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Effects of glutamine on level of cytokines in serum of rats with severe acute pancreatitis

Journal of Endocrine Surgery.2011;05(5):317-319,339. doi:10.3760/cma.j.issn.1674-6090.2011.05.011

Objective To explore the effects of glutamine (Gln) on tumor necrosis factor-alpha (TNF-α),interleukin-6(IL-6),and interleukin-10 (IL-10) in rats with severe acute pancreatitis (SAP).Methods 54 Sprague-Dawley rats were randomly divided into 3 groups ( n =18 for each group):Gln treatment group ( Gln),SAP model group (SAP),and negative control group (NC).SAP was induced by injection of 4％ sodium taurocholate through common bile duct with a fine needle and the puncture hole in the bile duct was closed by medical sealant glue.Sham operation was performed in the rats of NC group.Rats in Gln group received Gln injection and rats in SAP group and NC group received normal saline instead of Gln.Ascites volume and blood amylase were measured at 3,6 and 12 hours after injection and plasma cytokines were detected by enzyme-linked immunosorbent assay (ELISA).Gross and histological changes of pancreas were evaluated by a scoring system.Results The ascites volume,serum amylase level,gross and histological scores,TNF-α level,and IL-6 level were significantly higher in SAP group than in NC group at each time point(P＜0.05).IL-10 level was significantly higher in SAP group than in NC group at 3 hour point(P＜0.05).The ascites volume,serum amylase level,and gross and histological scores were significantly lower in Gln group than in SAP group at the time point of 3 hour and 6 hour after injection( P ＜ 0.05 ).Level of TNF-α and IL-6 was significantly lower in Gln group than in SAP group at each time point( P ＜0.05 ).IL-10 level was lower in Gln group than in SAP group at 3 hour point( P ＜0.05 ).Conclusion Gln is effective in SAP treatment by decreasing the serum level of proinflammatory cytokine and ameliorating the pathological damage of pancreatic tissues in rats.

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The report of 242 cases of minimally invasive open thyroid surgery under direct view

Jian DENG ; Bin HU ; Yeping ZHAO ; Fankai WANG ; Guangmin XU ; Zhiguang ZHANG

Journal of Endocrine Surgery.2009;3(5):323-324,331. doi:10.3760/cma.j.issn.1674-6090.2009.05.009

Objective To get minimally invasive and cosmetic effect,minimal incision was used in thyroid surgery.Methods By using MPBS series instruments,thyroid surgeries were performed through anterior cervical tiny incision approach.Results 164 cases of subtotal theroidectomy and 78 cases of thyroid individual lobe resection were performed.The length of incision were(2.0 ± 0.5)cm,and the duration of operation time were(40 ± 10)min.the volume of blood loss were(30 ± 10)ml.There was no conversion to traditional open operation.After 3 years follow-up,short and long term complications were not found.Conclusions Minimally incision thyroid surgery has advantages of less trauma,cosmetic effect and does not compromise the safety.The disadvantages of this method is limited operative field and inconvenience for operation,which need to be further improved.

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Primary non-Hodgkin's lymphoma of the adrenal gland: 2 cases report and review of the literature

Jie LI ; Xin GOU ; Chaodong LIU ; Zhaobing TANG

Journal of Endocrine Surgery.2010;04(4):231-232,235. doi:10.3760/cma.j.issn.1674-6090.2010.04.006

Objective To discuss the clinical features, diagnosis and therapy of primary adrenal lymphoma (PAL) . Methods Two patients (65-year old and 52-year old respectively) who complained vague pain were analyzed. Occupying lesions in adrenal gland were discovered by computed tomography (CT) and diagnosed by needle biopsy and laparoscopic surgery. Results The two patients in our hospital were diagnosed as nonHodgkin's lymphoma. They were treated with chemotherapy and one of them was partial response. Literatures on PAL were reviewed. In the literature, 7 of the 65 patients achieved complete response, 15 partial response, 43 death or unspecified and the survival duration was 3 days to 26 months. Conclusions Most of PAL are bilateral, without specific clinical characters. Neele biopsy is the first choice to make the diagnosis. The therapeutic modalities for PAL include surgery, chemotherapy, surgery followed by chemotherapy as well as radiation therapy. The prognosis of PAL is poor if other organs are involved.

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The efficacy of retroperitoneal laparoscopic and open surgery in the treatment of adrenal adenoma：a randomized controlled study

Dong ZHOU ; Xiaoqing ZHOU ; Peng LI ; Qihuan ZHU

Journal of Endocrine Surgery.2014;(2):156-158,176. doi:10.3760/cma.j.issn.1674-6090.2014.02.020

