RESUMO
Sleep deprivation (SD) has a profound impact on the central nervous system, resulting in an array of mood disorders, including depression and anxiety. Despite this, the dynamic alterations in neuronal activity during sleep deprivation have not been extensively investigated. While some researchers propose that sleep deprivation diminishes neuronal activity, thereby leading to depression. Others argue that short-term sleep deprivation enhances neuronal activity and dendritic spine density, potentially yielding antidepressant effects. In this study, a two-photon microscope was utilized to examine the calcium transients of anterior cingulate cortex (ACC) neurons in awake SD mice in vivo at 24-hour intervals. It was observed that SD reduced the frequency and amplitude of Ca2+ transients while increasing the proportions of inactive neurons. Following the cessation of sleep deprivation, neuronal calcium transients demonstrated a gradual recovery. Moreover, whole-cell patch-clamp recordings revealed a significant decrease in the frequency of spontaneous excitatory post-synaptic current (sEPSC) after SD. The investigation also assessed several oxidative stress parameters, finding that sleep deprivation substantially elevated the level of malondialdehyde (MDA), while simultaneously decreasing the expression of Nuclear Factor erythroid 2-Related Factor 2 (Nrf2) and activities of Superoxide dismutase (SOD) in the ACC. Importantly, the administration of gallic acid (GA) notably mitigated the decline of calcium transients in ACC neurons. GA was also shown to alleviate oxidative stress in the brain and improve cognitive impairment caused by sleep deprivation. These findings indicate that the calcium transients of ACC neurons experience a continuous decline during sleep deprivation, a process that is reversible. GA may serve as a potential candidate agent for the prevention and treatment of cognitive impairment induced by sleep deprivation.
RESUMO
Objective:To evaluate A modified Blumgart pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy.Methods:The clinical data of 81 patients undergoing laparoscopic pancreaticoduodenectomy in Zhengzhou University Affiliated Cancer Hospital from Jan 2019 to Jan 2022 were retrospectively analyzed. Among them, 26 patients underwent modified Blumgart anastomosis and 55 underwent conventional Blumgart anastomosis.The data of demographics, liver function, pancreatic texture, operational result and complications were compared between the two groups.Results:The preoperative data (body mass index, preoperative albumin, prealbumin, transaminase, total bilirubin) between two groups were comparable ( P>0.05). There was no significant difference in pancreatic texture, pancreatic duct diameter and intraoperative blood loss between the two groups ( P>0.05). The modified group had shorter total operation time ( P<0.05), shorter pancreaticojejunostomy time ( P<0.05), shorter postoperative hospital stay ( P<0.05). The incidence of total pancreatic fistula and biochemical fistula in the modified group were lower than those in the conventional group ( P<0.05). There was no significant difference in the incidence of B/C grade pancreatic fistula and bile leakage, postoperative bleeding, infection and delayed gastric emptying between the two groups ( P>0.05). Conlusions:The modified Blumgart pancreaticojejunostomy during laparoscopic pancreaticoduodenectomy is safe, easy to do and time saving. While the incidence of postoperative pancreatic fistula with clinical significance and other major complications were similar to traditional Blumgart procedure.
