Objective To investigate the practicability and safety of laparoscopic anatomical hepatectomy.Method 40 patients with space occupying lesions in the liver underwent laparoscopic anatomical hepatectomy between Jan.2008 and Mar.2012.The diagnoses were hepatocellular carcinoma (HCC) (n=13),recurrent HCC (n =1 ),cholangiocarcinoma ( n =1 ),metastatic cancer ( n=6),hepatolithiasis (n=10),hemangioma (n=7),FNH (n=1) and liver cell adenoma (n =1).Intraoperative ultrasound was routinely performed to locate lesions and intrahepatic structures.Selective hemihepatic vascular occlusion was applied during resection. High frequency cautery,CUSA and Ligasure were used to transect liver parenchyma. Hemolocks were applied when large blood vessels and bile ducts were encountered.Endo-GIA was used if necessary.The operations included right hemihepatectomy (n =3),left hemihepatectomy (n =10),resections of segment Ⅴ and Ⅵ (n=5),segment Ⅴ (n=3),segment Ⅵ (n =4),and segment Ⅳb (n =1).Result34 hepatectomics were performed laparoscopically.6 patients were converted to open surgery.There was no perioperative death. The operating time was 250.21±50.94 min,and intraoperative blood loss was 420.20± 120.10 ml.Bile leakage was diagnosed in 2 patients after operation.Conclusion With careful patient selection,and improvement in surgical technique and apparatus,laparoscopic anatomical hepatectomy has become safe and practicable.The operation has the advantages of minimal invasion and rapid recovery. It can be regarded as a standard procedure for selected benign and malignant lesions.

Objective To observe the migration and distribution of OECs in injured spinal cord and discuss their relation with the recovery of spinal cord function. Methods The rats were contused by a force of 10 g · 25 mm with NYU-impactor at T10 level. The OECs acutely isolated from green fluorescence protein (GFP) rats were purified, identified and then transplanted into the injured site and the rostral and caudal parts of the spinal cord one week after injury, with total volume of the transplanted OECs for 90 000/μl. Within 13 weeks after transplantation, the migration and distribution of OECs were qualitatively observed on the cryo-sections under fluorescence light microscope. The area and the length of OECs distribution were semi-quantitatively determined. The locomotor function of the spinal cord was appraised by BBB score. Results OECs were located collectively in the transplanted site at early stage after transplantation and then spread gradually mainly along the long axis of the cord. OECs could be found in the cavity of the contused spinal cord. The area and the length of OECs distribution were increased from 1.33 mm2 and 4.23 mm respectively at one week to 3.30 mm2 and 7.68 mm respectively at 13 weeks after transplantation. In the meantime, the locomotor function was gradually improved. Conclusion OECs can migrate within the contused spinal cord, as may contribute to the recovery of locomotor function.

Objective To investigate the expression of 14-3-3 β in esophageal squamous cell carcinoma (ESSC) tissue,and to explore the relationship between 14-3-3 β and clinicopathological factors,prognosis.Methods The 14-3-3 β expressed in tumors and adjacent normal epithelia from 78 esophageal squamous cell carcinoma patients was detected by immunohistochemical staining.Results The mild and strong expression in the nucleus of esophageal squamous cell carcinoma and adjacent tissues was 62.8％ (49/78) and 17.9％ (14/78),there was significant difference (P ＜ 0.01).The mild and strong expression in the cytoplasm of esophageal squamous cell carcinoma and adjacent tissues was 69.2％ (54/78) and 29.5％ (23/78),there was significant difference (P ＜ 0.01).The 14-3-3 β was associated with the differentiation degree of esophageal squamous cell carcinoma(P ＜ 0.01).It had nothing to do with sex,age,TNM stage,size and survival rate (P ＞ 0.05).Conclusions The expression of 14-3-3 β is significantly up-regulated in esophageal squamous cell carcinoma patients.The expression of 14-3-3 β in the nucleus and cytoplasm is higher and has positively associated with tumor differentiation degree.

Objective To explore the clinical effects of unilateral placement of plastic stents by ERCP for nonresectable Bismuth type IV hilar cholangiocarcinoma.Methods A prospective study was conducted in 42 patients with nonresectable Bismuth type IV hilar cholangiocarcinoma,who had unilateral insertion of plastic stents in the recent 4 years,All of the patients had successful insertion of single plastic stent by ERCP manipulation.Early results (less than 30 days) of procedure-related complications,mortality,long-term results (greater than 30 days) and survival were observed.Results All of the 42 patients had successful drainage.Mean total bilirubin value decreased from (332.3?163.4)?mol/L to (30.6?18.5)?mol/L,and complete resolution of jaundice was achieved in 61.9% (26/42)of the patients.Early comlications included papilla bleeding due to EST in 4 of 42 patients (9.5%) and acute cholangitis in 10 of 42 patients (23.8%).No procedure-related death occurred.All of the patients needed to have their stents replaced periodically,and the median duration up to the first stent replacement was 65 d,and without significant differences between the two groups in stent insertion to the left and right hepatic duct.Median duration of stent patency was 5.15 months,and median patient survival was 6.5 months,but also no significant differences were found between the two groups.Conclusions Unilateral plastic stent insertion is safe and feasible,can achieve adequate drainage for relatively long time,and can improve life quality and survival for patients with nonresectable hilar cholangiocarcinoma.

