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Update on the Diagnosis and Treatment of Combined Hepatocellular Cholangiocarcinoma

Journal of Clinical and Translational Hepatology 2024年第2期12卷 210-217页

作者： Kai-Jian Chu Yoshikuni Kawaguchi Han Wang xiao-qing jiang Kiyoshi Hasegawa Biliary Surgical Department No.1 Eastern Hepatobiliary Surgical HospitalThe Naval Medical UniversityShanghaiChina Hepato-Biliary-Pancreatic Surgery Division Department of SurgeryGraduate School of MedicineThe University of TokyoTokyoJapan Department of Pathology Eastern Hepatobiliary Surgical HospitalThe Naval Medical UniversityShanghaiChina

Combined hepatocellular-cholangiocarcinoma(cHCC-CCA)is a unique type of liver tumor that contains both hepatocellular carcinoma and cholangiocarcinoma components within a single *** fifth edition of the World Health Organization classification provides a definition and diagnostic criteria for ***,the heterogeneous histomorphology and presentation resulting from variation of the proportion of each component poses challenges for clinical diagnosis and treatment.A diagnosis of cHCC-CCA may be suggested by the synchronous elevation of serum tumor markers for hepatocellular carcinoma and cholangiocarcinoma,a mixed enhancement pattern on imaging,and a discrepancy between the elevation of tumor marker and the imaging enhancement *** examination using hematoxylin and eosin staining is considered the gold standard for diagnosing cHCC-CCA,and comprehensive examination of resection or biopsy specimens is crucial for an accurate ***,there is no standard treatment for cHCC-CCA,and surgery is the *** hepatectomy with lymphadenectomy is among the recommended surgical *** role of liver transplantation in the management of cHCC-CCA is still *** chemoembolization may be effective for unresectable cHCC-CCA,particularly for hypervascular ***,the available evidence does not support systemic therapy for advanced *** prognosis of cHCC-CCA is generally poor,and there is no established staging *** research is needed to better understand the histogenesis and clinical management of *** review provides an overview of the current literature on cHCC-CCA with a focus on its clinical characteristics,pathological diagnosis,and management.

关键词： Combined hepatocellular-cholangiocarcinoma Clinical characteristics Imaging characteristics Pathological diagnosis Treatment

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A New Fluorescent Sensor for Transition Metal Ions in Aqueous Solution

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Chinese Chemical Letters 2000年第6期11卷 551-554页

作者： Li Jian jiang Zhi Lin WANG xiao qing jiang Qin Hui LUO(Coordination Chemistry Institute Nanjing University Nanjing 210093) Coordination Chemistry Institute Nanjing University Nanjing 210093 China

A new fluorescent sensor consisted of fluorenyl and dioxotetraaza unit, dimethyl-6-(9-fluorenyl)-1,4,8,11-tetraazaundencane-5,7-dione (L), was synthesize fluorescent sensor for transition metal ions in aqueous solution.

关键词： fluorenyl dioxotetramine fluorescence sensor transition metal

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Effect of BCP ultrathin layer on the performance of organic light-emitting devices

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Optoelectronics Letters 2008年第5期4卷 317-320页

作者： WANG Hong YU Jun-sheng LI Lu TANG xiao-qing jiang Ya-dong School of Optoelectronic Information State Key Laboratory of Electronic Thin Films and Integrated Devices University of Electronic Science and Technology of China Chengdu 610054 China

Based on conventional double layer device, triple layer organic light-emitting diodes (OLEDs) with two heterostructures of indium-tin oxide (ITO)/N,N'-diphenyl-N,N'-bis(1-naphthyl)(1,1'-biphenyl)-4,4'-diamine(NPB)/2,9-dimethyl-4,7-diphenyl- 1,10-phenanthroline (BCP)/ 8-Hydroxyquinoline aluminum (Alq3)/Mg:Ag using vacuum deposition method have been fabricated. The influence of different film thickness of BCP layer on the performance of OLEDs has been investigated. The results showed that when the thickness of the BCP layer film gradually varied from 0.1 nm to 4.0 nm, the electrolumines- cence (EL) spectra of the OLEDs shifted from green to greenish-blue to blue, and the BCP layer acted as the recombination region of charge carriers related to EL spectrum, enhancing the brightness and power efficiency. The power efficiency of OLEDs reached as high as 7.3 lm/W.

