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Objective:To investigate the safety of minimally invasive liver resection for resectable hepatocellular carcinoma (HCC) complicated with portal hypertension.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 807 patients with resectable HCC who underwent minimally invasive liver resection in 8 medical centers, including Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine et al, from June 2011 to November 2022 were collected. There were 670 males and 137 females, aged 58(50,66)years. Of the 807 patients, 173 cases with portal hypertension were divided into the portal hypertension group, and 634 cases without portal hypertension were divided into the non-portal hypertension group. Observation indicators: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) intraoperative and post-operative situations; (3) subgroup analysis. Propensity score matching was done by the 1:1 nearest neighbor matching method, with the caliper setting as 0.001. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was constructed using the non-parameter rank sun test. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of the 807 patients, 268 cases were successfully matched, including 134 cases in the portal hypertension group and 134 cases in the non-portal hypertension group. The elimination of the tumor diameter and robot-assisted surgery confounding bias ensured comparability between the two groups after propensity score matching. (2) Intraoperative and postoperative situations. The occlusion time of porta hepatis, cases with intraoperative blood transfusion, cases with postoperative complication, cases with complication >Ⅱ grade of Clavien-Dindo classification, cases of Clavien-Dindo classification as Ⅰ grade, Ⅱ grade, Ⅲ grade, Ⅳ grade, cases with liver related complication were 27.0(15.0,43.0)minutes, 33, 55, 15, 13, 29, 14, 1, 37 in the portal hypertension group, versus 35.0(22.0,60.0)minutes, 17, 25, 5, 14, 9, 4, 1, 13 in the non-portal hypertension group, showing significant differences in the above indicators between the two groups ( Z=-2.15, χ2=6.30, 16.39, 4.38, 20.72, 14.16, P<0.05). (3) Subgroup analysis. Results of subgroups analysis showed that in cases with major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 243.5(174.6,296.3)minutes, 200.0(150.0,600.0)mL, 7.5(6.0,13.0)days in the portal hypertension group, versus 270.0(180.0,314.5)minutes, 200.0 (75.0,450.0)mL, 7.0(5.5,10.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.54, -1.73, -0.92, P>0.05). In cases with non-major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 8.0(5.0,10.0)days in the portal hypertension group, versus 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.5,9.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-1.39, -0.10, 1.05, P>0.05). In cases with anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 210.0(150.0,285.0)minutes, 150.0(50.0,200.0)mL, 8.0(6.0,9.3)days in the portal hypertension group, versus 225.5(146.3,306.8)minutes, 100.0(50.0,250.0)mL, 7.0(6.0,9.0)days in the non-portal hypertension group, showing no significant difference in the above indica-tors between the two groups ( Z=-0.75, -0.26, -0.91, P>0.05). In cases with non-anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 173.5(120.0,231.5)minutes, 175.0(50.0,300.0)mL, 7.0(5.0,11.0)days in the portal hyper-tension group, versus 186.0(123.0,262.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.0,9.5)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.97, -1.12, -0.98, P>0.05). Conclusion:Minimally invasive liver resection or even major liver resection is safe and feasible for screened HCC patients complicated with portal hyper-tension, but attention should be paid to the prevention and treatment of postoperative complications.
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Objective:To analyze the molecular characteristics of hemagglutinin-neuraminidase (HN) gene of human parainfluenza virus type 3 (HPIV3) among the cases with acute respiratory tract infection (ARI) in Henan Province.Methods:Nasal/throat swab samples collected from patients with severe acute respiratory tract infection (SARI) in Luohe and patients with influenza-like illness (ILI) in Zhengzhou were used in this study. HPIV nucleic acids in the samples were detected using real-time fluorescent PCR. HPIV3-positive samples were subjected to RT-PCR for the amplification of HN genes and the sequences were analyzed with Sanger method. CExpress and MEGA7.0 software were used for sequences editing, evolution tree construction and gene sequence analysis.Results:A total of 374 throat swab samples collected form ARI cases in Luohe and Zhengzhou were tested and 20 (5.3%) of them were positive for HPIV3. Eighteen HPIV3 HN gene sequences were successfully amplified and all belonged to C3 subgroups, including 16 sequences of C3f genotype and two sequences of C3a genotype. The 18 HN gene sequences shared the homology of 97.6%-100.0% in nucleotide and 99.3%-100.0% in amino acid, but the differences between them and the prototype strain Wash/47885/57 were significant. There were 12 amino acid mutations shared by them, including four function-related mutations (H295Y, I391V, D556N and I53T). There were no significant differences in the nucleotide or amino acid sequences as compared with the epidemic strain of China/BCH4210A/2014.Conclusions:The C3f and C3a branches of HPIV3 were the epidemic genotypes in Henan Province in recent years and a local circulating prevalence might be established. Continuous and in-depth monitoring of HPIV3 C3 subtype would be of great significance for the prevention and control of HPIV3-associated diseases.
