1.Diagnosis and treatment of primary duodenal papilla neoplasm
Chunlan HE ; Ping CHEN ; Yun TANG
Chinese Journal of General Surgery 2001;0(08):-
ObjectiveTo study the diagnosis and treatment of primary duodenal papilla neoplasm(PDPN). MethodsThe clinical data of 64 patients with PDPN were analysed retrospectively. Results Among 38 cases received deodunscopy, PDPN were found in 32 cases (84.2%). Tumors were found in 49 of 51 cases received ERCP. There were 2 cases of benign tumor and 62 of maligancies in this series. 4 of 46 cases survived 4 years after Whipple operation,and 4 of 11 cases underwent lacal resection of PDPN suvived 4~6 years. ConclusionsTEndoscopy and ERCP are main methods for the diagnosis of PDPN; It is essential to use the rationale operation to improve the results of surgical treatment.
2.Percutaneous transhepatic cholecystoscopy in treating cholecystolithiasis
Xu REN ; Chunlan ZHU ; Xiufen TANG
Chinese Journal of Digestive Endoscopy 2001;0(03):-
Objective To evaluate the significance of percutaneous transhepatic cholecystoscopy ( PTCCS) in managing cholecystolitheasis. Methods From September 1999 to November 2001, eighty - six patients with symptomatic gallstones were allocated into this study. At first percutaneous transhepatic gallbladder drainage ( PTGBD) was carried out, one week later the formed fistula was dilated by bouginage to 16-22Fr in diameter, thereafter cholecystoscope was inserted into gallbladder through the dilated fistula to extract the stones using basket or electrohydraulic lithotripsy (EHL). Results PTGBD was attempted successfully in 82 out of 86 cases, PTCCS was performed in 80 of them. The amount of stones ranged from 1 to 76, single stone in 28 patients, stones more than two in 52 , with stone size ranged from 5 to 32 mm, and stones greater than 15mm in 45 cases. The stones were removed only using basket in 28, and by EHL in 54 cases due to their large size. The overall stone removal rate was 97. 5 % (78/80) . Complication of peritonitis appeared in 4 cases (4. 7% ) requiring emergent surgical intervention. The follow - up period with an average of 16. 4 months, gallstones recurred in 2 cases (2.5%). Stones were assayed by intra - red spectrom-etry in 30 of 54 patients with EHL, cholesterol stone existed in 24 of them. Conclusion PTCCS is relatively a safe and effective procedure for those patients with high risk on surgical cholecystectomy, or unsuitable to receive laparoscopic cholecystectomy. If the patients were selected strictly along the rules of indication, the complication and stone recurrence can be avoided.
3.Risk factors of recurrent common bile duct stones after ERCP
Xiufen TANG ; Xu REN ; Chunlan ZHU ; Xiaohong XU
Chinese Journal of Digestive Endoscopy 2010;27(11):572-575
Objective To investigate the risk factors of recurrent common bile duct (CBD) stones after treatment with endoscopic retrograde cholangiopancreatography (ERCP). Methods A total of 802 patients with CBD stone and with complete follow-up data were recruited to the study, among which 297 patients were accompanied with gallstone, 222 patients having undergone cholecystectomy before ERCP and 283 having no gallstones. The CBD stone recurrent frequency and the possible risk factors were calculated with uni- and multi-variate logistic regression analysis. Results The patients were followed up at a mean duration of 84. 8 months, and CBD stone re-occurred in 92 (11.5%). Both uni- and multivariate analysis showed gallstones, CBD larger than 1.5 cm, endoscopic mechanical lithotrity (EML) and angle of bile duct less than 120° were risk factors of recurrence. Multivariate analysis showed cholesterol stones, cholangeal stricture or sphincter of Oddis dysfunction (SOD) were all risk factors for reccurrence. Univariate analysis revealed that history of cholecystectomy or Billroth Ⅱ gastrectomy, stones larger than 1.5 cm and multiple stones were risk factors of recurrence. Conclusion For those with CBD stones undergoing ERCP, gallstone,common bile larger than 1. 5cm, EML and the angle of CBD less than 120° are major risk factors of recurrence. History of cholecystectomy and Billroth Ⅱ gastrectomy, SOD, large CBD stone ( ≥1.5 cm), cholesterol stone and multiple stones are also associating risk factors.