关键词：电致发光器件超薄层 OLEDs 异质结构

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A special growth manner of intrahepatic biliary cystadenoma

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World Journal of Gastroenterology 2009年第48期15卷 6134-6136页

作者： Bin Yi qing-Bao Cheng xiao-qing jiang Chen Liu Xiang-Ji Luo Hui Dong Bai-He Zhang Meng-Chao Wu Department of Biliary Surgery Eastern Hepatobiliary Surgery Hospital Second Military Medical University Shanghai 200438 China Department of Pathology Eastern Hepatobiliary Surgery Hospital Second Military Medical University Shanghai 200438 China

We report a case of a 56-year-old woman with intrahepatic biliary cystadenoma(IBC)accompanying a tumor embolus in the extrahepatic bile duct,who was admitted to our department on October 13,*** showed an asymmetry dilation of the biliary tree,different bile signals in the biliary tree,a multiloculated lesion and an extrahepatic bile duct lesion with internal septation.A regular left hemihepatectomy en bloc was performed with resection of the entire tumor,during which a tumor embolus protruding into the extrahepatic bile duct and originating from biliary duct of segment 4 was ***,the multiloculated tumor was confirmed to be a biliary cystadenoma with an epithelial lining composed of biliary-type cuboidal cells and surrounded by an ovarian-like *** aggressive en bloc resection was recommended for the multiloculated *** workup,clinicians and surgeons need to be aware of this different presentation.

关键词： Intrahepatic biliary cystadenoma Growth manner Tumor embolus

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An end-to-side suspender pancreaticojejunostomy: A new invagination pancreaticojejunostomy

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Hepatobiliary & Pancreatic Diseases International 2018年第2期17卷 163-168页

作者： Bin Li Chang Xu Zhi-Quan Qiu Chen Liu Bin Yi Xiang-Ji Luo xiao-qing jiang Department of Biliary Tract Surgery Eastern Hepatobiliary Surgery Hospital Secondary Military Medical University

Background: Postoperative pancreatic fistula(POPF) is a severe complication of the pancreaticoduodenectomy(PD). Recently, we introduced a method of suspender pancreaticojejunostomy(PJ) to the PD. In this study, we retrospectively analyzed various risk factors for complications after PD. We also introduced and assessed the suspender PJ to demonstrate its ***: Data from 335 patients with various periampullary lesions, who underwent the Whipple procedure(classic Whipple procedure or pylorus-preserving) PD by either traditional end-to-side invagination PJ or suspender PJ, were analyzed. The correlation between either perioperative or postoperative complications and corresponding PD approaches was evaluated by univariate ***: A total of 147 patients received the traditional end-to-side invagination PJ, and 188 patients were given the suspender PJ. Overall, 51.9% patients had various complications after PD. The mortality rate was 2.4%. The POPF incidence in patients who received the suspender PJ was 5.3%, which was significantly lower than those who received the traditional end-to-side invagination PJ(18.4%)(P < 0.001).Univariate analysis showed that PJ approach and the pancreas texture were significantly associated with the POPF incidence rate(P < 0.01). POPF was a risk factor for both postoperative abdominal cavity infection(OR = 8.34, 95% CI: 3.99–17.42, P < 0.001) and abdominal cavity hemorrhage(OR = 4.86, 95% CI:1.92–12.33, P = 0.001).Conclusions: Our study showed that the impact of the pancreas texture was a major risk factor for pancreatic leakage after a PD. The suspender PJ can be easily accomplished and widely applied and can effectively decrease the impact of the pancreas texture on pancreatic fistula after a PD and leads to a lower POPF incidence rate.

关键词： Pancreaticoduodenectomy Pancreaticojejunostomy Postoperative pancreatic fistula

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Influence of PVK:NPB hole transporting layer on the characteristics of organic light-emitting devices

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Optoelectronics Letters 2008年第3期4卷 201-204页

作者： WEN Wen YU Jun-sheng LI Lu MA Tao TANG xiao-qing jiang Ya-dong State Key Laboratory of Electronic Thin Films and Integrated Devices School of Optoelectronic Information Universityof Electronic Science and Technology of China （UESTC） Chengdu 610054 P. R. China

A doping system consisting of NPB and PVK is employed as a composite hole transporting layer （CHTL）. By adjusting the component ratio of the doping system, a series of devices with different concentration proportion of PVK ： NPB are constracted. The result shows that doping concentration of NPB enhances the competence of hole transporting ability, and modifies the recombination region of charge as well as affects the surface morphology of doped film. Optimum device with a maximum brightness of 7852 cd/m^2 and a power efficiency of 1.75 lm/W has been obtained by choosing a concentration proportion of PVK ： NPB at 1：3.