RESUMO
Objective:To investigate the feasibility and safety of laparoscopic liver tumor resection in children.Methods:The clinical data of 6 children undergoing laparoscopic liver tumor resection from June 2018 to March 2020 in the Affiliated Tumor Hospital, Zhengzhou University were retrospectively analyzed.Results:There were 4 males and 2 females among the 6 cases, with the average age of (7±2)years.All the children were admitted to the hospital with a liver occupying examination due to physical discomfort.Preoperative diagnosis: 3 cases of hepatoblastoma, 1 case of primary liver cancer, 1 case of hepatic adenoma and 1 case of hepatic nodular hyperplasia.All the children successfully completed laparoscopic liver tumor resection without conversion to open surgery.Among them, 3 children obtained left hemihepatectomy, 1 child underwent hepatic left lobectomy, 1 child was given VI hepatectomy, and 1 child accepted hepatic caudate lobectomy.The operation time was(90±9)min, and the average intraoperative blood loss was (83±26) mL.All children had no blood transfusion during or after operation.There were no bleeding, bile leakage, infection and liver failure after operation.All children had no gastric tube before surgery and the fluid diet was given on the first day after operation, and the postoperative median hospital stay was 4(3-5) days.The pathology were consis-tent with the preoperative diagnosis, and the resections were all radical operation resections.The follow-up period was from 2 to 23 months, and all the children recovered well and no recurrence was observed.Conclusions:Laparoscopic liver tumor resection in children is safe and feasible, which can minimize trauma, reduce intraoperative bleeding and shorten the hospital stay without increasing the incidence of postoperative complications.Laparoscopic liver tumor resection in children has certain advantages.
RESUMO
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors, and its features of insidious onset, rapid development, and high recurrence bring great challenges to the long-term survival of HCC patients. Molecular-targeted drugs and immune checkpoint inhibitors have become the research hotspots in the treatment of HCC, and a large number of clinical trials have found that combined therapy has achieved a good clinical effect. This article mainly introduces the application of combined therapy with molecular-targeted drugs and immune checkpoint inhibitors and other combined therapies in HCC and points out that combined therapy related to systemic therapy or local therapy has become the latest research hotspot in HCC treatment.
RESUMO
Objective:To compare the clinical outcomes between the new cold-circulation bipolar radiofrequency assisted versus Habib-4X bipolar radiofrequency assisted open hemihepatectomy.Methods:A retrospective study was conducted on 45 patients who underwent bipolar radiofrequency assisted open hemihepatectomy at the Affiliated Tumor Hospital of Zhengzhou University from October 2016 to January 2020. There were 28 males and 17 females, with an average age of 52.2 years. These patients were divided into the experimental group ( n=20) who underwent the new cold-circulation bipolar radiofrequency assisted open liver resection, and the control group ( n=25) who underwent the Habib 4X bipolar radiofrequency assisted open liver resection. The postoperative alanine aminotransferase (ALT), postoperative aspartate aminotransferase (AST), liver coagulative necrosis plane width, speed of liver parenchymal transection, electrode needle carbonization rate, and postoperative complications were compared between groups. Results:In the experimental group, the speed of liver parenchymal transection was (5.0±2.0) cm 2/min, the width of the coagulative necrosis plane was (1.36±0.21) cm, the AST on the first postoperative day was (177.0±79.3) U/L, the ALT on the first postoperative day was (200.2±78.5) U/L, and the electrode needle tip carbonization rate was 20.0% (4/20). These figures were significantly better than the control group with (3.6±1.7) cm 2/min, (1.93±0.16) cm, (233.2±66.6) U/L, (249.2±62.9) U/L, and 56.0% (14/25), respectively (all P<0.05). The postoperative complication rate was 15.0% (3/20) in the experimental group and 24.0% (6/25) in the control group ( P>0.05). Conclusion:Cold-circulation bipolar radiofrequency assisted hemihepatectomy was safe and feasible. It had the advantages of rapid transection of liver parenchyma, a low electrode tip carbonization rate, and a more accurate coagulation range.
