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Combined invagination and duct-to-mucosa techniques with modifications:anew method of pancreaticojejunal anastomosis

遗传学进步促进粮食安全与人口健康高峰论坛

作者： Yiliang Zhanga,Wei Weia,Na Chenga,Kaihui Wanga,Bin Lib,Xiaoqing Jiang(b), Shuhan Sun(a) a Department of Medical Genetics and b The first Department of biliary Duct Surgery in eastern hepatic biliary hospital,secondary military medicine university,Shanghai 200433,China.

Hepatitis C virus(HCV) infection usually induces chronic hepatic inflammation,which favors the initiation and progression of hepatocellular ***,microRNA-155 (miR-155) plays an important role in regulating both inflammation and ***, little is known about whether and how miR-155 provides the link between inflammation and cancer. In this study,we found that miR-155 levels were markedly increased in patients infected with HCV. miR-155 transcription was regulated by NF-κB,and p300 increased NF-κB-dependent miR-155 *** overexpression of miR-155 significantly inhibited hepatocyte apoptosis and promoted cell proliferation,whereas miR-155 inhibition induced G0/G1 *** miR-155 resulted in nuclear accumulation ofβ-catenin and a concomitant increase in cyclin D1, c-myc and ***-of-function and loss-of-function studies demonstrated that miR-155 promoted hepatocyte proliferation and tumorigenesis by increasing Wnt signaling in vitro and in vivo, and DKK1(Wnt pathway inhibitor) overexpression inhibited the biological role of miR-155 in ***,adenomatous polyposis coli(APC),which negatively regulates Wnt signaling, was identified as the direct and functional target of ***:HCV-induced miR-155 expression promotes hepatocyte proliferation and tumorigenesis by activating Wnt *** present study provides a better understanding of the relationship between inflammation and tumorigenesis,and thus may be helpful in the development of effective diagnosis and treatment strategies against HCV-HCC.

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Hepatobiliary & Pancreatic Diseases International 2011年第4期10卷 422-427页

作者： Bin Zhu,Li Geng,You-Gang Ma,Yong-Jie Zhang and Meng-Chao Wu Second Department of biliary Surgery and Department of Special Treatment,eastern Hepatobiliary Surgery hospital,Second military Medical university,Shanghai 200438,China Second Department of biliary Surgery Eastern Hepatobiliary Surgery Hospital Second Military Medical University Shanghai 200438 China Department of Special Treatment Eastern Hepatobiliary Surgery Hospital Second Military Medical University Shanghai 200438 China

BACKGROUND:Soft pancreatic texture and a small main pancreatic duct are thought to be the most significant risk factors for the occurrence of pancreatic fistula (PF),a common and serious complication after pancreaticoduodenectomy (PD).This is in part due to the technical difficulties of pancreaticojejunostomy (PJ) posed by a soft gland with a normal-sized *** deal with this problem,we developed a new anastomotic technique which combines the two most widely used techniques,namely,the invagination technique and the duct-to-mucosa technique,with a modification of the suture route and insertion of a temporary stent ***:Between January 2003 and December 2009,ninetytwo consecutive patients underwent PD in which the new PJ technique was *** and follow-up data of these patients were reviewed for operative details,early postoperative events,and outcomes at 6 months after the *** was defined by the International Study Group on Pancreatic Fistula (ISGPF) guidelines and graded (A,B or C) according to the clinical procedures and ***:In this group of 92 patients,there was only 1 early death from acute renal *** was observed in 11 patients (12.0%),8 in grade A,1 in grade B,and 2 in grade *** the 2 patients in grade C,PF was surgically *** were no early or late deaths attributable to *** months after the operation,all of the patients were free of PJ-related symptoms except for 2,who were found to have ***:Our modified technique is simple and safe in *** data suggest that this technique produces excellent early and medium-term results.

关键词： pancreaticoduodenectomy pancreaticojejunostomy pancreatic fistula

Risk factors of intrahepatic cholangiocarcinoma in patients with hepatolithiasis:a case-control study

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Hepatobiliary & Pancreatic Diseases International 2011年第6期10卷 626-631页

作者： Zhen-Yu Liu,Yan-Ming Zhou,Le-Hua Shi and Zheng-Feng YinAuthor Affiliations:Molecular Oncology Laboratory and Department of Comprehensive Treatment I,eastern Hepatobiliary Surgery hospital,Second military Medical university,Shanghai 200438,China Department of Hepato-biliary-Pancreato-Vascular Surgery,First Affiliated hospital,Xiamen university,Xiamen 361003,China Molecular Oncology Laboratory Eastern Hepatobiliary Surgery Hospital Second Military Medical University Shanghai 200438 China Department of Comprehensive Treatment I Eastern Hepatobiliary Surgery Hospital Second Military Medical University Shanghai 200438 China Department of Hepato-biliary-Pancreato-Vascular Surgery First Affliated Hospital Xiamen University Xiamen 361003 China

