Objective To investigate the diagnostic value of PIgP/SC in diagnosis of primary hepatic cancer.Methods 58 patients with primary hepatic cancer,60 patients with liver cirrhosis and 60 healthy volunteers were studied.4 ml fasting venous blood was collected from all subjects.Serum level of AFP was detected with electrochemical chemiluminescence immunoassay system and plasma PIgR/SC level was detected by ELISA method.The level of PIgR/SC and AFP was detected at one week after surgical resection in patients with hepatic cancer.Results The levels of AFP and PIgR/SC in the three groups were significantly different (P＜0.01),and PIgR/SC was higher than that in patients with cirrhosis and volunteers (P＜0.01).There was no significant difference between patients with liver cirrhosis and liver cirrhosis(P＞0.05).AFP was higher in patients with HCC than patients with cirrhosis and volunteers.AFP was higher in patients with cirrhosis than volunteers,and the difference was statistically significant(P＜0.01).Sensitivity of PIgR/SC and AFP was 89.3％ and 54.8％,specificity was 84.6％ and 91％,Youden index was 0.751 and 0.458,AUC was 0.920 and 0.761,respectively.There was significant difference in AUC (Z=3.251,P＜0.05) of the two detection indexes for detection of primary hepatic cancer.Conclusion The value of PIgR/SC in diagnosis of primary liver cancer may by higher than that of AFP.

Objective To conduct a meta-analysis to explore the merits and disadvantage of total endoscopic thyroidectomy and conventional open thyriodectomy.Methods A database searching was performed on the Chinese BioMedical Literature on disc(CBM),China National Knowledge Infrastructure(CNKI),wanfang database,VIP database and PubMed database.Prospective randomized controlled studies about total endoscopic thyroidectomy and conventional open thyroidectomy were selected and analyzed.RevMan 5.2 was used for statistical analysis.Results Eleven studies matched the selection criteria,which involved 1082 patients,among whom 505 patients underwent total endoscopic thyrodiectomy (endoscopy group) and 577 patients underwent conventional open thyroidectomy (open group).Outcomes of total endoscopy group and open group in satisfaction,operation time,drainage fluid,complications and post-operative hospital stay etc were compared.Meta analysis showed endoscopy group were supeior to open group in terms of intraoperative blood loss (WMD＝-17.86,95％ CI:[-26.18,-9.54]),postoperative hospital stay (WMD＝-0.95,95％ CI:[-1.40,-0.50])and patients' satisfaction (WMD＝4.03,95％ CI:[1.20,13.58])while the operation time was longer in endoscopy group than in open group (WMD＝12.61,95％ CI:[2.85,22.38]).There was no statistical significance on postoperative drainage(WMD＝ -0.70,95％ CI:[-32.79,31.39]) or complications (RR＝0.84,95％ CI:[0.54,1.29])for the two groups.Conclusions Total endoscopic thyriodectomy has advantages in terms of satisfaction,post-operative hospital stay,and intraopetative blood loss while it takes more operation time.There is no difference among drainage fluid or complication.

Objective To explore the effect of intraoperative parathyroid hormone (IOPTH) examination on parathyroidectomy for primary hyperparathyroidism.Methods The clinical data of 41 PHPT patients who received IOPTH monitoring (IOPTH group) from Jan.2009 to Dec.2014 were retrospectively analyzed.The clinical manifestation,examination and changes of parathyroid hormone and calcium before and after operation were collected.Results There were 12 males and 29 females.36 cases had parathyroid adenoma,and 5 cases were parathyroid carcinoma.23 cases were positive in 24 cases of 99Icm-MIBI parathyroid adenoma radionuclide examination,and 2 cases were positive in 3 cases of parathyroid carcinoma radionuclide 99Tcm-MIBI inspection (P＝ 0.213).10 mins after tumor resection,PTH in all cases decreased by 50％ or more than that before tumor resection except for one case of parathyroid carcinoma.23 cases appeared hypocalcemia in 36 cases of parathyroid adenoma after surgery and 2 cases appeared hypocalcemia in 5 cases of parathyroid cancer patients (P＝0.361).No postoperative hoarseness,cough,bleeding occoured.Patients were followed up from 6 to 72 months.Hypocalcemia symptoms recovered 2 weeks to 3 months after surgery.No permanent hypoparathyroidism occured.One case of parathyroid carcinoma died of hypercalcemia 5 months after surgery.The remaining 40 cases survived without recurrence or death.Conclusions Intraoperative PTH monitoring can help doctors analyze whether all the hyperthyroidism glands have been removed,which can help to avoid miss diagnosis of multiple gland disease and unnecessary bilateral neck exploration.This method is highly accurate so it is recommended for routine use in PHPT surgery.