Objective To compare the advantages and disadvantages of retroperitoneal laparoscopic sur -gery and open surgery in treatment of adrenal adenoma , in order to provide the clinical evidence for the selection of surgical treatment of adrenal adenoma .Methods 120 cases undergoing surgical treatment from Jan .2005 to Dec.2010 were randomly divided into laparoscopic group and open surgery group .Operation indicators , postop-erative recovery indicators , postoperative clinical manifestations , success of operation , complications and follow-up data were evaluated and compared between the 2 groups.Results 3 cases in laparoscopic group and 4 cases in open surgery group withdrew.The operation time, intraoperative blood loss, and blood transfusion cases were (89.6 ±18.4)min vs (124.2 ±27.3)min, (70.2 ±17.2)ml vs (205.7 ±51.9)ml, and 8 cases vs 20 cases in laparo-scopic group and open surgery group .Extubation time, starting feeding time, time of getting out of bed, and length of hospital stay were (2.8 ±1.3)d vs (4.2 ±2.0)d, (1.7 ±1.1)d vs (2.9 ±1.4)d, (2.6 ±1.2)d vs (5.1 ± 3.1)d and (6.2 ±3.1)d vs (13.5 ±5.4)d in laparoscopic group and open surgery group .Postoperative analge-sic using cases and drainage volume were 11 cases vs 43 cases, and(15.4 ±4.2)ml vs(45.1 ±12.7)ml in lapa-roscopic group and open surgery group .The difference had statistical significance (P＜0.01).The cost was simi-lar between the 2 groups(P>0.05).The open surgery group had no death or relapse within 1 year, while 5 cases in laparoscopic group converted to laparotomy , with 1 case of death and 2 cases of relapse within 1 year.The complications incidence was 3.51%(2/57)in laparoscopic group, obviously lower than 16.07%(9/56)in open surgery group(P＜0.01).Conclusions Compared to the traditional open surgery, retroperitoneal laparoscopic sur-gery has advantages of less trauma, fewer complications, and faster postoperative recovery in treatment of adrenal ade-noma.Experience and skills of surgeon need to be improved to reduce the possibility of failure or recurrence .

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Relationship between invasion and changes of mRNA epression of MMP-2, TIMP-2 and CD147 in human pituitary adenoma

Yongchuan GUO ; Jing LIU ; Wan WANG ; Yin YU ; Qianlei LIANG ; Jingxin WANG

Journal of Endocrine Surgery.2010;04(4):219-221,224. doi:10.3760/cma.j.issn.1674-6090.2010.04.002

Objective To investigate the relationship between tumor invasion and changes of mRNA expression of MMP-2, TIMP-2 and CD147 in human pituitary adenoma. Methods 60 patients with pituitary adenoma were devided into two groups, invasive and non-invasive group, by MRI. The expression level of MMP-2,TIMP-2 and CD147 in the samples of pituitary adenoma was measured by semiquantitative reverse transcriptasepolymerase chain reaction (RT-PCR). Pearson analysis was used to reveal the correlation between the expression of each marker. Results The mRNA expression level of MMP-2 and CD147 was significantly higher in invasive pituitary adenoma group than that in non-invasive group (P ＜ 0. 01 ) while the mRNA expression level of TIMP-2was lower in invasive pituitary adenoma group than that in non-invasive group (P ＜0.01 ). According to Pearson analysis, the mRNA expression of MMP-2 was positively correlated with CD147 in invasive pituitary adenoma (r=0. 69, P ＜ 0. 05 ), and M MP-2 was negatively correlated with TIMP-2 in non-invasive pituitary adenoma (r =-0.68, P ＜ 0.05 ). Conclusions The invasion of human pituitary adenoma are closely related to the low expression level of TIMP-2 as well as the high expression level of MMP-2 and CD147. MMP-2, TIMP-2 and CD147 can be used as indicators of tumor invasion of human pituitary adenoma.

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Expression of vascular endothelial growth factor D (VEGF-D) and urokinase-type plasminogen activator in human rectal carcinoma and their relationship with tumor invasion and metastasis

Zhulin LI ; Mingcai ZHU ; Pujiang DONG

Journal of Endocrine Surgery.2009;3(2):85-87,102. doi:10.3760/cma.j.issn.1674-6090.2009.02.005

Objective To explore the expression of endothelial growth factor-D (VEGF-D) and uroki-nase-type plasminogen activator(uPA) in rectal carcinoma and to reveal their correlation to the tumor invasion and metastasis.Methods The expression of VEGF-D and uPA in 30 cases with rectal carcinoma and normal tissue was detected by immunohistochemistry and Western blot.Results The expression of VEGF-D and uPA was de-tected both in tumor tissue and normal tissue, but significantly higher in tumor tissue (P < 0.01), they expressed mostly in endochylema.The expression of VEGF-D or uPA was significantly higher in Dukes' stage C + D than that in Dukes' stage A + B(P <0.01), was also higher in tissues with lymph node metastasis or distant metasta-sis than those without metastasis(P <0.05 ,P <0.01).They were found to be lower in cancer tissue along with the differentiation degree increase(P < 0.05) .Condnsions The overexpression of VEGF-D and uPA in rectal carcinoma may play an important part in the tumorigenesis and progression of rectal carcinoma.

