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Effects of simulated carbon dioxide and helium peumoperitoneum on proliferation and apoptosis of gastric cancer cells

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World Journal of Gastroenterology 2008年第14期14卷 2241-2245页

作者： Ying-Xue Hao Hua Zhong Chao Zhang Dong-Zu Zeng Yan Shi Bo Tang Pei-Wu Yu department of General surgery and Center of Minimal Invasive Gastrointestinal surgery Southwest Hospital Third Military Medical University Chongqing 400038 China department of Ultrasonography Southwest Hospital Third Military Medical University Chongqing 400038 China

AIM:To investigate the effects of carbon dioxide (CO2) and helium insufflation administered at different pressures on the growth and apoptosis of cultured human gastric cancer cells. METHODS:The gastric cancer cells MKN-45 were exposed to a CO2 and helium environment maintained at different pressures (0, 5, 10 and 15 mmHg). The cells were exposed to simulated pneumoperitoneum environment for 4 h, and pH of the culture media was measured after it was moved to normal conditions for 0, 2, 4, 6 and 8 h. Proliferation viability of MKN-45 was examined by 3-4,5Dimethylthiazol-2-yl,5-diphenyltetrazolium bromide or triazolyl blue (MTT) assay after it was moved to normal conditions. Apoptotic ratio was measured by Annexin V-FITC/PI double labelled staining. RESULTS:The pH of media was acid and recovered to normal after 4 h in the CO2 group while it was basic in the helium group. There was no difference between CO2 groups (under 10 mmHg ) and control group (P > 0.05) in the proliferative viability of the cells. The cultured cells exposed to 15 mmHg CO2 environment grew more slowly than control group from 4 to 7 d (P 0.05). The proliferative viability in helium group was not obviously different from the control group (P > 0.05). The apoptotic ratio of the cultured cells was markedly higher than that of the control group (P 0.05). CONCLUSION:There is no obvious effect in the proliferation and apoptosis of MKN-45 cells under 10 mmHg CO2 insufflation pressure and helium in any pressure. Fifteen mmHg CO2 insufflation pressure can inhibit the proliferation of the cells and improve apoptosis.

关键词： Pneumoperitoneum Gastric cancer cells Proliferation Apoptosis

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Preoperative prediction of hepatocellular carcinoma microvascular invasion based on magnetic resonance imaging feature extraction artificial neural network

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World Journal of Gastrointestinal surgery 2024年第8期16卷 2546-2554页

作者： Jing-Yi Xu Yu-Fan Yang Zhong-Yue Huang Xin-Ye Qian Fan-Hua Meng Center of Hepatobiliary Pancreatic Disease Beijing Tsinghua Changgung HospitalSchool of Clinical MedicineTsinghua UniversityBeijing 102218China department of Surgical Beijing Tsinghua Changgung HospitalSchool of Clinical MedicineTsinghua UniversityBeijing 102218China department of Anesthesiology Huashan HospitalFudan UniversityShanghai 200040China

BACKGROUND Hepatocellular carcinoma(HCC)recurrence is highly correlated with increased *** invasion(MVI)is indicative of aggressive tumor biology in *** To construct an artificial neural network(ANN)capable of accurately predicting MVI presence in HCC using magnetic resonance *** This study included 255 patients with HCC with tumors<3 *** annotated the tumors on the T1-weighted plain MR ***,a three-layer ANN was constructed using image features as inputs to predict MVI status in patients with *** pathological examination is considered the gold standard for determining *** operating characteristic analysis was used to evaluate the effectiveness of the *** Using the bagging strategy to vote for 50 classifier classification results,a prediction model yielded an area under the curve(AUC)of ***,correlation analysis revealed that alpha-fetoprotein values and tumor volume were not significantly correlated with the occurrence of MVI,whereas tumor sphericity was significantly correlated with MVI(P<0.01).CONCLUSION Analysis of variable correlations regarding MVI in tumors with diameters<3 cm should prioritize tumor *** ANN model demonstrated strong predictive MVI for patients with HCC(AUC=0.79).

