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Portal vein tumor thrombus is a bottleneck in the treatment of hepatocellular carcinoma

Cancer Biology & Medicine 2016年第4期13卷 452-458页

作者： Ju-Xian Sun Jie Shi Nan Li Wei-Xing Guo Meng-Chao Wu Wan-Yee Lau Shu-Qun Cheng department of Hepatic surgery vi Eastern Hepatobiliary Surgical Hospital Faculty of Medicine Chinese University of Hong Kong

The effect of portal vein tumor thrombus(PVTT) on the prognosis of patients with hepatocellular carcinoma has become clear over the past several decades. However, identifying the mechanisms and performing the diagnosis and treatment of PVTT remain challenging. Therefore, this study aimed to summarize the progress in these areas. A computerized literature search in Medline and EMBASE was performed with the following combinations of search terms: "hepatocellular carcinoma" AND "portal vein tumor thrombus." Although several signal transduction or molecular pathways related to PVTT have been identified, the exact mechanisms of PVTT are still largely unknown. Many biomarkers have been reported to detect microvascular invasion, but none have proved to be clinically useful because of their low accuracy rates. Sorafenib is the only recommended therapeutic strategy in Western countries. However, more treatment options are recommended in Eastern countries, including surgery, radiotherapy(RT), transhepatic arterial chemoembolization(TACE), transarterial radioembolization(TARE), and sorafenib. Therefore, we established a staging system based on the extent of portal vein invasion. Our staging system effectively predicts the long-term survival of PVTT patients. Currently, several clinical trials had shown that surgery is effective and safe in some PVTT patients. RT,TARE, and TACE can also be performed safely in patients with good liver function. However, only a few comparative clinical trials had compared the effectiveness of these treatments. Therefore, more randomized controlled trials examining the extent of PVTT should be conducted in the future.

关键词：门静脉肝癌治疗 MEDLINE 临床试验随机对照试验识别机制计算机检索

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A stable and reliable animal model for hepatocellular carcinoma with portal vein tumor thrombus

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Hepatobiliary & Pancreatic Diseases International 2022年第1期21卷 90-93页

作者： Zong-Tao Chai Zhen-Hua Chen Xiu-Ping Zhang Jin-Kai Feng Zong-Han Liu Shu-Qun Cheng department of Hepatic surgery vi Eastern Hepatobiliary Surgery HospitalSecond Military Medical University225 Changhai RoadShanghai 200433China Faculty of Hepato-Biliary-Pancreatic surgery the First Medical Center of Chinese People’s Liberation Army(PLA)General HospitalBeijing 100039China

To the Editor:Hepatocellular carcinoma(HCC)is one of the most common cancers worldwide[1,2].Portal vein tumor thrombus(PVTT)has been demonstrated to be a poor prognostic indicator for HCC[3-5].However,effective treatment for the condition is still limited.Un-derstanding the insight into the molecular mechanisms behind PVTT development may help to establish a new therapeutic strat-egy.

关键词： thrombus carcinoma hepatocellular

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Identification of portal vein tumor thrombus with an independent clonal origin in hepatocellular carcinoma via multi-omics data analysis

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Cancer Biology & Medicine 2019年第1期16卷 147-156页

作者： Shupeng Liu Zaixin Zhou Yin Jia Jie Xue Zhiyong Liu Kai Cheng Shuqun Cheng Shanrong Liu Clinical Research Center Changhai Hospital Second Military Medical University department of Laboratory Diagnostics Changhai Hospital Second Military Medical University department of Hepatic surgery vi Eastern Hepatobiliary Surgery Hospital Second Military Medical University

Objective: Multiple mechanisms underlying the development of portal vein tumor thrombus(PVTT) in hepatocellular carcinoma(HCC) have been reported recently. However, the origins of PVTT remain unknown. Increasing multi-omics data on PVTTs in HCCs have made it possible to investigate whether PVTTs originate from the corresponding primary tumors(Ts).Methods: The clonal relationship between PVTTs and their corresponding primary Ts was investigated using datasets deposited in public databases. One DNA copy number variations dataset and three gene expression datasets were downloaded for the analyses.Clonality analysis was performed to investigate the clonal relationship between PVTTs and Ts from an individual patient.Differential gene expression analysis was applied to investigate the gene expression profiles of PVTTs and Ts.Results: One out of 19 PVTTs had no clonal relationship with its corresponding T, whereas the others did. The PVTTs with independent clonal origin showed different gene expression and enrichment in biological processes from the primary Ts. Based on the unique gene expression profiles, a gene signature including 24 genes was used to identify pairs of PVTTs and primary Ts without any clonal relationship. Validation in three datasets showed that these types of pairs of PVTTs and Ts can be identified by the 24-gene signature.Conclusions: Our findings show a direct evidence for PVTT origin and consolidate the heterogeneity of PVTTs observed in clinic.The results suggest that PVTT investigation at a molecular level is clinically necessary for diagnosis and treatment.

