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| 1 | High-dose Iodized Oil Transcatheter Arterial Chemoembolization For Patients with Large Hepatocellular Carcinoma显示文摘AIM:To conduct a randomized trial to evaluate the role ofusing high-dose iodized oil transcatheter arterialchemosmbolization(TACE)in the treatment of largehepatocellular carcinoma(HCC).METHODS:From January 1993 to June 1998,473 patientswith unresectable hepatocellular carcinoma ware divided intotwo groups:216 patients in group A received more than20mL iodized oil during the first TACE treatment;257patients in group B received 5-15mL iodized oil in the sameway.The Child's classification and ICG-R15 for evaluatingthe liver function of the patients ware done before thetreatment.During the TACE procedure the catheters wasinserted into the target artery selectively and the tumorvessels ware demonstrated with contrast medium in thehepatic angiography.The anticancar drugs mixed withiodized oil(Lipiodol)ware Epirubicin and Mitomycin.Ingroup A,112 cases received 20-29mL Lipiodol in the firstprocedure,85 cases 30-39mL,19 cases more than 40mL.The largest dose was 53 mL and the average dose was28.3mL.In group B,119 cases received 5-10mL Lipiodol,138 cases received 11-15mL,and the average dose was11.8mL.RESULTS:High-dose Lipiodol chemoembolization causedtolerable side effects and a little hurt to the liver function inthe patients with Child grade A or ICG-R15<20.But thepatients with child grade B or ICG-R15>20 had higher risk ofliver failure after high-dose TACE.More type Ⅱ and type Ⅱlipiodol accumulations in CT scan after 4 weeks of TACEware seen in the group A patients than those in the group Bpatients(P<0.01).The resection rate and complete tumornecrosis rate in group A ware higher than those of group B(P<0.05).The 1-,2-,3-year survival rates of group Apatients with Child grade A ware 79.2%,51.8% and 34.9%,respectively,better then those of group B(P<0.001).CONCLUSION:High-dose Lipiodol can result in morecomplete tumor necrosis by blocking both arteries and small portal veins of the tumor.High-dose TACE for treatment oflarge and hypervascular hepatocallular carcinoma ispractically acceptable with the better effect than the routinedose.For the patients with large and hypervascular tumor ofChild grade A liver function or ICG-R15 less than 20%,oilychemoembolization with 20-40mL Lipiodol is recommended. | Min-Shan Chen Jin-Qing Li Ya-Qi Zhang Yun-Fei Yuan Yong-Ping Guo Xiao-Jun Lin Guo-Hui Lim Department of Hepatobiliary Cancer Center of Sun Yet-sen University of Medical Sciences,Guangzhou 510060,China Li-Xia Lu Wei-Zhang Zhang Department of Radiology Cancer Center of Sun Yet-sen University of Medical Sciences,Guangzhou 510060,China | 2002 | World Journal of Gastroenterology2002，8，1： | 58 |
| 2 | Severe biliary complications after hepatic artery embolization显示文摘AIM: To study the mechanism and treatment of severebiliary complications arising from hepatic artery embolization(HAE).METHODS: Of seven cases of intra- and extrahepatic biliarydamage resulting from hepatic artery embolization reportedsince 1987, 6 suffered from hepatic haemangioma, the othercase was due to injection of TH compound into the hepaticartery during operation. The hepatic artery was injected withethanol so as to evaluate the liver damage in experimentalrats.RESULTS: All the cases were found to have destructivedamage of intra- and extrahepatic bile duct at the hilum withbiliary hepetocirrhosis. Experimental results revealednecrosis of the liver parenchyma, especially around theportal tract and obliteration of intrahepatic bile duct.CONCLUSIONS: To prevent the severe biliary comlications ofHAE, the use of HAE for hepatic haemangioma which waswidely practiced in China, should be re-evaluated. Hepaticarterial embolization of hepatic haemangioma may result insevere destructive biliary damages and its indiscriminate useshould be prohibited. | Xiao-Qiang Huang Zhi-Qiang Huang Wei-Dong Duan Nin-Xing Zhou Yu-Quan Feng Department of Hepatobiliary Surgery,General Hospital of PLA,Beijing 100853,China | 2002 | World Journal of Gastroenterology2002，8，1： | 54 |
| 3 | Roux-en-Y choledochojejunostomy using novel magnetic compressive anastomats in canine model of obstructive jaundice显示文摘BACKGROUND:The traditional hand-sewn Roux-en-Y choledochojejunostomy is technically complicated,and the incidence of postoperative complications has remained high.A set of novel magnetic compressive anastomats was introduced to facilitate choledochojejunostomy and improve the prognosis of patients.METHODS:After ligating the common bile duct for 7 days,16 dogs were randomly divided into two groups (n=8 per group).Anastomats were used in the study group,and the traditional hand-sewn method was used in the control group for standard Roux-en-Y choledochojejunostomy.We compared the operation time,incidence of complications,gross appearance,and pathological disparity in stoma between the two groups in 1-month and 3-month follow-up examinations.RESULTS:The time spent on constructing the anastomosis for the study group was significantly shortened.Although no anastomotic stenosis occurred in the two groups,the narrowing rate of biliary-enteric anastomosis was much higher in the control group.There was one case of bile leakage in the control group,whereas no bile leakage occurred in the study group.A smoother surface,an improved layer apposition,and a lower local inflammatory response were identified in the anastomosis of the study group.CONCLUSION:The structures of the novel magnetic compressive anastomats are simple,and they are time-saving,safe and efficient for performing Roux-en-Y choledocho- jejunostomy procedures in a canine model of obstructive jaundice. | Chao Fan,Xiao-Peng Yan,Shi-Qi Liu,Chun-Bao Wang,Jian-Hui Li,Liang Yu,Zheng Wu and Yi Lv Department of Hepatobiliary Surgery and Department of Pathology,First Affiliated Hospital,School of Medicine,Xi’an Jiaotong University,Xi’an 710061,China Department of Surgical Oncology,Third Affiliated Hospital,School of Medicine,Xi’an Jiaotong University,Xi’an 710068,China | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，1： | 49 |
