Objective To explore the application value of Da Vinci robot-assisted laparoscopic pancreaticoduodenectomy combined with portal vein (PV) resection and artificial vascular graft and reconstruction.Methods The retrospective descriptive study was adopted.The clinical data of 1 patient with cancer of pancreatic head combined with biliary and duodenal obstructions who was admitted to the Southwest Hospital of the Third Military Medical University in November 2015 were collected.Da Vinci robot-assisted laparoscopic pancreaticoduodenectomy combined with PV resection and artificial vascular graft and reconstruction were applied to the patient due to intraoperative tumor extensive invasion to the PV and angiogenesis around the tumor.The operation time,volume of intraoperative blood loss and transfusion,time of postoperative drainage-tube removal,postoperative complications,result of postoperative pathological examination,duration of postoperative hospital stay and results of follow-up were observed.The follow-up of outpatient examination and telephone interview was performed to detect the survival of the patient up to February 2016.Results The patient underwent successful Da Vinci robot-assisted laparoscopic pancreaticoduodenectomy combined with PV resection and artificial vascular graft and reconstruction.The length of intraoperative excisional PV,operation time,volume of intraoperative blood loss,volume of red blood cell suspension and blood plasma infusions were 3 cm,670 minutes,600 mL,400 mL and 200 mL,respectively.The patient got out-off-bed activity at postoperative day 1 and fluid diet intake after gastric-tube removal at postoperative day 3,and drainage-tube was removed at postoperative day 8.No postoperative complication was detected.The patient had unblocked main PV without obvious stenosis and filling defect by computer tomography rescanning.Adenosquamous carcinoma of the pancreatic head was confirmed by postoperative pathological examination.There were negative resection margins from the proximal and distal duodenum to the pancreas.The patient was discharged from hospital at postoperative day 12 and followed up for 3 months,with a good survival.Conclusions Da Vinci robot-assisted laparoscopic pancreaticoduodenectomy combined with PV resection and artificial vascular graft and reconstruction are safe and feasible in the treatment of the cancer of pancreatic head combined with biliary and duodenal obstructions,with a good short-term outcome.

Amino Acid Metabolism, Inborn Errors ; diagnosis ; metabolism ; therapy ; Diagnosis, Differential ; Diet ; Glutarates ; metabolism ; urine ; Humans ; Infant ; Male ; Riboflavin ; therapeutic use ; Treatment Outcome

OBJECTIVETo investigate the association of R219K and M883I polymorphisms of ATP binding cassette transporter 1 gene with lipid metabolism and the susceptibility to coronary atherosclerotic heart disease in Chinese population.

METHODSGenotypes were determined by PCR-restriction fragment length polymorphism and Primer introduced restriction analysis-PCR techniques, respectively, in 248 unrelated CHD-free controls and 224 CHD cases.

RESULTSSmoking, high blood pressure and high serum glucose were independent risk factors for CHD. Multivariate logistic regression analysis revealed that individuals carrying at least one 219K variant allele (RK + KK genotypes) had a significantly decreased risk for CHD (adjusted OR = 0.41; 95% CI = 0.27-0.61) compared with the wild-type genotype (219RR) and only 883II homozygotes displayed a decreased risk for CHD (adjusted OR = 0.54; 95% CI = 0.26-1.11) compared with 883MM and 883MI genotypes. Furthermore, compared with individuals with both wild genotypes (219 RR and 883 MM or 883 MI) other individuals with all other assembly genotypes had a significantly decreased risk (adjusted OR = 0.39, 95% CI = 0.26-0.60). Plasma HDL-C in 219K allele carriers were markedly higher than those in 219 K non-carriers in controls (P = 0.037).

CONCLUSIONThe ABCA1 R219K polymorphism may be involved in the variability of serum HDL-C and the susceptibility to coronary artery disease.

ATP Binding Cassette Transporter 1 ; ATP-Binding Cassette Transporters ; genetics ; Aged ; Case-Control Studies ; Coronary Artery Disease ; genetics ; Female ; Genetic Predisposition to Disease ; Humans ; Male ; Middle Aged ; Polymorphism, Single Nucleotide

OBJECTIVETo investigate the relationship between apolipoprotein A5(apoA5) - 1131T > C polymorphism and the susceptibility of coronary artery disease (CAD) in Chinese.

METHODSThe restriction fragment length polymorphism of apoA5 gene - 1131T > C was studied using PCR in a case-control study which enrolled 235 patients with CAD diagnosed by angiography and 262 healthy controls from Jiangsu province.

RESULTSThe frequencies of T, C allele were 59.57%ì40.43% and 65.65%, 34.35% in CAD group and control group respectively. There was statistically significant difference in allele frequencies between CAD group and control group (P < 0.05). The susceptibility to CAD for the CC genotype was much higher than that for wild type TT (OR = 1.872, 95% CI = 1.039 - 3.376, P = 0.037), even after the use of Logistic regression models (OR = 2.285, 95% CI = 1.222 - 4.274, P = 0.012). In control group, there was significant difference in TG levels among different genotypes, the C allele carriers had higher serum TG concentration (P = 0.007).

