AIM： To explore a simple, effective, safe and operable pretreatment for conferring tolerance against ischemia- reperfusion （I-R） injury in rat livers. METHODS： Forty-five rats were divided into five groups （each ...AIM： To explore a simple, effective, safe and operable pretreatment for conferring tolerance against ischemia- reperfusion （I-R） injury in rat livers. METHODS： Forty-five rats were divided into five groups （each group n = 9）. Group C： control group; group G： geranylgeranylacetone （GGA） was administered without heat stress; group S： local heat stress alone; group WG： GGA plus whole-body heat stress; group SG： GGA administration plus local heat stress. After completion of the I-R procedure, the ischemic-reperfused liver lobes in five groups were resected and tested for heat shock protein （HSP70） by RT-PCR, Western blotting analysis and immunohistochemical staining. The blood samples were collected for ALT and AST measurement at the end of occlusion of blood supply, 30 min after reperfusion, 24, 48, 72 h after surgery from the inferior vena cava. Survival was monitored for 1 wk. RESULTS： The production of HSP70 after I-R injury increased, the liver enzyme levels after reperfusion decreased rapidly, and the survival rates increased in groups C-SG. CONCLUSION： The combination of GGA plus local somatothermal stimulation is a simple, effective, safe and operable pretreatment to induce HSP70 in patients with liver tumor and cirrhosis before hepatectomy and in donors before harvesting graft for liver transplantation.2005 The WJG Press and Elsevier Inc. All rights reserved.展开更多
AIM： To describe a new classification method of righth epatectomy according to the different special positionsof tumors.METHODS： According to positions, 91 patients with malignant hepatic tumor in the right liver lo...AIM： To describe a new classification method of righth epatectomy according to the different special positionsof tumors.METHODS： According to positions, 91 patients with malignant hepatic tumor in the right liver lobe were divided into six groups： tumors in the right posterior lobe and （or） the right caudate lobe compressing the right portal hilum （n = 14, 15.4%）, tumors in the right liver lobe compressing the inferior vena cava and （or） hepatic veins （n = 11, 12.9%）, tumors infiltrating diaphragmatic muscle （n = 7, 7.7%）, tumors in the hepatorenal recess （infiltrating the right fatty renal capsule, transverse colon and right adrenal gland, n = 8, 8.8%）, tumors deeply located near the vertebral body （n = 3, 3.3%）, tumors at other sites in the right liver lobe （the control group, n = 48,52.75%）. The values of intraoperative blood loss （IBL）, tumor＇s maxim cross-section area （TMCSA）, and time of hepatic hilum damping （THHC） and incidence of postoperative complications were compared between five groups of tumor and control group, respectively.RESULTS： The THHC in groups 1-4 was significantly longer than that in the control group, the IBL in groups 1-4 was significantly higher than that in the control group, the TMCSA in groups 2-4 was significantly larger than that in the control group, and the ratio of IBL/TMCSA in group 1 was significantly higher than that in the control group. There was no significant difference in the indexes between group 5 and the control group.CONCLUSION： The site of tumor is the key factor that determines IBL.展开更多
Objective:Percutaneous radiofrequency ablation(PRFA) is known to be as effective as hepatectomy for small hepatocellular carcinoma(HCC) in the long-term.We wished to ascertain how it is for recurrent small HCC.Methods...Objective:Percutaneous radiofrequency ablation(PRFA) is known to be as effective as hepatectomy for small hepatocellular carcinoma(HCC) in the long-term.We wished to ascertain how it is for recurrent small HCC.Methods:From January 2009 to November 2011,a series of sixty-one patients were included in the study according to the criteria:each patient had one recurrent HCC,less than 5 cm in diameter.Twenty-six of the 61 patients were treated with PRFA and the other 35 were treated with repeat hepatectomy.Results:The interval from first surgery to recurrent for repeat hepatectomy and PRFA groups were(1,239.60±1,017.00) d and(903.42±975.11) d respectively(P=0.066).The tumor-free time after repeat hepatectomy and PRFA were(310.23±159.50) d and(278.27±123.29) d respectively(P=0.584).Size of tumor in repeat hepatectomy and PRFA were(7.34±3.16) cm^2 and(5.59±3.40) cm^2(P=0.215),the total expenditure for each patient of the two groups were(26,150.66±7,923.60) yuan and(21,135.00±1,156.76) yuan(RMB),and the time of hospitalization for each of the two groups were(15.29±4.28) d and(7.46±2.20) d(P<0.001).Conclusion:PRFA is proved to be as effective as repeat hepatectomy in the treatment of recurrent small HCC,and superior to repeat hepatectomy as it is less invasive.展开更多