Objective To observe the expression of brain-derived neurotrophical factor (BDNF) in injury spinal cord after transplantation olfactory ensheathing cells (OECs), and to investigate the mechanism of OECs repairing spinal cord injury.Methods OECs from GFP transgenic rats were separated and cultured for transplantation. Spinal cord injury rats were separated two groups by random digits table. In experimental group, OECs suspension were transplanted into injured spinal cord following spinal cord injury. In control group, DMEM was transplanted into the injured spinal cord after spinal cord injury. Motor function was evaluated per week after transplantation. The expression levels of BDNF mRNA and protein were detected by using RT-PCR and immunohistochemistry respectively, and compared with those from normal SD rats.Results Motor function of two groups was improved gradually after transplantation. The motor function scores in experimental group was obviously higher than in control group at 21st day after transplantation (P<0.05). A lot of survival GFP OECs distributed around impaired myeloid tissue. At 21st day after transplantation, BDNF mRNA and protein expression in experimental group were strongest (P<0.05), and stronger in control group than in normal group (P<0.05).Conclusion The transplantation of OECs can repair the injured spinal cord by increasing the expression of BDNF mRNA and protein to improve local microenvironment.

Neural crest stem cells originated from hair follicle (epidermal neural crest stem cell, EPI-NCSC) are easy to obtain and have potentials to differentiate into various tissues, which make them eminent seed cells for tissue engineering. EPI-NCSC is now used to repair nerve injury, especially, the spinal cord injury. To investigate their effects on repairing peripheral nerve injury, EPI-NCSC from a GFP-SD rat were primarily cultured on coated dishes and on a poly lactic acid coglycolic acid copolymer (PLGA) membrane. Methyl thiazolyl tetrazolium (MTT) assay showed that the initial adhesion rate of EPI-NCSC was 89.7% on PLGA membrane, and the relative growth rates were 89.3%, 87.6%, 85.6%, and 96.6% on the 1st, 3rd, 5th, 7th day respectively. Cell cycles and DNA ploidy analysis demonstrated that cell cycles and proliferation indexes of cultured EPI-NCSC had the same variation pattern on coated dishes and PLGA membrane. Then cultured EPI-NCSC were mixed with equal amount of extracellular matrix and injected into a PLGA conduit to connect a 10 mm surgery excision gap of rat sciatic nerve, Dulbecco's Modified Eagle's medium (DMEM) was used to substitute EPI-NCSC in the control group. After four weeks of transplantation, the defected sciatic nerve achieved a histological restoration, the sensory function of rat hind limb was partly recovered and the sciatic nerve index was also improved. The above results showed that a PLGA conduit filled with EPI-NCSC has a good repair effect on the peripheral nerve injury.
Animals ; Cells, Cultured ; Neural Crest ; cytology ; Neural Stem Cells ; cytology ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; pathology ; Spinal Cord Injuries ; Stem Cell Transplantation ; Tissue Engineering

Objective To study the feasibility and safety of laparoscopic hepatic caudate lobe resec tion.Methods The clinical data of seven patients who underwent laparoscopic hepatic caudate lobe resection in our hospital were retrospective analyzed.There were 3 male and 4 female patients.The mean age was 45.3 years.The primary diseases included hepatic haemangioma (n =2),metastatic liver cancer (n =2),hepatocellular carcinoma (n =1),recurrent hepatocellular carcinoma (n =1) and hepatic adenoma (n =1).The total blood loss,operation time,hospital stay after surgery and complication were analyzed.Results The surgery was successful in all these 7 patients and no patients required any conversion to open surgery.Five patients underwent partial caudate lobe resection,and the remaining 2 underwent combined left hemi hepatectomy with partial caudate lobe resection.The operation time ranged from 200 to 250 minutes with a mean of 235 minutes.The intraoperative blood loss ranged from 40 to 600 ml with a mean of 188 ml.There was no postoperative bleeding and bile leakage.The resections were all R0 resections.Conclusions Laparoscopic hepatic caudate lobe resection was safe and feasible in appropriate patients.Familiarity with anatomy of the liver caudate lobe and skilled laparoscopic techniques are important to carry out this surgery.

