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Objective To investigate the indications, techniques and results of laparoscopic hepatectomy. Methods The clinical data and follow-up results of 463 patients who received laparoscopic hepatectomy at our institute were retrospectively analyzed. Results From March 1, 2007 to March 31, 2011, 463 cases of laparoscopic hepatectomy were successfully carried out. Of the 463 patients,165 were with primary liver cancer, 29 with metastatic liver cancer, 143 with hepatic hemangioma, 81with hepatolithiasis and 45 with other benign liver diseases (including hepatic angiomyolipoma, hepatocellular adenoma, focal nodular hyperplasia and chronic liver abscess). The surgical approaches included laparoscopic left lateral lobectomy (93 cases), left hepatectomy (71 cases), extended left hepatectomy (4 cases), right hepatectomy (29 cases), right posterior lobectomy (24 cases), hepatectomy of segment Ⅵ (56 cases), extended right hepatectomy (2 cases), central hepatectomy (8 cases) and hepatectomy of segments Ⅶ/Ⅷ, Ⅳa, caudate lobe and the junction of segment Ⅵ and Ⅶ (41 case).Nonanntomic and wedge resection were performed on 121 patients, and combined resection on 14 patients. The mean operation time, blood loss, length of hospital stay and incidence of postoperative complications were (244.71 ± 105. 07) minutes, (460. 26±425.81) ml, (15.51 ±4.36) days and 9.29%, respectively. And no operative death occurred. In the 194 cases with malignant liver lesions,185 cases were followed up for 2 to 50 months. The 1 year and 3 year overall and disease free survival rate were 90. 8% and 87.9% , 84.2% and 73. 7% respectively. Conclusions As a means of minimally invasive surgical approach, laparoscopic hepatectomy can be selectively adopted for the treatment of all kinds of liver diseases which located at different parts of the liver, with the advantages of smaller trauma, quick recovery and cosmetic benefits. The short-term results of laparoscopic hepatectomy is superior to and its long-term results is equal to that of open surgery. Benign liver diseases, small hepatocellular carcinoma and metastatic liver cancer are the good indications for laparoscopic hepatectomy.
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Objective: To investigate the expression of hypoxia inducible factor-1α(HIF-1α) in HepG2 cells cultured under hypoxia for different time periods, and to assess its relationship with vascularization and cell apoptosis. Methods: HepG2 cells were cultured in a medium containing cobalt chloride (125 μmol/L) for different time periods (0, 1, 2, 4, 6, and 8 hours). RT-PCR was used to measure the expression of HIF-1α mRNA, VEGF mRNA, and bcl-2 mRNA, and bax mRNA at the above time points; Western blot was used to determine the expression of Caspase-3 protein and the activity of Caspase 3 enzyme. Results: After 1-2 hour culture under hypoxia, the expression of HIF-1α mRNA, VEGF mRNA, and bcl-2 mRNA began to increase gradually, peaked at 4 h, and then decreased, but were still higher than that before culture. There was no obvious change in the expression of bax mRNA and the ratio of bcl-2 to bax mRNA expression had a similar change with that of bcl-2 mRNA expression. The changes of Caspase-3 protein/mRNA and Caspase-3 enzyme activity were contrary to that of HIF-1α. Conclusion: HIF-1α may inhibit the apoptosis of hepatic cancer cells through regulating the expression of VEGF, bcl-2, bax, and Caspase-3, and the inhibition is related to the severity of hypoxia.
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Objective To evaluate the impact of the recombined plasmid vector with enhanced green fluorescent protein (EGFP) encoding soluble tumor necrosis factor related apoptesis inducing ligand (pIRES-EGFP-sTRAIL) on proliferation and apoptosis of human hepatocellular carcinoma cell line HepG2, and investi-gate the feasibility and efficiency of the transfection of pIRES- EGFP- sTRAIL into HepG2 by ultrasound micro-bubble contrast agent. Methods pIRES-EGFP-sTRAIL was constructed and transfected into HepG2 cells by using different types of mediated methods: microbubble echocontrast agent combining appropriate dose of ultra-sound irradiation, liposome method, microbubble echocontrast agent only or blank medium treatment. Transfec-tion efficiency was evaluated by EGFP-expressed cell count; proliferation-lnhibiting rate and the apoptosis rate of HepG2 cells were determined by MTT method and flow cytometry analysis; changes of cell morphology were examined by microscopy with Hoechst33258 dyeing; expression of caspase-8 and caspase-3 was detected by Western blot. Results Ultrasound microbubbh enhanced pIKES-EGFP-sTRAIL uptake by HepG2 cells, and the transfection efficiency was significantly higher in ultrasound microlmbble group than that in other groups( P<0.05 ) ; pIRES- EGFP- sTBAIL effectively inhibited HepG2 cell proliferation and induced cell apoptosis by triggering caspase cascade. Both the inhibiting rate and apoptosis rate were significantly higher in ultrasound microbubble group than those in other groups(P<0.05). Conclusion pIRES-EGFP-sTRAIL expresses ef-fectively in HepG2 cells, sTRAIL has a potential role on the inhibiting proliferation and inducing apoptosis of HepG2 cells by triggering caspase cascade, and this role can be enhanced by the administration of low-intensity ultrasound and microbubble echecontrast agent.
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Objective:To investigate the expression of hypoxia inducible factor-1?(HIF-1?) in HepG2 cells cultured under hypoxia for different time periods, and to assess its relationship with vascularization and cell apoptosis. Methods: HepG2 cells were cultured in a medium containing cobalt chloride (125 ?mol/L) for different time periods ( 0, 1, 2, 4, 6, and 8 hours ).RT-PCR was used to measure the expression of HIF-1? mRNA,VEGF mRNA,and bcl-2 mRNA, and bax mRNA at the above time points; Western blot was used to determine the expression of Caspase-3 protein and the activity of Caspase-3 enzyme. Results: After 1-2 hour culture under hypoxia, the expression of HIF-1? mRNA,VEGF mRNA,and bcl-2 mRNA began to increase gradually, peaked at 4 h, and then decreased, but were still higher than that before culture. There was no obvious change in the expression of bax mRNA and the ratio of bcl-2 to bax mRNA expression had a similar change with that of bcl-2 mRNA expression. The changes of Caspase-3 protein/mRNA and Caspase-3 enzyme activity were contrary to that of HIF-1?. Conclusion: HIF-1? may inhibit the apoptosis of hepatic cancer cells through regulating the expression of VEGF, bcl-2, bax, and Caspase-3, and the inhibition is related to the severity of hypoxia.
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Objective To improve the treatment effect of primary hepatic cancer (PHC). Methods Analysis of the influential factors on treatment effect of PHC in China, and propose the countermeasure. Results and Conclusions The main factors influencing the treatment effect of PHC in China are the followings: (1) Most patients with PHC of subclinical type failed to be diagnosed and treatment in time. (2) As a wrong idea PHC has been considered an “uncurable disease", so the treatment strategy is nagative. (3) Unsuitable choice of treatment resulted in some PHC unable to be resected. (4) Intraoperative massive bleeding due to unskill-operative techniques, increase the postoperative morbidity and mortality. (5) The manner of treatment is not positive for PHC patients with portal cancer thrombosis, bile duct cancer hteombosis and portal hyperlension. (6) Combined therapy can not be used or unsuitably used. The following things should be done in order to improve the treatment effect of PHC: (1) Strengthening improving the health-protective consciousness of people and regular examinaton of “high risk" population. (2) Renewing the professional knowledge in time to improve the level of diagnosis, treatment and operative techniques of medical personnel. (3) strengthening the basic medical research to make a break through in PHC treatment.