Objective]To explore the metastasis regulatory of lymph node of papillary thyroid cancer and to analyze the influence factors.[Methods]Clinical data of 375 papillary thyroid cancer patients at our hospital between Jun 2011 and Sep 2015 were retrospectively reviewed and summarized the metastasis regulatory of lymph nodes and the tumor characteristics.[Results]All selected patients were diagnosed papillary thyroid cancer. The Total metastasis rate of cervical lymph node was 67.47%,the metastasis rate of region Ⅵ lymph nodes was 64.27%;the metastasis rate of region Ⅱ~Ⅴ lymph nodes was 36.53%. The metastasis rate of lymph nodes of the patients with tumor diameter over 1 cm,breaking through thyroid membrane and invading the cervical muscle were significantly increased(P < 0.05).[Conclusion]The central group lymph nodes were the most metastasis region of papillary thyroid cancer and should routinely be dissected by the first time of surgery. When the tumor diameter greater than 1 cm or cancer breakthrough thyroid membrane and/or invading the cervical muscles ,the ipsilateral lateral neck lymph nodes should be dissected at the same time.

AIM:To investigate the effect of heat shock protein 75 ( Hsp75 ) over-expression on Aβ-induced neurotoxicity in the neural stem cells and to explore its mechanism.METHODS:An adenovirus-mediated Hsp75 over-ex-pression vector was used in vitro.The mouse neural stem cell C17.2 was cultured in vitro and divided into control group, Aβgroup, negative adenovirus vector transfection group and Hsp75 over-expression adenovirus vector transfection group. The transfection and cellular immune identification were detected by fluorescence microscopy.The cell morphology was ob-served under inverted phase-contrast microscope.The cell viability and apoptosis were detected by MTT assay and flow cy-tometry, respectively.Hsp75 over-expression and cleaved caspase-3 protein level were measured by Western blot.RE-SULTS:Observation by fluorescence microscopy indicated that C17.2 cells were successfully transfected and Hsp75 gene was effectively expressed in the neural stem cells after transfection.In addition, the morphology and viability of the cells did not change and these cells did not differentiate after transfection.As compared with control group, the cell viability in Aβgroup and negative adenovirus vector transfection group was significantly decreased (P<0.05), and the cell apoptotic rate and cleaved caspase-3 level (P<0.05) were increased.As compared with Aβgroup and negative adenovirus vector transfection group, Hsp75 over-expression significantly increased the cell viability, and decreased the cell apoptosis and cleaved caspase-3 level ( P<0.05 ) .CONCLUSION: Hsp75 over-expression protects the neural stem cells against Aβ-induced injury.The mechanism may be related to inhibiting caspase-3 pathway-dependent apoptosis.

Objective To evaluate the short-term and long-term elinical effect of hepatectomy using Tissue-Link & Cusa,compared to the Pringle maneuver.Methods Clinical data of 87 HCC patients who had received hepatectomy by the Pringle's Maneuver (group A) or Tissue-Link & Cusa (group B) were retrospectively analyzed.Results The average amount of bleeding in Group A was more than group B (t =2.030,P =0.023).The time of operation in group A was shorter than group B (t =-2.896,P =0.006).The postoperative supplement of albumin in group A was more than group B,the level of serum total bilirubin on 7th day after operation was higher than group B (P ＜ 0.05).There was no significant difference in postoperation complications and the time in hospital (P ＞0.05).The rate of incisional recurrence and the rate of metastasis in or out of the liver in group A were higher than group B (P =0.029,0.021,0.016).The 2-and 3-year tumor-free survival rates and the 3-year overall survival rates in group A were lower than that in group B (P =0.047,0.036,0.042).Conclusions Hepatectomy using Tissue-Link & Cusa is superior to the Pringle's maneuver for the treatment of primary hepatocellular carcinoma.It has a clear operative field,less operative bleeding,less damage to liver function and a lower relapse rate of incisional margin.

AIM:To investigate the role of phospholipase C epsilon 1 ( PLCE1 ) in modulating the apoptotic mechanism in lung adenocarcinoma A 549 cells.METHODS:PLCE1 inhibitor U-73122 was used to suppress the expres-sion of PLCE1.The expression of PLCE1 and p53 in A549 cells was evaluated by quantitative real-time PCR and Western blotting.Apoptosis was assessed by flow cytometry .RESULTS:A549 cells expressed high level of PLCE1 and low level of p53.Inhibition of PLCE1 markedly increased the expression of p 53, and increased the apoptosis of A 549 cells.CON-CLUSION:PLCE1 suppresses apoptosis of A549 cells via inhibiting the expression of p53.

Objective To evaluate the effect of preoperative transarterial chemoembolization (TACE) for resectable hepatocellular carcinoma (HCC).Methods HCC patients undergoing up-front hepatectomy (group A) were compared with those receiving TACE before hepatectomy (group B).Results Tumor size decreased significantly after TACE (t =3.3 1,P =0.021).The rates of tumor encapsulation and liver adhesions were significantly more often seen in group B.There were fewer tumor-residual and more frequent necrosis in group B.Operative time in group B was longer (t =2.71 ,P =0.046).The average blood loss and complication rate were of no difference between the two groups.The occurrence of pleural effusion and intrahepatic recurrence rate in group A was higher than group B (x2 =3.85 ,P =0.031) (x2 =2.76,P =0.046).The overall survival rate from the second year postoperative in group B was higher than group A (x2 =3.37, P =0.043).Conclusions TACE could diminish tumor, advance encapsulation and reduce tumor-residual.Preoperative TACE does not improve 1-, 2-, and 3-year tumor-free survival rates but improve 1-, 2-, and 3-year overall survival rates.

