Recovery of the alografted smalintestine functions

ＲｅｃｏｖｅｒｙｏｆｔｈｅａｌｏｇｒａｆｔｅｄｓｍａｌｉｎｔｅｓｔｉｎｅｆｕｎｃｔｉｏｎｓＪＩＡＮＧＺｈｉＷｅｉ，ＬＩＪｉｅＳｈｏｕ，ＬＩＮｉｎ，ＬＩＹｏｕＳｈｅｎｇ，ＬＩＵＦａｎｇＬａｎ，ＳＨＥＮＧＸｕｅＱｉｎａｎｄＣＨＥＮＧＹｏｎｇ...     

Arterial chemoembolization for hepatocellular carcinoma

ＡｒｔｅｒｉａｌｃｈｅｍｏｅｍｂｏｌｉｚａｔｉｏｎｆｏｒｈｅｐａｔｏｃｅｌｕｌａｒｃａｒｃｉｎｏｍａＦＡＮＪｉａｎ,ＴＥＮＧａｏＪｉｎｇ,ＨＥＳｈｉＣｈｅｎｇ,ＧＵＯＪｉｎＨｅ,ＹＡＮＧＤｏｎｇＰｅｉａｎｄＷＥＮＧＧｕｏＹｉｎｇＳｕｂｊｅ...     

Endoscopic monitoring in small bowel transplantation

ＥｎｄｏｓｃｏｐｉｃｍｏｎｉｔｏｒｉｎｇｉｎｓｍａｌｂｏｗｅｌｔｒａｎｓｐｌａｎｔａｔｉｏｎＬＩＹｏｕＳｈｅｎｇ，ＬＩＪｉｅＳｈｏｕ，ＬＩＮｉｎｇ，ＪＩＡＮＧＺｈｉＷｅｉ，ＬＩＹｕａｎＸｉｎａｎｄＬＩＸｉａｏＨｕａＳｕｂｊｅｃｔｓｈｅａｄｉ...     

Combined treatment of advanced hepatic carcinoma guided by laparoscope

ＣｏｍｂｉｎｅｄｔｒｅａｔｍｅｎｔｏｆａｄｖａｎｃｅｄｈｅｐａｔｉｃｃａｒｃｉｎｏｍａｇｕｉｄｅｄｂｙｌａｐａｒｏｓｃｏｐｅＺＨＵＪｉａｎｇＦａｎ，ＸＵＳｈｅｎｇＸｉａｎ，ＺＨＡＮＧＸｉａｏＨｕａ，ＳＨＯＮＧＬＩＰｉｎｇａｎｄＳＨＡＮＬｉＣ...     

Expression of lectin receptors during hepatocarcinogenesis induced by chemicalcarcinogen in rats.

ＥｘｐｒｅｓｉｏｎｏｆｌｅｃｔｉｎｒｅｃｅｐｔｏｒｓｄｕｒｉｎｇｈｅｐａｔｏｃａｒｃｉｎｏｇｅｎｅｓｉｓｉｎｄｕｃｅｄｂｙｃｈｅｍｉｃａｌｃａｒｃｉｎｏｇｅｎｉｎｒａｔｓＮＩＵＺｈａｏＳｈａｎ１，ＺＨＡＮＧＺｈａｏＣｈｅｎｇ１，ＺＯＵＷｅｉ１...     

In vitro production of TNFα,IL-6 and sIL-2R in Chinese patients with ulcerative colitis

ＩｎｖｉｔｒｏｐｒｏｄｕｃｔｉｏｎｏｆＴＮＦα，ＩＬ６ａｎｄｓＩＬ２ＲｉｎＣｈｉｎｅｓｅｐａｔｉｅｎｔｓｗｉｔｈｕｌｃｅｒａｔｉｖｅｃｏｌｉｔｉｓＸＩＡＢｉｎｇ１，ＧＵＯＨａｉＪｉａｎ１，ＪＢＡＣｒｕｓｉｕｓ２，ＤＥＮＧＣｈａｎｇＳｈｅｎｇ...     

Relationship between ras p53 gene RNA and protein expression and HCC metastasis

Ｒｅｌａｔｉｏｎｓｈｉｐｂｅｔｗｅｅｎｒａｓｐ５３ｇｅｎｅＲＮＡａｎｄｐｒｏｔｅｉｎｅｘｐｒｅｓｓｉｏｎａｎｄＨＣＣｍｅｔａｓｔａｓｉｓＺＨＥＮＧＳｈｉＸｉ１，ＬＩＵＬｉＪｉａｎｇ２，ＳＨＡＯＹｏｎｇＳｈｅｎｇ３，ＺＨＥＮＧＱｉｎｇＰｉｎｇ１...     

