C, D and E were intravenously injected with nitroglycerin 0.5μg/kg/min,1μg/kg/min and 2μg/min in 30 min respectively, and group A and B was injected with Sodium Chloride 0.5ml. The indexes of changed pathomorphology and ET/NO, TXB2/6-keto-PGF1a, were determined at the 6th and 12th hour after operations, respectively. Results The specimen data of the 6th and 12th hour displayed that the indexes of changed pathomorphology, ET, ET/NO, TXB2, and TXB2/6-keto-PGF1a of the group C,D and E degraded respectively, compared to group B(P < 0.05). Conclusion The nitroglycerin could degrade ET, ET/NO,TXA2 and TXA2/PGI2, improve the microcirculation of pancreas, and delay the pathological inflammation change in SAP rats.
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Objective To investigate the expression change of ghtathione S-transferase π(GSTπ)protein and mRNA in the HepG2 cell after multiple thermotherapy.Methods HepG2 cells were treaded by ten repeated cycles of exposure at 43 degree C for 80 minutes twice a day，the sensibility of HepG2 cell to Adriamycin was analyzed by MTr assay，and the expression of QSTπprotein and mRNA were detected by immunohistochemical method and RT-PCR.Results The drug resistance to Adriamycin was gained by HepG2 cells after multiple thermotherapy，and the expression of GSTπ protein and mRNA wag strengthened.Conclusions The resistance of heated HepG2 cells to chemotherapeutics was concerned with overexpression of GSTπ protein and mRNA.
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Objective To investigate the change of apoptosis and drug resistance after multiple thermotherapy On the HepG2 Cell. Methods After HepG2 cell were treaded by ten repeated cycles of exposure at 43 degree C for 80 minutes twice a day，the sensibility of HepG2 cell to Adfiamyein was analyzed by MTr assay.The apoptosis Was detected by kit，and the expression of Bcl-2 or Bax protein and mRNA were detected by immunohistochemical method and RT-PCR respective.Results The drug resistance to Adfiamycin Was gained by HepG2 cell after multiple thermotherapy.The rate of apoptosis was decreased，the expression of Bcl一2 protein and mRNA Was strengthened，and the ratio of Bcl-2/Bax increased.Conclusions The resistance of heated HepG2 cell to chemotherapeutics Was related with the decreased rate of apoptosis，overexpression of Bcl-2 protein and mRNA，and increased ratio of Bcl-2/Bax.
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Objective To examine the effects of carbon dioxide (CO2) pneumoperitoneum on local pancreas pathological changes,serum levels of amylase,IL-1,IL-6,and the positive rate of dissolubility adhesion molecule (CD11a/CD18 and CD11b/CD18) expression in rats with severe acute pancreatitis (SAP). Methods Fifty healthy male Sprague-Dawley (SD) rats were randomly divided into 3 groups:CO2 pneumoperitoneum group (n=20):SAP was induced by injecting 5% sodium taurocholate through retrogradely common biliopancreatic ducts via duodenal papilla,and then CO2 pneumoperitoneum was established at a pressure of 12 mm Hg (1 mm Hg=0.133 kPa) for 30 min; SAP group (n=20):The rats were treated as same as CO2 pneumoperitoneum group,except CO2 pneumoperitoneum; Simple operation group (n=10):Laparotomy was performed and nothing was done to duodenum and pancreas except for moving them softly. The blood samples were collected for examining serum levels of amylase,IL-1,IL-6,and the positive rates of CD11a/CD18 and CD11b/CD18 expression,and histopathologic examination of pancreas was performed. Results Compared with simple operation group,the pancreatic pathologic histology score,serum levels of amylase,IL-1,IL-6,and the positive rates of CD11a/CD18 and CD11b/CD18 expression were significantly higher in CO2 pneumoperitoneum group and SAP group (P=0.000). The levels of IL-1 and IL-6 were significantly lower in CO2 pneumoperitoneum group as compared to SAP group (P=0.000). There was no significant difference between CO2 pneumoperitoneum group and SAP group in pancreatic pathologic histology score (P=0.294),the level of serum amylase (P=0.073),the positive rates of CD11a/CD18 (P=0.155) and CD11b/CD18 expression (P=0.201). Conclusion CO2 pneumoperitoneum has inhibitory effect on the levels of IL-1 and IL-6,rather than the positive rates of CD11a/CD18 and CD11b/CD18 expression in SD rats with SAP.
