中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

2016 No. 5

Display Method:
Editorial
Value of artery resection in pancreatic cancer surgery
Jiang KuiRong, Hu Hao, Miao Yi
2016, 32(5): 826-829. DOI: 10.3969/j.issn.1001-5256.2016.05.001
Abstract:

Locally advanced pancreatic cancer often invades the surrounding blood vessels. Currently,pancreatectomy combined with venous resection for the treatment of patients with venous involvement is accepted worldwide,but pancreatectomy combined with arterial resection for arterial involvement is still controversial. With reference to the latest research advances at home and abroad and the experience in our center,this article investigates the value of arterial resection in pancreatic cancer surgery,in order to provide a reference for clinical studies.

Therapeutic guidelines
Guideline for diagnosis and treatment of herb-induced liver injury
Branch of Hepatobiliary Diseases, China Association of Chinese Medicine, Branch of Chinese Patent Medicine, China Association of Chinese Medicine
2016, 32(5): 835-843. DOI: 10.3969/j.issn.1001-5256.2016.05.003
Abstract(3672) PDF (2360KB)(1082)
Abstract:
Expert consensus on clinical application of glycyrrhizin preparation in the treatment of liver diseases
Expert Committee on Clinical Application of Glycyrrhizin Preparation in the Treatment of Liver Diseases
2016, 32(5): 844-852. DOI: 10.3969/j.issn.1001-5256.2016.05.004
Abstract(4443) PDF (1921KB)(1219)
Abstract:
The American College of Preventive Medicine position statement on hepatitis C virus infection
Rao HuiYing, Wei Lai
2016, 32(5): 853-856. DOI: 10.3969/j.issn.1001-5256.2016.05.005
Abstract:
An excerpt of evidence-based clinical practice guidelines for chronic pancreatitis by Japanese Society of Gastroenterology in 2015 
Li XiaoQing
2016, 32(5): 857-859. DOI: 10.3969/j.issn.1001-5256.2016.05.006
Abstract:
Discussions by experts
Clinical features of pancreatic cystic neoplasms and its therapeutic strategy
Zhang JiaLi, Ge ChunLin
2016, 32(5): 860-863. DOI: 10.3969/j.issn.1001-5256.2016.05.007
Abstract:
The detection rate of pancreatic cystic neoplasms obviously increases with the development of imaging technology. However,it is still difficult to make the differential diagnosis between different types of pancreatic cystic neoplasms. For pancreatic cystic neoplasms,the physical condition of the patient,tumor size,location,patient preference,and other potential factors should be considered to develop an individualized treatment. The incidence rate of complications is high,although the operative mortality of pancreatic cystic neoplasms is very low. Therefore,it is necessary to strictly make the treatment decision for pancreatic cystic neoplasms.
Early diagnosis of pancreatic cancer
Liu Xu, Guo XiaoZhong
2016, 32(5): 864-866. DOI: 10.3969/j.issn.1001-5256.2016.05.008
Abstract:
Pancreatic cancer has a high degree of malignancy and a poor prognosis,and at present,early diagnosis of pancreatic cancer is very difficult. This article reviews the changes in molecular biological characteristics in the development,progression,and metastasis of pancreatic cancer and related mechanisms and determines the potential targets for clinical diagnosis of pancreatic cancer. This article also summarizes the clinical manifestations of pancreatic cancer,high- risk factors,tumor markers,and the role of combined determination and new equipment in early diagnosis,and points out that the application of serological and radiological examinations and identification of new tumor markers are important methods to improve the early diagnosis of pancreatic cancer in clinical practice.
New thoughts and techniques in pancreatic anastomosis
Feng YeChen, Wang Min, Qin RenYi
2016, 32(5): 867-869. DOI: 10.3969/j.issn.1001-5256.2016.05.009
Abstract:
The surgical procedures of pancreaticoduodenectomy are always controversial,and digestive tract reconstruction,especially the method of pancreatic anastomosis,has been one of the difficulties. This article introduces the methods of digestive tract reconstruction in pancreaticoduodenectomy at home and abroad and points out that the pancreas should be classified according to the size of pancreatic duct and the texture of the pancreas. The article puts forward the new“individualized”method of digestive tract reconstruction and instructs surgeons to select the appropriate surgical procedure to reduce the incidence of postoperative complications such as pancreatic fistula.
Chinical experience of laparoscopic spleen-preserving distal pancreatectomy
Wang GuangYi, Jiang Chao
2016, 32(5): 870-872. DOI: 10.3969/j.issn.1001-5256.2016.05.010
Abstract:

Due to the limitations of laparoscopic surgery,the lack of special instrument,and the particular location,structure,and function of the pancreas,laparoscopic pancreatic surgery develops slowly and is used only for diagnosis. With the innovation of laparoscopic instruments,the increases in operative experience,and the improvement in laparoscopic technology,laparoscopic distal pancreatectomy is safe and effective for the appropriate cases. In order to avoid the splenectomy- associated complications,laparoscopic spleen- preserving distal pancreatectomy is preferable. There are mainly two methods to preserve the spleen: Kimura' s method and Warshaw' s method. The Kimura' s method is a difficult technology and has a high risk,but it can preserve all functions of the spleen and has few complications. The Warshaw's method has a narrow indication,a low risk of bleeding,and a short operation time,but it has a high incidence of complications and can hardly preserve all functions of the spleen. Therefore,the Kimura' s method is the first choice to preserve the spleen and the Warshaw' s method is a replacement technology.

Original articles_Pancreatic diseases
Efficacy of high-dose hypofractionated radiotherapy in elderly patients with stage Ⅳ pancreatic cancer
Ren Gang, Wang YingJie, Di YuPeng, Chang DongShu, Kang XiaoLi, Zhu FuHai, Wu WeiZhang, Liu Xian, Xia TingYi
2016, 32(5): 873-875. DOI: 10.3969/j.issn.1001-5256.2016.05.011
Abstract:

Objective To investigate the efficacy and toxic and adverse effects of high- dose hypofractionated radiotherapy in elderly patients with stage Ⅳ pancreatic cancer. Methods The clinical data of the patients with pancreatic cancer and distant metastasis who were admitted to our hospital from September 2011 to May 2015 were collected,and all the patients underwent high- dose hypofractionated helical tomotherapy. The data on efficacy and toxic and adverse effects were obtained through follow- up,and the evaluation of adverse effects was performed according to National Cancer Institute- Common Terminology Criteria for Adverse Events version 4. 02. The Kaplan- Meier method was used for survival analysis. Results A total of 33 patients older than 65 years received the high- dose hypofractionated radiotherapy.Of all the patients,30 received follow- up visits,and the follow- up rate was 91. 0%. The median survival time was 9 months,the 1- year overall survival rate was 24. 0%,and the rate of pain relief was 80. 0%( 20 /25). The treatment outcome of pancreatic lesions could be evaluated in 17 patients,among whom 4( 23. 5%) achieved partial remission,12( 70. 6%) achieved stable disease,and 1( 5. 9%) experienced progression. As for toxic and adverse effects,the incidence rate of grade 3 hematologic toxicity was 6. 7%( 2 /30),and no patients experienced grade > 2 upper gastrointestinal reactions. Conclusion In elderly patients with stage IV pancreatic cancer,high- dose hypofractionated radiotherapy has tolerable toxic and adverse effects and can relieve cancer pain and prolong survival time.