关键词： Hepatocellular carcinoma portal vein tumor thrombus clonal origin copy number variation bioinformatics

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A novel chemotherapy strategy for advanced hepatocellular carcinoma: a multicenter retrospective study

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Chinese Medical Journal 2022年第19期135卷 2338-2343页

作者： Juxian Sun Chang Liu Jie Shi Nanya Wang Dafeng Jiang Feifei Mao Jingwen Gu Liping Zhou Li Shen Wan Yee Lau Shuqun Cheng department of Hepatic surgery vi Eastern Hepatobiliary Surgery HospitalThe Second Military Medical UniversityShanghai 200433China department of Integrative Oncology Eastern Hepatobiliary Surgery HospitalThe Second Military Medical UniversityShanghai 200433China department of Outpatient department Eastern Hepatobiliary Surgery HospitalThe Second Military Medical UniversityShanghai 200433China department of Oncology First Hospital of Jlin UniversityChangchunJlin 1300China department of Oncology Zhejiang Sian International Hospital JiaxingZhejang 314000China Tongji University Cancer Center Shanghai Tenth People's HospitaSchool of MedicineTongji UniversitShanghai 200040China Faculty of Medicine The Chinese University of Hong KongPrince of Wales HospitalShatinNew TerritoriesHong Kong SAR 999077China.

Background:Chemotherapy is a common treatment for advanced hepatocellular carcinoma,but the effect is not satisfactory.The study aimed to retrospectively evaluate the effects of adding all-trans-retinoic acid(ATRA)to infusional fluorouracil,leucovorin,and oxaliplatin(FOLFOX4)for advanced hepatocellular carcinoma(HCC).Methods:We extracted the data of patients with advanced HCC who underwent systemic chemotherapy using FOLFOX4 or ATRA plus FOLFOX4 at the Eastern Hepatobiliary surgery Hospital,First Hospital of Jilin University,and Zhejiang Sian International Hospital and retrospectively compared for overall survival.The Cox proportional hazards model was used to calculate the hazard ratios for overall survival and disease progression after controlling for age,sex,and disease stage.Results:From July 2013 to July 2018,111 patients with HCC were included in this study.The median survival duration was 14.8 months in the ATRA plus FOLFOX4 group and 8.2 months in the FOLFOX4 only group(Pvival and disease progression were 0.465(95%confidence interval:0.298–0.726;P=0.001)and 0.474(0.314–0.717;Pvival and time to disease progression in patients with advanced HCC.

关键词： Hepatocellular carcinoma ATRA plus FOLFOX4 Overall survival All-trans-retinoic acid Fluorouracil Leucovorin Oxaliplatin

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Targeting RAS phosphorylation in cancer therapy:Mechanisms and modulators

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Acta Pharmaceutica Sinica B 2021年第11期11卷 3433-3446页

作者： Yuran Qiu Yuanhao Wang Zongtao Chai Duan Ni Xinyi Li Jun Pu Jie Chen Jian Zhang Shaoyong Lu Chuan Lv Mingfei Ji department of Urology Changzheng HospitalNaval Military Medical UniversityShanghai 200003China department of Pathophysiology Key Laboratory of Cell Differentiation and Apoptosis of Chinese Ministry of EducationShanghai Jiao Tong UniversitySchool of MedicineShanghai 200025China department of Hepatic surgery vi Eastern Hepatobiliary Surgery HospitalSecond Military Medical UniversityShanghai 200438China department of Cardiology Renji HospitalShanghai Jiao Tong UniversitySchool of MedicineShanghai 200120China department of Plastic surgery Changhai HospitalNaval Military Medical UniversityShanghai 200438China

RAS,a member of the small GTPase family,functions as a binary switch by shifting between inactive GDP-loaded and active GTP-loaded state.RAS gain-of-function mutations are one of the leading causes in human oncogenesis,accounting for w19%of the global cancer burden.As a well-recognized target in malignancy,RAS has been intensively studied in the past decades.Despite the sustained efforts,many failures occurred in the earlier exploration and resulted in an‘undruggable’feature of RAS proteins.Phosphorylation at several residues has been recently determined as regulators for wild-type and mutated RAS proteins.Therefore,the development of RAS inhibitors directly targeting the RAS mutants or towards upstream regulatory kinases supplies a novel direction for tackling the anti-RAS difficulties.A better understanding of RAS phosphorylation can contribute to future therapeutic strategies.In this review,we comprehensively summarized the current advances in RAS phosphorylation and provided mechanistic insights into the signaling transduction of associated pathways.Importantly,the preclinical and clinical success in developing anti-RAS drugs targeting the upstream kinases and potential directions of harnessing allostery to target RAS phosphorylation sites were also discussed.

