Malignant fibrous histiocytoma (MFH) is a pleomorphic mesenchynal sarcoma. It is uncommonly arises primarily from the intra-peritoneal cavity. Primary peritoneal MFH with tumor bleeding and rupture is rare. We describ...Malignant fibrous histiocytoma (MFH) is a pleomorphic mesenchynal sarcoma. It is uncommonly arises primarily from the intra-peritoneal cavity. Primary peritoneal MFH with tumor bleeding and rupture is rare. We describe the imaging features of a 70-year-old patient presenting with ruptured hemorrhagic peritoneal MFH at subhepatic area,accompanied by massive hemoperitoneum,mimicking a ruptured pedunculated hepatocellular carcinoma. Computed tomography (CT) revealed a large heterogeneous enhanced subhepatic mass with adjacent liver,gallbladder and colon invasion. Tumor hemorrhage and rupture complicated with peritoneal seeding and massive bloody ascites were also detected. Angiography showed a hypervascular tumor fed by enlarged right hepatic arteries,cystic artery and omental branches of gastroepiploic artery. The patient underwent laparotomy for tumor resection,but the tumor recurred one month after operation. To our knowledge,the CT appearance of ruptured intraperitoneal MFH complicated by hemoperitoneum has not been previously described.展开更多
Colorectal cancer(CRC) is the third most common cancer and the fourth most common cause of cancerrelated death worldwide. Besides the lymphatic and haematogenous routes of dissemination,CRC frequently gives rise to tr...Colorectal cancer(CRC) is the third most common cancer and the fourth most common cause of cancerrelated death worldwide. Besides the lymphatic and haematogenous routes of dissemination,CRC frequently gives rise to transcoelomic spread of tumor cells in the peritoneal cavity,which ultimately leads to peritoneal carcinomatosis(PC). PC is associated with a poor prognosis and bad quality of life for these patients in their terminal stages of disease. A loco-regional treatment modality for PC combining cytoreductive surgery and hyperthermic intraperitoneal peroperative chemotherapy has resulted in promising clinical results. However,this novel approach is associated with significant morbidity and mortality. A comprehensive understanding of the molecular events involved in peritoneal disease spread is paramount in avoiding unnecessary toxicity. The emergence of PC is the result of a molecular crosstalk between cancer cells and host elements,involving several well-defined steps,together known as the peritoneal metastatic cascade. Individual or clumps of tumor cells detach from the primary tumor,gain access to the peritoneal cavity and become susceptible to the regular peritoneal transport. They attach to the distant peritoneum,subsequently invade the subperitoneal space,where angiogenesis sustains proliferation and enables further metastatic growth. These molecular events are not isolated events but rather a continuous and interdependent process. In this manuscript,we review current data regarding the molecular mechanisms underlying the development of colorectal PC,with a special focus on the peritoneum and the role of the surgeon in peritoneal disease spread.展开更多
Objective:To analyze the inhibitory effect of genistein on matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) through inhibition of nuclear factor-kappa B (NF-κB ) activation.Methods: A total o...Objective:To analyze the inhibitory effect of genistein on matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) through inhibition of nuclear factor-kappa B (NF-κB ) activation.Methods: A total of 36 female mice were divided into six groups (n=6 in each group): control group (untreated mice), endometriosis mice group, and endometriosis mice groups administered with genistein at different doses (1.30 mg/day;1.95 mg/day;2.60 mg/day;and 3.25 mg/day). The genistein treatment was performed for 14 d. The expressions of NF-κB , MMP-2 and MMP-9 on the endometriosis lesions were analyzed by the immunohistochemical technique.Results: The activity of NF-κB in the endometriosis group increased significantly than that of the control group (P<0.05). The expression of MMP-2 or MMP-9 in the endometriosis group increased significantly than that of the control group (P<0.05). Administration of genistein at different doses was capable of significantly reducing the activity of NF-κB compared to that of the endometriosis group (P<0.05), reaching the level comparable to that of the control group at the third highest dose (P>0.05). The four doses of genistein administration were capable of significantly reducing the expression of MMP-2 compared to that of the endometriosis group (P<0.05), reaching an expression comparable to that of the control group for the highest dose (P>0.05). Administration of genistein at different doses was capable of significantly reducing the expression of MMP-9 compared to that of the endometriosis group (P<0.05), reaching the level comparable to that of the control group at the highest dose (P>0.05). Conclusions:Genistein suppresses the expression of MMP-2 and MMP-9 through suppressing NF-κB activity in the peritoneum of murine model of endometriosis.展开更多
