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中华消化外科杂志 2017年第2期16卷 113-115页

作者： section of hepatic surgery 中华医学会外科学分会肝脏外科学组

《肝细胞癌外科治疗方法的选择》于2000年10月25—28日在湖北省武汉市召开的“第六届全国肝脏外科学术会议”期间，经中华医学会外科学分会肝脏外科学组全体委员讨论通过后颁布；其后分别于2004年和2008年进行两次修订。

关键词：肝细胞癌外科手术共识

Expert Consensus on Laparoscopic Hepatectomy(2013 Version)

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2013年第6期33卷 791-797页

作者： National hepatic surgery Group,Society of surgery,Chinese Medical Association National hepatic surgery Group Society of SurgeryChinese Medical Association

Background： Laparoscopic hepatectomy has many advantages over open surgery, including minimiza- tion of local injury, reduced systemic reactions, and faster postoperative recovery. The aim of this ＂Consensus＂ is to provide guidance and reference to surgeons who perform, or are interested in per- forming laparoscopic liver surgeries. Methods： The National hepatic surgery Group of the Society of surgery, a professional society of the Chinese Medical Association, gathered 60 expert hepatic surgeons in Wuhan, China in December 2012, and an ＂Expert Consensus on Laparoseopic Hepatectomy＂ was developed. Results： The types of hepatectomy, indications and contraindications, preoperative preparation, anes- thesia, patient position, insuffiation pressure, port position, control of hepatic inflow and outflow, indi- cations for conversion to open surgery, and surgical devices and equipment are reviewed. Techniques and procedures of various laparoscopic hepatectomies are also discussed.

关键词： Expert Consensus on Laparoscopic Hepatectomy Version

小儿胰腺实性假乳头状瘤临床诊治专家共识(2023版)

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中华肝胆外科杂志 2024年第1期30卷 1-8页

作者：中华医学会小儿外科学分会肝胆学组中华医学会小儿外科学分会肿瘤学组詹江华段飞王焕民闫学强王智茹朱真闯孙溶涓不详天津市儿童医院(天津大学儿童医院)普外科天津300134 华中科技大学同济医学院附属武汉儿童医院普外科武汉430016 首都医科大学附属北京儿童医院肿瘤外科北京100045 华中科技大学同济医学院附属武汉儿童医院天津市儿童医院

小儿胰腺实性假乳头状瘤(SPN)为胰腺低度恶性上皮性外分泌肿瘤,无典型临床表现及诊断特异性肿瘤标志物,术前诊断主要依赖影像学检查,手术为主要治疗方式。当前国内各中心对小儿SPN的诊断标准、分型、手术指征、术式选择、术后随访等方... 详细信息

小儿胰腺实性假乳头状瘤(SPN)为胰腺低度恶性上皮性外分泌肿瘤,无典型临床表现及诊断特异性肿瘤标志物,术前诊断主要依赖影像学检查,手术为主要治疗方式。当前国内各中心对小儿SPN的诊断标准、分型、手术指征、术式选择、术后随访等方面尚存在争议。本共识根据循证医学证据,结合专家组成员多次讨论及德尔菲问卷调查结果制定,以期规范我国小儿SPN诊疗流程并提高总体诊治水平。

关键词：儿科学胰腺肿瘤诊断治疗共识

Site-specific conjugation of bifunctional chelator BAT to mouse IgG1 Fab~1 fragment

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Acta Pharmacologica Sinica 2006年第2期27卷 237-241页

作者： Jun LI~1 Xue-hao WANG Xiao-ming WANG Zhao-lai CHEN Division of hepatic surgery.Department of surgery,the First Affiliated Hospital of Nanjing Medical University and Jiangsu Province Hospital.Nanjing 210029.China Division of hepatic surgery Department of Surgery the First Affiliated Hospital of Nanjing Medical University and Jiangsu Province Hospital Nanjing China

