Research progress in endoscopic retrograde cholangiopancreatography-mediated photodynamic therapy for cholangiocarcinoma / 中南大学学报(医学版)

The malignant degree of cholangiocarcinoma is high, and the early diagnosis is difficult. The vast majority of patients are unresectable when they are diagnosed. The patients have low quality of life and short survival cycle. Traditional radiotherapy and chemotherapy have poor efficacy and lead to side effects, and thus lack effective control measures for cholangiocarcinoma. Endoscopic retrograde cholangiopancreatography (ERCP) is an important method for diagnosing and treating biliary tract diseases. Photodynamic therapy (PDT) is a new local treatment for cholangiocarcinoma. In recent years, ERCP-mediated PDT treatment of cholangiocarcinoma has gradually emerged. ERCP-mediated PDT can effectively relieve the symptoms of patients with cholangiocarcinoma, improve the patients' quality of life, prolong the survival cycle, and is expected to become a new treatment for cholangiocarcinoma.

Role of PpⅨ-based photodynamic therapy in promoting the damage and apoptosis of colorectal cancer cell and its mechanisms / 中南大学学报(医学版)

Objective:To explore the effects of protoporphyrin Ⅸ (PpⅨ)-mediated photodynamic therapy (PDT) on induction of apoptosis and death in colon cancer cell and the underlying mechanisms.Methods:The cell killing effect of PDT on HCT116 cell was determined by cell counting kit (CCK).The cells were divided into a control group,a single light group,a single PpⅨ group,and a PDT group.Hoechst 33342 and flow cytometry was used to assess the cell apoptosis.Western blot was employed to analyze the expressions ofbd-2,bax,and caspase-3.Reactive oxygen species (ROS) was detected by flow cytometry.Results:The viability of HCT116 cell was decreased gradually with the increase of irradiation dose (P<0.05).Compared to the other 3 groups,ROS production,the number of apoptotic cells and the protein expressions ofbax and caspase-3 in PDT group increased,while bcl-2 expression was decreased (P<0.05).Conclusion:PpⅨ-mediated PDT can enhance the apoptosis in HCT116 cell,which may be related to mitochondrial apoptosis pathway.

Current situation,outcome analysis and trends of the health reform of Changchun city / 中华医院管理杂志

Furthering of the health reform calls for better health care system,greater public financing,and deepened reform of public hospitals.Introduced in this paper are the actions taken and outcomes of the health reform in Changchun city,including the essential medicines system to minimize drug prices,improvement of the primary healthcare system to minimize people's financial burden,greater public spending to enhance public welfare nature of medical institutions,enhanced competencies of primary medical institutions to introduce rational classification of patient flow,and enhanced equity of public services to promote people's health.On such basis,further reform proposals were made for Changchun's health reform.

Association study between different number of inferomedial screws and their efficacy in locking plate of proximal humerus fractures / 中华骨科杂志

Objective To investigate the association between different number of inferomedial screws (0-3 screws) and their efficacy in locking plate of proximal humerus fractures.Methods Data of 90 patients who had undergone locking plate for proximal humerus fracture between January 2007 and December 2012 were retrospectively analyzed.They were divided into four groups according to the number of inferomedial screws.In the NS (no-screw support) group,36 patients did not have inferomedial screws for mechanical support of the inferomedial region of the proximal humerus; in the OS (one-screw support) group,23 patients had the reconstruction by insertion of only one inferomedial screw; there were 19 patients in the TS (two-screw support) group and 12 in the ThS (three-screw support) group.There were no significant differences among 4 groups in sex,fracture type and age.The Constant scores of the shoulder function,changes in humeral head height at the latest follow-up,incidence of complications and time for fracture healing among the 4 groups were collected.Results The follow-ups for the patients ranged from 12 to 56 months (mean,21.4 months).At the latest follow-up,the ThS,TS,OS and NS groups had a mean Constant score of 76.7 (SD,11.6),74.1 (SD,7.4),66.8 (SD,10.7),65.8 (SD,10.2),respectively; the mean change in humeral head height were 1.4 (SD,1.0) mm,2.9 (SD,1.2) mm,5.3(SD,3.2) mm and 6.7(SD,3.3) mm,respectively.There were no significant differences between the ThS and TS groups in Constant score,and Constant scores in ThS and TS groups were significantly higher than those in OS and NS groups.However,the loss in humeral head height in the ThS group was significantly less than those in the TS,OS and NS groups,and the loss in humeral head height in TS group was significantly less than those in the OS and NS groups.There were no significant differences among 4 groups in time for fracture healing and incidence of complications.Conclusion Locking plate in general do not appear to be a panacea for proximal humerus fractures especially in cases of medial comminution or bone defects because of the malreduction of the medial cortical bone.However,medial support with two or three inferomedial screws being meticulously placed in the inferomedial region may enhance the mechanical stability of medial column support and allow for better maintenance of reduction.

