ObjectiveTo explore the clinicopathological characteristics of combined hepatocellular and cholangiocarcinoma (cHCC-CC), and the prognostic factors associated with survival. MethodesThe clinical features of 31 patients with cHCC-CC from 1995 to 2010 in West China Hospital of Sichuan University underwent liver resection were analyzed retrospectively. The prognostic factors were analyzed by using univariate and multivariate analysis. ResultsOf these 31 patients, 25 men and 6 women, with a median age of 58 years, underwent liver resection for cHCC-CC. Twentythree cases (74.2%) showed positive of hepatitis B surface antigen (HBsAg), 13 cases (41.9%) had elevated AFP≥20μg/L, 18 cases (58.1%) with liver cirrhosis, 8 cases (25.8%) showed presence of lymph node metastases. The 1-, 3-, and 5-year overall survival rates of these patients were 61.3%, 32.3%, and 12.9%, respectively. Univariate analysis showed that invasion of portal vein, microscopic tumor thrombi, positive resection margins, and lymph node involvement were significant prognostic factors. Multiple analysis revealed the positive resection margins and lymph node involvement were independent prognostic factors for overall survival. ConclusionsThe prognosis of patients with cHCC-CC is poor. R0 resection is the only available treatment in curing these patients.
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.
ObjectiveTo investigate the effect of peroxisome proliferator-activated receptorγ(PPARγ) agonist on bile duct fibrosis induced by transforming growth factor-β1 (TGF-β1). MethodsPrimary cultures of bile duct fibroblast were treated with different concentrations of pioglitazone (PGZ) or 15-deoxy-Δ12, 14-prostaglandin J2 (15d-PGJ2) and then treated with TGF-β1. The mRNA levels of collagenⅠ(COLⅠ)、fibronectin (FN)、α-smooth muscle actin (α-SMA) and connective tissue growth factor (CTGF) were determined by RT-PCR. ResultsPGZ and 15-d-PGJ2 could down regulated the mRNA levels of COLⅠ, FN, α-SMA and CTGF induced by TGF-β1 (3 ng/mL). The same concentration of 15d-PGJ2 was a more potent inhibitor ofα-SMA and less potent inhibitor of COLⅠthan PGZ. But PGZ had the same effect as 15d-PGJ2 on CTGF. ConclusionPPARγagonist can prevent fibrosis induced by TGF-β1.
ObjectiveTo analyze risk factors of gastric paralysis following pancreaticoduodenectomy so as to offer help for prevention and treatment of gastric paralysis. MethodDomestic and international literatures about gastric paralysis following pancreaticoduodenectomy were collected, diagnostic criteria, risk factors, and the latest progress of gastric paralysis were summarized. ResultsGastric paralysis is one of the most common postoperative complications following pancreaticoduodenectomy. It might be caused by many risk factors, such as operation method, gastrointestinal anastomosis, abdominal complications, chronic hyperglycemia, and excess infusion, etc. ConclusionsAlthough definition of gastric paralysis by ISGPS is widely adopted, it fails to distinguish gastric paralysis from impaired gastric function related to other postoperative complications and it might result in an overestimation of its true morbidity. The risk factors of occurrence of gastric paralysis are still in controversy and results of research in different centers are not same, more prospective randomized controlled trials are needed.