关键词： RAS Phosphorylation Undruggable Protein kinases Allostery

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Anterior cervical corpectomy decompression and fusion for cervical kyphosis in a girl with Ehlers-Danlos syndrome:A case report

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World Journal of Clinical Cases 2019年第4期7卷 532-537页

作者： Huang Fang Peng-Fei Liu Chang Ge Wen-Zhi Zhang Xi-Fu Shang Cai-Liang Shen Rui He department of Spinal surgery The First Affiliated Hospital of USTC department of Spinal surgery The First Affiliated Hospital of Anhui Medical University

BACKGROUND Spinal deformities in Ehlers-Danlos syndrome(EDS; type vi) are generally progressive and severe. Surgical treatment has been described for kyphoscoliosis in the thoracolumbar spine. However, there are few studies describing the consequences of an anterior approach in cervical kyphosis. An anterior approach may not be able to fully decompress the spinal canal and restore the normal curvature of the cervical spine. Therefore, the anterior approach for cervical kyphosis in young children is hard. We describe the first case in an EDS girl with cervical kyphosis who received satisfactory anterior cervical corpectomy decompression and fusion.CASE SUMMARY The chief complaints of a 16-year-old girl with EDS were double upper limb weakness for 7 years and double lower limb walking instability for 2 years.Moreover, the imaging results revealed that the degree of kyphosis from cervical vertebra 2 to 4 accompanying with spinal cord compression was 30°. An anterior cervical corpectomy involving cervical vertebra 3 and a titanium mesh implant were performed with internal fixation. The results at 3 mo after surgery demonstrated that the anterior fusion was solid, and the kyphosis of the cervical spine was corrected. Additionally, the power of all four extremities was significantly improved.CONCLUSION The incidence rate of cervical kyphosis in EDS is rare. The surgical treatment for these patients, especially an anterior approach, is challenging. Therefore, to develop safer and more effective strategies to treat cervical kyphosis in EDS,there is still much work to do.

关键词： Cervical kyphosis Ehlers-Danlos syndrome Anterior cervical corpectomy decompression and fusion Case report

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Surgical Treatment for Proximal Humerus Fractures Comparison between Plate Fixation and Kapandji’s Pinning

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Open Journal of Orthopedics 2022年第12期12卷 474-484页

作者： Issam Ait Hadj Sliman Amine Abdelaoui Elhoussain Zim Mohamed Haddou Amine Benhima Imad Abkari Youssef Najeb department of Orthopedic surgery and Trauma Hopital Ibn-Tofail CHU Mohammed VI Marrakesh Morocco

Introduction: Proximal humerus fractures are common, however, there is no consensus on a decision-making algorithm for the therapeutic management of these fractures, the aim of this study is to evaluate and compare functional results between two surgical techniques and to deduce the satisfactory results of the Kapandji’s pinning which, compared to the screw plate, should keep its place in the therapeutic arsenal. Patients and Methods: It’s a retrospective study, including two groups: The first of 18 patients treated with palm-tree pinning using kapandji’s technique, the second of 16 patients treated with anatomical screw plate at the orthopedic trauma service of the Mohamed vi university hospital between July 2013 and July 2018. We compared the results of the two techniques by studying three parameters which are the healing time, the anatomical reduction, and the functional outcomes. The average age was 46 years, and the sex ratio (M/F) was 2.3. Results: The statistical analysis of functional and radiological results showed no significant difference between the two techniques, indeed the average healing time was 56.3 days in the group treated by screw plate and 55.2 days in the group treated by Kapandji’s pinning (p = 0.46), Constant’s score was 73.18 and 79.05 respectively (p = 0.27) and the average cephalodiaphyseal angle was 49.03° and 52.07°, respectively (p = 0.35). Discussion: This study has clearly shown, as reported in the literature, that there is no conclusive evidence to suggest superiority of os-teosynthesis by anatomical plate versus kapandji’s pinning. However, the simple achievement of pinning according to kapandji’s technique, the preservation of soft tissues and the low cost make us prefer this technique. Furthermore, despite the progress noted in the development of osteosynthesis means of the proximal humerus, percutaneous pinning should always keep its place.

