Objective:To study the feasibility and safety of combining liver suspension with 3D laparoscopy in resection of liver tumors in segments 7 and 8.Methods:The data of 26 patients who underwent liver tumor resection in segments 7 and 8 with 3D laparoscopy at Jinhua Hospital of Zhejiang University from January 2018 to December 2019 were retrospectively analyzed. There were 20 males and 6 females, with an average age of 58.7 years. All patients underwent liver tumor resection in segments 7 and 8 with liver suspension combining with 3D laparoscopy. The operative data was analysed.Results:For 25 patients underwent successful operations, and 1 patient was converted to open surgery. The mean operating time was 153 (65-350) min. The Pringle's maneuver was used in 15 patients. The mean blood loss was 155 (30-1 200) ml. Postoperative ascites developed in 4 patients (16.0%), and pleural effusion in 2 patients (8.0%). There was no bile leakage or incisional infection. The mean postoperative hospital stay was 6.2 (4-10) days.Conclusion:The liver suspension technique combing with 3D laparoscopy is safe and effective for resection of liver tumors in segments 7 and 8.

Objective: To study the feasibility of using a double purse-string bridging pancreaticojejunostomy in total laparoscopic pancreaticoduodenectomy (TLPD). Methods: A database of 35 patients who underwent TLPD using a double purse-string bridging pancreaticojejunostomy from January 2016 to January 2019 in Jinhua Hospital of Zhejiang University was retrospectively reviewed. The perioperative outcomes were analyzed. Results: All the 35 patients underwent TLPD successfully. The surgery time was (370.2±33.5) min, and the time of constructing the pancreaticojejunostomy was (28.4±12.6) min. The hospital stay after surgery was (14.2±6.9) days. Five patients developed postoperative complications, including pancreatic fistula in 3 patients, bile leakage in 1 patient, gastroparesis (complicated with abdominal infection) in 1 patient, and abdominal infection in 3 patients (2 patients with pancreatic fistula, and 1 patient with gastroparesis). All the patients with complications responded well to conservative treatment. Conclusions A double purse-string bridging pancreaticojejunostomy was simple and widely applicable. It is safe and feasible in total laparoscopic pancreaticoduodenectomy and should be promoted in clinical practice.

Pancreatic duct stone is a sequel of chronic pancreatitis and may be found in the main ducts,side branches or parenchyma.These stones obstruct the pancreatic ducts and produce ductal hypertension,which leads to pain,the cardinal feature of CP.Surgical operation has been the preferred treatment of pancreatic duct stones in many domestic and external pancreatic medical centers.Lithotomy by longitudinal pancreatic duct incision and Roux-en-Y anastomosis of pancreatic duct to jejunum is the main and effective surgical procedure,while micro-surgery was also rational for the treatment of pancreatic duct stones.However,further studies with a larger sample size and longer follow-up duration are needed to improve the surgical technique and verify our initial results.

Objective To study the safety and feasibility of laparoscopic spleen-preserving distal pancreatectomy (LSPDP) in the treatment of pancreatic benign and borderline tumors.Methods The clinical data of 15 patients with preoperative diagnoses of pancreatic benign or borderline tumors who underwent LSPDP in the Jinhua Hospital,Zhejiang University from March 2013 to March 2017 were retrospectively analyzed.The diameter of tumors ranged from 2.6 to 6.8 cm,with an average of 4.4 cm.Results 15 patients were successfully treated with LSPDP.Twelve patients underwent splenic vessels preservation and 3 without splenic vessels preservation.The average operation time was 215 min (160 ～ 270 min).The mean intraoperative blood loss was 340 ml (180 ～700 ml),and the average postoperative hospital stay was 10.5 days (7 ～ 16 days).There was no patient with postoperative abdominal hemorrhage.Three patients developed postoperative pancreatic fistula and they were treated successfully with conservative therapy.Two patients developed splenic infarction,and the splenic infarction improved markedly after two months on CT.The pathological diagnoses showed 9 patients with serous cystadenoma,4 patients with mucinous cystadenoma,1 patient with a pancreatic neuroendocrine tumor and 1 patient with a solid pseudopapillary tumor.There was no recurrence on follow-up which ranged from 6 to 24 months.Conclusions Laparoscopic spleen-preserving distal pancreatectomy was safe and feasible in the treatment of pancreatic benign or borderline tumors.The Kimura procedure should be performed in preference to the Warshaw procedure.