RESUMO
Objective:To investigate the application value of a new internal cold circula-tion bipolar radio frequency device in open hepatectomy.Methods:The retrospective cohort study was conducted. The clinical data of 85 patients with hepatocellular carcinoma who underwent open hepatectomy at the Affiliated Tumor Hospital of Zhengzhou University from February 2017 to January 2020 were collected. There were 48 males and 37 females, aged from 32 to 74 years, with a median age of 52 years. Of 85 patients, 45 cases undergoing hepatectomy assisted by the new internal cold circulation bipolar radio frequency device were allocated into new internal cold circulation bipolar radio frequency device group, and 40 cases undergoing hepatectomy assisted by Habib-4X bipolar radio frequency device were allocated into Habib-4X group, respectively. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted by outpatient, inpatient reexamination and telephone interview to detect the postoperative complications and death of patient within postoperative 30 days up to May 2020. Measurement data with normal distribution were represented as Mean± SD, and independent sample t test was used for comparison between groups. Measurement data with skewed distribution were expressed as M(range), and nonparametric Mann-Whitney U test was used for comparison between groups. Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Repeated measurement data were anlyzed by the repeated ANOVA. Results:(1) Intraoperative situations: the time of crosscutting process for liver parenchyma, average area transection speed, coagulation tissue width, cases with needle bleeding rate and electrode needle charring were (55±16)minutes, (4.8±1.2)cm 2/minute, (1.4±0.2)cm, 6, 10 for the new internal cold circulation bipolar radio frequency device group, versus (64±15)minutes, (3.6±1.0)cm 2/minute, (1.8±0.2)cm, 14, 25 for the Habib-4X group, respectively, showing significant differences in the above indicators between the two groups ( t=2.665, 4.973, 9.204, χ2=5.525, 14.184, P<0.05). (2) Postoperative situations: for the new internal cold circulation bipolar radio frequency device group, the total bilirubin (TBil) was (20±12)μmol/L, (25±12)μmol/L, (20±14)μmol/L at postoperative 1, 3, 7 days, the prothrombin time (PT) was (15.4±2.2)seconds, (14.2±2.1)seconds, (12.7±0.8)seconds, the alanine aminotransferase (ALT) was (288±248)IU/L, (132±61)IU/L, (67±32)IU/L, the aspartate aminotransferase (AST) was (279±114)IU/L, (50±22)IU/L, (30±13)IU/L. For the Habib-4X group, the TBil was 1(22±15)μmol/L, (23±10)μmol/L, (19±8)μmol/L at postoperative 1, 3, 7 days, PT was (15.8±2.8)seconds, (14.3±2.0)seconds, (13.6±1.3)seconds, the ALT was (369±269)IU/L, (133±99)IU/L, (54±30)IU/L, the AST was (345±125)IU/L, (60±36)IU/L, (32±11)IU/L. There were significant differences in the time effect of PT, ALT, AST between the two groups ( F=18.364, 23.020, 93.786, P<0.05). There was no significant difference in the time effect, between-group effect, interaction effect of TBil or between-group effect, interaction effect of PT, ALT, AST between the two groups ( F=2.421, 1.424, 0.522, 1.593, 0.312, 0.121, 0.267, 1.027, 0.600, P>0.05). (3) Follow-up: 85 patients were followed up for 4 to 39 months, with a median follow-up time of 16 months. There were 5 patients in the new internal cooling circulation bipolar radiofrequency device group and 8 patients in the Habib-4X group with complications, respectively, showing no significant difference in overall complications between the two groups ( χ2=1.292, P>0.05). The number of deaths in the new internal cooling circulation bipolar radio frequency device group and Habib-4X group was 0 and 1, respectively, showing no significant difference between the two groups ( P>0.05). Conclusion:The new internal cold-circulating bipolar radio frequency device for open hepatectomy is safe and effective, which cuts the liver parenchyma faster, has lower carbonization rate at the tip of electrode needle, and has more accurate coagulation range.