AIM: To investigate the significance of Twist2 for colorectal cancer (CRC). METHODS: In this study, 93 CRC patients were included who received curative surgery in Eastern Hepatobiliary Surgery Hospital from January 19...AIM: To investigate the significance of Twist2 for colorectal cancer (CRC). METHODS: In this study, 93 CRC patients were included who received curative surgery in Eastern Hepatobiliary Surgery Hospital from January 1999 to December 2010. Records of patients' clinicopathological characteristics and follow up data were reviewed. Formalin-fixed, paraffin-embedded tissue blocks were used to observe the protein expression of Twist2 and E-cadherin by immunohistochemistry. Two independent pathologists who were blinded to the clinical information performed semiquantitative scoring of immunostaining. A total score of 3-6 (sum of extent + intensity) was considered as Twist2-positive expression. The expression of E-cadherin was divided into two levels (preserved and reduced). An exploratory statistical analysis was conducted to determine the association between Twist2 expression and clinicopathological parameters, as well as E-cadherin expression. Furthermore, the variables associated with prognosis were analyzed by Cox's proportional hazards model. Kaplan-Meier analysis was used to plot survival curves according to different expression levels of Twist2. RESULTS: Twist2-positive expression was observed in 66 (71.0%) samples and mainly located in the cytoplasm. Forty-three (46.2%) samples showed reduced expression of E-cadherin. There were no significant correlations between Twist2 expression and any of the clinicopathological parameters. However, Twist2-positive expression was significantly associated with reduced expression of E-cadherin (P=0.040). Multivariate analysis revealed that bad M-stage [hazard ratio (HR)=7.694, 95%CI: 2.927-20.224,P < 0.001] and Twist2-positive (HR=5.744, 95%CI: 1.347-24.298,P=0.018) were the independent risk factors for poor overall survival (OS), while Twist2-positive (HR=3.264, 95%CI: 1.455-7.375, P=0.004), bad N-stage (HR=2.149, 95%CI: 1.226-3.767, P=0.008) and bad M-stage (HR=10.907, 95%CI: 4.937-24.096, P < 0.001) were independently associated with poor disease-free survival (DFS). Survival curves showed a definite trend for Twist2-negative patients to have longer OS and DFS than Twist2-negative patients, not only overall, but also for patients in different stages, especially for DFS of patients in stage Ⅲ (P=0.033) and Ⅳ (P=0.026). CONCLUSION: Our data suggests, for the first time, that Twist2 is a valuable prognostic biomarker for CRC, particularly for patients in stage Ⅲ and Ⅳ.展开更多
Background Many studies have reported the benefit of hepatic resection for solitary and metachronous metastases from gastric cancer. However, indications and surgical results for synchronous hepatic metastases from ga...Background Many studies have reported the benefit of hepatic resection for solitary and metachronous metastases from gastric cancer. However, indications and surgical results for synchronous hepatic metastases from gastric carcinoma have not been clearly defined. This study was performed to assess the benefits and limits of simultaneous combined resection of both primary gastric cancer and synchronous hepatic metastases, as well as to identify prognostic factors affecting the survival.展开更多
文摘AIM： To explore a simple, effective, safe and operable pretreatment for conferring tolerance against ischemia- reperfusion （I-R） injury in rat livers. METHODS： Forty-five rats were divided into five groups （each group n = 9）. Group C： control group; group G： geranylgeranylacetone （GGA） was administered without heat stress; group S： local heat stress alone; group WG： GGA plus whole-body heat stress; group SG： GGA administration plus local heat stress. After completion of the I-R procedure, the ischemic-reperfused liver lobes in five groups were resected and tested for heat shock protein （HSP70） by RT-PCR, Western blotting analysis and immunohistochemical staining. The blood samples were collected for ALT and AST measurement at the end of occlusion of blood supply, 30 min after reperfusion, 24, 48, 72 h after surgery from the inferior vena cava. Survival was monitored for 1 wk. RESULTS： The production of HSP70 after I-R injury increased, the liver enzyme levels after reperfusion decreased rapidly, and the survival rates increased in groups C-SG. CONCLUSION： The combination of GGA plus local somatothermal stimulation is a simple, effective, safe and operable pretreatment to induce HSP70 in patients with liver tumor and cirrhosis before hepatectomy and in donors before harvesting graft for liver transplantation.2005 The WJG Press and Elsevier Inc. All rights reserved.
文摘AIM： To describe a new classification method of righth epatectomy according to the different special positionsof tumors.METHODS： According to positions, 91 patients with malignant hepatic tumor in the right liver lobe were divided into six groups： tumors in the right posterior lobe and （or） the right caudate lobe compressing the right portal hilum （n = 14, 15.4%）, tumors in the right liver lobe compressing the inferior vena cava and （or） hepatic veins （n = 11, 12.9%）, tumors infiltrating diaphragmatic muscle （n = 7, 7.7%）, tumors in the hepatorenal recess （infiltrating the right fatty renal capsule, transverse colon and right adrenal gland, n = 8, 8.8%）, tumors deeply located near the vertebral body （n = 3, 3.3%）, tumors at other sites in the right liver lobe （the control group, n = 48,52.75%）. The values of intraoperative blood loss （IBL）, tumor＇s maxim cross-section area （TMCSA）, and time of hepatic hilum damping （THHC） and incidence of postoperative complications were compared between five groups of tumor and control group, respectively.RESULTS： The THHC in groups 1-4 was significantly longer than that in the control group, the IBL in groups 1-4 was significantly higher than that in the control group, the TMCSA in groups 2-4 was significantly larger than that in the control group, and the ratio of IBL/TMCSA in group 1 was significantly higher than that in the control group. There was no significant difference in the indexes between group 5 and the control group.CONCLUSION： The site of tumor is the key factor that determines IBL.