关键词： Hepatocellular carcinoma Microvascular invasion Artificial neural network Magnetic resonance imaging Tumor sphericity Area under the curve

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Is delayed gastric emptying so terrible after pylorus-preserving pancreaticoduodenectomy? Prevention and management

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World Journal of Gastroenterology 2006年第39期12卷 6382-6385页

作者： Xian-Min Bu Jin Xu Xian-Wei Dai Kai Ma Fu-Quan Yang Jun Hu Nai-Fu Wang department of Hepatobiliary Pancreatic surgery 2nd Affiliated Hospital China Medical University Shenyang Liaoning Province China department of general surgery Panjin hospital of traditional Chinese medicine Panjin Liaoning Province China

AIM： To explore some operative techniques to prevent the occurrence of delayed gastric emptying （DGE） alter pylorus-preserving pancreaticoduodenectomy （PPPD）.METHODS： One hundred and eighty-six patients in a single medical center who accepted PPPD were retrospectively studied. The incidence of DGE was investigated and the influence of some operative techniques on the prevention of DGE was analyzed.RESULTS： During the operative process of PPPD, the methods of detached drainage of pancreatic fluid and bile and gastric fistulization were used. Postoperatively, six patients suffered DGE among the 186 cases; the incidence was 3.23% （6/186）. One of them was complicated with intraabdominal infection at the same time, and two with pancreatic leakage.CONCLUSION： Appropriate maneuvers during operation are essential to avoid postoperative DGE in PPPD. The occurrence of DGE is avoidable. It should not be used as an argument to advocate hemigastrectomy in PPPD.

关键词： Delayed gastric emptying Pylorus-preserving pancreaticoduodenectomy Gastric fistulization

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Evaluation of novel slim biopsy forceps for diagnosis of biliary strictures: Single-institutional study of consecutive 360 cases(with video)

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World Journal of Gastroenterology 2017年第35期23卷 6429-6436页

作者： Kenjiro Yamamoto Takayoshi Tsuchiya Takao Itoi Shujiro Tsuji Reina Tanaka Ryosuke Tonozuka Mitsuyoshi Honjo Shuntaro Mukai Kentaro Kamada Mitsuru Fujita Yasutsugu Asai Yukitoshi Matsunami Yuichi Nagakawa Hiroshi Yamaguchi Atsushi Sofuni department of Gastroenterology and Hepatology Tokyo Medical University Third department of surgery Tokyo Medical University department of Pathology Tokyo Medical University

AIM To evaluate the feasibility and reliability of endoscopic transpapillary bile duct biopsy for the diagnosis of biliary *** A total of 360 patients(241 men) who underwent endoscopic retrograde cholangiopancreatography for biliary strictures with biopsy from April 2012 to March 2016 at Tokyo Medical University Hospital were retrospectively reviewed. This study was approved by our Institutional Review Board(No. 3516). Informed consent was obtained from all individual participants included in this study. The biopsy specimens were obtained using a novel slim biopsy forceps(Radial Jaw 4P, Boston Scientific, Boston, MA, United States).RESULTS The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 69.6%, 100%, 100%, 59.1%, and 78.8%, respectively. The sensitivity was 75.6% in bile duct cancer, 64% in pancreatic cancer, 61.1% in gallbladder cancer, and 57.1% in metastasis. In bile duct cancer, a lower sensitivity was observed for perihilar bile duct stricture(68.7%) than for distal bile duct stricture(83.1%). In terms of the stricture lengths of pancreatic cancer, gallbladder cancer, and metastasis, a longer stenosis resulted in a better sensitivity. In particular, there was a significant difference between pancreatic cancer and gallbladder cancer(P < 0.05). One major complication was perforation of the extrahepatic bile duct with bile leakage. CONCLUSION Endoscopic transpapillary biopsy alone using novel slim biopsy forceps is feasible and reliable, but restrictive. Biopsy should be performed in consideration of the stricture level, stricture length, and cancer type.