Background:In the treatment of colorectal cancer,laparoscopic surgery has seen a significant amount of success.Reducing the risk of postoperative complications and improving patients’quality of life can be accomplish...Background:In the treatment of colorectal cancer,laparoscopic surgery has seen a significant amount of success.Reducing the risk of postoperative complications and improving patients’quality of life can be accomplished by appropriately employing pelvic peritoneal repair and sigmoid colostomy when appropriate.Objective:To compare fusion closure of pelvic peritoneum combined with extraperitoneal colostomy with non-closure of pelvic peritoneum combined with intraperitoneal colostomy in patients with low rectal cancer who had permanent colostomy.Methods:Low rectal cancer patients admitted to Hengshui People’s Hospital for permanent colostomy were evaluated.The participants were divided into two groups:an observation and a control group.All 30 cases in the observation group underwent pelvic peritoneum closure and extraperitoneal colostomy,while the other 30 cases in the control group underwent intraperitoneal colostomy.The C-reactive protein(CRP)levels of the participants in both groups were evaluated for 6 months to 2 years(24 h before,24 h after,48 h after,96 h after surgery).Results:Comparing the colostomy operative time,time to first passage of flatus postoperatively,time to first defecation postoperatively,length of hospital stay,laboratory indicators,stoma-related complications,colostomy function,etc.,the colostomy operative time significantly differed between the two groups(P<0.05);the observation group did considerably better than the control group in terms of stoma-related complications and bowel movement control 6 months after surgery(P<0.05);and although serum CRP levels increased in both groups 48 h after surgery,the difference was significant(P<0.05).Conclusion:Extraperitoneal colostomy can improve the quality of life of patients with permanent stoma and reduce the occurrence of stoma-related complications.Thus,this technique is worthy of promotion in clinical practice.展开更多
BACKGROUND Caval vein thrombosis after hepatectomy is rare, although it increases mortality and morbidity. The evolution of this thrombosis into a septic thrombophlebitis responsible for persistent septicaemia after a...BACKGROUND Caval vein thrombosis after hepatectomy is rare, although it increases mortality and morbidity. The evolution of this thrombosis into a septic thrombophlebitis responsible for persistent septicaemia after a hepatectomy has not been reported to date in the literature. We here report the management of a 54-year-old woman operated for a peripheral cholangiocarcinoma who developed a suppurated thrombophlebitis of the vena cava following a hepatectomy.CASE SUMMARY This patient was operated by left lobectomy extended to segment V with bile duct resection and Roux-en-Y hepaticojejunostomy. After the surgery, she developed Streptococcus anginosus, Escherichia coli, and Enterococcus faecium bacteraemias, as well as Candida albicans fungemia. A computed tomography scan revealed a bilioma which was percutaneously drained. Despite adequate antibiotic therapy,the patient's condition remained septic. A diagnosis of septic thrombophlebitis of the vena cava was made on post-operative day 25. The patient was then operated again for a surgical thrombectomy and complete caval reconstruction with a parietal peritoneum tube graft. Use of the peritoneum as a vascular graft is an inexpensive technique, it is readily and rapidly available, and it allows caval replacement in a septic area. Septic thrombophlebitis of the vena cava after hepatectomy has not been described previously and it warrants being added to the spectrum of potential complications of this procedure.CONCLUSION Septic thrombophlebitis of the vena cava was successfully treated with antibiotic and anticoagulation treatments, prompt surgical thrombectomy and caval reconstruction.展开更多
A major diagnostic challenge to the evaluation of an incomplete intestinal obstruction is to distinguish between infectious and malignant etiologies.We present a case of an elderly woman complaining of abdominal pain ...A major diagnostic challenge to the evaluation of an incomplete intestinal obstruction is to distinguish between infectious and malignant etiologies.We present a case of an elderly woman complaining of abdominal pain accompanied with nausea and vomiting,and failure to pass gas or stools.Anti-tuberculosis drugs were used to relieve her abdominal pain,and a needle biopsy of the peritoneal cavity showed evidence of primary papillary serous carcinoma of the peritoneum(PSCP). This is a rare description of tuberculosis in the setting of PSCP.This report illustrates the potential complex nature of malignancies,and emphasizes the need to consider coexistence of malignancy and infection in patients, especially in those with risk factors for malignancy who fail with antibiotic therapy.展开更多