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Objective:To investigate the expression and clinical significance of peptide/histidine transporter solute carrier family 15 member 4 (SLC15A4) in peripheral blood mononuclear cells (PBMCs) of patients with systemic lupus erythematosus (SLE).Methods:Fifty-five patients with SLE were divided into active SLE group and stable SLE group according to SLE disease activity index (SLEDAI) score, and 13 healthy volunteers were used as controls. The expression of SLC15A4 in PBMCs were detected by Western blot method. Moreover, the correlation between the expression of SLC15A4 and clinical and laboratory parameters of SLE patients were analyzed. The expression of SLC15a4 in the three groups was compared based on one-way analysis of variance (ANOVA), and the correlation between SLC15A4 expression level and clinical indicators was analyzed by Pearson correlation.Results:The expression levels of SLC15A4 in active SLE group, stable SLE group and healthy control group were (0.96±0.19), (0.88±0.14), (0.78±0.24), respectively. The expression level of SLC15A4 in SLE with active disease was higher than that in healthy controls ( F=4.47, P=0.015). In addition, the expression of SLC15A4 in PBMCs of SLE patients was positively correlated with the quantity of anti-double stranded DNA (anti-dsDNA) antibody, erythrocyte sedimentation rate (ESR) and systemic lupus erythematosus disease activity index (SLEDAI) ( r=0.29, P=0.031; r=0.36, P=0.007; r=0.32, P=0.017, respectively). However, the expression of SLC15A4 in PBMCs had no significant correlation with 24-h urinary protein ( r=0.45, P=0.127) and C3 ( r=0.20, P=0.133). Conclusion:SLC15A4 is involved in the pathogenesis of SLE and its expression in PBMCs of SLE patients can be used as an index to evaluate disease activity.
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Objective:To analyze the clinical characteristics and prognosis of twin premature infants with necrotizing enterocolitis (NEC).Methods:The clinical data of twin preterm infants with NEC treated in Shengjing Hospital of China Medical University from January 2009 to December 2018 were retrospectively analyzed and compared with singleton preterm infants, thus clarifying clinical characteristics and treatment outcomes of twin preterm infants with NEC.Results:The incidence of NEC in twin premature infants was significantly higher than that in singleton premature infants [8.1% (124 /1 539 cases) vs.3.8% (497/13 198 cases), χ2=62.887, P<0.001]. The number of small twins in natural delivery group was more than that of large twins [(23 cases vs.5 cases), χ2=8.09, P<0.05]. Compared with singleton NEC preterm infants, twin NEC preterm infants had significantly lower birth weight [(1 424±439) g vs.(1 761 ± 596) g, t=-15.07, P<0.001], higher rate of mechanical ventilation after birth [37.1% (46/124 cases) vs.17.9%(89 / 497 cases), χ2=15.539, P<0.001], and higher mortality [13.7%(17/124 cases) vs.7.0%(35/497 cases), χ2=5.401, P<0.05]. Compared with singleton preterm infants with NEC, twin preterm infants with NEC had significantly higher surgical treatment rate [54.8%(68/124 cases) vs.43.9%(218/497 cases), χ2=27.885], younger operation age [(20.6 ± 17.5) d vs.(29.4 ± 24.4) d, t =-5.673], higher degrees of anemia [(118.284 ± 22.429) g/L vs.(127.460±28.352) g/L , t=-3.398], thrombocytopenia [(213.57 ± 150.548)×10 9/L vs.(220.25 ± 169.610)×10 9/L, t =-3.238], metabolic acidosis(7.215 ± 0.211 vs.7.355±0.418, t=-4.207), rate of shock [(52.9%(36/68 cases) vs.36.7%(80/218 cases), χ2= 5.673], and the rate of mechanical ventilation[54.4% (37/68 cases) vs.35.8%(78/218 cases), χ2=7.484](all P<0.05). Extensive intestinal necrosis was the main cause of death in either singleton or twin preterm infants with NEC.After 1 year of follow-up, there was no significant difference in the proportion of growth retardation, the proportion of serious neurodevelopmental problems and mortality between the 2 groups (all P>0.05). Conclusions:Twin preterm infants born with poor physical fitness, and they have a high incidence of NEC with a rapid progression that require the early intervention.The operation rate of twin preterm infants with NEC is high and the postoperative complications are serious.Close observation, reasonable analysis, early prevention and intervention are needed to reduce the incidence and mortality of twin preterm infants with NEC and improve the prognosis.