关键词： Endoscopic transpapillary biopsy Biopsy forceps Biliary stricture Bile duct cancer Endoscopic retrograde cholangiography

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Patterns of lymph node metastasis are different in colon and rectal carcinomas

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World Journal of Gastroenterology 2010年第42期16卷 5375-5379页

作者： Hao Wang Xian-Zhao Wei Chuan-Gang FU Fu-Ao Cao Rong-Hua Zhao department of Colorectal surgery Changhai Hospital Second Military Medical University Shanghai 200433 China department of surgery College of Medicine University of Saskatchewan Saskatoon SK S7N0W8Canada

AIM:To describe patterns of lymph node metastasis in invasive colon and rectal ***:Clinical data of 2340 patients with colorectal carcinoma(stageⅠ to Ⅲ) who received radical resection,was retrospectively *** the 2340 patients,1314 patients suffered from rectal carcinoma and 1026 from colon *** with rectal cancer who received neoadjuvant chemoradiation therapy were *** analysis was performed using MannWhitney,χ 2 and Cochran's and Mantel-Haenszel tests(SPSS 15.0).A two-tailed P < 0.05 was considered statistically ***:Lymph node retrieval in the rectal carcinoma group was significantly lower than that in the colon carcinoma group(P < 0.001),while positive lymph node retrieval in the rectal carcinoma group was significantly higher than that in the colon carcinoma group(P < 0.001).The proportion of lymph node positive(N+) cases was higher(patients with one or more positive lymph nodes) in the rectal carcinoma group(P = 0.004).The number of N+ cases was compared at different T stages(T1-T4) to eliminate background bias and the results were confirmed(P < 0.001).In addition,the lymph node ratio(the ratio of number of positive lymph nodes over the number of lymph nodes examined) of stage Ⅲ cases in the rectal carcinoma group was significantly higher than that in the colon carcinoma group(P < 0.001).CONCLUSION:Rectal carcinomas seem more prone to metastasize to the lymph nodes than colon carcinomas,which may be of potential clinical significance.

关键词： Lymph node Metastasis Colon Rectum Neoplasms

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Locoregional therapy response in patients with hepatocellular cancer waiting for liver transplantation:Only selection or biological effect?

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World Journal of Gastroenterology 2018年第31期24卷 3469-3471页

作者： Quirino Lai Michele Di Martino Pierleone Lucatelli Gianluca Mennini department of General surgery and Organ Transplantation Sapienza University of Rome department of Radiology Sapienza University of Rome

Locoregional treatments(LRT) represent a broad strategy used for reducing the risk of drop-off and contextually improving the survivals in patients with hepatocellular cancer receiving a liver transplantation(LT). However, it is not sufficiently clear if LRT are only a surrogate of tumor aggressiveness or if they consent a real benefit in terms of tumor stabilization. A recent study by Pommergaard et al reported the results from the European Liver Transplant Registry. Patients receiving LRT before LT had better 5-year survival rates respect to no-LRT cases(69.7% vs 65.8%; P < 0.001). When the number of LRT was tested, one-to-two treatments were connected with improved survivals respect to no treatment [hazard ratio(HR) = 0.85 and 0.71, respectively]. The efficacy of LRT was also reported in the presence of larger tumors(HR = 0.78) and micro-macrovascular invasion(HR = 0.71). The results observed in the present study are partially in discordance with other analyses showing a detrimental effect of LRT. The main problem in the interpretation of these results is connected with the possible initial selection biases present in the studies. The most recent guidelines suggest to perform LRT before the transplant, but the level of evidence is typically low due to the absence of prospectively designed studies.

