Objective To study the expression of proliferating cell nuclear antigen (PCNA) in the occurrence and development of hepatocellular carcinoma. Methods Sixty SD rats were randomly divided into control group and experimental group. 3′MeDAB was administrated into rats to establish the experimental model of hepatocarcinoma. The expressions of PCNA of different phases were detected by immunohistochemistry and the liver pathologic changes were observed by optical microscope. Results The process of canceration was divided into three stages: inflammation, proliferative fibrosis and hepatic carcinoma. The expression of PCNA firstly presented in the oval cells that located in the portal area at the stage of inflammation, and a part of PCNA were hyperexpressed in the portal area. The expression rate of PCNA in the middle phase of inflammatory stage was higher than that of any other phases but declined later. Yet, when it came to the stage of hepatic carcinoma, the rate increased again. Conclusion Under the experimental circumstance when liver cancer is caused by the carcinogenic agent, PCNA may be firstly expressed in the oval cells, and the dynamic expression of PCNA may be an indicator for the early diagnosis of hepatocarcinogenesis.
【Abstract】Objective To explore the distribution and migration of oval cells in progressive hepatic injury. Methods Sixty SD rats were divided into the control group (n=20) and experimental group (n=40). After the establishment of hepatic carcinoma models, C-kit was continuously detected by immunohistochemistry and the liver pathologic changes were regularly observed by optical microscopy.Results The hepatic surface was smooth with eumorphism in histology in the control group. The C-kit positive cells were occasionally found. In the experimental group, the oval cells with C-kit positive were initially discovered in the portal regions in the second week, and these cells proliferated along the bile duct epithelia. With the hepatic injury becoming more serious, the oval cells extended into the hepatic lobular regions from the portal regions. When hepatocellular carcinoma occurred，the majority were mixed carcinomas, and the oval cells were found inside and outside the carcinoma nodes. In this period, the most of C-kit positive cells still located in the portal regions. Conclusion ①The oval cells are the most sensitive cells for the hepatic injury. ②The oval cells which migrate unruly participate in the formation of hepatic pseudolobules. ③The oval cells play an important role in hepatocarcinogenesis.
ObjectiveTo study the clinical value of digital technology assisted minimally invasive surgery in diagnosis and treatment of hepatolithiasis. MethodsThe image data of 64-slice spiral CT scanning were obtained from five patients of complicated hepatolithiasis and introduced into medical image three-dimensional visualization system (MI-3DVS) for three-dimensional reconstruction. On the basis of the data of three-dimensional reconstruction, minimally invasive surgical planning of preoperation was made to obtain reasonable hepatectomy and cholangiojejunostomy, and then preoperative emulational surgery was carried out to minimize the extent of tissue damage and provide guidance to actual operation. ResultsLiver, biliary system, stone, blood vessel, and epigastric visceral organ were successfully reconstructed by MI-3DVS, which showed clearly size, number, shape, and space distribution of stone, and location, degree, length, and space distribution of biliary stricture, and anatomical relationship of ducts and vessels. The results of three-dimensional reconstruction were successfully confirmed by actual operation, which was in accordance with emulational surgery. There was no operative complication. No retained stone in internal and external bile duct was found by Ttube or other supporting tube cholangiography on one month after operation. ConclusionThree-dimensional digitizing reconstruction and individual emulational surgery have important significance in diagnosis and treatment of complicated hepatolithiasis by minimally invasive technique.
Objective To study the relationship between the expression of p53，bcl-2 and nm23 and clinicopathology in the patients with gastric cancer and to probe the correlation among the expression of three kinds of oncogene.Methods Eighty cases of different differentiated gastric cancer, 37 cases of peri-tumor atypical mucosa hyperplasia and 20 cases of normal gastric mucosa were stained by immunohistochemistry (SP method).The expression of p53,bcl-2 and nm23 was analyzed with their relation to histologic type，differentiation，lymph node metastasis and prognosis of gastric carcinoma.Results The positive rates of bcl-2 protein expression in mild,middle and severe peritumor atypical hyperplasia were 7.1%, 18.1% and 25.0%. There was no obvious difference among 3 groups (Pgt;0.05). The bcl-2 positive rates of welldifferentiated and poordifferentiated gastric cancer were 78.2% and 48.5% respectively, the difference was obvious (P＜0.05). The positive expression rate of p53 protein in welldifferentiated gastric cancer was 72.5%, obviously lower than that of poordifferentiated gastric cancer (86.2%,P＜0.05). The positive rate of nm23 in welldifferentiated gastric cancer was 84.3%, obviously higher than that of poordifferentiated (17.2%),and the expression rate of nonlymph node metastasis group was higher than that of lymph node metastasis group (P＜0.05). The expression rate of nm23 protein was closely correlated to tumor differentiation and lymph node metastasis (P＜0.05). There was a negative correlation between p53 and bcl-2 expression. Conclusion bcl-2 and p53 can be important indices for tumor differentiation and prognosis. nm23 protein plays an important inhibiting role in the process of gastric cancer metastasis and may be a molecular biological basis for the evaluation of patients prognosis in gastric cancer.
Objective To investigate the significance of three dimensional (3D) visualization and virtual surgery system in liver transplantation surgery. Methods Two patients suffered from cholangiolithiasis were scanned by 64 slice helical-CT on livers and the data were collected. Man-made segmentation and true up on the image from the data were carried out. 3D moulds of the liver and the intrahepatic vessels were reconstructed by VTK software respectively. And then, the moulds were imported to the FreeForm Modeling System for modifying. At last, auxiliary partial orthotopic liver transplantation was simulated with the force-feedback equipment (PHANTOM). Results ①It had greatly verisimilar image for the reconstructed 3D liver moulds with artery, vein, portal vein and bile duct; By liver seeing through, it had high fidelity and b 3D effect for the intrahepatic artery, vein, portal vein and bile duct, and their spatial disposition and course and correlationship were shown clearly. ②In the virtual surgery system, the virtual scalpel could be manipulated on 3D liver mould with PHANTOM. The simulating effect was the same as the clinic operation for auxiliary partial orthotopic liver transplantation. Plane visualization of hepatic resection and intrahepatic vessel cutting was achieved by adjusting the transparency of the resection part. Life-like could be felt and power feeling could be touched during virtul operation. Conclusion ①The visualized liver mould reconstructed is 3D and verisimilar, and it is helpful to design reasonable scheme for liver transplantation. ②It not only can improve the surgical effect and decrease the surgical risk, but also can reduce the complications and enhance the communication between doctor and patient through designing surgical plan and demonstrating visualized operation before surgery. ③Visualized liver transplantation surgery is helpful for medical workers to train and study.