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Superior pancreatic lymphadenectomy with portal vein priority via posterior common hepatic artery approach in laparoscopic radical gastrectomy

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World Journal of Clinical Cases 2022年第6期10卷 1834-1842页

作者： Yu-Jia Zhang Rong-Chao Xiang Jun Li Yong Liu Si-Ming Xie Liang An Hua-Lin Li gang mai Department of General Surgery Deyang City People's HospitalDeyang 618000Sichuan ProvinceChina

BACKGROUND D2 lymph node dissection for advanced gastric cancer is advocated,and station 8p lymph node should be considered in selected patients,which is,however,technically *** To introduce a new and easy-to-perform procedure for dissection of the lymph nodes superior to the *** A series of patients who underwent laparoscopic gastrectomy for gastric cancer were retrospectively included with utilization of a new procedure for superior pancreatic lymphadenectomy(LND)with portal vein priority via the posterior common hepatic artery approach(SPLD-PPPH)based on a newly defined portal *** surgical outcome of the patients,as well as the efficacy and safety of SPLD-PPPH are *** A total of 51 patients were included with most of them being male(n=34,66.7%).According to the 8th edition of AJCC TNM staging,there were four(7.8%)patients in stage I,13(25.5%)in stage II,33(64.7%)in stage III and one(2.0%)in stage *** average duration for LND was about 1 h(67.7±6.9 min).After surgery,four patients developed morbidities,but all were treated successfully with no perioperative *** the 51 patients included,the percentage of patients who had lymph node metastasis at station 8p was 9.8%.Of note,with a total of 14 lymph nodes harvested at station 8p,the incidence of nodal metastasis was 14.3%.CONCLUSION About one in 10 patients with advanced gastric cancer had nodal metastasis at station *** new approach of SPLD-PPPH is safe and effective for D2+LND during laparoscopic radical gastrectomy.

关键词： Laparoscopic radical gastrectomy Lymphadenectomy Lymph node metastasis Portal vein priority Lymph node

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Malrotation causing duodenal chronic obstruction in an adult

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World Journal of Gastroenterology 2009年第9期15卷 1144-1146页

作者： Jun Gong Zhen-Jiang Zheng gang mai Xu-Bao Liu Department of General Surgery West China Hospital Sichuan University Chengdu 610041 Sichuan Province China

Congenital duodenal obstruction is rare in adulthood. An unusual presentation of this condition has led to difficult preoperative *** present a case of proximal jejunal obstruction by a congenital band in an adult and... 详细信息

关键词：十二指肠旋转不良先天性十二指肠梗阻成人阻塞慢性术前诊断

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Monitoring of clinical islet transplantation

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Chinese Medical Journal 2013年第3期126卷 578-585页

作者： HE Si-rong mai gang LU Yan-rong CHEN You-nan ZHANG Shuang CHENG Jing-qiu Key Laboratory of Transplantation Engineering and Immunology Ministry of Health Regenerative Medicine Research Center West China Hospital Sichuan University Chengdu Sichuan 610041 China Department of Surgery West China Hospital Sichuan University Chengdu Sichuan 610041 China

Islet transplantation has recently emerged as one of the most promising therapeutic approaches to improving glycometabolic control in diabetic patients. The Edmonton trials demonstrated a marked improvement in the short-term rate of success of islet transplantation, with an 80% rate of insulin-independence being at 1 year after transplantation, as reported by several institutions worldwide. Unfortunately, this rate consistently decreases to 10% by 5 years post-transplantation.

