AIM: To summarize the experience of diagnosis and treatment of congenital choledochal cyst in the past 20 years (1980-2000). METHODS: The clinical data of 108 patients admitted from 1980 to 2000 were analyzed retrospe...AIM: To summarize the experience of diagnosis and treatment of congenital choledochal cyst in the past 20 years (1980-2000). METHODS: The clinical data of 108 patients admitted from 1980 to 2000 were analyzed retrospectively. RESULTS: Abdominal pain,jaundice and abdominal mass were presented in most child cases. Clinical symptoms in adult cases were non-specific, resulting in delayed diagnosis frequently. Fifty-seven patients (52.7%) had coexistent pancreatiobiliary disease. Carcinoma of the biliary duct occurred in 18 patients (16.6%).Ultrasonic examination was undertaken in 94 cases, ERCP performed in 46 cases and CT in 71 cases. All of the cases were correctly diagnosed before operation. Abnormal pancreatobiliary duct junction was found in 39 patients. Before 1985 the diagnosis and classification of congenital choledochal cyst were established by ultrasonography preoperatively and confirmed during operation, the main procedures were internal drainage by cyst enterostomy. After 1985, the diagnosis was established by ERCP and CT, and cystectomy with Roux-en-Y hepaticojejunostomy was the conventional procedures.In 1994, we reported a new and simplified operative procedure in order to reduce the risk of choledochal cyst malignancy. Postoperative complication was mainly retrograde infection of biliary tract, which could be controlled by the administration of antibiotics, there was no perioperative mortality. CONCLUSION: The concept in diagnosis and treatment of congenital choledochal cyst has obviously been changed greatly.CT and ERCP were of great help in the classification of the disease.Currently, cystectomy with Roux-en-Y hepaticojejunostomy is strongly recommended as the choice for patients with type I and type IV cysts. Piggyback orthotopic liver transplantation is indicated in type V cysts (Caroli's disease) with frequently recurrent cholangitis.展开更多
AIM:To assess the patency of pancreaticoenterostomy and pancreatic exocrine function after three surgical methods. METHODS: A pig model of pancreatic ductal dilation was made by ligating the main pancreatic duct. Afte...AIM:To assess the patency of pancreaticoenterostomy and pancreatic exocrine function after three surgical methods. METHODS: A pig model of pancreatic ductal dilation was made by ligating the main pancreatic duct. After 4 wk ligation, a total of 36 piglets were divided randomly into four groups. The piglets in the control group underwent laparotomy only; the others were treated by three anastomoses: (1) end-to-end pancreaticojejunostomy invagination (EEPJ); (2) end-to-side duct-to- mucosa sutured anastomosis (ESPJ); or (3) binding pancreaticojejunostomy (BPJ). Anastomotic patency was assessed after 8 wk by body weight gain, intrapancreatic ductal pressure, pancreatic exocrine function secretin test, pancreatography, and macroscopic and histologic features of the anastomotic site. RESULTS: The EEPJ group had significantly slower weight gain than the ESPJ and BPJ groups on postoperative weeks 6 and 8 (P < 0.05). The animals in both the ESPJ and BPJ groups had a similar body weight gain.Intrapancreatic ductal pressure was similar in ESPJ and BPJ. However, pressure in EEPJ was significantly higher than that in ESPJ and BPJ (P < 0.05). All three functional parameters, the secretory volume, the flow rate of pancreatic juice, and bicarbonate concentration, were significantly higher in ESPJ and BPJ as compared to EEPJ (P < 0.05). However, the three parameters were similar in ESPJ and BPJ. Pancreatography performed after EEPJ revealed dilation and meandering of the main pancreatic duct, and the anastomotic site exhibited a variable degree of occlusion, and even blockage. Pancreatography of ESPJ and BPJ, however, showed normal ductal patency. Histopathology showed that the intestinal mucosa had fused with that of the pancreatic duct, with a gradual and continuous change from one to the other. For EEPJ, the portion of the pancreatic stump protruding into the jejunal lumen was largely replaced by cicatricial fibrous tissue. CONCLUSION: A mucosa-to-mucosa pancreatico- jejunostomy is the best choice for anastomotic patency when展开更多