Expression and significance of Axin2 in pancreatic cancer cells
Zhang Tao, Chen GuoDong, He GengSheng, He Jun
2016, 32(5): 876-879. DOI: 10.3969/j.issn.1001-5256.2016.05.012
Abstract:

Objective To investigate the expression of Axin2 in pancreatic cancer cells,and to observe the influence of Axin2 on the proliferation,invasion,and migration of human pancreatic cancer cells( PANC- 1). Methods Quantitative real- time PCR was used to measure the expression of Axin2 in pancreatic cancer cell lines with different invasive abilities( PANC- 1,Mia Pa Ca- 2,and Bx PC- 3) and immortalized normal pancreatic cells( H6C7). PANC- 1 cells with low expression were transfected with over- expressed Axin2 plasmid by transient transfection. MTT assay,Transwell assay,and scratch assay were used to determine the proliferation,invasion,and migration of cells transfected with over- expressed Axin2. One- way analysis of variance was used for comparison between multiple groups,and SNK- q test was used for comparison between any two groups. Results The relative expression levels of Axin2 in PANC- 1,Bx PC- 3,Mia Pa Ca- 2,and H6C7 cells were 0. 13 ± 0. 01,0. 42 ± 0. 05,0. 24 ± 0. 011,and 1. 00 ± 0. 00,respectively,and PANC- 1 cells had the lowest expression level of Axin2,with significant differences compared with the other cells( all P < 0. 05). When PANC- 1 cells were transfected with over- expressed Axin2 plasmid,the cells in the over- expression group had a significant increase in the expression level of Axin2 compared with those in the blank group and the negative control group( both P < 0. 05). Compared with those in the non- transfection group and the blank group,PANC- 1 cells in the over- expression group showed significant reductions in the proliferation,invasion,and migration abilities. Conclusion The expression of Axin2 is down- regulated in pancreatic cancer cell lines and decreases with the increasing invasion ability,suggesting the role of tumor suppressor gene. High expression of Axin2 can reduce the proliferation,invasion,and migration abilities of PANC- 1 cells.

Specific antitumor immune response induced by infusion of Capan-2 pancreatic cancer cells and dendritic cells: an in vitro study
Chen Jiang, Xu WenDa, Li HongYu, Zhao JiaJun, Guo XiaoZhong
2016, 32(5): 880-884. DOI: 10.3969/j.issn.1001-5256.2016.05.013
Abstract:

Objective To investigate the specific antitumor immune response induced by the infusion of Capan- 2 pancreatic cancer cells and dendritic cells( DC). Methods DC were isolated from the peripheral blood mononuclear cells( PBMC) derived from 6 patients with pancreatic cancer and cultured. The DC obtained were divided into three groups. In group 1,PEG- DMSO was used for induction,and DC and Capan- 2 cells were fused to bear tumor antigens. In group 2,DC were cultured with Capan- 2 cells. In group 3,DC were cultured alone. Flow cytometry was used to detect PE- MUC4 / FITC- CD86 double- labeled cells and assess the fusion rate,and MTT assay was used to determine the changes in viability of DCs in each group. IFNγ enzyme- linked immunosorbent assay was used to detect the activation reactions of cytotoxic T lymphocytes( CTLs) induced by DCs. The 51 Cr standard cytotoxicity test was used to determine the killing effect of antigen- specific CTLs induced by DCs on in vitro pancreatic cancer cells. An analysis of variance was used for comparison between multiple groups. The LSD- t test was used for comparision between any two groups. Results The DC- Capan- 2 fused cells expressed DC phenotype( CD86) and MUC4 molecules and had a significantly higher double- positive rate for CD86 and MUC4 than the co- cultured group( 38. 30% ±7. 30% vs 7. 21% ± 1. 06%). In the fusion group,the viability of DCs decreased in a time- dependent manner and reached62. 81% at 96 hours after transfection,while in the co- cultured group,the viability of DCs was maintained above 80%. The viability of DC showed a significant difference between these two groups( P < 0. 05). The release of IFNγ showed a significant difference between CTLs induced by DC- Capan- 2 fused cells and those induced by DCs in the co- cultured group( 85. 34 ± 2. 97 U / ml vs 19. 07 ± 4. 25 U / ml,P<0. 05). The specific CTLs induced by DC- Capan- 2 fused cells could effectively identify identified and killed the HLA- A2~+/ MUC4~+Capan- 2 cells and the HLA- A2~+/ MUC4-PANC- 1 cells,but did not effectively identify and kill the HLA- A2-/ MUC4-Mia Pa Ca- 2 cells and the HLA- A2-/ MUC4~+As PC- 1 cells. Conclusion The fusion of pancreatic cells and DCs can induce a pronounced CTL anti- tumor immune response in CTLs,which is limited by which was restricted by MHC class I antigen presentedpresentation.

Original articles_Viral hepatitis
Risk factors for recurrence after drug withdrawal in HBeAg-positive chronic hepatitis B patients completing pharmacotherapy with nucleos(t) ide analogues
Hu BoBin, Jiang JianNing, Fu JiaXin, Wang BaoJian, Wu XiaoLi, Liang Peng, Mo YanYan, Fu YanPing, Du Man, Liu Yu
2016, 32(5): 885-889. DOI: 10.3969/j.issn.1001-5256.2016.05.014
Abstract:

Objective To investigate the risk factors for recurrence after drug withdrawal in HBeAg- positive chronic hepatitis B( CHB)patients completing the treatment with nucleos( t) ide analogues( NAs). Methods A total of 60 HBeAg- positive CHB patients who visited and were treated in The First Hospital Affiliated to Guangxi Medical University from May 2004 to December 2014 were enrolled. The drugs were withdrawn after the patients reached the criteria for drug withdrawal in related guidelines. The univariate and multivariate Cox proportional hazards regression model analyses were performed for 15 factors which might influence recurrence,i. e.,sex,age,a family history of HBV infection,baseline HBV DNA load,baseline total bilirubin( TBil) level,baseline alanine aminotransferase( ALT) level,baseline aspartate aminotransferase( AST) level,duration of virologic response,time to disappearance of HBeAg,time from the start of medication to the development of HBeAg seroconversion,duration of consolidation therapy after HBeAg seroconversion,total course of the treatment,prolonged course of the treatment,HBs Ag level at drug withdrawal,and drug type. The Kaplan- Meier method was used for calculating the cumulative recurrence rate. Results The mean course of the treatment was 37. 36 ± 12. 67 months,the prolonged course of the treatment was 7. 0( 2. 0 ~ 13. 0) months,and 56. 7% of all patients experienced recurrence. Sex,age,baseline HBV DNA load,baseline TBil level,baseline ALT level,baseline AST level,duration of virologic response,duration of consolidation therapy,total course of the treatment,prolonged course of the treatment,and drug type were not significantly associated with recurrence after drug withdrawal in patients who met the criteria for drug withdrawal( all P > 0. 05). A family history of HBV infection( RR = 1. 583,P = 0. 047),time to HBeAg seroconversion( RR = 1. 205,P = 0. 015),and HBs Ag level at drug withdrawal were independent risk factors for recurrence after drug withdrawal. The patients with time to HBeAg seroconversion > 12 months had a significantly higher recurrence rate than those with time to HBeAg seroconversion < 12 months( 80. 0% vs 48. 9%,P < 0. 001). Conclusion A family history of HBV infection,delayed HBeAg seroconversion,and high HBs Ag level at drug withdrawal are major risk factors for recurrence after drug withdrawal in HBeAg- positive CHB patients who have met the criteria for drug withdrawal in the treatment with NAs. If HBeAg- positive CHB patients can acquire immune control,recurrence after withdrawal of NAs will be reduced.

