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Inhibitory effects of sustained-release 5-fluorouracil microparticles on the growth of HepG2 cells

Feng XIE ; Jiamei YANG ; Feng XU ; Tong KAN ; Yangqing HUANG ; Fei FAN

Chinese Journal of Digestive Surgery.2008;7(6):433-435.

Objective To evaluate the inhibitory effects of sustained-release 5-fluorouracil(5-FU)micmparticles on the growth of HepG2 eels.Methods The inhibitory effects of sustained-releage 5-FU micropartides,5-FU microparticles and poly L-lactic acid on HepG2 cells were detected by MTT assay.The HepG2 cell apoptosis was demonstrated by flow cytomerry after Hoehest staining.Results The survival rate of HepG2 cells in sustained-release 5-FU microparticles group decreased as time passed by.The survival rate of HepG2 cells in 5-FU microparticles group wag the lowest on the first day,and then it increased gradually.The survival rates of HepG2 ceHs in 5-FU microparticles group on day 21 and 28 were hJigher than those in sustained-release 5-FU microparticles group.The survival rate of HepG2 cells in poly L-lactic acid group WSB higher than that in the other two groups.The difference upon survival rate among the 3 groups had statistical significance(F=3163.52,128.47.P＜0.01).Conclusions The sustained-release 5-FU micropartieles could keep on inhibiting tlle growth and inducing apoptosis of HepG2 cells in time-dependant manner.The inhibitory effect of sustained-release 5-FU is better than that of 5-FU microparticles.

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Effects of huaier granule on hepatocellular carcinoma after Hver transplantation

Xiaobin FENG ; Junhua AI ; Shuguo ZHENG ; Shuguang WANG ; Ping BIE

Chinese Journal of Digestive Surgery.2008;7(6):428-430.

Objective To investigate the auxiliary effects of huaier granule on hepatoeellular carcinoma (HCC)patients after liver transplantation.Methods Sixty HCC patients who had undergone liver transplantation from Julv 2004 to June 2006 and met the standard of UCSF were involved in this study.All patients were divided into huaier granule group(n=20),chemotherapy group(n=15),huaier granule+chemotherapy group (n=15)and control group(n=10).The white blood cell count,liver function,cell immunity and immunologieal reiection were detected.The 1-year tumor recurrence rate wag calculated.Results The white blood cell counts in chemotherapy group 1,3,and 6 months after treatment were significantly lower than that before treatment (F=62.053,58.472,49.807,P＜0.05).The changes of white blood cell counts of the other 3 groups before and aftertreatment were small.The difference on the white blood cell counts of the 4 groups had no statistical 8ignincanee(F=102.361,113.412,87.572,P＜0.05).The NK activity,CD4+/CD8+ ratio,IL-2 level in huaier granule group and huaier granule+chemotherapy group 1,3,6 months after treatment were significantly higher than those before treatment,and were significantly higher than those in chemotherapy group and control group(P＜0.05).No immunological rejection occurred in all the groups.Two patients in each group had recurrence and metastasis of HCC within 1 year after the treatment.and the incidence in control group was higher than the other 3 groups(P＜0.05). Conclusions Humer granule can increase the white blood cell count which is decreased after chemotherapy,impmve cellular immunity,and effectively suppress the recurrence and metastasis of HCC at the first year after operation.

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Efficacy of transcatheter arterial chemoembolization via omentul artery for hepatocellular carcinma

Qiang LI ; Maoqiang WANG ; Peng SONG ; Feng DUAN ; Fengyong LIU ; Zhijun WANG

Chinese Journal of Digestive Surgery.2008;7(6):425-427.

Objective To assess the value of transcatheter arterial chemoembolization(TACE)via omental artery for hepatocellular carcinoma(HCC).Methods Twenty-seven patients with HCC which was nourished by omental artery underwent TACE.Postoperative clinical manifestations,laboratory tests and imaging findings were observed and compared with the angiographic findings.Results The tumor Was located at the peripheral region of right lobe in 26 patients and at the lower part of segment IV in 1.Thirty-eight omental arteries supplying HCC were observed angiographically.The omental artery in 18 patients was successfully embolized.Hepatic hemostasis was achieved in all patients with ruptured HCC.No severe complication occurred,and tumor recurrence Wag observed in 15 patients postoperatively.Conclusions Omental artery supplying HCC is mostly seen in patients who have undergone multiple TACEs and patients with the focus which is located at the peripheral region of right lobe.TACE via omentai artery is safe and feasible,although the residual rate of the HCC is high.

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Factors influencing the prognosis of 276 patients with pancreatic cancer

Yunpeng HUA ; Lijian HANG ; Baogang PENG ; Shaoqiang LI ; Jiefu HUANG

Chinese Journal of Digestive Surgery.2008;7(6):413-415.

