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Objective:To study the clinical manifestations and prognosis of patients with liver perivascular epithelioid cell tumor (PEComa).Methods:The clinical manifestations, imaging findings, pathological features, treatment and prognosis of 17 patients with liver PEComa managed in Shenzhen People's Hospital from September 2002 to January 2020 were retrospectively analysed.Results:The patient age of onset of liver PEComa was 22 to 54 years (average 34.8 years). There were 13 females and 4 males. 82%(14/17) of patients presented with no significant symptoms. 15/17 had solitary tumors. The diagnostic rate using preoperative B-ultrasound, CT and MRI was low. Postoperative pathological studies showed the tumor cells were mainly epithelioid cells with hyaline or eosinophilic cytoplasm. There were abundant blood vessels in the tumor tissues. Adipose tissues were also seen. Immunohistochemistry showed both HMB45 and Melan-A positivities to arrive at the diagnosis. All patients were treated with surgical resection. There were no recurrence, metastasis, or death on follow-up.Conclusion:Hepatic PEComa occurred more frequently in young women and it had no specific clinical manifestations. Except for a small number of tumors with adipose tissue detected on preoperative imagings, this tumor was difficult to diagnose, or even be suspected on preoperative imagings. Pathological examination combined with immunohistochemistry after surgery established the diagnosis. Surgery resulted in good prognosis.
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Objective To evaluate the efficacy of one stage laparoscopic choledocholithotomy and cholecystectomy vs.ERCP cholecystolithiasis and cholecystectomy (staged) for cholecystolithiasis complicated with choledocholithiasis.Methods From Jan 2015 to Jun 2017,100 consecutive patients underwent randomized one-stage (TCLCBDE + LC) or two-stage (ERCP + subsequent LC) treatment for common bile duct (CBD) stones.Data evaluated were hospital costs,success rate of one-stage versus two-stage management,postoperative morbidity and GIQLI.Results 47 patients underwent ERCP plus LC two-stage treatment while 46 patients underwent one-stage treatment.Overall success rate of primary intervention for CBD stone clearance was 95.7％ and 97.8％ (P =1.0).Postoperative morbidity was 10.6％ vs.6.5％ (P =0.735),and postoperative hospital stay was (16 ± 5) days vs.(11.9 ± 2.9) days (P ＜ 0.01).One-stage laparoscopic transcystic management was the least costly option compared to two-stage management (19 415 ±2 167)yuan vs.(26 767 ±4 387)yuan (P ＜0.01).GIQLI improved faster in one-stage management group.Conclusion Transcystic one-stage management for gall stones with choledocholithiasis results in shorter hospital stay,lower costs and faster recovery than the two-stage management.
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BACKGROUND:Pancreatic stem cels can maintain the islet structurein vitro, reduce necrosis and apoptosis of islet cels,in vitro prolong islet survival, and keep islet activity. OBJECTIVE: To observe the possibility of preserving viability of isletsin vivo by co-transplanting fetal rat pancreatic stem cels and islets so as to improve the outcome of islet transplantation. METHODS:Thirty-five adult rats were randomly divided into five groups, including co-transplantation, islet transplantation alone, pancreatic stem celltransplantation alone, diabetes control and normal control groups. Diabetic models were established in the former four groups by intraperitoneal injection of streptozotocin-citrate buffer. Pancreatic stem cels from the fetal rats at pregnant 16 days or islets from adult Sprague-Dawley rats. RESULTS AND CONCLUSION:In the co-transplantation group, the levels of blood glucose and plasma insulin returned to the normal after 5 days of co-transplantation, and the survival time of islets was (18.2±2.4) days. In the islet transplantation alone group, the level of blood glucose was reduced to normal after 1 week of transplantation, and the survival time of islets was (14.4±2.1) days. Significant different was found between the survival time of islets between this two groups (P < 0.05). However, the level of blood glucose was stil abnormal in the other groups. These findings indicate that the co-transplantation of fetal rat pancreatic stem cels and islets can prolong the survival time of isletsin vivo, protect viability of islets and improve the outcome of islet transplantation.
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Objective Compare the reproductive activity of pancreatic stem cells isolated from diabetic rat with that of normal rat to assess the effect of microenvirement on stem cells'proliferation.Methods Diabetic rat model were prepared by peritoneal injecting 60mg/kg streptozotocin.Pancreata from 10 diabetic rats and 10 normal rats were trimmed and digested into single cells which were then inoculated onto the culture plate respectively.After passaging 3 generation the cells were identified by nestin immunostaining.During culturing the cell growth curve was observed and the cell cycle of the third and seventh generation cultured cells was evaluated by flow cytometry.Results After passaging pancreatic stem cells was purified and identified by nestin immunostaining.The reproductive activity of diabetic rat was much better[ratio of s stage:(20.7?2.7)% vs(14.1?2.5)%,P0.05].Conclusions The stem cells are stimulated to proliferate after islet injure.The reproductive activity of cells can be provoked by the microenvironment.