BACKGROUND:Why 3.3% to 10% of all patients with hepatolithiasis develop intrahepatic cholangiocarcinoma (ICC) remains *** carried out a hospital-based case-control study to identify risk factors for the development of ICC in patients with hepatolithiasis in ***:Eighty-seven patients with pathologically diagnosed hepatolithiasis associated with ICC and 228 with hepatolithiasis alone matched by sex,age (±2 years),hospital admittance and place of residence were interviewed during the period of *** ratios (OR) and 95% confidence intervals (CI) were calculated for each risk ***:Among the patients with hepatolithiasis associated with ICC,the mean age was 57.7 years and 61.0% were female Univariate analysis showed that the significant risk factors for ICC development in hepatolithiasis were smoking,family history of cancer,appendectomy during childhood (under age 20),and duration of symptoms >10 *** multivariate stepwise logistic regression analysis,smoking (OR=1.931,95% CI:1.000-3.731),family history of cancer (OR=5.175,95% CI:1.216-22.022),and duration of symptoms >10 years (OR=2.348 95% CI:1.394-3.952) were independent ***:Smoking,family history of cancer and duration of symptoms >10 years may be risk factors for ICC in patients with hepatolithiasis.

关键词： risk factors intrahepatic cholangiocarcinoma hepatolithiasis case-control study

Expression of HBx protein in hepatitis B virus-infected intrahepatic cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2012年第5期11卷 532-535页

作者： Yan-Ming Zhou, Lu Cao, Bin Li, Xiu-Zhong Zhang, Zheng-Feng Yin Department of Hepato-biliary-Pancreato-Vascular Surgery, First Affiliated hospital of Xiamen university, Xiamen 361003, China Department of Molecular Oncology,Department of Pathology, eastern Hepatobiliary Surgery hospital,Second military Medical university, Shanghai 200438, China Department of Hepato-biliary-Pancreato-Vascular Surgery First Affiliated Hospital of Xiamen University Xiamen 361003 Shanghai China Department of Molecular Oncology Eastern Hepatobiliary Surgery Hospital Second Military Medical University Shanghai 200438 Shanghai China Department of Pathology Eastern Hepatobiliary Surgery Hospital Second Military Medical University Shanghai 200438 Shanghai China

BACKGROUND: Hepatitis B virus (HBV) is an etiological factor of intrahepatic cholangiocarcinoma (ICC), but the pathogenic mechanisms remain unclear. This study aimed to investigate the expression and possible role of HBx, an HBV- encoded potentially oncogenic protein, in HBV-infected ICC. METHODS: Tissue samples were obtained from 54 specimens of HBV-infected ICC. Forty-four specimens were of peripheral type and 10 hilar type. Formalin-fixed, paraffin-embedded sections of the specimens were immunohistochemically stained for HBx and p53. RESULTS: HBx expression was found in 70.4% (38/54) of the specimens, and it was more frequently seen in the peripheral type than in the hilar type (79.5% vs 30.0%, P=0.002). All three well-differentiated ICCs expressed HBx, whereas 76.9% (30/39) moderately-differentiated and 41.7% (5/12) poorly-differentiated ICCs had HBx expression (P=0.033). Patients with HBx expression had a significantly higher prevalence of elevated serum alpha-fetoprotein (P=0.033). p53 protein expression was found in 18 of 54 cases (33.3%), and was not correlated with that of HBx. CONCLUSIONS: HBx may contribute to the pathogenesis of ICC, particularly the peripheral type. p53 abnormality may not play a significant role in HBx-mediated oncogenicity during ICC carcinogenesis.

关键词： hepatitis B virus HBx protein p53 intrahepatic cholangiocarcinoma

Resection of the Caudate Lobe Tumor of Liver

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The Chinese-German Journal of Clinical Oncology 2002年第1期1卷 19-20页

作者： ZHOU Weiping, WU Mengchao, YAO Xiaoping eastern Hepatobiliary Surgery hospital, Second military Medical university, Shanghai 200438, China eastern Hepatobiliary Surgery hospital Second Military Medical University Shanghai China