| 4 | Ultrasonography guided percutaneous radiofrequency ablation for hepatic cavernous hemangioma显示文摘AIM: Hepatic cavernous hemangioma (HCH) is the mostcommon benign tumor of the liver and its management isstill controversial. Recent successin situ radiofrequencyablation of hepatic malignancies has led us to consider usingthis technique in patients with HCH. This study was to assessthe efficacy, safety, and complications of percutaneousradiofrequency ablation (PRFA) under ultrasonographyguidance in patients with HCH.METHODS: Twelve patients (four men and eight women,age ranged 33-56 years, mean age was 41.7 years) with 15hepatic cavernous hemangiomas (2.5 cm to 9.5 cm) weretreated using the RF-2000 generator and 10-needle LeVeenelectrode percutaneously guided by B-ultrasound. Lesionslarger than 3 cm were treated by multiple overlappingablations that encompass the entire lesion as well as a rimof normal liver tissue (approximately 0.5 cm).RESULTS: All the patients who received PRFA therapy hadno severe pain, bleeding or bile leakage during and afterthe procedures. Nine to 34 months′ follow-up (mean, 21months) by ultrasound and/or spiral CT scan demonstratedthat the ablated lesions in this group were shrunk remarkably,and the shrunken range was 38-79 % (mean, 67 % per 21months). The contrast enhancement was disappeared withinthe tumor or at its periphery in all cases on spiral CT scansobtained 3 to 6 months after treatment.CONCLUSION: The results of this study suggest that PRFAtherapy is a mini-invasive, simple, safe, and effective methodfor the treatment of selected patients with HCH. | Yan Cui Li-Yan Zhou Man-Ku Dong Ping Wang Min Ji Xiao-Ou Li Chang-Wei Chen Zi-Pei Liu Yong-Jie Xu Hong-Wen Zhang Department of Hepatobiliary Surgery,Beijing 306 Hospital,Chaoyang District,Beijing 100101,China | 2003 | World Journal of Gastroenterology2003，9，9： | 43 |
| 5 | Effect of NF-κB and p38 MAPK in activated monocytes/macrophages on pro-inflammatory cytokines of rats with acute pancreatitis显示文摘AIM: Proinfiammatory cytokines TNF-α and IL-6 play a main role in acute pancreatitis (AP). Cytokine biosynthesis runs through two major signaling pathways at the level of proteins: nuclear transcription factor-κB (NF-κB) and p38 mitogen-activated protein kinase (p38 MAPK). The aim of the study was to investigate the effect of NF-κB and p38 MAPK in activated monocytes/macrophages on cytokines of rats with acute pancreastitis.METHODS: Taurocholate (3 % and 5 %) at doses of 1 mL/kg was administered into the biliopancreatic duct of male Sprague-Dawley (SD) rats to reduce acute edematous pancreariris (AEP) and acute necrotizing pancreatitis (ANP).Pancreatic tissues were prepared immediately after death.At this point, blood was obtained for determination of serum amylase and pro-inflammatory TNF-α and IL-6. Activated monocytes/macrophages were captured from blood and so were ascites. NF-κB and p38 MAPK in activated monocytes/macrophages were measured by immunohistochemistry method. Pancreatic tissue samples were prepared for routine light microscopy, using hematoxylin and eosin (HE) staining.RESULTS: The serum levels of amylase were 3 056.00±1 232.35 IU/L and 4 865.12±890.34 IU/L at 3 and 6 hours in ANP group, which were significantly higher than those (3 056.00±1 232.35 TU/L and 3 187.17±821.16 IU/L) (P<0.05,respectively) in AEP group. In ascites the levels were 3.32±1.01 g and 3.76±1.12 g at 3 and 6 hours in ANP group,which were significantly higher than those (1.43±1.02 g and 2.56±1.21 g) (P<0.05, respectively) in AEP group. The serum levels of TNF-α were 54.27±23.48 pg/ml and 67.83±22.02 pg/ml in AEP group and 64.28±20.79 pg/ml and 106.59±43.71 pg/ml in ANP group, and the serum levels of IL-6 were 428.12±140.30 pg/ml and 420.13±139.40 pg/ml in AEP group and 1 600.32±309.78 pg/ml and 2 203.76±640.85 pg/ml in ANP group, which were far significantly higher than those in sham group (P<0.001, respectively). The serum level of TNF-α 6 hours after establishment of the studied model and that of IL-6 at 3 and 6 hours in ANP group were significantly higher than those in AEP (P<0.05, P<0.001, P<0.05). In ANP group, the levels of serum TNF-α and IL-6 6 hours after establishment of the studied model were significantly higher than those 3 hours after establishment of studied model (P<0.05, P<0.05, respectively). Three and 6 hours after establishment of the model, typical pathological changes of AEP and ANP were found, such as large numbers of inflammatory cells, edema, hemorrhage, necrosis, large amount of ascites. In AEP, NF-κB