关键词： islet transplantation islet labeling graft function immunological monitoring complications

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Recurrence and survival after surgery for pancreatic cancer with or without acute pancreatitis

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World Journal of Gastroenterology 2019年第39期25卷 6006-6015页

作者： Qian Feng Cheng Li Sheng Zhang Chun-Lu Tan gang mai Xu-Bao Liu Yong-Hua Chen Department of Pancreatic Surgery West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Rehabilitation Medicine Center West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Hepatobiliary Surgery The First Affiliated Hospital of Xinxiang Medical UniversityXinxiang 453100Henan ProvinceChina Department of Hepatobiliary Surgery Deyang People's HospitalDeyang 618000Sichuan ProvinceChina

BACKGROUND In pancreatic cancer,acute pancreatitis(AP)is a serious morbidity,but its negative effect on long-term outcomes remains to be *** To investigate the effects of AP on the tumor recurrence pattern of pancreatic ductal adenocarcinoma(PDAC)and tumor-specific *** The medical records of 219 patients with curative pancreatectomy for pancreatic cancer at the Pancreatic Surgery Center of West China Hospital from July 2012 to December 2016 were analyzed *** severity of acute pancreatitis was classified according to the Atlanta classification of *** patient demographics and tumor characteristics were *** recurrence was defined as a relapse within 12 mo after *** and disease-free survival and recurrence patterns were *** acute pancreatitis was excluded because its negative effects can be *** Early recurrence in AP group was significantly higher than in non-AP group(71.4%vs 41.2%;P=0.009).Multivariate analysis of postoperative early recurrence showed that moderate or severe AP was an independent risk factor for an early recurrence[odds ratio(OR):4.13;95%confidence interval(CI):1.41-12.10;P=0.01].The median time to recurrence was shorter in patients with AP than in those without(8.4 vs 12.8 mo;P=0.003).Multivariate analysis identified AP as an independent prognostic factor for overall survival[relative risk(RR):2.35;95%CI:1.45-3.83]and disease-free survival(RR:2.24;95%CI:1.31-3.85)in patients with *** Patients with moderate or severe acute pancreatitis developed recurrences earlier than those *** or severe AP is associated with shorter overall and disease-free survival of patients with PDAC.

关键词： Acute pancreatitis Pancreatic ductal adenocarcinoma Recurrence Prognosis Overall survival Disease-free survival

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Meta-analysis of laparoscopic vs open liver resection for hepatocellular carcinoma

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World Journal of Gastroenterology 2012年第45期18卷 6657-6668页

作者： Jun-Jie Xiong Kiran Altaf Muhammad A Javed Wei Huang Rajarshi Mukherjee gang mai Robert Sutton Xu-Bao Liu Wei-Ming Hu Department of Hepato-Biliary-Pancreatic Surgery West China HospitalSichuan University Liverpool NIHR Pancreas Biomedical Research Unit Royal Liverpool University HospitalUniversity of LiverpoolLiverpool L69 3GAUnited Kingdom Pancreatic Diseases Research Group Department of Integrated Traditional and Western MedicineWest China HospitalSichuan University

AIM:To conduct a meta-analysis to determine the safety and efficacy of laparoscopic liver resection(LLR) and open liver resection(OLR) for hepatocellular carcinoma(HCC).METHODS:PubMed(Medline),EMBASE and Science Citation Index Expanded and Cochrane Central Register of Controlled Trials in the Cochrane Library were searched systematically to identify relevant comparative studies reporting outcomes for both LLR and OLR for HCC between January 1992 and February *** authors independently assessed the trials for inclusion and extracted the ***-analysis was performed using Review Manager Version 5.0 software(The Cochrane Collaboration,Oxford,United Kingdom).Pooled odds ratios(OR) or weighted mean differences(WMD) with 95%CI were calculated using either fixed effects(Mantel-Haenszel method) or random effects models(DerSimonian and Laird method).Evaluated endpoints were operative outcomes(operation time,intraoperative blood loss,blood transfusion requirement),postoperative outcomes(liver failure,cirrhotic decompensation/ascites,bile leakage,postoperative bleeding,pulmonary complications,intraabdominal abscess,mortality,hospital stay and oncologic outcomes(positive resection margins and tumor recurrence).RESULTS:Fifteen eligible non-randomized studies were identified,out of which,9 high-quality studies involving 550 patients were included,with 234 patients in the LLR group and 316 patients in the OLR *** was associated with significantly lower intraoperative blood loss,based on six studies with 333 patients [WMD:-129.48 mL;95%CI:-224.76-(-34.21) mL;P = 0.008].Seven studies involving 416 patients were included to assess blood transfusion requirement between the two *** LLR group had lower blood transfusion requirement(OR:0.49;95%CI:0.26-0.91;P = 0.02).While analyzing hospital stay,six studies with 333 patients were *** in the LLR group were found to have shorter hospital stay [WMD:-3.19 d;95%CI:-4.09-(-2.28) d;P < 0.00001] than their OLR

