ObjectiveTo evaluate the effect of preoperative percutaneous transhepatic biliary drainage (PTBD) on postoperative outcomes after pancreaticoduodenectomy.MethodsThe clinical data of 115 patients undergoing pancreatoduodenectomy between 2001 and 2009 were retrospectively analyzed.The diagnosis of periampullary cancer or cancer of the pancreatic head was confirmed histologically.The preoperative total bilirubin level was more than 100 μmol/L and there was no concomitant cholangitis.Forty-two patients underwent PTBD (PTBD group),and 73 were not drained (early operation group).The following parameters were analyzed:wound infection,intra-abdominal abscess,intra-abdominal or gastrointestinal bleeding,biliary or pancreatic leakage,gastroparesis,morbidity and mortality.The length of hospital stay and cost were also assessed.ResultsThe perioperative mortality and morbidity were 2.38％/54.76％ in the PTBD group and 2.74％/50.68％ in the early operative group,respectively.There were no significantly differences between these two groups.Similar results were obtained in biliary leak,pancreatic leak,intra-abdominal infection,wound infection and gastroparesis.The length of hospital stay and cost were significantly less in the early operation group than the PTBD group.ConclusionsPTBD had no beneficial effects on postoperative outcomes following pancreaticoduodenectomy.For distal biliary obstruction,PTBD should not be carried out routinely.

Objective To investigate the value of Habib 4X in hepatic resection. Methods The clinical outcome of 21 patients with liver disease who received liver resection at the Tianjin Third Central Hospital from November 2009 to April 2010 were retrospectively evaluated. All the operations were carried out by using Habib 4X. Results All patients received hepatectomy, including right hepatectomy in three patients, left hepatectomy in one patient, multiple segmentectomy in nine patients, single segmentectomy in seven patients and partial liver resection in one patient. All tumors were reseeted completely. The mean operation time was (50±25) minutes and the mean blood loss was(129±117)ml. No patient was transferred to ICU. Three patients were complicated with bile leakage, one with lymphatic leakage and four with pleural effusion, and they were cured by non-surgical treatment. There were no patients with postoperative hemorrhage, incision infection or hepatic failure. No mortality was observed. The mean postoperative hospital stay was(19±14)days. Conclusions Radiofrequency energy was applied along the margins of the tumor to create zones of necrosis before resection with a scalpel, offering hepatobiliary surgeons an additional method for performing liver resections with minimal blood loss, low morbidity and mortality rates. As for malignant tumors, minor or major liver resection assisted by Habib 4X is safe, and it can reduce the chance of positive incisal margin.

Objective To analyze the features of clinical diagnosis and treatment of duodenal gastrointestinal stromal tumors(GIST).Methods Retrospective analysis was performed on clinical data of 5 cases of duodenal GIST treated in our hospital between April 2002 and May 2009.Results The duodenal GIST was mainly located in the 2nd(3/5)and 3rd portion of duodenum(2/5).Clinical diagnosis of the disease mainly depended on barium meal examination, gastrointestinal endoscopy, and CT scanning.Two patients were treated with pancreaticoduodenectomy, 1 with segmental duodenectomy and 2 with local resection.After operation, 2 patients had recurrence and 1 of them underwent adjuvant therapy with Gleevec.Conclusion Surgical resection is the only effective therapeutic method for duodenal GIST.Various surgical procedures are mainly determined by the location and size of the tumors.For patients with a high degree of pathologic grade, adjuvant therapy with Gleevec is necessary.