RESUMO
Objective:To study the safety and efficacy of liquid isolation assisted technology in ultrasound-guided percutaneous radiofrequency ablation for hepatocellular carcinoma adjacent to liver surfaces.Methods:A retrospective study was conducted on 246 patients with hepatocellular carcinoma near liver surfaces treated by radiofrequency ablation from November 2016 to November 2019 at the Department of Hepatobiliary and Pancreatic Surgery, Affiliated Tumor Hospital of Zhengzhou University. There were 182 males and 64 females, aged (56.7±9.2) years. The patients were divided into the liquid isolation group with liquid isolation assisted technology for radiofrequency ablation ( n=131) and the conventional treatment group with conventional radiofrequency ablation ( n=115). The complication, one-time complete ablation and progression-free survival rates were compared between the two groups. Results:The incidence of intraoperative complications in the liquid isolation group was 21.4% (28/131), versus 20.9% (24/115) in the conventional treatment group. There was no significant difference between the two groups ( P>0.05). The incidence of postoperative complications in the liquid isolation group was 20.6% (27/131), which was significantly lower than that in the conventional treatment group 33.9% (39/115) ( P<0.05). The incidence of postoperative pain in the liquid isolation group was 6.1% (8/131), which was significantly lower than that in the conventional treatment group 15.7% (18/115) ( P<0.05). For the 131 patients in the liquid isolation group, there were 183 tumors near to liver surfaces. For the 115 patients in the conventional treatment group, there were 142 lesions near to liver surfaces. The one-time complete ablation rate in the liquid isolation group was 94.0% (172/183), which was significantly higher than the 75.4% (107/142) in the conventional treatment group ( P<0.05). The progression-free survival rate in the liquid isolation group was significantly better than that in the conventional treatment group ( P<0.05). Conclusion:The liquid isolation technique increased the one-time complete ablation rate of liver cancer adjacent to liver surfaces, reduced the incidence of postoperative complications and improved prognosis.
RESUMO
Hepatocellular carcinoma (HCC) is mostly treated by surgery combined with interventional therapy, chemotherapy, radiotherapy and local treatment. However, it often relapses after the operation. And the prognosis of advanced patients is poor, and the effective rate of chemotherapy and molecular targeted therapy is low. Recent studies indicated that the occurrence and progress of HCC are closely related to the immune function of the body. Immunotherapy, as a new type of tumor therapy, has drawn much attention. By improving the immunogenicity of tumor cells and the killing sensitivity of effector cells, it stimulates the immune function of the body, prolongs the progression-free survival time and the overall survival time of patients, and becomes an integral part of the comprehensive treatment of liver cancer. This article reviewd the progress in immunotherapy of HCC in the recent years.
RESUMO
Objective@#To investigate the safety, efficacy and the key points of ultrasound-guided percutaneous radiofrequency ablation (RFA) in treatment of caudate lobe liver tumor.@*Methods@#The clinical data of 30 patients with caudate lobe liver tumor (57 lesions, 33 caudate lobe lesions) in the Affiliated Tumor Hospital of Zhengzhou University from January 2017 to December 2018 were retrospectively analyzed. All the patients were treated with ultrasound-guided percutaneous radiofrequency ablation. The puncture approach and single-needle or double-needle radiofrequency ablation were chosen according to the lesion location. The efficacy after treatment was evaluated according to the imaging examination. The deadline of follow-up was January 31, 2019, and the median follow-up time was 10 (1 to 20) months. After ablation, CT/MR was performed to evaluate whether the lesions were completely ablated. The effect of treatment and short-term complication were recorded.@*Results@#Thirty patients were successfully treated with ultrasound-guided percutaneous radiofrequency ablation. Among the 33 caudate lobe lesions, complete ablation rate at one time was 81.8% (27/33); local tumor progression rate after treatment was 12.1% (4/33), and the median time was 2.5 months. The new lesion rate was 26.7% (8/30), and the median time was 3.0 months. Two patients had significant abdominal pain, 1 patient had fever, 1 patient had hypoxemia during the ablation, and total incidence of complication was 13.3% (4/30). There was no bile leakage, gastrointestinal tract injury, uncontrollable bleeding and other serious complications and related deaths.@*Conclusions@#For the caudate lobe liver tumor, ultrasound-guided percutaneous radiofrequency ablation is safe and effective. It is necessary to select the appropriate puncture approach, avoid the intrahepatic duct reasonably and master the key points of ablation.