关键词： Allocation Recurrence Trans-arterial chemo-embolization Radiofrequency ablation Model for end-stage liver disease

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Remimazolam for sedation in gastrointestinal endoscopy:A comprehensive review

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World Journal of Gastrointestinal Endoscopy 2024年第7期16卷 385-395页

作者： Dushyant Singh Dahiya Ganesh Kumar Syeda Parsa Manesh Kumar Gangwani Hassam Ali Amir Humza Sohail Saqr Alsakarneh Umar Hayat Sheza Malik Yash R Shah Bhanu Siva Mohan Pinnam Sahib Singh Islam Mohamed Adishwar Rao Saurabh Chandan Mohammad Al-Haddad Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityMO 66160United States department of Internal Medicine Chandka Medical CollegeSindh 77280Pakistan department of Gastroenterology and Hepatology University of Arkansas For Medical SciencesLittle RockAR 72205United States Division of Gastroenterology Hepatology and NutritionEast Carolina University/Brody School of MedicineGreenvilleNC 27858United States department of surgery University of New Mexico School of MedicineAlbuquerqueNM 87106United States department of Internal Medicine University of Missouri-Kansas CityKansas CityMO 64108United States department of Internal Medicine Geisinger Wyoming Valley Medical CenterWilkes BarrePA 18711United States department of Internal Medicine Rochester General HospitalRochesterNY 14621United States department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States department of Internal Medicine Sinai hospitalBaltimoreMD 21215United States department of Hepatology University of MissouriColumbiaMO 65211United States department of Internal Medicine Guthrie Robert Packer HospitalSayrePA 18840United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Division of Gastroenterology and Hepatology Indiana University School of MedicineIndianapolisIN 46202United States

Worldwide,a majority of routine endoscopic procedures are performed under some form of sedation to maximize patient ***,benzodiazepines and opioids continue to be widely ***,in recent years,Remimazolam is gaining immense popularity for procedural sedation in gastrointestinal(GI)*** is an ultra-short-acting benzodiazepine sedative which was approved by the Food and Drug Administration in July 2020 for use in procedural *** has shown a favorable pharmacokinetic and pharmacodynamic profile in terms of its non-specific metabolism by tissue esterase,volume of distribution,total body clearance,and negligible drug-drug *** also has satisfactory efficacy and has achieved high rates of successful sedation in GI ***,studies have demonstrated that the efficacy of Remimazolam is non-inferior to Propofol,which is currently a gold standard for procedural sedation in most parts of the ***,the use of Propofol is associated with hemodynamic instability and respiratory *** contrast,Remimazolam has lower incidence of these adverse effects intra-procedurally and hence,may provide a safer alternative to Propofol in procedural *** this comprehensive narrative review,highlight the pharmacologic characteristics,efficacy,and safety of Remimazolam for procedural *** also discuss the potential of Remimazolam as a suitable alternative and how it can shape the future of procedural sedation in gastroenterology.

关键词： Remimazolam Endoscopy Sedation Outcomes Efficacy Safety Pharmacokinetics

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Prevention effect of medical self-crosslinking sodium hyaluronate gel on epidural scar adhesion after laminectomy

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Asian Pacific Journal of Tropical Medicine 2014年第6期7卷 501-504页

作者： Hua Liu Hai-Feng Li Jian-Yuan Wang Orthopaedic department of PLA 474 Hospital Spinal surgery department of of First Affiliated Hospital of Xinjiang University