and p38 MAPK in activated monocytes/macrophages were moderately found at 3 and 6 hours after introduction of the model. However, in ANP,the expression of NF-κB and p38 MAPK in activated monocytes/macrophages was upregulated evidently at 3 and 6 hours after introduction of the model, reaching their highest levels at 6 hours after introduction of the model, which were consistent with the levels of TNF-α and IL-6.CONCLUSION: Cytokine TNF-α and IL-6 play a main rolein acute pancreatitis, expression of NF-κB and p38 MAPK in activated monocytes/macrophages might play a major role in cytokine transcription and biosynthesis. | Hong-Shan Liu Cheng-En Pan Qing-Guang Liu Wei Yang Xue-Min Liu, Department of Hepatobiliary Surgery, First Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China | 2003 | World Journal of Gastroenterology2003，9，11： | 42 |
| 6 | Changes of gut bacteria and immune parameters in liver transplant recipients显示文摘BACKGROUND: Liver transplantation is one of the most effective therapeutic options for patients with end-stage liver diseases, and gut microbiota is actively involved in potential infections in pretransplant and posttransplant patients. However, the diversity of gut microbiota and its relationship with the immune parameter of liver transplantation recipients are not well understood. METHODS: We collected fresh feces and blood samples from 190 participants in China from November 2004 to May 2008, including 28 healthy volunteers, 51 cirrhotic patients and 111 liver-transplanted patients. Six interesting gut bacteria, plasma endotoxin, serum cytokines (i.e., tumor necrosis factor alpha and interleukin-6) and fecal secretory IgA (SIgA) were investigated by real-time quantitative PCR, chromogenic limulus amoebocyte assay, sandwich-type enzyme-linked immunosorbent assay and radioimmunoassay, respectively. RESULTS: All Eubacteria, Bifidobacterium spp., Faecalibacterium prausnitzii and Lactobacillus spp. were significantly lower in the liver transplantation recipients while Enterobacteriaceae and Enterococcus spp. were significantly higher (P<0.05). Except for Enterococcus spp., other bacteria showed a tendency to restore to normal level along with the time after liver transplantation. Plasma endotoxin, interleukin-6 and fecal SIgA in cirrhotic patients increased significantly, but not in liver transplantation recipients. Plasma endotoxin and interleukin-6 were negatively correlated with all Eubacteria and the Bacteroides-Prevotella group, while tumor necrosis factor alpha was not significantly correlated with these six gut bacteria in cirrhotic patients.CONCLUSIONS: Our study demonstrates that abundant gut bacteria were altered significantly in both cirrhotic and liver transplantation patients, while plasma endotoxin and interleukin-6 increased remarkably in cirrhotic patients, showing significant correlations with gut microbiota. Interestingly, our data show a tendency for these gut bacteria to restore to normal levels in liver transplantation recipients. | Zhong-Wen Wu, Zong-Xin Ling, Hai-Feng Lu, Jian Zuo, Ji-Fang Sheng, Shu-Sen Zheng and Lan-Juan Li State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases Key Lab of Combined Multiorgan Transplantation, Ministry of Public Health, Key Lab of Organ Transplantation and Department of Hepatobiliary and Pancreatic Surgery , First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，1： | 37 |
| 7 | Relationship between expression of Smac and Survivin and apoptosis of primary hepatocellular carcinoma显示文摘BACKGROUND: T he second mitochondria-derived activator of caspase/direct inhibitor of apoptosis-binding protein with low pI (Smac/DIABLO) was recently identified as a protein that is released from mitochondria in response to apoptotic stimuli and promotes apoptosis by antagonizing inhibitor of apoptosis proteins. Furthermore, Smac/DIABLO plays an important regulatory role in the sensitization of cancer cells to both immune- and drug-induced apoptosis. However, little is known about the clinical significance of Smac/DIABLO in various cancers including hepatocellular carcinoma (HCC). This study was undertaken to investigate the expression of Smac and Survivin and their relationship with the apoptosis in primary HCC. METHODS: The expression of Smac and Survivin proteins was evaluated by immunohistochemistry. The mRNA expression of Smac and Survivin was evaluated by reverse transcription-polymerase chain reaction (RT-PCR) in HCC tissues of 50 patients, para-carcinoma tissues of 20 patients, and normal liver tissues of 15 patients. RESULTS: Smac mRNA was detected by RT-PCR in HCC tissues of 21 (42.0%) of the 50 patients, para-carcinoma tissues of 19 (95.0%) of the 20 patients, and normal liver tissues of 15 (100%) of the 15 patients. Survivin mRNA was found in HCC tissues of 46 of the 50 patients, para- carcinoma tissues of 2 of the 20 patients, and normal liver tissues of 0 of 15 patients. Immunohistochemistry revealed Smac protein in HCC tissues of 20 patients (40.0%), in para-carcinoma tissues of 18 patients (90.0%), and normal liver tissues of 15 patients (100.0%). The expression of Smac was significantly different in HCC tissues and non- HCC tissues. Survivin protein was found in HCC tissuesin 45 patients, para-carcinoma tissues in 2 patients, and normal liver tissues in none of the patients. The expression of Survivin was significantly different in HCC tissues and non-HCC tissues. CONCLUSION: Smac inhibits apoptosis of HCC cells by suppression of Survivin, and the two genes probably form an important link in the signal pathway of HCC cells. | Shi-Ting Bao, Shui-Qing Gui and Mu-Sheng Lin Department of Hepatobiliary Surgery, Affiliated Hospital of Guangdong Medical College, Zhanjiang 524001, China | 2006 | Hepatobiliary & Pancreatic Diseases International2006，5，4： | 28 |
