Progress of ICG fluorescence imaging in pancreatic surgery / 中华肝胆外科杂志

In recent years, with the application and exploration of fluorescence imaging technology in pancreatic surgery, it has brought new changes and new hope for the intraoperative treatment of pancreatic diseases. Intraoperative fluorescence imaging with indocyanine green (ICG) as probe is increasingly applied in identify neoplasms, real-time margin assessment, tissue perfusion, lymph node detection, anastomotic leakage and so on, which provides a new means for intraoperative decision-making. This article reviewed the progress in the application of ICG fluorescence imaging in pancreatic surgery.

Operative strategy and short-term efficacy of recurrent groin hernia / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the appropriate operative strategy in recurrent groin hernia repair.</p><p><b>METHODS</b>Clinical and follow-up data of 82 patients with recurrent groin hernia undergoing operation at Department of Pancreatobiliary Surgery, Xiangya Hospital of Central South University from April 2010 to April 2017 were analyzed retrospectively. The operative approaches included laparoscopic transabdominal preperitoneal (TAPP) hernia repair, Lichtenstein repair and hybrid repair. Surgical method selection was based on the basis of European Hernia Society guidelines, combined with hernia histories, preoperative examination results and intra-operative results: (1) When an anterior approach (Lichtenstein, Bassini or Shouldice surgery) was adopted in the previous operation, TAPP was preferred for the recurrent groin hernia. (2) When the previous operation was an posterior approach [TAPP or total extraperitoneal hernioplasty (TEP)], Lichtenstein method was preferred. Moreover, Lichtenstein surgery with local anesthesia or nerve block was also selected when the patient could not tolerate general anesthesia. (3) When extensive preperitoneal adhesions were found in patients with previous anterior approach repair during laparoscopic exploration, especially in patients who had relapsed after multiple operations or had previous biochemical glues injection, hybrid surgery was preferred.</p><p><b>RESULTS</b>All 82 patients completed operations smoothly. TAPP, Lichtenstein and hybrid operation were applied in 74, 4 and 4 patients, respectively, with median operative time of 70 minutes (40-130 minutes) in TAPP, 60 minutes (40-90 minutes) in Lichtenstein and 120 minutes (70-150 minutes) in hybrid operation, respectively. The median numerical rating scales (NRS) score was 2 (0-6) on postoperative day 1. The incidences of postoperative seroma, pain and urinary retention were 4.9% (4/82), 2.4% (2/82) and 1.2% (1/82) respectively. The median postoperative hospital stay was 2 days (1-6 days). Seventy-two patients were followed-up from 11 to 87 months. The median follow-up period was 27 months. The median inguinal pain questionnaire (IPQ) score was 2 (0-8) month after operation. One recurrent case was reported 1 year after operation. No incision or mesh infection and long-term inguinal chronic pain were observed.</p><p><b>CONCLUSIONS</b>For recurrent patients with previous open anterior approach, TEP and TAPP repair are equivalent surgical techniques, and the choice should be tailored to the surgeon's expertise. For those with previous TAPP or TEP repair, Lichtenstein technique is recommended. For those with adhesions both in anterior transverse fascia and pre-peritoneum, hybrid operation may be the preferable choice according to adhesion conditions.</p>

Effect of ERH gene knockdown on the proliferation and apoptosis of T24 cells in human bladder cancer / 肿瘤研究与临床