BACKGROUND:Nerve invasion is a specific type of tumor expansion and characteristic manifestation of pancreatic cancer(PC),with an incidence rate ranging from 50% to 100%.It is an important prognostic factor for pancre...BACKGROUND:Nerve invasion is a specific type of tumor expansion and characteristic manifestation of pancreatic cancer(PC),with an incidence rate ranging from 50% to 100%.It is an important prognostic factor for pancreatic cancer,and its early detection is helpful in the management of the disease.This study was undertaken to analyze retrospectively the relationship between neural invasion and multiple clinicopathological features and to provide evidences for clinicians in the management of neural invasion in patients with PC.METHODS:Formalin-fixed paraffin-embeded specimens of PC taken from 215 patients were examined for the presence of neural invasion under a light microscope.Analyzed was the relationship between neural invasion and multiple clinicopathological feature including preoperative fasting blood glucose level,amylase level,serum CA19-9 level,abdominal pain,lumbar and back pain,and the expressions of p53 and Ki67 in tumor tissues.RESULTS:Preoperative fasting blood glucose level,serum CA19-9 level and p53 positive cells in cancer tissue were increased with the rise of pathological grade(P【0.05).These indices were significantly higher in patients with neural invasion than in those without(P【0.05).Further analysis revealed a positive correlation between p53 and Ki67 overexpression and lymphatic metastasis(P【0.05).Referred pain was positively correlated with neural invasion(P【0.05).Patients with PC perineural invasion were more likely to have a higher pathological grade(P【0.05).CONCLUSIONS:Our data indicated that the preoperative fasting blood glucose level,serum CA19-9 level,and referred pain are novel predictive markers for neural invasion in patients with PC.p53 and Ki67 play important roles in neural invasion of PC.Management of hyperglycemia may serve as an auxiliary treatment to curb neural invasion in PC.展开更多
AIM: To summarize systematically our ten-year experiencein non-surgical treatment of postoperative bile leakage, andexplore its methods and indications.METHODS: The clinical data of 57 patients with postoperativebile ...AIM: To summarize systematically our ten-year experiencein non-surgical treatment of postoperative bile leakage, andexplore its methods and indications.METHODS: The clinical data of 57 patients with postoperativebile leakage treated non-surgically from January 1991 toDecember 2000 were reviewed retrospectively.RESULTS: The site of the leakage was mainly the disruptedor damaged fistulous tracts oft tube in 25 patients (43.9 %),the fossae of gallbladder in 14 cases (24.6 %), the cut surfaceof liver in 7 cases(12.3 %), and it was undetectable in theother 2 cases. Besides bile leakage, the wrong ligation of bileducts was found in 3 patients, residual stones of the distal bileduct in 5 patients, benign papillary strictures in 3, and bilomaresulting from bile collections in 2. The diagnoses were madeaccording to the history of surgery, clinical situation, abdominalparacentesis, ultrasonography, ERCP, PTC, MRI/MRCP,gastroscopy and percutaneous fistulography. All 57 patientswere treated non-surgically at the beginning of bile leakage.The non-surgical methods included keeping original drainageunobstructed, percutaneous abdominal paracentesis ordrainage, percutaneous transhepatic cholangial/biliary drainage(PTCD/PTBD),endoscopic management, traditional Chinesemedicine and so on. Of the 57 patients,2 patients died,5 wereconverted to reoperation later, the other 50 were directly curedby non-surgical methods without any complication. The curerate of the non-surgery was 82.5 % (50/57).CONCLUSION: Many nonoperative methods are availableto treat postoperative bile leakage. Non-surgical treatmentmay serve as the first choice for the treatment of bile leakagefor its advantages in higher cure rate, convenience and safetyin practice. It is important to choose the specific non-surgicalmethod according to the volume, site of bile leakage andpatient′s condition.展开更多
AIM: To investigate whether hypoxia inducible factor-1α (HIF-1α) is linked to the protective effects of ischemic preconditioning (IP) on sinusoidal endothelial cells against ischemia/reperfusion injury. METHODS: Sin...AIM: To investigate whether hypoxia inducible factor-1α (HIF-1α) is linked to the protective effects of ischemic preconditioning (IP) on sinusoidal endothelial cells against ischemia/reperfusion injury. METHODS: Sinusoidal endothelial cell lines ECV-304 were cultured and divided into four groups: control group, cells were cultured in complete DMEM medium; cold anoxia/warm reoxygenation (A/R) group, cells were preserved in a 4℃ UW solution in a mixture of 95% N2 and 5% CO2 for 24 h; anoxia-preconditioning (APC) group, cells were treated with 4 cycles of short anoxia and reoxygenation before prolonged anoxia- preconditioning treatment; and anoxia-preconditioning and hypoxia inducible factor-1α (HIF-1α) inhibitor (I-HIF-1) group, cells were pretreated with 5 μm of HIF-1α