4.Thyroid dysfunction induced by interferon α therapy in chronic hepatitis
Yuejun PAN ; Ruosu YING ; Huimin FAN ; Chunlan ZHANG ; Xiaoping TANG
Chinese Journal of Clinical Infectious Diseases 2008;1(3):153-155
Objective To investigate the prevalence and clinical characteristics of thyroid dysfunction induced by IFNα therapy in patients with chronic hepatitis.Methods Thyroid function of 310 patients with chronic hepatitis receiving IFNα therapy were evaluated.Results Serum free tri-iodothymnine (F13),free thyroxine(FT4)and sensitive thyroid-stimulating hormone(sTSH)of all patients were normal and TGAb was negative before IFNα therapy.After the treatment,10 patients(10/3 10,3.22%)had thyroid dysfunction,in which 7 were of hypothyroidism and 3 were of hyperthyroidism.The thyroid function of all patients recovered within 1-year follow-up.Conclusions IFNα therapy may induce thyroid dysfunction in patients with chronic hepatitis,in which prognosis can be good when appropriate treatment is given.
5.Correlation between bile amylase elevation and biliary tract disease in patients with normal pancreaticobiliary junction
Xu REN ; Xiufen TANG ; Ming DU ; Chunlan ZHU
Chinese Journal of Digestive Endoscopy 2010;27(3):123-126
Objective To investigate the relationship between bile amylase (BA) elevation and biliary tract disease in patients with normal pancreaticobiliary junction (NPBJ). Methods The bile juice was collected from bile duct in 202 consecutive cases who underwent therapeutic endoscopic retragrade cholangiopancreatography (ERCP) for biliary diseases ( biliary bile group), and from gallbladder (GB) in 73 consecutive cases who underwent percutaneous transbepatic cholecystoscopy for extraction of GB stone ( GB bile group). In biliary bile group, in addition to the measurement of BA, the level of lipnse (n =68), bacteria culture ( n = 149 ), manometry of Oddi's sphincter ( n = 27 ) and bile duct ( n = 38) were also performed. In GB bile group, additional GB biopsy was taken in 31 cases. No patient with pancreaticobiliary maljunction, history of cholangiojejunostomy or post-endoscopic sphincterotomy was included in the study. Results In biliary bile group, BA level was elevated in 95 patients (47. 0% ), in which there was no significant difference between neoplastic and non-neoplastic cases ( 56. 9% vs. 43.7%, P > 0. 05 ), although BA was elevated in most patients with hiler cholangiocarcinoma (7/9). The level of BA was correlated with bile lipase (r =0. 561 ), but not with pressure of Oddi's sphincter or bile duct. No significant difference in positive rate of bile bacteria culture was detected between patients with normal BA level and those with elevated level. In GB bile group, BA level was elevated in 25 patients (34. 3% ), in which the frequency of GB epithelium dysplasia is 87.5%, which was significantly higher than that from patients with normal BA level ( P < 0. 001 ). Conclusion The patients with biliary tract disease and NPBJ have high incidence of reflux of pancreatic juice into bile duct. In patients with elevated BA level, there was no significant difference between incidences of neoplastic or non-neoplastic disease, while the frequency of GB epithelium dysplasia and hilar cholangiocarcinoma were higher than those from patients with normal BA level.
6.Clinicopathological significance of MMP-2 and MMP-9 expressions in non-small cell lung cancer:a tissue microarray study
Chunlan TANG ; Heping YANG ; Xiuwu BIAN ; Qingliang WANG ; Rong ZHANG
Journal of Third Military Medical University 1988;0(06):-
0.05). The positive rates of MMP-2 and MMP-9 were significantly higher in the cases with lymphnode metastasis [84.72% (61/72) and 77.78% (56/72)] than those without lymphnode metastasis [50% (4/8) and 37.50% (3/8), P
7.The value of biliary tumor markers for differentiatial diagnosis of benign and malignant biliary diseases
Lixin TANG ; Xu REN ; Lingling ZHANG ; Xiufen TANG ; Chunlan ZHU ; Yongping QU
Chinese Journal of Digestive Endoscopy 2014;31(1):22-25
Objective To investigate the value of biliary tumor markers for differential diagnosis of the benign and malignant biliary tract diseases.Methods Tumor markers (CA19-9,CEA and CA242) examination and bacterial culture were performed in a total of 160 patients,who underwent therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for biliary diseases.Resuts There were significant differences between malignant group and benign group in bile and serum in the level of CA19-9,CEA and CA242 (P <0.05) ; Cut-off value,according to ROC curve,was 239 ku/l in CA19-9,40 ng/ml in CEA and 60 ku/ml in CA242,respectively.There were significant differences between the bile marker and the serum marker in sensitivity,accuracy,negative predicative value of CEA (P < 0.05).No significant differences was found in specificity between the serum group and the bile group.There were significant differences in bile CA19-9 level between cholangiocarcinoma,pancreatic cancer,duodenal papilla carcinoma with carcinoma metastasizing to bile duct,and hepatocellular carcinoma (P < 0.05).Both in benign group and malignant group,there were significant differences in CA19-9 level between infectious bile and noninfectious bile (P < 0.05).Conclusion The level of CA19-9,CEA and CA242 in bile can be applied to differentiate benign and malignant biliary diseases.The bile tumor markers do not have advantage over serum tumor markers in specificity for diagnosis.Bile bacterial infection can result in the elevation of bile CA19-9 while it does not have impact on differential diagnosis.