CONCLUSIONapoA5 - 1131T > C polymorphism is associated with an increased risk of CAD and is also in strong association with serum TG levels.

Aged ; Apolipoprotein A-V ; Apolipoproteins A ; genetics ; Asian Continental Ancestry Group ; genetics ; China ; Coronary Artery Disease ; blood ; genetics ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; genetics ; Humans ; Lipids ; blood ; Logistic Models ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; genetics ; Triglycerides ; blood

The expression and implication of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) in residual hepatic tumor cells after lipiodol embolization were investigated. Two weeks after transplantation of VX2 tumor cells into the livers of rabbits, a xenograft model of the human hepatic neoplasm was successfully established. Forty rabbits were randomly divided into control group (n=20) and lipiodol group (n=20). For the control group, 1 mL normal saline was injected through the gastroduodenal artery, whereas 0.3 mL/kg lipiodol was applied for the lipiodol group. One week after embolization, the expression level of VEGF in the plasma was measured by using enzyme-linked immunosorbent assay (ELISA). A three-step immunohistochemical technique (ABC) was employed to detect the protein levels of VEGF and MMP-9 and the quantitative PCR for their mRNA levels was performed in the residual tumor cells. The VEGF in the plasma was significantly higher in the lipiodol group (1.42±0.29 ng/mL) than in the control group (1.12±0.21 ng/mL) (P<0.01). Moreover, the positive rate of VEGF protein in the residual tumor cells was significantly higher in the lipiodol group (62.13%±7.69%) than in the control group (53.16%±9.17%) (P<0.05). Similarly, the MMP-9 expression in the residual tumor cells was higher in the lipiodol group. The mRNA levels of VEGF (2.9313±2.4231) and MMP-9 (3.5721±1.6107) in the lipiodol group were significantly higher than those in the control group (1.5728±0.9453 and 1.7573±1.0641, respectively, P<0.05). Therefore, it was reasonable to speculate that the increased expression of VEGF and MMP-9 in residual hepatic tumor cells and tumor angiogenesis post-embolization would be responsible for the increased metastatic potentiality and invasiveness of these cells.
Animals ; Carcinoma, Hepatocellular ; metabolism ; therapy ; Cell Line, Tumor ; Embolization, Therapeutic ; methods ; Ethiodized Oil ; therapeutic use ; Hemostatics ; therapeutic use ; Liver Neoplasms ; metabolism ; therapy ; Matrix Metalloproteinase 9 ; metabolism ; Neoplasm, Residual ; metabolism ; Rabbits ; Treatment Outcome ; Up-Regulation ; drug effects ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVEThrough observing the morphological changes of the prepared influenza viruses (H1N1) treated with the different concentration of Nonidet P-40 solutions and added with antibody against the influenza virus using transmission electron microscopy (TEM), to explore the principle of application of the internal antibody for immunoassay of influenza virus.

METHODSThrough treating the virus samples with serial diluted Nonidet P-40 solutions from 0.01% to 0.2% and/or not adding antibody against the influenza virus, then investigating the samples by TEM to obtain the morphological changes of the virions.

RESULTSThe serial images show that the denudation degree of the virions is proportional with the rise of NP-40 concentration, and partly denuded virion image appeared at 0.1% NP-40 treatment, also under this condition no influence was observed on antibody binding to the virus.

CONCLUSIONThis work demonstrated the interaction between influenza virion and its antibody under nonionic surfactants existing, which supports the advantages of sample preparation for immunoassay enveloped virus using internal antibody theoretically.

Animals ; Antibodies, Viral ; chemistry ; Chick Embryo ; Influenza A Virus, H1N1 Subtype ; drug effects ; ultrastructure ; Microscopy, Electron, Transmission ; Polyethylene Glycols ; pharmacology ; Protein Binding ; Viral Envelope Proteins ; chemistry ; Virion ; drug effects ; ultrastructure

OBJECTIVETo study the correlation of eating raw fish with primary hepatic carcinoma (PHC), and to investigate the synergistic effect of HBV infection, alcohol consumption and eating raw fish on the oncogenesis of PHC.

METHODSA hospital-based case-control study was conducted among 500 PHC patients and 500 non-cancerous patients in order to compare the history of eating raw fish. The synergistic pathogenetic action of eating raw fish, HBV infection and alcohol consumption on carcinogenesis of PHC was analyzed by crossover analysis and multiple logistic regression.

RESULTSThe rates of eating raw fish in the past between the case (54.8%) and the control group (8.4%) were significantly different (P < 0.001). OR value of suffering PHC in the patients who ate raw fish in the past was 13.6 (95% CI: 9.1-19.5) when compared with the non-cancerous patient. HBV infection, alcohol consumption and eating raw fish showed an interactive effect on the development of PHC, with a relative excessive risk of interaction(RERI) of 195.3 and 17.8; attributable proportion of interaction (API) of 0.8630 and 0.5251; and synergy index (S) of 7.5 and 2.8, respectively.

CONCLUSIONA history of eating raw fish may be an important risk factor for suffering primary hepatic carcinoma. HBV infection, alcohol consumption and eating raw fish may have a synergistic effect on the developing of primary hepatic carcinoma.