Aim:To perform a site-specific conjugation of Fab’ fragments of a mouse mono-clonal antibody(MoAb)B43(of IgG1subtype)to a bifunctional chelator 6-[p-(bromoacetamido)benzyl]-1,4,8,11-tetraazacyclotetradecane-N,N′,N″,N′″-tetraacetic acid(BAT)via the thiol groups in the hinge distal to the antigen-binding site of the Fab~***:B43 was cleaved using a simple 2-step ***,stable F(ab~1)2was produced by pepsin ***~1 with tree thiol in thehinge region was then obtained by cysteine reduction of F(ab~1)***,a site-specific conjugation of Fab~1 to thiol-specific BAT was performed in a ***:The Fab~1 fragment had approximately 1.8 free thiol groups permolecule after cysteine *** conjugation efficiency and the chemicalyield were approximately 1.28 moles chelator/Fab′ and 74% of the initial concentra-tion of Fab′,*** F(ab′)2,Fab′ and Fab′-BAT all maintained reason-able antigen-binding properties.67Cu labeling of the conjugate under standardconditions did not impair the immunoreactivity of Fab′-***:This isa simple and efficient method for producing immunoreactive conjugates of Fab′-BAT,which can be used to make radiometal-labeled conjugates for further diag-nostic and therapeutic applications.

关键词： conjugation BAT chelator monoclonal antibody

Adenovirus-expressed preS2 antibody inhibits hepatitis B virus infection and hepatic carcinogenesis

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World Journal of Gastroenterology 2012年第4期18卷 349-355页

作者： Qian Zhang,Department of Infectious Diseases,Changhai Hospital,Second Military Medical University,Shanghai 200433,China Zhi-Qing Li,Hu Liu,Jia-He Yang,Department of hepatic surgery,Eastern Hepatobiliary surgery Hospital,Second Military Medical University,Shanghai 200438,China Qian Zhang Department of Infectious Diseases Changhai Hospital Second Military Medical University Shanghai 200433 China.

AIM:To investigate the inhibitory effect of hepatitis B virus (HBV) preS2 antibody (preS2Ab) against HBV in-fection and HBV-associated hepatic ***:An adenoviral vector carrying the full-length light and heavy chains of the HBV preS2Ab gene,Ad315-preS2Ab,was *** linked immunosorbent assay (ELISA) and Western blotting analyses were used to determine the preS2Ab expres-sion levels in *** techniques were used to examine the binding affinity between the expressed HBV preS2Ab and HBV-positive liver *** were also used to determine hepatitis B surface antigen (HBsAg) levels to assess the inhibitory effect of the preS2Ab against HBV infection in L02 *** inhibitory effect of preS2Ab against hepatic carcinogen-esis was studied with diethylnitrosamine (DEN)-induced hepatocellular carcinomas (HCCs) in HBV transgenic ***:The expression of HBV preS2Ab increased with increases in the multiplicity of infection (MOI) of Ad315-preS2Ab in L02 cells,with 350.87 ± 17.37 μg/L of preS2Ab when the MOI was 100 plaque forming units (pfu)/*** expressed preS2Abs could recog-nize liver cells from HBV transgenic *** results showed that L02 cells expressing preS2Ab produced less HBsAg after treatment with the serum of HBV pa-tients than parental L02 cells expressing no *** transgenic mice treated with Ad315-preS2Ab had fewer and smaller cancerous nodes after induction with DEN than mice treated with a blank Ad315 vec-tor or untreated ***,the administration of Ad315-preS2Ab could alleviate hepatic cirrhosis and decrease the serum levels of alanine transaminase and aspartate ***:Adenovirus-mediated HBV preS2Ab expression could inhibit HBV infection in L02 cells,and then inhibit DEN-induced hepatocellular carcinogenesis and protect hepatic function in HBV transgenic mice.

关键词： Hepatitis B virus Adenoviral vector PreS2 antibody Hepatocellular carcinoma Gene therapy

Changes of serum alpha-fetoprotein and alpha-fetoprotein-L3 after hepatectomy for hepatocellular carcinoma: prognostic significance

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Hepatobiliary & Pancreatic Diseases International 2012年第6期11卷 618-623页

作者： Xiao-Feng Zhang, Zheng-Feng Yin, Kui Wang, Zong-Qin Zhang, Hai-Hua Qian,Le-Hua ShiAuthor Affiliations: The 4th Department of hepatic surgery ,Molecular Oncology Laboratory , Eastern Hepatobiliary surgery Hospital, Second Military Medical University, Shanghai 200438, China The 4th Department of hepatic surgery Eastern Hepatobiliary Surgery Hospital Second Military Medical University Shanghai 200438 China Molecular Oncology Laboratory Eastern Hepatobiliary Surgery Hospital Second Military Medical University Shanghai 200438 China

