Laparoscopic Common Bile Duct Exploration Is a Safe and Effective Strategy for Elderly Patients.

PURPOSE: Laparoscopic common bile duct exploration (LCBDE) has been widely used to remove common bile duct (CBD) stones. However, surgery is not considered as the first treatment choice for elderly patients with CBD stones because of the potential risk of postoperative complications. This study aims to evaluate the safety and efficiency of LCBDE for elderly patients. METHODS: From April 2011 to October 2016, 265 consecutive patients underwent LCBDE. We performed a retrospective study and divided these patients into 2 groups. The younger group was younger than 70 years old (n = 179), and the elderly group was 70 years old or older (n = 86). We compared patient demographics, clinical characteristics, intraoperative parameters, postoperative complications, and incidence of recurrent stone between the 2 groups. RESULTS: The elderly patients had higher preoperative morbidity of chronic diseases, such as pulmonary diseases, heart diseases, arterial hypertension, and abdominal operation history ( P < .05). There were no significant differences between the 2 groups in terms of operation time, intraoperative blood loss, conversion rate to open surgery, total cost, overall complications, and incidence of recurrent stone ( P > .05). CONCLUSION: LCBDE can also be carried out as a safe and effective approach to remove CBD stones in elderly patients, although they have higher risk of chronic diseases.

Laparoscopic Exploration Can Salvage Recurrent Common Bile Duct Stone after Cholecystectomy.

Conventionally, patients suffered from recurrent common bile duct (CBD) stone after cholecystectomy are suggested to be treated with endoscopic retrograde cholangiopancreaticography. This study was designed to explore the feasibility of laparoscopic common bile duct exploration (LCBDE) as a salvage procedure for recurrent CBD calculi after cholecystectomy. A retrospective review was conducted of data from 65 patients who underwent LCBDE for recurrent CBD calculi after cholecystectomy from January 2011 to July 2015. LCBDE was successfully carried out in 61 cases, with a successful rate of 93.8 per cent. Three cases required open conversion because of serious abdominal adhesion, and one case for intraoperative bleeding. Postoperative bile leakage occurred in two cases, and bile peritonitis developed in one case; all these three patients with complications were fully cured by conservative treatment. A postoperative retained CBD stone was found in one patient, which was extracted with endoscopic sphincterotomy. Furthermore, it was found that the mean operative time and length of postoperative hospital stay were much shorter in primary closure group (n = 49) than in T-tube drainage group (n = 12), and the hospital expense was also lower in primary closure group. We suggest that LCBDE could be a novel approach as a salvage procedure for the recurrent CBD stone after cholecystectomy, and we prefer to intraoperative primary closure of CBD if possible.

HtrA1 regulates epithelial-mesenchymal transition in hepatocellular carcinoma.

BACKGROUND AND AIMS: Epithelial-mesenchymal transition (EMT) is involved in the development and progression of cancer. HtrA1 had been showed to play a modulatory role in metastasis of hepatocellular carcinoma (HCC). The relationship between HtrA1 and EMT in HCC was investigated in the present study. METHODS: The HtrA1 expression in human HCC tumor tissues and cells was determined by real-time PCR. SiRNA-HtrA1 and pcDNA-HtrA1 were respectively transfected into HepG2 and MHCC97H cells to observe their effects on cell migration and expression of EMT-associated markers Vimentin and E-cadherin. The relationship between HtrA1 and EMT in 60 HCC patients was also investigated. RESULTS: HtrA1 expression of tumor tissues was down-regulated with the increasing of number in lymph nodes metastasis in HCC patients. HtrA1 down-regulation led to the significant increase of cell migration, Vimentin expression and decrease of E-cadherin expression, while HtrA1 overexpression resulted in an opposite function. The HtrA1 expression was positively related to the E-cadherin level (R(2) = 0.5903, P < 0.001) and negatively correlated with Vimentin level (R(2) = 0.6067, P < 0.001) in tumor tissues of HCC, respectively. CONCLUSION: HtrA1 expression was closely related to EMT, which might be a potential mechanism underlying metastasis of HCC.

Thermal infrared emissivity spectrum and its characteristics of crude oil slick covered seawater.

