ObjectiveTo summarize the research progress of tissue-engineered bile duct in recent years. MethodsThe related literatures about the tissue-engineered bile duct were reviewed. ResultsIn recent years, the research of tissue-engineered bile duct has made a breakthrough in scaffold materials, seed cells, growth factors etc. However, the tissue-engineered bile duct is still in the research stage of animal experiments, which can not be directly applied to clinical practice. ConclusionsThe research of tissue-engineered bile duct becomes popular at present. With the rapid development of materials science and cell biology, the basic research and clinical application of tissue-engineered duct will be more in-depth research and extension, which might bring new ideas and therapeutic measures for patients with biliary defect or stenosis.
Objective To investigate the feasibility of elective laparoscopic hepatectomy in the treatment of ruptured hepatocellular carcinoma. Methods We tried to perform an elective laparoscopic hepatectomy for a middle-aged man who had a ruptured hepatocellular carcinoma without active hemorrhage. The data of this patient was summarized. Results The patient received the elective laparoscopic hepatectomy, and the liver lesions were completely removed. The operation was successful. Operative time was 300 min and intraoperative bleeding was 500 mL. Postoperative recovery of this patient was good and no complication occurred. The abdominal drainage tube was removed on 4 days after operation, and he discharged on 8 days after operation. The pathology confirmed that the hepatocellular carcinoma was moderately differentiated and ruptured. Conclusion Elective laparoscopic hepatectomy is safe and feasible in the treatment of ruptured hepatocellular carcinoma for specific patient, but this operation needs to be performed by experienced surgeons with laparoscopic skills.
ObjectiveTo investigate activation of phosphatidylinositol 3 hydroxykinase (PI3K)/AKT pathway and sphingosine 1-phosphate receptor 2 (S1PR2) in peripheral blood mononuclear cells (PBMCs) of acute obstructive cholangitis (AOC) rats and their effects on systemic inflammation in rats.Methods① In vitro experiment: The isolated PBMCs from the rats were divided into 4 groups: a control group, LY294002 treatment group, lipopolysaccharide (LPS) treatment group, and LPS+LY294002 treatment group. The levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the supernatant were detected and the phosphorylation levels of PI3K and AKT and protein level of S1PR2 in the PBMCs were detected. ② In vivo experiment: The rats were randomly divided into four groups: a control group, LY294002 treatment group, AOC model group, and AOC+LY294002 treatment group. The survival rate of rats was recorded, the liver function (ALT, AST, and TBIL), TNF-α, and IL-6 levels in the serum were detected. The phosphorylation levels of PI3K and AKT and protein level of S1PR2 in the PBMCs of the rats were detected. Results① The results of in vitro experiment: The levels of TNF-α and IL-6 in the LPS+LY294002 treatment group were significantly lower than those in the LPS treatment group (P<0.050). The phosphorylation levels of PI3K and AKT and protein level of S1PR2 in the LPS+LY294002 treatment group were significantly lower than those in the LPS treatment group (P<0.050). ② The results of in vivo experiment: The survival rate of rats in the AOC+LY294002 treatment group was higher than those in the AOC group. The serum levels of ALT, AST, TBIL, TNF-α, and IL-6 in the AOC+LY294002 treatment group were significantly lower than those in the AOC model group (P<0.050). The phosphorylation levels of PI3K and AKT and protein level of S1PR2 in the AOC+LY294002 treatment group were significantly lower than those in the AOC model group (P<0.050).ConclusionInhibition of activation of PI3K/AKT pathway in PBMCs can inhibit expression of S1PR2, then alleviate systemic inflammatory response induced by AOC in rats.
ObjectiveTo investigate the feasibility and safety of percutaneous transhepatic choledochoscopic lithotripsy (PTCSL) in the treatment of recurrent type Ⅱa hepatolithiasis.MethodsAll of 293 patients with recurrent type Ⅱa hepatolithiasis admitted to the Second Affiliated Hospital of Chongqing Medical University from December 2010 to December 2017 were collected retrospectively, 82 of whom were treated with the PTCSL (PTCSL group), 211 of whom were treated with traditional open surgery (open group). The patients were matched according to the ratio of 1∶1 by using the method of propensity score matching, then the patients were compared after matching.ResultsA total of 59 pairs were successfully matched, that was, there were 59 patients in the PTCSL group and open group, respectively. Compared with the open group, the PTCSL group had the similar conditions such as the gender, age, preoperative Child-Pugh classification, and times of previous biliary operations, etc. (P>0.050). There was no perioperative death in both groups. There were no significant differences between the two groups in the success rate, operation time, times of operations, time of T tube removal after operation, stone residual rate, and stone recurrence rate (P>0.050). Although the hospital costs of the PTCSL group was higher than that of the open group (P<0.050), the PTCSL group had various advantages, such as less intraoperative bleeding, smaller incisional scar, shorter hospital stay and postoperative ventilation time, and lower rate of total postoperative complications (P<0.050).ConclusionsAfter learning curve, PTCSL has many advantages over traditional open surgery in treatment of recurrent type Ⅱa hepatolithiasis. PTCSL is a minimally invasive surgery, which is safe and effective.
ObjectiveTo determine the expressions of Lgr5 protein and Ki-67 protein in gastric cancer tissues, and to analyze the possible function in the carcinogenesis and development of gastric cancer.MethodsThe SABC immunohistochemical method was adopted to examine the expressions of Lgr5 protein and Ki-67 protein in the 69 paraffin slices of gastric cancer from the patients, with the adjacent normal gastric tissue as the control group. The statistical relationship between the expressions of these two kinds of proteins and clinicopathologic features of gastric cancer was examined respectively.ResultsIn the gastric cancer tissue group, the expressions of Lgr5 protein and Ki-67 protein upregulated in comparison to the adjacent normal gastric tissue group [Lgr5 protein: 87.0% (60/69) versus 16.7% (5/30), χ2=45.81, P<0.001; Ki-67 protein: 79.7% (55/69) versus 36.7% (11/30), χ2=17.43, P<0.001]. The expressions of Lgr5 protein and Ki-67 protein all upregulated in the N1–N3 stage groups, lowly differentiated+undifferentiated groups and positive Helicobacter pylori (HP) groups. The expression of Lgr5 protein upregulated in the T3+T4 stage groups in comparison to T1+T2 stage groups, while, no significant relationship was found in the expression of Ki-67 protein and tumor T staging. No significant relationship was found between the gender or metastasis and the expression of these two proteins. There was a positive correlation between the Lgr5 protein expression and the Ki-67 protein expression in the gastric cancer (rs=0.340, P=0.004).ConclusionsIn the development progress of gastric cancer, the Lgr5 protein might get involved in the mechanism of tumor invasion, lymph nodal metastasis, and low differentiation. Ki-67 protein might get involved in the mechanism of lymph nodal metastasis and low differentiation. The two proteins, together with the HP infection, might play a synergistic role in tumorigenesis and development.