RESUMO
Objective To investigate the safety, efficacy and the key points of ultrasound-guided percutaneous radiofrequency ablation (RFA) in treatment of caudate lobe liver tumor. Methods The clinical data of 30 patients with caudate lobe liver tumor (57 lesions, 33 caudate lobe lesions) in the Affiliated Tumor Hospital of Zhengzhou University from January 2017 to December 2018 were retrospectively analyzed. All the patients were treated with ultrasound- guided percutaneous radiofrequency ablation. The puncture approach and single-needle or double-needle radiofrequency ablation were chosen according to the lesion location. The efficacy after treatment was evaluated according to the imaging examination. The deadline of follow-up was January 31, 2019, and the median follow-up time was 10 (1 to 20) months. After ablation, CT/MR was performed to evaluate whether the lesions were completely ablated. The effect of treatment and short-term complication were recorded. Results Thirty patients were successfully treated with ultrasound-guided percutaneous radiofrequency ablation. Among the 33 caudate lobe lesions, complete ablation rate at one time was 81.8% (27/33); local tumor progression rate after treatment was 12.1% (4/33), and the median time was 2.5 months. The new lesion rate was 26.7% (8/30), and the median time was 3.0 months. Two patients had significant abdominal pain, 1 patient had fever, 1 patient had hypoxemia during the ablation, and total incidence of complication was 13.3% (4/30). There was no bile leakage, gastrointestinal tract injury, uncontrollable bleeding and other serious complications and related deaths. Conclusions For the caudate lobe liver tumor, ultrasound-guided percutaneous radiofrequency ablation is safe and effective. It is necessary to select the appropriate puncture approach, avoid the intrahepatic duct reasonably and master the key points of ablation.
RESUMO
Objective To study the diagnosis,treatment and prognosis of patients with solid-pseudopapillary tumor of the pancreas (SPTP).Methods The clinical and follow-up data of 68 patients with SPTP treated in the Affiliated Tumor Hospital of Zhengzhou University from January 2008 to March 2017 were retrospectively analyzed.Results There were 6 males and 62 females,with an average age +/-S.D.of (32.0 ± 12.0) years.The mean tumor size was (4.4 ±2.3) cm.The primary symptom was abdominal pain,and a pancreatic mass was subsequently detected.All the patients underwent surgical resection which included pancreaticoduodenectomy,duodenal preserving pancreatic head resection,distal pancreatectomy,middle pancreatectomy,local excision,resection of pancreatic tail plus splenectomy and distal pancreaticosplenectomy.Postoperative histopathological examination confirmed solid pseudopapillary tumor of the pancreas in all these patients.Twenty-one patients (30.9％) developed postoperative complications,which included pancreatic fistula in 12 patients (17.7％),hemorrhage in 2 patients (2.9％),pleural effusion in 2 patients (2.9％),incision infection in 3 patients (4.4％),and gastric emptying disorder in 2 patients (2.9％).There was no in-hospital mortality.The average length of hospital stay was (26.0 ± 10.0) days.Of the 57 patients (83.8％) who were followed-up (mean 38 months,range 3 to 114 months),11 patients developed postoperative indigestion and 2 patients diabetes.No patient developed tumor recurrence,metastasis and death.Conclusions SPTP is a low grade malignant tumor,which is found primarily in young women.The clinical characteristics are non-specific,and preoperative diagnosis is difficult.Excellent prognosis can be achieved with surgical resection which is the preferred treatment for SPTP.
