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Objective To analyze the clinical outcomes and surgical procedures of 32 patients who underwent laparoscopic radical resection of hilar cholangiocarcinoma.Methods From January 2013 to July 2018,32 patients who were diagnosed to have hilar cholangiocarcinoma underwent total laparoscopic treatment in Second Hospital of Hebei Medical University.The clinical data of these patients were recorded,including the general data,Bismuth types,AJCC types,postoperative complications,pathological findings,and follow-up results.Results This study included 20 males and 12 females with a mean age of 60.9±8.8 years and a body mass index of 22.6±3.2 kg/m2.According to the preoperative imaging studies,the Bismuth types Ⅰ,Ⅱ,Ⅲa,Ⅲb,and Ⅳ were found in 12,2,3,4 and 11 patients,respectively.Laparoscopic radical resection of hilar cholangiocarcinoma and bilioenteric anastomosis was performed in 12 patients,with radical resection and external bile drainage in 6 patients,extended hemihepatectomy with caudate lobectomy in 6 patients and concomitant portal vein resection in 2 patients.The mean operative time was 365.6± 121.9min and the median intraoperative blood loss was 300 (75,400) ml.Intraoperative red cell and plasma transfusion were 0-15 U and 400(0,625)ml,respectively.According to the Clavien-Dindo complication classification system,5 of 32 (15.6％) patients developed type Ⅱ morbidity.The postoperative pathological findings revealed bile duct adenocarcinoma in 30 patients and mucinous adenocarcinoma in 2 patients.The median size of cancer was 3.0 (1.0,3.5) cm.According to the 8th AJCC staging system,stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ were found in 6,13,11,and 2 patients,respectively.A negative resection margin was achieved in 24 of 32 patients (75％).Up to August 6,30 of 32 patients (93.8％) were followed up and the overall 1-,2-,and 3-year survival rates for the patients who underwent laparoscopic radical resection for hilar cholangiocarcinoma were 80.0％,53.0％,and 53.3％.The median survival time was 21.8 months.Conclusion Total laparoscopic surgery for hilar cholangiocarcinoma was safe and feasible if performed by an experienced surgeon after accurate preoperative evaluation.
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Objective To study the feasibility of laparoscopic pancreaticoduodenectomy ( LPD) in the treatment of pancreatic head cancer, and to analyze the short-term postoperative outcomes. Methods The clinical data of 57 patients with pancreatic head cancer who underwent laparoscopic pancreaticoduode-nectomy from April 2015 to November 2017 in the Second Hospital of Hebei Medical University were retro-spectively analyzed. Results Of the 57 patients, conversion to open surgery was required in 2 patients, and major venous resection and reconstruction were performed in 9 patients, including 8 end-to-end anastomosis, and 1 synthetic graft interposition. Total pancreatectomy was carried out in 4 patients. For the remaining 53 patients, pancreaticojejunal mucosal anastomoses were carried out in 50 patients, and sleeve pancreaticojeju-nostomy in 3 patients. The mean operative time and operative blood loss were 497 (240～720) min and 435 (50～3 000 ) ml, respectively. The mean postoperative hospital stay was 17. 7 ( 6. 0 ～59. 0 ) days. Postoperative complications were detected in 26. 3% (15/57) of patients, which included delayed gastric emptying (DGE) in 4 patients, Grade B pancreatic fistula (PF) in 4 patients, biliary fistula ( BF) in 2 patients, postpancreatectomy hemorrhage ( PPH) in 2 patients, intraabdominal infection in 1 patient and pulmonary infection in 2 patients. All the patients with DGE recovered with conservative treatment and they were discharged home. Reoperation was only required in the two patients with PPH. One patient died after the operation. The postoperative pathological results revealed pancreatic duct adenocarcinoma in 53 patients, adenosscale carcinoma in 1 patient and neuroendocrine carcinoma in 3 patients. The maximum and minimum tumor sizes were 7. 0 cm×5. 0 cm×3. 5 cm and 2. 5 cm×1. 5 ×1. 0 cm, respectively. The mean lymph nodes harvest and positive lymph node retrieval were 14(1～60) and 0. 7(0～3), respectively. Negative resection margins were obtained in 84. 2% (48/57) of patients. This study was censored on December 31, 2017. The follow-up for these patients ranged between 1 to 32 months. Mortality occurred in 21 patients, including 1 patient with a ruptured aneurysm 2 months after operation, 2 patients with GI bleeding 2 and 9 months respectively after operation, 1 patient with severe pulmonary infection and 17 patients with cancer recurrence with survival varying from 2 to 21 months. 35 patients were still alive. Conclusion Laparoscopic pancreaticoduodenectomy is a safe and feasible procedure for pancreatic head cancer.