关键词：光散射性状半导体传输过程

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Treatment of massive pancreaticojejunal anastomotic hemorrhage after pancreatoduodenectomy

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World Journal of Gastroenterology 2009年第13期15卷 1625-1629页

作者： Chen Liu Ying-He Qiu Xiang-Ji Luo Bin Yi xiao-qing jiang Wei-Feng Tan Yong Yu Meng-Chao Wu Billiary Unit of Eastern Hepatobilliary Surgery Hosipital Shanghai200438 China

AIM： To compare the treatment modalities for patients with massive pancreaticojejunal anastomotic hemorrhage after pancreatoduodenectomy （PDT）.METHODS： A retrospective study was undertaken to compare the outcomes of two major treatment modalities： transcatheter arterial embolization （TAE） and open surgical hemostasis. Seventeen patients with acute massive hemorrhage after PDT were recruited in this study. A comparison of two treatment modalities was based upon the clinicopathological characteristics and hospitalization stay, complications, and patient prognosis of the patients after surgery.RESULTS： Of the 11 patients with massive hemorrhage after PDT treated with TAE, 1 died after discontinuing treatment, the other 10 stopped bleeding completely without recurrence of hemorrhage. AIJ the 10 patients recovered well and were discharged, with a mean hospital stay of 10.45 d after hemostasis. The patients who underwent TAE twice had a re-operation rate of 18.2% and a mortality rate of 0.9%. Among the six patients who received open surgical hemostasis, two underwent another round of open surgical hemostasis. The mortality was 50%, and the recurrence of hemorrhage was 16.67%, with a mean hospital stay of 39.5 d.CONCLUSION： TAE is a safe and effective treatment modality for patients with acute hemorrhage after PDT. Vasography should be performed to locate the bleeding site.

关键词： Pancreatoduodenectomy Massivehemorrhage Transcatheter artery embolization Complication Treatment

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Combined detection tumor markers for diagnosis and prognosis of gallbladder cancer

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World Journal of Gastroenterology 2014年第14期20卷 4085-4092页

作者： Yun-Feng Wang Fei-Ling Feng Xu-Hong Zhao Zhen-Xiong Ye He-Ping Zeng Zhen Li xiao-qing jiang Zhi-Hai Peng Department of Hepatobiliary Surgery Qianfoshan HospitalShandong University Department of General Surgery Yangpu HospitalTongji University School of Medicine The First Department of Biliary Surgery Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University Central Experiment Laboratory Yangpu HospitalTongji University School of Medicine

AIM: To clarify the value of combined use of markers for the diagnosis of gallbladder cancer and prediction of its prognosis. METHODS: Serum cancer antigens (CA) 199, CA242, carcinoembryonic antigen (CEA), and CA125 levels were measured in 78 patients with gallbladder cancer (GBC), 78 patients with benign gallbladder diseases, and 78 healthy controls using electrochemiluminescence. CA199, CA242, CEA, and CA125 levels and positive rates were analyzed and evaluated pre-and post-operatively. Receiver operator characteristic curves were used to determine diagnostic sensitivity and specificity of GBC. Survival time analysis, including survival curves, and multivariate survival analysis of a Cox proportional hazards model was performed to evaluate independent prognostic factors. RESULTS: Serum CA242, CA125, and CA199 levels in the GBC group were significantly higher when compared with those in the benign gallbladder disease and healthy control groups (P < 0.01). With a single tumor marker for GBC diagnosis, the sensitivity of CA199 was the highest (71.7%), with the highest specificity being in CA242 (98.7%). Diagnostic accuracy was highest with a combination of CA199, CA242, and CA125 (69.2%). CA242 could be regarded as a tumor marker of GBC infiltration in the early stage. The sensitivity of CA199 and CA242 increased with progression of GBC and advanced lymph node metastasis (P < 0.05). The 78 GBC patients were followed up for 6-12 mo (mean: 8 mo), during which time serum CA199, CA125, and CA242 levels in the recurrence group were significantly higher than in patients without recurrence (P < 0.01). The post-operative serum CA199, CA125, and CA242 levels in the non- recurrence group were significantly lower than those in the GBC group (P < 0.01). Multivariate survival analysis using a Cox proportional hazards model showed that cancer of the gallbladder neck and CA199 expression level were independent prognostic factors. CONCLUSION: CA242 is a marker of GBC infiltration in

关键词： Gallbladder cancer Tumor marker Combined detection Diagnosis Prognosis

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Influences of dexmedetomidine on stress responses and postoperative cognitive and coagulation functions in patients undergoing radical gastrectomy under general anesthesia

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World Journal of Gastrointestinal Surgery 2023年第6期15卷 1169-1177页

