The clinical significance and underlying correlation of pStat-3 and integrin αvß6 expression in gallbladder cancer.

BACKGROUND: Both phosphorylated signal transducer and activator of transcription 3(pStat-3) and integrin αvß6 can play vital role in the development and progression of cancer. However, little is known about their expression correlation and clinical significance in gallbladder cancer(GBC). OBJECTIVE: The aim of our present study was to investigate the expression of pStat-3 and integrin αvß6, two proteins' correlation and their clinical significance in GBC tissues. RESULTS: The expression of pStat-3 and integrin αvß6 were both significantly associated with T stage, lymph node metastasis status, TNM stage (P=0.008, P=0.000, P=0.000 and P=0.036, P=0.001,P=0.000,respectively). IHC and Western blot showed their expressions in GBC tissues were higher than that in paraneoplastic tissues. Moderate positive correlation existed between the two proteins (r =0.349, P <0.001). The survival analysis by Kaplan-Meier and Cox regression model showed that GBC patients with pStat-3 or integrin αvß6 positive expression had a significantly poorer 2-year survival rate (P = 0.002 and 0.000, the log-rank test, respectively), and either marker could act as unfavorable independent prognostic factors(RR=1.907, P=0.021 and RR=2.046, P=0.038). MATERIALS AND METHODS: The expression levels of pStat-3 and integrin αvß6 were analyzed in GBC cancerous and paraneoplastic tissues of 97 cases via immunohistochemistry(IHC) and further validated by western blot method. Besides, SPSS software was used to observe their clinical significance as well as the two proteins' correlation. CONCLUSION: pStat-3 and integrin αvß6 were indicators of tumor's progression and poor prognosis of patients with GBC. And the further study involving them may provide a helpful therapeutic target in prevention and treatment of GBC patients.

Integrin ß6 can be translationally regulated by eukaryotic initiation factor 4E: Contributing to colonic tumor malignancy.

It is well known that both eukaryotic initiation factor 4E (eIF4E) and integrin αvß6 can contribute to malignant behavior of colon cancer. We have found that integrin αvß6 and eIF4E were co-expressed and positively correlated in colon cancer tissues. Recently, deregulation of the protein synthesis apparatus has begun to gain attention as a major participant in cancer development and progression. However, the regulation of integrin ß6 expression at translational level has never been investigated before. In present study, gene-silencing technique for eIF4E by small interfering RNA (siRNA) was used in all the subsequent experiments, in order to investigate whether eIF4E could translationally regulate expression of integrin ß6 in colon cancer SW480 and HT-29 cell lines. Additionally, the subsequent effects of eIF4E knockdown on cellular malignant behavior were observed. siRNA in SW480 and HT-29 transfectants. Subsequently, protein expression of ß6 was markedly suppressed, while mRNA expression of ß6 showed no significant variation before and after eIF4E RNA interfering. Therefore, it could be seen that eIF4E could upregulate the expression of ß6, without effect on ß6 mRNA expression. More importantly, after treated with eIF4E siRNA, cellular migratory capacity on fibronectin of HT-29 and ß6-transfected SW480 as well as their survival to 5-FU was decreased distinctly. Expression of integrin ß6 could be translationally regulated by eIF4E, which subsequently contributed to tumor malignancy through enhancing cellular migration, survival, anti-apoptosis, and chemoresistance of colon cancer in vitro. Thus, targeting eIF4E in integrin αvß6 expressing tumors can be a potential therapeutic strategy for patients with colon cancer.

Diagnosis and treatment of hepatic hereditary hemorrhagic telangiectasia / 中华消化外科杂志