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Acute myeloid leukaemia (AML) is the most common form of acute leukaemia in adults, with increasing incidence with age and a generally poor prognosis. Almost 20% of AML patients express mutant isocitrate dehydrogenase 2 (mIDH2), which leads to the accumulation of the carcinogenic metabolite 2-hydroxyglutarate (2-HG), resulting in poor prognosis. Thus, global institutions have been working to develop mIDH2 inhibitors. SH1573 is a novel mIDH2 inhibitor that we independently designed and synthesised. We have conducted a comprehensive study on its pharmacodynamics, pharmacokinetics and safety. First, SH1573 exhibited a strong selective inhibition of mIDH2 R140Q protein, which could effectively reduce the production of 2-HG in cell lines, serum and tumors of an animal model. It could also promote the differentiation of mutant AML cell lines and granulocytes in PDX models. Then, it was confirmed that SH1573 possessed characteristics of high bioavailability, good metabolic stability and wide tissue distribution. Finally, toxicological data showed that SH1573 had no effects on the respiratory system, cardiovascular system and nervous system, and was genetically safe. This research successfully promoted the approval of SH1573 for clinical trials (CTR20200247). All experiments demonstrated that, as a potential drug against mIDH2 R140Q acute myeloid leukaemia, SH1573 was effective and safe.
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Objective: To investigate the efficacy and adverse effects of immune checkpoint inhibitor (ICI) for advanced non-small cell lung cancer (NSCLC) resistant to epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI). Methods: The clinical data of 49 patients with advanced NSCLC who received ICI treatment after EGFR-TKI resistance in the Chinese People's Liberation Army General Hospital from January 2015 to March 2019 were collected. Statistical methods were used to analyze the efficacy and adverse effects of immunotherapy in patients with EGFR TKI-resistant NSCLC, and to clarify the relationship between clinical characteristics and the curative efficacy and prognosis of patients. Results: The objective response rate was significantly higher in patients with combination therapy than those with monotherapy (28.6% vs. 7.1%, P60 years had longer progression free survival than those with moderate differentiation (5.1 vs. 2.8 months, P=0.03), monotherapy (6.8 vs. 2.3 months, P60 years and combination therapy were independent protective factors for PFS (P<0.001). Although combination therapy group had higher overall adverse event rate than monotherapy group, there was no significant difference in the adverse reaction rate of grade 3 and above between both groups (P= 0.28). Conclusions:The efficacy of monotherapy with ICI was poor in EGFR TKI-resistant patients with late-stage NSCLC, while combination therapy could significantly improve the curative efficacy and prognosis of patients. Although the overall rate of adverse events
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Lung cancer is the most common malignant tumor with the highest morbidity and mortality worldwide, and its imposes an insupportable burden on patients due to its poor prognosis. The diagnosis and treatment of lung cancer is under great pressure. Therefore, it is urgent to explore effective therapeutic targets and molecular markers. Circular RNA (circRNA) is a kind of covalently closed non-coding RNAs, which has attracted much attention due to its conservation, stability and tissue specificity. Many studies have found that circRNA participates in the regulation of lung cancer through various mechanisms such as sponging miRNA and plays a part vital role in the early diagnosis, treatment and prognosis evaluation. In recent years, there have been numerous studies on circRNA in lung cancer. This paper summarizes the current progress of circRNA in the diagnosis, treatment and prognosis of lung cancer. .
