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The rise of high intensity focused ultrasound (HIFU) non-invasive therapy for solid tumors

Ruo FENG ; Hui ZHU ; Faqi LI ; Haibing SU ; Xun CHEN

Chinese Journal of Hepatobiliary Surgery.2011;17(1):77-78. doi:10.3760/cma.j.issn.1007-8118.2011.01.027

In the 40 years of last centry American scientists put forward a concep of high intensity focused ultrasound (HIFU) therapeutic technique and had done some technical and clinical studies. Since 90 years the HIFU surgery technique treating tumors anew rised abruptly in the world. China firstly put out a comprehensive HIFU tumor treating sistem and successfully treated many solid tumors such as breast cancer, bone tumor, liver cancer etc.. Now the treating sistem has already exported to England, Italy,Spain, Japan, Colea etc. and treated tens thousands tumor patients. In the field of noninvasive ultrasound treating tumor technique China has continually kept the leading position in the world.

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Early islet graft failure due to hypoxia: review and our experimental experience

Gang MIAO ; Jingyong XU ; Yanyang ZHAO ; Junmin WEI

Chinese Journal of Hepatobiliary Surgery.2011;17(1):73-76. doi:10.3760/cma.j.issn.1007-8118.2011.01.026

Pancreas and islet transplantation is the only treatment that can cure type 1 diabetes mellitus. Less invasive and more targeted surgical and immunosuppressive regimens make islet transplantation a more attractive treatment for type 1 diabetes. Current methods of islet isolation and purification cause hypoxic stress to which β cells are extremely vulnerable. Transplanted islets need to re-establish their vascular system in order to obtain sufficient oxygen and nutrient supply for stable engraftment. However, this process takes at least 7- 14 days to complete. Massive (＞50%) β cells are dead before revascularization due to hypoxia, especially the core of the islets. Therefore, the obvious critical problem is the circulatory deficit to which the islets are susceptible in the immediate post-transplant period.In the current study, we reviewed various hypoxic-related insults to islets before complete engraftment, and feasible strategies to reduce hypoxic-induced apoptosis based on our experimental experiences together with that of others and investigated the possibility of revascularization in islet transplantation.

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Inhibition of invasiveness of pancreatic carcinoma cell line PANC-1 by suppression of MMP-2 gene expression using RNA interference

Xuefeng ZHU ; Dechun LI ; Yijun CHEN ; Jianwei XU ; Jili GU ; Dongming ZHU ; Jiannong CEN

Chinese Journal of Hepatobiliary Surgery.2010;16(11):863-866. doi:10.3760/cma.j.issn.1007-8118.2010.11.021

Objective To investigate the inhibitory effects of RNA interference on expression of matrix metalloproteinase-2(MMP-2)gene and invasiveness of human pancreatic cancer cell line PANC-1 in vitro.Methods Small interference RNA targeting MMP-2 gene was designed and constructed to plasmid pGCsi-U6.Recombinant plasmids were transfected to pancreatic carcinoma PANC1 cells with Lipofectamine 2000.The efficiency of transfection was evaluated by flow cytometry.RQPCR was used to detect the expression of MMP-2 mRNA.The expression of MMP-2 protein was determined by ELISA.The invasiveness of PANC-1 cells was measured by transwell chamber experiment.MTT assay was used to detect the proliferation and growth of PANC-1 cells.Results Sequencing confirmed that the MMP-2 siRNA plasmid was successfully constructed.The best efficiency of transfecting recombinant plasmid was 82.1%.After transfection of the MMP-2 siRNA plasmid, the MMP-2 gene expression of PANC-1 cells was suppressed to 71.74 %(P＜0.05),and protein expression of MMP-2 fell to 49.82%(P＜0.05).The corresponding inhibition ratio of invasiveness was 33.0%(P＜0.05).There was no marked difference in proliferation rate measured by MTT assay among different groups(P＞0.05).Conclusions RNAi targeting MMP-2 can suppress invasiveness of PANC-1 cells in vitro.This suggests that MMP-2 could be a target for gene therapy of pancreatic carcinoma.RNAi is expected to open up a new prospect for tumor therapy.