BACKGROUND: Alpha-fetoprotein (AFP) is the most established tumor marker of hepatocellular carcinoma (HCC), but one of its limitations is non-specificity. Many studies have demonstrated that alpha-fetoprotein-L3 (AFP-L3) is more specific than AFP in the early diagnosis and prognosis of HCC. However, there is a lack of knowledge about the post-hepatectomy profiles of serum AFP and AFP-L3 values in HCC patients. To identify the profiles after surgical resection of HCC, we analyzed the correlation between the profiles and postoperative HCC recurrence or survival, and evaluated their utility in predicting postoperative therapeutic efficacy and prognosis. METHODS: From August 2003 to December 2004, 318 patients with positive serum AFP who had received surgical resections were enrolled in this study. Preoperative and postoperative serum AFP and AFP-L3 levels were measured simultaneously and regularly, and their postoperative profiles during a long term follow-up were recorded and summarized. RESULTS: A high ratio of AFP-L3 to total AFP was shown to correlate with pathologic features of aggressiveness. The overall 1-, 3-, and 5-year recurrence rates of the whole series were 28% 57%, and 84%, and the overall survival rates were 86%, 61% and 33%, respectively. The changes of serum AFP and AFP-L3 after hepatectomy for HCC were classified into 3 groups (group A: AFP-L3 undetectable; group B: AFP-L3 10%). Patients with positive postoperative AFP-L3had significantly earlier recurrence than those with negative results. The overall survival was significantly shorter in the positive groups than in the groups negative for postoperative ***: Post-hepatectomy changes in serum AFP and AFP-L3 levels occurred in three distinct patterns, which were closely correlated with HCC recurrence and patient survival with different prognostic values.

关键词： hepatocellular carcinoma hepatectomy alpha-fetoprotein alpha-fetoprotein-L3

Combined splenocaval or mesocaval C shunt and portoazygous devascularization in the treatment of portal hypertension: analysis of 150 cases

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Hepatobiliary & Pancreatic Diseases International 2006年第1期5卷 70-73页

作者： Liu-Shun Feng and Xiao-Ping Chen hepatic surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China hepatic surgery Center Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China. Fengliushun@***

BACKGROUND: Portal hypertension is a common disease and its major surgical therapeutic approaches include devascularization and shunting. This study was undertaken to investigate the effects of combined splenocaval or mesocaval C shunt and portoazygous devascularization (combined procedures) on portal hypertension. METHODS: The clinical data of 150 patients with portal hypertension who had undergone combined procedures at the First Affiliated Hospital of Zhengzhou University from May1990 to May 2003 were analyzed retrospectively. RESULTS: The mean free portal pressure (FPP) was 25.6±1.83 mmHg, 18.0±2.07 mmHg and 18.4±2.19 mmHg before operation, after splenectomy plus splenocaval or mesocaval C shunt, and combined procedures, respectively. There was no operative death in all patients. The 1-7 year follow-up of 100 patients showed rebleeding in 3 patients, encephalopathy in 4, thrombosis of artificial vascular graft in 3, and dying from liver failure in 2. CONCLUSIONS: The combined procedures can not only decrease portal pressure but also preserve hepatic blood flow to some extent. It may be one of the best choices for treating portal hypertension in China.

关键词： hypertension portal vein blood vessel prosthesis devascularization shunting

Salviae miltiorrhizae ameliorates cirrhosis and portal hypertension by inhibiting nitric oxide in cirrhotic rats

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Hepatobiliary & Pancreatic Diseases International 2003年第3期2卷 391-396页

作者： Hai Wang Xiao-Ping Chen Fa-Zu Qiu the hepatic surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China hepatic surgery Center Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China.

OBJECTIVE: To determine the effect of Salviae miltiorrhizae on cirrhosis and portal hyperiension by inhibiting nitric oxide synthase type Ⅱ (NOSⅡ) in rats. METHODS: Real time RT-PCR was used to detect the expression of NOSII mRNA. The enzymatic activity of nitric oxide synthase and the circulating levels of nitric oxide (NO), systemic and portal hemodynamics, and quantification of cirrhosis were measured with highly sensitive methods. Traditional Chinese medicine was utilized to treat cirrhotic rats and the function of NO was evaluated. Double-blind method was applied in the experiment constantly. RESULTS: The concentration of NO increased markedly at all stages of cirrhosis, and so did the enzymatic activity of NOS, antl the iNOSmRNA expressed greatly. Meanwhile the portal-venous-pressure (PVP), portal-venous-now (PVF) increased significantly. NO, Nos and iNOSmHNA were positively correlated to the quanlity of hepatic fihrosis. Salviae Miltiorrhizae significantly inhibited NO production and inhibited the expression of iNOSmRNA. CONCLUSIONS: The increased hepatic expression of NoSIⅡ is one of the important factors causing cirrhosis and portal hypertension. Salviae Miltiorrhizae significantly ameliorates cirrhosis and portal hypertension.