Objective To study the value of transcatheter arterial chemoembolization (TACE)in combination with portal vein chemotherapy (PVC) after resection of hepatocellular carcinoma to prolong survival. Methods From January 2000 to July 2007, 168 patients with hepatocellular carcinoma (HCC) underwent tumor resection in our hospital. After operation, TACE in combination with PVC was performed in 48 patients (combined group), TACE alone in 26 (TACE group), PVC alone in 50 (PVC group) and none of the above in 44 (control group). All the patients were followed up for 17-96 months. The 1-, 3-and 5-year survival rates were compared among the 4 groups. Results Accumulative 1-, 3-and 5-year survival rates were higher in the combined and TACE groups than in PVC and control groups. Conclusion After resection of HCC, combined use of TACE and PVC is the same as TACE in prolonging patient survival. However, it is better than PVC alone and non-surgical procedure.

Natural killer (NK) cells, as an essential part of innate immunity, can directly identify and kill tumor cells after being activated by the synergistic action of surface inhibitory receptors and activated receptors. It can secrete cytokines to recruit dendritic cells (DCs), induce DCs maturation and enhance adaptive immune response. It can target cancer stem cells (CSCs) and circulating tumor cells (CTCs) to inhibit cancer metastasis. NK cells have a unique inflammatory tendency, which can respond to cytokines and chemokines released from tumor sites and migrate to tumor sites, making them occupy an important advantage in cancer targeted therapy. The research on cancer targeted therapy of NK cells as drug delivery carriers, NK cell membrane-coated biomimetic nanoparticles, and NK cell extracellular vesicles (NKEVs) has attracted more and more attention. The article will focus on the mechanism of NK cells inhibiting cancer, and summarize the research progress of cancer targeted therapy of NK cells.

Astragali Radix, as a tonic with a long history, is one of the most common traditional Chinese medicines. Recently, chemical composition and pharmacological activities of Astragali Radix have been widely reported. Polysaccharide, triterpenes and flavonoids are regarded to its effective components. Pharmacological experiments and clinical reports show that Astragali Radix has good effects on immune-regulation, anti-tumor, anti-virus, diabetes, anti-aging and so on. Therefore, it shows a good prospect to make good use of its effective components.
Astragalus Plant ; chemistry ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Polysaccharides ; analysis ; Triterpenes ; analysis

Cardiac Catheterization ; Heart Septal Defects, Ventricular ; therapy ; Humans ; Prosthesis Implantation ; instrumentation ; Septal Occluder Device

OBJECTIVETo investigate the influences of mobile phone radiation on the quality and DNA methylation of human sperm in vitro.

METHODSAccording to the fifth edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen, we randomly selected 97 male volunteers with normal semen parameters and divided each semen sample from the subjects into two equal parts, one exposed to mobile phone radiation at 1950 M Hz, SAR3. 0 W/kg for 3 hours while the other left untreated as the control. We obtained routine semen parameters as well as the acrosomal reaction ability, apoptosis and DNA methylation of sperm, and compared them between the two groups.

RESULTSCompared with the control, the radiation group showed significantly decreased progressive sperm motility ([36.64 ± 16.93] vs [27.56 ± 16.92]%, P < 0.01) and sperm viability ([63.72 ± 16.35] vs [54.31 ± 17.35]%, P < 0.01) and increased sperm head defects ([69.92 ± 4.46] vs [71.17 ± 4.89]%, P < 0.05), but no significant differences in sperm acrosomal reaction ([66.20 ± 6.75] vs [64.50 ± 3.47]%, P > 0.05). The early apoptosis rate of sperm cells was remarkably higher in the radiation group ([6.89 ± 9.84]%) than in the control ([4.44 ± 5.89]%) (P < 0.05). However, no statistically significant differences were found between the control and radiation groups in the DNA methylation patterns of the paternal imprinting gene H19 ICR ([0.60 ± 0.02] vs [1.40 ± 0.03]%, P > 0.05) or the maternal imprinting gene KvDMR1 ([0.00 ± 0.00] vs [1.80 ± 0.031%, P > 0.05).

CONCLUSIONMobile phone radiation reduces the progressive motility and viability of human sperm and increases sperm head defects and early apoptosis of sperm cells.