HBx-DNA probe preparation and its application in study of hepatocarcinogenesis

ＨＢｘＤＮＡｐｒｏｂｅｐｒｅｐａｒａｔｉｏｎａｎｄｉｔｓａｐｐｌｉｃａｔｉｏｎｉｎｓｔｕｄｙｏｆｈｅｐａｔｏｃａｒｃｉｎｏｇｅｎｅｓｉｓＧＡＯＦｅｎｇＧｕａｎｇ,ＳＵＮＷｅｎＳｈｅｎｇ,ＣＡＯＹｉｎｇＬｉｎ,ＺＨＡＮＧＬｉＮｉｎｇ,ＳＯＮ...     

Bile acids in serum and bile of patients with cholesterol gallstone

ＢｉｌｅａｃｉｄｓｉｎｓｅｒｕｍａｎｄｂｉｌｅｏｆｐａｔｉｅｎｔｓｗｉｔｈｃｈｏｌｅｓｔｅｒｏｌｇａｌｓｔｏｎｅＨＡＮＴｉａｎＱｕａｎ１,ＺＨＡＮＧＳｈｅｎｇＤａｏ１,ＴＡＮＧＷｅｎＨａｏ２ａｎｄＪＩＡＮＧＺｈａｏＹａｎ１Ｓｕｂｊｅｃｔｈｅ...     

Menetrier's disease with lymphocytic gastritis：Report of two cases

Ｍｅｎｅｔｒｉｅｒ′ｓｄｉｓｅａｓｅｗｉｔｈｌｙｍｐｈｏｃｙｔｉｃｇａｓｔｒｉｔｉｓ：ＲｅｐｏｒｔｏｆｔｗｏｃａｓｅｓＺＨＡＮＧＸｉａｎｇＳｈｅｎｇ，ＺＨＡＮＧＹａｎ，ＷＵＳｈｕＨｕａ，ＨＡＮＹｕＺｈｅｎｇ，ＬＩＢｉｎａｎｄＭＡＹｕｎＳｕｂｊ...     

Comparative study on the effects of hepatic arterial embolization with Bletilla striata or Gelfoam in treatment of primary hepatic carcinoma

AIM: To study the safety and efficacy of hepatic arterial embolization (HAE) with Bletilla striata powders containing traditional Chinese herbs in the treatment of primary hepatic carcinoma (PHC). METHODS: From May 1990 to September 1993, 106 patients with PHC were treated by HAE with different types of Bletilla striata powders (n = 56) or Gelfoam powders (n = 50) under clearly specified conditions. We analyzed the effects and complications associated with these two types of treatment. RESULTS: The Bletilla striata powders produced extensive and permanent proximal embolization of the hepatic artery, and stimulated the formation of collateral circulation. Treatment could be stopped for as long as 6-12 mo, and there was obvious evidence of tumor necrosis and shrinkage. The patient survival rates at 1, 2, and 3 years were 81.9%, 44.9%, and 33.6%, respectively, and the mean survival time without a serious complication was 19.8 mo. Patients in the Bletilla striata group displayed better clinical effects from their treatment when compared with patients in the Gelfoam group. CONCLUSION: Bletilla striata powders are superior to Gelfoam powders when used for angioembolus in patients with hepatic carcinoma.     

白芨与明胶海绵栓塞治疗肝癌疗效的对比研究

目的研究中药白芨粉粒栓塞肝动脉治疗肝癌的疗效和安全性.方法从1990年5月-1993年9月,在相同条件下,分别使用白芨和明胶海绵颗粒栓塞肝动脉治疗肝癌56例和50例,分析两组的疗效和并发症.结果白芨粉粒具有强大的永久性,中心性栓塞血管作用,侧支循环形成少、时间晚;治疗间隔时间长,为6-12月;肿块坏死缩小显著,患者1,2,3年生存率分别为81.9%,44.9%,33.6%,平均生存期19.8月;无严重并发症发生.所有临床疗效均优于明胶组.结论中药白芨粉粒是一种较理想的肝癌血管栓塞剂.     