关键词： Meta分析原发性肝癌切除术开放式腹腔镜随机效应模型随机对照试验 MEDLINE

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Standard Versus Extended Pancreaticoduodenectomy in Treating Adenocarcinoma of the Head of the Pancreas

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Chinese Medical Sciences Journal 2013年第2期28卷 107-112页

作者： Jun Gong gang mai Zhen-jiang Zheng Guang-ming Xiang Wei-ming Hu Bo-le Tian Zhao-da Zhang Xu-bao Liu Department of Hepatobiliary and Pancreatic Surgery Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital Department of Hepatobiliary and Pancreatic Surgery West China HospitalSichuan University

Objectives To compare the postoperative complications and survival of standard pancreatoduodenectomy (SPD) and extended pancreatoduodenectomy (EPD) in patients with resectable adenocarcinoma of the head of the *** Between January 1994 and December 2011,165 patients with biopsy-proven adenocarcinoma of the pancreatic head were treated in West China Hospital,among whom 93 underwent SPD and 72 had *** and survival after the surgery were analyzed *** The median operation time of the EPD group was longer compared with the SPD group (375 minutes vs.310 minutes,P<0.01),the volume of blood transfusion was larger (700 mL vs.400 mL,P<0.05),while the median hospital stay (13.5 days vs.12 days,P = 0.79) and the total complication rates were comparable (34.7% vs.32.4%,P=0.93).The total recurrence rates of the SPD and EPD groups were not significantly different (52.7% vs.43.1%,P=0.83).No significant differences were found between the SPD and EPD groups in 1-year (81.7% vs.86.1%),3-year (38.7% vs.43.1%),5-year (16.7% vs.19.4%),and median survivals (19.8 months vs.23.2 months,P= 0.52).Conclusion The postoperative complications and survival donot differ significantly between SPD and EPD.

关键词：十二指肠切除术腺癌治疗标准并发症 SPD 中位数

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ω-3多不饱和脂肪酸强化的肠外营养对胰腺癌患者术后炎性介质及免疫功能的影响

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陕西医学杂志 2023年第7期52卷 862-866,888页

作者：许严麦刚西南医科大学四川泸州646000 德阳市人民医院普外科四川德阳618000

目的:探究经ω-3多不饱和脂肪酸强化的肠外营养对胰腺癌(PCA)根治术患者术后炎性介质及免疫功能的影响。方法:将接受胰十二指肠切除术的80例PCA患者随机分为常规组(n=40)和ω-3组(n=40),常规组术后给予常规肠外营养治疗,ω-3组给予ω-3... 详细信息