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Comparison of venous port access and peripherally inserted central catheters in adjuvant chemotherapy for patients with breast cancer

Dengchao WANG ; Ruijiao LIN ; Zaizhong ZHANG ; Liying LIN ; Songbing LIN ; Lie WANG ; Bing WANG

Journal of Endocrine Surgery.2014;(2):120-122,126. doi:10.3760/cma.j.issn.1674-6090.2014.02.008

Objective To compare the effects of venous port access ( VPA ) with peripherally inserted central catheters ( PICC) in patients with breast cancer .Methods 120 cases with breast cancer were divided into 2 groups from Jan.2009 to Dec.2010,among whom 60 cases were with VPA when receiving operation , and the other 60 cases were with PICC after the operation .The success rate of catheterization , duration of catheter in-dwelling and catheter-related complications of the 2 groups were compared .Results The one-time success rate of catheterization was 100%in VPA group and 66.7%in PICC group .The catheters were retained for more than 12 months in 59 cases in VPA group,while only 4 cases in PICC group retained catheter for more than 12 months. The complications occurred to 1 case in VPA group ( 1.7%) and 9 cases in PICC group ( 15%) .Conclusion VPA is an ideal pathway for chemotherapy of patients with breast cancer , which can reduce nursing work and is worth to be promoted in clinical practice .

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Diagnosis and treatment of Hashimoto's disease accompanying with thyroid cancer

Huayou LUO ; Ming ZHONG ; Yan TIAN ; Liang SUN

Journal of Endocrine Surgery.2011;05(2):101-102,119. doi:10.3760/cma.j.issn.1674-6090.2011.02.009

Objective To analyze clinical features, diagnosis, treatment and prognosis of Hashimoto's disease ( HD) accompanying with thyroid cancer. Methods Clinical data of 10 cases of HD accompanying with thyroid cancer admitted from Jan. 1998 to Jan. 2008 were analyzed retrospectively. Results Pathology revealed 8 cases had HD accompanying with papillary cancer and 2 cases had HD with follicle cancer. Mild hoarse voice was observed in 2 cases. Varying degree of hypothyrosis was observed in 9 cases and all patients were treated with thyroxin. Conclusions It is difficult to diagnose HD accompanying with thyroid cancer preoperatively. Knowing the indications of operative exploration of HD is very important and surgical management is the best treatment. The operation should follow the principle of radical thyriodectomy. Patients should be treated with thyroxin postoperatively.

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Diagnosis and treatment of 126 cases of acute biliary pancreatitis

Dengqiu ZHAO ; Yefeng WU ; Longxiang ZHOU

Journal of Endocrine Surgery.2010;04(4):242-243,248. doi:10.3760/cma.j.issn.1674-6090.2010.04.010

Objective To explore the diagnosis and treatment of acute biliary pancreatitis (ABP) and when to operate. Methods 126 cases of ABP from Jan. 2005 to Dec. 2009 in our hospital were analyzed retrospectively. Results The cases number of the mild non-obstructive type, mild obstructive type, severe non-obstructive type, and severe obstructive type was 54, 33, 15, 24 respectively. 43 patients underwent early operation, 80 patients underwent postponed operation and three patients died preoperatively as a consequence of fulminat severe pancreatitis. 117 cases ( 92.86% ) were cured and 9 cases ( 7. 14% ) with severe acute pancreatitis died. Conclusion ABP should be treated according to its type. The key to reduce the complications and increase the cure rate is to determine the proper operation time according to the condition of individual patient.

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Bilateral adrenal tumors from different tissues: 1case report and literature review

Yushi ZHANG ; Hanzhong LI ; Jianchun XIAO ; Yi ZHOU ; Zhien ZHOU ; Anli TONG

Journal of Endocrine Surgery.2012;06(3):179-181,187. doi:10.3760/cma.j.issn.1674-6090.2012.03.010

Objective To improve the recognization of bilateral adrenal tumors from different tissues and to discuss the treatment.Methods One case of bilateral adrenal tumors from different tissues:pheochromocytoma in one side and adrenocortical adenoma in the other side was reported and the data of syptoms,physical features,auxillary examination,diagnosis and treatment were retrospectively reviewed.Results The patient was diagnosed as adrenocorticotropic hormone (ACTH) -independent Cushing's syndrome in other hospital and received laparoscopic adrenalectomy for right adrenal tumor.During the operation the blood pressure fluctuated seriously and was even more than 200 mm Hg.The pathological report showed the mass was pheochromocytoma.After the operation,the patient's clinical manifcstation was not changed.Half a year later the lab test showed blood ACTH was still less than 5 pg/ml,24 h urinary-free cortisol (UFC) was 571.32 μg,and 24 h urinary catecholamines (U CA) was:noradrenalin (NE) 22.80 μg,epinephrine (E) 2.55 μg,dopamine (DA) 92.92 μg.CT detected a mass in left adrenal gland.The patient received laparoscopic adrenalectomy for left adrenal tumor after being transferred to Peking Union Medical College Hospital.The tumor was proved as adrenocortical adenoma by postoperational pathology.One week after the operation,the 24 h UFC was 56.2 μg.Conclusions Bilateral adrenal tumors from different tissues are very rare in clinic.Adrenalectomy for tumors from both sides and remaining the normal adrenal glands are recommended.

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