作者： Xiang-Fei Ma Shi-Jia Lv Shen-Qiao Wei Bing-Rong Mao Xiu-Xia Zhao xiao-qing jiang Fei Zeng Xue-Ke Du Department of Anesthesiology The Second Affiliated Hospital of Guangxi Medical UniversityNanning 530007Guangxi Zhuang Autonomous RegionChina

BACKGROUND Radical gastrectomy(RG)is commonly used in the treatment of patients with gastric cancer(GC),but this procedure may lead to stress responses,postoperative cognitive dysfunction,and blood coagulation abnormalities in *** To investigate the influences of dexmedetomidine(DEX)on stress responses and postoperative cognitive and coagulation functions in patients undergoing RG under general anesthesia(GA).METHODS One hundred and two patients undergoing RG for GC under GA from February 2020 to February 2022 were retrospectively *** these,50 patients had received conventional anesthesia intervention[control group(CG)]and 52 patients had received DEX in addition to routine anesthesia intervention[observation group(OG)].Inflammatory factor(IFs;tumor necrosis factor-α,TNF-α;interleukin-6,IL-6),stress responses(cortisol,Cor;adrenocorticotropic hormone,ACTH),cognitive function(CF;Mini-Mental State Examination,MMSE),neurological function(neuron-specific enolase,NSE;S100 calciumbinding protein B,S100B),and coagulation function(prothrombin time,PT;thromboxane B2,TXB2;fibrinogen,FIB)were compared between the two groups before surgery(T0),as well as at 6 h(T1)and 24 h(T2)after *** Compared with T0,TNF-α,IL-6,Cor,ACTH,NSE,S100B,PT,TXB2,and FIB showed a significant increase in both groups at T1 and T2,but with even lower levels in OG vs *** groups showed a significant reduction in the MMSE score at T1 and T2 compared with T0,but the MMSE score was notably higher in OG compared with *** In addition to a potent inhibitory effect on postoperative IFs and stress responses in GC patients undergoing RG under GA,DEX may also alleviate the coagulation dysfunction and improve the postoperative CF of these patients.

关键词： Dexmedetomidine Radical gastrectomy General anesthesia Inflammatory factors Stress responses

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Surgical procedure and prognosis of hilar cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2004年第3期3卷 453-457页

作者： Bin Yi, Bai-He Zhang, Yong-Jie Zhang, xiao-qing jiang, Bao-Hua Zhang,Wen-Long Yu, qing-Bao Chen and Meng-Chao Wu Department of Biliary Surgery, Eastern HepatobiliarySurgery Hospital, Shanghai 200438 , China Department of Biliary Surgery Eastern Hepatobiliary Surgery Hospital Shanghai 200438 China. billyyi@***

BACKGROUND: Hilar cholangiocarcinoma has a low radi-cal resection rate and a poor long-term survival rate. In re-cent years, its prognosis has been improved with advance-ment of preoperative diagnostic techniques and surgicaltechniques. The aim of this study was to evaluate the prog-nostic factors of hilar cholangiocarcinoma and the relationsof surgical procedure to the prognosis of the ***: A retrospective cohort study was done in 198patients with hilar cholangiocarcinoma (117 men and 81women, aged from 27 to 81 years) , who had been admit-ted to this hospital from December 1997 to December *** symptoms were jaundice (94.5%), pruritus (56.6%)and abdominal pain (33.8%). Bismuth-Corlette classifica-tion showed type in 14 patients, type in 19, type in12, type in 15, type in 112, and unclassifiable typein 26. 144 patients underwent laparotomy and others re-ceived bile drainage endoscopically (including endoscopicretrograde biliary drainage (ERBD) or endoscopic metalbiliary endoprosthesis (EMBE) in 21 patients, endoscopicnose-biliary drainage (ENBD) in 31 or percutaneous trans-hepatic cholangiodrainage in 2. 120 patients (83.3%) re-ceived tumor resection including radical resection in 59 pa-tients (41.0%). Twenty-three patients underwent paunchedbiliary exploration and ***: Cox' s regression model analysis showed thatoccupation, preoperative total serum bilirubin level, opera-tive procedure and postoperative adjuvant radiation weresignificantly related to postoperative survival rate in con-trast to gender, age, choledocholithiasis, hepatitis, preope-rative serum CA19-9 level, Bismuth-Corlette type, his-topathologic grading and postoperative chemotherapy. Thesurvival of patients in groups of biliary drainage, palliativeresection and radical resection differed statistically and pro-longed in a descending order. No statistical difference wasfound between ERBD or EMBE group and palliative resec-tion group. So was between ERBD or EMBE group

关键词： cholangiocarcinoma/surgery prognosis cholangiopancreatography endoscopic retrograde

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