ObjectiveTo investigate the influencing factors of portal vein thrombosis (PVT) after splenectomy in patients with portal hypertension.MethodsClinical data of 67 patients with liver cirrhosis and portal hypertension undergoing splenectomy + endoscopicvariceal ligation in Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University between March 2012 and April 2015 were retrospectively studied. Among the 67 patients, 47 were males and 20 were females with the average age of (47±8) years old. Thirty-five patients underwent laparoscopic splenectomy and 32 patients underwent open splenectomy. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were divided into the PVT group and the non-PVT group according to whether PVT developed after surgery. The influencing factors of PVT in two groups were compared. The comparison of the influencing factors of PVT was conducted usingt test or chi-square test.ResultsEleven cases developed PVT after splenectomy with the incidenceof 16% (11/67) including 6 cases of laparoscopic splenectomy and 5 of open splenectomy. The incidence of PVT was associated with Plt and the concentration of D-dimer in blood circulation. Blood Plt of the PVT group was (739±39) ×109/L, which was significantly higher than (318±51)×109/L of the non-PVT group (t=14.678,P<0.05). The concentration of D-dimer of the PVT group was (7.4±1.1) mg/L, which was significantly higher than (4.0±0.9) mg/L of the non-PVT group (t=5.458, P<0.05). The incidence of PVT was not associated with surgical procedure (χ2=0.028,P>0.05).Conclusion The incidence of PVT after splenectomy is associated with Plt and the concentration of D-dimer and is not associated with surgical procedure.

BACKGROUND:Previous studies have confirmed that bone marrow mesenchymal stem cells in vitro can promote hepatic stel ate cellapoptosis and inhibit its activity, in which the mechanism of action remains unknown. OBJECTIVE:To screen out apoptosis-related genes during hepatic stel ate cellapoptosis regulated by bone marrow mesenchymal stem cells using gene chip technology. METHODS:Purified human bone marrow mesenchymal stem cells were seeded in 6-wel Transwel plate and cocultured with hepatic stel ate cells. Cultured human bone marrow mesenchymal stem cells alone served as control group, and cultured for 72 hours. The alterations in apoptosis-related genes were analyzed between culture alone group and coculture group using gene chip technology. The genes strongly associated with regulation of hepatic stel ate cells were selected. RESULTS AND CONCLUSION:By the functional classification of second-generation SABiosciences Gene chips, apoptotic gene screening found that after coculture, significantly upregulated genes in bone marrow mesenchymal stem cells contained:AKT1, PIK3R2, DAPK1, DHCR24, NOTCH2 and BDNF. Combined with previous findings, we hypothesized that NOTCH may play a key role in the regulation of hepatic stel ate cells by bone marrow mesenchymal stem cells.

Objective To review the diagnosis and treatment of severe complications after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). Methods Clinical data of 15 patients with severe complications after TACE of HCC in Department of General Surgery, Lingnan Hospital, the Third Afifliated Hospital of Sun Yat-sen University from June 2011 to May 2013 were analyzed retrospectively. The informed consents of all patients were obtained and the ethics committee approval was received. There were 12 males and 3 females with age ranging from 40 to 78 years old and the median age of 55 years old. Results Manifestations of cholangitis such as abdominal pain, fever, rising white blood cell etc. were observed in all the patients. According to the clinical manifestations, history of receiving TACE and imaging examinations, 10 cases were diagnosed with biloma after TACE of HCC, 4 cases with liver abscess and 1 case with ischemic cholangitis. All the patients received basic treatments of anti-infection, cholagogue and liver protection. Ten cases with biloma were cured after receiving ultrasound-guided percutaneous transcatheter drainage of biloma, percutaneous transhepatic cholangial drainage (PTCD) and endoscopic nasobiliary drainage (ENBD). Four cases with liver abscess were cured after receiving ultrasound-guided percutaneous transcatheter drainage of liver abscess, local douche with antibiotics. One case with ischemic cholangitis received drainage of 3 catheters of PTCD and the serum bilirubin went down from 500μmol/L to 300μmol/L, but gave up treatment ifnally because of complicating severe biliary infection and gastrointestinal hemorrhage. Conclusions The diagnosis of severe complications after TACE of HCC is mainly based on the clinical manifestations, history of receiving TACE and imaging examinations. The therapies include basic treatments of anti-infection, cholagogue and liver protection etc., and symptomatic treatments of ultrasound-guided percutaneous drainage, PTCD, ENBD, etc.

Objective To analyze the short-term and long-term effectiveness of radiofrequency ablation combined with transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC).Methods The clinical data of 70 HCC patients who had received thermal ablation (group A) done or in combination with TACE (group B) were retrospectively analyzed.Results The rate of intrahepatic distant recurrence in group B (25 cases) was lower than that in group A (45 cases) (X2 =3.845,P =0.046) and the tumor-free survival rate was higher than group A (X2 =5.020,P =O.030).There were no differences in the local tumor progression rate (X2 =0.853,P =0.374) and overall survival (x2 =2.316,P =0.154) between two groups.Incidence of bone marrow suppression in group B was higher than that of group A (X2 =5.642,P =0.042).Major complications didn't occur in any group(X2 =2.016,P =0.183).The costs was higher(t =7.738,P ＜0.001) and the hospital stay was longer (t =5.921,P =0.003) in group B than group A.Conclusions Compared with ablation alone,combined therapy is able to reduce short-term recurrence,and improve tumor-free survival.Combine therapy is safe and effective method for small liver carcinoma.