目的:探究经ω-3多不饱和脂肪酸强化的肠外营养对胰腺癌(PCA)根治术患者术后炎性介质及免疫功能的影响。方法:将接受胰十二指肠切除术的80例PCA患者随机分为常规组(n=40)和ω-3组(n=40),常规组术后给予常规肠外营养治疗,ω-3组给予ω-3多不饱和脂肪酸强化的肠外营养治疗,均治疗14 d。比较两组术前、术后1 d、术后7 d、术后14 d血常规指标[白细胞(WBC)、淋巴细胞百分率(LYMPH%)、中性粒细胞在白细胞中所占百分比(NEUT%)、红细胞(RBC)]、营养指标[总蛋白(TP)、白蛋白(ALB)、前白蛋白(PALB)]、炎性介质[白细胞介素-6(IL-6)、白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)]和免疫指标[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、成熟T淋巴细胞(CD3^(+))、诱导性T细胞(CD4^(+))]变化,并对比两组并发症情况、住院时间及住院费用。结果:术后,两组患者WBC、NEUT、RBC均呈先增加后下降趋势(均P0.05);两组患者LYMPH呈先降低后增加趋势(P0.05)。术后,两组患者TP、ALB、PALB、IgA、IgG、CD3^(+)、CD4^(+)均呈先降低后增加趋势(均P0.05);ω-3组总住院费用显著高于常规组(P<0.05)。结论:经ω-3多不饱和脂肪酸强化的肠外营养对胰腺癌患者术后效果理想,可有效改善营养水平,调节炎性介质和免疫功能,但花费较高。

关键词： ω-3多不饱和脂肪酸肠外营养胰腺癌炎性介质免疫功能并发症

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Effect of recombinant human growth hormone and interferon gamma on hepatic collagen synthesis and proliferation of hepatic stellate cells in cirrhotic rats

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Hepatobiliary & Pancreatic Diseases International 2012年第3期11卷 294-301页

作者： Yong-Hua Chen, Bing-Qing Du, Zhen-Jiang Zheng, Guang-Ming Xiang, Xu-Bao Liu and gang mai Department of Hepatobiliopancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China Department of Hepatobiliopancreatic Surgery West China Hospital Sichuan University Chengdu 610041 China

BACKGROUND: Fibrosis plays a key role in the development of liver cirrhosis. In this study, we investigated the effect of growth hormone and interferon gamma on hepatic collagen synthesis and the proliferation of hepatic stellate cells in a cirrhotic rat model. METHODS: Cirrhosis was induced in rats using carbon tetrachloride. Rats were simultaneously treated with daily subcutaneous injections of recombinant human growth hormone or interferon gamma combined with recombinant human growth hormone. The control group was given saline. The relative content of type I and type IV collagen was assessed by indirect immunofluorescence analysis. Activated hepatic stellate cells were prepared from cirrhotic rats. The 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H-tetrazolium bromide (MTT) method was used to assess the effects of recombinant human growth hormone and interferon gamma on these cells in vitro. RESULTS: Both qualitative and quantitative analysis showed that type I and type IV collagen secretion increased with time after recombinant human growth hormone administration and was significantly higher than control and recombinant human growth hormone combined with interferon gamma administration. In vitro, recombinant human growth hormone significantly stimulated hepatic stellate cell proliferation in a concentration-dependent manner (10 -3 -10 -1 mg/100 μL), andinterferon gamma (10 -2 -10 -1 μg/100 μL) significantly inhibited their growth compared to the control group. Interferon gamma combined with recombinant human growth hormone eliminated this growth-promoting effect to a certain degree in a concentration-dependent manner (10 -1 μg/100 μL, P0.05) and a time-dependent manner (P<0.05). CONCLUSIONS: Recombinant human growth hormone increased collagen secretion in cirrhotic rats in vivo and promoted the proliferation of hepatic stellate cells from cirrhotic rats in vitro. It is possible that concurrent interferon gamma therapy can offset

关键词： growth hormone interferon gamma hepatic stellate cell liver cirrhosis collagen

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p65NF-κB/RelA在胰腺炎中诱导Kupffer细胞凋亡的机制

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基因组学与应用生物学 2020年第7期39卷 3355-3361页

作者：刘航麦刚西南医科大学附属医院泸州646000 德阳市人民医院德阳618000

研究p65NF-κB/relA在胰腺炎诱导的Kupffer细胞凋亡中的作用。用缺乏胆碱的乙硫氨酸补充饮食(CDE)诱导雌性小鼠急性胰腺炎。将p65 siRNA转染体外培养的小鼠Kupffer细胞系,用胰腺弹性蛋白酶处理模拟胰腺炎,利用逆转录聚合酶链反应,免疫... 详细信息