Detecting oil slick covered seawater surface using the thermal infrared remote sensing technology exists the advantages such as: oil spill detection with thermal infrared spectrum can be performed in the nighttime which is superior to visible spectrum, the thermal infrared spectrum is superior to detect the radiation characteristics of both the oil slick and the seawater compared to the mid-wavelength infrared spectrum and which have great potential to detect the oil slick thickness. And the emissivity is the ratio of the radiation of an object at a given temperature in normal range of the temperature (260-320 K) and the blackbody radiation under the same temperature , the emissivity of an object is unrelated to the temperature, but only is dependent with the wavelength and material properties. Using the seawater taken from Bohai Bay and crude oil taken from Gudao oil production plant of Shengli Oilfield in Dongying city of Shandong Province, an experiment was designed to study the characteristics and mechanism of thermal infrared emissivity spectrum of artificial crude oil slick covered seawater surface with its thickness. During the experiment, crude oil was continuously dropped into the seawater to generate artificial oil slick with different thicknesses. By adding each drop of crude oil, we measured the reflectivity of the oil slick in the thermal infrared spectrum with the Fourier transform infrared spectrometer (102F) and then calculated its thermal infrared emissivity. The results show that the thermal infrared emissivity of oil slick changes significantly with its thickness when oil slick is relatively thin (20-120 µm), which provides an effective means for detecting the existence of offshore thin oil slick In the spectrum ranges from 8 to 10 µm and from 13. 2 to 14 µm, there is a steady emissivity difference between the seawater and thin oil slick with thickness of 20 µm. The emissivity of oil slick changes marginally with oil slick thickness and clearly below that of seawater in the spectrum range from 11. 7 to 14 µm, this spectrum range can be practically used to distinguish oil slick from seawater; Around the wavelength of 11.72, 12.2, 12.55, 13.48 and 13.8 µm, the emissivity of oil slick presents clearly increasing or decreasing trends with the increase of its thickness, which are one of the best wavelengths for observing the offshore oil slick and estimating its thickness.

miR-17-5p inhibitor enhances chemosensitivity to gemcitabine via upregulating Bim expression in pancreatic cancer cells.

BACKGROUND: miR-17-5p is reported to be overexpressed in pancreatic cancer, and it plays an important role in carcinogenesis and cancer progression. Gemcitabine is the standard first-line chemotherapeutic agent for pancreatic cancer, however the chemoresistance limits the curative effect. AIMS: In the present study, we investigated whether inhibition of miR-17-5p could enhance chemosensitivity to gemcitabine in pancreatic cancer cells. METHODS: miR-17-5p inhibitor was transfected to pancreatic cancer cell lines Panc-1 and BxPC3, and then cell proliferation, cell apoptosis, caspase-3 activation, and chemosensitivity to gemcitabine were measured in vitro. RESULTS: Our data showed that Panc-1 and BxPC3 cells transfected with miR-17-5p inhibitor showed growth inhibition, spontaneous apoptosis, higher caspase-3 activation, and increased chemosensitivity to gemcitabine. In addition, miR-17-5p inhibitor upregulated Bim protein expression in a dose-dependent manner without changing the Bim mRNA level, and it increased the activity of a luciferase reporter construct containing the Bim-3' untranslated region. CONCLUSIONS: These results prove that miR-17-5p negatively regulates Bim at the posttranscriptional level. We suggest that miR-17-5p inhibitor gene therapy would be a novel approach to chemosensitization for human pancreatic cancer.

siRNA directed against survivin enhances pancreatic cancer cell gemcitabine chemosensitivity.

Survivin is known to be overexpressed in various human malignancies, including pancreatic cancer, and to cause resistance to radiation and chemotherapy, so the regulation of this molecule could be a new strategy for treating pancreatic cancer. In our study, a short interfering RNA (siRNA) plasmid expression vector against survivin was constructed and transfected into human pancreatic cancer cell lines of Panc-1 and BxPC3. The expression of survivin mRNA and protein among the stable transfected cells and the untransfected cells was detected by semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR) and Western blot, respectively. Tumor cell growth in vitro was assessed by trypan blue exclusion. The cell cycle distribution and cell apoptosis were measured by flow cytometry. The cytotoxicity assay was measured by the MTT test. Our results showed that survivin siRNA treatment caused a specific and profound decrease of survivin mRNA and protein that was associated with decreased cell growth, spontaneous apoptosis, and a specific G0/G1 arrest. Furthermore, the suppression of survivin can enhance the chemosensitivity of pancreatic cancer cells to gemcitabine significantly. We suggest that the RNAi against survivin gene strategy would be a potential approach to chemosensitization therapy in human pancreatic cancer.