Analysis of learning curve of laparoscopic splenectomy / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the surgical outcomes of laparoscopic splenectomy and to investigate the learning curve of laparoscopic splenectomy.@*METHODS@#Forty cases of laparoscopic splenectomy (performed by W.Y. between September 2008 and August 2010) in our general surgery department were reviewed, and the cases were divided equally into 4 groups (group I, II, III, IV) according the time sequence of the operations. The operating time, blood loss, conversion to open surgery, conversion to hand-assisted laparoscopic splenectomy, postoperative hospital stay, postoperative liquid diet recovery time, intra- and postoperative complications and the operative frequency were compared.@*RESULTS@#There were no statistical differences among the groups in age and gender (P>0.05). The operating time, blood loss and postoperative hospital stay of groups III and IV were significantly less than those of groups I and II (P0.05). Frequency of conversion to open surgery, of conversion to hand-assisted laparoscopic splenectomy, of complications among the four groups were also not statistically different (P>0.05). The operative frequency of group I-IV increased from 1.25/month to 2.5/month.@*CONCLUSION@#The learning curve of laparoscopic splenectomy for surgeon who was experienced in open splenectomy and laparoscope cholecystectomy is approximately 20 cases, and the operative frequency is about 1.33/month.

Expression of RAD51 and MAX in pancreatic cancer rats / 中南大学学报(医学版)

Objective To establish a model of pancreatic cancer induced by 7,12-dimethylbenzathracene (DMBA) in SD rats, and to detect the expression levels of RAD51 and Myc-associated factor X (MAX) and their effect on carcinogenesis of rat pancreas. Methods Ninety SD rats were randomly divided into 3 groups: a model group, an intervention group, and a control group. DMBA was directly implanted into the parenchyma of rat pancreas (the model group and the intervention group). Rats in the intervention group were treated with 1 mL trichostatin A (TSA) saline solution (1 μg/mL) via ip weekly. Rats within 3～5 months in the model group and the intervention group were executed and observed by macrograph and under microscope. Meanwhile, the rats in the control group were executed at 5th month. The EnVision~(TM) immunohistochemistry to assay the expression levels of RAD51 and MAX was used in conventional paraffin-embedded sections from the above pancreatic specimens.Results The incidence of pancreatic cancer in the model group within 3-5 months was 48.7% (18/37), including 17 ductal adenocarcinomas and 1 fibrosarcoma. The incidence of pancreatic cancer in the intervention group within 3-5 months was 33.3%(12/36), including 11 ductal adenocarcinomas and 1 fibrosarcoma. The maximal diameter of mass in the model group was significantly higher than that in the intervention group (P＜0.05). No pathological changes were found in pancreas of the control group and other extra-pancreatic main organs of the model group and the intervention group (such as the liver, biliary tract, gastrointestine tract, kidney, and lung). The positive rate of RAD51 was significantly higher in ductal adenocarcinoma in the model group, the intervention group, and the model group +the intervention group than those in corresponding groups of non-cancerous pancreatic tissues (P＜0.01), but the positive rate of MAX expression was opposite to RAD51 expression(P＜0.01). The positive tissues of RAD51 expression and/or negative tissues of MAX expression in non-cancerous tissues showed atypical-hyperplasia of ductal epitheli. Pacncreas of the control group showed the negative expression of RAD51 and positive expression of MAX. Two cases of fibrosarcoma showed the negative expression of RAD51 and MAX.Conclusion DMBA directly implanted into the parenchyma of pancreas can obtain an ideal pancreatic cancer model with high incidence in a short time. The TSA might have an inhibitive effect on carcinogenesis and growth of rat pancreas. The over-expression of RAD51 and/or lose-expression might have important effect on carcinogenesis induced DMBA in rat pancreas.