关键词： nitric oxide synthase message ribonuleie acid Salviae miltiorrhizae hepatic cirrhosis portal hemodynamics pathogenesis

Changes of immune function in patients with liver cirrhosis after splenectomy combined with resection of hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2003年第4期2卷 562-565页

作者： Zhi-Xin Cao Xiao-Ping Chen Zai-De Wu the hepatic surgery Center, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China hepatic surgery Center Tongji Hospital of Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China. czxtj@***

OBJECTIVE: To study the changes of immune function in liver cirrhosis patients after splenectomy combined with resection of hepatocellular carcinoma (HCC). METHODS: Sixteen patients with HCC associated with liver cirrhosis were divided into two groups: splenectomy combined with hepatectomy (splenectomy group n=7) and hepatectomy (non-splenectomy group, n=9). T lymphocyte subsets such as CD4, CD8, CD4/CD8 and Th lymphocyte cytokines such as interferon γ (IFN-γ), IL-2, IL-10 in 7 ml peripheral venous blood before operation and 2 months after operation were examined and compared between the two groups. RESULTS: There was no significant difference in pre-operative CD4, CD8, CD4/CD8, IL-2, IFN-γ, IL-10 levels in the two groups. Two months after operation, the levels of CD4 (38.2%±3.7%), CD4/CD8 (1.7±0.3), IFN-γ (104.4±14.9 pg/ml), 1L-2 (98.6±18.6 pg/ml) were increased and those of CD8 (23.7±3.7 pg/ml), IL-10 (55.5±11.2 pg/ml) levels were decreased in the splenectomy group. The levels of CD4 (32.5%±4.0%), CD4/CD8 (1.1±0.1), IFN-γ(70.5±12.6 pg/ml), IL-2(80.9±13.5 pg/ml) in the non-splenectomy group were much lower than those in the splenectomy group, but the levels of CD8 (29.4%±4.0%), IL-10 (89.4±10.0 pg/ml) in the non-splenectomy group were significantly higher than those in the splenectomy group (P<0.05). CONCLUSIONS: Splenectomy combined with hepatectomy for HCC patients associated with liver cirrhosis does not decrease but promote the recovery of T lymphocyte subsets and Th1/Th2 cytokines from imbalance and improve anti-tumor immune function of the patients.

关键词： hepatocellular carcinoma liver cirrhosis splenectomy immunity

Prevention and management of pleural effusion following hepatectomy in primary liver cancer

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Hepatobiliary & Pancreatic Diseases International 2005年第3期4卷 375-378页

作者： Jian-Jun Yan, Xiang-Hua Zhang, Kai-Jian Chu, Liang Huang, Fei-Guo Zhou and Yi-Qun Yan Department of hepatic surgery, Eastern Hepatobiliary surgery Hospital, Second Military Medical University, Shanghai 200438, China Department of hepatic surgery Eastern Hepatobiliary Surgery Hospital Second Military Medical University Shanghai 200438 China. Yiqunyan@***

Postoperative pleural effusion occurs frequently after hepatectomy. The risk factors, prevention and management of postoperative pleural effusion in patients with primary liver cancer (PLC) who have undergone hepatectomy and the value of the argon beam coagulator (ABC) for the prevention of pleural effusion are studied. METHODS:A total of 523 patients with PLC at our institution who had had right hepatectomy from July 2000 to June 2004 were studied retrospectively. Comparative analysis was made to identify the factors contributing to postoperative pleural effusion and the efficacy of various managements. RESULTS:Of the 523 patients whose livers were dissociated using argon beam cutting and/or coagulation, 20(3.8%) developed pleural effusions;whereas in the other 467 patients underwent hepatectomy with suture ligation of the diaphragmatic secondary wound surface during the same period, 49(10.5%) had pleural effusion (Phepatic insufficiency with ascites, duration of hepatic occlusion and underlying cirrhosis. CONCLUSIONS: Dissociation of the liver by argon beam cutting and/or coagulation can save suture ligation of the diaphragmatic secondary wound surface and may also prevent postoperative pleural effusion. Pleural drainage using an indwelling central-venous-catheter (CVC) in the pleural cavity is safe and efficacious.

关键词： primary liver cancer hepatectomy postoperative pleural effusion argon beam cut and/or coagulation central venous catheter