Objective To explore the correlation among ST-2,adiponectin(APN),positive growth dif-ferentiation factor -15(GDF-15)and senile heart failure,and to investigate the diagnostic values of these indica-tors. Methods Totally 129 patients(15 patients of NYHA Ⅰ,60 of NYHA Ⅱ,28 of NYHA Ⅲ and 26 of NYHAⅣin study group)with heart failure and 30 control subjects(control group)were enrolled in the study.Se-rum levels of ST-2,APN and GDF-15 were determined by ELISA,and their correlation with senile heart failure was analyzed.Results Compared with those in control group,serum levels of ST-2,APN and GDF-15 in study group were significantly increased(P<0.05).There were significant differences in serum levels of ST-2,APN and GDF-15 among patients of different classifications in study group(P<0.05)and the higher level of cardiac func-tion,the higher serum ST-2,APN and GDF-15. There was a positive correlation among serum ST-2,APN and GDF-1. Conclusions The serum levels of ST-2,APN and GDF-1 are positively related to the severity of senile heart failure,thus it could be served as the index of diagnosis,curative effect monitoring and prognosis of patients with heart failure.

OBJECTIVETo investigate the status of exclusive breastfeeding(EBF) and possible influencing factors during 0-7 days postpartum in China.

METHODSDuring 2011 to 2013, healthy mothers and neonates who were in the period of 0- 7 days postpartum from 8 provinces across different regions of China were recruited to take the questionnaire investigations and physical examinations. Information about socio-economic, pregnant, and delivery status, infant healthy situation and feeding indicators was collected to calculate the rate of exclusive breastfeeding during 0- 7 days postpartum and analyze the influencing factors.

RESULTSA total of 1 882 pairs of mothers and neonates were covered by this study. The rate of EBF was 13.3% (250 cases) during 0- 7 days postpartum. Bottle feeding (OR=0.08, 95% CI: 0.05- 0.12), the mothers themselves mixed fed at their 0-4 months old (OR=0.22, 95%CI: 0.08-0.58), the mothers who had used methods to stimulate milk secretion (OR=0.58, 95% CI: 0.35- 0.94) might decrease the EBF rate. Compared with the mothers who believed that their breast milk was not enough for their infants, the mothers who believed breastmilk was enough may increase the EBF rate (OR=6.04, 95%CI: 3.34-10.94). Comparing to the EBF rate of Beijing, Yunnan (OR=0.10, 95%CI: 0.04-0.24), and Gansu(OR=0.03,95%CI: 0.01-0.08) had lower EBF rate during 0-7 days postpartum. What's more, the EBF rate increased with the increasing neonates' age (OR=1.33, 95% CI: 1.16- 1.53).

CONCLUSIONThe EBF rate during 0- 7 days postpartum is still low in China and had significant differences in different regions. Suboptimal feeding knowledge and practices affected the EBF rate significantly.

Bottle Feeding ; Breast Feeding ; statistics & numerical data ; China ; Female ; Humans ; Infant, Newborn ; Milk, Human ; Mothers ; Postpartum Period ; Pregnancy ; Surveys and Questionnaires

OBJECTIVETo investigate the role of microRNA-34a (miR-34a) in regulating the cell cycles of bladder cancer cell line J82 and explore the underlying mechanism.

METHODSJ82 cells were transfected with a miR-34a mimic or an inhibitor to induce miR-34a overexpression or silencing. The RNA level of miR-34a in the transfected cells was detected by real-time PCR, and CD44 expressions at the mRNA and protein levels were detected by real-time PCR and Western blotting. Luciferase reporter assay was used to detect the activation of 3'UTR of CD44, and flow cytometry was performed to analyze the cell cycle changes.