Objective To summarize the experiences in the diagnosis and treatment of the hepatic hereditary hemorrhagic telangiectasia (HHHT).Methods The clinical data of 15 HHHT patients who were admitted to the Qilu Hospital,People's Hospital of Mengyin,People's Hospital of Liaocheng,Henan Provincial People's Hospital,the Second Hospital of Hebei Medical University,First Affiliated Hospital of Zhejiang University were retrospectively analyzed.The clinical manifestation,features of imaging and laboratory examination were summarized,and the diagnosis,treatment and prognosis of the disease were investigated.Results HHHT patients had nonspecific symptoms in the early stage,and some patients presented with right upper quadrant discomfort,shortness of breath,anemia and liver bruit.The condition of HHHT patients could be worsened by liver cirrhosis or portal hypertension rapidly.The results of color doppler ultrasound and computed tomography showed intrahepatic telangiectasia,arteriovenous fistula and hepatic artery aneurysm in the 15 patients.Digital subtraction angiography was not clear enough for 2 HHHT patients with more than 1 enlarged hepatic arteries,but computed tomographic angiography was feasible.According to the degree and stages of the HHHT,all the 15 patients were divided into asymptomatic HHHT,simple HHHT and complex HHHT.Among the 6 patients who underwent surgical treatment,5 received ligation or banding of the enlarged hepatic arteries with subsequent disappearance of symptoms.Three patients received interventional treatment,and the treatment for 1 patient with complex HHHT was failed,and the patient died 30 months after medical treatment.Six patients were treated by conservative treatment,2 patients of them had no symptoms at the beginning,then they suffered from hepatic dysfunction and ascites at 21 and 35 months,respectively,and 1 of them died 6 months later.Four patients received medical treatment,and the results of color doppler ultrasound and computed tomography showed the pathological changes were aggravated gradually.Conclusions Telangiectasia,intrahepatic arteriovenous fistula and hepatic artery aneurysm are the main imaging characteristics of HHHT,and imaging diagnosis has significant value in the diagnosis of HHHT.HHHT is a progressive disease,early,active and individualized treatment is beneficial to the patients.The outcome of ligation or banding of the hepatic arteries is satisfactory.

Hepatectomy and porta-enterostomy for Bismuth type Ⅳ hilar cholangiocarcinoma / 中华普通外科杂志

Objective To investigate clinical result of hepatectomy and porta-enterostomy in the treatment of Bismuth type Ⅳ hilar cholangiocarcinoma.Methods Nine patients with Bismuth type Ⅳ hilar cholangiocarcinoma underwent accurate hilar resection(portal parecnchyma resection including about Ⅰ cm of the hilar part of the segments 5 and 4b and caudate lobe beyond the tumor),and the biliary drainage was reconstructed by Roux-en-Y portal parecnchyma-jejunum lpop anastomosis.None of the biliary radicals had to be ligated and all of them were drained into thus constructed"biliary pool".Results Hilar resection was successfully performed in all cases,and there was no postoperative mortality.Aspartate transaminase and alanine transaminase and serum bilirubin decreased evidently four weeks later.Three patients presented postoperative complications.One patient developed a transient anastomotic leakage,while one patient developed self-limiting hemobilia,wound infection occurred in one patient.All three patients were treated conservatively and recovered.The mean Karnofsky performance score was 86,with which they could carry on normal activity with minor symptoms of disease.Two patient died after 9 months and 17 months of extensive metastasis and intrahepatic metastasis respectively.The remaining seven patients are alive by a mean followup of 24.9 months after surgery without any signs of recurrence.Conclusions With accurate hilar resection and portal parecnchyma-to-enterostomy,the patients considerably benefit from the preservation of liver parenchyma and patent biliary drainage and radical resection.So the Hew technique prolongs the survival time and enhances the quality of life of the patients.

Feasibility of transvaginal endoscopic cholecystectomy / 中华消化外科杂志

Objective To investigate the feasibility and safety of transvaginal endoscopic cholecystectomy.Methods The clinical data of 88 female patients who underwent cholecystectomy at the Qilu Hospital of Shandong University from May to November, 2009 were retrospectively analysed. Among all the patients, 32 received transvaginal endoscopic cholecystectomy ( NOTES group) and the remaining 56 patients received laparoscopic cholecystectomy (LC). Thirty-two patients who received LC at the same period were selected (LC group)acccording to age, body mass index, type and severity of disease to conduct a matched case-control study. The differences in time span of postoperative pain, anodyne dose, enterokinesia recovery time, operation time, out-ofbed activity time, average hospital stay and hospitalization expenses between the two groups were compared using the paired t test. Results Cholecystectomies were successfully carried out for all the patients. The intraoperative blood loss, operation time, degree of pain, anodyne doses, enterokinesia recovery time, out-of-bed activity time,average hospital stay and hospitalization expenses were (5.7 ± 1.5 ) ml, ( 76 ± 27 ) minutes, 2.2 ± 0.6, ( 10 ±6) mg, (25±5) hours, (9±3) hours, (2.1 ±1.2) days and (1.12±0.34) ×104 yuan in NOTES group, and they were ( 13.9 ± 3.1 ) ml, (38 ± 16) minutes, 6.7 ± 1.5, (28 ± 8) mg, (45 ± 8) hours, (26 ± 6) hours,(4.3 ± 2.1 ) days and ( 1.54 ± 0.18 ) × 104 yuan in the LC group. There were significant differences between the two groups (t = 5.098, - 4.712, 2.417, 3.203, 3.089, 4.136, 4.786, 3.917, P ＜ 0.05 ). Conclusion Transvaginal endoscopic cholecystectomy is safe and feasible, and it is superior to tranditional LC.

