Objective To summarize the research status of percutaneous ultrasound interventional therapy for the patients with hepatic echinococcosis, and to provide some experience and reference for the treatment of disease in clinical medical personnel. Method The relevant literature on percutaneous ultrasound intervention therapy for hepatic echinococcosis both domestically and internationally was summarized and analyzed. Results For the patients with hepatic cystic echinococcosis (HCE), ultrasound-guided percutaneous transhepatic drainage is safe and effective for the World Health Organization Informal Working Group classification CE1 and CE3a cysts. For the patients with hepatic alveolar chinococcosis (HAE), although radical resection is still the gold standard, ultrasound-guided microwave ablation had better postoperative recovery and less trauma for patients with lesion diameter ＜5 cm; Due to limited research on the efficacy and safety of ultrasound-guided radiofrequency ablation for patients with HAE, further exploration is needed; Ultrasound guided percutaneous cyst puncture drainage is used for external drainage of necrotic material in the cyst cavity, which can effectively control infection and remove necrotic tissue; percutaneous transhepatic cholangial drainage (PTCD) could effectively relieve biliary obstruction, improve liver function, and enhance the quality of life of patients with advanced HAE complicated with obstructive jaundice. Conclusions Ultrasound-guided percutaneous interventional techniques have their own advantages and disadvantages in treatment of hepatic echinococcosis. For patients with HCE, strict indications and contraindications should be followed when performing percutaneous ultrasound interventions. For patients with HAE, early-stage small lesions should be prioritized for microwave ablation, and patients in the middle and late stages with larger lesions or those with intra-cyst infection or jaundice should be treated with percutaneous cyst puncture drainage and PTCD to alleviate symptoms, following the second stage operation.
ObjectiveTo understand the role of complement system in the immune mechanism of hepatocellular carcinoma (HCC) and its potential therapeutic value, and to provide reference for related research in the field of HCC immunotherapy. MethodsRead and review the national and international literature on hepatocellular carcinoma and complement-related studies. ResultsA total of eight complement components closely related to HCC were summarized, which play an important role in the immune regulation of HCC, and their activation can be involved in the occurrence and development of HCC through a variety of mechanisms, and their use as complement inhibitors can regulate the activity of complement-related activation pathways and enhance anti-tumor ability, potentially providing a new strategy for the treatment of HCC. ConclusionA variety of complement components in the complement system play an important role in regulating the immune mechanism of HCC, and the activation of the complement system is closely related to the occurrence and development of HCC, which is expected to be a potential immunotherapeutic target for HCC. However, the combination of complement-related inhibitor therapy with other antitumor immunotherapies carries certain risks and benefits, which need to be thoroughly investigated.
ObjectiveTo evaluate roles and advantages of magnetic resonance imaging (MRI) and compute.tomography (CT) in preoperative assessment for hepatic alveolar echinococcosis. MethodMRI and CT scan imaging data of 60 patients with hepatic alveolar echinococcosis underwent radical surgery were retrospectively analyzed. ResultsMRI scanning could accurately identify the peripheral zone and marginal zone of hepatic alveolar echinococcosis lesions, and CT could not accurately show the above structures. In assessment of anatomic relation between vascular and lesions, MRI findings of 52 cases were in full compliance with corresponding intraoperative findings, and 8 cases were partial compliant. However, CT findings of 35 cases were in full compliance with corresponding intraoperative findings, 13 cases were partial compliant, and 12 cases were not compliant at all. In assessment of anatomic relation between biliary and lesions, MRCP could clearly show the bile duct, bile duct stenosis location and degree; CT scanning could only show widened bile duct, but could not accurately judge bile duct dilatation. ConclusionsMRI exerts some obvious advantages in preoperative evaluation of hepatic alveolar echinococcosis, and could accurately find relation between lesions and vascular or biliary system. MRI should be used as routine examination for patients with hepatic alveolar echinococcosis.