| 8 | Pancreatic encephalopathy in 24 patients with severe acute pancreatitis显示文摘BACKGROUND: Pancreatic encephalopathy (PE), an un- familiar complication of severe acute pancreatitis ( SAP) , is difficult to diagnose and treat, and it has a high mortality. The aim of this study was to investigate the manifestation, classification, mechanism and therapy of PE. METHODS: Of 132 patients with SAP treated at our hospi- tal from March 1994 to March 2004, 24 patients complicated by PE were analyzed retrospectively. RESULTS: The causes of SAP were mostly biliary and alco- holic. Twenty-four patients (18.2%) were complicated by PE within 3 hours-38 days ( average 6. 6 days) [ 21 (87. 5%) within 2 weeks, and 3(12.5%) after 2 weeks]. Eleven pa- tients were male and 13 female, with an average of 47 years (range 25-72 years). Excitement or restrain was the main manifestation. Nine patients (37.5%) received surgery and 15 (62.5%) conservative treatment, with a mortality of 11.1 % (1/9) and 66.7% (10/15), respectively. CONCLUSIONS: PE occurs 2 weeks after SAP and is part of multiple organ failure (MOF). Some patients have PE in the late stage of SAP because of lack of VitB1 and nutri- tion. But PE can be prevented by prescribing adequate nu- trition and VitB1 in the early stage of SAP. | Xiong Ding, Chang-An Liu, Jian-Ping Gong and Sheng-Wei Li Chongqing, China Department of Hepatobiliary Surgery, Second Clinical College, Chongqing University of Medical Sciences, Chongqing 400010, China | 2004 | Hepatobiliary & Pancreatic Diseases International2004，3，4： | 26 |
| 9 | Clinicopathologic features, diagnosis and surgical treatment of intrahepatic cholangiocarcinoma in 104 patients显示文摘BACKGROUND: The outcome of surgical treatment of pa- tients with intrahepatic cholangiocarcinoma (ICC) is poor. This study was designed to analyze the relationship between clinicopathologic features and the survival time after opera- tion. METHODS: The operation was performed in 104 patients with mass-forming type ICC at our hospital between No- vember 1996 and May 2000. Seventy-nine patients (76.0%) were followed up successfully. Sixteen clinicopathological variables including age, sex, history of chronic liver di- sease , HBsAg, operation, adjuvant therapy, ascites, lymph node metastasis, invasion of adjacent organs, tumor size, necrosis of tumor, envelope, intrahepatic metastasis, Inter- national Union Against Cancer (UICC) TNM staging, his- tology, and cirrhosis were selected for univariate and multi- variate analyses to evaluate their influence on the prognosis. RESULTS: The accumulative 1-, 3-, 5-year survival rates of the 79 patients were 49.4%, 17.3%, 9.6% respectively. Univariate analysis revealed that sex (P=0.0221), HBsAg (P=0.0115), operation (P=0.0042), adjuvant therapy (P= 0.0389), ascites (P=0.0001), invasion (P=0.0220), intra- hepatic metastasis (P=0.0000) and TNM stage (P= 0.0001) were related to survival time. Multivariate analysis revealed that HBsAg, ascites and TNM stage were signifi- cantly related to prognosis. CONCLUSION: Early diagnosis and treatment and major hepatectomy are essential to improving the results of surgi- cal treatment of ICC patients. | Xiao-Hui Fu, Zhao-Hui Tang, Ming Zong, Guang-Shun Yang, Xiao-Ping Yao and Meng-Chao Wu Shanghai, China Department of Comprehensive Therapy of Hepatobi- liary Tumors, Eastern Hepatobiliary Surgery Hospital, Shanghai 200438, China | 2004 | Hepatobiliary & Pancreatic Diseases International2004，3，2： | 24 |
| 10 | Multi-slice three-dimensional spiral CT cholangiography: a new technique for diagnosis of biliary diseases显示文摘Objective: To validate multi-slice three-dimensionalspiral CT cholangiography (3-D CTC) in clinical di-agnosis of biliary diseases.Methods: This study included 146 patients with bili-ary diseases, involving 73 cases of biliary tumor, 87cases of radioparent calculus, 12 cases of post cholan-gio-jejunostomy and one case of congenital choledo-chocyst. The data of thin-slice volumetric CT scanwere sent to the workstation (GE Advantage Win-dows 3. 1). Rational 3-D CTC including maximumintensity projection, minimum intensity projection,surface shaded display, CT virtual endoscopy andray sumption was performed. The diagnostic accura-cy of 3-D CTC was compared with that of conven-tional CT, ultrasonography and endoscopic retro-grade cholangiopancreaticography (ERCP).Results: Different biliary diseases showed distinct ima-ging manifestations on 3-D CTC, As a new techniquefor assessing the status of post cholangio-jejunosto-my, 3-D CTC was superior to conventional CT, ul-trasonography and ERCP in diagnosis of negative bil-iary calculus, extrahepatic cholangiocarcinoma,cancer embolus of the biliary duct, carcinoma of thepancreas head and periampullar carcinoma. It wasalso superior to conventional CT, ultrasonography orequal to ERCP in diagnosis of hilar cholangiocarcino-ma, but inferior to conventional CT and ultrasonog-raphy in diagnosis of gallbladder cancer.Conclusion: 3-D CTC as a non-invasive and sensitivetechnique for the diagnosis of biliary diseases withhigh diagnostic accuracy will greatly increase the de-tection rate of biliary diseases. | Ai-Min Xu Hong-Yan Cheng Wen-Bin Jiang Dong Chen Yu-Chen Jia Meng-Chao Wu the Department of Radiology, Eastern Hepatobiliary Surgery Hospital, Shanghai 200438, China | 2002 | Hepatobiliary & Pancreatic Diseases International2002，1，4： | 22 |
