1.Selection and clinical significance of the extent of hepatectomy for gallbladder cancer
Journal of Clinical Surgery 2017;25(6):472-475
Gallbladder cancer is the most common malignant neoplasm in biliary system,with a high degrade of malignancy,invasion and metastasis.The prognosis is heartbreaking.Radical surgery is the only possible way for curing.The current understanding of China's doctors at all levels on radical surgery of gallbladder cancer is chaotic.Based on the latest version eighth TNM staging of the American Joint Committee on Cancer(AJCC)of gallbladder cancer,making a review of the literature,combined with the author's personal experience,we have interpreted the reasonable selection of hepatectomy of gallbladder cancer,in order to improve the doctors at all levels to regulate the understanding of hepatectomy and the prognosis of gallbladder cancer.
3.Interventional Treatment for Superior Vena Cava Syndrome with Malignant Causes
Lei SONG ; Feng WANG ; Donghua JI
Chinese Journal of Minimally Invasive Surgery 2001;0(04):-
Objective To evaluate the efficacy and clinical value of percutaneous transluminal angioplasty(PTA)with stenting for the treatment of superior vana cava syndrome(SVCS)with malignant causes.Methods A total of 13 patients with SVCS with malignant causes were enrolled in this study.Among the patients,2 had mediastinal cancer,and 11 had metastatic mediastinal tumor.The malignancy of the primary tumors of the 11 patients,including pulmonary cancer in 8,esophageal cancer in 2,and breast cancer in 1,were all confirmed by pathological examination.Via the right femoral vein,a pigtail catheter was introduced percutaneously into the proximate or remote end of the stenotic segment for the visualization of the SVC.After the location,length,and gravity of the stenosis were determined,Wallstent(Boston Scientific,USA)was placed into the SCV,if the patients had no local thrombosis in the stenotic segment.In one patient,a Z-shape stent(COOK,USA)was inserted simultaneously.For the cases complicated with thrombosis,the Wallstent was inserted after local thrombolysis.Results The procedure was completed in all the 13 patients with a success rate of 100%.The average length of the stenotic segment was 4.3 cm(3-6 cm).In one patient,two stents were used,while in the others only one stent was inserted.Thrombolysis was carried out before stenting in 6 patients.The intravenous pressure at the proximate end of the stenotic segment was determined with the patients supine before and after stenting.The pressure decreased from(26.2?1.6)cm H2O to(4.3?0.8)cm H2O after the operation.Postoperative angiography showed no collateral vein in the patients.The SCVS disappeared 0 to 3 days after the surgery.The patients were followed up for 8-26 months with a median of 13.During this period,8 patients died of multiple organ failure caused by multiple metastasis of the primary tumor in 4 to 10 months;the other 5 patients survived(3 of them received further therapies)without recurrence of SCVS.Conclusion PTA with stenting combined with local thrombosis is an effective and invasive treatment for patients with SCVS with malignant causes.
4.A case with hereditary fructose intolerance.
Si-jin ZHANG ; Ji WANG ; Lei ZHANG
Chinese Journal of Pediatrics 2006;44(12):957-957
5.Comparative analysis of the efficacy of neural navigation assisted endoscopic treatment for hypertensive cerebral hemorrhage
Lei JI ; Rui CHENG ; Chunhong WANG ; Hongming JI
International Journal of Surgery 2016;43(10):663-667,封4
Objective To explore the clinical application and value of endoscopic surgery in the treatment of hypertensive cerebral hemorrhage assisted with neuronavigation,we compared it with traditional craniotomy.Methods We collected hypertensive cerebral hemorrhage patients with the application of neuronavigation assisted endoscopic surgery from January 2012 to November 2015,and randomly selected 30 cases as experimental group;and collected hypertensive cerebral hemorrhage patients with craniotomy and then randomly selected 30 cases as the control group.What did we respectively record about the two groups were postoperative GCS score,skin incision length,operation time,bleeding volume,length of stay,postoperative complications,and KPS score of the postoperative follow-up of sixth months;after that,the dates of the two groups were compared and analyzed.Results Compared the experimental group to the control group,postoperative GCS score did not achieve statistically significant difference (P > 0.05);in the skin incision,there was statistically significant difference between two groups (P < 0.05),the average incision length in the experimental group was (4.25 ±0.44) cm,however it was (13.27 ± 1.01) cm in the control group;as for the operation time,it was averagely (93.93 ±21.04) min for the experimental group,and (176.50 ± 35.65) min for the control group,there was statistical difference between two groups (P <0.05);with regard to the amount of intraoperative bleeding,the mean amount in the experimental group was (69.83 ± 23.83) ml,and (196.17 ± 33.83) ml in the control group,the difference was statistically significant (P < 0.05);and the average hospitalization days for the test group was (13.33 ± 1.79) d,(16.20 ± 4.31) d for the control group,it was considered statistically significant (P < 0.05);in complications,the test group incidence was significantly lower than that in the control group,the difference between the two groups has statistical significance (P < 0.05);after postoperative follow-up of 6 months,we found that the prognosis of experimental group is better than that of control group,and statistical significance was described by analyzing the KPS scores of two groups (P < 0.05).Conclusions Neuronavigation assisted endoscopic technique in the treatment of hypertensive cerebral hemorrhage has many advantages,such as accurate localization,direct vision,perfect hemostasis,and less bleeding.It is minimally invasive and can also shorten the operation time as well as lengths of stay.Besides,it can reduce the incidence of complications and bring better postoperative recovery.