研究p65NF-κB/relA在胰腺炎诱导的Kupffer细胞凋亡中的作用。用缺乏胆碱的乙硫氨酸补充饮食(CDE)诱导雌性小鼠急性胰腺炎。将p65 siRNA转染体外培养的小鼠Kupffer细胞系,用胰腺弹性蛋白酶处理模拟胰腺炎,利用逆转录聚合酶链反应,免疫印迹分析和酶联免疫吸附实验确定p65NF-κB/relA在Kupffer细胞中的作用。结果显示,全细胞中的总p65蛋白水平没有差异(p>0.05);然而,非靶向控制蛋白p42MAPK显著增加(p<0.01)。在患有CDE胰腺炎的小鼠中,核p65蛋白显著增加(p<0.01)。与p65mRNA相比,p65siRNA转染显著减弱(p<0.01)。此外,p65 siRNA转染可显著降低整个细胞p65蛋白的表达,并呈剂量和时间依赖性。p65蛋白的全细胞提取物在1080 nm范围内随着p65siRNA剂量的增加而显著减少(p<0.01)。非靶向蛋白p42MAPK水平没有改变。弹性蛋白酶诱导的KCL3-2细胞中p65的核发生转位(p<0.01)。转染p65siRNA的KCL3-2细胞显著减弱了弹性蛋白酶诱导的p65核转位(p<0.01)。体内(CDE诱导的胰腺炎)和体外(弹性蛋白酶处理)均显著上调Fas/Fas L的表达,CDE诱导的胰腺炎组和弹性蛋白酶组都显著增加小鼠肝脏中活化的Caspase-3。p65NF-κB/relA的核转位对于应激诱导的Kupffer细胞中Fas/FasL的上调至关重要。

关键词：胰腺炎缺乏胆碱的乙硫氨酸 Kupffer细胞 p65NF-κB/relA

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儿童急性白血病合并脓毒性休克临床分析

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中国实验血液学杂志 2022年第6期30卷 1708-1714页

作者：刘婷华雷嘉颖麦友刚方建培中山大学孙逸仙纪念医院儿科广东广州510120

目的:分析儿童急性白血病合并脓毒性休克的临床特点并探讨预后相关因素。方法:收集并回顾性分析中山大学孙逸仙纪念医院儿童重症监护室(PICU)2012年3月至2021年3月收治的70例急性白血病合并脓毒性休克患儿的临床资料,分析比较存活组与... 详细信息

目的:分析儿童急性白血病合并脓毒性休克的临床特点并探讨预后相关因素。方法:收集并回顾性分析中山大学孙逸仙纪念医院儿童重症监护室(PICU)2012年3月至2021年3月收治的70例急性白血病合并脓毒性休克患儿的临床资料,分析比较存活组与死亡组患者的临床特点,应用多因素logistic回归分析探讨死亡相关危险因素。结果:70例患儿中男41例,女29例,中位年龄为7.0(1.0-15.0)岁。57例(81.4%)为医院获得性感染,病原菌以G~-菌为主(50/66,75.8%),临床主要表现为冷休克(64/70,91.4%)。最终24例死亡,病死率为34.3%。与存活组比较,死亡组患者年龄更小,休克前住院时间、发热持续时间及静脉抗生素暴露时间更长,休克时生命体征更不平稳,PLT水平更低、CRP与PCT水平更高,病情严重程度更重,合并心功能不全、需要机械通气的病例更多,比较差异均具有统计学意义(均P9.5分(敏感度75.0%,特异度87.0%)。结论:急性白血病合并脓毒性休克患儿病情进展迅速、病死率高,当pSOFA>9.5分、合并急性心功能不全时预后不良。

关键词：急性白血病脓毒性休克儿童预后

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