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OBJECTIVE@#To explore the molecular basis for a blood donor with an ABO subtype.@*METHODS@#The proband and his family members were subjected to serological analysis. Their genotypes were determined by real-time PCR and sequencing of the coding regions of ABO gene.@*RESULTS@#The proband was determined as an ABw subtype. By sequencing analysis, the proband was typed as A102/BW03. Compared with ABO*B.01, the proband was found to harbor a 721C>T variant (ABO*BW.03 allele) in exon 7 of the ABO gene, which caused substitution of Arginine at position 241 by Tryptophan resulting in a ABW phenotype. The blood type of the proband's sister was similar to that of the proband. The maternal serological pattern was B type, and the result of sequencing suggested that the genotype fit with B101/Bw03.@*CONCLUSION@#The 721C>T in the exon 7 of the ABO glycosyltransferase gene probably underlies the Bw03 phenotype. The ABO*Bw.03 variant of the proband and his sister were inherited from their mother.
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Female , Humans , Male , ABO Blood-Group System , Genetics , Amino Acid Substitution , Genotype , Pedigree , Exome SequencingABSTRACT
OBJECTIVE: This study aims to evaluate the effects and pregnancy outcomes of gonadotropin-releasing hormone agonist (GnRH agonist) combined with aromatase inhibitor (AI) in preserving the fertility of obese women with grade 1 endometrial cancer (EC). METHODS: This study recruited obese EC patients who wished to preserve their fertility. The treatment regimen consisted of intramuscular GnRH agonist 3.75 mg every 4 weeks and oral AI 2.5 mg daily. The maintenance regimen was the same as the initial treatment regimen. Primary outcomes included response rate, time to complete response (CR), and time to recurrence; pregnancy outcomes included the time to pregnancy, pregnancy rate and live birth rate. RESULTS: Six obese patients with EC were included in this study, with the age (mean±standard deviation [SD]) of 30.5±3.3 years and body mass index (mean±SD) of 35.0±1.4 kg/m2. CR rate was 100%, and time to CR was 3–6 months. None of the patients had recurrence after a median follow-up of 4.0 years (range, 1.3–7.0 years). The most common side effects were menopause-like symptoms. Among these patients, no weight gain was observed during treatment. The pregnancy rate and live birth rate was 50.0% and 75.0%, respectively, with a median time to pregnancy of 2.4 years (range, 1.0–5.5 years). CONCLUSION: The combination of GnRH agonist and AI demonstrated promising long-term effect in young obese EC patients who wished to preserve their fertility. No weight gain side effects were observed. Further studies with a larger sample size are needed to fully evaluate this novel treatment regimen.
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Female , Humans , Pregnancy , Aromatase Inhibitors , Aromatase , Body Mass Index , Endometrial Neoplasms , Fertility , Follow-Up Studies , Gonadotropin-Releasing Hormone , Live Birth , Obesity , Organ Sparing Treatments , Pilot Projects , Pregnancy Outcome , Pregnancy Rate , Recurrence , Sample Size , Time-to-Pregnancy , Weight GainABSTRACT
Objective To study the effect of psoralen isoflavone on the treatment of PC12 cells injured by Aβ and the mechanism on the effect of the psoralen isoflavones on the expression of related proteins. Methods The PC12 cells were divided into blank group, model group, E2 group, and psoralen isoflavones group by random number table method, In addition to the blank group the rest of each group culture medium were added 20μmol/L of Aβ25-35 modeling, The E2 group was added to the 10-3μmol/L oestrogen and psoralen isoflavones group for the intervention of 102-10-6 μmol/L.The proliferation rate of PC12 cells was detected by MTT assay, and the expression of APP, BACE1, ERβ, p-ERK and Aβ protein was detected by Western Blot. Results Compared with the model group, the proliferation of PC12 cells induced by 10-1μmol/L of psoralen isoflavone increased (101％ vs. 52％, P<0.01); The expression of p-ERK (0.751± 0.066 vs. 0.364 ± 0.015), ERβ(0.756 ± 0.105 vs. 0.337 ± 0.045) increased significantly (P<0.01); APP (0.382 ± 0.039 vs. 0.479 ± 0.015), BACE1 (0.517 ± 0.024 vs. 0.622 ± 0.029), Aβ (0.430 ± 0.032 vs. 0.581 ± 0.030) expression amount were significantly lower (P<0.05). Conclusions Psoralen isoflavones have a certain therapeutic effect on PC12 cells injured by Aβ.