Objective Increase therapeutic effective rat e of post-perineum malignant carcin oma and decrease side effects.Method Inject chemotherapy drugs such as 5-FU,DDP and /or IL-2into tumors at variant po ints induced by B-...Objective Increase therapeutic effective rat e of post-perineum malignant carcin oma and decrease side effects.Method Inject chemotherapy drugs such as 5-FU,DDP and /or IL-2into tumors at variant po ints induced by B-ultrasound.Result The general effective rate was 72.7%in 11patients,which is hig her than other therapies.Conclusion B-ultrasound interventional thera py is recommended in the treatment of post-peritoneum malig nant tumors.展开更多
The metastatic pattern of colon cancer is typically well characterized,with initial dissemination occurring through regional lymphatics,followed by hematogenous spread.The most frequent sites of metastasis in colorect...The metastatic pattern of colon cancer is typically well characterized,with initial dissemination occurring through regional lymphatics,followed by hematogenous spread.The most frequent sites of metastasis in colorectal cancer(CRC)include regional lymph nodes(50%–70%),liver(35%–50%),lungs(21%),peritoneum(15%),and ovaries(13%).1 Isolated distant lymph node metastasis,particularly in the absence of concurrent systemic disease,is exceedingly rare in CRC.To date,only six cases of isolated axillary lymph node metastasis(ALNM)from colorectal primaries have been documented in the literature.1–6 Even more uncommon is the incidental discovery of malignant cells in anastomotic doughnuts following stoma reversal procedures.Herein,we report a rare case involving both the incidental histopathological detection of tumor cells within doughnuts during stoma closure and the subsequent development of isolated ALNM after curative resection of sigmoid colon carcinoma.展开更多
Background Long-term peritoneal dialysis (PD) requires that the peritoneal membrane remain effective for dialysis. Research directed toward human peritoneal morphology and structure is limited. The present study was p...Background Long-term peritoneal dialysis (PD) requires that the peritoneal membrane remain effective for dialysis. Research directed toward human peritoneal morphology and structure is limited. The present study was performed to investigate morphological changes of the human peritoneal membrane during PD and to elucidate the possible mechanisms of its functional deterioration. Methods A total of 32 peritoneal biopsies were performed in normal subjects (n=10),uremic nondialysis patients (n=12) at the time of catheter insertion,and PD patients (n=10) at the time of catheter removal or reinsertion or at the time of renal transplantation. Peritoneal morphology was examined by light microscopy,scanning electron microscopy,and transmission electron microscopy. Results The peritoneal membrane in normal subjects consisted of a monolayer of mesothelial cells on a basement membrane and a layer of connective tissue containing cells,blood vessels,and lymphatic vessels. Mesothelial cells were polygonal,often elongated,and had numerous microvilli on their luminal surface. There were lots of oval or roundish pinocytotic vesicles in the cytoplasm of the mesothelial cells. The peritoneal morphology of uremic nondialysis patients was similar to that of normal subjects. However,significant abnormalities of the peritoneal membrane were observed in PD patients,and the changes were found to be progressive. Microvilli were the first site of damage which involved microvilli shortening,a gradual reduction in their number,and,eventually,the total disappearance of microvilli. Mesothelial cells then detached from the basement membrane, disappearing completely in some cases. In the end,the peritoneal membrane consisted only of submesothelial connective tissue without any cells.Conclusions PD can modify peritoneal morphology and structure. The morphological change is progressive and may be one of the important causes of peritoneal failure. Peritoneal biopsies can provide lots of valuable information about the effects of PD. Studying the relationship between peritoneal structure and its function proved very useful for understanding the physiopathology of the peritoneum during PD.展开更多
Objective To investigate the expression of aquaporin-1 (AQP1) in the human peritoneum and to evaluate the effect of peritoneal dialysis (PD) on its expression.Methods Peritoneal biopsies were obtained from normal subj...Objective To investigate the expression of aquaporin-1 (AQP1) in the human peritoneum and to evaluate the effect of peritoneal dialysis (PD) on its expression.Methods Peritoneal biopsies were obtained from normal subjects (n =10), uremic nondialysis patients (n = 12) at catheter insertion and PD patients ( n = 10) at the time of catheter removal, reinsertion or renal transplantation. Western blot, immuno-histochemical staining and reverse transcript-polymerase chain reaction ( RT-PCR) techniques were used to investigate AQP1 expression.Results All peritoneal samples expressed AQP1 at both mRNA and protein levels. Western blot revealed a major band at 28 kD as well as more diffuse bands between 35 and 50 kD. The 28 kD band represents the nonglycosylated form of the protein while the 35 - 50 kD bands correspond to glycosylated AQP1. Immunohistochemical staining found the positive deposits were distributed in the mesothelial cells, endothelial cells of capillaries, venules and small veins, whereas no signal was detected in the arterioles. Semi-quantitative analysis showed that AQP1 expression was remarkably stable in all samples, whatever their origin (P>0. 05).Conclusions Our findings suggested that AQP1 is the molecular counterpart of an ultra small pore during PD. Secondly, the peritoneal mesothelial cell might also be involved in peritoneal transcellular water transport. As regards whether or not the structural or distributional alterations of AQP1 in the peritoneum may be more obviously expressed during PD, further study is needed.展开更多