A new method of NOTES:experimental study of totally transtracheal endoscopic thyroidectomy on animals / 中国现代普通外科进展

Objective:To investigate the feasibility and safety of a new method of natural orifice transluminal endoscopic surgery(NOTES) -totally transtracheal endoscopic thyroidectomy(TTET) .Methods:Three miniature swines and 6 beagle dogs were underwent TTET.Under general anesthesia,special designed endotracheal tube with 2-channel was used and endoscope and instruments were inserted through the respective channel.Incision of tracheal anterior wall was accomplished and partial or subtotal thyroidectomy was performed.Finally,the defects in the trachea were sutured with ENDO STITCH instrument.Results:Partial thyroidectomy was successfully accomplished on 3 pigs and subtotal thyroidectomy was done on 6 dogs.No serious complications such as anoxia,asphyxia,airway obstruction and death occurred during the operation.Animals were sacrificed 2h after the procedure and incision of trachea was found to be closely sutured.There were no subcutaneous emphysema and haematoma formation.Conclusion:Preliminary experimental results showed the feasibility and safety of TTET.Transtracheal access maintains the integrity of cervical tissues and achieves an optimal cosmetic outcome.TTET may open up a new field of NOTES on thyroid surgery.

Relationsip between PTEN and VEGF Expression and Clinicopathological Characteristics in HCC / 华中科技大学学报（医学）（英德文版）

To investigate the expressions and significance of the tumor suppressor gene phosphatase and tensin homlog deleted on chromosome ten protein (PTEN) and vascular endothelial growth factor (VEGF) in hepatocellular carcinoma (HCC), and to analyze the relationship between their expressions and the tumor's invasion and their pericarcinomatous tissues, the correlation of their expressions with the tumor's clinicopathological characteristics and invasion potential were studied. Our study showed that the expression level of PTEN in HCC was remarkably lower than that in pericarcinomatous liver tissues, while the expressions of both VEGF and MVD were higher than that in pericarcinomatous liver tissues. Correlation analysis revealed that the expression of PTEN was negatively related to the progression of the pathological differentiation and invasion of tumor, whereas the expressions of VEGF and MVD were positively related. Moreover, there was a negative relationship between the expression of PTEN and the expressions of VEGF and MVD, and a positive one between VEGF and MVD. The expressions of PTEN and VEGF may reveal the degree of differentiation and the invasive potential of HCC tissues. The mechanism by which the lack of PTEN expression probably induces abnormal hyperexpression of VEGF may play an important role in the invasion and metastasis of HCC.

Relationsip between PTEN and VEGF expression and clinicopathological characteristics in HCC / 华中科技大学学报（医学）（英德文版）

To investigate the expressions and significance of the tumor suppressor gene phosphatase and tensin homlog deleted on chromosome ten protein (PTEN) and vascular endothelial growth factor (VEGF) in hepatocellular carcinoma (HCC), and to analyze the relationship between their expressions and the tumor's invasion and their pericarcinomatous tissues, the correlation of their expressions with the tumor's clinicopathological characteristics and invasion potential were studied. Our study showed that the expression level of PTEN in HCC was remarkably lower than that in pericarcinomatous liver tissues, while the expressions of both VEGF and MVD were higher than that in pericarcinomatous liver tissues. Correlation analysis revealed that the expression of PTEN was negatively related to the progression of the pathological differentiation and invasion of tumor, whereas the expressions of VEGF and MVD were positively related. Moreover, there was a negative relationship between the expression of PTEN and the expressions of VEGF and MVD, and a positive one between VEGF and MVD. The expressions of PTEN and VEGF may reveal the degree of differentiation and the invasive potential of HCC tissues. The mechanism by which the lack of PTEN expression probably induces abnormal hyperexpression of VEGF may play an important role in the invasion and metastasis of HCC.

Difference in hTERT Gene Expressions between HbsAg-Positive and HbsAg-Negative Hepatocellular Carcinoma / 华中科技大学学报（医学）（英德文版）

Summary: To investigate the difference in expression of hTERT gene between HbsAg-positive human hepatocellular carcinoma (HCC) and HbsAg-negative HCC and to explore the relationship between HBV infection and hTERT gene expression in HCC. The expression of hTERT protein in 30 cases of HbsAg positive HCC and 17 cases of HbsAg negative HCC was detected by immunohistochemistry (SP method), and the expression of hTERT mRNA was analyzed by reverse transcription polymerase chain reaction (RT-PCR). t-test, Chi-squared test and cochran- armitage trend test were used to see whether there was an interrelation between HBsAg and hTERT gene in HCC. The expression of hTERT protein was mostly located in plasm and occasionally in the nucleus of liver cancer cells. The positive rate of hTERT protein and hTERT mRNA in HbsAg positive HCC- 93.33 % (28/30) and 83.33 % (25/30) respectively which were much higher than those in HbsAg negative HCC- 52.94 % (9/17), 47.06 % (8/17) (P<0.01) respectively. HbsAg is related to hTERT gene expression in human hepatocellular carcinoma. The hTERT gene activated by the efficacious ingredient of HBV may play an important role in hepatocellular transformation and carcinogenesis.