Objective To analyze the factors influencing the prognosis of patients with pancreatic cancer.Methods The clinical data of 276 patients with pancreatic cancer who had been admitted to our department from September 1995 to August 2005 were retrospectively analyzed.Cox regression analysis was used to screen out independent risk factors influencing the prognosis of patients with pancreatic head cancer or pancreatic body and tail cancer,and Kaplan-Meier method to calculate the median survival time.The effects of tumor location on the prognosis were examined by Log-rank and Breslow test.Results Cox regression analysis showed that the diameter of tumor,invasion of the superior mesenteric vessel and treatment method were the independent risk factors influencing the prognosis of patients with pancreatic head cancer;while age,lymphadenectasis and treatment method were the independent risk factors influencing the prognosis of patients with pancreatic body and tail cancer.The median survival time of patients with pancreatic head cancer and pancreatic body and tail cancer after radical resection were 460 days and 480 days,which were significantly longer than 240 days and 200 days of patients who received palliative treatment or gave up treatment.The median survival time of patients with whole pancreatic cancer was 117 days,which was significantly shorter than 330 days of patients with pancreatic head cancer and 300 days of pancreatic body and tail cancer.Conclusions Radieal resection is currently the best choice for pancreatic cancer.The prognosis is poor for patients with pancreatic head cancer(diameter≥4 cm)and invasion of the superior mesenteric vessel.Patients with age≤60 and lymphadenectasis are the factors resulting in poor prognosis of pancreatic body and tail cancer.The prognosis of patients with pancreatic head cancer and pancreatic body and tail cancer are close.Patients with whole pancreatic cancer is in the terminal stage with the worst prognosis.

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Diagnosis and treatment of solid-pseudopapillary tumor of pancreas

Yupei ZHAO ; Bo PAN ; Taiping ZHANG ; Ya HU ; Quan LIAO

Chinese Journal of Digestive Surgery.2008;7(6):409-412.

Objective To summarize the clinical experience of diagnosis and treatment of solid-pseudopapillary tumor of pancreas(SPTP),and to work out the diagnosis and treatment process which matches the conditions of China.Methods The clinical data of consecutive 50 patients with SPTP who had been admitted to our hospital from January 2001 to March 2007 were retrospectively analyzed.Of all patients,3 were male and 47 female.Their median age Was 24 years(13-60 years).Preoperative imaging examination revealed typical findings and tumor markers were negative.SPIP of 23 cases were located in the head of pancreas,3 in the neck of pancreas,2 in the uncinate process of pancreas.3 in the body of pancreas,18 in the tail of pancreas,and the location of SPTP of 1 case was uncertain.Forty-eight patients underwent the operation of SPTP resection,1 of exploratory laparotomy and 1 of CT-guided fine-needle aspiration biopsy of metastatic lesions.Results Forty-nine out of 50 patients were diagnosed"pancreatic mass"preoperatively.Eighteen of the 32 patients with intact tumor capsule and 11 of the 16 patients without intact tumor capsule underwent operation without pathological examination.Thirty-two patients were followed up for 3-55 months,and no metastasis or invasion of the SPTP was observed.Conclusions Yong females are in the high risk group of SPTP.CT is the most valuable preoperative imaging test.Complete surgical resection is the first choice treatment with good prognosis.Resection of the head of pancreas with the preservation of duodenum and resection of body and tail of pancreas+splenectomy are the commou modalities used for the treatment of SPTP.The intactness of the tumor capsule is an important factor in making surgical plan and deciding the necessity of intraoperative frozen section pathological examination.The most common postoperative complication of SPTP resection is pancreatic fistula.

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Decompressive laparotomy in the treatment of severe acute pancreatitis complicated with abdominal compartment syndrome

Weiming ZHU ; Jianfeng GONG

Chinese Journal of Digestive Surgery.2008;7(6):406-408.

Abdominal compartment syndrome(ACS)is an important factor contributing to the multiple organ dysfunction syndrome which is commonly seen in patients with severe acute pancreatitis(SAP).As a life-saving procedure,decompressive laparotomy is widely applied to patients with SAP complicated with ACS,especially to patients with edema of the visceral tissues caused by massive fluid resuscitation at the early stage of the disease.However,decompressive laparotomy should be adopted with caution since it is associated with enteroatmospherie fistula,intraabdominal infection,postoperative ileus,third space losses,hypothermia and hemia.Therefore,decompressive laparotomy should only be considered after conservative management had failed.The indications for decompressive laparotomy are as follows:(1)intraabdominal pressure＞25 nnn Hg;(2)adequate ventilation of the patient is difficult;(3)pereutaneous drainage of ascites is not helpful.Timely temporal abdominal closure is helpful in preventing complications.Infected peripanereatie necrosis is the indication for peripancreatic exploration or necroseetomy.A thorough knowledge of decompressive laparotomy is essential for individualized management of patients with SAP complicated with ACS.