| 11 | Risk factors of intrahepatic cholangiocarcinoma in patients with hepatolithiasis:a case-control study显示文摘BACKGROUND:Why 3.3% to 10% of all patients with hepatolithiasis develop intrahepatic cholangiocarcinoma (ICC) remains unknown.We carried out a hospital-based case-control study to identify risk factors for the development of ICC in patients with hepatolithiasis in China.METHODS:Eighty-seven patients with pathologically diagnosed hepatolithiasis associated with ICC and 228 with hepatolithiasis alone matched by sex,age (±2 years),hospital admittance and place of residence were interviewed during the period of 2000-2008.Odds ratios (OR) and 95% confidence intervals (CI) were calculated for each risk factor.RESULTS:Among the patients with hepatolithiasis associated with ICC,the mean age was 57.7 years and 61.0% were female Univariate analysis showed that the significant risk factors for ICC development in hepatolithiasis were smoking,family history of cancer,appendectomy during childhood (under age 20),and duration of symptoms >10 years.In multivariate stepwise logistic regression analysis,smoking (OR=1.931,95% CI:1.000-3.731),family history of cancer (OR=5.175,95% CI:1.216-22.022),and duration of symptoms >10 years (OR=2.348 95% CI:1.394-3.952) were independent factors.CONCLUSION:Smoking,family history of cancer and duration of symptoms >10 years may be risk factors for ICC in patients with hepatolithiasis. | Zhen-Yu Liu,Yan-Ming Zhou,Le-Hua Shi and Zheng-Feng YinAuthor Affiliations:Molecular Oncology Laboratory and Department of Comprehensive Treatment I,Eastern Hepatobiliary Surgery Hospital,Second Military Medical University,Shanghai 200438,China Department of Hepato-Biliary-Pancreato-Vascular Surgery,First Affiliated Hospital,Xiamen University,Xiamen 361003,China | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，6： | 21 |
| 12 | Clinical significance of serum intercellular adhesion molecule-1 detection in patients with hepatocellular carcinoma显示文摘INTRODUCTION Since the late 1980s,studies on the expression ofintercellular adhesion molecule-1(ICAM-1)inpatients with malignancies have demonstrated thatICAM-1 may strongly express in two forms in suchdiseases:membranous one on the surface of tumorcells(membrane-bound ICAM-1)and soluble one incirculation(soluble ICAM-1,sICAM-1). | Ming Hui Mei Jing Xu Qin Fen Shi Jing Hong Yang Qian CHen Li Ling Qin Department of Hepatobiliary Surgery, Institute of Hepatobiliary Surgery,Guilin Medical College,Guilin 541001,Guangxi Province,China | 2000 | World Journal of Gastroenterology2000，6，3： | 20 |
| 13 | Serum thymosin β4 levels in patients with hepatitis B virus-related liver failure显示文摘AIM:To investigate whether serum thymosinβ4 can provide diagnostic or prognostic information in liver failure patients caused by chronic hepatitis B virus(HBV) infection. METHODS:Serum thymosinβ4 levels were measured in 30 patients with acute-on-chronic liver failure(ACLF), 31 patients with chronic liver failure(CLF),30 patients with compensated liver cirrhosis(CR)and 32 patients with chronic hepatitis B and 30 healthy controls.Serum thymosinβ4 levels were measured by enzyme-linked immunosorbent assay and Child-Pugh and model for end-stage liver disease(MELD)scores were calculated for each patient on admission.RESULTS:Compared with healthy controls,serum thymosinβ4 levels in ACLF,CLF,CR and chronic hepatitis B patients were significantly lower,6.5047 (4.7879-10.5314)μg/mL vs 0.4632(0.2759-0.8768) μg/mL,0.6981(0.5209-1.2008)μg/mL,1.8053 (0.8110-2.3397)μg/mL,3.7803(1.8570-6.4722)μg/mL, respectively(P<0.001).The levels of thymosinβ4 in liver failure(ACLF or CLF)patients were markedly lower than that in CR(P<0.001),and a difference was also found between CLF and ACLF patients(P=0.038).In patients with chronic liver disease,there was a positive relationship between thymosinβ4 levels and albumin, choline esterase,and platelet(P<0.001),and negative relationship with alanine aminotransferase(P=0.020), aspartate aminotransferase,total bilirubin,international normalized ratio of prothrombin time,and Child-Pugh and MELD scores(P<0.001).Of the 61 liver failure patients,the thymosinβ4 levels of non-survivors were significantly lower than that of survivors(P=0.007). Receiver operating characteristics analysis identified a thymosinβ4 cutoff level of 0.5708μg/mL for predicting poor prognosis in all liver failure patients.The serial thymosinβ4 values were observed in 13 liver failure inpatients.Lower initial values were observed in the death.While greater improvement in thymosinβ4 value was found in those who recovered from the disease. CONCLUSION:Serum thymosinβ4 can be used as an important potential predictor for liver failure caused by chronic HBV infection. | Tao Han,Ying Liu,Huan Liu,Zheng-Yan Zhu,Yan Li,Shi-Xiang Xiao,Zhen Guo,Zhen-Gang Zhao,Department of Hepatology,Tianjin Institute of Hepatobiliary Disease,Tianjin Key Laboratory of Artificial Cells,Tianjin Third Central Hospital,Tianjin Medical University,83 Jintang Road,Tianjin 300170, China | 2010 | World Journal of Gastroenterology2010，16，5： | 20 |