Method for calculating the blood concentration of isoflurane with the inspired and expired concentrations during laparoscopic surgery / 中国现代普通外科进展

Objective: To estimate the blood concentration of isoflurane with the inspired andexpired concentrations during laparoscopic surgery. Methods: 2 sections were divided in this experiment: section 1:23 adult patients (ASA I～II)were received abdominal surgeries,of whom,12 patients for non-laparoscopic surgeries and the others for laparoscopic surgeries. Central venous blood samples were collected for gas chromatography determination 20, 40, 60, 80 min after inhalating isoflurane . We could receive two different F value (the fraction of uptake of isoflurane)through the formula. Section 2: 27 patients were recruited for abdominal surgeries, 13 for laparoscopic surgeries and the others for non-laparoscopic surgeries. All of the processes were the same as the former. Then we confirm the results obtained from section1. Results: The F was 0.52 in the laparoscopic surgeries and 0.44 in the nonlaparoscopic surgeries. In the laparoscopic surgeries, the bias (MDPE) was 17% , accuracy (MDAPE)was 22.88% and the wobble was 11.7% .The correlation coefficient (r)was 0.83. In the nonlaparoscopic surgeries, the MDPE was 5.37% , the MDAPE was 16.02% , the wobble was 15.86% .The correlation coefficient was 0.90. Conclusion: The formula could be used in abdominal surgeries to evaluate the concentration of isoflurane according to the clinical standard of MDPE

Effects of neuromuscular block on entropy indices and bispectral index during propofol anesthesia / 中国现代普通外科进展

0.05),only RE increased significantly in 2 minutes after injection(P

Changes of mGluR4 and the effects of its specific agonist L-AP4 in a rodent model of diffuse brain injury.

OBJECTIVE: Excessive release of glutamate from nerve terminals following diffuse brain injury (DBI) is thought to contribute to neuronal calcium overload leading to calcium-mediated cell damage. Metabotropic glutamate receptor subtype 4 (mGluR4) is regarded as one of the neuroprotective receptors in mammalian brains. Therefore, the mGluR4 specific agonists might exert neuroprotective effects after DBI. The focus of this study is to examine the changes of expression of mGluR4 after DBI and the role of its specific agonist L-AP4 in vivo. METHODS: One hundred and sixty-one male SD rats were randomized into two groups. Group A included normal control, sham-operated control and DBI group. DBI was produced by Marmarou's diffuse head injury model. The mRNA expression of mGluR4 was detected by hybridization in situ. Group B included DBI alone, DBI treated with normal saline and DBI treated with L-AP4. All DBI rats were trained in a series of performance tests, following which they were subjected to DBI. At 1 and 12 h, animals were injected intracerebroventricularly with L-AP4 (100 mM, 10 microl) or normal saline, respectively. The rats were tested for motor and cognitive performance at 1, 3, 7, 14 days post-injury and the damaged neurons were detected. RESULTS: There was no significant difference between the normal control group and sham-operated group in the expression of mGluR4 (P>0.05). The animals exposed to DBI showed a significant increased expression of mRNA of mGluR4 compared with that of the sham-operated animals 1 h after injuries (P<0.05). At 6 h, the evolution of neuronal expression of mGluR4 in the trauma alone group was relatively static. Compared with saline-treated control animals, rats treated with L-AP4 showed decreased number of damaged neurons and a better motor and cognitive performance. CONCLUSIONS: The increased expression of mGluR4 is an important process in the pathophysiological of DBI and its specific agonist L-AP4 can provide a remarkable neuroprotection against DBI not only at the histopathological level but also in the motor and cognitive performance.

DIAGNOSIS AND MICROSURGICAL TREATMENT OF TUMORS IN SPINAL CANAL / 解放军医学杂志

Objective To study the effective methods of diagnosis and microsurgical treatment for tumors in spinal canal. Methods The diagnosis, treatment, and prognosis of 192 patients with spinal tumors admitted to our department ( from Jan,1992 to Dec,2002) were retrospectively analyzed. Results All the patients in this group underwent operative treatment. Total removal of tumor was achieved in 162 cases (84.4%), subtotal removal of tumor in 18 cases (9.4%), and removal a large portion of tumor with decompression in 12 cases (6.3%). Postoperatively, 163 patients (84.9%) were cured, the neurological symptoms were apparently improved in 27 patients (14.1% ), and unchanged in 2 patients (1.0%). No operative death occurred. Conclusion Early diagnosis and treatment of spinal tumor are important measures to improve prognosis. Imaging and microsurgery play a key role in the diagnosis and treatment of spinal tumors.

