Open surgical treatment of choledochocele: A case report and review of literature.

Choledochocele (also known as type III choledochal cyst according to Todani's classification) is a cystic dilation of the distal segment of the common bile duct protruding into the duodenal lumen. Cases are rare and the etiology remains unclear. It is usually misdiagnosed as peptic ulcer, as in the patient whose case is described here. Multislice spiral computed tomography and magnetic resonance cholangiopancreatography may be comparable to endoscopic retrograde cholangiography for diagnosis of choledochocele. Both endoscopic therapy and open surgical management are safe options, and size of the cyst plays a role in the decision-making for which approach to apply. A 50-year-old woman admitted to our hospital with upper abdominal pain caused by choledochocele with large size was successfully treated by open surgical management. We present the details of her case in this case report and discuss the recent literature on such cases and their therapeutic management.

Berberine Increases Doxorubicin Sensitivity by Suppressing STAT3 in Lung Cancer.

Berberine (BBR), an alkaloid component isolated from Chinese medicinal herb Huang Lian, has aroused broad interests for its antitumor effect in recent years. The signal transducer and activator of transcription 3 (STAT3), plays critical roles in malignant transformation and progression and was found to be constitutively activated in a variety of human cancers. In this study, we show that BBR inhibited cell proliferation, induced apoptosis, and suppressed tumor spheroid formation of lung cancer cell lines. These effects were correlated with BBR-mediated suppression of both phosphorylated and total levels of STAT3 protein. Furthermore, BBR promoted STAT3 degradation by enhancing ubiquitination. Importantly, we demonstrated that BBR was able to inhibit doxorubicin (DOX)-mediated STAT3 activation and sensitize lung cancer cells to the cytotoxic effect of DOX treatment. Given that BBR is widely used in clinic with low toxicity, our results are potentially important for the development of a novel combinatorial therapy with BBR and DOX in the treatment of lung cancer.

Tumor-enhancing activity of Basigin expression in gallbladder carcinoma and its prognostic role.

Basigin (EMMPRIN/CD147) is a multifunctional membrane glycoprotein that is overexpressed in many solid tumors and is involved in tumor invasion and angiogenesis. The main purpose of this study was to investigate the tumor-enhancing activity of Basigin in a gallbladder carcinoma (GC) cell line and in primary GC tissues. A system that blocks Basigin in the human primary GC cell line GBC-SD was developed using RNA interference. GBC-SD cells were transfected with the small interfering RNA that target Basigin, then the proliferative, invasive and migration activities of the cells were assayed in vitro. Additionally, tissue samples from 98 patients with GC and 26 patients with chronic cholecystitis were stained with anti-Basigin antibody for immunohistochemical analysis. Furthermore, the association of Basigin expression with the clinicopathological characteristics and prognosis of the patients was analyzed. siRNA-treated GBC-SD cells exhibited significantly decreased growth ability, invasion and migration capacities compared to control cells in vitro. Moreover, clinicopathological analysis demonstrated that the intensity of Basigin staining in cancerous tissue was significantly associated with the histological type (p=0.02), distant metastasis (p<0.01) and Nevin stage (p<0.01) of GC. A proportional hazards model revealed the survival rate of patients with stronger Basigin expression to be the lowest (p<0.01). These results suggest that Basigin is a prognostic marker and potential therapeutic target for patients with GC.

[Expression and clinical significance of highly expressed protein in cancer (Hec 1) in human primary gallbladder carcinoma].

AIM: To investigate the relationship between the expression of highly expressed protein in cancer (Hec 1) and infiltration, metastasis and prognosis of human primary gallbladder carcinoma (PGC). METHODS: The expression of Hec 1 in was detected 108 patients with PGC by SABC immunohistochemistry with 15 cases of chronic cholecystitis as control. Then, a 5 year follow-up was carnedout in 96 out of 108 patients to analyze the correlation between Hec 1 and prognosis of the patients. RESULTS: The clinical pathological characteristics of PGC and clinical outcome of the patients were associated with the expression of Hec 1. Hec 1 was highhy expressed in cancer tissues with lymph node metastasis and poor differentiation. Especially, a statistical correlation was found with more advanced Nevin stages of PGC (P < 0.05). Moreover, the 5-year survival rate of the patients with PGC whose expression of Hec 1 was positive was significantly lower than that of the patients without Hec 1 expression (P < 0.01). CONCLUSION: Hec 1 may be associated with the development, infiltration and metastasis of PGC. The combination of Hec 1 expression in cancer tissues with clinical staging may faliliate the auurate predication of patients' prognosis.

[Surgical treatment of 2465 primary hepatolithiasis cases].

OBJECTIVE: To summarize the experience of surgical treatment of primary hepatolithiasis. METHODS: To analyze the clinical data, operation choice, postoperative complications of 2465 cases of primary hepatolithiasis retrospectively. RESULTS: Of the patients, 2034 received external drainage (82.5%) and 431 received internal drainage (17.5%) and 586 were performed adjunctive partial hepatectomy (23.8%). The postoperative complications were found in 211 cases (8.6%) and 17 cases (0.7%) died after the operation. One thousand seven hundred and sixty-seven cases (71.7%) have been followed up for 2 to 25 years, among them therapeutic effect of 1518 cases (85.9%) was excellent or good, 315 cases (17.8%) had residual stone and 115 cases (6.5%) recurred. CONCLUSIONS: It could decrease the incidence rate of complications, residual stone and recurrence in the patients with hepatolithiasis after surgical therapy to pinpoint the situs of the lithiasis and biliary stricture and managed properly before the surgery.