A new method of NOTES:experimental study of totally transtracheal endoscopic thyroidectomy on animals / 中国现代普通外科进展

Objective:To investigate the feasibility and safety of a new method of natural orifice transluminal endoscopic surgery(NOTES) -totally transtracheal endoscopic thyroidectomy(TTET) .Methods:Three miniature swines and 6 beagle dogs were underwent TTET.Under general anesthesia,special designed endotracheal tube with 2-channel was used and endoscope and instruments were inserted through the respective channel.Incision of tracheal anterior wall was accomplished and partial or subtotal thyroidectomy was performed.Finally,the defects in the trachea were sutured with ENDO STITCH instrument.Results:Partial thyroidectomy was successfully accomplished on 3 pigs and subtotal thyroidectomy was done on 6 dogs.No serious complications such as anoxia,asphyxia,airway obstruction and death occurred during the operation.Animals were sacrificed 2h after the procedure and incision of trachea was found to be closely sutured.There were no subcutaneous emphysema and haematoma formation.Conclusion:Preliminary experimental results showed the feasibility and safety of TTET.Transtracheal access maintains the integrity of cervical tissues and achieves an optimal cosmetic outcome.TTET may open up a new field of NOTES on thyroid surgery.

The experimental study of cell density mediated integrin αγβ6 expression and MMP-9 secretion in colon cancer cells / 中华普通外科杂志

Objective To detect the effect of cell density off both integrin αγβ6 expression and matrix metalloproteinase-9(MMP-9)secretion in colon cancer cells. Methods Flow cytometry was applied to analyze αγβ6 expression in human WiDr colon cancer cell lines and human HaCaT keratinocyte cells, respectively,at high-and low-cell density culture.The MMP-9 aetivity level for various coloIl cancer cell lines, WiDr and SW480 cells at high-and low-cell density culture was analyzed using Biotrak MMP-9 activity assay and Gelatin Zymography assay, respectively. Results High cell density significantly enhances integrin αγβ6 expression for WiDr cells expressing αγβ6 compared with low density,but no increase was observed for human keratinocyte HaCaT cells. Biotrak MMP-9 assay indicated that the amount of MMP-9 secreted per cell for WiDr and SW480 B6 cells at high cell density culture was(3.3±1.2)×10-7ng/cell and(27.2±3.0)× 10-7ng/cell respectively; However,at low cell density it was(1.8±0.7)× 10-7ng/cell and(10.9±2.0)×10-7 ng/cell,respectively. It was 2-3-fold higher for WiDr and SW480 β6 cells at high cell density compared with that at low cell density, but no density-dependent increase observed for SW480 wild cells lack αγβ6 expression(t=0.47,P＞0.05),MMP-9 secretion for SW480 wild cells was(3.9±1.7)× 10-7 ng/cell at hish cell density and(3.8 ±0.7)×10-7 ng/cell at low eell density(P＞0.05),respectively. Gelatin zymography assay also indicated that the level of MMP-9 in SW480 B6 cells expressing αγβ6 was evidently higher at high density than at low density, however no density-dependent increase observed for SW480 wild cells and HaCaT cells. Conclusions High cell density induces integrin αγβ6 expression and promotes MMP-9 secretion in colon cancer cells, which constitutes the basis for a self-perpetuating system of tumor infiltrating growth in colon cancer progression.

Study on Gallbladder Carcinoma Apoptosis Induced by Antisense Oligodeoxynucleotide Targeting survivin / 中国普外基础与临床杂志

Objective To study the apoptosis of gallbladder carcinoma cell line GBC-SD induced by antisense oligodeoxynucleotide (ASODN) targeting survivin. Methods ASODN targeting survivin was transfected into GBC-SD cells mediated by lipofectin. Cultured cells were divided into 3 groups: control group,sense oligonucleotide (SODN) group and ASODN group. After transfected for 16 h, the cultured cells were harvested and the following texts were carried out. The expression of survivin mRNA was detected by RT-PCR. Flow cytometer were used to detect apoptosis. Morphological changes were observed by electron microscopy. Results The expression of survivin mRNA was decreased 47.83% in ASODN group while apoptosis was increased from (0.50?0.23)% to (26.28? 3.91)%. Abnormal morphological changes of cells were observed in ASODN group and apoptosis bodies were found in some gallbladder carcinoma cells. Conclusion The expression of survivin may be decreased in GBC-SD cells after ASODN transfection.ASODN targeting survivin could induce gallbladder carcinoma cells apoptosis effectively.