MICRONEUROSURGICAL TREATMENT OF CLOSED SPINAL CORD INJURY / 解放军医学杂志

Objective To discuss the principles of surgical treatment of closed spinal cord injury. Methods The treatment and outcome of a series of 210 patients with closed spinal cord injury admitted to our department from Jan, 1990 to Jan, 2003 were retrospectively analyzed. Results Of the 210 patients, 113 cases (53.8%) were classified as grade A, 49 cases (23.3%) as grade B, 37 cases (17.6%) as grade C, and 11 cases (5.2%) as grade D, respectively, according to Frankel's classification. After treatment and followed-up for 3 months to 10 years, 42 cases (20.0%) were re-classified as grade A, 15 cases (7.1%) as grade B, 45 cases (21.4%) as grade C, 61 cases (29.0%) as grade D, and 47 cases (22.4%) as grade E. Conclusion Surgical treatment for a patient with closed spinal cord injury depends on findings of examination of the nervous system, tomographic examination of the spinal cord, indications for decompression of the spinal cord, stabilization of the spine, early ambulation and rehabilitation. Principles of the treatment of closed spinal cord injury include early treatment, decompression of the spinal cord with operation, reduction and fixation, prevention of complications, and rehabilitation.

Change of mGluR1α and mGluR5 in CA1 region of rat brain after infrasonic damage and the protective effect of MCPG / 细胞与分子免疫学杂志

Aim To explore the change of mGluR1α and mGluR5 expression in brain CA1 region after infrasonic action, and the role of antagonist MCPG in rats. Methods 160 SD rats were divided randomly into infrasonic damage group and MCPG therapy group. The two groups were subdivided into control group and 1-time, 7-time and 14-time groups respectively. Rats were exposed to 8Hz, 130dB infrasound two hours each time. Expression of mGluR1α and mGluR5 were detected by immunohistochemical staining and in situ hybridization methods. The morphological changes of neurons after MCPG therapy were observed under microscopes. Results Comparing with the control group, the number and the A value of mGluR1α and mGluR5 positive cells changed after one infrasonic action(P∨ 0.05); and the expression of mGluR1α and mGluR5 in the 7-time group were most obvious(P∨ 0.01); in the 14-time group, they recovered already to normal level. Morphological study confirmed that MCPG protected neurons from infrasonic damage. Conclusion Change of mGluR1α and mGluR5 activity can mediate exciting neurotoxicity after infrasonic action, and it is one of the major factors relative to neurons injury, MCPG had an protective effect on brain damage caused by infrasound.

The expressions and clincal significance of PTEN and pAkt in hepatocellular carcinoma / 中国医师杂志

Objective To investigate the expressions and clinical significance of the tumor supressor gene phosphatase and tensin homlog deleted on chromosome ten protein(PTEN) and oncogene phosphoserine/threonine protein kinase B(phospho-serine/threonine protein kinase Akt/PKB,pAkt) in hepatocellular carcinoma(HCC).Method The expressions of PTEN and pAkt in 65 cases of HCC and their pericarcinomatous tissues were detected by immunohistochemical staining with S-P method.Results The positive expression rate of PTEN in HCC was significantly lower than that in pericarcinomatous liver tissues,and the positive rate of pAkt was significantly higher than that in pericarcinomatous liver tissues(all P

Role of integrin ?v?6 in proliferation and apoptosis of gastric cancer AGS cells / 中国现代普通外科进展

Objective: To explore the role of integrin ?v?6 in proliferation and apoptosis of gastric cancer AGS cells. Methods: Gastric cancer AGS cells were treated with ?v?6 monoclonal antibody 10D5 or the negative control mouse immunogloblins IgG2a. Cell viability was measured by MTT assay, cell apoptosis was detected by FCM, and caspase-3 activity was examined by Western blot. Results: Compared with the control and IgG2a group, the apoptotic rate and caspase-3 activity of AGS cells treated with 10D5 increased, meanwhile cells survival rate decreased. There were significant differences of the indexes between the 10D5 group and the other two groups (P0.05). Conclusion: Integrin ?v?6 plays an important role in the proliferation and apoptosis of gastric cancer AGS cells.