We conducted a trial to assess the influence of closure or nonclosure of the peritoneum and subcutaneous tissue on the clinical outcomes of cervical cancer patients who underwent radical hysterectomy with lower abdom-i...We conducted a trial to assess the influence of closure or nonclosure of the peritoneum and subcutaneous tissue on the clinical outcomes of cervical cancer patients who underwent radical hysterectomy with lower abdom-inal cross incision.This randomized controlled trial was performed on 158 cervical cancer patients in our hospital between January 2002 and June 2004.Eighty-two patients were allocated to the“closure”group and 76 patients to the“nonclosure”group.Results showed that non-closure of the peritoneum and subcutaneous tissue could shorten operation time and febrile duration,reduce antibiotics requirement,increase the volume of drainage and decrease the incidence of liquefaction of subcutaneous fat(P<0.05).There was no difference in blood loss,postoperative complications,bowel function restoration and post-operative stay between the two groups(P>0.05).Our study revealed that closure of the peritoneum and subcutaneous tissue provides no immedi-ate postoperative benefits while unnecessarily lengthening surgical time and anesthesia exposure.The practice of closure of the peritoneum and subcutaneous tissue at radical hysterectomy should be questioned.展开更多
The use of natural polysaccharide crosslinkers for decellularized matrices is an effective approach to prepare cardiovascular substitute materials.In this research,NalO_(4)was applied to oxidize konjac glucomannan to ...The use of natural polysaccharide crosslinkers for decellularized matrices is an effective approach to prepare cardiovascular substitute materials.In this research,NalO_(4)was applied to oxidize konjac glucomannan to prepare the polysaccharide crosslinker oxidized konjac glucomannan(OKGM).The as-prepared crosslinker was then used to stabilize collagen-rich decellularized porcine peritoneum(DPP)to construct a cardiovascular substitute material(OKGM-fixed DPP).The results demonstrated that compared with GA-fixed DPP and GNP-fixed DPP,3.75%OKGM[1∶1.5(KGM∶NalO_(4))]-fixed DPP demonstrated suitable mechanical properties,as well as good hemocompatibility,excellent anti-calcification capability,and anti-enzymolysis in vitro.Furthermore,3.75%OKGM[1∶1.5(KGM∶NalO_(4))]-fixed DPP was suitable for vascular endothelial cell adhesion and rapid proliferation,and a single layer of endothelial cells was formed on the fifth day of culture.The in vivo experimental results also showed excellent histocompatibility.The current results demonstrted that OKGM was a novel polysaccharide cross-linking reagent for crosslinking natural tissues featured with rich collagen content,and 3.75%OKGM[1∶1.5(KGM∶NalO_(4))]-fixed DPP was a potential cardiovascular substitute material.展开更多
The peritoneum is mainly composed of mesothelial cells,fiber cells,and fibers,with many free cells that come from tissue capillaries.Siniperca chuatsi is a valuable fish commodity and important freshwater aquaculture ...The peritoneum is mainly composed of mesothelial cells,fiber cells,and fibers,with many free cells that come from tissue capillaries.Siniperca chuatsi is a valuable fish commodity and important freshwater aquaculture species in China.With the increase in the scale of its breeding,bacterial and viral disease of the S.chuatsi has become increasingly rampant in recent years.This study analyzed the peritoneal gene expression profile using transcriptome technology for the first time.The results showed that 95,711 unigenes were expressed in the peritoneum with an average length of 920.72 bp.In addition to the housekeeping genes,the genes of extracellular matrix protein 1a(ecm1),Angiopoietin-related protein 4-like(angptl4)and cysteine-rich protein 1(crip1)were highly expressed genes in the peritoneum,and they are key factors in peritoneal development and the maintenance of morphology.Meanwhile,many immune genes were also expressed in the peritoneum,including beta-2-microglobulin(b2m),MHC II invariant chain(cd74),prostate stem cell antigen-like protein(psca),claudin(cldn),heat shock protein 90(hsp90),complement component 4(c4),radical S-adenosyl methionine domain-containing protein 2(rsad2),and cathepsin S(ctss).The RT-PCR results showed that different genes exhibited different expression profiles.The transcriptome data indicated that b2m,cldn,hsp90,c4,and rsad2 were highly expressed in the peritoneum.b2m,cd74,psca,c4,and ctss were highly expressed after embryonic hatching,whereas cldn,hsp90,and rsad2 were expressed at early embryonic stages.Quantitative PCR demonstrated that b2m,cd74,cldn,hsp90,c4,and ctss genes were highly expressed after immunostimulation.This study provides significant data for studying the morphological and functional diversity of fish peritoneum and lays a foundation for research on mandarin fish immunity.展开更多