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Objective To investigate the proliferation rate of HepG2 cell after multiple thermotherapy and the possible reasons related to it. Methods After HepG2 cell were treaded by ten repeated cycles of heat exposure at 43 ℃ for 80 minutes twice a day, the doubling time of cell was analyzed, and the cell cycle, bcl-2 mRNA and bax mRNA were detected. Results The proliferation rate of HepG2 cell which treated with heat speeded up, the percentage of G2 and S in cell cycle increased, the expression of bcl-2 mRNA strengthened and the rate of bcl-2/bax increased. Conclusion The speeded proliferation of HepG2 cell after multiple thermotherapy is related to its high percentage of DNA duplicated and dividing cell, strengthened expression of bcl-2 mRNA and increased rate of bcl-2/bax.
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Objective To investigate the apoptosis rate and the mRNA and protein expressions of Bcl-2 and Bax in the remained HepG2 cells after successive thermotherapy for 10 days.Methods After the HepG2 cells were treated with ten repeated cycles of heat exposure at 43℃ for 80 minutes twice a day,the rate of apoptosis was analyzed,and the mRNA and protein expressions of Bcl-2 and Bax were detected.Results Before and after treatment with heat,the apoptosis rates of HepG2 cells were(9.0%?0.8%) and(5.8%?1.3%) respectively(P
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Objective To evaluate the difference between subrenal capsule assay (SRCA) and monotetrazolium (MTT) assay in anticancer chemosensitivity test and explore the possible cause of bringing the difference,in order to provide theoretical basis for clinical practice.Methods SRCA and MTT assay were carried out with fresh rectum carcinoma in three groups:5-FU,amethopterin(MTX) and mitomycin (MMC).The day 1,3,5 after SRCA,every subgroups was injected with 5-FU ,MMC and MTX respectively and the RR was observed at the sixth day;In MTT assay ,the drug,s concentration was 1/10 PPC of each group's drug and the IR was worked out at the fourth day after MMT assay.Results According to the result of chemosensitivity in the 60 groups,20 groups of them were accorded with,other 40 groups were not.The positive and negative according rate of tumor's sensitivity to drug was 33 3% and there was statistical difference between the two methods.Conclusions There were considerable difference between SRCA and MTT assay in anticanaer chemosensitivity test.
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Objective Because of local infiltrated growth and spread,the operative resection of hilar (cholangiocacinoma) is very difficult. Recently,combined extended hepatectomy and vascular resection had been performed for treatment of hilar cholangiocarcinoma and has greatly increased the resection rate and survival rate.However, it is associated with high operative morbidity and mortality. The aim of this study is to explore a reasonable hepatic resection strategy, that is safe and beneficial for the patient. Method Sixteen (consecutive) cases of hilar cholangiocarcinoma with involvement of hilar vessels have been treated in our hospital since 1977. En bloc resection of the hilar tumor that included hepatic segment I,IV and involved blood (vessel), as well as hepato-duodenal ligament skeletonization was performed in 15 patients. Results All 15 cases were successfully operated on with a resection rate of 93.8%, and 12 cases with R_0 resection. The operative mortality and in-hospital mortality rate were 0. Temporary bile leak and abdominal infection (respectively) developed in 1 patienteach,with an overall morbidity of 13.3%,and both were cured by non-(operative) therapy. No case of liver failure occurred. Follow up showed the median survival was 22 months and 7 are still alive. Conclusions (1)The resection rate and survival rate for hilar cholangiocarcinoma could be improved by combination of liver and hilar vascular resection.(2)Hilar cholangiocarcinoma mainly spreads to the medial segment(S4) and caudate(S1), and these segments need to be resected in the combined (operation).(3)Although resection of the middle part of liver takes little more time than hemi-hepatectomy and trisegmentectomy, it could preserve more liver parenchyma and reduce postoperative morbidity (such as liver failure) and mortality rates.(4)The resection of the hilar blood vessel involved by tumor was necessary to improve the resection rate and cure rate. Reconstruction of the blood vessel was made selectively by taking the circumstances into consideration.