肝动脉化疗,栓塞损害肝功能的临床研究

肝动脉化疗，栓塞对肝功能损害的系统分析，国内外文献报道甚少。笔者对收治的５２例肝癌肝动脉化疗，栓塞后的肝功能变化进行了前瞻性研究。结果显示：（１）全部患者治后肝功能均有不同程度的损害，某些肝功能指标高达治前水平的３－４倍，为正常的５－１０倍；（２）大部分肝功能有１月内恢复至汉前水平或正常，３例肝功能持续性恶化，直至肝功能衰竭而死亡；（３）栓塞组的肝功能损害较化疗组严重。     

Predictors and clinical outcomes for spontaneous rupture of hepatocellular carcinoma

AIM:To determine the risk factors for hepatocellular carcinoma(HCC) rupture,and report the management and long-term survival results of patients with spontaneous rupture of HCC.METHODS:Among 4209 patients with HCC who were diagnosed at Eastern Hepatobiliary Surgery Hospital from April 2002 to November 2006,200(4.8%) patients with ruptured HCC(case group) were studied retrospectively in term of their clinical characteristics and prognostic factors.The one-stage therapeutic approach to manage ruptured HCC consisted of initial management by conservative treatment,transarterial embolization(TACE) or hepatic resection.Results of various treatments in the case group were evaluated and compared with the control group(202 patients) without ruptured HCC during the same study period.Continuous data were expressed as mean ± SD or me-dian(range) where appropriate and compared using the unpaired t test.Categorical variables were compared using the Chi-square test with Yates correction or the Fisher exact test where appropriate.The overall survival rate in each group was determined using the Kaplan-Meier method and a log-rank test.RESULTS:Compared with the control group,more patients in the case group had underlying diseases of hypertension(7.5% vs 3.0%,P =0.041) and liver cirrhosis(87.5% vs 56.4%,P 0.001),tumor size 5 cm(83.0% vs 57.4%,P 0.001),tumor protrusion from the liver surface(66.0% vs 44.6%,P 0.001),vascular thrombus(30.5% vs 8.9%,P 0.001) and extrahepatic invasion(36.5% vs 12.4%,P 0.001).On multivariate logistic regression analysis,underlying diseases of hypertension(P = 0.002) and liver cirrhosis(P 0.001),tumor size 5 cm(P 0.001),vascular thrombus(P = 0.002) and extrahepatic invasion(P 0.001) were predictive for spontaneous rupture of HCC.Among the 200 patients with spontaneous rupture of HCC,105 patients underwent hepatic resection,33 received TACE,and 62 were managed with conservative treatment.The median survival time(MST) of all patients with spontaneous rupture of HCC was 6 mo(range,1-72 mo),and the overall survival at 1,3 and 5 years were 32.5%,10% and 4%,respectively.The MST was 12 mo(range,1-72 mo) in the surgical group,4 mo(range,1-30 mo) in the TACE group and 1 mo(range,1-19 mo) in the conservative group.Ninety-eight patients in the control group underwent hepatic resection,and the MST and median diseasefree survival time were 46 mo(range,6-93 mo) and 23 mo(range,3-39 mo) respectively,which were much longer than that of patients with spontaneous rupture of HCC undergoing hepatic resection(P 0.001).The 1-,3-,and 5-year overall survival rates and the 1-,3-and 5-year disease-free survival rates in patients with ruptured HCC undergoing hepatectomy were 57.1%,19.0% and 7.6%,27.6%,14.3% and 3.8%,respectively,compared with those of 77.1%,59.8% and 41.2%,57.1%,40.6% and 32.9% in 98 patients with-CONCLUSION:Prolonged survival can be achieved in selected patients undergoing one-stage hepatectomy,although the survival results were inferior to those of the patients without ruptured HCC.     

Appropriate treatment strategies improve survival of hepatocellular carcinoma patients with portal vein tumor thrombus

AIM:To evaluate the survival benefits of different treatment strategies for hepatocellular carcinoma(HCC)patients with portal vein tumor thrombus(PVTT)and to determine the prognosis factors.METHODS:Between 2007 and 2009,338 HCC patients treated for PVTT were retrospectively studied.The patients were divided into 4 groups that underwent different treatments:the conservative treatment group(n=75),the transarterial chemoembolization(TACE)group(n=86),the hepatic resection group(n=90),and the hepatic resection associated with postoperative TACE group(n=87).Survival rates were determined using the Kaplan-Meier method and differences between the groups were identified through log-rankanalysis.Cox’s proportional hazard model was used to identify the risk factors for survival.RESULTS:The mean survival periods for patients in the conservative treatment,TACE,hepatic resection and hepatic resection associated with postoperative TACE groups were 3.8,7,8.2 and 15.1 mo,respectively.Significant differences were observed in the survival rates.For the surgical resection associated with postoperative TACE group,the survival rates after 1,2 and3 years were 49%,37%and 19%,respectively.These results were significantly higher than those of the other groups(P<0.05).Meanwhile,the 1,2 and 3 year survival rates for the surgical resection group were 28%,20%and 15%,whereas those for the TACE group were17.5%,0%and 0%,respectively.These values significantly increased after hepatic resection compared with those after TACE(P<0.05).CONCLUSION:Surgical resection is the most effective therapeutic strategy for HCC patients with PVTT and results in high hepatic functional reserve.For patients who can tolerate the procedure,postoperative TACE is necessary to prevent recurrence and prolong the survival period.     