Objective To investigate the effect of ERH gene knockdown on the proliferation and apoptosis of human bladder cancer T24 cells. Methods T24 cells infected by lentivirus with interference on ERH gene sequence were cloned to establish stable T24 cells clone in ERH gene suppression. The expression of ERH mRNA gene in bladder cancer was detected by using quantitative real time polymerase chain reaction (qPCR). The effects of ERH knockout on the cell proliferation and apoptosis were examined by using methylthiazolyl tetrazolium (MTT) assay, colony formation assay and flow cytometry. The effect of ERH knockout on the tumorigenic effect of T24 cells in vivo was verified by subcutaneous tumor formation in nude mice. Results After lentiviral transfection, qPCR results showed that the knockdown effect of ERH mRNA in ERH normal group (untreated T24 cells) was better than that in ERH gene knockdown group, and the difference was statistically significant [(1.006±0.126) vs. (0.079±0.007); t=12.72, P=0.0002]. After knocking out ERH gene, MTT assay showed that the proliferation ability of T24 cells in ERH gene knockdown group was weakened compared with ERH normal group, and the difference was statistically significant [A490 value: (0.13±0.00) vs. (0.66±0.01);t=104.61, P<0.0001]. Colony formation assay indicated that the ability of clone in ERH normal group was weakened compared with ERH gene knockdown group [(10.5 ±1.2) vs. (196.4 ±4.0); t= 73.63, P< 0.0001]. Flow cytometry showed that the cell apoptosis rate in ERH gene knockdown group was higher than that in ERH normal group [(11.0 ±0.5) ％ vs. (4.2 ±0.5) ％; t= 16.06, P<0.0001]. Imaging results of subcutaneous tumor formation in nude mice showed that the total fluorescence intensity of the tumor area in ERH gene knockdown group was (4.67 ±0.59) × 1010 μW/cm2, and the corresponding part in ERH normal group was (9.54±4.20) × 1010μW/cm2 (t=3.64, P=0.0051);tumor weight in ERH gene knockdown group was (0.80±0.62) g, and in ERH normal group was (1.79±0.71) g (t=3.33, P=0.0037). Conclusion ERH gene knockout can inhibit the proliferation of human bladder cancer T24 cells, and promote the cell apoptosis.

Radical surgery for adenocarcinoma of body and tail of pancreas: current status and future perspectives / 中华肝胆外科杂志

Radical resection is crucial in the surgical treatment of adenocarcinoma of the body and tail of pancreas.It usually refers to negative resection margin and dissection of regional lymph nodes.In recent reports,the definition of R0 margin has been updated,and radical antegrade modular pancreatosplenectomy (RAMPS),which was first described by Strasberg et al,contributes to achieving negative tangential margins.In some cases,extended radical resections were adopted in an attempt to achieve R0 margin.However,it would increase operation related morbidity and mortality,which should be taken into account before the procedure.Lymph nodes metastasis is an important prognostic factor.Extended lymph nodes dissection does not seem to bring survival benefits,while itg helpful in assessing the tumor stages and patients' prognosis.Laparoscopic distal pancreatectomy (LDP) has been applied in the treatment of ductal adenocarcinoma of the pancreas in reports with small sample sizes.But it remains controversial whether LDP is superior comparing to conventional open methods in regards to oncological outcomes.Curently,surgery is the promising method that may cure adenocarcinoma of the body and tail of pancreas.Highlighting radical resection will bring more survival benefits to patients.

Quality of life following radical gastrectomy in patients with gastric carcinoma / 中国现代普通外科进展

Objective:To compare the quality of life following total gastrectomy(TG) with that folliwng subtotal gastrectomy(SG) in patients with gastric carcinoma.Methods:Sixty-six patients underwent gastrectomy between 2003 and 2005 at the Department of General Surgery of the Qilu Hospital were enrolled into this study.Among them,15 underwent TG,42 accepted distal end subtotal gastrectomy(DSG) and 9 underwent proximal end(PSG) .The EORTC quality of life questionnaire QLQ-STO20 was used in the present retrospective study to assess follow quality of life of thes patients.The food-intake,local symptom and quality of life of the 3 groups were compared.Results:Patients recovered worse in short term after TG compared with PSG,but there was no statistical difference in the near future.But both of them were not as good as DSG.The contraflow was common and serious after PSG.The incidence rate of abdominal distension was high.Conclusion:The indication of TG for carcinoma of the superior part of stomach can be extented properly.Evidence-Based Medicine should be used to screen better reconstruction mode.On the base of radical cure,quality of life should be improved as far as possible.

Serum level of MMP-3 and the expressions of VEGF-C and MMP-3 in gastric cancer / 中国现代普通外科进展

Objective: To investigate the level of MMP-3 in the serum of gastric cancer pa-tients and to examine the expression of VEGF-C in gastric cancer, to evaluate the effects of the two factors on the development process of cancer. Methods: The enzyme linked immunosorben assay (ELISA) method was used to detect the serum levels of MMP-3 in 50 patients with gastric cancer. The immunohistochemical method was utilized to analyze the expressions of VEGF-C and MMP-3 in 50 resected specimens. Results: The preoperative serum level of MMP- 3 (30.96?9.75 ng/mL) was significantly higher than that of postoperative group (16.29 ?5.92 ng/mL) and control group (14.43?4.82 ng/mL) (P