Correlation between serum interleukin-1 receptor antagonist and disease severity in patients with HBV-related liver failure
Lai JingLan, Liu YuMing, Lin Chun, Sun Fang, Zhou Rui, Lin Yong, Lin YuanBao
2016, 32(5): 890-893. DOI: 10.3969/j.issn.1001-5256.2016.05.015
Abstract:

Objective To investigate the correlation between serum interleukin- 1 receptor antagonist( IL- 1Ra) level and disease severity in patients with acute- on- chronic hepatitis B liver failure( HBV- ACLF). Methods A total of 31 patients with HBV- ACLF who visited Fuzhou Infectious Disease Hospital from October 2013 to January 2015 were enrolled as study subjects. Another 28 patients with acute hepatitis B( AHB) and 30 patients with chronic hepatitis B( CHB) were enrolled as controls. The Q- Plex was used to measure the peripheral blood concentrations of cytokines including IL- 1Ra,interleukin- 1β( IL- 1β),interleukin- 6( IL- 6),interleukin- 4,interleukin- 10,tumor necrosis factorα( TNFα),and interferonγ. Liver function and coagulation function were examined for each group,and the correlations of concentrations of serum cytokines including IL- 1Ra with Model for End- Stage Liver Disease( MELD) score and HBV DNA were analyzed. The Kruskal- Wallis H test was used for comparison of continuous data between multiple groups,and the Mann- Whitney U test was used for comparison between any two groups; the chi- square test was used for comparison of categorical data between groups. The Spearman rank correlation was used for correlation analysis. Results The IL- 1Ra level and IL- 1Ra / IL- 1β ratio showed significant differences between the three groups( all P < 0. 05),and the HBV- ACLF group had a significantly higher IL- 1Ra level than the CHB group and the AHB group [186. 46( 162. 68-512. 90) pg/ml vs 70. 47( 47. 07-92. 47) pg/ml,Z =6. 300,P <0. 001; 186. 46( 162. 68-512. 90) pg/ml vs 143. 69( 117. 75-208. 54) pg / ml,Z = 2. 505,P = 0. 012]. The HBV- ACLF group had a significantly lower IL- 1Ra / IL- 1β ratio than the AHB group[2. 92( 2. 20- 4. 74) vs 4. 54( 2. 75- 6. 05),Z = 1. 966,P = 0. 048],but a significantly higher IL- 1Ra/IL- 1β ratio than the CHB group [2. 92( 2. 20- 4. 74) vs 2. 49( 1. 50- 2. 50),Z = 2. 682,P < 0. 001]. The HBV- ACLF group had significantly higher IL- 1β,IL- 6,and TNFα levels than the other two groups( all P < 0. 01). Serum IL- 1Ra level was negatively correlated with total bilirubin( TBil) and MELD score( r =- 0. 506 and- 0. 818,both P < 0. 01) but was positively correlated with prothrombin activity( PTA)( r =0. 475,P = 0. 007). Conclusion IL- 1Ra is negatively correlated with TBil and MELD score and positively correlated with PTA,which are the indicators for the severity of HBV- ACLF. IL- 1Ra may play an important role in the pathogenesis of HBV- ACLF.

Effects of hepatitis B virus on the expression of Toll-like receptor 9,interferon regulatory factor-7,and interferon-α in plasmacytoid dendritic cells in the umbilical cord blood of healthy parturients
Peng JianPing, Sun KeWei, Yin SiHan, Wu YuNan
2016, 32(5): 894-898. DOI: 10.3969/j.issn.1001-5256.2016.05.016
Abstract:

Objective To investigate the effects of hepatitis B virus( HBV) on the expression of Toll- like receptor 9( TLR9),interferon regulatory factor- 7( IRF- 7),and interferonα( IFNα) in plasmacytoid dendritic cells( pDCs) cultured in vitro in the umbilical cord blood of healthy parturients. Methods Hep G 2. 2. 15 cells were cultured in vitro,and the culture supernatants of Hep G 2. 2. 15 in each well were collected. HBV particles were obtained by ultracentrifugation,and HBV DNA concentration was measured by fluorescent- probe PCR. pDCs( on day 7 of culture) and HBV( 1 × 105 copies / ml,1 × 106 copies / ml,1 × 107 copies / ml,and blank control) were co- cultured for 24 hours,and then cultured continuously for another 24 hours with Cp G ODN 2216 at a final concentration of 2 μg / ml. The mRNA expression of TLR9 and IRF- 7 in pDCs was measured by real- time PCR,the protein expression of TLR9 and IRF- 7 in pDCs was measured by Western blot,and the level of IFNα was measured by ELISA. The analysis of variance was used for comparison of continuous data between multiple groups,and the SNK- q test was used for comparison between any two groups; the common logarithms of HBV DNA copies were obtained,and the linear regression analysis was performed to investigate the correlation between related indicators and the common logarithms of HBV DNA copies. Results Compared with the blank control group and the HBV 1 × 105 copies / ml group,the HBV 1 × 106 copies / ml and HBV 1 × 107 copies / ml groups had significantly lower mRNA expression of TLR9 and IRF- 7,significantly lower protein expression of TLR9 and IRF- 7,and significantly lower expression of IFNα( all P < 0. 05). The inhibitory effects of HBV on the mRNA expression of TLR9 and IRF- 7,the protein expression of TLR9 and IRF- 7,and the expression of IFNα in the culture supernatants of pDCs rose with the increasing HBV DNA load( r =- 0. 729,- 0. 761,- 0. 657,- 0. 703,and- 0. 803,all P < 0. 05). Conclusion After in vitro treatment with HBV,the mRNA and protein expression of TLR9 and IRF- 7 in normal pDCs is reduced,leading to reduced secretion of downstream IFNα. HBV can inhibit the function of normal pDCs and cause persistent HBV infection.