基金Supported by the grant of Ministry of Science and Technology of the People' s Republic of China(2008ZX10002-25)National Natural Science Foundation of China(81070359)
文摘Objective:Percutaneous radiofrequency ablation(PRFA) is known to be as effective as hepatectomy for small hepatocellular carcinoma(HCC) in the long-term.We wished to ascertain how it is for recurrent small HCC.Methods:From January 2009 to November 2011,a series of sixty-one patients were included in the study according to the criteria:each patient had one recurrent HCC,less than 5 cm in diameter.Twenty-six of the 61 patients were treated with PRFA and the other 35 were treated with repeat hepatectomy.Results:The interval from first surgery to recurrent for repeat hepatectomy and PRFA groups were(1,239.60±1,017.00) d and(903.42±975.11) d respectively(P=0.066).The tumor-free time after repeat hepatectomy and PRFA were(310.23±159.50) d and(278.27±123.29) d respectively(P=0.584).Size of tumor in repeat hepatectomy and PRFA were(7.34±3.16) cm^2 and(5.59±3.40) cm^2(P=0.215),the total expenditure for each patient of the two groups were(26,150.66±7,923.60) yuan and(21,135.00±1,156.76) yuan(RMB),and the time of hospitalization for each of the two groups were(15.29±4.28) d and(7.46±2.20) d(P<0.001).Conclusion:PRFA is proved to be as effective as repeat hepatectomy in the treatment of recurrent small HCC,and superior to repeat hepatectomy as it is less invasive.
基金Supported by National Natural Science Foundation of China,grant, No. 81201937 and 81070359
文摘AIM: To investigate the significance of Twist2 for colorectal cancer (CRC). METHODS: In this study, 93 CRC patients were included who received curative surgery in Eastern Hepatobiliary Surgery Hospital from January 1999 to December 2010. Records of patients' clinicopathological characteristics and follow up data were reviewed. Formalin-fixed, paraffin-embedded tissue blocks were used to observe the protein expression of Twist2 and E-cadherin by immunohistochemistry. Two independent pathologists who were blinded to the clinical information performed semiquantitative scoring of immunostaining. A total score of 3-6 (sum of extent + intensity) was considered as Twist2-positive expression. The expression of E-cadherin was divided into two levels (preserved and reduced). An exploratory statistical analysis was conducted to determine the association between Twist2 expression and clinicopathological parameters, as well as E-cadherin expression. Furthermore, the variables associated with prognosis were analyzed by Cox's proportional hazards model. Kaplan-Meier analysis was used to plot survival curves according to different expression levels of Twist2. RESULTS: Twist2-positive expression was observed in 66 (71.0%) samples and mainly located in the cytoplasm. Forty-three (46.2%) samples showed reduced expression of E-cadherin. There were no significant correlations between Twist2 expression and any of the clinicopathological parameters. However, Twist2-positive expression was significantly associated with reduced expression of E-cadherin (P=0.040). Multivariate analysis revealed that bad M-stage [hazard ratio (HR)=7.694, 95%CI: 2.927-20.224,P < 0.001] and Twist2-positive (HR=5.744, 95%CI: 1.347-24.298,P=0.018) were the independent risk factors for poor overall survival (OS), while Twist2-positive (HR=3.264, 95%CI: 1.455-7.375, P=0.004), bad N-stage (HR=2.149, 95%CI: 1.226-3.767, P=0.008) and bad M-stage (HR=10.907, 95%CI: 4.937-24.096, P < 0.001) were independently associated with poor disease-free survival (DFS). Survival curves showed a definite trend for Twist2-negative patients to have longer OS and DFS than Twist2-negative patients, not only overall, but also for patients in different stages, especially for DFS of patients in stage Ⅲ (P=0.033) and Ⅳ (P=0.026). CONCLUSION: Our data suggests, for the first time, that Twist2 is a valuable prognostic biomarker for CRC, particularly for patients in stage Ⅲ and Ⅳ.
文摘Background Many studies have reported the benefit of hepatic resection for solitary and metachronous metastases from gastric cancer. However, indications and surgical results for synchronous hepatic metastases from gastric carcinoma have not been clearly defined. This study was performed to assess the benefits and limits of simultaneous combined resection of both primary gastric cancer and synchronous hepatic metastases, as well as to identify prognostic factors affecting the survival.