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Objective To explore the cause,clinical manifestation,diagnosis,treatment and prognosis of neonatal gastrointestinal perforation (GIP),for the purpose of improving treatment and prognosis.Methods Clinical data of neonates diagnosed as GIP in our hospital were reviewed retrospectively from 2011 to 2015.The etiology,clinical manifestation and prognosis were evaluated,and multiple-variate analysis was employed to discriminate mortality risk factors.Reanlts One hundred and eleven neonates with complete clinical records were identified.Seventy-six were boys and 35 were girls.Caesarean were more common than vaginal delivery.Preterm neonates were more common than term baby (61 vs.50),and low-birth-weight neonates were more common.Mortality for boys and girls were 19.7％ and 31.6％ respectively (P ＜0.05).Abdominal distention was the most symptoms,and perforation caused by NEC (necrotizing enterocolitis) manifested differently from other perforations.Pneumoperitoneum was reported only in 64％ with plain abdominal x-ray.NEC accounted for most of GIP in our study,and other causes were gastric rupture,intestinal atresia,spontaneous intestinal perforation (SIP) and Hirschsprung's disease.GIP caused by NEC had the highest mortality,but the difference was not significant among groups.Heum was the most common site of perforation.Incision infection was the most postoperative complication.73 ％ infants were cured eventually with an overall mortality rate of 27 ％.Conclusion Main mortality risk factors included gender,weight,respiratory complications,ventilation,etc.,while gestational age,respiratory distress at birth,perforation site and multiple perforations seemed have nothing to do with the mortality.Pneumoperitoneum on plain film is still the first choice of diagnosis.Abdominal ultrasound is useful for the diagnosis of GIP.
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Objective To investigate the fetal management of prenatally diagnosed fetal mediastinal masses and the initial experience of neonatal thoracoscopic minimally invasive treatment. Methods We per-formed a retrospective study from November 2015 to November 2016 of all newborns affected by mediastinal masses and treated by thoracoscopic surgery. This group of cases were found with mediastinal masses by pre-natal ultrasound. The earliest detection of abnormal time was 16 to 31 weeks of pregnancy,with an average of 25 weeks. In the fetal period,the patients were treated with multidisciplinary consultation and individual man-agement. Prenatal examinations helped us except for chromosomal abnormalities and other organ abnormali-ties. After birth,the patients underwent CT and MRI examination. The diameter of the tumor was 1. 7 to 5. 7 cm,with an average of 3. 2 cm. The operative age was 4 to 29 days,with an average of 12. 4 days. This group of newborns were performed thoracoscopic mass resection and confirmed by intraoperative pathological exam-ination. Results After individualized precise prenatal management,all children were born successfully and confirmed that prenatal diagnosis was accurate. All mediastinal masses were completely excised in the neo-natal period. Five mediastinal masses were completely excised. One posterior mediastinum immature teratoma was converted to open thoracotomy. The mean operative duration was 112 min(100 to 150 min). There was no operative complication with a minimal amount of blood loss. With a smooth recovery,the hospital stay was 11-17 days. Pathological results included:1 esophageal duplication,2 bronchogenic cysts,1 lymphangioma, 1 cystic teratoma of anterior mediastinum,1 immature teratoma of posterior mediastinum. During a mean fol-low-up period of 8-14 months,neither complication nor recurrence occurred. Conclusion These are the pre-conditions for early treatment of neonatal patients with mediastinal masses,including definite prenatal diagno-sis,multidisciplinary consultation system and individualized and accurate fetal management. Throcoscopic ex-cision of mediastinal masses is both feasible and safe in neonates. Proper preoperative case selection may pre-vent a conversion into thoracotomy due to huge solid mass.