关键词： Fracture of Proximal Humerus Osteosynthesis Humeral Anatomical Plate Kapindji’s Pinning

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Head and Neck Primary Mucosal Melanoma: Report of 17 Cases

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International Journal of Otolaryngology and Head & Neck surgery 2015年第2期4卷 86-93页

作者： Btissaam Belhoucha Zahra Essaadi Youssef Rochdi Hassan Nouri Lahcen Aderdour Mona Khouchani Abdelaziz Raji department of ENT CHU Med VI Marrakech Morocco department of Oncology and Radiotherapy CHU Med VI Marrakech Morocco

Introduction: Mucosal melanoma (MM) is a rare disease, accounting for 1.7% - 3% of all melanomas and 8% of all head and neck melanomas. It’s a rare cancer with a very poor prognosis. Materials and Methods: We retrospectively reviewed the records of 17 patients with primary mucosal melanomas of the head and neck who were diagnosed between January 2007 and December 2012. Results: Our patient population included 9 women and 8 men. The age ranged from 61 to 75 years. The primary site of disease was in the sinonasal cavity for 12 patients (70%) and oral cavity for 5 patients. Treatment modalities for mucosal melanoma include surgical resection with or without neck dissection, immunochemotherapy, and radiation therapy (RT). 15 patients had attempted curative resections. Two patients received palliative radiation therapy as the primary treatment and chemotherapy as the adjuvant treatment. Discussion: Primary mucosal melanoma is a rare cancer and represents only 1.7% - 3% of all primary melanomas [1]-[3]. Mucosal melanoma must always be considered for multimodality therapy: surgical excision, medical oncology, and radiation therapy. Despite its radioresistant nature of tumor, the role of radiation therapy following surgical intervention has typically been advocated.

关键词： Malignant Melanoma Oral Mucosa Sinonasal Cavity Radiation Therapy Prognosis

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Volvulus of Colon Sigmoide in the General surgery department of Chu Gabriel Toure

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Surgical Science 2022年第1期13卷 46-52页

作者： Maïga Amadou Diakité Ibrahima Bah Amadou Diallo Aly Boubacar Traoré Bathio Moussa Diassana Sidibé Boubacar Yoro Koné Tani Doumbia Arouna Adama Traoré Amadou Saye Zakari Diallo Mamadou Konaté Moussa Saadé Oumou Hélène Kanté Lassana Konaté Madiassa Dembélé Souleymane Samaké Moussa Dembélé Bakary Tientigui Traoré Alhassane Togo Adégné General surgery department University Hospital Bamako Mali General surgery department Sikasso Hospital Sikasso Mali Reference Center of Commune vi Bamako Mali

Introduction: Sigmoid colon volvulus is a medico-surgical emergency which represents a common cause of colonic occlusion, it is characterized by strangulation of the sigmoid loop around its meso colic axis producing low mechanical occlusion [1]. Apart from this form conventionally described, the volvulus of the sigmoid colon can occur along an organoaxial axis. This form has been highlighted in the literature thanks to the diagnostic contribution of multi-detector scanners [2]. Objective: To determine the hospital frequency of sigmoid colon volvulus;to write the clinical and para-clinical aspects of sigmoid colon volvulus;write down the different treatments used for the management of sigmoid colon volvulus.

关键词： Sigmoid Volvulus General surgery department

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Diagnosis and Therapeutic Aspects of the Ileo-Sigmoidian Node in the General surgery department of Gabriel Toure Chu

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Surgical Science 2022年第1期13卷 23-27页

Introduction: Emergency medico-surgical ileosigmoid node is a rare cause of intestinal obstruction. Diagnosis and treatment must be prompt. Objective: To determine the frequency of NIS, to describe the diagnostic aspects, therapeutic aspects and to analyze the postoperative effects. Methodology: Retrospective and prospective study from January 2006 to December 2020 including all patients operated on for ileosigmoid node confirmed by the intraoperative diagnosis at the CHU Gabriel Touré. Results: From January 2006 to December 2020 (15 years), 30 cases of ileo-sigmoid node were recorded in the service. During this period NIS accounted for 0.19% of surgeries. Abdominal pain was present in (100%) of cases, vomiting was present in 80% and cessation of materials and gas (57%). All of our patients underwent ASP and CT (1 case). All of our patients were operated on, and exploration revealed intestinal necrosis in 97%. The surgical procedures performed were colostomy according to HARTMANN (63%), anastomosis resection (16%), devolvulation (10%). Restoration of continuity was achieved in (73%). The postoperative consequences were straightforward in (80%). Morbidity was 17% including infection of the lining. Mortality was 3% (1 case). Conclusion: NI

关键词： Ileosigmoid Node Digestive surgery Bamako Mali

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