Objective To study the feasibility and safety of pure laparoscopic right hemihepatectomy for hepatocellular carcinoma via the anterior approach.Methods The data of five patients with hepatocellular carcinoma who underwent pure laparoscopic right hemihepatectomy at the First People's Hospital of Foshan between December 2013 and December 2016 were retrospectively analyzed.Patients'operation time,blood loss,blood transfusion rate,surgical margins,hospital stay,complication and short term outcomes were reviewed.Results All the five patients completed pure laparoscopic right hemihepatectomy without conversion to open surgery.The average (range) operation time was 6.0 (5 ～ 8) h.The average blood loss was 340 (110 ～ 600) ml.No patient received blood transfusion.The average surgical margin was 2.4 (1 ～4.5) cm.The average postoperative hospital stay was 7 (4 ～ 15) d.The average follow-up was 22 (2 ～38) months.Three patients experienced postoperative complications,which included ascites,pleural effusion,and ascites accompanied by biliary leakage,respectively.The last patient recovered well from drainage.No liver failure,cancer recurrence or death was noted.Conclusions This study demonstrated that pure laparoscopic right hemihepatotectomy via the anterior approach is a minimally invasive procedure which has the advantage of fast postoperative recovery.It was feasible and safe to treat hepatocellular carcinoma with favorable short-term outcomes.

ObjectiveTo investigate the influence of olsalazine on tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) in patients with chronic ulcerative colitis.MethodsSixty patients with chronic ulcerative colitis(observation group),including 22 chronic recurrent cases and 38 chronic persistent cases,were enrolled and treated with olsalazine.Meanwhile,60 healthy volunteers without disease history of ulcerative colitis were selected as control group.The concentrations of TNF- α and IL-10 in serum of the two groups were detected by ELISA and compared.ResultsBefore treatment,the concentration of TNF- α in serum of the observation group was significantly higher than that of control group [ (57.2 ± 10.1 )ng/L vs.(27.2 ± 6.9) ng/L],while IL-10 was significantly lower than that of control group[ (9.2 ± 2.1 ) ng/L vs.(17.3 ±2.9) ng/L] (P ＜0.05).Before treatment,the concentration of TNF-α in serum in chronic persistent patients and chronic recurrent patients[ (56.9 ± 9.9),(57.3 ± 9.7) ng/L ] were significantly higher than that in control group,and serum IL-10 in chronic persistent patients and chronic recurrent patients [ (9.1 ± 2.3 ),(8.4 ± 2.5 ) ng/L ] was significantly lower than that in control group (P＜ 0.05 ).The concentration of TNF- α in serum in observation group after treatment was obviously lower than that before treatment [(28.1 ±8.9) ng/L vs.(57.2 ± 10.1 ) ng/L],and IL-10 was obviously higher than that before treatment [(13.4 ± 10.7) ng/L vs.(9.2 ±2.1 )ng/L] (P ＜ 0.05).The concentration of serum TNF-αand IL-10 in chronic persistent and chronic recurrent patients before and after treatment had statistical significance (P＜0.05 ).ConclusionsOlsalazine can significantly decrease the concentration of TNF- α and increase the concentration of IL-10 in serum in patients with chronic ulcerative colitis.It is worthy of application in clinic.

Objective To detect the myelinating role of olfactory ensheathing cells (OECs in the contused spinal cord and their impact on remyelination.Methods The rats were subjected to spinal cord injury at T10(10 g ×25 mm) using a NYU-Ⅱ impactor.One week later,the rats were transplanted with green fluorescence protein (GFP)-OECs (OECs group) or an equal volume of Dulbecco' s modification of Eagle's medium (DMEM) (control group) at epicenter of the injury as well as its rostral and caudal sites.Six weeks after transplantation,the spinal cords were removed for frozen section.Myelin basic protein (MBP),protein zero (P0),and S100 protein (S100) were determined with qualitative and semi-quantitative immunocytochemical assay.Moreover,plastic embedded semithin and ultrathin sections were prepared for qualitative and semi-quantitative examination under light microscopy and electroscopic study of myelin sheath ultrastructure.Results In OECs group,the nerve fibers labeled with S100,MBP,and PO were extended from the normal tissues to the injured region and even grew through the region with space consuming of 12.3％,11.6％,and 9.3％ respectively.Moreover,there were no statistical differences regarding the number of fibers labeled by the three proteins,but all were significantly larger than that in control group (2.89％,P ＜ 0.01).Number of myelinated nerve fibers in injured regions on hemithin sections was increased significantly to 354.67 ± 59.00 in OECs group,with significant difference compared with 167.33 ± 42.16 in control group (P ＜ 0.01).The regenerated myelin sheaths in OECs group were smaller and thicker than those in control group.Conclusions OECs can accelerate regeneration of myelinated nerve fibers.Additionally,some OECs form myelin sheaths themselves,but the sheath structures are relatively thinner.