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Objective To evaluate the feasibility and efficacy of laparoscopic liver resection (LLR) in elderly patients with hepatocellular carcinoma (HCC). Methods Twenty-nine elderly patients undergoing laparoscopic liver resection (LLR) and 58 elderly patients receiving open liver resection (OLR) for HCC were included from January 2013 to December 2015 in our department of Fujian Medical University. Two groups were 1:2 matched for gender ,tumor numbers ,and operative procedure.Besides ,general clinical data ,intraoperative data ,postoperative recovery ,and postoperative survival were compared. Results The postoperative hospital stay was shorter in the LLR group [(9.1±3.8)days]thanintheOLRgroup[(11.8±5.1)days](t= -2.66,P<0.05).Theincidence of portal triad clamping was lower in the LLR group than in the OLR group (34.5％ vs.60.3％ ,χ2 =5.18 ,P<0.05). The removal time of abdominal drainage tube was earlier in the LLR group (4.18 ± 1.94)days than in the OLR group (5.4 ± 2.1)days (t= -2.48 ,P<0.05). The overall survival (OS) showed no difference (37.08 months vs.38.72 months ,t=0.72 ,P=0.789). The disease-free survival (DFS) showed no difference (29.00 months vs.27.49 months ,t=0.53 ,P=0.467). Conclusions LLR in elderly patients with HCC can achieve the same long-term outcome as the conventional open hepatectomy ,and LLR has better short-term outcomes with obvious advantages of minimal invasion.
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Objective To investigate the incidence,clinical characteristics,diagnosis and treatment of various congenital duodenal obstruction in neonates.Methods Cases diagnosed with congenital duodenal obstruction admitted to Shengjing Hospital from 2006 to 2015 were collected.Clinical characteristics and prognosis were then analyzed.Results One hundred and seventy-one patients were included(106 males and 65 females),among which 26 were premature and 145 mature.In these patients,55 were diagnosed with duodenal atresia or stenosis,39 annular pancrea,89 midgut malrotation (70 associated with midgut volvulus),and 15 with at least two conditions above.Bile vomiting was the most common clinical manifestation.For 41.52％ of the patients,symptoms occurred within the first 24 hours after birth,and children with duodenal stenosis,duodenal atresia,or annular pancreas were significantly linked with earlier symptoms than patients with intestinal malrotation.Positive diagnosis rate of abdominal plain film,abdominal doppler ultrasonography,and upper gastrointestinal contrast were 73.10％,37.14％,and 100％,respectively,with significant difference (P ＜ 0.01).Compared with those whose first diagnosis were executed postnally,patients whose anomalies were found prenatally were diagnosed and operated significantly earlier(P ＜0.01).Postoperative fasting time and hospitalization time of patients with various malformations were significantly longer than groups with single anomaly.Among the 171 cases,162 were performed operation(9 cases abandoned treatment because of extensive intestinal necrosis),145 cases recovered well 25 quitted,and 1 died,with a cure rate of 94.77 ％.Postoperative short-term complications included incision infection,unwound,intestinal perforation and anastomotic fistula.Conclusion The causes of congenital duodenal obstruction include duodenal atresia or stenosis,annular pancreas and congenital intestinal malrotation,among which congenital intestinal malrotation is most common.A higher incidence was seen in male infants.The onset of symptoms is seen later in intestinal malrotation.The positive diagnosis rate of upper gastric contrast study is highest.The recovery process for patients diagnosed prenatally is not better than patients diagnosed after birth.Patients with multiple malformations need more time to cure.The prognosis is excellent in most cases.