文摘Malignant fibrous histiocytoma (MFH) is a pleomorphic mesenchynal sarcoma. It is uncommonly arises primarily from the intra-peritoneal cavity. Primary peritoneal MFH with tumor bleeding and rupture is rare. We describe the imaging features of a 70-year-old patient presenting with ruptured hemorrhagic peritoneal MFH at subhepatic area,accompanied by massive hemoperitoneum,mimicking a ruptured pedunculated hepatocellular carcinoma. Computed tomography (CT) revealed a large heterogeneous enhanced subhepatic mass with adjacent liver,gallbladder and colon invasion. Tumor hemorrhage and rupture complicated with peritoneal seeding and massive bloody ascites were also detected. Angiography showed a hypervascular tumor fed by enlarged right hepatic arteries,cystic artery and omental branches of gastroepiploic artery. The patient underwent laparotomy for tumor resection,but the tumor recurred one month after operation. To our knowledge,the CT appearance of ruptured intraperitoneal MFH complicated by hemoperitoneum has not been previously described.
基金Supported by the Agency for Innovation by Science and Technology in Brussels,Belgium(to Lemoine L)foundation Limburg Sterk Merk,Hasselt University,Ziekenhuis OostLimburg and Jessa Hospital,Belgium(to Lemoine L,whom is a researcher for the Limburg Clinical Research Program UHasseltZOL-Jessa)
文摘Colorectal cancer(CRC) is the third most common cancer and the fourth most common cause of cancerrelated death worldwide. Besides the lymphatic and haematogenous routes of dissemination,CRC frequently gives rise to transcoelomic spread of tumor cells in the peritoneal cavity,which ultimately leads to peritoneal carcinomatosis(PC). PC is associated with a poor prognosis and bad quality of life for these patients in their terminal stages of disease. A loco-regional treatment modality for PC combining cytoreductive surgery and hyperthermic intraperitoneal peroperative chemotherapy has resulted in promising clinical results. However,this novel approach is associated with significant morbidity and mortality. A comprehensive understanding of the molecular events involved in peritoneal disease spread is paramount in avoiding unnecessary toxicity. The emergence of PC is the result of a molecular crosstalk between cancer cells and host elements,involving several well-defined steps,together known as the peritoneal metastatic cascade. Individual or clumps of tumor cells detach from the primary tumor,gain access to the peritoneal cavity and become susceptible to the regular peritoneal transport. They attach to the distant peritoneum,subsequently invade the subperitoneal space,where angiogenesis sustains proliferation and enables further metastatic growth. These molecular events are not isolated events but rather a continuous and interdependent process. In this manuscript,we review current data regarding the molecular mechanisms underlying the development of colorectal PC,with a special focus on the peritoneum and the role of the surgeon in peritoneal disease spread.
文摘Objective:To analyze the inhibitory effect of genistein on matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) through inhibition of nuclear factor-kappa B (NF-κB ) activation.Methods: A total of 36 female mice were divided into six groups (n=6 in each group): control group (untreated mice), endometriosis mice group, and endometriosis mice groups administered with genistein at different doses (1.30 mg/day;1.95 mg/day;2.60 mg/day;and 3.25 mg/day). The genistein treatment was performed for 14 d. The expressions of NF-κB , MMP-2 and MMP-9 on the endometriosis lesions were analyzed by the immunohistochemical technique.Results: The activity of NF-κB in the endometriosis group increased significantly than that of the control group (P<0.05). The expression of MMP-2 or MMP-9 in the endometriosis group increased significantly than that of the control group (P<0.05). Administration of genistein at different doses was capable of significantly reducing the activity of NF-κB compared to that of the endometriosis group (P<0.05), reaching the level comparable to that of the control group at the third highest dose (P>0.05). The four doses of genistein administration were capable of significantly reducing the expression of MMP-2 compared to that of the endometriosis group (P<0.05), reaching an expression comparable to that of the control group for the highest dose (P>0.05). Administration of genistein at different doses was capable of significantly reducing the expression of MMP-9 compared to that of the endometriosis group (P<0.05), reaching the level comparable to that of the control group at the highest dose (P>0.05). Conclusions:Genistein suppresses the expression of MMP-2 and MMP-9 through suppressing NF-κB activity in the peritoneum of murine model of endometriosis.
