Application of near-infrared fluorescence imaging in hepatectomy of hepatocellular carcinoma / 临床肝胆病杂志

Multimodality therapy based on surgery is the main treatment method for hepatocellular carcinoma (HCC), and hepatectomy requires the removal of primary tumor and the preservation of normal liver tissue to the maximum extent. However in clinical surgery, it is difficult to accurately identify tumor tissue and its boundary with visual inspection and palpation, which often results in under-resection or over-resection. Near-infrared fluorescence (NIRF) imaging is a real-time noninvasive imaging technique with low costs and high sensitivity, and extensive studies have been conducted to investigate its application in guiding surgical resection of tumors. With the development of fluorescence imaging system and fluorescence probe, intraoperative tumor localization and boundary determination can be realized to make the surgery more accurate. This article reviews the development of various NIRF probes for intraoperative navigation in HCC and discusses current challenges and potential opportunities of these imaging probes.

Therapeutic efficacy of a tuberculosis DNA vaccine encoding heat shock protein 65 of Mycobacterium tuberculosis and the human interleukin 2 fusion gene.

Use of therapeutic DNA vaccines is a promising strategy against tuberculosis (TB), however, their immunogenicity still needs to be improved. In this study, a plasmid DNA vaccine expressing heat shock protein 65 (HSP65) and the human interleukin 2 (IL-2) fusion gene was constructed. Immune responses induced by the vaccine in the mice and protection against Mycobacterium tuberculosis (MTB) were investigated, along with the therapeutic effect of the DNA vaccine on tuberculosis in mice. Administration of the HSP65-IL-2-DNA vaccine enhanced Th1-type cellular responses by producing greater amounts of interferon-gamma (IFN-gamma) and IL-2 with a higher titer of antigen-specific anti-Hsp65 IgG2a. Compared with the Bacille Calmette-Guérin (BCG) vaccine, the DNA vaccine was able to evoke both CD4 and CD8 T-cell responses, with an especially high percentage of CD8 T-cells. The DNA vaccine was also able to induce high antigen-specific cytotoxicity activity against target cells. When the mice were challenged with virulent MTB H37Rv, a dramatic decrease in the numbers of MTB colony forming units in the spleen and lungs was observed in the mice immunized with HSP65-IL-2-DNA (P<0.05). Meanwhile, the bacterial numbers in TB infected mice treated with the DNA vaccine were also significantly reduced. The protective and therapeutic effects of the HSP65-IL-2-DNA vaccine in the spleen and lungs were superior to that of the HSP65-DNA vaccine (P<0.05). These results suggest that the DNA vaccine expression of IL-2 and the HSP65 fusion gene enhances the immunogenicity and protective as well as therapeutic effects of the HSP65-DNA vaccine against TB in mice by improving the Th1-type response.

Approaches selection on palliative operation styles for malignant obstructive jaundice diseases / 肿瘤研究与临床

Objective To explore the selection of palliate operation styles for unresectable malignant obstructive jaundice diseases. Methods The clinical data of 112 cases of unresectable malignant obstructive jaundice diseases in the last 5 years were analyzed retrospectively. Results The rate of operation mortality was 7.1％ and the incidence rate of post-operative cholangitis was 17.3 ％.The survival time in the Roux-en-Y choledochojejunostomy group was (9.4±1.6) months, and there were no significant differences among laparotomy stent internal drainage group[(9.8±12.5)months]and the PTCD stent internal drainage group [(9.0± 3.1)months]. But survival time in the laparotomy bridge internal drainage group [(6.8±1.7)months]was significantly lower (P＜0.05). The survival times in the ERCP stent drainage group [(3.5±2.2)months]and exploratory laparotomy group [(2.8±2.7)months]were even more significantly lower (P＜0.01).Conclusion As a palliative operation for unresectable malignant obstructive jaundice diseases, Roux-en-Y choledochojejunostomy applies to the middle and distal obstruction,laparotomy stent internal drainage applies to hilar obstruction,ERCP stent drainage only applies to distal obstruction,and PTCD stent internal drainage applies to any part obstruction of the bile duct. The Roux-en-Y choledochojejunostomy, laparotomy stent internal drainage, and PTCD stent internal drainage would improve the life time and life quality of these patients.