Objective To explore the alteration and effect of autophagy in pancreas tissue of rat injected by exenatide.Methods Diabetes model rats were induced by two-month high-sugar and high-fat diet and streptozotocin injection (35 mg/kg) in normal rats.50 SD male rats were divided into four groups according to the principle of complete random design,namely normal control group (n=10),normal exenatide-injected group (n=10),diabetes-model control group (n=l5) and diabetes-model exenatide-injected group (n=15).Rats in exenatide-injected groups were subcutaneously injected with exenatide respectively in 5 μg/kg dose each time,twice a day,at 8 a.m.and 6 p.m.Animal weights were weighted weekly and the dose of exenatide was adjusted according to current weight.Rats in the two control groups were injected with the corresponding amount of saline.Mter 10 weeks of treatment,all rats were killed and pancreatic tissues were disposed.Immunohistochemistry was used to measure the expression of GLP-1R in pancreatic tissues.Western blot was used to test the expressions of LC3-Ⅰ,LC3-Ⅱ and p62 in pancreatic tissues,and LC3-Ⅱ/Ⅰ ratio and p62 were compared between any two groups.All specimens were stained with hematoxylin-eosin (HE).The data were expressed as means ± standard deviation and were analyzed by unpaired Student t test using SPSS 18.0 statistics software.P value ＜0.05 was considered to be statistically significant for all tests.Results The pancreatic tissues from 13 rats (6 from the normal exenatide-injected group and 7 from the diabetes-model exenatide-injected group) appeared pathological changes such as gland structure damage,pancreatic cells atrophy and cells compartment broadening.The expressions of GLP-1R,LC3-Ⅱ and p62,and LC3B-Ⅱ/Ⅰ ratio in the two exenatide-injected groups were higher than those in the respective control group,and the differences had statistical significance (P＜0.05).Conclusions Long-term subcutaneous injection of exenatide can upregulate the expression of GLP-1R in rat pancreatic acinar cells and may induce the impaiment of autophagy flux in rat pancreatic cell.

Objective To investigate the expression and significance of signal pathway Wnt/β-catenin in prostate cancer stem cells.Methods Prostate cancer tissues,hyperplasia prostate tissues and normal prostate tissues were collected,then prostate cancer stem cells were selected from cell suspension in the culture system of serum-free medium by magnetic activated cell sorting system.Immunohistochemical SP test,RT-PCR and Western blot were applied to test the expression of Wnt and β-Catenin mRNA or protein in prostate cancer stem cells,hyperplasia prostate tissues and normal prostate tissues.Results The protein expression of Wnt and β-Catenin was higher in prostate cancer tissues compared with that in hyperplasia prostate tissues and normal prostate tissues;mRNA expression of Wnt and β-Catenin was higher in prostate cancer stem cells (4.57±0.83,3.93±0.78) than in hyperplasia prostate tissues (1.32±0.35,1.48±0.44) and normal prostate tissues (1.00±0.12,1.00±0.11),and the difference was statistically significant (F＝13.287,12.648,P＝0.000).Protein expression of Wnt and β-Catenin was higher in prostate cancer stem cells(0.87±0.10,1.12±0.23) than in hyperplasia prostate tissues(0.39±0.08,0.64±±0.11) and normal prostate tissues (0.33±0.09,0.45±0.10),and the difference was statistically significant (F＝16.625,14.417,P＝0.000).Conclusion Signal pathway Wnt/β-catenin is stimulated abnormally in prostate cancer stem cells,causing the occurrence of prostate cancer,providing a new research direction for treatment of prostate cancer.

Objective To estimate the safety,feasibility and generalization of three point single-incision laparoscopic cholecystectomy (SILC).Methods The clinical data of 1 126 patients who underwent three-point SILC at the second department of Hepatobiliary Surgery of Zhu Jiang Hospital,Southern Medical University From January 1,2011 to December 30,2015 was analyzed retrospectively.The patient who were indicated for conventional laparoscopic cholecystectomy were included,but those suspected malignant diseases of gallbladder were excluded.Results Of the 1126 patients,the surgery was performed successfully in 923 patients,and 192 patients need extra ports due to the adhesion and difficulty of exposing the Calots triangle,and 11 were converted to open surgery due to severe adhesion,with the success rate being 81.9％.The operating time was (29.5 ± 12.2) min (from the entrance of laparoscope to the removing of gallbladder),the blood loss was (8.7 ± 7) ml,and the hospital stay time was (1.4 ± 0.7) d (after surgery).There were three cases of bile duct injury:two of them were bile leak of aberrant duct,one of them was bile leak of cystic duct damaged by heat.And there was one case of injury of duodenum,22 cases of umbilicus hematoma,13 cases of hematoma of thorax,and 2 cases of thoracic hemorrhage who required surgery.There were no hernia,aerothorax and so on.Conclusion Three point SILC is a technology that is safe,maneuverable and suitable for being carried out in clinical practice.