RESULTSThe expression level of miR-34a was significantly increased and CD44 expression significantly lowered in cells transfected with miR-34a mimic; miR-34a inhibitor transfection caused reverse effects on miR-34a and CD44 expressions. MiR-34a mimics downregulated while miR-34a inhibitor enhanced the activation of 3'UTR of CD44 with corresponding changes in the expressions of some cell cycle-related proteins. MiR-34a mimics and miR-34a inhibitor induced opposite changes in J82 cell cycle, which were partly reversed by CD44.

CONCLUSIONMiRNA-34a regulates cell cycles by targeting CD44 in human bladder carcinoma cell line J82.

Cell Cycle ; Cell Line, Tumor ; Down-Regulation ; Humans ; Hyaluronan Receptors ; metabolism ; MicroRNAs ; metabolism ; RNA, Messenger ; Real-Time Polymerase Chain Reaction ; Transfection ; Urinary Bladder Neoplasms ; pathology

Objective To investigate the role of microRNA-34a (miR-34a) in regulating the cell cycles of bladder cancer cell line J82 and explore the underlying mechanism. Methods J82 cells were transfected with a miR-34a mimic or an inhibitor to induce miR-34a overexpression or silencing. The RNA level of miR-34a in the transfected cells was detected by real-time PCR, and CD44 expressions at the mRNA and protein levels were detected by real-time PCR and Western blotting. Luciferase reporter assay was used to detect the activation of 3'UTR of CD44, and flow cytometry was performed to analyze the cell cycle changes. Results The expression level of miR-34a was significantly increased and CD44 expression significantly lowered in cells transfected with miR-34a mimic; miR-34a inhibitor transfection caused reverse effects on miR-34a and CD44 expressions. MiR-34a mimics downregulated while miR-34a inhibitor enhanced the activation of 3'UTR of CD44 with corresponding changes in the expressions of some cell cycle-related proteins. MiR-34a mimics and miR-34a inhibitor induced opposite changes in J82 cell cycle, which were partly reversed by CD44. Conclusion MiRNA-34a regulates cell cycles by targeting CD44 in human bladder carcinoma cell line J82.

Objective To investigate the role of microRNA-34a (miR-34a) in regulating the cell cycles of bladder cancer cell line J82 and explore the underlying mechanism. Methods J82 cells were transfected with a miR-34a mimic or an inhibitor to induce miR-34a overexpression or silencing. The RNA level of miR-34a in the transfected cells was detected by real-time PCR, and CD44 expressions at the mRNA and protein levels were detected by real-time PCR and Western blotting. Luciferase reporter assay was used to detect the activation of 3'UTR of CD44, and flow cytometry was performed to analyze the cell cycle changes. Results The expression level of miR-34a was significantly increased and CD44 expression significantly lowered in cells transfected with miR-34a mimic; miR-34a inhibitor transfection caused reverse effects on miR-34a and CD44 expressions. MiR-34a mimics downregulated while miR-34a inhibitor enhanced the activation of 3'UTR of CD44 with corresponding changes in the expressions of some cell cycle-related proteins. MiR-34a mimics and miR-34a inhibitor induced opposite changes in J82 cell cycle, which were partly reversed by CD44. Conclusion MiRNA-34a regulates cell cycles by targeting CD44 in human bladder carcinoma cell line J82.

ObjectiveTo investigate the feasibility and efficacy of using the hepatoduodenal ligament tension-reduced operation (tension-reduced operation in short) for iatrogenic bile duct injury where the bile duct was severely defective. MethodsBetween March 2006 and May 2009, the authors treated 6 patients with iatrogenic bile duct injury (Bismuth type Ⅱ : 5 patients and type Ⅲ : 1 patient). A no. 7 black silk thread was used to hold the hilar plate tissues and the seromuscular layer of the bulbous part of the duodenum closer together and knots were tied. This method brought the porta hepatis and the duodenal bulb closer together and the hepatoduodenal ligament was shortened. An end to end anastomosis could then be made between the two broken ends of the defective bile duct without tension. ResultsSix patients suffered from bile duct injury and they recovered fully after the tensionreduced operation. There was no complication on follow-up. ConclusionsThe tension-reduced operation was efficacious in the treatment of iatrogenic bile duct injury. This technique should be popularized and more widely used.