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Treatment and prevention of residual gallbladder: a report of 56 cases

Youchi FU ; Zhiqing GAO ; Zhengcai LIU ; Hongtao ZHANG

Chinese Journal of Hepatobiliary Surgery.2010;16(11):806-808. doi:10.3760/cma.j.issn.1007-8118.2010.11.002

Objective To explore methods for the treatment and prevention of residual gallbladder.Methods Clinical data of 56 patients with residual gallbladder were retrospectively analyzed.Results All 56 cases were diagnosed through clinical imaging examination and cured by selective operation of residual gallbladder resection.Conclusion The residual gallbladder can be diagnosed by repeated biliary symptoms in patients with a history of cholecystectomy and imaging examination.Residual gallbladder resection is an effective therapy for the treatment of residual gallbladder.

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On development of pancreatic endocrine surgery in China

Xi CHEN

Chinese Journal of Hepatobiliary Surgery.2010;16(11):801-805. doi:10.3760/cma.j.issn.1007-8118.2010.11.001

The paper summarized the current situation of diagnosis and treatment of pancreatic endocrine tumors (PETs)in China.In recent sixty years, we understand PETs more deeply, and have all kinds of imaging technique to localize the tumors.It makes more cases having been diagnosed.Operation is the most important and the first choice of treatment.The concept of minimal-invasion runs through the surgical procedure.Multi-model strategy is used in therapy for malignant PETs with liver metastasis.Basic research is focused in mechanism and early diagnosis and it helps the clinical practice.Specialization and co-operation are emphasized in the development of PETs diagnosis and treatment.

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Expression of p16 in cholangiocarcinoma-related diseases

Feifeng LIN ; Junzhe JIN

Chinese Journal of Hepatobiliary Surgery.2010;16(11):895-896. doi:10.3760/cma.j.issn.1007-8118.2010.11.037

The mutations and deletions of the MTS1/p16 gene are widespread in a variety of human tumor tissues.It has been shown that p16 plays an important role in the formation and development of cholangiocarcinoma as research on cholangiocarcinoma has progressed over the years, and it is thought that the abnormal expression of p16 in highly involved in cholangiocarcinoma-related diseases.All these findings indicate that p16 is closely related to cholangiocarcinoma.Early diagnosis of cholangiocarcinoma is still poor, so p16 may be a qualitative and quantitative tumor marker of high diagnostic value and may provide an opportunity for some new therapeutic methods such as targeted therapy.It can achieve the purpose of early diagnosis and early treatment to enhance the survival rate of patients.

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Advancement in researches of role of Hedgehog signal pathway in pathogenesis of pancreatic cancer

Kun HAO ; Xuehai XIE ; Yinmo YANG

Chinese Journal of Hepatobiliary Surgery.2011;17(1):70-72. doi:10.3760/cma.j.issn.1007-8118.2011.01.025

The Hedgehog (Hh) signaling pathway plays a key role in the embryonic development, which is formed by the Hedgehog(Hh) , membrane-receptor complex Patched (Ptch) and Smoothened (Smo), multifunctional transcription factors Glioma-associated oncogene homolog (Gli) and other signal molecules. The Hh signaling pathway controls a variety of developing processes, however, no or less expression is observed in the normal pancreas tissues.The mutational activation of the Hh signaling pathway is associated with tumorigenesis and metastasis of the pancreatic cancer. The aim of this review is to present a brief overview of the Hedgehog signaling pathway in the mechanism of the tumorigenesis of the pancreatic cancer.

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Expression of Slug in pancreatic cancer and inhibitory effects of anti-Slug on invasion and migration of pancreatic carcinoma cells

Kejun ZHANG ; Zhuangming YU ; Zhengwen WANG ; Chuandong SUN ; Dechun LI ; Bingyuan ZHANG ; Yun LU ; Wei ZHAO

Chinese Journal of Hepatobiliary Surgery.2011;17(1):31-35. doi:10.3760/cma.j.issn.1007-8118.2011.01.010