RESUMO
Objective To study the safety and efficacy of artificial ascites-assisted ultrasound guided percutaneous radiofrequency ablation (RFA) of liver tumors adjacent to the gastrointestinal tract.Metbods After ultrasound-guided percutaneous placement of a central venous tube,saline was injected into the abdominal cavity.The presence of fluid between the liver tumor and its adjacent gastrointestinal organs forms a zone of isolation.Radiofrequency ablation (RFA) was then carried out.This is a retrospective study on 32 patients whose lesions were adjacent to the gastrointestinal tract treated from January 2015 to December 2016 with RFA after establishment of artificial ascites.One month after ablation,CT/MR was performed to evaluate whether the lesions were completely ablated.Results All the 39 lesions in the 32 patients were successfully treated with RFA after establishment of artificial ascites.The complete ablation rate was 92.3 ％ (30/32) after one ablation session.One patient developed a high fever after surgery,another patient had nausea and vomiting during surgery,and two more patients complained of right shoulder and back pain.There were no severe complications such as hemorrhage or gastrointestinal perforation.There was no treatment related deaths.Conclusions For liver tumors which were adjacent to the gastrointestinal tract,establishment of artificial ascites significantly improved the visual field under ultrasound,and reduced the chance of collateral gastrointestinal thermal injury.The treatment of ascites-assisted ultrasound guided percutaneous radiofrequency ablation of liver cancer was safe and efficacious.
RESUMO
Objective To evaluate the effect of parecoxib combined with ropivacaine for incision infiltration on agitation during recovery from anesthesia in patients undergoing abdominal hepatectomy. Methods Forty patients of both sexes, aged 35-64 yr, with body mass index of 18-24 kg∕m2 , of Ameri-can Society of Anesthesiologists physical statusⅠ or Ⅱ, undergoing elective partial hepatectomy, were di-vided into parecoxib sodium group ( group P ) and parecoxib sodium plus ropivacaine group ( group RP ) with 20 cases in each group. Parecoxib sodium 40 mg was intravenously injected at 30 min before operation in group P. Parecoxib sodium 40 mg was intravenously injected at 30 min before operation, and incision in-filtration was performed with 0. 5％ ropivacaine 20 ml at the end of surgery in group RP. Patient-controlled intravenous analgesia was performed at the end of surgery in both groups. The development of agitation, re-spiratory depression and nausea and vomiting was recorded within 30 min after operation. Blood samples were collected from the radial artery immediately before induction ( T0 ) , at the end of surgery ( T1 ) and at removal of extubation ( T2 ) for determination of plasma cortisone ( Cor) concentrations ( by radio-immunity method), plasma epinephrine (E) and norepinephrine (NE) concentrations (by enzyme-linked immu-nosorbent assay) and blood glucose ( using a blood gas analyzer) . Results Compared with the baseline at T0 , the plasma concentrations of Cor, Glu, E and NE were significantly increased at T1,2 in two groups ( P>0. 05) . The incidence of agitation and plasma concentrations of Cor, Glu, E and NE were significantly low-er at T1,2 in group RP than in group P ( P<0. 05) . No patients developed nausea and vomiting and respira-tory depression in two groups. Conclusion Parecoxib combined with ropivacaine for incision infiltration can decrease the occurrence of agitation during recovery from anesthesia, which is related to inhibiting stress responses of patients undergoing abdominal hepatectomy.
RESUMO
Objective To evaluate laparoscopic splenectomy through amputation of secondary splenic pedicles.Methods From February 2010 to March 2016 33 patients underwent laparoscopic splenectomy.Patients were followed up by outpatient examination and telephone interview.Follow-up period ended in April 2016.Results All the 33 patients successfully underwent laparoscopic amputation of secondary splenic pedicle splenectomy.The operation time and volume of intraoperative blood loss were (155 ± 42) min and (210 ± 50) ml.Three patients had postoperative complications including two with ascites sand one with small amount splenic fossa bleeding.All the patients were followed up for a median time of 21 months (range,1-65 months).During the follow-up,1 patient died of hepatic encephalopathy and 32 patients were doing well.Conclusion Laparoscopic amputation of secondary splenic pedicle splenectomy is safe and feasible.