EFFECTS OF LOW SHEAR STRESS ON DEVEIOPMENT AND EXPRESSION OF ?-ACTIN AND c-Myc OF VASCULAR SMOOTH MUSCLE CELLS OF COMMON CAROTID ATHEROSCLEROSIS / 解剖学报

Objective To investigate effects of low shear stress on atherosclerosis,the development of atherosclerosis and expression of ?actin and cMyc proteins were studied in VSMC of common carotid artery under low shear stress. Methods We established the atherosclerotic model of left common carotid artery that presented low shear stress by the operation of ligating the left external carotid artery in rabbits.The histomorphology of the carotid arteries was examined by light microscopy.The expression of ?actin and cMyc was studied by immunohistochemistry. Results The typical atherosclerosis was observed and the atherosclerotic lesion was obviously accelerated under low shear stress.The expression of ?actin was downregulated and the phenotype of VSMC converted from contractile phenotype into synthetic phenotype,and expression of cMyc increased in VSMC of the artery under low shear stress.Conclusion This new model of atherosclerosis under low shear stress was successfully established,which provides a new tool for studying the effects of low shear stress on atherosclerosis.The results show that the atherosclerotic lesion is obviously accelerated and VSMC tends to proliferate in response to low shear stress.

Effect of S100A8/A9 Protein Complex on F-actin Network in Human Cervical Carcinoma Cell Line,CasKi Cells / 中国微创外科杂志

Objective To investigate the effect of S100A8/A9 protein complex on the surface morphology and the F-actin network in human cervical carcinoma cell line,CasKi cells.Methods After being cultured with 20 ?g/ml S100A8/A9 protein complex,the cell skeleton of the CasKi cells were observed under a confocal scanning fluorescence microscope by staining the F-actin network.Atomic force microscopy(AFM) was employed to reveal the change of ultrastructure of the cell surface in vivo.ResultsAfter being cultured with the S100A8/A9 protein complex for 24 hours,the F-actin network disorder was revealed.Most of the F-actins distributed peripherally.The OD value of the F-actin decreased significantly from 92.42?5.16 to 57.67?3.70 after been treated with the S100A8/A9(t=5.268,P=0.000).The AFM showed a withdrawing morphology with reduced pseudopodia and destruction of stress fibers. Conclusion S100A8/A9 protein complex can change the ultrastructure of the surface of CasKi cells and its stress fibers by re-distributing of the F-actin in the cells.

STUDY ON THE ACUPUNCTURE EFFECTS UPON THE OPIOID LIKE PEPTIDE IMMUNOHIS-TOCHEMICAL REACTIVITY IN GUINEA PIGS' CIRCULATING LYMPHOCYTES / 解剖学报

The met-enkephalin (MEK), leu-enkephalin (LEK) and ?-endorphin (?-EP) immunoreactivities were detected in the circulating lymphocytes of 64 guinea pigs by PAP immunohistochemical method under the conditions of electroacupuncture, naloxone or exogenous opioid like peptides (OLP). Subsequently the ?-naphthyl acetate esterase (ANAE)was demonstrated on partial immunostained lymphocyte samples. The results showed that the OLP immunoreactivity with different intensity was found in approximate 96％ of the lymphocytes. There was a positive correlation between the ANAE-focal pattern lymphocytes and MEK-IIRL (intense immunoreactivity lymphocytes)or ?-EP-IIRL; whereas there was no significant correlation between the ANAE-focal pattern lymphocytes and LEK-IIRL. The MEK-IIRL, LEK-IIRL and ?-EP-IIRL were all increased markedly in the guinea pigs which underwent electroacupuncture at "Zusanli" points. There was no significant difference in MEK-IIRL, LEK-IIRL and ?-EP-IIRL, when the acupuncture group, naloxone group and control group were compared with each other. However, the LEK-IIRL, MEK-IIRL and ?-EP-IIRL could be depressed by naloxone, when the lymphocytes were preincubated with 10~(-7)mol/L of MEK, LEK or ?-EP in vitro. Hence, the naloxone group had a significant difference in MEK-IIRL, LEK-IIRL or ?-EP-IIRL when compared with the acupuncture group. A high peak of the lymphocyte MEK-IR among the range of 10~(-10)—10~(-8)mol/L of MEK preincubation in the acupuncture group when compared with the control group. It suggests that electroacupuncture may enhance activity of the unbound MEK receptor.