Original articles_Liver neoplasms
Therapeutic effect of transcatheter arterial chemoembolization combined with thalidomide or sorafenib in treatment of unresectable primary liver cancer: a comparative analysis
Zheng Kang, He MengGuo, Wang ZhiXiang
2016, 32(5): 899-903. DOI: 10.3969/j.issn.1001-5256.2016.05.017
Abstract:

Objective To investigate the therapeutic effect and adverse effects of transcatheter arterial chemoembolization( TACE) combined with thalidomide or sorafenib in the treatment of unresectable primary liver cancer. Methods A total of 102 patients who underwent TACE combined with thalidomide or sorafenib in 215 Hospital of Nuclear Industry of Shaanxi Province from January 2012 to August 2013 were enrolled and divided into TACE- thalidomide group( 49 patients) and TACE- sorafenib group( 53 patients). The short- term outcome,long- term outcome,changes in related indices,and adverse events were evaluated. The independent- samples t- test was applied for comparison of continuous data between groups,and the paired t- test was applied for comparison of continuous data within one group; the chi- square test was applied for comparison of categorical data between groups; the survival curve was used for survival analysis,and the log-rank test was applied for survival comparison. Results The indices of short- term outcome,objective response rate and disease control rate,showed no significant differences between the two groups. The 2- year survival showed a significant difference between the two groups( χ2=4. 692,P = 0. 03). The log- rank test showed that overall survival time and median progression- free survival time showed significant differences between the two groups( χ2= 8. 267 and 6. 896,P = 0. 004 and 0. 009). After treatment,alpha- fetoprotein( AFP) and gamma- glutamyl transpeptidase( GGT) showed significant differences between the two groups( t = 2. 035 and 2. 843,P = 0. 038 and 0. 025). The incidence rates of nausea / vomiting,dizziness / headache,rash / desquamation,and increased blood pressure showed significant differences between the two groups( all P < 0. 05). Conclusion TACE combined with thalidomide has the same short- term therapeutic effect as TACE combined with sorafenib and can improve the patient's long- term outcome and significantly reduce the levels of AFP and GGT,but it has high incidence of nausea / vomiting and dizziness / headache.

Association between single nucleotide polymorphism of microRNA-146a and recurrence after liver cancer surgery
Zhang Hua, He DeHua, Li GuiZhong
2016, 32(5): 904-907. DOI: 10.3969/j.issn.1001-5256.2016.05.018
Abstract:

Objective To investigate the association between the single nucleotide polymorphism( SNP) of miRNA- 146 a rs2910164 and recurrence after liver cancer surgery. Methods A total of 89 patients with primary liver cancer who underwent radical resection for liver cancer in Maojian Hospital of Dongfeng Medical Group were enrolled,and according to the presence or absence of postoperative recurrence,they were divided into recurrence group and non- recurrence group. The Taq Man probe method was used to determine the genotypes( G / C)of miRNA- 146 a rs2910164. The frequency of each genotype was compared between the two groups to investigate the association between the SNP of MicroRNA- 146 a and recurrence after liver cancer surgery. The independent- samples t test was used for comparison of continuous data between the two groups,the chi- square test was used for comparison of categorical data between the two groups,and multivariate logistic regression analysis was used to determine the factors associated with the recurrence of liver cancer. Results The three genotypes of miRNA- 146 a G / C in non- recurrence group conformed to the Hardy- Weinberg equilibrium law( P > 0. 05). After the surgery for liver cancer,the frequency of miRNA- 146 a G / C genotype showed a significant difference between the recurrence group and the non- recurrence group( χ2= 9. 115,P = 0. 010),and compared with the non- recurrence group,the recurrence group had a significantly higher frequency of miRNA- 146a( rs2910164) CG genotype( χ2= 4. 013,P = 0. 039) and a significantly lower frequency of GG genotype( χ2= 9. 046,P = 0. 003). The multivariate logistic regression analysis showed that tumor diameter( OR = 1. 075,P = 0. 003 9) and miRNA- 146a( rs2910164) CG genotype( OR = 6. 215,P = 0. 001 4) were the risk factors for recurrence after the surgery for liver cancer,and that miRNA146a( rs2910164) GG genotype was the protective factor against recurrence after the surgery for liver cancer( OR = 0. 382,P = 0. 002 5).Conclusion The SNP of MiRNA- 146a( rs2910164 C / G) is associated with recurrence after the radical surgery for liver cancer,and the CG genotype of rs2910164 may be the risk factor for postoperative recurrence after the surgery for liver cancer.

Effect of sorafenib combined with thalidomide on angiogenesis in chick chorioallantoic membrane
Guo ZhenYa, Ye JunFeng, Xie QianKun, Wang GuangYi
2016, 32(5): 908-910. DOI: 10.3969/j.issn.1001-5256.2016.05.019
Abstract:

Objective To investigate the effect of sorafenib and / or thalidomide on angiogenesis in chick chorioallantoic membrane( CAM).Methods White eggs incubated for 7 days were used to establish a CAM model. The model eggs were randomly divided blank control group,sorafenib group,thalidomide group,and sorafenib / thalidomide group. After treatment,each egg was incubated for another 2 days.The CAM samples were collected and fixed to take their pictures under a microscope,and the vascular coverage of each sample was calculated.Comparison between these groups was made by analysis of variance,and comparison between each two groups was made by SNK- q test.Results The thalidomide group or sorafenib group had significantly lower vascular coverage than the blank control group( 30. 2% ± 2. 9%or 26. 5% ± 2. 1% vs 38. 3% ± 2. 7%,P < 0. 05). The sorafenib / thalidomide group had significantly lower vascular coverage than the thalidomide group or sorafenib group( 12. 6% ± 1. 5% vs 30. 2% ± 2. 9% or 26. 5% ± 2. 1%,P < 0. 05). Conclusion Both sorafenib and thalidomide have a good anti- angiogenic effect on CAM,but a combination of the two drugs shows better efficacy.