| 14 | Protective effect of probiotics on intestinal barrier function in malnourished rats after liver transplantation显示文摘BACKGROUND: Most patients waiting for liver transplantation have end-stage liver diseases with malnutrition, which is prone to induce intestinal barrier dysfunction after liver transplantation. We aimed to study the effect of probiotics on intestinal barrier function in malnourished rats following liver transplantation with long-term antibiotics. METHODS: Twelve Lewis rats were selected as donors. Twelve BN rats, which served as recipients, were subjected to malnutrition by semi-starvation for 4-5 weeks. They were randomly divided into two groups: a control group which received phosphate-buffered saline and a probiotics group which received Bifidobacterium and Lactobacillus. All recipients were injected with intramuscular imipenem and subcutaneous cyclosporine A. Furthermore, six normal BN rats without any drugs or operations served as a normal group. Eight days after operation, all rats were sacrificed for examination of the following parameters: serum levels of endotoxin and TNF-α, bacterial translocation, intestinal microflora, ileocecal sIgA, lymphocyte numbers, and phenotypes (CD4, CD8, αβTCR, γδTCR)ofPeyer'spatches. RESULTS: In recipients subjected to malnutrition, weight decreased by 20% and they survived until 8 days after operation. Compared with the normal group, all recipients on postoperative day 8 showed increased levels of serum endotoxin and TNF-α as well as increased counts oftranslocated bacteria. Meanwhile, there were decreases in counts of Bifidobacterium and Lactobacillus in the ileocecum, sIgA concentration, and lymphocytes of Peyer's patches. Moreover, partial alteration in lymphocyte phenotypes was evidenced by elevated ratios of CD8 + and γδTCR + lymphocytes. In contrast, compared to the control group, supplementation with probiotics reduced the levels of serum endotoxin, TNF-α and bacterial translocation, increased the counts of Bifidobacterium and Lactobacillus, the concentration of sIgA and lymphocytes of Peyer's patches, and also slightly restored the alteration of lymphocyte phenotypes. CONCLUSION: Supplementation with probiotics including Bifidobac-terium and Lactobacillus promoted partial restoration of intestinal microflora and improved intestinal barrier function in malnourished rats after liver transplantation with long-term use of antibiotics. | Zhi-Gang Ren, Hui Liu, Jian-Wen Jiang, Li Jiang, Hui Chen, Hai-Yang Xie, Lin Zhou and Shu-Sen Zheng Key Laboratory of Combined Multi-organ Transplan- tation, Ministry of Public Health, and Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China and Institute of Immunology, Zhejiang University School of Medicine, Hangzhou 310058, China | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，5： | 20 |
| 15 | Correlation between gene expression of CCK-A receptor and emptying dysfunction of the gallbladder in patients with gallstones and diabetes mellitus显示文摘BACKGROUND: The incidence of gallstone is higher in patients with diabetes mellitus than in general population because of hypomotility and lowered emptying function. The aim of this study was to investigate the gene expression of cholecystokinin-A ( CCK-A) receptor in patients with gallstones and diabetes mellitus and its correlation with the hypomotility of the gallbladder. METHODS: Smooth muscle was taken from the gallbladder after cholecystectomy and total RNA was extracted from it by Trizol reagent to compose cDNA. CCK-A receptor was enlarged by reverse transcription-polymerase chain reaction (RT-PCR) and identified by electrophoresis. Based on the analysis of images, the relative expression of the CCK-A re- ceptor was obtained after comparison of the CCK-A recep- tor and β-action. The emptying function of the gallbladder was measured with B ultrasound before operation. RESULTS: Gallbladder ejetion fraction ( GBEF2 ) (%) (24.9±12.7) decreased more significantly in patients with gallstones and diabetes mellitus than in those with simple gallstone (61.5±8.5) (P <0.01). In the two groups, a frac- tion of 540bp of CCK-A receptor could be testified respec- tively, but the relative expression was different. Compared to the expression of β-action, it was 0. 400 ±0.068 in pa- tients with gallstones and diabetes mellitus, but 0. 622 ± 0.070 in those with gallstone only (F =7.169, P <0.01). The result was consistent with the decreased contractility. CONCLUSIONS: The gene expression of CCK-A receptor on the smooth muscle of the gallbladder may decrease more significantly in patients with gallstone and diabetes mellitus than in those with gallstone only; this result is con- sistent with the decreased motih’ty. Thus the lowered ex- pression of CCK-A receptor is probably the cause of hypo-motility in patients with gallstones and diabetes mellitus. | Xiong Ding, Chang-You Lu, Ying Mei, Chang-An Liu and Yu-Jun Shi Chongqing, China Department of Hepatobiliary Surgery, Second Clinical College, Chongqing Medical University, Chongqing 400010, China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，2： | 20 |