8.Impact of pancreatobiliary reflux in normal pancreatobiliary junction on gallbladder
Xiping ZHU ; Xu REN ; Hong JIANG ; Xiaoying LI ; Lingling ZHANG ; Xiufen TANG ; Chunlan ZHU
Chinese Journal of Digestive Endoscopy 2012;(12):669-672
Objective To explore the impact of pancreatobiliary reflux (PBR) in normal pancreatobiliary junction on gallbladder.Methods A total of 54 patients receiving cholecystectomy for gallbladder diseases underwent ultrasonography to evaluate the thickness of gallbladder wall,inner layer and gallbladder wall blood flow before operation.The bile juice was sampled during ERCP in 45 patients with common bile duct stone and during cholecystectomy in 9 patients to detect amylase level.All patients with normal pancreatobiliary junction enrolled in the study were assigned into PBR group (n =24) and controlled group (n =30) according to their bile amylase level.Resected gallbladder specimens were examined histopathologically and then tested for expression of COX2,Ki-67 and p53 immunohistochemically.Results PBR group included 20 cases of cholelithiasis and 4 gallbladder polyp,among which 23 were occult PBR (OPBR) and 1 high confluence of pancreatobiliary ducts (HCPBD),which was similar to pancreatobiliary maljunction (PBM) pathologically.The control group recruited 28 cases of cholelithiasis and 2 gallbladder polyp.There were no differences in frequency of inflammation,hyperplasia,metaplasia or expression of p53 between the two groups (p > 0.05),while higher presence of dysplasia and higher expression of COX2 and Ki-67 were seen in PBR group (p < 0.05).Conclusion In patients with OPBR,although hyperplasia and metaplasia in gallbladder epithelium were similar to those induced by cholelithiasis,dysplasia and active proliferation might relate to progress to malignancy.
9.A primary study of the different protein expression profiles between human oral squamous cell carcinoma and normal oral mucosa tissues
Wenmei WANG ; Chunlan ZHENG ; Qingang HU ; Wenhui JIANG ; Xiaofeng HUANG ; Wei TANG
Journal of Practical Stomatology 2009;25(4):540-543
Objective: To identify the different protein expression profiles between human oral squamous cell carcinoma (OSCC) and normal oral mucosa tissues, and provide experimental data for further study of the development mechanism of OSCC. Methods: 10 cases of OSCC and paired normal oral mucosa tissues were collected and analyzed through two-dimensional gel electrophoresis (2-DE) and matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS). Results: (1) The average protein spots of OSCC were 2 325±390, while that of normal oral mucosa tissues were 2 487±281. (2) 29 differential protein spots were found between OSCC and normal oral mucosa. Moreover, these protein spots were all down- regulated in OSCC compared with normal oral mucosa. Among these spots, 3 were identified as fibrin beta, triosephosphate isomerase (TIM) and unknown protein through mass spectrometry and bioinformation. Conclusion: Down-regulation of fibrin beta, Triosephosphate isomerase(TIM) and unknown protein are found in the development of OSCC and the mechanism needs further study.
10.Experimental study on determination of viability of Schistosoma japonicum cercariae by staining
Qinlu BAO ; Chunlan HUANG ; Dandan CHEN ; Xuelong WANG ; Shaosheng WANG ; Xiaoniu TANG ; Shulin ZHOU
Chinese Journal of Schistosomiasis Control 2015;(1):64-65,69
Objective To determine the viability of Schistosoma japonicum cercariae by staining. Methods Schistosoma japonicum cercariae were stained by 0.4%trypan blue 0.5%methylene blue?eosin?borax M.E.B 0.5%eosin 0.5%methy?lene blue and 0.05% neutral red respectively for 5 min then they were observed under a stereoscopic microscope. Results The dead cercariae were stained in the trypan blue M.E.B eosin and neutral red but unstained in the methylene blue. The vi?tal cercariae were unstained in all the five kinds of dyes. Conclusion The staining methods by using 0.4% trypan blue 0.5%M.E.B 0.5%eosin and 0.05%neutral red can be used to determine the viability of S. japonicum cercariae.