inhibitor NS398 in DMEM medium before subjected to the same treatment as group APC. After the anoxia treatment, each group was reoxygenated in a mixture of 95% air and 5% CO2 incubator for 6 h. Cytoprotections were evaluated by cell viabilities from Trypan blue, lactate dehydrogenase (LDH) release rates, and intracellular cell adhesion molecule-1 (ICAM-1) expressions. Expressions of HIF-1α mRNA and HIF-1α protein from each group were determined by the RT-PCR method and Western blotting, respectively. RESULTS: Ischemia preconditioning increased cell viability, and reduced LDH release and ICAM-1 expressions. Ischemia preconditioning also upregulated the HIF-1α mRNA level and HIF-1α protein expression. However, all of these changes were reversed by HIF-1α inhibitor NS398.CONCLUSION: Ischemia preconditioning effectively inhibited cold hypoxia/warm reoxygenation injury to endothelial cells, and the authors showed for the first time HIF-1α is causally linked to the protective effects of ischemic preconditioning on endothelial cells.展开更多
Eukaryotic initiation factor subunit c(eIF3c) has been identified as an oncogene that is over-expressed in tumor cells and,therefore,is a potential therapeutic target for gene-based cancer treatment.This study was foc...Eukaryotic initiation factor subunit c(eIF3c) has been identified as an oncogene that is over-expressed in tumor cells and,therefore,is a potential therapeutic target for gene-based cancer treatment.This study was focused on investigating the effect of small interfering RNA(siRNA)-mediated eIF3c gene knockdown on colon cancer cell survival.The eIF3c gene was observed to be highly expressed in colon cancer cell models.The expression levels of the gene in eIF3c siRNA infected and control siRNA infected cells were compared via real-time polymerase chain reaction(PCR) and western blotting analysis.Cell proliferation levels were analyzed employing 3-(4,5-dimethylthiazol 2-yl)-2,5-diphenyltetrazolium bromide(MTT) and colony formation assays.Furthermore,the effects of eIF3c gene knockdown on the cell cycle and apoptosis were analyzed using flow cytometry.The results showed that suppression of eIF3c expression significantly(P<0.001) reduced cell proliferation and colony formation of RKO colon cancer cells.The cell cycle was arrested by decreasing the number of cells entering S phase.Further,apoptosis was induced as a result of eIF3c knockdown.Collectively,eIF3c deletion effectively reduced the survival of colon cancer cells and could be used as a therapeutic tool for colon cancer therapy.展开更多
为了系统研究锂离子电池正极片制作工艺对电池性能的影响,采用Li Fe PO4作为正极活性材料组装成扣式实验电池,分别考察了正极片的涂敷厚度、辊压压下率、辊压道次数和辊压温度对电池主要电化学性能的影响,发现这些工艺因素显著影响电池...为了系统研究锂离子电池正极片制作工艺对电池性能的影响,采用Li Fe PO4作为正极活性材料组装成扣式实验电池,分别考察了正极片的涂敷厚度、辊压压下率、辊压道次数和辊压温度对电池主要电化学性能的影响,发现这些工艺因素显著影响电池性能,而且都可以归结为通过影响电池内阻而影响电池性能的。当涂敷厚度为100 mm、辊压压下率为50%、辊压道次数为3、辊压温度为160℃时电池有比较好的综合性能。展开更多
文摘AIM: To summarize the experience of diagnosis and treatment of congenital choledochal cyst in the past 20 years (1980-2000). METHODS: The clinical data of 108 patients admitted from 1980 to 2000 were analyzed retrospectively. RESULTS: Abdominal pain,jaundice and abdominal mass were presented in most child cases. Clinical symptoms in adult cases were non-specific, resulting in delayed diagnosis frequently. Fifty-seven patients (52.7%) had coexistent pancreatiobiliary disease. Carcinoma of the biliary duct occurred in 18 patients (16.6%).Ultrasonic examination was undertaken in 94 cases, ERCP performed in 46 cases and CT in 71 cases. All of the cases were correctly diagnosed before operation. Abnormal pancreatobiliary duct junction was found in 39 patients. Before 1985 the diagnosis and classification of congenital choledochal cyst were established by ultrasonography preoperatively and confirmed during operation, the main procedures were internal drainage by cyst enterostomy. After 1985, the diagnosis was established by ERCP and CT, and cystectomy with Roux-en-Y hepaticojejunostomy was the conventional procedures.In 1994, we reported a new and simplified operative procedure in order to reduce the risk of choledochal cyst malignancy. Postoperative complication was mainly retrograde infection of biliary tract, which could be controlled by the administration of antibiotics, there was no perioperative mortality. CONCLUSION: The concept in diagnosis and treatment of congenital choledochal cyst has obviously been changed greatly.CT and ERCP were of great help in the classification of the disease.Currently, cystectomy with Roux-en-Y hepaticojejunostomy is strongly recommended as the choice for patients with type I and type IV cysts. Piggyback orthotopic liver transplantation is indicated in type V cysts (Caroli's disease) with frequently recurrent cholangitis.