Objective To analyze the operative technique and results of the resection for caudate lobe carcinoma of the liver. Methods The liver was fully freed of the ligments, short hepatic veins were divided and sutured, and the tumor was then freed from the inferior vena cava(IVC) . The caudate lobe was resected alone or in combination with other segment.Results 28 patients underwent resection of caudate lobe tumor. The number of the short hepatic veins transected and tied was 2-5 ( mean 3) . An intermittent Pringle' s manoeuver was used in 26 patients with a median occlusion time of 21.7 ( range 10-32) min. The median blood loss was 574 (range 100? 300) ml. No major complications such as massive bleeding and biliary fistula occurred. Intraop-erative total vascular occlusion was perfored on only 5 cases. All patients were discharged from the hospital. Outpatient periodic TAE plus chemotherapy was performed. Postoperative recurrence and metastasis was found in 13 cases,with 5 deaths.Conclusion The use of third porta hepatis dissection for resection of the caudate lobe tumor can reduce the risk of massive bleeding during the operation and can raise the rate of resection of caudate lobe tumor.

关键词： liver neoplasms hepatectomy

Endoscopic Palliative Treatment for Malignant Obstructive Jaundice: A Report of 929 Cases

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The Chinese-German Journal of Clinical Oncology 2002年第1期1卷 32-35页

作者： HU Bing, ZHOU Daiyun, GONG Biao, WANG Shuzhi, WU Mengchao eastern Hepatohiliary Surgery hospital, Second military Medical university Shanghai 200438, China Eastem Hepatobiliary Surgery hospital Second Military Medical University Shanghai China

Objective To review the experience with endoscopic palliative treatment for malignant obstructive jaundice (MOJ) in 929 patients. Methods 929 patients (598 males and 331 females) underwent 1 215 endoscopic palliative drainages for MOJ in our hospital. Tumor obstruction occurred in the distal common bile duct (CBD) (263 patients) , the middle CBD (43), and the hilum (909) . The mean biliru-bin level was 284.3umol/L( range 26 - 810) . Of the 1 215 drainages, 599 were performed by stenting with plastic endoprosthesis, 385 by naso-biliary catheterization, 167 by expandable metal stents, 39 by combined drainage method, 19 by tumor sphincterotomy and 6 by endoscopic fistulostomy.Results The successful rate of endoscopic procedure was 94.3 % . The jaundice symptom was improved in 81.8 % of the patients with a significant reduction of serum bilirubin in 64.7% . The complication after treatment occurred in 23 cases (2.6%), including cholangitis (23 cases), pancreatitis (8 cases), and bleeding (one case), and 3 cases were dead (0.2%) . The median survival time of all patients was 14 months and life time analysis showed a life expectancy of 75.9% , 44.0% and 25.2% at 1, 2 and 3 years respectively. Conclusion In the patients with MOJ secondary to pancreatobiliary malignancy, successful endoscopic drainage provides adequate relief of biliary obstruction and is associated with low morbidity and mortality. Endoscopic interventional treatment may be considered as an alternative of palliative biliary operation for the late stage of pancreatic and biliary malignancies.

关键词： biliary tract neoplasm jaundice cholangiopancreatography, endoscopic retrograde

Definition of the "Forth Porta Hepatis" and Related Applied Anatomy

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Definition of the "Forth Porta Hepatis" and Related Applied ...

Stable Skin-specific Overexpression of Human CTLA4-Ig in Transgenic Mice through Seven Generations

中国抗癌协会胆道肿瘤专业委员会第二届全国胆道肿瘤学术会议

作者： Yan Peining,Jiang Xiaoqing biliary Truct Surgery DepartmentⅠ,eastern Hepatobiliary Surgical hospital & Institute, The Second military university,Shanghai

Objective:To provide the morphological data on small branches of portal vein in transverse furrow of porta hepatis for hepatic ***:Small branches of portal vein in transverse furrow of porta hepatis were liberated in 30 liver *** starting and entry point,diameter,Courser and quantity were observed and/or ***:30 specimens were counted totally 181 small branches located in transverse furrow of porta hepatis,of which 83 coming from the main left portal vein(46%in ratio);56 coming from bifurcation of the main portal vein(31%in ratio);42 coming from the main right portal vein(23%in ratio) and of which 40 getting in hepatic segmentⅣ(22%in ratio);17 getting in hepatic segmentⅤ(9%in ratio);7 getting in hepatic segment VI(4%in ratio);41 getting in hepatic segmentⅦ(23%in ratio);76 getting in caudate lobe(42%in ratio).The average conjugate diameter of all small branches was 2.25±*** specimen owned 3 to 12(mean:6.0±2.4) small *** named them "short portal veins" according to the significant surgery status and regular origin and Courser of small branches of portal vein in transverse furrow of porta hepatis,and we named the area where short portal veins located "the fourth porta hepatis". Conclusion:Short portal vein exists in every *** of "short portal vein" and "fourth porta hepatis" could help surgeons avoid damaging short portal vein and also portal vein during correlated operations,such as caudate lobe resection,duodenohepatic ligament lymph node dissection,etc.

