Application of single cell sequencing technology in liver regeneration / 中华消化外科杂志

The liver is a highly proliferative organ. As the liver injured, the hepatocytes can quickly enter the cell cycle to restore the volume and function of liver. Liver regeneration involves complex processes that depend on the interaction of many different cell types. As limited by the average cell change level in tissues, traditional sequencing methods can only acquire the average genetic information reflecting dominant cell subpopulations, but ignore the secondary cell subpopu-lations, which leads to the loss of cellular heterogeneity information. Single-cell sequencing tech-nology can analyze the biological behavior of single cell, which helps to better understand the distri-bution, interaction and cell heterogeneity of different cells during liver regeneration. The authors review the application of single cell sequencing technology in liver regeneration.

Research Progress of Targeting uPA-uPAR System in Tumor Therapy / 肿瘤防治研究

The uPA-uPAR system is highly expressed in various tumor tissues. This system can promote the degradation of extracellular matrix proteins, as well as combine with vitronectin and integrin to transmit intracellular signal transduction. Subsequently, it mediates the occurrence and development of tumors. In recent years, a series of therapeutic programs that target this system has achieved notable results in tumor treatment, and some of them have been under the clinical trial stage, thus providing new ideas for tumor targeted therapy. Therefore, this paper intends to provide a review of research progress on the gene therapy, drug therapy, and immunotherapy targeting uPA-uPAR system.

Research progress of the FLOT regimen in neoadjuvant treatment for gastric cancer / 中华消化外科杂志

With the deepening research of comprehensive treatment for gastric cancer, the FLOT regimen has begun to be used for the treatment of gastric cancer patients. FLOT neoadjuvant regimen can significantly improve the R 0 resection rate and prolong the overall survival time of locally advanced gastric cancer patients. FLOT regimen combined with immune-checkpoint inhibi-tors, targeted therapy and hyperthermic intraperitoneal chemotherapy have great potential in neo-adjuvant therapy for gastric cancer. The authors systematically analyse the development history and latest clinical research progress of FLOT neoadjuvant regimen for gastric cancer based on their clinical practice experience.

Research Progress on Anti-Tumor Mechanism of Theaflavins Natural Products / 肿瘤防治研究

Theaflavins are a class of natural products extracted from black tea or green tea, with significant anti-tumor effects on gastric cancer, liver cancer, breast cancer and other tumors. Theaflavins were once considered as the new products for anticancer therapy. However, the anti-tumor mechanism of theaflavins involves a variety of biological processes, and the regulation is complex. Therefore, this article summarizes the role of theaflavins in promoting tumor cell apoptosis, inducing tumor cell mitotic arrest and regulating tumor immunity, and reviews the inhibition of tumorigenesis and growth through MAPK, PI3K/AKT, Hedgehog, NF-κB, JAK/STAT and Wnt/β-Catenin signal pathways, in order to provide new ideas for cancer treatment and anti-cancer drug development.

Research progress in Lamins in malignant tumors / 中南大学学报(医学版)

Changes in nuclear morphology are common in malignant tumors, but the underlying molecular mechanisms remain poorly understood. Lamins is involved in supporting nuclear structure, and the expression of Lamins is the molecular basis for nuclear morphological changes during tumor progression. In recent years, the research on the relationship between Lamins and malignant tumors has made great progress. Lamins is of great value in the diagnosis, treatment, and prognosis of various malignant tumors.

Research advance in gastric neuroendocrine tumors / 中南大学学报(医学版)

Gastric neuroendocrine tumors are rarely seen in the gastric tumors, because there are few case reports and the clinical diagnosis rate is low. There is no consensus treatment method in the world. However, with the benefit of esophagogastrodenoscopy and widespread use of proton pump inhibitors, the diagnostic rate of gastric neuroendocrine tumors is on the increase, which gives us an updated understanding for the pathogenesis and pathophysiology of the disease. By studying its pathogenesis, scholars have found that hypergastrinemia caused by various causes is closely related to its occurrence. Gastric neuroendocrine tumors are classified into different types or pathological grades depending on the state of progression of the disease and the unique clinical manifestations. Clinically used diagnostic methods include gastroscopy, medical imageology, nuclear medicine, gastrin, CgA, etc. There are also differences in treatments depending on the clinical classification. If the disease progresses rapidly and the grade is high, surgical resection of the lesion plus postoperative adjuvant chemotherapy should be actively performed. Other better treatments are still being explored.