RESUMO
Objective To investigate the clinical efficacy of precise liver resection of liver tumors adjacent to the main pipeline.Methods The retrospective and descriptive study was conducted.The clinical data of 22 patients who underwent precise resection of liver tumors adjacent to the main pipeline in the Affiliated Tumor Hospital of Zhengzhou University between December 2014 and June 2016 were collected.According to preoperative precise evaluation and fully intraoperative exposed tumors,different methods of blood flow occlusion were choosed timely,and then precise resection of the liver was evaluated based on tumor location and size,relationship between tumor and blood vessels and the degree of liver cirrhosis.The operation procedures,operation time,time of liver resection,volume of intraoperative blood loss,number of patients with perioperative blood transfusion,postoperative complications,duration of postoperative hospital stay and follow-up were observed.The follow-up was performed by outpatient examination and telephone interview up to September 2016.Tumor recurrence of patients with hepatocellular carcinoma (HCC) was monthly detected by alpha-fetoprotein retest and color Doppler ultrasound of the liver or computed tomography (CT) within 3 months postoperatively.Tumor recurrence of patients with cholangiocarcinoma was monthly detected by tumor marker retests,color Doppler ultrasound of the liver or CT,and then patients without tumor recurrence received reexamination once every 2 months after 3 months.Patients with liver hemangioma were followed up once every 2-3 months and once every 6 months after half a year,and follow-up included the liver function,ultrasound and other imaging examinations to detect the tumor recurrence.Measurement data with normal distribution were represented as-x±s.Results All the 22 patients underwent successful precise resection of liver tumors.Twenty patients received intraoperative ultrasound localization.Blood flow occlusion of 22 patients:Pringle was conducted in 6 patients,treatment of the corresponding hepatic pedicle in 3 patients,selective hepatic blood flow occlusion in 8 patients,total hepatic blood flow occlusion in 2 patients and non-hepatic portal occlusion in 3 patients.Precise resection of the liver of 22 patients:1 patient underwent right trisegrnentectomy,2 underwent left hepatectomy,2 underwent segment Ⅳ a resection of the liver,2 underwent segment Ⅳ resection of the liver,3 underwent segment Ⅴ resection of the liver,3 underwent segment Ⅷ resection of the liver,1 underwent middle lobe resection of the liver and 8 underwent partial resection of the liver.Operation time,time of liver resection,volume of intraoperative blood loss and number of patients with perioperative blood transfusion were (213±39) minutes,(57± 19) minutes,(518± 98) mL and 3,respectively.Of 22 patients,5 with postoperative complications were improved after symptomatic treatment,including 2 with effusion at surgical site,2 with right pleural effusion and 1 with bile leakage.The duration of postoperative hospital stay of 22 patients was (8.9± 1.6)days.Twenty-one patients were followed up for 3-20 months,with a median time of 12 months.Two of 22 patients had recurrence during the follow-up,and no recurrence at surgical site was detected.Conclusion Precise resection of liver tumors adjacent to the first and second hepatic hilum is safe and feasible,with the advantages of less intraoperative bleeding and low incidence of postoperative complications.
RESUMO
Objective To study the expression of Notch3 in pancreatic ductal adenocarcinoma (PDAC) and to find out its relationship with clinical features and overall survival in patients with pancreatic ductal adenocarcinoma.Methods PDAC and adjacent non-cancerous tissues from 80 patients who under went surgery for primary PDAC in the Affiliated Tumor Hospital of Zhengzhou University were collected between 2008 and 2015.The specimens were divided into two subgroups by immunohistochemical staining of Notch3:the low expression group (0-4 points) and the high expression group (5-12 points).Correlations between expression of Notch3 with clinical features and prognosis of patients with PDAC were analyzed.Results A high expression of Notch3 gene was significantly associated with tumor grade,metastasis,venous invasion and TNM staging.Univariate Cox regression analysis showed that metastasis,venous invasion,TNM stage and protein expression of Notch3 were strongly correlated with overall survival of patients.Multivariate analysis showed that metastasis,TNM stage and Notch3 were independent risk factors of overall survival in patients with PDAC.Kaplan-Meier survival curves indicated that a high expression of Notch3 was an important risk factor of poor survival.Conclusions A high expression of Notch3 was significantly associated with progression and poor prognosis of PDCA.Notch3 may serve as a new indicator of PDAC progression and patient survival outcomes.