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Objective:To compare the short-and long-term outcomes of laparoscopic liver resection (LLR) with those of open liver re-section (OLR) for hepatocellular carcinoma (HCC). Methods:Clinical data from patients who suffered from HCC and received LLR or OLR from January 2013 to May 2016 in The First Affiliated Hospital of Fujian Medical University were analyzed restrospectively. To over-come selection bias, a 1:1 match was performed via a case-control study. After case-control matching was completed, 105 patients were included in each group. Short-term outcomes of operation and postoperation as well as long-term outcomes, including disease-free survival and overall survival rates, were evaluated. Relevant statistical methods were used for statistical analysis. Results: The postoperative hospital stay of the laparoscopic group was shorter (8.68 ± 2.82 vs. 10.61 ± 2.95 days, P<0.01) and its use of portal triad clamping was less (20.0%vs. 41.0%, P<0.01) than those of the open group. The abdominal drainage tube of the laparoscopic group was also removed at an earlier time than that of the open group (4.45±2.53 vs. 5.40±2.43 days, P<0.01). The 1-, 2-, and 3-year overall survival rates of the laparoscopic group were 96.88%, 87.54%, and 79.50%, respectively. By comparison, the 1-, 2-, and 3-year overall survival rates of the open group were 94.91%, 86.29%, and 76.37%, respectively (P=0.670). The 1-, 2-, and 3-year disease-free survival rates of the laparoscopic group were 72.09%, 60.16%, and 52.08%, respectively, while the 1-, 2-, and 3-year disease-free survival rates of the open group were 69.48%, 56.50%, 48.13%, respectively (P=0.388). Conclusion:LLR is a safe and feasible procedure. LLR in the selected patients with HCC showed similar long-term outcomes to those of OLR. The postoperative hospital stay of these patients who underwent LLR was shorter and their use of portal triad clamping was less than those of the patients who received OLR. The abdomi-nal drainage tube of the former was also removed at an earlier time than that of the latter. Therefore, the short-term outcomes of LLR were better than those of OLR.
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Objective To detect the expression of matrix metalloproteinase (MMP)-7 and MMP-19 in the liver tissue of young rat models with biliary atresia (BA) and to explore their roles in progressive fibrosis.Methods Totally 132 Wistar newborn rats were subjected to common bile duct ligation (BDL) at day 3 after birth to establish animal models of biliary atresia.Sixty-two young rats served as the control group.Liver tissues were collected at days 3,7,14,21,and 28.Immunohistochemistry,Western blotting,and RT-PCR were used to detect the expression of MMP-7 and MMP-19.Results The BA models manifested cholestasis as early as 24 h after BDL.HE and Masson staining revealed progressive hepatic fibrosis.The expression of MMP-7 was observed to increase with time and was significantly higher in the experimental group when compared to control.The expression of MMP-19 was also found to gradually increase with time;however,it was lower than the control group.Conclusion MMP-7 and MMP-19 may be involved in the fibrosis of biliarv atresia.
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Objective To investigate the relationship between cathepsin L and apoptosis cell in rats after cerebral ischemia reperfusion.Methods Sixty healthy male Sprague-Dawley Rats (10-12 weeks old,260-300 g) were chosen.Based on the random number table method,the rats were randomly divided into sham-operated control group (Sham group,n =10),ischemia-reperfusion group (model group,n =25),and Z-FY-DMK intervention group (CLI group,n =25).Rats were randomly divided into 6 h,12 h,24 h,and 48 h four subgroups in model group and CLI group,respectively.Modified transient middle cerebral artery occlusion was made as Longa described,the intervention groups were injected intracerebroventricularly Z-FY-DMK (20 μg / 1μ1 ×5 μl) preoperative 30 min prior to surgery,Sham group and schemia reperfusion injury (IRI) group were injected intracerebroventricularly dimethyl sulfoxide (DMSO) 5 μ1 (10ml/L) at the same time.Cell apoptosis was detected by terminal dexynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) straining.Western blotting was used to detect the expression of cathepsin L and caspase-3.Results In the cortical area of ischemic brain,apoptosis cells of sham operation group were rare,while apoptosis of nerve cells of model group with 6 hours reperfusion were visible,and were gradually increased in the order of 12 hours,24 hours and 48 hours.At the same time point,the apoptosis cells of CL intervention group (6 h,12 h,24 h,48 h) were obviously less than model group (P ＜0.05).Western blotting found little visible cathepsin L protein expression in ischemic cerebral cortex preoptic in the sham group.For model group,the cathepsin L expression initially increased in sub groups with 6 hours reperfusion,reached to a peak in sub groups with 12 hours and 24 hours,and remained a high level in sub groups with 48 hours reperfusion.Compared to model group,the cathepsin L expressions of CL intervention group were obviously decreased at all time points (P ＜ O.05).Conclusions Cathepsin L may be involved in neuronal apoptosis by means of caspases 3 pathway.