Objective To study the efficacy and feasibility of the one-stage and two classification method to treat concomitant gallbladder stones and common bile duct stones.Methods 56 consecutive patients with concomitant gallbladder stones and common bile duct stones in Central Hospital of Huzhou were treated with the one-stage and two classification method from January 2013 to January 2017.According to the size and quantity,common bile duct stones were divided into difficult stones and non difficult stones.In plan A (n =35),endoscopic stone clearance and laparoscopic cholecystectomy were undertaken in a single operation to treat non difficult stones,In plan B (n =21),laparoscopic cholecystectomy and CBD exploration without T-tube insertion were undertaken in a single operation to treat difficult stones.The operation success rate,postoperative complications,hospitalization stay and follow-up outcomes were analyzed.Results Fifty-six patients were enrolled in the study.Fifty-one patients were treated by the one-stage and two classification method.Among them,thirty-two patients followed treatment plan A.Three patients were convened to plan B because of failure of bile duet intubation.Nineteen patients were treated by plan B.One patient was converted to laparotomy,and another underwent T-tube drainage.The incidence of complication was 7.1％.Post-ERCP pancreatitis happened in one patient.Post ERCP bleeding happened in another patient (1.6％).Bile leakage occurred in one patient,and incision infection occurred in one patient.There were no deaths.During a follow-up of 6-24 months,no stone recurrence and bile duct stenosis were observed.Conclusion The one-stage and two classification method was an effective and feasible alternative to manage concomitant gallbladder stones and common bile duct stones.

Objective To investigate the effect of occult HBV infection (OBI) on carcinogenesis of cryptogenic hepatocellular carcinoma.Methods Samples of hepatocellular carcinoma (HCC) and pericarcinomatous tissues obtained after hepatectomy from January 2011 to November 2013 at the Third Affiliated Hospital of Sun Yat-Sen University were collected.They were divided into two groups:the cryptogenic HCC group (the CH group,n =26) and the HBV related HCC group (the HH group,n =40).These samples were compared with the normal liver tissues obtained in 30 patients.HBV DNA was identified by the nested polymerase chain reaction and the immunohistochemical method was taken to examine the hepatitis B virus X protein (HBx) and Yes-associated protein (YAP) expressions.Results OBI was identified in 20 (77.8％) cryptogenic HCC patients and 8 (26.7％) in the control group.There was a significant difference between the two groups (x2 =14.072,P ＜ 0.05).HBV DNA was detected in all the HBV-related HCC patients.The HBx protein expression was mainly located in the cytoplasm of liver cells and liver cancer cells,but YAP was expressed in the nucleus.Both of them showed diffuse brown or tan particles.In the HH group and the CH group,the positive expression rates of HBx protein in the tumorous tissues were 80.0％ and 90.0％,respectively,and 85.0％ and 82.5％ in the nontumorous tissues,but only in 40.0％ in the control group.The positive expression rates of YAP in the tumorous tissues were 65.0％ and 67.5％,respectively,15.0％ and 20.0％ in the nontumorous tissues,respectively,but only in 12.5％ in the control group.The HBx expression in the cancerous tissues and para-cancerous tissues of the HH group and the CH group showed no significant difference (P ＞ 0.05),but the YAP expression in the tumor tissues was significantly higher than that in the nontumorous tissues (P ＜ 0.05).The HBx and YAP expressions in the HH group were comparable to the CH group (P ＞ 0.05).However,their expressions in the cancerous tissue of the HH group and the CH group were significantly higher than in the normal liver tissues (P ＜ 0.05).Conclusion A high prevalence of HBV infection was observed in HBsAg-negative HCC and the high expressions of HBx and YAP might be involved in the process of cryptogenic hepatocellular carcinoma.

Intraductal papillary mucinous neoplasm (IPMN) is a kind of epithelial neoplasms of mucin-producing cells arising in the main duct and/or branch ducts of the pancreas,and it is one of the precancerous lesions of the pancreatic cancer.With the development of pathology and radiology,the diagnostic rate of IPMN has been gradually increased and given a new understanding on the pathological characteristics,clinical diagnosis and treatment of IPMN.This review overviewed the classification,diagnosis,management and prognosis of IPMN,aiming to deepen the understanding of IPMN and improve the level of diagnosis and treatment.

As an essential trace element for human,Zn is involved in the synthesis of various enzymes,and plays important roles in the growth and proliferation of cells.At the cellular level,Zn2+ homeostasis is maintained through the complex mechanisms of uptake,storage and excretion,where the Zn transporter families play certain roles.Two major Zn transporter families,namely the SLC30 (ZnT) family and the SLC39 (ZIP) family,have been identified,which act to control the intra-and extracellular equilibrium of Zn2+.While the ZnT family mainly transports Zn out of the cells,while the ZIP family mainly contributes to the uptake and transport of Zn into the cells.The ZIP family has been noted to be associated with various diseases,and be closely related to the development and progression of tumors.Recent studies have suggested low ZIP1 and ZIP2 expression in prostate cancer,high ZIP6,ZIP7 and ZIP10 expression in breast cancer,high ZIP3 and ZIP4 expression in pancreatic cancer,and high ZIP5 and ZIP6 expression in esophageal cancer.The ZIP family may,therefore,function as tumor suppressor genes in prostate cancer,and oncogenes in pancreatic cancer,breast cancer and esophageal cancer.This paper reviews the latest research progress on SLC39 transporter family and tumors.