ObjectiveTo observe effect of echinococcus cyst fluid on proliferation and cell cycle progression of rat hepatic stellate cells (HSC-T6), and to preliminarily reveal a new mechanisms of pro-fibrogenic effect of alveolar echinococcosis. MethodsHSC-T6 cells were treated with different concentrations (0.00-0.90 mg/mL) of echinococcus cyst fluid. Then, the morphological changes were observed under the inverted microscope, the impacts on proliferation and cell cycle were tested by the CCK-8 assay and flow cytometry respectively. ResultsAfter treated by echinococcus cyst fluids with different concentrations (0.00-0.90 mg/mL) for 24 h, the most cells shrinked fusiform shape with more slender synapses, and the proliferation activities were increased with the concentration of echinococcus cyst fluid increasing when it was higher than 0.05 mg/mL (P<0.05), the proportion of G0/G1 was decreased (P<0.05) and those of S and G2/M were increased (P<0.05) with the concentration of echinococcus cyst fluid increasing. ConclusionsEchinococcus cyst fluid could promote proliferation of HSC-T6 cells in a dose-dependent manner, which might due to its impact on cell cycle progression. Therefore, alveolar echinococcosis might promote hepatic fibrosis through regulating hepatic stellate cells, but further research on detail needs to be done in future.
ObjectiveTo explore potential value of three-dimensional reconstruction technique for preoperative evaluation of hepatic alveolar echinococcosis. MethodsTwenty-one cases of hepatic alveolar echinococcosis proved by postoperative pathological examination in Affiliated Hospital of Qinghai University from October 2013 to March 2014 were analyzed retrospectively. The three periods of patients’ liver dynamic thin layerCTscan images were collected and imported in three-dimensional reconstruction software by DICOM format. The volume of the virtual resected liver tissue was calculated by software, and then was compared with the actual resected liver tissue volume. ResultsThe resected liver volume was (761.94±505.77) mL and (756.19±501.78) mL in the virtual surgery and in the veritable surgery, respectively. The proportion of resected liver in the total liver was (39.27±18.75)% and (38.95±16.99)% in the virtual surgery and in the veritable surgery, respectively. The resected liver volume had no significant difference between the virtual surgery and veritable surgery (P>0.05), which a positive relation (r=0.989, P<0.001). ConclusionThe limited preliminary data in this study show that three-dimensional reconstruction technique and virtual planning system for surgery could accurately guide resection of lesion and provide preoperative guidance of accurate liver resection for hepatic alveolar echinococcosis.
ObjectiveTo summarize clinical treatments of hepatic alveolar echinococcosis in recent years and provide a new basis for guiding clinical practice. MethodsThe relevant literatures about treating hepatic alveolar echinococcosis at home and abroad were reviewed. The clinical curative effect and advantages or disadvantages among various treatments were analyzed. ResultsThe radical surgery was still the primary treatment of hepatic alveolar echinococcosis, liver transplantation was more used in the treatment of the late hepatic alveolar echinococcosis. surgery combined with chemical therapy had an obvously clinical curative effect. ConclusionsWith a high incidence and poor prognosis of hepatic alveolar echinococcosis, it is difficult to cure. Radical surgery, liver transplantation, chemotherapy and radiation therapy have been used in clinical treatment of hepatic alveolar echinococcosis. It is essential to fully acknowledge indications of various treatments. At the same time, if occurrence and development of this disease could be further researched, it might bring us a new hope of curing hepatic alveolar echinococcosis.
ObjectiveTo detect expressions of interleukin-17 (IL-17) and interleukin-27 (IL-27) proteins in liver tissue of hepatic alveolar echinococcosis. MethodsThe edge liver tissues (from the lesion edge 0.5 cm) and the normal liver tissues (from the lesion edge 5 cm) of 20 patients with hepatic alveolar echinococcosis in the Affiliated Hospital of Qinghai University were collected and stored at-80℃ freezer. The immunohistochemical method was used to detect the expressions of IL-17 and IL-27 proteins in these two tissues. ResultThe positive rates of IL-17 and IL-27 protein expressions in the edge liver tissues were significantly higher than those in the normal liver tissues[IL-17:80.0% (16/20) versus 10.0% (2/20), χ2=12.36, P < 0.01; IL-27:85.0% (17/20) versus 20.0% (4/20), χ2=12.36, P < 0.01]. ConclusionHigh expressions of IL-17 and IL-27 protein in edge liver tissue might participate in progress of hepatic alveolar echinococcosis.