Original articles_Biliary diseases
Preventive measures for bile duct injury and bleeding during laparoscopic cholecystectomy
Huang Wei, Chen Yi
2016, 32(5): 911-913. DOI: 10.3969/j.issn.1001-5256.2016.05.020
Abstract:
Objective To investigate the surgical methods for the prevention of bile duct injury and bleeding during laparoscopic cholecystectomy( LC). Methods The clinical data of 600 patients who underwent LC from September 2010 to June 2013 were analyzed retrospectively,and with reference to related articles and data,the methods for the prevention of bile duct injury and bleeding were summarized.Results Among the 600 patients,2 were converted to open surgery and 1 experienced biliary fistula after LC. There were no long- term complications,and all the patients were cured and discharged,without deaths. Conclusion The key points in preventing bile duct injury and bleeding during LC are the attention to blunt dissection and fine anatomy of the Calot's triangle,the emphasis on the separation and identification of the three- dimensional structure of the neck of the gallbladder,a flexible and proper treatment of the anatomic structures of the bile duct in patients with acute or subacute cholecystitis,and a decision on the resection or preservation of the gallbladder wall,which is made according to the situation during surgery.
Clinical effects of laparoscopy and laparotomy in treatment of gangrenous cholecystitis
Zhou JingSong, Pu DongLi, Du ZiYou
2016, 32(5): 914-917. DOI: 10.3969/j.issn.1001-5256.2016.05.021
Abstract:
Objective To compare the clinical effects of laparoscopic cholecystectomy( LC) and open cholecystectomy( OC) in the treatment of gangrenous cholecystitis and their influence on inflammatory mediators. Methods A total of 82 patients with gangrenous cholecystitis who underwent surgery in 22 Hospital of PLA from January 2012 to June 2015 were enrolled and divided into LC group( 42 patients) and OC group( 40 patients). The condition of surgery and perioperative levels of inflammatory mediators were compared between the two groups.The t- test was used for comparison between the two groups,and the chi- square test was used for categorical data. Results All the patients underwent the surgery successfully without deaths during the perioperative period,and three patients were converted to laparotomy.The rate of partial cholecystectomy,time of operation,intraoperative blood loss,and hospital costs showed no significant differences between the two groups( all P > 0. 05). The LC group had a shorter length of postoperative hospital stay,a lower rate of drainage tube placement,and fewer postoperative complications compared with the OC group,but only the length of postoperative hospital stay showed a significant difference between the two groups( t = 7. 472,P < 0. 001). The LC group experienced significant reductions in the serum white blood cell count( WBC),C- reactive protein( CRP),interleukin- 6( IL- 6),and tumor necrosis factor α( TNFα) on days 3 and 5 after surgery( all P < 0. 05). The OC group experienced significant increases in serum WBC,CRP,IL- 6,and TNFα on day 1 after surgery,and significant reductions in these indices on days 3 and 5 after surgery( all P < 0. 05). The LC group had significantly lower serum WBC,CRP,IL- 6,and TNFα on days 1,3,and 5 after surgery compared with the OC group( all P < 0. 05). Conclusion LC is safe and effective in the treatment of gangrenous cholecystitis. Compared with OC,LC has the advantages of less trauma and faster recovery after surgery and can reduce the release of inflammatory mediators.
Risk factors for long-term complications after endoscopic sphincterotomy for benign biliary and pancreatic diseases
Ding ShiHua, Wu DongHai, Guo HaiJian, Liu Jun
2016, 32(5): 918-920. DOI: 10.3969/j.issn.1001-5256.2016.05.022
Abstract:
Objective To investigate the risk factors for long- term complications after endoscopic sphincterotomy( EST) for benign biliary and pancreatic diseases. Methods The follow- up data of the patients who underwent EST in Department of Gastroenterology,The First Affiliated Hospital of Shenzhen University,from July 2008 to June 2013 were analyzed retrospectively,and the risk factors for long- term complications after EST were investigated. The chi- square test was applied for comparision of categorical data betwee groups. The Kaplan-Meier method was applied to analyze the cumulative incidence of complications,and the univariate and multivariate logistic regression analyses were applied to investigate the risk factors for long- term complications. Results The patients were followed up for 4- 57 months,and the mean follow- up time was 30. 9 ± 12. 1 months. The cumulative incidence of long- term complications after EST was 9. 9%( 18 /182),and these complications included recurrent common bile duct stones( n = 9),recurrent cholangitis( n = 6),acute cholecystitis( n = 2),and biliary stricture( n = 1). There were significant differences between the two groups in diameter of common biledute,pneumobilia,and juxtapapillary diverticulum( all P < 0. 05). The multivariate logistic regression analysis showed that diameter of common bile duct ≥15 mm( OR = 4. 82,95% CI: 1. 08- 21. 55,P = 0. 040) and pneumobilia( OR = 6. 19,95% CI: 1. 23- 31. 23,P = 0. 027) were the risk factors for long- term complications after EST. Conclusion The incidence of long- term complications after EST for benign biliary and pancreatic diseases is low,and diameter of common bile duct ≥15 mm and pneumobilia are the risk factors for long- term complications after EST.
Original articles_New technology and therapeutic strategy
Experience in application of pancreaticojejunostomy with double purse-string suture in laparoscopic pancreaticoduodenectomy
Zhang Wei, Wang YingChao, Liu Kai, Liu SongYang, Fu Yu, Liu YaHui
2016, 32(5): 921-924. DOI: 10.3969/j.issn.1001-5256.2016.05.023
Abstract:
Objective To investigate double purse- string suture as a safe and effective method for pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy. Methods A total of 6 patients who recently underwent laparoscopic pancreaticoduodenectomy in The First Hospital of Jilin University were enrolled. Their surgical methods and clinical data were analyzed retrospectively to analyze the application of double purse- string suture in laparoscopic pancreaticoduodenectomy. Results All the 6 patients completed the surgery successfully,and the mean time of operation was 317 min( range 260- 370 min). The mean time of pancreaticojejunostomy was 31 min( range 25- 39 min),and the mean intraoperative blood loss was 125 ml( range 50- 350 ml). There was no postoperative bleeding. Two patients experienced pancreatic leakage,among whom 1 experienced grade A pancreatic leakage which healed spontaneously,and the other patient experienced grade B pancreatic leakage which healed after treatment. Conclusion Double purse- string suture is a safe,effective,and convenient method for pancreaticojejunostomy during laparoscopic pancreaticoduodenectomy.
Original articles_Others
Effect of endoscopic injection of cyanoacrylate in treatment of acute esophageal and gastric variceal bleeding in children
Zhang XiaoXing, Li Qian, Yang KaiLong, Han Peng, Zhang YingXu
2016, 32(5): 925-927. DOI: 10.3969/j.issn.1001-5256.2016.05.024
Abstract:

Objective To investigate the effect and safety of endoscopic injection of cyanoacrylate in the treatment of esophageal and gastric variceal bleeding( EGVB) in children. Methods The clinical data of 35 children with acute EGVB who were treated with endoscopic injection of cyanoacrylate in Children's Hospital of Baoji Maternal and Child Health Care Hospital from August 2010 to August 2015 were analyzed retrospectively. The emergency response rate,rebleeding rate,and incidence of complications after the treatment were analyzed statistically. Results Thirty- five patients received 46 times of endoscopic injection of cyanoacrylate in total. The response rate to the initial injection was 95. 6%( 44 /46). The volume of cyanoacrylate injected was 0. 2- 0. 6 ml,with a mean volume of 0. 4 ± 0. 2 ml. The emergency hemostasis rate was 93. 4%( 43 /46),the rebleeding rate was 11. 4%( 4 /35),and the cycle for 4 patients with the recurrence of bleeding to be cured was 1. 2- 23. 0 months( mean 12. 1 ± 10. 9 months). One patient experienced abdominal pain,and no patients experienced ectopic embolism. Two patients died after injection. Conclusion Frequent,small- volume endoscopic injection of cyanoacrylate is an effective and convenient therapeutic method for EGVB in children,has few complications,and holds promise for clinical application.