Survival rates according to barcelona clinic liver cancer sub-staging system after transarterial embolization for intermediate hepatocellular carcinoma

AIM: To investigate the survival rates after transarterial embolization(TAE).METHODS: One hundred third six hepatocellular carcinoma(HCC) patients [90 barcelona clinic liver cancer(BCLC) B] were submitted to TAE between August 2008 and December 2013 in a single center were retrospectively studied. TAE was performed via superselective catheterization followed by embolization with polyvinyl alcohol or microspheres. The date of the first embolization until death or the last follow-up date was used for the assessment of survival. The survival rates were calculated using the Kaplan-Meier method, and the groups were compared using the log-rank test.RESULTS: The overall mean survival was 35.8 mo(95%CI: 25.1-52.0). The survival rates of the BCLC A patients(33.7%) were 98.9%, 79.0% and 58.0% at 12, 24 and 36 mo, respectively, and the mean survival was 38.1 mo(95%CI: 27.5-52.0). The survival rates of the BCLC B patients(66.2%) were 89.0%, 69.0% and 49.5% at 12, 24 and 36 mo, respectively, and the mean survival was 29.0 mo(95%CI: 17.2-34). The survival rates according to the BCLC B sub-staging showed significant differences between the groups, with mean survival rates in the B1, B2, B3 and B4 groups of 33.5 mo(95%CI: 32.8-34.3), 28.6 mo(95%CI: 27.5-29.8), 19.0 mo(95%CI: 17.2-20.9) and 13 mo, respectively(P = 0.013).CONCLUSION : The BCLC sub-stagingsystem could add additional prognosis information for postembolization survival rates in HCC patients.     

还原型谷胱甘肽在原发性肝癌介入治疗中护肝作用的观察

目的探讨还原型谷胱甘肽(GSH)在原发性肝癌病人介入治疗中的护肝作用。方法原发性肝癌病人72例,随机分为两组,对照组和治疗组各36例。所有病例在行肝动脉灌注化疗(HAI)及肝动脉栓塞治疗(HAE)的同时进行保肝治疗,对照组给予能量合剂、门冬氨酸钾镁和肌苷静脉滴注,当天介入治疗前使用一次,介入治疗后1次/日×7天。治疗组在上述给药的基础上加用GSH1500mg/m2.d静脉滴注,当天介入治疗前使用一次,介入治疗后1次/日×7天。治疗前后监测肝功能变化及腹水生成情况。结果介入治疗后第3天两组病人皆出现不同程度的肝功能受损,但治疗组ALT、AST、TBIL上升幅度均较对照组低(P<0.05)。介入治疗后第7天两组病人肝功能皆好转,但治疗组ALT和AST显著低于对照组,TP显著高于对照组(P<0.05)。两组腹水生成率的差异无统计学意义(P>0.05)。结论GSH在原发性肝癌病人介入治疗中可产生显著的保肝作用。     

Multimodality treatment in hepatocellular carcinoma patients with tumor thrombi in portal vein

AIM To compare the therapeutic effect andsignificances of multimodality treatment forhepatocellular carcinoma (HCC) with tumorthrombi in portal vein (PVTT).METHODS HCC patients (n=147) with tumortrombi in the main portal vein or the first branchof portal vein were divided into four groups bythe several therapeutic methods. There wereconservative treatment group in 18 out ofpatients (group A); and hepatic artery ligation(HAL) and/or hepatic artery infusion (HAI)group in 18 patients (group B), in whompostoberative chemoembolization was doneperiodically; group of removal of HCC with PVTTin 79 (group C) and group of transcatheterhepatic arterial chemoembolization (TACE) orHAI and/or portal vein infusion (PVI) afteroperation in 32 (group D).RESULTS The median survival period was 12months in our series and the 1-, 3-, and 5-yearsurvival rates were 44.3%, 24.5% and 15.2%,respectively. The median survival times were 2,5, 12 and 16 months in group A, B, C and D,respectively. The 1-, 3- and 5-year survival rateswere 5.6%, 0% and 0% in group A; 23.2%,5.6% and 0% in group B; 53.9%, 26.9% and16.6% in group C; 79.3%, 38.9% and 26.8% ingroup D, respectively. Significant differenceappeared in the survival rates among the groups (P<0.05).CONCLUSION Hepatic resection with removalof tumor thrombi and HCC should increase thecurative effects and be encouraged for theprolongation of life span and quality of life forHCC patients with PVTT, whereas the besttherapeutic method for HCC with PVTT is withregional hepatic chemotherapy orchemoemblization after hepatic resection withremoval of tumor thrombi.     