The role of TNF-? in the establishment and development of model of pancreatic cancer / 中国普通外科杂志

Objective To establish a model of pancreatic cancer(PC)in SD rats,and to study the changs of serum levels of AMS and TNF-? and the significances.Methods Dimethylbenzanthracene(DMBA)was directly implanted into pancreatic parenchyma of SD rats(experimental group,group A),and in the process of establishing PC,weekly TSA by 1P was done in intervention group(group B).The tumor development of rats executed within 3～5 months in Group A and Group B were observed by HE staining and gross examination.Meanwhile,the rats in the sham operation group(Group C)were executed at 5 months.The levels of serum AMS were detected by autobiochemical assay apparatus,and the levels of serurn TNF-? were determined by ELISA.Results(1)The incidence of pancreatic cancer in Group A within 3～5 months was 48.7%(18/37),including 17 cases of pancreatic ductal adenocarcinoma and 1 case of fibrosarcoma.The incidence of pancreatic cancer in Group B was 33.3%(12/36),including 11 pancreatic ductal adenocarcinoma and 1 case of fibrosarcoma.The maximal diameter of tumor mass in Group A was higher than that in Group B((P

Effect of adenovirus-mediated myoglobin gene expression in decreasing hepatic ischemia reperfusion injury / 中国普通外科杂志

Objective To study the effect of expression of myoglobin which mediated by adenovirus,on ATP value of liver and the protective effect on liver ischemia reperfusion injury.Methods Adenovirus carrying CMV promoter sequences linked to the human myoglobin gene(AdCMVMyo) were transfected into rats liver. Then myoglobin, hepatic ATP levels and liver function were evaluated. Results Myoglobin expression was verified in rat livers after AdCMVMyo transfection. The ATP levels in rat livers 72 hours after AdCMVMyo transfection were significantly higher than that in control group(P

Expression and significance of EZH_2 and PTEN in pancreatic cancer and non-cancerous pancreatic tissues in rats / 中国普通外科杂志

Objective To study the expressive levels of EZH2 and PTEN in pancreatic cancer and non-cancerous tissue,and the effects on carcinogenesis of rat pancreas.Methods dimethylbenzathracene(DMBA) was directly implanted into the parenchyma of rat pancreas(group A,group B).The rats of group B were treated with 1 mL trichostatin A(TSA) solution(1?g/mL) intravenously per weer 1 week after the model were set up.The rats of group A,B were killed within 3-5 months and the rats in the control(C group) were executed at 5 months to observe the develope of pancreatic cancer by macrograph and microscopy,The EnVisionTM immunohistochemistry was used to assay the expression of EZH2 and PTEN in above pancreatic specimens.Results(1) The incidence of pancreatic cancer within 3-5 months in group A was 48.7%(18/37),including 17 cases of ductal adenocarcinoma and 1 case of fibrosarcoma.The incidence of pancreatic cancer in group B was 33.3%(12/36),including 11 cases of ductal adenocarcinoma and 1 cases of fibrosarcoma.The mean maximal diameter of mass was significantly higher in group A than that in group B(P 0.05).The non-cancerous pancreatic tissues with positive expression of EZH2 and/or negative expression of PTEN showed mild to severe atypical hyperplasia of ductal epithelium.An inconsistency was found between the expression of EZH2 and PTEN in ductal adenocarcinoma(P =0.045).Pancreas of group C showed negative expression of EZH2 and positive expression of PTEN.Two cases of fibrosarcoma showed negative expression of EZH2 and PTEN.Conclusions By use of higher dose of DMBA directly implanted into the parenchyma of pancreas,high incidence of pancreatic cancer can be obtained.TSA could have an inhibitive effect on carcinogenesis and growth of pancratic cancer.The activation of EZH2 gene and inactivation of PTEN gene might have Key effects on pancreas carcinogenesis induced by DMBA in rat.

A technique of T-tube replacement / 中国普通外科杂志

Objective To explore the technique of T-tube replacement after choledochoscopy.Methods Choledochoscopy was performed in 256 cases,replacement of T-tube was conducted by direct insertion technique in 85 cases(Group A),and by a wire-guide technique in 171 cases(Group B).Results Three cases of T-tube replacement were unsuccessful in group A,in one case of which,the T-tube was misguided into the bowel and the patient recovered after conservative treatment following the withdrawal of T-tube.In group B,all the T-tube replacements were conducted successfully with the wire-guide technique.Conclusions Replacement of T-tube is facilitated by the wire-guide technique.