Objective To introduce the methods and the advancements of early diagnosis in primary carcinoma of gallbladder (PCG), and improve the early diagnostic rate of PCG. Methods Recent relevant literatures were reviewed. Results It was difficult in early diagnosis of PCG and with a poor prognosis. Comprehending case history and careful examination and being assisted by multiple imaging methods and molecular biology technology could markedly improve the early diagnostic rate. Conclusion Comprehending the progress will contribute a lot of improving the early diagnostic rate and selecting reasonable clinical methods to be used in early diagnosis of PCG.
ObjectiveTo summarize the surgical treatment and explore factors which influencing prognosis of hilar cholangiocarcinoma. MethodsClinical data of 189 cases of hilar cholangiocarcinoma who treated in our hospital from Jan. 2000 to Dec. 2010 and clinicopathological factors that might influence survival were analyzed retrospectively. A multivariate factor analysis was performed through Cox proportional hazard model. ResultsOf 189 cases, 62 cases received radical resection, 54 cases received palliative surgery, and 73 cases received non-resection surgery. Operative procedure (RR=0.165), differentiated degree (RR=2.692), lymph node metastasis (RR=3.014), neural infiltration (RR=2.857), and vascular infiltration (RR=2.365) were found to be the statistically significant factors that influenced survival by multivariate factor analysis through the Cox proportional hazard model. ConclusionsRadical resection is the best treatment for hilar cholangiocarcinoma. Skeletonized hepatoduodenal ligament, complete excision of infiltrated nerve and blood vessel are important influence factors to improve the prognosis of hilar cholangiocarcinoma.
目的 评价3DMax补片在腹腔镜下全腹膜外修补术(totally extraperitoneal,TEP)中修补腹股沟疝的价值。方法 回顾性分析我院2009年2～6月期间腹腔镜下应用3DMax补片对18例腹股沟疝患者行TEP的临床资料，分析其手术时间、住院时间、复发和并发症发生情况。结果 18 例患者中Ⅰ型疝3例，Ⅱ型疝4例，Ⅲ型疝9例，Ⅳ型疝2例； 斜疝11例，直疝6例，股疝1例。成功完成腹腔镜下TEP 17例。1例因疝内容物为末端回肠，与疝囊粘连并局部狭窄梗阻，中转开放手术切除部分回肠。手术时间40～95 min，平均65.4 min。术后均未使用镇痛剂，术后住院时间2～7 d，平均住院5.5 d。术后发生阴囊血清肿1例，经穿刺排液后愈合良好。随访1～6个月，无复发病例。结论 腹腔镜下TEP具有创伤小、恢复快、复发率低等优点，采用预先成型的3DMax 补片使手术操作更加简便。
Objective To study the effects of L-arginine （L-Arg） on cell proliferation, inducible nitric oxide synthase (iNOS) expression and cell cycle in human colon carcinoma cell line LS174 through nitric oxide (NO) pathway. Methods LS174 cells were cultured in medium with L-Arg at different concentrations for different times. MTT method was employed to evaluate the level of the cell proliferation. The production of NO in culture supernatants of LS174 cell was detected with enzyme reduction of nitrate. The distribution of the cell cycle was detected with the flow cytometry (FCM). The expression level of iNOS in the cells was determined by Western blot and SP immunocytochemical staining method. Results The growth of LS174 was promoted by the L-Arg at low concentration (0.125 mmol/L) and inhibited at high concentrations (0.5， 2， 8 and 32 mmol/L). The level of NO was increased with the increasing concentration of L-Arg in culture medium. To compare with the control group, the ratio of cells at S phase was increased after 48 hours’ treatments with high concentrations (0.5, 2, 8 and 32 mmol/L) of L-Arg (P＜0.05, P＜0.01); while there was no obvious difference after treatments with low concentration (0.125 mmol/L) of L-Arg (Pgt;0.05). With the increase of the concentration of L-Arg, the expression of iNOS was increased as compared with control group. The higher the concentration of L-Arg was, the better the effect. Conclusion L-Arg can induce the expression of iNOS resulting in increase the production of nitric oxide (NO). Low concentration of L-Arg can promote the growth of LS174 cells, while high concentration ones can inhibit growth and proliferation. The high concentration of L-Arg could induce S phase arrestion in the cell cycle.
Tostudytheexpressionofproliferatingcellnuclearantigen(PCNA)inhumangastricneoplasmanditsclinicalsignificance.TheexpressionofPCNAwassemiquantitativelyanalysedimmunohistochemically(ABC)in10gastricadenomatouspolypand94gastriccarcinomas.Results:①PCNAlabelingindex(LI)showedasignificantdifferentiationindifferentpathologicstate(Plt;0.01),②PCNALIingastriccarcinomawasindepednetofsexandage(Pgt;0.05),butcorrelatedwiththegrowingmannerofthetumor,tumordifferentiation,serosalinfiltration,nodalmetastasisandclinicalstages(Plt;0.05),③ThecorrelationwasfoundbetweenPCNALIandprognosisofgastriccarcinoma(Plt;0.05).AmoderategradeofPCNAexpressiongenerallyhadabetterprognosis.Conclusions:TheseresultssuggestthatPCNALIisafairlygoodindextoindicatebiologicbehaviorandprognosisingastriccarcinoma.