Progress in study on the treatment of gastric cancer with docetaxel / 中南大学学报(医学版)

Gastric cancer is one of the most common malignant gastrointestinal tumors.Docetaxel alone or combination with other drugs can attenuate the progress of disease,prolong the overall response rate and the median overall survival rate in advanced gastric cancer.However,the incidence of toxicities is high.Moreover,there is no uniform standard for dosage and course for docetaxel treatment.Currently,its efficacy is not definite.

Advances in Study on DCF Regimen in Treatment of Advanced Gastric Cancer / 胃肠病学

Gastric cancer is one of the most common malignancies and chemotherapy is the main method for the treatment of advanced gastric cancer. Chemotherapy can improve the quality of life and prolong the survival time of patients with advanced or metastatic gastric cancer. The DCF regimen (docetaxel,cisplatin and 5-fluorouracil)is effective for patients with advanced gastric cancer. However,because of the severe hematological toxicity and gastrointestinal reaction caused by DCF regimen,its clinical application is still limited. This article reviewed the research progress of DCF regimen in treatment of advanced gastric cancer.

Research progress in epidemiology, diagnosis and treatment for pancreatic cancer / 中南大学学报(医学版)

Pancreatic cancer is a highly lethal disease in gastrointestinal malignant tumors.The mortality of pancreatic cancer closely parallels its incidence.Most patients with pancreatic cancer remain asymptomatic until the disease reaches an advanced stage.There is no program for screening patients at high risk of pancreatic cancer.Although CT,MRI,positron emission tomography,endoscopic ultrasonography,and endoscopic ultrasonography-guided fine-needle aspiration offer high diagnostic ability for pancreatic cancer,it cannot be found at the early stage easily.Surgical resection is regarded as the only potentially curative treatment and adjuvant chemotherapy is given after surgery.This article reviews epidemiology,risk factors,diagnosis and treatment for pancreatic cancer by summarizing relevant literature.

Clinical study on surgical method and prognosis in diffuse-type advanced gastric cancer / 中南大学学报(医学版)

OBJECTIVE@#To explore the prognosis and surgical method for diffuse-type advanced gastric cancer (AGC).
@*METHODS@#The clinicopathological data of patient, who underwent curative gastrectomy in the Second Hospital Affiliated to Lanzhou University from 2005 to 2010, were analyzed retrospectively. The prognostic factors of diffuse-type AGC were analyzed by Cox regression models. The patients were divided into a total gastrectomy group (n=120) and a subtotal gastrectomy group (n=167) according to the surgical approach. Survival rates were established by the Kaplan-Meier method and compared by the Log-rank test between the total gastrectomy group and the subtotal gastrectomy group.
@*RESULTS@#A total of 287 patients with diffuse-type AGC were enrolled in this study, including 120 patients in the total gastrectomy group and 167 patients in the subtotal gastrectomy group. Univariate analysis showed that the prognosis of diffuse-type AGC was associated with body mass index, number of retrieved lymph nodes, Borrmann type, tumor size, T stage, N stage, tumor-node-metastasis (TNM) stage, extent of resection, surgical margin, postoperative complication, perineural and vascular invasion (all P<0.01). Multivariate analysis showed that normal body mass index, tumor size, T stage, N stage, total gastrectomy, surgical margin, postoperative complication were the independent predictors for diffuse-type AGC (all P<0.05). The 5-year overall survival rate and progression-free survival rate for diffuse-type AGC after curative gastrectomy were 17.8% and 13.6%, respectively. The median survival time and progression-free survival of them were 22 and 18 months, respectively. The overall survival rate and progression-free survival rate in the total gastrectomy group was significantly higher than that in the subtotal gastrectomy (P<0.01); the extended extent of lymph node dissection, the lower rate of positive surgical margin and postoperative complications were present in the total gastrectomy group (all P<0.05 or P<0.01).
@*CONCLUSION@#The patients with diffuse-type AGC have a poor prognosis. The great tumor diameter, advanced T stage, advanced N stage, subtotal gastrectomy, high rate of positive surgical margin and postoperative complication are independent risky factors for the diffuse-type AGC. However, the total gastrectomy may be beneficial to patients.

Safety and efficacy of ligasure vessel sealing system for thyroidectomy: a Meta analysis / 中华内分泌外科杂志

Objective To evaluate the safety and efficacy of ligasure vessel sealing system (LVSS) and conventional ligation haemostasis in thyroidectomy.Methods Pubmed,EMBASE,Medline,and CNKI were performed to search for randomized controlled trial.Literature selection and data collection were completed by 2 researchers independently.The assessment of methodological quality was conducted with Cochrane Handbook 5.1.The Review Manager software 5.2 was used for Meta analysis.Results A total of 11 studies (934 patients) were involved.Meta-analysis indicated that the operation time was shorter in LVSS group [WMD=-12.47,95％ CI (-18.33,-6.61),P＜0.0001].No significant difference was found in intra-operative blood loss,incidence of hypocalcaemia,recurrent laryngeal nerve (RLN) injury,or hospitalization time between the 2 groups (P＞0.05).Conclusion LVSS can reduce the operation time without increasing intra-operative blood loss,incidence of hypocalcemia,RLN injury,or hospitalization time,which is a safe and effective haemostasis method.