Risk factors and surgical outcomes for spontaneous rupture of BCLC stages A and B hepatocellular carcinoma: A case-control study

AIM: To investigate the risk factors and surgical outcomes for spontaneous rupture of Barcelona Clinic Liver Cancer (BCLC) stages A and B hepatocellular carcinoma (HCC).METHODS: From April 2002 to November 2006, 92 consecutive patients with spontaneous rupture of BCLC stage A or B HCC undergoing hepatic resection were included in a case group. A control arm of 184 cases (1:2 ratio) was chosen by matching the age, sex, BCLC stage and time of admission among the 2904 consecutive patients with non-ruptured HCC undergoing hepatic resection. Histological confirmation of HCC was available for all patients and ruptured HCC was confirmed by focal discontinuity of the tumor with surrounding perihepatic hematoma observed intraoperatively. Patients with microvascular thrombus in the hepatic vein branches were excluded from the study. Clinical data and survival time were collected and analysed.RESULTS: Sixteen patients were excluded from the study based on exclusion criteria, of whom 3 were in the case group and 13 in the control group. Compared with the control group, more patients in the case group had underlying diseases of hypertension (10.1% vs 3.5%, P = 0.030) and liver cirrhosis (82.0% vs 57.9%, P < 0.001). Tumors in 67 (75.3%) patients in the case group were located in segments II, III and VI, and the figure in the control group was also 67 (39.7%) (P < 0.001). On multivariate analysis, hypertension (HR = 7.38, 95%CI: 1.91-28.58, P = 0.004), liver cirrhosis (HR = 6.04, 95%CI: 2.83-12.88, P < 0.001) and tumor location in segments II, III and VI (HR = 5.03, 95%CI: 2.70-6.37, P < 0.001) were predictive for spontaneous rupture of HCC. In the case group, the median survival time and median disease-free survival time were 12 mo (range: 1-78 mo) and 4 mo (range: 0-78 mo), respectively. The 1-, 3- and 5-year overall survival rates and disease-free survival rates were 66.3%, 23.4% and 10.1%, and 57.0%, 16.8% and 4.5%, respectively. Only radical resection remained predictive for overall survival (HR = 0.32, 95%CI: 0.08-0.61, P = 0.015) and disease-free survival (HR = 0.12, 95%CI: 0.01-0.73, P = 0.002).CONCLUSION: Tumor location, hypertension and liver cirrhosis are associated with spontaneous rupture of HCC. One-stage hepatectomy should be recommended to patients with BCLC stages A and B disease.     

Comparative analysis of radiofrequency ablation and resection for resectable colorectal liver metastases

AIM:To evaluate the therapeutic efficacy of radiofrequency ablation(RFA)for resectable colorectal liver metastases(CRLM)compared with that of resection.METHODS:Between June 2004 and June 2009,we retrospectively analyzed 29 patients with resectable CRLMs;17 patients underwent RFA,and 12 underwent hepatic resection.All of the patients were informed about the treatment modalities and were allowed to choose either of them.RFA including an intraoperative approach was performed by a radiologist;otherwise,hepatic resection was performed by a surgeon.Comparative analysis of the two groups was performed,including comparisons of gender,age,and clinical outcomes,such as primary tumor stage and survival rates.RESULTS:The mean tumor size was significantly larger in the resection group(3.59 cm vs 2.02 cm,P<0.01),and the 5-year overall survival(OS)rate for all patients was 44.7%.There was no difference in the 5-year OS rates between the RFA and resection groups(37.8%vs66.7%).Univariate analysis indicated significantly lower5-year OS rates for patients with a tumor size>3cm.The 5-year disease-free survival(DFS)rates were17.6%and 22.2%in the RFA and resection groups,respectively(P=0.119).Univariate analysis revealed that in cases of male gender,age>65 years,T stage<Ⅳ,absence of lymphatic metastasis,and tumor size>3 cm,RFA resulted in significantly inferior 5-year DFS rates compared with surgical resection.CONCLUSION:Surgical resection revealed superior outcomes in the treatment of resectable CRLMs,particularly in cases with a hepatic tumor size>3 cm.