关键词： short portal vein portal vein applied anatomy forth porta hepatis

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Acta Biochimica et Biophysica Sinica 2006年第3期38卷 171-178页

作者： Yong WANG~1 Yong NI~(1,3) Hong WEI~1* Feng-Chao WANG~2 Liang-Peng GE~1 Xiang GAO~41 Department of Animal Science,College of Basic medicine,Third military Medical university,Chongqing 400038,China 2 Institute of Combined Injury,College of military Preventive medicine,Third military Medical university,Chongqing 400038,China 3 School of Life Sciences,Southwest university,Chongqing 400715,China 4 Animal Model Research Institute,Nanjing university,Nanjing 210093,China Department of Animal Science College of Basic Medicine Third Military Medical UniversityChongqing 400038 China School of Life Sciences Southwest UniversityChongqing 400715 China Institute of Combined Injury College of Military Preventive Medicine Third Military Medical UniversityChongqing 400038 China Animal Model Research Institute Nanjing UniversityNanjing 210093 China

Skin graft rejection is a typical cellular immune response,mainly mediated by T *** lymphocyte associated antigen 4-immunoglobin (CTLA4-Ig) extends graft survival by blocking the T cellco-stimulation pathway and inhibiting T cell *** investigate the efficacy of CTLA4-Ig in prolong-ing skin graft survival,human CTLA4-Ig (hCTLA4-Ig) was engineered to overexpress in mouse skin bytransgenesis using the K14 *** transcription-polymerase chain reaction (RT-PCR) and West-ern blot assay indicated that the expression of CTLA4-Ig remained skin-specific and relatively constantcompared to the internal control protein,AKT,through seven *** presence and concentrationof the hCTLA4-Ig protein in transgenic mouse sera was determined by enzyme-linked immunosorbent assay(ELISA),and the results indicated that the serum CTLA4-Ig concentration also remained constant *** of transgenic mouse skins grafted onto rat wounds was remarkably prolonged com-pared to that of wild-type skins from the same mouse strain,and remained comparable among all *** suggested that the bioactive hCTLA4-Ig protein was stably expressed in transgenical micethrough at least seven generations,which was consistent with the stable skin-specific CTLA4-Ig *** results demonstrated that the transgenic expression of hCTLA4-Ig in skin driven by the K14 promoterremained constant through generations,and a transgenic line can be established to provide transgenic skinwith extended survival reproducibly.

关键词： cytotoxic T lymphocyte antigen 4-Ig transgenic mice skin K14 promoter

The expression and antigenicity identification of recombinant rat TGF-β1 in bacteria

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Cell Research 2001年第2期11卷 95-100页

作者： GAO CHUN FANG, XIAN TAO KONG, AXEL M GRESSNER, RALF WEISKIRCHEN Department of Laboratory medicine, Changzheng hospital, Second military Medical university, Shanghai 200003, China Institute of Clinical Chemistry and Pathobiochemistry, Central Laboratory, R 1Department of Laboratory medicine Changzheng Hospital Second Military Medical University Shanghai 200003 China 1Department of Laboratory medicine Changzheng Hospital Second Military Medical University Shanghai 200003 China 2Institute of Clinical Chemistry and Pathobiochemistry Central Laboratory RWTH-University Hospital Pauwelsstr 30 D-52074 Aachen Germany 2Institute of Clinical Chemistry and Pathobiochemistry Central Laboratory RWTH-University Hospital Pauwelsstr 30 D-52074 Aachen Germany

In order to study structure-function details of TGF-β1, the recombinant mature form of rat TGF-β1 was expressed in bacteria. Synthesis of the 112 amino-acid carboxyl-terminal part of TGF-β1 (amino acid 279-390) was controlled by an inducible gene expression system based on bacteriophage T7 RNA polymerase. This system allowed an active and selective synthesis of recombinant TGF-β1. The molecular weight of expressed TGF-β1 monomer determined on SDS-polyacrylamide gel under reducing conditions was about 13 kD. Serial detergent washes combined with a single gel-filtration purification step were sufficient to purify the expression product to homogeneity. Amino-terminal sequencing revealed that the N-terminal of the recombinant protein was identical to the published data. In Western blot analysis the recombinant polypeptide showed excellent antigenicity against polyclonal TGF-β1 antibody. The mature recombinant rat TGF-β1 expressed in this study provides a useful tool for future detailed structural and functional studies.

关键词： TGF-β1 recombinant expression inclusion bodies purification antigenicity.