Adolescent ; Adult ; Aged ; Alcohol Drinking ; Animals ; Carcinoma, Hepatocellular ; epidemiology ; etiology ; virology ; Case-Control Studies ; China ; epidemiology ; Eating ; Female ; Fishes ; Hepatitis B ; Humans ; Liver Neoplasms ; epidemiology ; etiology ; virology ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Risk Factors ; Seafood ; Young Adult

OBJECTIVETo study into the genetic polymorphism of DC-SIGN and DC-SIGNR's exon 4 in Chinese hepatitis C patients and its relationship with HCV infection susceptibility.

METHODSPatients with hepatitis C (n=300, group A) and healthy subjects (n=520, group B) were genotyped and analysed for the repeat sequence of polymorphism of DC-SIGN and DC-SIGNR's exon 4 using PCR and DNA sequencing.

RESULTSThe distribution of genotypes and alleles in DC-SIGN's exon 4 in the two groups did not differ significantly (P > 0.05). The difference of allele frequency in DC-SIGNR's exon 4 between the two groups was also not significant (P > 0.05). However, 9/5 genotype distribution frequency of DC-SIGNR's exon 4 in patients with hepatitis C was significantly higher than that in the healthy subjects (P < 0.05).

CONCLUSIONThere is no significant correlation between the genetic polymorphism of DC-SIGN's exon 4 and HCV infection susceptibility. 9/5 genotype distribution frequency of DC-SIGNR's exon 4 in patients with hepatitis C is significantly higher and may be associated with HCV infection susceptibility.

Adolescent ; Adult ; Aged ; Asian Continental Ancestry Group ; genetics ; Blood Donors ; Case-Control Studies ; Cell Adhesion Molecules ; genetics ; Child ; Exons ; Female ; Genetic Predisposition to Disease ; Genotype ; Hepatitis C, Chronic ; ethnology ; genetics ; Humans ; Lectins, C-Type ; genetics ; Male ; Middle Aged ; Polymorphism, Genetic ; Receptors, Cell Surface ; genetics ; Young Adult

OBJECTIVETo investigate the presence of abnormal metabolism in the thalamus and hypothalamus in patients with first-episode depression.

METHODSThirty drug-naive patients with first-episode depression and 30 age-matched controls were scanned with proton magnetic resonance spectroscopy ((1)H-MRS) for Naa, Cho, Cr and mI.

RESULTSCompared with the control group, the patients showed significantly reduced mI and mI/Cr of the hypothalamus, reduced mI/Cr of the left thalamus, and lowered Cho, ml, and ml/Cr of the right thalamus (P<0.05).

CONCLUSIONPatients with first-episode depression may have myo-inositol and phosphoric acid metabolism disorder in the thalamus and hypothalamus with malfunction of cellular osmotic pressure adjustment mechanism. Abnormal mI/Cr in the thalamus and hypothalamus may represent an important biochemical change in advanced patients with depression.

Adolescent ; Adult ; Case-Control Studies ; Choline ; metabolism ; Creatine ; metabolism ; Depression ; diagnosis ; Female ; Humans ; Hypothalamus ; metabolism ; Inositol ; metabolism ; Magnetic Resonance Spectroscopy ; methods ; Male ; Middle Aged ; Protons ; Thalamus ; metabolism ; Young Adult

BACKGROUNDOne effect of solid tumors is severe hypoxia of local tissues. Heme oxygenase-1 (HO-1) is highly expressed in a variety of human tumor tissues; its induction and activity are closely related to growth of solid tumors. Hypoxia inducible factor-1 (HIF-1) is a transcription factor that regulates hypoxia signal transduction and plays a central role in tumor hypoxia regulation. However, whether and how changes in HO-1 activity affect HIF-1 gene expression has not been reported previously.

METHODSHypoxia-inducible models were established using gastric cancer cell lines (SGC-7901) in a hypoxia incubator. Cells were placed in four groups: Group A, transfected by plasmid harboring HO-1 shRNA; Group B, transfected with scrambled shRNA vector; Group C, treated with hemin; and Group D, exposed to hypoxia only. Expressions of HO-1 and HIF-1 mRNAs were quantified by reverse transcription-polymerase chain reaction. Expressions of HO-1 and HIF-1 proteins were determined by immunohistochemistry and Western blotting.

RESULTSmRNA and protein levels of HO-1 and HIF-1 in the control group were significantly higher than in Group A (P < 0.01), but lower than in Group C (P < 0.01). Chromatin immunoprecipitation analysis showed that HIF-1 was identified as the direct HO-1 target gene.

CONCLUSIONWhile affected by HIF-1, HO-1 up-regulation promotes the expression of HIF-1 and the down-regulation of HO-1 suppresses the expression of HIF-1 gene.

Blotting, Western ; Cell Hypoxia ; genetics ; physiology ; Cell Line, Tumor ; Chromatin Immunoprecipitation ; Heme Oxygenase-1 ; genetics ; metabolism ; Humans ; Hypoxia-Inducible Factor 1 ; genetics ; metabolism ; Immunohistochemistry ; RNA, Small Interfering ; Reverse Transcriptase Polymerase Chain Reaction