Liver transplantation and brain death legislation in the mainland area of China / 国际外科学杂志

For patients with poor liver function as a result of the final stage of liver disease,liver transplantation is the best way to prevent them from death.Recently,liver transplantation in China get a rapid development,however,patients who need liver transplantation are much more than livers that can be transplanted,that is a bottleneck problem for liver transplantation,adoption of brain death must be a useful way to deal with this problem.More than a hundred countries have adopted brain death and their liver transplantation developed much better than China.Thus,we should pay more attention to brain death and corresponding legislation to promote the development of liver transplantation.

Research progress of Lauren classification for gastric cancer / 中南大学学报(医学版)

Gastric cancer (GC) is one of the most common malignant tumors with high heterogeneity. According to Lauren classification, GC is divided into intestinal type and diffuse type. With rapid progress in technologies and ideas in the clinical diagnosis for GC, the normalized and individualized comprehensive treatment has become the main trend. However, the clinicopathological characteristics, remedy and prognosis for GC may be different because of the different classifications and stages.

Clinical feature of gallbladder cancer in Northwestern China: a report of 2 379 cases from 17 institutions / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the clinical features of patients with gallbladder cancer from 17 hospitals in 5 Northwestern provinces (autonomous region) of China from 2009 to 2013.</p><p><b>METHODS</b>A total of 2 379 cases with gallbladder cancer in 17 tertiary hospitals from 5 Northwestern provinces of China from January 2009 to December 2013 were reviewed retrospectively. The clinical data was collected by standardized "Questionnaire for Clinical Survey of Gallbladder Cancer in Northwestern Area of China". χ² test was used to analyze the data.</p><p><b>RESULTS</b>(1) Gallbladder cancer from 17 hospitals accounted for 1.6%-6.8% of all bile tract diseases from 2009 to 2013 in Northwestern China, average was 2.7%. Gallbladder cancer accounted for 0.4%-0.9% of abdominal surgery, average was 0.7%. (2) The incidence of gallbladder cancer was higher in the aged females, the ration of female to male was 1.0 to 2.1. The average age of gallbladder cancer was (64 ± 11) years. The occupation of patients was mainly farmers (χ² = 147.10, P < 0.01). (3) 57.2% of the gallbladder cancers were associated with gallstones. (4) The main pathological patterns of gallbladder cancer were moderate and poor differentiated adenocarcinoma, showing an aggressive malignancy. TNM stage IV accounted for 55.1% of all cases, which was associated with the poor prognosis. (5) The curative resection rate was 30.4%.</p><p><b>CONCLUSIONS</b>Gallbladder cancer is common in the aged females and mainly at advanced stage. The screening and follow-up of high-risk groups with ultrasound and other methods regularly could increase the early diagnosis rate of gallbladder cancer, aggressive surgical resection combined with other comprehensive treatment could improve the prognosis of patients.</p>

Meta-analysis of total thyroidectomy for multinodular goiter / 中南大学学报(医学版)

OBJECTIVE@#To systematically evaluate the efficiency and safety of total thyroidetomy (including near-total tyhroidectomy) versus subtotal thyroidectomy for multinodular goiter.@*METHODS@#The literatures were searched from Cochrane Library, PubMed, Embase, Chinese Biological Medical Datebase, Chinese National Knowledge Infrastructure, and Chinese Science and Technology Journal Full-text Database as of November 2013. We included all randomizad controlled trials on total (including near-total) versus subtotal thyroidectomy in the treatment of multinodular goiter. The collecting of data and quality assessment were respectively completed by 2 researchers. RevMan5.1 software was used for Meta-analysis.@*RESULTS@#We collected 7 literatures conforming to the standard, incuding 2 192 patients. The Metaanalysis outcomes showed that total thyroidectomy was associated with lower nodule recurrence rate (OR=0.13, 95% CI: 0.07-0.22, P<0.001) and higher in transient hypoparathyroidism rate (OR=2.33, 95% CI: 1.72-3.17, P<0.001). However, no statistical difference was seen comparing total and subtotal thyroidectomy in permanent recurrent laryngeal nerve paralysis rate (OR= 0.81, 95% CI: 0.24-2.74, P=0.74) and permanent hypoparathyroidism rate (OR=2.94, 95% CI: 0.48- 18.11, P=0.24).@*CONCLUSION@#Nodule recurrence rate of total thyroidectomy for multinodular goiter is lower than subtotal thyroidectomy and does not increase permanent complications.