6.Integrated account audits management of medical insurance payment
Difei WANG ; Xiaojing WANG ; Boya ZHAO ; Xu GUO ; Lei JI
Chinese Journal of Hospital Administration 2013;29(8):606-609
Using the enterprise resource planning(ERP)management mode,the paper analyzed the present medical insurance payment audit accounts at public hospitals,and probed into the establishment of an information management platform for medical insurance payment audit accounts in the ERP environment.The purpose is to perfect the management of medical insurance payment audit accounts,increase the efficiency of hospital's working capital,strengthen the quality and efficiency of hospital management.
7.CysC specific peptides: bioinformatics analysis and mass spectrometry verification
Lei SHEN ; Huimin WANG ; Huoyan JI ; Pei SHEN ; Jianxin WANG
Chinese Journal of Clinical Laboratory Science 2017;35(6):444-447
Objective To analyze the specific peptide of cystatin C (CysC) and its characteristics by bioinformatics technology,and verify the predicted results by mass spectrometry.Methods Online software was applied to analyze the physicochemical properties and homology of CysC peptides hydrolyzed by trypsin and predict the associated parameters of ionized fragmentation of specific peptide by mass spectrometry.Precursor ion scan and product ion scan were conducted on the samples of synthetic specific peptide.The recombinant human CysC and serum samples were analyzed by mass spectrometry after trypsin digestion.The results of analysis were compared with the outcomes predicted by bioinformatics.Results T3 (ALDFAVGEYNK) was considered as the specific peptide of CysC by software analysis.When selecting[M + 2H] 2 + for product ion scan,almost all the y and b ions of fragmentation were observed using tandem mass spectrometry (MS/MS),showing consistency with Skyline predictions.Moreover,both the peptides from the human recombinant CysC and serum sample following the trypsin digestion were eluted at the same time with the isotope-labeled T3 * under the fixed conditions.Conclusion Bioinformatics technology could be available for picking out the specific peptides of target protein quickly and efficiently and predicting the ionized fragmentation precisely by mass spectrometry scanning.
9.Bibenzyl from Dendrobium inhibits angiogenesis and its underlying mechanism.
Chenyuan GONG ; Bin LU ; Li YANG ; Lei WANG ; Lili JI
Acta Pharmaceutica Sinica 2013;48(3):337-42
Bibenzyl is a type of active compounds abundant in Dendrobium. In the present study, we investigated the inhibitory effects of six bibenzyls isolated from Dendrobium species on vascular endothelial growth factor (VEGF)-induced tube formation in human umbilical vascular endothelial cells (HUVECs). All those bibenzyls inhibited VEGF-induced tube formation at 10 micromol x L(-1) except tristin, and of which moscatilin was found to have the strongest activity at the same concentration. The lowest effective concentration of moscatilin was 1 micromol x L(-1). Further results showed that moscatilin inhibited VEGF-induced capillary-like tube formation on HUVECs in a concentration-dependent manner. Western blotting results showed that moscatilin also inhibited VEGF-induced phosphorylation of VEGFR2 (Flk-1/KDR) and extracellular signal-regulated kinase 1/2 (ERK1/2). Further results showed that moscatilin inhibited VEGF-induced activation of c-Raf and MEK1/2, which are both upstream signals of ERK1/2. Taken together, results presented here demonstrated that moscatilin inhibited angiogenesis via blocking the activation of VEGFR2 (Flk-1/KDR) and c-Raf-MEK1/2-ERK1/2 signals.
10.Establishment of a rat model of alcoholic liver fibrosis induced by complex factors
Lei WANG ; Guang JI ; Peiyong ZHENG ; Aihua LONG
Journal of Integrative Medicine 2006;4(3):281-4
OBJECTIVE: To establish a model of alcoholic liver fibrosis (ALF) in rats induced by complex factors. METHODS: Forty-seven healthy male rats were divided into three groups: normal control group (n=12), minor CCl4 group (n=12) and complex factors group (n=27). The rats in the complex factors group were fed a complex diet including alcohol, corn oil and pyrazole, and administered with intraperitoneal injection of minor CCl4 to induce ALF. During induction process, the histopathological changes of liver tissue and the values of liver-to-body weight ratio were both observed regularly. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (gamma-GT) in these three groups were all examined at the 12th week of the induction process. RESULTS: At the 12th week of the induction process, the model of ALF induced by complex factors was successfully established in rats, and the histopathological presentations showed alcoholic fatty liver, hepatitis and liver fibrosis in a sequence along with the induction process. The value of liver-to-body weight ratio and the serum levels of ALT, AST and gamma-GT of rats in the complex factors group were all significantly different from those in the other two groups. CONCLUSION: It is a steady and effective way to induce ALF in rats with complex diet and minor CCI4 injection.