基金the Medical Science Research Project of Hebei Province(20211322).
文摘Background:In the treatment of colorectal cancer,laparoscopic surgery has seen a significant amount of success.Reducing the risk of postoperative complications and improving patients’quality of life can be accomplished by appropriately employing pelvic peritoneal repair and sigmoid colostomy when appropriate.Objective:To compare fusion closure of pelvic peritoneum combined with extraperitoneal colostomy with non-closure of pelvic peritoneum combined with intraperitoneal colostomy in patients with low rectal cancer who had permanent colostomy.Methods:Low rectal cancer patients admitted to Hengshui People’s Hospital for permanent colostomy were evaluated.The participants were divided into two groups:an observation and a control group.All 30 cases in the observation group underwent pelvic peritoneum closure and extraperitoneal colostomy,while the other 30 cases in the control group underwent intraperitoneal colostomy.The C-reactive protein(CRP)levels of the participants in both groups were evaluated for 6 months to 2 years(24 h before,24 h after,48 h after,96 h after surgery).Results:Comparing the colostomy operative time,time to first passage of flatus postoperatively,time to first defecation postoperatively,length of hospital stay,laboratory indicators,stoma-related complications,colostomy function,etc.,the colostomy operative time significantly differed between the two groups(P<0.05);the observation group did considerably better than the control group in terms of stoma-related complications and bowel movement control 6 months after surgery(P<0.05);and although serum CRP levels increased in both groups 48 h after surgery,the difference was significant(P<0.05).Conclusion:Extraperitoneal colostomy can improve the quality of life of patients with permanent stoma and reduce the occurrence of stoma-related complications.Thus,this technique is worthy of promotion in clinical practice.
文摘BACKGROUND Caval vein thrombosis after hepatectomy is rare, although it increases mortality and morbidity. The evolution of this thrombosis into a septic thrombophlebitis responsible for persistent septicaemia after a hepatectomy has not been reported to date in the literature. We here report the management of a 54-year-old woman operated for a peripheral cholangiocarcinoma who developed a suppurated thrombophlebitis of the vena cava following a hepatectomy.CASE SUMMARY This patient was operated by left lobectomy extended to segment V with bile duct resection and Roux-en-Y hepaticojejunostomy. After the surgery, she developed Streptococcus anginosus, Escherichia coli, and Enterococcus faecium bacteraemias, as well as Candida albicans fungemia. A computed tomography scan revealed a bilioma which was percutaneously drained. Despite adequate antibiotic therapy,the patient's condition remained septic. A diagnosis of septic thrombophlebitis of the vena cava was made on post-operative day 25. The patient was then operated again for a surgical thrombectomy and complete caval reconstruction with a parietal peritoneum tube graft. Use of the peritoneum as a vascular graft is an inexpensive technique, it is readily and rapidly available, and it allows caval replacement in a septic area. Septic thrombophlebitis of the vena cava after hepatectomy has not been described previously and it warrants being added to the spectrum of potential complications of this procedure.CONCLUSION Septic thrombophlebitis of the vena cava was successfully treated with antibiotic and anticoagulation treatments, prompt surgical thrombectomy and caval reconstruction.
文摘A major diagnostic challenge to the evaluation of an incomplete intestinal obstruction is to distinguish between infectious and malignant etiologies.We present a case of an elderly woman complaining of abdominal pain accompanied with nausea and vomiting,and failure to pass gas or stools.Anti-tuberculosis drugs were used to relieve her abdominal pain,and a needle biopsy of the peritoneal cavity showed evidence of primary papillary serous carcinoma of the peritoneum(PSCP). This is a rare description of tuberculosis in the setting of PSCP.This report illustrates the potential complex nature of malignancies,and emphasizes the need to consider coexistence of malignancy and infection in patients, especially in those with risk factors for malignancy who fail with antibiotic therapy.
文摘Objective Increase therapeutic effective rat e of post-perineum malignant carcin oma and decrease side effects.Method Inject chemotherapy drugs such as 5-FU,DDP and /or IL-2into tumors at variant po ints induced by B-ultrasound.Result The general effective rate was 72.7%in 11patients,which is hig her than other therapies.Conclusion B-ultrasound interventional thera py is recommended in the treatment of post-peritoneum malig nant tumors.