Combined intestine-auxiliary liver transplantation in rats / 中华器官移植杂志

Objective To observe the long-term effect of combined intestine/auxiliary liver transplantation in rat.Methods Male Lewis rats were used. Total small bowel and 60 % liver were transplanted en bloc with an aortic segment that contained the celiac axis and superior mesenteric artery ensuring the blood supply to the graft. The end-to-side anastomosis was made between donor infrahepatic vena cava (IHVC) and recipient IHVC. The recipient small bowel was resected and the intestine continuity was restored. Sham control (laporotomy only) and transplantation groups were included. Ten rats in each group were followed-up for 18 months and then sacrificed. Liver function tests, terminal deoxynuleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate (dUTP) nick end labeling (TUNEL) staining and proliferating cell nuclear antigen (PCNA) staining of liver tissue were evaluated.Results Sixteen rats survived over the operation. There were no significant differences in liver function tests between the sham control group and transplantation group. The grafted liver was hypertrophic and native liver did not regenerate 18 months following transplantation with an increased liver/body weight ratio. TUNEL-staining showed no significant differences among grafted liver, native liver of the recipient rat in transplantation group and the liver of the rat in control group. PCNA-staining revealed that the native liver in transplantation group had a lower proportion of TUNEL-positive hepatocytes. Conclusion This experimental study confirmed the long-term consequences of combined intestine-auxiliary liver transplantation, and the results suggest that liver/body weight ratio can be increased.

Diagnosis and treatment of benign tumor of the duodenum / 中国普通外科杂志

Objective To investigate the diagnosis and treatment of patients with benign tumor of duodenum(BTD). Methods Clinico-pathological data of 24 patients with BTD treated by surgery in our department in recent 21 years were analyzed retrospectively. Among the 24 cases, 18 cases underwent local resection, 4 segmental duodenectomy, 1 subtotal gastrectomy and 1 pylorus-preserving pancreatoduodenectomy. Results Abdominal pain, digestive tract hemorrhage and duodenal obstruction were the common clinical manifestations of BTD. The correct diagnostic rates of air barium double contrast radiography and duodenoscopy were 82.4% and 93.3% respectively. The result of surgical treatment was satisfactory, except 1 patient who died of acute myocardial infarction 6 days after the operation. Of the 24 patients, the pathological examination showed as follows 8 had a villous adenoma, 6 gastrointestinal stromal tumor, 5 Brunner′s gland adenoma, 2 leiomyoma, 2 multiple adenomas in familial adenomatous polyposis, 1 hemangioma. Conclusions Air barium double contrast radiography and duodenoscopy are mainsteps for the diagnosis of BTD. The best treatment is surgical resection.

Clinical significance of E-Cadherin expression in breast carcinoma / 中国现代普通外科进展

Objective:To investigate the clinical significance of E-Cadherin (E-CD) expression in breast carcinoma.Methods:The expression of E-CD gene in human breast carcinomas was studied by immunohistochemistry(SABC) in 92 patients and the relationship between the expression and the clinical pathologic parameters was observed.Results:The positive rate of E-CD expression was 48.9%(45/92).The group with negative E-CD expression has higher incidence of distant metastasis (34%,16/47)than the positive one (15.6%,7/45)(P

THE EXPERIMENTAL STUDY OF ESTROGEN EFFECT ON PRECANCEROUS LESION AND K-ras MUTATION IN RATS ' PANCREATIC ACINAR CELLULAR CANCER / 中国现代普通外科进展

Objective: To set up the animal model of precancerous lesion of rats' pancreatic acinar cellular cancer,and to learn estrogen's effect on this lesion's biological feature and K-ras gene mutation. Methods: male Wistar rats were injected Azaser-ine 30mg/kg(ip). Some rats received Estradiol-17 P Valerate(0.18mg/100g/2weeks, im) .4 months later, rats'pancreas were autopsied and K-ras gene mutation were detected by PCR-SSCP method. Results : The incidence of AACN were very high. The incidence of K-ras gene mutation was 42.1% in rats without estrogen and 25.6% with estrogen. Conclusion: Azaserine could induce precancerous lesion of rats' pancreatic acinar cancer successfully, K-ras gene mutation was early change during this process Estrogen could inhibit this precancerous lesion's happen and development to some degree.

Inhibition of survivin and bcl-2 Antisense Oligodeoxynucleotides Combined Transfection on the Human Gallbladder Carcinoma Cell Line GBC-SD in vitro / 中国肿瘤生物治疗杂志

Objective: To investigate the effect of survivin and bcl-2 antisense oligodeoxynucleotides ( AsODN) combined transfection on the human gallbladder carcinoma cell line GBC-SD in vitro. Methods: Survivin and Bcl-2 protein expressions were detected by immunohistochemical method; Cultured cells were divided into 4 groups: Nomal control group, survivin antisense observed group, bcl-2 antisense observed group and combined group. After transfected for 24 h, the expression of survivin mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR). Cell morphological changes were observed under electron microscopy. Apoptosis index (AI) was examined by flow cytometry; Inhibitory rate (IR) was determined by the colorimetri MTT cell viability and proliferation assay. Results: Survivin and Bcl-2 protein were highly expressed in gall bladder carcinoma cells; The expression of survivin mRNA was decreased 47. 8%. Abnormal morphological changes of cells were observed in the three AsODN transfection groups; The AI in survivin antisense observed group,bcl-2 antisense observed group,and combined group was 11.38%?3.91% , 9.26%?4.15% , 28.45%?6.34% respectively and significantly higher than the nomal control group (P