Establishment of a rat model of early-stage liver failure and Th17/Treg imbalance
Li Dong, Lu ZhongHua, Gan JianHe
2016, 32(5): 928-932. DOI: 10.3969/j.issn.1001-5256.2016.05.025
Abstract:

Objective To investigate the methods for establishing a rat model of early- stage liver failure and the changes in Th17,Treg,and Th17 / Treg after dexamethasone and thymosin interventions. Methods A total of 64 rats were randomly divided into carbon tetrachloride( CCl4) group and endotoxin [lipopolysaccharide( LPS) ]/D- galactosamine( D- Gal N) combination group to establish the rat model of early- stage liver failure. The activities of the rats and changes in liver function and whole blood Th17 and Treg were observed to evaluate the effectiveness of the rat model. Dexamethasone and thymosin were used for intervention and related effects were observed. The t- test was used for comparison of continuous data between groups,and the paired t- test was used for comparison of continuous data within one group.Results The serum levels of alanine aminotransferase,aspartate aminotransferase,and total bilirubin showed significant increases in the model groups and were significantly different from those in the control group( CCl4group: t =- 3. 95,- 3. 60,and- 3. 57,P = 0. 006,0. 009,and 0. 009; LPS / D- Gal N combination group: t =- 10. 56,- 9. 63,and- 11. 82,all P < 0. 001). After the model was established,the rats showed an increase in Th17,a reduction in Treg,and Th17 / Treg imbalance. The liver pathology in the rats in the model groups was consistent with the changes in early- stage liver failure. After dexamethasone intervention,the rats showed a reduction in Th17( CCl4group: 0. 830 ± 0. 224 vs 0. 580 ± 0. 105,t = 3. 25,P = 0. 014; LPS / D- Gal N combination group: 1. 301 ± 0. 163 vs 0. 921 ±0. 141,t = 4. 12,P = 0. 004),an increase in Treg( CCl4group: 0. 317 ± 0. 076 vs 0. 385 ± 0. 083,t =- 11. 13,P < 0. 001; LPS / D-Gal N combination group: 0. 351 ± 0. 110 vs 0. 570 ± 0. 119,t =- 4. 06,P = 0. 005),and Th17 / Treg rebalance( CCl4group: 2. 201 ±0. 556 vs 1. 511 ± 0. 534,t = 3. 56,P = 0. 09; LPS / D- Gal N combination group: 3. 699 ± 0. 976 vs 1. 619 ± 0. 423,t = 3. 82,P = 0. 07).After thymosin intervention,the rats showed an increase in Th17( CCl4group: 1. 161 ± 0. 219 vs 1. 270 ± 0. 230,t =- 5. 74,P = 0. 001;LPS / D- Gal N combination group: 0. 451 ± 0. 095 vs 0. 929 ± 0. 130,t =- 8. 61,P < 0. 001),a reduction in Treg( CCl4group: 0. 643 ±0. 100 vs 0. 615 ± 0. 092,t = 2. 66,P = 0. 032; LPS / D- Gal N combination group: 0. 200 ± 0. 085 vs 0. 161 ± 0. 095,t = 3. 15,P =0. 016),and aggravation of Th17 / Treg imbalance( CCl4group: 1. 799 ± 0. 625 vs 2. 071 ± 0. 587,t =- 6. 47,P < 0. 001; LPS / D- Gal N combination group: 2. 244 ± 0. 634 vs 5. 770 ± 1. 455,t =- 11. 72,P < 0. 001). Conclusion The two methods of CCl4 and LPS / D-Gal N combination can successfully establish the rat model of early- stage liver failure with no deaths,and liver histological results and serum biochemical changes are in consistence with the changes in early- stage liver failure. Dexamethasone intervention helps to improve Th17 /Treg imbalance,while thymosin intervention causes aggravation of Th17 / Treg imbalance.

Mechanism of α-naphthyl isothiocyanate inducing cholestatic hepatitis: a preliminary study
Li Hua, Li YiMing, Lu Le
2016, 32(5): 933-937. DOI: 10.3969/j.issn.1001-5256.2016.05.026
Abstract:

Objective To investigate the mechanism of α- naphthyl isothiocyanate( ANIT) inducing cholestatic hepatitis. Methods A total of 60 healthy male Sprague- Dawley rats were randomly divided into normal control group( N group with 30 rats) and model group( ANIT group with 30 rats),and each group was further divided into three subgroups according to different time phases after gavage( at 24,48,and 72 hours after gavage),with 10 rats in each group. The serum levels of alanine aminotransferase( ALT),aspartate aminotransferase( AST),gamma- glutamyl transpeptidase( GGT),and total bilirubin( TBil) were measured,and the level of malondialdehyde( MDA) in the liver was measured. A light microscope was used to observe the pathological changes in the liver,and a transmission electron microscope was used to observe the changes in the ultrastructure of the bile canaliculus. A confocal laser scanning microscope was used to analyze the mean fluorescence intensity of phalloidine labeled by fluorescein isothiocyanate in order to determine the change in the level of fibrous actin( F- actin). Results After the administration of ANIT by gavage,the model group showed significant increases in the serum levels of ALT,AST,GGT,and TBil and the level of MDA in liver tissue compared with the normal control group. The model group also showed damage in the structure of the hepatic lobules,hyaline degeneration of hepatocytes,spotted,patchy,and focal necrotic lesions,and neutrophil infiltration mostly confined to the hepatocytes around the bile duct,proliferation of biliary epithelial and fibrous tissues,widened perisinusoidal spaces,dilation of the bile canaliculi,extensive shedding of microvilli,and formation of bile thrombi in the bile capillaries,as well as a low fluorescence intensity of F- actin. The above changes were the most obvious at 48 hours; recovery began at 72 hours,but significant differences were still seen between the two groups. Conclusion ANIT can cause lipid peroxidation in liver tissue and lead to degeneration and necrosis of liver cells,damage of microvilli of the bile canaliculi,and formation of bile thrombi,as well as reduction in the expression of F- actin in the bile canaliculi. Therefore,it affects the function of the liver to secrete bile and causes cholestatic hepatitis.