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Objective To cvaluate the efficacy and safety of HabibTM VesOpen intravascular radiofrequency catheter percutaneous radiofrequency ablation combined with TACE in the treatment of portal vein tumor thrombus of primary hepatocellular carcinoma.Methods Thirty-nine patients with primary hepatocellular carcinoma complicated with portal vein thrombosis were treated with HabibTM VesOpen intracavitary catheter ablation combined with TACE.The postoperative success rate,complication,blood index,α-fetoprotein (AFP),portal vein patency and tumor thrombus imaging changes were assessed.Results All of 39 patients underwent surgery successfully without occurrence of perforation,infection,hepatapostema,intra-abdominal hemorrhage nor other complications associated with surgery.Blood routine examinations (WBC,RBC,PLT) after 2 weeks and 4 weeks of surgery had no statistical difference compared with those of preoperation.Liver function indexes including ALT,AST,ALB had statistical difference before and after the surgery except for TBIL.AFP had statistical difference before and after surgery.Doppler ultrasonography after 4 weeks showed blood flow in original blocked portal vein.Enhanced CT or MR examinations after 8 weeks on the abdomen,suggested that tumors were shrinked or disappeared.Conclusion Radiofrequency catheter ablation with intracavitary radiofrequency catheter of HabibTM VesOpen is an effective method in the treatment of portal vein tumor thrombus in primary hepatocellular carcinoma.
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Objective To observe liver pathological characteristics of the autoimmune hepatitis (AIH) C57BL/6 mice.Methods We established AIH C57BL/6 mice model with mixed adjuvants of allogenic liver antigens and complete freund's adjuvant by intraperitoneal injection.Then we determined and compared the body weight,alanine aminotransferase (ALT),aspartate aminotransferase (AST) between the normal control group (N group) and AIH model group (M group).And we compared the pathological characteristics of liver,spleen,heart,lung,kidney between two groups.Results We successfully established AIH C57BL/6 mice model.Compared with N group,we found that the average weight increase of mice in M group was decreased,ALT and AST of mice in M group were boosted.In M group,liver of mice presented typical interface of hepatitis,lymphocytic infiltration,even severe hepatitis,and showed spotty necrosis,multi-acinar necrosis.Some showed early sign of liver fibrosis by aprearing fibrous tissue hyperplasia.M group mouse's spleens were enlarged significantly.The spleen had darker color,not neat,and not smooth.Meanwhile,results were analyzed with statistics to confirm whether there was a significant difference between two groups (P＜0.05).About lungs,hearts and kidneys of mice in two groups,the pathological features were not found,and there was no statistic difference (P＞0.05).Conclusions The liver pathological characteristics of AIH C57BL/6 mice are similar to AIH patients.The results provide the pathological basis for the experimental research of autoimmune hepatitis.
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Objective To evaluate the clinical value of continuous monitoring of intracranial pressure in old patients with hypertensive cerebral hemorrhage?Methods The clinical data of 217 cases of old patients with hypertensive cerebral hemorrhage, including 105 patients underwent continuous monitoring of intracranial pressure(monitoring group) and 112 patients without monitoring of intracranial pressure(control group),were retrospectively analyzed?The times and the total dosage of mannitol, the complications and prognosis of two groups were compared?Results The times and the total dosage of mannitol of monitoring group was respectively (42?1±5?4) times and ( 820?1±114?8) g,significantly less than that of control group((59?5±8?2) times, (1187?7±241?5) g;P=0?032,0?011)?The rate of pulmonary infection and stress ulcer showed no significant difference between two groups ( P = 0?608, 0?471 )?The rate of acute renal insufficiency and electrolyte disturbances was significantly lower in the monitoring group than that in the control group ( 11?4%( 12/104 ) vs?29?6%( 33/112 ) , 28?6%( 30/105 ) vs?41?9%( 47/112 );P = 0?004, 0?036 )?The prognosis of the monitoring group was better than that of the control group(72% vs?48%;χ2=13?02,P<0?01)?Conclusion Intracranial pressure monitoring has an important value for the treatment of old patients with hypertensive cerebral hemorrhage.