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The protective effects of Da Chai Hu Granules (DCHKL) on islet cells which were incubated with 4 mmol x L(-1) alloxan (AXN) were studied. The viability of islet cells were measured with MTT. Insulin released into medium and in islets was detected by radioimmunoassay. Cell apoptosis rate was determined by flow cytometry. The expression of anti-apoptotic gene Bcl-2 and pro-apoptotic gene Bax in islet cells were measured with RT-PCR (reverse transcription polymerase chain reaction). Serum containing DCHKL can promote the activity of islet cells significantly (P < 0.01). Basal insulin secretion and high glucose-stimulated insulin secretion increased significantly (P < 0.01). Serum containing DCHKL can inhibit apoptosis of islet cells, the ratio of apoptosis was decreased. Serum containing DCHKL increased expression of Bcl-2 mRNA and decreased expression of Bax mRNA. DCHKL can significantly promote proliferation of islet cells and increase the amount of basal secretion of pancreatic islet cells and high glucose-stimulated insulin secretion. The expression of Bcl-2 increased significantly. The expression of Bax decreased significantly. DCHKL have a protective effect on the islet cells.
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Objective:To observe the killing effect of irradiated peripheral blood mononuclear cells (PBMCs) at low dose combined with apogossypolone (ApoG2) on cultured human prostate cancer PC-3 cells.Methods:Human PBMCs were irradated by gamma ray at 1 gray,the irradiation dose rate was 17 Gy/min.The experiment were divided into PC-3 tumor cell control group,PC-3 cells with irradiated and non-irradiated PBMCs co-culture groups,ApoG2 treatment group,irradiated PBMCs and ApoG2 co-treatment group.Acridine orange/ethidium bromide (AO/EB) staining and MTT method were used to observe the killing effect of PBMCs and/or ApoG2.Results:The killing activity of irradiated PBMCs group and ApoG2 treatment group were obviously increased and were higlaer than that of non-irradiated group (P＜0.05).The killing activity of combined group were much higher than that of irradiated group and ApoG2 treatment group (P ＜0.01 ).Conclusion:Irradiated PBMCs at low dose combined with ApoG2 can enhances the anti-tumor effects markedly.
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AIM: To establish the quality standard for Jinqiaomai Tablets ( Fagopyri Dibotryis Rhizoma). METHODS: Fagopyri Dibotryis Rhizoma was identified by TLC. The contents of (-)-epicatechin and procyanidin B2 were determined simultaneously by HPLC,the Symmetry C18 column (5 ?m,3. 9 mm id ? 150 mm) was used. The water (adjust pH value to 3. 00 ? 0. 02 with phosphoric acid)-acetonitrile (92 ∶ 8) was used as a mobile phase,the detecting wavelength was at 280 nm. The column temperature was at 35 ℃. RESULTS: Fagopyri Dibotryis Rhizoma could be identified. The calibration curve of (-)-epicatechin was linear in the range of 0. 113 6-2. 272 ?g with the correlation of 0. 999 968 (n = 8). The average recovery of (-)-epicatechin was 97. 12% ,RSD = 0. 92% (n = 6). The calibration curve of procyanidin B2 was linear in the range of 0. 166 4-1. 664 ?g with the correlation of 0. 999 702(n = 8). The average recovery of procyanidin B2 was 98. 26% ,RSD = 0. 61% (n = 6). CONCLUSION: The method is specific,reliable and accurate,so it can be used for the quality control of Jinqiaomai Tablets.