| 16 | Changes of serum alpha-fetoprotein and alpha-fetoprotein-L3 after hepatectomy for hepatocellular carcinoma: prognostic significance显示文摘BACKGROUND: Alpha-fetoprotein (AFP) is the most established tumor marker of hepatocellular carcinoma (HCC), but one of its limitations is non-specificity. Many studies have demonstrated that alpha-fetoprotein-L3 (AFP-L3) is more specific than AFP in the early diagnosis and prognosis of HCC. However, there is a lack of knowledge about the post-hepatectomy profiles of serum AFP and AFP-L3 values in HCC patients. To identify the profiles after surgical resection of HCC, we analyzed the correlation between the profiles and postoperative HCC recurrence or survival, and evaluated their utility in predicting postoperative therapeutic efficacy and prognosis. METHODS: From August 2003 to December 2004, 318 patients with positive serum AFP who had received surgical resections were enrolled in this study. Preoperative and postoperative serum AFP and AFP-L3 levels were measured simultaneously and regularly, and their postoperative profiles during a long term follow-up were recorded and summarized. RESULTS: A high ratio of AFP-L3 to total AFP was shown to correlate with pathologic features of aggressiveness. The overall 1-, 3-, and 5-year recurrence rates of the whole series were 28% 57%, and 84%, and the overall survival rates were 86%, 61% and 33%, respectively. The changes of serum AFP and AFP-L3 after hepatectomy for HCC were classified into 3 groups (group A: AFP-L3 undetectable; group B: AFP-L3 <10%; and group C: AFP-L3 >10%). Patients with positive postoperative AFP-L3had significantly earlier recurrence than those with negative results. The overall survival was significantly shorter in the positive groups than in the groups negative for postoperative AFP-L3.CONCLUSION: Post-hepatectomy changes in serum AFP and AFP-L3 levels occurred in three distinct patterns, which were closely correlated with HCC recurrence and patient survival with different prognostic values. | Xiao-Feng Zhang, Zheng-Feng Yin, Kui Wang, Zong-Qin Zhang, Hai-Hua Qian,Le-Hua ShiAuthor Affiliations: The 4th Department of Hepatic Surgery ,Molecular Oncology Laboratory , Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，6： | 19 |
| 17 | The molecular mechanism underlying angiogenesis in hepatocellular carcinoma: the imbalance activation of signaling pathways显示文摘OBJECTIVE: To explore the effect of two dominating signaling pathways, VEGF/KDR andangiopoietins/Tie2, on the formation of new blood vessel in hepatocellular carcinoma (HCC) growth andmetastasis.METHODS: RT-PCR and Western blot were employed to evaluate the VEGF/KDR andangiopoietins/Tie2 expression in samples from 23 patients with HCC. Meanwhile, microvessel density(MVD) was determined as a marker of angiogenesis by counting CD34 positive cells with the method ofimmunohistochemistry.RESULTS: The two pathways were activated in all HCC samples. The expressions of vascular endothelialgrowth factor (VEGF) and angiopoietin-2 (Ang2) were significantly higher (P<0.05) in hepatocellularcarcinoma tissues and the margin of the tumor than those in control groups, and so did CD34 positivecells. Although significant difference in the expression of kinase insert domain containing receptor (KDR)and Ang1/Tie2 was not observed in all groups, their distinct high levels were seen in hepatoma and itsmargin compared with normal and cirrhotic liver. VEGF and Ang2 expressions were seen up-regulated inHCC with vascular invasion and satellite lesion.CONCLUSIONS: The two signaling pathways, VEGF/KDR and angiopoietins/Tie2 are activated in theprocess of angiogenesis in HCC and modulate the formation of new blood vessels. The imparity of the twosignaling pathways’ activation is to benefit HCC metastasis. In the two pathways, VEGF and Ang2 mayplay an important role in the process of angiogenesis, and are necessary indicators for the prognosis andmetastasis of HCC. This study provides another clue for the exploration of anti-angiogenic agents. | Zhi-Cheng Zhao Shu-Sen Zheng Yun-Le Wan Chang-Ku Jia Hai-Yang Xie the Department of Hepatobiliary Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China | 2003 | Hepatobiliary & Pancreatic Diseases International2003，2，4： | 19 |
| 18 | Risk factors and incidence of acute pyogenic cholangitis显示文摘BACKGROUND: Acute cholangitis varies from mild to severe form. Acute suppurative cholangitis (ASC), the severe form of acute cholangitis, is a fatal disease and requires urgent biliary decompression. Which patients are at a high risk of ASC and need emergency drainage is still unclear. The present study aimed to identify the factors for determining early-stage ASC and distinguishing ASC from acute cholangitis. METHODS: We analyzed 359 consecutive patients with acute cholangitis who had been admitted to the First Affiliated Hospital, Zhejiang University School of Medicine from January 2004 to May 2011. Emergency endoscopic retrograde cholangiopancreatography (ERCP) was carried out in all patients to decompress or clear the stones by experienced endoscopists Clinical and therapeutic data were collected, and univariate and multivariate analyses were performed to identify the potential risk factors of ASC. RESULTS: Of the 359 patients, 1 was excluded because of failure of ERCP drainage. Of the