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Eady and differential diagnosis of periampullary cancer

Yupei ZHAO

Chinese Journal of Digestive Surgery.2008;7(6):401-403.

Periampullary cancer is a kind of malignant cancer of digestive tract.It arises within 2 cm of the major duodenal papilla and eomprises cancers of the ampulla,distal comliiOll bile duct,pancreas and duodenum.Their clinical features and anatomic locations are similar,as are the therapeutic approaches.However,their long-term outcomes vary.Due to the bad prognosis,it is very important to make an early,accurate diagnosis and differential diagnosis of periampullary cancer.This article summarizes some basic methods and new developments of early and differential diagnosis of poriampullary cancer.

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Meta-analysis of the radical effect of laparoscopic resection for colorectal cancer in China

Peihua LU ; Guoqing TAO ; Wei SHEN ; Lü JI ; Jian SUN ; Zhiyang JIANG ; Cheng XIANG

Chinese Journal of Digestive Surgery.2008;7(6):458-460.

Objective To evaluate the radical effect and prognosis of laparoscopic resection for colorectal cancer in China.Methods Articles of non.randomized comparative studies(NRCs)of laparoscopic resection and open Burgery for colorectal cancer which were published before October 2007 were retrieved,and correlated indexeswere extraeted for meta.analysis.Results The mean quality score of the 14 articles selected was 18.92±1.27.The basic characteristics of patients in laparoscopic resection group were similar to those in open surgery group.Compared with open surgery group,the incised length of the intestine in the laparoscopic resection group was shorter by 0.66 cm.and the distance between distal margin of resection and tumor was farther by 0.26 cm.The 2-year survival rate of patients in laparoscopic group Was 1.67 times higher than that of open surgery group.There was no significant difference upon follow-up rate,tumor diameter,number of resected lymph nodes,local recurrence rate and distal metastasis rate between the 2 groups.Conclusions The results of meta-analysis show that laparoscopic resection has the sanle radical effect as open surgery for colorectal cancer.but the 2-year survival rate of patients treated by laparoscopic resection is comparatively higher.

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Efficacy of endoscopic papillary balloon dilatation for bile duct stones

Yang OU ; Yumin LI ; Liping YANG ; Xun LI ; Wence ZHOU

Chinese Journal of Digestive Surgery.2008;7(6):445-446.

Objective To assess the efficacy of endoscopic papillary balloon dilatation(EPBD)for bile duct stones.Methods Four hundred and six patients with bile duct stones who had been treated by ERCP from January 2000 to December 2000 were divided into EST group(n=205)and EPBD group(n=201)according to the admission time.The differences upon incidences of early and long-term complications,clearance rate of bile duct stones between the 2 groups were detected.Results There was no significant difierence upon the incidence of early complications.clearance rate of bile duct stones and incidence of pancreatitis between the 2 groups(χ2=0.540.0.058.0.010,P＞0.05).The incidence of eholecystitis and recurrence rate of bile duet stones in EST group were significantly higher than those in EPBD group(χ2=4.002,4.263,P＜0.05).Conclusions The incidence of cholecystitis and recurrence rate of bile duct stones after patients being treated by EPBD are significandy lower than EST.EPBD is superior to EST in protecting the sphincter of Oddi.

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Liver graft induces the immune tolerance of intestinal allograft in auxiliary en-bloc Hver-small bowel transplantation in pigs

Zhenyu YIN ; Xiaomin WANG ; Ning LI ; Yousheng LI ; Xiaodong NI ; Feng JIANG ; Jieshou LI

Chinese Journal of Digestive Surgery.2008;7(6):436-438.

Objective To study the effects of liver graft on the immune tolerance of intestinal allograft in auxiliary en-bloc liver-small bowel transplantation in pigs.Methods Seventy outbreed Landrace pigs were divided into 4 groups.Ten auxiliary liver-small bowel allotransplantations were performed in group A,B,C,respectively,and 5 segmental small bowel allotransplantatiom were performed in group D.Pigs were administered with routine and lower dose of cyclosporine and methylprednisolone in group B and C,respectively. No immunosuppressive agent was administered to pigs in group A and D.Results The initial time of acute rejection was obviously prolonged in group A than group D.and the acute rejection was milder in group A than group D(P＜0.05).There was no significant difference upon postoperative survival time,initial time of acute rejection and degree of acute rejection between group B and C(P＞0.05).Conclusions The immune tolerance of intestinal allograft Can be induced by liver graft in auxiliary en-bloc liver-small howel transplantation.

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