Objective To investigate expression of slug and E-cadherin in pancreatic cancer tissues and determine the inhibitory effects of anti-Slug, an anti-sense plasmid, on the invasion of pancreatic cancer cell lines in vitro. Methods Slug and E-cadherin protein and mRNA was analyzed by IHP and RT-PCR in 36 cases of pancreatic cancer. Then anti-Slug plasmid was transfected into herin and Slug expression. The inhibitory effects of anti-sense Slug were also detected by Transwell motility assay and Matrigel invasion assay. Results The expression of Slug and mRNA in metastatic pancreatic cancer tissue was higher than that in non-metastatic tissue. E-cadherin and mRNA was lower in metastasis tissues(P＜0.05). The inverse relationships were further observed by transient transfection of anti-Slug into SW1990H4 cells. The downregulated expression of Slug and re-expression of E-cadherin were found. The Slug mRNA levels were 0.985±0.016,0.973±0.014, 0. 554±0. 011 after 0, 48 h of transfection of anti-sense Slug, and that of E-cadherin were 0.120±0.001, 0.360±0.002, 0. 727±0. 006, respectively. The diference was significant between different time points (P＜0.05). The Slug mRNA levels were 0. 206±0.017, 0.968±0.015, and that of E-cadherin were 0. 18±0.002,0.727±0.006 after stable transfection of anti-sense Slug, and control plasmid, respectively. The diference was significant (P＜0.05). The motility activity(393±28, 352±24, 96 ±13 )and the invasion activity (223 ± 69, 202 ± 64, 65 ±19) of1 antisense Slug transfectant cells were significantly decreased as compared with those of control cells (P＜0.05). Conclusions Higher expression of slug and lower expression of E-cadherin is related to the invasion and metastasis in pancreatic cancer. A reverse corelation of E-cadherin and Slug expression exists in pancreatic cancer. Slug is possibly a potential target for cancer gene therapy blocking invasion and metastasis in human pancreatic cancer.

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An analysis of postoperative complications in aged patients receiving pancreaticoduodenectomy

Chunli ZHANG ; Yijun WANG

Chinese Journal of Hepatobiliary Surgery.2011;17(1):23-25. doi:10.3760/cma.j.issn.1007-8118.2011.01.008

Objective To analyze the postoperative complications in aged patients receiving pancreaticoduodenectomy. Methods Pancreaticoduodenectomy was employed for the treatment of 52 aged patients. Of the 52 patients with a mean age of 70.5(65-76), 32 were male and 20 female. Postoperative pathological examination confirmed that 24 patients suffered from Vater,s ampullary and duodenal cancers, 16 from pancreatic carcinoma and 12 from cholangiocarcinoma. Results The mortality was 7.7%. Severe complications included bleeding (upper gastrointestinal tract or abdominal cavity),MOF, ARDS, postsurgical gastroparasis syndrome(PGS), mental disorder, pancreaticogastrostomy leak and biliary-enteric anastomotic leak et al. Conclusion MOF is the main lethal complication. Incidence of PGS and mental disorder is high.

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Treatment of parapancreatic abscess with debridement by choledochoscope in combination with percutancous puncture drainage under ultrasound guidance: an analysis of 36 cases

Yong YAN ; Ruiwu DAI ; Tao WANG ; Lijun TANG ; Bingyin ZHANG

Chinese Journal of Hepatobiliary Surgery.2011;17(1):20-22. doi:10.3760/cma.j.issn.1007-8118.2011.01.007

Objective To explore a new method of parapancreatic abscess treatment and establish an idea of minimally invasive technologies for parapancreatic abscess to improve the recovery rate of acute pancreatitis. Methods The patients had experienced percutaneous puncture and placed drainage tube under the ultrasound guidance first, then the sinus tract was expanded gradually to 24F perimeter by Cook's fascia expender. Finally, the necrotic tissue and pyogenic membrane was removed and repeatedly washed under guidance of choledochoscopy. Results The recovery rate was 91.1 %(33/36). The complication incidence was 10.7% (hemorrage:2 cases, external intestinal fistula:3 cases, and fatal MOF: 1 case). Conclusions The viewpoint which parapancreatic abscess only can be cured by drainage operation can be changed by associating debridement by choledochoscope with percutaneous puncture drainage under the ultrasound guidance. It is a simple, safe and effective method. It can be used to reduce the patients' damage, complication and mortality and accomplish the idea of damage control by minimally invasive technologies.

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