Cell Phone ; DNA Methylation ; radiation effects ; Humans ; In Vitro Techniques ; Male ; Semen ; radiation effects ; Semen Analysis ; Sperm Head ; radiation effects ; Sperm Motility ; radiation effects ; Spermatozoa ; cytology ; radiation effects

To investigate the correlation between methylation and expression of multidrug resistance (mdr1) gene, restriction endonuclease HpaII combined with competitive PCR technique was used to quantitatively detect the methylation status of two CCGG sites located at -110 and -50 bp (region I and II) up to the transcription start site in mdr1 promoter in 54 AL and 9 MM patients. Semi-quantitative RT-PCR was used to detect the expression level of mdr1 gene. The results showed that inverse correlation between methylation rate of either region or total methylation rate and expression of mdr1 gene was observed. The correlation in the region I (r = -0.64) was closer than that in the region II (r = -0.4). High expression rate of mdr1 ascended significantly in low methylation group (n = 36) (P < 0.001). In comparison with chemotherapy sensitive group (n = 8), the methylation rate in refractory AL patients (n = 16) was lower (P = 0.05) in the region I, P < 0.05 in the region II and total regions. Comparing with the untreated patients (n = 36), the methylation rate in the region I and total methylation rate were lower in the patients with chemotherapy (n = 14) (P < 0.05). The methylation rate in the region II was also decreased after chemotherapy, however, no statistical significance was shown (P > 0.05). Increased mdr1 expression level accompanying with decreased methylation rate after chemotherapy was found, although no significant difference was shown (P = 0.06). It is concluded that the expression level of mdr1 gene was associated with the methylation status of CCGG in -110 and -50 bp upstream to the transcription start site, especially the -110 site. In both the patients treated with chemotherapy and the refractory patients, the methylation level of mdr1 gene decreased relatively. The rising expression of mdr1 gene after chemotherapy was associated with the decrease of methylation level.
DNA Methylation ; Genes, MDR ; Hematologic Neoplasms ; drug therapy ; genetics ; Humans ; Reverse Transcriptase Polymerase Chain Reaction

OBJECTIVETo evaluate the serum concentrations of E- selectin, integrinbeta(1) subunit and intercellular adhesion molecule-1 in gastric cancer patients and their clinicopathological significance.

METHODSThe serum levels of adhesion molecules E- selectin,intercellular adhesion molecule- 1 (ICAM- 1), and integrinbeta(1) were measured by enzyme-linked immunosorbent assay (ELISA) in 47 health subjects (control group) and in 57 patients with gastric cancer (gastric cancer group) before operation and 7 days after operation. Serum levels of above three factors were compared between the two groups.

RESULTSThe serum concentrations of E- selectin, integrinbeta(1) subunit and ICAM- 1 were higher in gastric cancer group with positive rate of 24.6% ,33.3% ,28.1% respectively. ICAM- 1 and integrinbeta(1) were significant higher in gastric cancer group than that in the control group (P< 0.01),but there was no significant difference in E- selectin between two groups (P=0.64). Serum concentrations of E-selectin, ICAM-1,and integrinbeta(1) were significantly correlated with clinicopathological features as following: clinicopathological stage,invasion depth,lymph node involvement,and presence of distant metastases(P< 0.05,P< 0.01). The serum levels of E- selectin, ICAM- 1, and integrinbeta(1) were decreased significantly after radical resection of gastric cancer,but not in patients with unresectable tumor. Elevated levels of three molecules were significant prognostic factors for patients with gastric cancer,but it could not independently be used to evaluate tumor stage.

CONCLUSIONSSerum concentrations of E- selectin, ICAM- 1,and integrinbeta(1) may reflect tumor progression and metastasis.

Adult ; Aged ; Biomarkers, Tumor ; blood ; E-Selectin ; blood ; Female ; Humans ; Integrin beta1 ; blood ; Intercellular Adhesion Molecule-1 ; blood ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Serum ; metabolism ; Stomach Neoplasms ; metabolism ; pathology