Brief reports
Clinical application of three-dimensional reconstruction in preoperative evaluation of hepatectomy
Li LianHai, Wang JianWei, Liu Bin, Xu HuiLing
2016, 32(5): 938-941. DOI: 10.3969/j.issn.1001-5256.2016.05.027
Abstract:
Case reports
Moxifloxacin-induced thrombocytopenia in treatment of moderately severe acute pancreatitis: a report of one case
Liu MingJiang, Qi WenLei, Zhang RuoYan, Du XiaoHong, Wang GuangYi, Ye JunFeng
2016, 32(5): 942-943. DOI: 10.3969/j.issn.1001-5256.2016.05.028
Abstract:
Pancreatic tuberculosis misdiagnosed as pancreatic cystadenoma: a report of one case
Liu YanQiu, Chen Jing, Liu Jie
2016, 32(5): 944-945. DOI: 10.3969/j.issn.1001-5256.2016.05.029
Abstract:
Adenosquamous carcinoma of the pancreas: a report of one case
Ma WenCong, Gu LiTong, Yao HaoChen, Zhang Ping
2016, 32(5): 946-947. DOI: 10.3969/j.issn.1001-5256.2016.05.030
Abstract:
A case of young female with cryptogenic cirrhosis
Wang JiuHeng, Li GuiYu, Wang YunZhong, Xu ChengJun, Zhao TieJian
2016, 32(5): 948-949. DOI: 10.3969/j.issn.1001-5256.2016.05.031
Abstract:
Giant hepatic angiomyolipoma: a report of one case and literature review
Guo Pei, Zheng RuiQi, Yu HuiHui, Hu YuLin
2016, 32(5): 950-952. DOI: 10.3969/j.issn.1001-5256.2016.05.032
Abstract:
A case of chronic hepatitis B virus carriers developing into hepatocellular carcinoma 
Liu LiLi, Qi Yue, Wang FengJiao, Hu Yue, Lu: Yang
2016, 32(5): 953-954. DOI: 10.3969/j.issn.1001-5256.2016.05.033
Abstract:
A case of hepatocellular carcinoma with Lambert-Eaton myasthenic syndrome as the first symptom
Fang XiZhu, Wang QiLong, Zhang Ping
2016, 32(5): 955-956. DOI: 10.3969/j.issn.1001-5256.2016.05.034
Abstract:
A case of autoimmune hepatitis with positive hepatitis C antibody
Lu: Jing, Xing Feng, Yuan JiLi, Liu ChengHai
2016, 32(5): 957-959. DOI: 10.3969/j.issn.1001-5256.2016.05.035
Abstract:
One case of primary hepatic amyloidosis 
Qiao Yan, Lu ShanShan, Wang HaiBo, You ShaoLi, Xin ShaoJie, Li Jin
2016, 32(5): 960-961. DOI: 10.3969/j.issn.1001-5256.2016.05.036
Abstract:
Four misdiagnosed cases of cholangiocarcinoma  
Yang ZhiGang, Cai YuHan
2016, 32(5): 962-963. DOI: 10.3969/j.issn.1001-5256.2016.05.037
Abstract:
Reviews
Roles of statins for lipid regulation in the pathogenesis and treatment of acute pancreatitis
Meng XiuNa, Wang Li, Tian Xing, Chen ChengLiang, Jiao Jian
2016, 32(5): 964-967. DOI: 10.3969/j.issn.1001-5256.2016.05.038
Abstract:

Besides regulating lipid,statins can inhibit inflammatory response,improve the function of endothelial cells,and protect intestinal mucosal barrier. Therefore,it can be used to relieve the clinical symptoms of acute pancreatitis,shorten the course of treatment,and improve the prognosis,and can play an important role in treatment. With the wide application of statins,their adverse effects are gradually being recognized,including acute pancreatitis. The World Health Organization database lists a variety of statins that can cause acute pancreatitis,but related mechanisms remain unknown. In view of the contradictory results mentioned above,this article reviews the current status,mechanisms of action,and roles of statins in acute pancreatitis and points out that further double- blind trials are needed to investigate the association between statins and acute pancreatitis.