文摘AIM:To assess the patency of pancreaticoenterostomy and pancreatic exocrine function after three surgical methods. METHODS: A pig model of pancreatic ductal dilation was made by ligating the main pancreatic duct. After 4 wk ligation, a total of 36 piglets were divided randomly into four groups. The piglets in the control group underwent laparotomy only; the others were treated by three anastomoses: (1) end-to-end pancreaticojejunostomy invagination (EEPJ); (2) end-to-side duct-to- mucosa sutured anastomosis (ESPJ); or (3) binding pancreaticojejunostomy (BPJ). Anastomotic patency was assessed after 8 wk by body weight gain, intrapancreatic ductal pressure, pancreatic exocrine function secretin test, pancreatography, and macroscopic and histologic features of the anastomotic site. RESULTS: The EEPJ group had significantly slower weight gain than the ESPJ and BPJ groups on postoperative weeks 6 and 8 (P < 0.05). The animals in both the ESPJ and BPJ groups had a similar body weight gain.Intrapancreatic ductal pressure was similar in ESPJ and BPJ. However, pressure in EEPJ was significantly higher than that in ESPJ and BPJ (P < 0.05). All three functional parameters, the secretory volume, the flow rate of pancreatic juice, and bicarbonate concentration, were significantly higher in ESPJ and BPJ as compared to EEPJ (P < 0.05). However, the three parameters were similar in ESPJ and BPJ. Pancreatography performed after EEPJ revealed dilation and meandering of the main pancreatic duct, and the anastomotic site exhibited a variable degree of occlusion, and even blockage. Pancreatography of ESPJ and BPJ, however, showed normal ductal patency. Histopathology showed that the intestinal mucosa had fused with that of the pancreatic duct, with a gradual and continuous change from one to the other. For EEPJ, the portion of the pancreatic stump protruding into the jejunal lumen was largely replaced by cicatricial fibrous tissue. CONCLUSION: A mucosa-to-mucosa pancreatico- jejunostomy is the best choice for anastomotic patency when
文摘BACKGROUND:Nerve invasion is a specific type of tumor expansion and characteristic manifestation of pancreatic cancer(PC),with an incidence rate ranging from 50% to 100%.It is an important prognostic factor for pancreatic cancer,and its early detection is helpful in the management of the disease.This study was undertaken to analyze retrospectively the relationship between neural invasion and multiple clinicopathological features and to provide evidences for clinicians in the management of neural invasion in patients with PC.METHODS:Formalin-fixed paraffin-embeded specimens of PC taken from 215 patients were examined for the presence of neural invasion under a light microscope.Analyzed was the relationship between neural invasion and multiple clinicopathological feature including preoperative fasting blood glucose level,amylase level,serum CA19-9 level,abdominal pain,lumbar and back pain,and the expressions of p53 and Ki67 in tumor tissues.RESULTS:Preoperative fasting blood glucose level,serum CA19-9 level and p53 positive cells in cancer tissue were increased with the rise of pathological grade(P【0.05).These indices were significantly higher in patients with neural invasion than in those without(P【0.05).Further analysis revealed a positive correlation between p53 and Ki67 overexpression and lymphatic metastasis(P【0.05).Referred pain was positively correlated with neural invasion(P【0.05).Patients with PC perineural invasion were more likely to have a higher pathological grade(P【0.05).CONCLUSIONS:Our data indicated that the preoperative fasting blood glucose level,serum CA19-9 level,and referred pain are novel predictive markers for neural invasion in patients with PC.p53 and Ki67 play important roles in neural invasion of PC.Management of hyperglycemia may serve as an auxiliary treatment to curb neural invasion in PC.
