Search

Solitary intrahepatic biliary cyst (SIBC) is a rare disease, and due to the lack of adequate understanding of it, SIBC is often misdiagnosed as simple liver cyst (SLC), which in turn affects the therapeutic effect. In order to arouse more attention to SIBC, combined with clinical experience in our center, this study specifically screened 3 representative cases of SIBC, and conducted a comprehensive retrospective analysis of their clinical characteristics, diagnosis and treatment process. Combined with the relevant literature, the diagnosis and treatment process of SIBC is widely discussed. [ABSTRACT FROM AUTHOR]

The current study describes the technical details of and the clinical prognosis for the "China stitch", a novel technique for hand-sewn esophagojejunostomy in totally laparoscopic total gastrectomy. This study also explores the feasibility and safety of the technique. Clinical data of 20 patients with esophagogastric junction cancer in Beijing Shijitan Hospital, Capital Medical University from January 2017 to April 2018 were retrospectively analyzed. All 20 patients underwent esophagojejunostomy via a novel hand-sewn technique that uses traction to turn the left or right wall of the esophagus into an anterior wall. This avoids the difficulty of suturing the posterior wall. All patients were followed until June 2019. All 20 patients successfully underwent the procedure. The mean operating time was 216.5 ± 24.9 (176-254) min, the mean hand-sewn reconstruction time was 44.4 ± 9.4 (26-61) min, intraoperative bleeding was 141.2 ± 24.9 (130-160) mL, and the number of resected lymph nodes was 23 ± 8 (14-33). After surgery, there was one case of anastomotic leakage and one case of anastomotic stenosis, but both were alleviated with conservative treatment. The mean duration of follow-up was 15 (4-33) months. There was no significant difference in postoperative complications of and shortterm oncologic prognosis for the 20 patients who underwent hand-sewn esophagojejunostomy and the 21 patients who underwent mechanical esophagojejunostomy during the same period. In conclusion, the "China stitch", a novel hand-sewn technique, is a cost-effective, safe, and reliable method for esophagojejunostomy in totally laparoscopic total gastrectomy. [ABSTRACT FROM AUTHOR]

To explore the effect of apurinic-apyrimidinic endonuclease I (APE-1) on hepatocyte immune inflammatory factors and cell apoptosis. The gene expression profiles of peripheral blood of patients with or without immune tolerance after liver transplantation were obtained from the Gene Expression Omnibus (GEO). Differentially expressed genes were analyzed with a program in the R language, and the APE-1 gene was identified as a gene related to immune tolerance of liver transplantation. Four APE-1 shRNA vectors were constructed in parallel and verified as correct using plasmid sequencing, real-time PCR, and Western blotting. An APE-1 overexpression vector was similarly constructed and verified as correct. The STRING website predicted the protein-protein interaction network of APE-1. ELISA was used to detect the effects of APE-1 silencing and overexpression on inflammatory cytokines IL-1ß, IL-10, TNFa, and INF-α in the control group, APE-1-silenced group, and APE-1 overexpression group. Flow cytometry was used to detect apoptosis in each group. Forty differentially expressed genes related to immune tolerance after liver transplantation were screened, and the highly expressed gene APE-1 was selected. The best APE-1 shRNA_1 vector and APE-1 overexpression vector were obtained. APE-1 is predicted to interact with ANP32A, FEN1, HMGB2, LIG1, MUTYH, NTHL1, OGG1, PCNA, POLB, SET, and other proteins. APE-1 silencing resulted in a significant increase in the expression of the inflammatory factors IL-1ß, IL-10, TNFa, and INF-α in L-02 cells. In contrast, the expression of APE-1 led to a significant decrease in the expression of inflammatory factors. APE-1 silencing significantly increased the rate of apoptosis of L-02 cells, and APE-1 overexpression resulted in a significant decrease in the rate of apoptosis of L-02 cells. In conclusion APE-1 affects the expression of inflammatory factors and apoptosis in L-02 cells, so it may be a key gene in immune tolerance of liver transplantation. [ABSTRACT FROM AUTHOR]

This research aimed to investigate the differential expression of apurinic-apyrimidinic endonuclease 1 (APE1) in hepatocellular carcinoma (HCC) tissues and cells and the effects on proliferation and apoptosis of cancer cells. Immunohistochemical techniques were used to detect the expression of APE1 in 80 cases of HCC and the corresponding paracancerous tissue microarrays; meanwhile, Western blots were used to detect the expression of APE1 in both human HCC BEL-7402, BEL-7405, HCC-9204, Hep3B, HepG2, SMMC-7721 and Huh- 7 cells, and normal hepatocyte L-02 cells. The relationship between APE1 expression and clinical pathological characteristics of HCC was statistically analyzed. APE1 shRNA vector was constructed in Hep 3B cells to establish a stably transfected cell line, using Western blots to determine the interference efficiency. Cell proliferation activity was detected with MTT assays, while apoptosis was detected with the Annexin V-FITC/PI double-labeling technique. The expression of APE1 in HCC tissues and cells was significantly up-regulated, and its expression was significantly different from TNM staging and histopathological grading. Down-regulation of APE1 expression significantly reduced the proliferative activity and increased the apoptosis rate of Hep 3B cells. In conclusion, APE1 demonstrates cancer progression potential at the clinical, tissue and cell level. It provides a new idea and theoretical basis for APE1-based clinical diagnosis, prognosis determination and molecular targeted therapy in treatment of HCC. [ABSTRACT FROM AUTHOR]

