Objective: To evaluate the efficacy and safety of reduced volume hepatectomy in treatment of advanced hepatic alveolar echinococcosis. Methods: The clinical data of 90 patients with advanced hepatic alveolar echinococcosis treated at the Qinghai Provincial People's Hospital from January 2017 to January 2019 were retrospectively analyzed. There were 41 males and 49 females, with an average age of 32 (range 11 to 58) years. The locations of the lesions, operations, complications and follow-up were analyzed. Results: 90 patients were treated with reduced volume focal hepatectomy, 38 with radical resection and 52 with quasi radical resection. The operation time was (361±22) min. The hospital stay was (22±2) day, and the blood loss was (781±37) ml. Red blood cells were transfused in 19 patients and plasma in 39 patients. Pringle’s maneuver was used in 12 patients, regional hepatic blood flow occlusion in 42 patients, and Glisson sheath occlusion in 26 patients. The total bilirubin, alanine aminotransferase and aspartate aminotransferase returned to normal in 3 to 14 days after operation. There were 12 patients who developed bile leakage, 41 pleural effusion and 26 effusion in the operation sites. A total of ninety patients were followed up for 2 to 24 months. There was no recurrence of echinococcosis after radical resection and no enlargement of residual lesions after quasi-radical resection. Conclusion Reduced-volume hepatectomy reduced the risk and difficulty of operation. The follow-up results were good. This approach provides a feasible scheme for treatment of advanced hepatic alveolar echinococcosis.

Echinococcosis is a disease caused by the Echinococcus species that parasitizes in humans. Alveolar echinococcosis (AE) which is caused by Echinococcus multilocularis is harmful to humans. AE mainly occurs in the liver and can be transferred to retroperitoneal lymph nodes, lung, brain, bone, spleen and other organs through lymphatic and blood vessels. Cholangiocarcinoma can occur in the intrahepatic and extrahepatic bile ducts and is more common in the hilar. We reported a case of hilar bile duct alveolar echinococcosis which was originally misdiagnosed an cholangiocarcinoma.
Bile Ducts ; Bile Ducts, Extrahepatic ; Bile ; Blood Vessels ; Brain ; Cholangiocarcinoma ; Echinococcosis ; Echinococcus ; Echinococcus multilocularis ; Humans ; Liver ; Lung ; Lymph Nodes ; Spleen

Pancreatic ductal adenocarcinoma has a high degree of malignancy, an insidious onset, and rapid progression, with no obvious abdominal manifestations and signs in the early stage. Most patients are already in the advanced stage and have distant organ metastasis at the time of diagnosis, and thus surgical treatment, chemoradiotherapy, and targeted drug therapy often have an unsatisfactory clinical effect. Recent studies have shown that transforming growth factor-β (TGF-β) is closely associated with the development and of tumors and plays a key role in the processes of tumor cell proliferation, invasion, migration, and angiogenesis. Although TGF-β signal can exert a powerful inhibitory effect on tumors through SMAD-mediated cell cycle arrest, TGF-β signal can also accelerate the development of pancreatic cancer by enhancing epithelial-mesenchymal transition, fibrosis, and immune escape. In this article, pancreatic cancer specifically refers to pancreatic ductal adenocarcinoma, and this article reviews the role of TGF-β in its signal transduction and the association of TGF-β with related factors and immune response, so as to provide a theoretical basis for targeted therapy for pancreatic cancer in the future.

Pancreatic cancer is one of the cancers with the worst prognosis, and its high metastasis rate and resistance to chemotherapy drugs have always been the tough problems in the medical field. At present, the effect of thymoquinone on pancreatic cancer has attracted wide attention, and it can exert an antitumor effect in pancreatic cancer by inhibiting cancer cell proliferation, promoting cancer cell apoptosis, inhibiting invasion and metastasis, enhancing the sensitivity to chemotherapy drugs, and exerting an anti-inflammatory effect. This review briefly introduces the current research status of the association between thymoquinone and pancreatic cancer in China and globally, so as to provide a reference for subsequent research.