ObjectiveTo investigate the expressions of type Ⅰ and type Ⅲ collagen protein in hepatic alveolar echinococcosis tissues, and to explore its relationship with the biological behavior in progress of hepatic alveolar echinococcosis (HAE). MethodsTwenty samples of normal liver tissues and liver tissues at the edge of the lesion with HAE in our hospital from Jan. 2012 to Dec. 2014 were collected, and HE and Masson staining were performed. The pathological changes and the degree of fibrosis of liver tissues around HAE lesion were observed under light microscope. The expressions of type Ⅰ and type Ⅲ collagen protein in liver tissues were detected by immunohistochemical staining. ResultsThe degree of liver fibrosis of liver tissues at the edge of the lesion with HAE was grade Ⅱ, and the degree of fibrosis of normal liver tissues was grade 0, the difference between the two was statistically significant (P < 0.05). The color index of type Ⅰand type Ⅲ collagen protein in the liver tissues at the edge of the lesion with HAE was 7.45±1.85 and 8.00±1.62, respectively, which were higher than those of normal liver tissues (3.10±1.02 and 3.50±0.89), the difference were statistically significant (t=-9.21, P=0.001;t=-10.88, P=0.001). ConclusionsThere is liver fibrosis around the lesion in the patients with HAE. HAE may promote the expressions of type Ⅰ and type Ⅲ collagen and then induce the occurrence of liver fibrosis.
Objective To detect and analize the expressions and it’s clinical significance of apoptosis factors in hepatic alveolar echinococcosis tissues by using antibody chip technology. Methods The liver tissue specimens (including the edge of lesions and normal liver tissues) of surgical resection of 6 patients with hepatic alveolar echinococcosis in Affiliated Hospital of Qinghai University were collected. The tissue protein was extracted and the level of apoptosis was detected by antibody chip technology. The data were analyzed by AAH-APO-G1 software. Results The expression levels of 5 kinds of apoptosis factors (Bad, Fas, IGFBP-3, P21 and XIAP) in the liver tissues of the marginal zone of hepatic alveolar echinococcosis were compared with that of the normal liver tissues, and the difference was statistically significant (P<0.05). The expression levels of Bad, Fas, IGFBP-3 and P21 were up-regulated, and the expression level of XIAP was down regulated. Conclusions Apoptosis-related factors play a role in the progression of the hepatic alveolar echinococcosis, there may be contact with the immune escape mechanisms, while promote apoptosis factor and inhibitory apoptosis factor that may exist the function imbalance, so more in-depth exploration the mechanism of apoptosis factors on hepatic alveolar echinococcosis in diagnosis and treatment have important significance.
Objective To summarize the nutritional assessment methods for liver cancer patients and their development, and to provide reference for rationally nutritional assessment and nutritional support. Method Domestic and foreign literatures were searched to summarize the nutritional assessment methods for liver cancer patients and their development, in order to determine a practical and feasible assessment method. Results The evaluation validity of traditionally nutritional assessment methods which contained many individual indicators was low. But subjective global assessment (SGA), mini nutritional assessment (MNA), and nutritional risk screening 2002 (NRS-2002) had similar evaluation validity, this 3 kinds of nutritional assessment methods were more suitable for liver cancer patients compared with the traditionally nutritional assessment methods. Conclusion The clinician should simultaneously apply SGA, MNA, NRS-2002, and other comprehensively nutritional assessment methods, as well as related anthropometric and laboratory indexes, to get a more accurate assessment of the nutritional status for patients with liver cancer.