RESUMO
Sorafenib is the only molecular targeted drug therapy for advanced liver cancer recommended by the European Association for the study of liver diseases (EASL), American Association for the study of liver diseases (AASLD) and the United States Food and Drug Administration (FDA). As a multi kinase inhibitors, sorafenib can inhibit multiple signal transduction pathways of tumor cell proliferation and angiogenesis and obviously prolong the late stage of disease progression time and overall survival in patients with hepatocellular carcinoma (HCC). Criteria for evaluation of the efficacy of sorafenib in the treatment of advanced hepatocellular carcinoma (HCC) is increasingly perfect. The author gives a brief overview of the molecular mechanism, efficacy and safety and efficacy evaluation criteria of sorafenib in the treatment of advanced liver cancer.
RESUMO
Objective To investigate the value of the Habib 4x bipolar radiofrequency device in resection of hepatic cancer complicated with liver cirrhosis.Methods The clinical data of 35 patients who underwent hepatectomy at the Affiliated Tumor Hospital of Zhengzhou University from May 2014 to May 2016 was collected.The preoperative diagnosis was based on the abdominal enhanced CT or MRI.The intra and postoperative indexes were recorded.Patients were followed up regularly.Measurement data with normal distribution and with skewed distribution were presented as (x-)± s or M (range),respectively.Results All the 35 patients successfully underwent hepatectomy.There were no serious postoperative complications.During the follow-up,2 patients had intrahepatic recurrences,none were on the surgical margin.As of the end of follow up,all the 35 patients were alive.Conclusions Habib 4x frequency hematischesis cutter assisted resection of hepatocellular carcinoma complicated with cirrhosis is safe,feasible.
RESUMO
Objective To investigate the clinical effect of laparoscopic radiofrequency ablation of hepatocellular carcinoma in liver cirrhosis patients.Methods The clinical data of 26 patients who underwent laparoscopic radiofrequency ablation were analyzed.Tumor location,size,and number,operation time,radiofrequency ablation time,intraoperative blood loss,postoperative complications and follow-up were recorded.Results Laparoscopic radiofrequency ablation were successfully performed in all patients under guiding color Doppler ultrasound.Mean operative time was (126 ± 32) min,intraopertive blood loss was (5-50) ml,there was no perioperative blood transfusion;there was no major complications such as bile leakage,bleeding,infection and liver failure postoperatively.There were 3 cases of ascites and 1 case of right pleural effusion,all being recovered by conservative therapy.The median hospitalization time was 3(2-7) days.23 patients were followed up for a median of 10(2-17) months,2 cases suffered from recurrence during follow-up with 1 case undergoing repeated ablation therapy.Conclusions Laparoscopic radiofrequency ablation of hepatocellular carcinoma in liver cirrhosis patients is safe and feasible,with the advantages of less damage to liver function,less trauma and low incidence of postoperative complications.
RESUMO
<p><b>OBJECTIVE</b>To identify potential mutation of the PAX6 gene in a family affected with congenital aniridia from northeastern China.</p><p><b>METHODS</b>Two patients were collected from the family and underwent full ophthalmologic examinations. Genomic DNA was extracted from all family numbers and 100 healthy controls. The coding regions and flanking sequence of the PAX6 gene were amplified by PCR amplification and subjected to bidirectional DNA sequencing.</p><p><b>RESULTS</b>A nonsense mutation (c.718 C>T) was identified in exon 9 in both patients but not in other unaffected families or the 100 healthy controls. However, obvious difference was noted in the phenotype between the two patients. One of the patient has presented irregular cornea, which was infrequently reported.</p><p><b>CONCLUSION</b>A c.718C>T transitional mutation has been found to underlie the aniridia, which showed an autosomal dominant inheritance pattern in this northeastern Chinese family.</p>