文摘The metastatic pattern of colon cancer is typically well characterized,with initial dissemination occurring through regional lymphatics,followed by hematogenous spread.The most frequent sites of metastasis in colorectal cancer(CRC)include regional lymph nodes(50%–70%),liver(35%–50%),lungs(21%),peritoneum(15%),and ovaries(13%).1 Isolated distant lymph node metastasis,particularly in the absence of concurrent systemic disease,is exceedingly rare in CRC.To date,only six cases of isolated axillary lymph node metastasis(ALNM)from colorectal primaries have been documented in the literature.1–6 Even more uncommon is the incidental discovery of malignant cells in anastomotic doughnuts following stoma reversal procedures.Herein,we report a rare case involving both the incidental histopathological detection of tumor cells within doughnuts during stoma closure and the subsequent development of isolated ALNM after curative resection of sigmoid colon carcinoma.
基金ThisstudywassupportedbytheNationalNaturalScienceFoundationofChina (No 3 9870 90 3 )andShanghaiEducationGrant (No 98QN65 )
文摘Background Long-term peritoneal dialysis (PD) requires that the peritoneal membrane remain effective for dialysis. Research directed toward human peritoneal morphology and structure is limited. The present study was performed to investigate morphological changes of the human peritoneal membrane during PD and to elucidate the possible mechanisms of its functional deterioration. Methods A total of 32 peritoneal biopsies were performed in normal subjects (n=10),uremic nondialysis patients (n=12) at the time of catheter insertion,and PD patients (n=10) at the time of catheter removal or reinsertion or at the time of renal transplantation. Peritoneal morphology was examined by light microscopy,scanning electron microscopy,and transmission electron microscopy. Results The peritoneal membrane in normal subjects consisted of a monolayer of mesothelial cells on a basement membrane and a layer of connective tissue containing cells,blood vessels,and lymphatic vessels. Mesothelial cells were polygonal,often elongated,and had numerous microvilli on their luminal surface. There were lots of oval or roundish pinocytotic vesicles in the cytoplasm of the mesothelial cells. The peritoneal morphology of uremic nondialysis patients was similar to that of normal subjects. However,significant abnormalities of the peritoneal membrane were observed in PD patients,and the changes were found to be progressive. Microvilli were the first site of damage which involved microvilli shortening,a gradual reduction in their number,and,eventually,the total disappearance of microvilli. Mesothelial cells then detached from the basement membrane, disappearing completely in some cases. In the end,the peritoneal membrane consisted only of submesothelial connective tissue without any cells.Conclusions PD can modify peritoneal morphology and structure. The morphological change is progressive and may be one of the important causes of peritoneal failure. Peritoneal biopsies can provide lots of valuable information about the effects of PD. Studying the relationship between peritoneal structure and its function proved very useful for understanding the physiopathology of the peritoneum during PD.
基金This study was supported by the National Natural Science Foundation of China (No.39870903) and Shanghai Education Grant (No.98QN65).
文摘Objective To investigate the expression of aquaporin-1 (AQP1) in the human peritoneum and to evaluate the effect of peritoneal dialysis (PD) on its expression.Methods Peritoneal biopsies were obtained from normal subjects (n =10), uremic nondialysis patients (n = 12) at catheter insertion and PD patients ( n = 10) at the time of catheter removal, reinsertion or renal transplantation. Western blot, immuno-histochemical staining and reverse transcript-polymerase chain reaction ( RT-PCR) techniques were used to investigate AQP1 expression.Results All peritoneal samples expressed AQP1 at both mRNA and protein levels. Western blot revealed a major band at 28 kD as well as more diffuse bands between 35 and 50 kD. The 28 kD band represents the nonglycosylated form of the protein while the 35 - 50 kD bands correspond to glycosylated AQP1. Immunohistochemical staining found the positive deposits were distributed in the mesothelial cells, endothelial cells of capillaries, venules and small veins, whereas no signal was detected in the arterioles. Semi-quantitative analysis showed that AQP1 expression was remarkably stable in all samples, whatever their origin (P>0. 05).Conclusions Our findings suggested that AQP1 is the molecular counterpart of an ultra small pore during PD. Secondly, the peritoneal mesothelial cell might also be involved in peritoneal transcellular water transport. As regards whether or not the structural or distributional alterations of AQP1 in the peritoneum may be more obviously expressed during PD, further study is needed.