Our purpose was to explore the remission of insulin resistance after bariatric surgery to discover the mechanism of diabetes remission excluding dietary factors. A retrospective case control study was conducted on patients with type 2 diabetes, who underwent laparoscopic sleeve gastrectomy (LSG) or laparoscopic gastric bypass surgery (LGB) in Beijing Shijitan Hospital from April 1, 2012 to April 1, 2013. The laboratory and anthropometric data was analyzed pre-surgery and during a 2-year follow-up. HOMA-IR was calculated and evaluated. The two surgical procedures were compared. No significant difference in complete remission rate was observed between the two groups (LGB group: 62.1%, LSG group: 60.0%, p = 0.892). HOMA-IR was reduced to a stable level at the 3rd month after surgery. The cut-off value of HOMA-IR was 2.38 (sensitivity: 0.938, specificity: 0.75) and 2.33 (sensitivity: 0.941, specificity: 0.778) respectively for complete remission after LSG or LGB surgery. Insulin resistance was improved while GLP-1 and Ghrelin was changed significantly in patients with type 2 diabetes prior to weight loss either in the LSG or LGB group. HOMA-IR decreased to less than the cut-off value at the 3rd month and was closely related to complete remission. The mechanism of bariatric surgery was not due just to simply dietary factors or body weight loss but also the remission of insulin resistance. [ABSTRACT FROM AUTHOR]

Current therapies to treat advanced hepatocellular carcinoma (HCC) are not satisfactory because of the high rate of recurrence after treatment and because of severe complications after surgery. Cancer vaccines have been studied for decades to achieve effective, microinvasive, long-lasting anti-tumor action. Cancer vaccines are designed to promote tumorspecific immune responses and increase specific cytotoxic CD8-positive T cells. This review summarizes 16 phase I clinical trials of cancer vaccines against HCC that have been conducted over the past 10 years. According to those trials, the Alpha fetoprotein (AFP), Glypican-3 (GPC3), and Multidrug resistance-associated protein 3 (MRP3) vaccines were well tolerated and safe. Some early clinical trials have shown that vaccination resulted in a large number of T cells activated by a specific tumor-associated antigen in the circulation, but clinical outcomes were not satisfactory. This may be because targets for immunosuppressive agents have yet to be clearly determined in HCC. Therapeutic regimens that combine activative agents and suppressive agents may profoundly improve clinical outcomes for patients with HCC in the future. [ABSTRACT FROM AUTHOR]

Tokyo Guideline 2013 (TG13) is an international guideline for the diagnosis, classification and treatment of acute cholangitis. Progress and controversy for the two years after TG13 was summarized. Endoscopic ultrasound (EUS) and magnetic resonance cholangiopancreatography (MRCP) are both effective imaging tests for common bile duct (CBD) stones. More factors e.g. obesity may be involved in severity assessment. Initiation of broad-spectrum antibiotics addressing the typical Gram-negative enteric bacteria spectrum and early biliary drainage are the mainstay therapeutic options. Early laparoscopic exploration is also an option for stone-related nonsevere acute cholangitis besides endoscopic retrograde cholangial or percutaneous transhepatic cholangial drainage. Surgical biliary drainage should be avoided in severe cholangitis. [ABSTRACT FROM AUTHOR]

This meta-analysis aimed to review the regeneration rate of future liver remnant (FLR) and perioperative outcomes after associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and two-stage hepatectomy (TSH). A web search was performed in "MEDLINE", "EMBASE", and "SCIENCE DIRECT" databases using both subject headings (MeSH) and truncated word to identify all the articles published that related to this topic. Pooled risk ratios were calculated for categorical variables and mean differences for continuous variables using the fixed-effects and random-effects models for metaanalysis. Three studies involved 282 patients, of whom 234 were in the TSH group and 48 in the ALPPS group. Morbidity was experienced in 56.3% patients in the ALPPS group and 36.1% in the TSH group. There was a statistical difference (RR = 1.08; Z = 3.24; 95% CI, p = 0.001). Second surgeries were performed successfully in 79.1% patients in the portal vein embolization (PVE) group and 100% in the ALPPS group. There was a statistical difference (Z = 2.48; 95% CI, p = 0.01). The mean regeneration rate of FLR in the ALPPS group was 56.4% compared with 52.8% in the TSH group. There was no statistical difference (95% CI, p = 0.34). So from the outcome of this meta-analysis, TSH had a similar remnant liver regeneration ability compared to ALPPS while the morbidity and mortality rates were relatively low. Cancer progression while waiting for the staged liver resection after portal vein embolization was a drawback for TSH. [ABSTRACT FROM AUTHOR]

Obesity and related metabolic diseases have become one of the world's most serious public health problems. Bariatric surgery has gone through a long and difficult development process, from being rejected to gradually recognized, then widely accepted, and finally becoming the "gold standard" for the treatment of morbid obesity with metabolic diseases. Procedures have constantly been improving and evolving as the concept of bariatric surgery has been reappraised. The comparison and selection of different procedures, the emergence of new technologies and treatment methods, and the in-depth study of the mechanism of metabolic weight loss surgery are effectively promoting the rapid development of bariatric surgery. This article looks at both the 2014 and 2019 editions of the Guidelines for Diagnosis and Treatment of Obesity and Type 2 Diabetes Mellitus from the Chinese Society of Metabolic and Bariatric Surgery (CSMBS), its review the development of bariatric surgery, and it describes surgical indications and contraindications, the mechanism of weight loss, and tailored selection of the surgical procedure in order to serve as a reference. [ABSTRACT FROM AUTHOR]