Laparoscopic cystogastrostomy with posterior approach for pancreatic pseudocyst drainage / 中南大学学报(医学版)

OBJECTIVE@#To determine the clinical value of laparoscopic cystogastrostomy in the treatment of pancreatic pseudocyst.@*METHODS@#Twenty-one patients with pancreatic pseudocyst received total laparoscopic cystogastrostomy. The data on intra-operative bleeding, operative time, post-operative time to get out of bed, time of first flatus/bowel motion, complication and duration of hospital stay were observed and analyzed retrospective1y.@*RESULTS@#Twenty-one patients were successfully carried out the laparoscopic surgery. The average operation time was 90(62-120) min. The blood loss was less than 100 mL in all patients. The average time of hospital stay was 8 d. After 12-18 month follow-up, all patients recovered smoothly without any complication.@*CONCLUSION@#Total laparoscopic cystogastrostomy with the posterior approach is a feasible, safe and minimal invasive procedure for pancreatic pseudocyst, which can be recommended to the clinical application.

Clinical significance of hepatitis B virus S gene mutation for recurrence of hepatitis B after liver transplantation / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To examine the incidence of hepatitis B virus (HBV) S gene mutation in recipients with recurrent HBV infection after liver transplantation (LT) and to evaluate the clinical significance of these mutants.</p><p><b>METHODS</b>Two-hundred-and-ninety-nine patients who received LT for HBV-related liver diseases in single centre were enrolled in the study and followed up. Serum HBV DNA was amplified by fluorescence quantitative polymerase chain reaction, and HBV-S gene mutation was detected by Sanger's enzymatic method.</p><p><b>RESULTS</b>Twelve of the 299 patients developed recurrent HBV after LT, and 2 of these 12 carried a mutant of the HBV-S gene (incidence rate of 16.67%). One of the patients had T126I and G145A mutations, and the other had a M 133L mutation. Cox regression modelling identified the risk factors of HBV recurrence after LT as HBV-YMDD mutants (P =0.01), HBV-S mutants (P =0.03) and compliance decrease (P =0.03).</p><p><b>CONCLUSION</b>HBV-S mutants may contribute to recurrence of HBV after LT, and the mechanism should be addressed in future studies.</p>

Clinical pathology of recurrent hepatitis B after liver transplantation / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the clinical pathology of recurrent hepatitis B after orthotopic liver transplantation (OLT).</p><p><b>METHODS</b>The clinical manifestation and hepatic pathological characteristics of 12 patients with recurrent hepatitis B after OLT were examined in this study by using hematoxylin and eosin staining,immunochemical staining of hepatitis B surface antigen and hepatitis B core antigen,tissue in situ hybridization of hepatitis B virus (HBV) DNA, and Mallory's trichrome staining.The survival rate of these OLT patients was assessed by Kaplan-Meier analysis.</p><p><b>RESULTS</b>The early stage of recurrent HBV infection in patients with OLT was characterized by active HBV replication and mild-to-moderate inflammation in the liver. Three of the 12 patients who were treated with combination therapy group were carriers of YMDD mutants and all three showed improvement in liver function and hepatic histology after receiving adefovir dipivoxil,instead of lamivudine,in the early stage of recurrent hepatitis B after OLT. Among the patients treated with lamivudine monotherapy, four did not achieve improvement at the early stage of recurrent hepatitis B and developed fibrosing cholestatic hepatitis (FCH).</p><p><b>CONCLUSION</b>Recurrent hepatitis B in patients who underwent OLT was characterized by mild-to-moderate viral hepatitis at the early stage and FCH at the later stage. Effective antiviral intervention at the early stage may reverse recurrent hepatitis B and prevent the disease progression to fatal FCH.</p>

Practice and experiences in precision hepatectomy / 中华消化外科杂志

With the wide application of liver transplantation techniques,rapid development of digital imaging medicine and continuous update of surgical implements,the theory of precision hepatectomy still keeps optimizing.Precision hepatectomy is not a surgical implement or surgical technique,but a concept of liver surgery emphasizing less bleeding,minimal invasion,fast recovery and long-term curative effect,which is updating and improving with the development of modern science.Much less intraoperative bleeding,shorter operation time,better postoperative recovery and long-term survival should be the chief pursuit and principle of precision hepatectomy.