remaining 358 patients with an average age of 62.7 years (range 17-90), 162 were diagnosed with ASC, and 196 with non-ASC. ENBD catheters were placed in 343 patients (95.8%), of whom 182 patients had stones removed at the same time, and plastic stent was placed in 25 patients (7.0%) Clinical conditions were improved quickly after emergency biliary drainage in all patients. Complications were identified in 11 patients (3.1%): mild pancreatitis occurred in 8 patients and hemorrhage in 3 patients. There was no mortality. Univariate analysis showed that several variables were associated with ASC: age, fever, decreased urine output, hypotension, tachycardia abnormal white blood cell count (WBC), low platelet, high C reactive protein (CRP), and duration of the disease. Multivariateanalysis revealed that advanced age, hypotension, abnormal WBC, high CRP, and duration of the disease were independent risk factors for ASC. CONCLUSIONS: This study demonstrates that advanced age, hypotension, abnormal WBC, high CRP, and long duration of antibiotic therapy are significantly associated with ASC. We recommend decompression by ERCP should be carried out in patients as early as possible. | Yun-Sheng Qin, Qi-Yong Li, Fu-Chun Yang , Shu-Sen Zheng Division of Hepatobiliary and Pancreatic Surgery Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health Key Laboratory of Organ Transplantation Zhejiang Province, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，6： | 18 |
| 19 | Diagnosis and treatment of solid-pseudopapillary tumor of the pancreas显示文摘BACKGROUND: Solid-pseudopapillary tumor (SPT) of the pancreas is a rare exocrine pancreatic tumor. Despite the increasing recognition of the tumor in recent years, its pathogenesis and apparent therapeutic algorithm remain unclear. This study was designed to define the clinical, imaging, and pathologic features and to improve the diagnosis and treatment of this rare disease. METHOD: The clinical, imaging, and pathologic findings of 9 SPT patients managed in our hospital between 2001 and 2005 were retrospectively analyzed, and related literatures were reviewed. RESULTS: In the 9 patients aged from 14 to 68 years, 8 were female and 1 male. The mean age of these patients at diagnosis was 30 years. Initially, 8 patients complained of vague abdominal pain and one patient had pancreatic mass detected incidentally by abdominal CT. The levels of blood and urine amylase and tumor markers were all within the normal range. B-US, CT and MRI demonstrated that tumors were well encapsulated and contained some degree of internal hemorrhage or cystic degeneration. The mean transverse diameter of these tumors was 5.4 cm (range, 2-10.5 cm). The tumors were located at the head (2 patients), body (2), body and tail junction (4), and tail (1) of the pancreas. Surgical procedures included pancreaticoduodenectomy, distal pancreatectomy, distal pancreatectomy with splenectomy, and enucleation. Histological examination showed solidified cystic areas and papillary protrusions. Two malignant tumors demonstrated retroperitoneal metastases and vascular invasion. Follow-up for 2.5 years on average showed that one patient died of tumor recurrence at 10 months and the rest were alive. CONCLUSIONS: SPT exhibits unique clinical and pathologic features and is readily diagnosed by its characteristic imaging and histological appearance. Surgical resection of the primary tumor and metastases is the treatment of choice. | Hao Zhang, Ting-Bo Liang, Wei-Lin Wang, Yan Shen, Guo-Ping Ren and Shu-Sen Zheng Department of Hepatobiliary Surgery , and Department of Pathology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China | 2006 | Hepatobiliary & Pancreatic Diseases International2006，5，3： | 18 |
| 20 | Pathogenesis of acute lung injury in rats with severe acute pancreatitis显示文摘BACKGROUND: Acute lung injury (ALI) is the most common and severe complication of severe acute pancreatitis (SAP). The elucidation of the mechanism of ALI contributes to the diagnosis and treatment of the illness. In this study, we studied the pathogenesis of ALI in rats with severe acute pancreatitis. METHODS: The rats were sacrificed at 1, 3, 5, 6, 9 and 12 hours after the establishment of the model of SAP. Pancreas and lung tissues were obtained for pathological study, and examination of microvascular permeability and myeloperoxidase (MPO) examination. The gene expressions of tumor necrosis factor-α (TNF-α) and intercellular adhesion molecule-1 (ICAM-1) in the pancreas and lung tissues were detected by reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: After the establishment of the SAP model, the degree of pancreatic and lung injury increased gradually along with the gradual increase of MPO activity and micro-vascular permeability. Gene expressions of TNF-α and ICAM-1 in the pancreas rose at 1 hour and peaked at 7 hours. In contrast, their gene expression in the lungs rose slightly at 1 hour and peaked at 9-12 hours. CONCLUSION: An obvious time window existed between SAP and lung injury, which is beneficial to the early prevention of the development of ALI. | Xue-Min Liu, Jun Xu and Zi-Fa Wang Department of Hepatobiliary Surgery, First Hospital, Xi’an Jiaotong University, Xi’an 710061 , China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，4： | 18 |
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