文摘We conducted a trial to assess the influence of closure or nonclosure of the peritoneum and subcutaneous tissue on the clinical outcomes of cervical cancer patients who underwent radical hysterectomy with lower abdom-inal cross incision.This randomized controlled trial was performed on 158 cervical cancer patients in our hospital between January 2002 and June 2004.Eighty-two patients were allocated to the“closure”group and 76 patients to the“nonclosure”group.Results showed that non-closure of the peritoneum and subcutaneous tissue could shorten operation time and febrile duration,reduce antibiotics requirement,increase the volume of drainage and decrease the incidence of liquefaction of subcutaneous fat(P<0.05).There was no difference in blood loss,postoperative complications,bowel function restoration and post-operative stay between the two groups(P>0.05).Our study revealed that closure of the peritoneum and subcutaneous tissue provides no immedi-ate postoperative benefits while unnecessarily lengthening surgical time and anesthesia exposure.The practice of closure of the peritoneum and subcutaneous tissue at radical hysterectomy should be questioned.
基金supported by National Key Research and Development Program of China[Nos.2016YFC1100900,2016YFC1100901,2016YFC1100903 and 2016YFC1100904]"From 0 to 1"innovative research projects of Sichuan University(2022SCUH0045)The Key Research and Development Program of Sichuan Province(2020YFS0278).
文摘The use of natural polysaccharide crosslinkers for decellularized matrices is an effective approach to prepare cardiovascular substitute materials.In this research,NalO_(4)was applied to oxidize konjac glucomannan to prepare the polysaccharide crosslinker oxidized konjac glucomannan(OKGM).The as-prepared crosslinker was then used to stabilize collagen-rich decellularized porcine peritoneum(DPP)to construct a cardiovascular substitute material(OKGM-fixed DPP).The results demonstrated that compared with GA-fixed DPP and GNP-fixed DPP,3.75%OKGM[1∶1.5(KGM∶NalO_(4))]-fixed DPP demonstrated suitable mechanical properties,as well as good hemocompatibility,excellent anti-calcification capability,and anti-enzymolysis in vitro.Furthermore,3.75%OKGM[1∶1.5(KGM∶NalO_(4))]-fixed DPP was suitable for vascular endothelial cell adhesion and rapid proliferation,and a single layer of endothelial cells was formed on the fifth day of culture.The in vivo experimental results also showed excellent histocompatibility.The current results demonstrted that OKGM was a novel polysaccharide cross-linking reagent for crosslinking natural tissues featured with rich collagen content,and 3.75%OKGM[1∶1.5(KGM∶NalO_(4))]-fixed DPP was a potential cardiovascular substitute material.
基金supported by grants from the China Agriculture Research System (CARS-46)the Key national and special project of blue granary science and technology innovation (2020YFD0900400).
文摘The peritoneum is mainly composed of mesothelial cells,fiber cells,and fibers,with many free cells that come from tissue capillaries.Siniperca chuatsi is a valuable fish commodity and important freshwater aquaculture species in China.With the increase in the scale of its breeding,bacterial and viral disease of the S.chuatsi has become increasingly rampant in recent years.This study analyzed the peritoneal gene expression profile using transcriptome technology for the first time.The results showed that 95,711 unigenes were expressed in the peritoneum with an average length of 920.72 bp.In addition to the housekeeping genes,the genes of extracellular matrix protein 1a(ecm1),Angiopoietin-related protein 4-like(angptl4)and cysteine-rich protein 1(crip1)were highly expressed genes in the peritoneum,and they are key factors in peritoneal development and the maintenance of morphology.Meanwhile,many immune genes were also expressed in the peritoneum,including beta-2-microglobulin(b2m),MHC II invariant chain(cd74),prostate stem cell antigen-like protein(psca),claudin(cldn),heat shock protein 90(hsp90),complement component 4(c4),radical S-adenosyl methionine domain-containing protein 2(rsad2),and cathepsin S(ctss).The RT-PCR results showed that different genes exhibited different expression profiles.The transcriptome data indicated that b2m,cldn,hsp90,c4,and rsad2 were highly expressed in the peritoneum.b2m,cd74,psca,c4,and ctss were highly expressed after embryonic hatching,whereas cldn,hsp90,and rsad2 were expressed at early embryonic stages.Quantitative PCR demonstrated that b2m,cd74,cldn,hsp90,c4,and ctss genes were highly expressed after immunostimulation.This study provides significant data for studying the morphological and functional diversity of fish peritoneum and lays a foundation for research on mandarin fish immunity.