文摘AIM: To summarize systematically our ten-year experiencein non-surgical treatment of postoperative bile leakage, andexplore its methods and indications.METHODS: The clinical data of 57 patients with postoperativebile leakage treated non-surgically from January 1991 toDecember 2000 were reviewed retrospectively.RESULTS: The site of the leakage was mainly the disruptedor damaged fistulous tracts oft tube in 25 patients (43.9 %),the fossae of gallbladder in 14 cases (24.6 %), the cut surfaceof liver in 7 cases(12.3 %), and it was undetectable in theother 2 cases. Besides bile leakage, the wrong ligation of bileducts was found in 3 patients, residual stones of the distal bileduct in 5 patients, benign papillary strictures in 3, and bilomaresulting from bile collections in 2. The diagnoses were madeaccording to the history of surgery, clinical situation, abdominalparacentesis, ultrasonography, ERCP, PTC, MRI/MRCP,gastroscopy and percutaneous fistulography. All 57 patientswere treated non-surgically at the beginning of bile leakage.The non-surgical methods included keeping original drainageunobstructed, percutaneous abdominal paracentesis ordrainage, percutaneous transhepatic cholangial/biliary drainage(PTCD/PTBD),endoscopic management, traditional Chinesemedicine and so on. Of the 57 patients,2 patients died,5 wereconverted to reoperation later, the other 50 were directly curedby non-surgical methods without any complication. The curerate of the non-surgery was 82.5 % (50/57).CONCLUSION: Many nonoperative methods are availableto treat postoperative bile leakage. Non-surgical treatmentmay serve as the first choice for the treatment of bile leakagefor its advantages in higher cure rate, convenience and safetyin practice. It is important to choose the specific non-surgicalmethod according to the volume, site of bile leakage andpatient′s condition.
文摘AIM: To investigate whether hypoxia inducible factor-1α (HIF-1α) is linked to the protective effects of ischemic preconditioning (IP) on sinusoidal endothelial cells against ischemia/reperfusion injury. METHODS: Sinusoidal endothelial cell lines ECV-304 were cultured and divided into four groups: control group, cells were cultured in complete DMEM medium; cold anoxia/warm reoxygenation (A/R) group, cells were preserved in a 4℃ UW solution in a mixture of 95% N2 and 5% CO2 for 24 h; anoxia-preconditioning (APC) group, cells were treated with 4 cycles of short anoxia and reoxygenation before prolonged anoxia- preconditioning treatment; and anoxia-preconditioning and hypoxia inducible factor-1α (HIF-1α) inhibitor (I-HIF-1) group, cells were pretreated with 5 μm of HIF-1α inhibitor NS398 in DMEM medium before subjected to the same treatment as group APC. After the anoxia treatment, each group was reoxygenated in a mixture of 95% air and 5% CO2 incubator for 6 h. Cytoprotections were evaluated by cell viabilities from Trypan blue, lactate dehydrogenase (LDH) release rates, and intracellular cell adhesion molecule-1 (ICAM-1) expressions. Expressions of HIF-1α mRNA and HIF-1α protein from each group were determined by the RT-PCR method and Western blotting, respectively. RESULTS: Ischemia preconditioning increased cell viability, and reduced LDH release and ICAM-1 expressions. Ischemia preconditioning also upregulated the HIF-1α mRNA level and HIF-1α protein expression. However, all of these changes were reversed by HIF-1α inhibitor NS398.CONCLUSION: Ischemia preconditioning effectively inhibited cold hypoxia/warm reoxygenation injury to endothelial cells, and the authors showed for the first time HIF-1α is causally linked to the protective effects of ischemic preconditioning on endothelial cells.
文摘Eukaryotic initiation factor subunit c(eIF3c) has been identified as an oncogene that is over-expressed in tumor cells and,therefore,is a potential therapeutic target for gene-based cancer treatment.This study was focused on investigating the effect of small interfering RNA(siRNA)-mediated eIF3c gene knockdown on colon cancer cell survival.The eIF3c gene was observed to be highly expressed in colon cancer cell models.The expression levels of the gene in eIF3c siRNA infected and control siRNA infected cells were compared via real-time polymerase chain reaction(PCR) and western blotting analysis.Cell proliferation levels were analyzed employing 3-(4,5-dimethylthiazol 2-yl)-2,5-diphenyltetrazolium bromide(MTT) and colony formation assays.Furthermore,the effects of eIF3c gene knockdown on the cell cycle and apoptosis were analyzed using flow cytometry.The results showed that suppression of eIF3c expression significantly(P<0.001) reduced cell proliferation and colony formation of RKO colon cancer cells.The cell cycle was arrested by decreasing the number of cells entering S phase.Further,apoptosis was induced as a result of eIF3c knockdown.Collectively,eIF3c deletion effectively reduced the survival of colon cancer cells and could be used as a therapeutic tool for colon cancer therapy.
文摘为了系统研究锂离子电池正极片制作工艺对电池性能的影响,采用Li Fe PO4作为正极活性材料组装成扣式实验电池,分别考察了正极片的涂敷厚度、辊压压下率、辊压道次数和辊压温度对电池主要电化学性能的影响,发现这些工艺因素显著影响电池性能,而且都可以归结为通过影响电池内阻而影响电池性能的。当涂敷厚度为100 mm、辊压压下率为50%、辊压道次数为3、辊压温度为160℃时电池有比较好的综合性能。