Objective:To analyze the effect and medical sclf-crosslinking sodium hyaluronate gel on epidural scar adhesion after ***:A total of 24 New Zealand L5 laminectomy rabbits were randomly divided into four groups,group A as the control group without any treatment:group B covered by sodium hyaluronate gel;group C and group D covered by 0.5 and1.0 mL medical self-crosslinking sodium hyaluronate *** rabbits were scored at various time points after 2.4,6,8,12 weeks,then the formation of scar was ***:In Groups B,C,D loose scar tissue occurred after 2 weeks of the operation,scar tissues were significantly less than that in group A,with mild inflammatory *** 8 weeks,the scar tissues of group B were significantly more than that of groups C,*** two weeks,group B,C were back to the preoperative level;After 4 weeks,group D was back to the preoperative level;After four weeks,the CSEP of group A was increased significantly,which was significantly higher than that in groups B,C,*** motor function score of group A,group B and group C were the same as preoperative,but that in group D it was decreased significantly,and then it gradually *** 4 weeks it kept a stable *** motor function score of group A was decreased gradually after the operation,which kept a stable level after 4 weeks,the motor function score was significantly lower man that in groups B,C,***:Determination of somatosensory evoked potentials is sensitive indicator of spinal cord injury;Application of medical selfcrosslinking sodium hyaluronate gel is effective on epidural scar adhesion after laminectomy.

关键词： Animal Hyaluronic acid Laminectomy Induced potentials Somatosensory

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Exocrine pancreatic function during the early recovery phase of acute pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2009年第3期8卷 316-319页

作者： Raffaele Pezzilli Patrizia Simoni Riccardo Casadei Antonio M.Morselli-Labate department of Digestive Diseases and Internal Medicine department of surgery University of BolognaSant'Orsola-Malpighi Hospital

BACKGROUND:Exocrine pancreatic dysfunction has been reported in humans in the convalescent period after acute pancreatitis,but the data are scarce and *** study aimed to prospectively assess the exocrine pancreatic function in patients with acute pancreatitis at the time of their refeeding. METHODS:Fecal elastase-1 was determined on the day of refeeding in all consecutive acute pancreatitis patients with their first episode of the *** were 75 patients including 60(80.0%)patients with mild acute pancreatitis and 15(20.0%)patients with severe acute pancreatitis. Etiologically 61 patients(81.3%)had biliary disease,1(1.3%) had alcoholic disease and 3(4.0%)had hypertriglyceridemia. No causes of acute pancreatitis were found in the remaining 10 patients(13.3%).The mean(±SD)refeeding time after the attack of acute panereatitis was 11.2±10.2 days. RESULTS:Pathological values of FE-1 were found in 9 of the 75 patients(12.0%):7(9.3%)patients with mild pancreatitis and 2(2.7%)patients with severe pancreatitis(P=1.000). The frequency of the pathological values of fecal elastase-1 was significantly different from that of various etiologies of the disease(P=0.030).It was significantly lower in patients with biliary pancreatitis(9.8%;P=0.035)than in one patient with alcoholic pancreatitis(P=0.126),one patient with hypertriglyceridemia-induced pancreatitis(33.3%; P=0.708),and one patient with idiopathic pancreatitis (10.0%;P=0.227).Pathological fecal elastase-1 was not significantly related to sex,age or day of ***:Exocrine pancreatic function should be routinely assessed in patients with acute pancreatitis at the time of refeeding in order to supplement their diet with pancreatic extracts.

关键词： exocrine pancreatic insufficiency pancreatic elastase pancreatic pseudocyst pancreatitis,acute necrotizing pancreatitis,alcoholic

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Oleanolic acid and ursolic acid inhibit proliferation in transformed rat hepatic oval cells

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World Journal of Gastroenterology 2014年第5期20卷 1348-1356页

作者： Yu-Ying Han Xiao-Wei Xue Zheng-Ming Shi Peng-Yan Wang Xin-Rui Wu Xue-Jiang Wang department of Medical Genetics Capital Medical University department of Pathology and Physiology Capital Medical University department of surgery Beijing Jishuitan Hospital

AIM: To investigate H2O2-induced promotion proliferation and malignant transformation in WB-F344 cells and anti-tumor effects of ursolic acid (UA) and oleanolic acid (OA).

关键词： Oxidative stress Hepatocarcinogenesis Malignant transformation Oleanolic acid Ursolic acid

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