Classification and diagnosis of pancreatic cystic neoplasm
Lu: Yan, Zhang XiaoWen
2016, 32(5): 968-971. DOI: 10.3969/j.issn.1001-5256.2016.05.039
Abstract:
Pancreatic cystic neoplasm is a relatively rare potential neoplasm in clinical practice and has a low- grade malignancy. Pancreatic cystic neoplasm is classified as serous cystic neoplasm,mucinous cystic neoplasm,intraductal papillary mucinous neoplasm,and solid pseudopapillary neoplasm. Due to its complex pathological type and the deep location of the pancreas,patients often lack typical clinical symptoms and signs,which may easily lead to misdiagnosis or missed diagnosis. This article introduces the classification of pancreatic cystic neoplasm and research advances in serological examinations,cyst puncture and aspiration,and imaging examinations in the diagnosis of pancreatic cystic neoplasm and points out a combination of various examinations can improve the rate of confirmed diagnosis of pancreatic cystic neoplasm.
Research advances in 125 radioactive seed implantation for treatment of unresectable pancreatic cancer
Tao WeiJie, Shi XiaoJu, Wang GuangYi
2016, 32(5): 972-976. DOI: 10.3969/j.issn.1001-5256.2016.05.040
Abstract:
In recent years,125 radioactive seed implantation has been greatly developed for the treatment of unresectable pancreatic cancer,and clinical practice shows that it has good therapeutic effects in relieving pain,controlling local tumor progression,and prolonging patients' survival time. This article introduces the physical and biological features of125 radioactive seeds and the advantages and disadvantages of implantation,as well as the therapeutic method,surgical safety,and clinical effects of125 radioactive seed implantation in the treatment of unresectable pancreatic cancer. This article points out that it is an effective therapeutic method and should be widely applied in well-equipped hospitals.
Predictive value of HBs Ag quantification in pegylated interferon therapy for chronic hepatitis B
Zhang HaiYue, Zhou Pei, Gong ZuoJiong
2016, 32(5): 977-980. DOI: 10.3969/j.issn.1001-5256.2016.05.041
Abstract:
Antiviral therapy is the most important thing in the treatment of chronic hepatitis B( CHB). Pegylated interferon( PEG- IFN)has both antiviral and immunomodulatory effects,and after drug withdrawal,30%- 40% of patients can achieve HBe Ag seroconversion and sustained virologic response. Many studies have shown that HBs Ag quantification can be used as an index to predict the anti- HBV effect of PEG- IFN and sustained immune control after drug withdrawal. This article reviews the relationship between HBs Ag levels before,during,and after PEG- IFN therapy and antiviral effect to clarify the significance of HBs Ag quantification in the PEG- IFN treatment of CHB and to guide the regimen of antiviral therapy.
Renal safety in chronic hepatitis B patients treated with nucleos(t) ide analogues
Ning Ling, Sun Jian, Chen Nan, Hou JinLin
2016, 32(5): 981-985. DOI: 10.3969/j.issn.1001-5256.2016.05.042
Abstract:
Nucleos( t) ide analogues( NAs) are commonly used as the antiviral treatment in patients with chronic hepatitis B( CHB). The majority of patients need long term medication. Renal injury has been observed in some patients treated with NAs in clinical practice. Therefore,this article reviews the issues regarding renal safety in CHB patients treated with NAs from the following aspects: the possible mechanisms of renal injury,the incidence of renal injury in patients treated with various NAs in recent clinical studies,and the management of renal injury in CHB patients,in order to select the most appropriate drugs for patients.
Research advances in chronic hepatitis B complicated by pulmonary tuberculosis
Liu PingXiang, Cheng ShuQuan
2016, 32(5): 986-991. DOI: 10.3969/j.issn.1001-5256.2016.05.043
Abstract:
In recent years,increasing attention has been paid to co- infection with hepatitis B virus and mycobacterium tuberculosis,which is characterized by a high incidence,as well as the changes in the progression,prognosis,and treatment outcome of original diseases,toxic or side effects,and even the drug resistance of pathogens. This article reviews the incidence,pathogenesis,and therapeutic progress in patients with chronic hepatitis B complicated by pulmonary tuberculosis,so as to provide new ideas for further research.
Research advances in innate immunity against hepatitis B virus
Li FengLi, Hua Juan, Lu YinPing, Yang DongLiang
2016, 32(5): 992-996. DOI: 10.3969/j.issn.1001-5256.2016.05.044
Abstract:
When hepatitis B virus( HBV) invades the human body,innate immunity acts the earliest and plays an important role. When an adult is infected with HBV,HBV can often be eliminated spontaneously. However,if HBV infection occurs right after birth or when the patient is young,the disease tends to become chronic and affect the whole life. In the incipient stage of HBV infection,innate immune response plays an important role in inhibiting viral replication,and the prognosis of HBV infection depends on the combined effect of host and virus. This article briefly introduces the research advances in the cells,cytokines,and signaling pathways that play important roles in the host's innate immunity against HBV and their mechanisms of action,and points out their potential values in clinical treatment.
Research advances in chronic hepatitis C complicated by autoimmune hepatitis
Wang HaiQiong, Tang ShanHong, Ceng WeiZheng, Zhang Yong, Mou Dong, Gao Hui
2016, 32(5): 997-1000. DOI: 10.3969/j.issn.1001-5256.2016.05.045
Abstract:
There are not many studies on chronic hepatitis C complicated by autoimmune hepatitis,and up to now,the clinical diagnosis and treatment of such diseases still face many difficulties. Although related articles put forward some recommendations,there are no standard guidelines for diagnosis and treatment,and clinical physicians need to provide treatment for these patients based on their personal experience. This article summarizes related articles on chronic hepatitis C complicated by autoimmune hepatitis in order to provide help to clinical physicians when they face similar clinical problems in the future.
Role of bone morphogenetic protein-7/Smads signaling pathway in hepatic fibrosis
Hou Fei, Liu RuiXia, Yin ChengHong
2016, 32(5): 1001-1004. DOI: 10.3969/j.issn.1001-5256.2016.05.046
Abstract:
Hepatic fibrosis is the process in which the human body repairs the liver tissue damaged due to various reasons. Recent studies have found that bone morphogenetic protein- 7( BMP- 7) and the downstream Smads can antagonize the effect of transforming growth factor- β1,which induces hepatic fibrosis,through various pathways,including inducing the degradation of extracellular matrix,inhibiting cell apoptosis,reducing the expression of various proinflammatory factors,and promoting the regeneration of hepatocytes. This article investigates the role of BMP- 7 / Smads signaling pathway in hepatic fibrosis.
Research advances in cirrhotic cardiomyopathy
Zhang ShiRong, Chen DongFeng
2016, 32(5): 1005-1008. DOI: 10.3969/j.issn.1001-5256.2016.05.047
Abstract:
Cirrhotic cardiomyopathy( CCM) refers to the abnormalities in cardiac structure and function in patients with liver cirrhosis. The pathogenesis of CCM involves the apoptosis of cardiomyocytes,impaired β- receptors,and increased levels of cardiodepressant factors such as nitric oxide,carbon monoxide,endocannabinoids,bacterial endotoxins,and inflammatory mediators. At present,there are no unified diagnostic criteria for CCM,and a clinical diagnosis can be made based on clinical manifestation,plasma brain natriuretic peptide,N- terminal pro- brain natriuretic peptide,electrocardiographic findings,ultrasound findings,and the results of cardiac magnetic resonance imaging. The treatment of CCM involves controlling liver cirrhosis and protecting the myocardium,and the best therapeutic method is liver transplantation at the right time.
Research advances in the role of autophagy in liver cells and regulation of MAPK pathway
Jiang Na, Ping Jian, Xu LieMing
2016, 32(5): 1009-1012. DOI: 10.3969/j.issn.1001-5256.2016.05.048
Abstract:
Autophagy is a highly conservative cellular process in eukaryotes that plays an important role in nutrition and energy metabolism in the liver. It can promote the autophagy of hepatocytes and protect the hepatocytes against the adverse external stimulation,but excessive autophagy can cause autophagic cell death of hepatocytes. Hepatic stellate cells( HSC) play an important role in the development and progression of liver fibrosis. Autophagy can provide energy for their activation,but may also lead to their death. This article introduces the relationship of autophagy with hepatocytes / HSC and the mitogen- activated protein kinase pathway,and points out that in- depth studies on the relationship between autophagy and pathway regulation during liver fibrosis can provide new targets for developing antifibrotic drugs.
Role of liver X receptor in process of cholesterol metabolism and its mechanism of action
Chen Yu, Fan XiaoFei, Zheng ZhongQing, Wang BangMao
2016, 32(5): 1013-1017. DOI: 10.3969/j.issn.1001-5256.2016.05.049
Abstract:
Cholesterol is a component of cell membrane and plays a vital role in maintaining metabolism and normal functions in human body. Liver X receptor( LXR) is a nuclear receptor expressed in abundance in the liver. It influences the process of cholesterol metabolism through regulating the synthesis,transformation,and transportation of cholesterol and bile acid at the level of hepatocytes,and therefore,it plays an important role in maintaining cholesterol homeostasis in human body. In addition,LXR can inhibit the intestinal absorption of dietary cholesterol,reduce exogenous cholesterol level and total cholesterol level in human body,and prevent hypercholesterolemia and formation of gallstones. This article summarizes the mechanism of action of LXR in regulating cholesterol metabolism at both liver and intestinal levels.
Research advances in association between diseases outside the gallbladder and gallstones
Li Juan, Wei XiaoGuo, Lu QiMing, Zhan Li, Liu PengCheng
2016, 32(5): 1018-1021. DOI: 10.3969/j.issn.1001-5256.2016.05.050
Abstract:
Gallstones is a common digestive system disease in China and has a complex pathogenesis. It is often considered that it is mediated by many factors in the genetic background,including biliary cholesterol supersaturation,intestinal cholesterol hyperabsorption,abnormal cholesterol nucleation in bile,dysfunction in gallbladder dynamics,and cholestasis. This article reviews the role of the above mechanisms in the association between diseases outside the gallbladder and gallstones. Based on current evidence,the above diseases may promote the formation of gallstones,and active intervention of the above diseases outside the gallbladder may help to expand new strategies for the prevention and treatment of gallstones.
Research advances in palliative treatment of cholangiocarcinoma
Wang Xing, Li XiangCheng
2016, 32(5): 1022-1025. DOI: 10.3969/j.issn.1001-5256.2016.05.051
Abstract:
Although radical resection is the only method to cure cholangiocarcinoma,most patients are in the advanced stage at the time of diagnosis and miss the best time for surgery. The palliative treatment focusing on biliary drainage reconstruction can improve patients' quality of life and prolong survival time. This article introduces the latest advances in palliative treatment for cholangiocarcinoma in recent years. Patients can benefit from the treatment methods such as biliary stenting and palliative surgery. Local and systemic adjuvant therapies are also indispensible,such as radiotherapy,chemotherapy,photodynamic therapy,and immunotherapy,but their therapeutic effects await further investigation. With the continuous development of basic research and medical techniques,the traditional therapeutic methods will be constantly improved. The new therapeutic methods targeting the pathogenesis of cholangiocarcinoma will also play an important role and bring benefits to the patients.
Liver alkaline phosphatase: a marker of cholestasis and bile duct injury
Shen FeiFei, Lu LunGen
2016, 32(5): 1026-1030. DOI: 10.3969/j.issn.1001-5256.2016.05.052
Abstract:
Studies show that serum alkaline phosphatase( ALP) can be used not only to evaluate cholestasis,but also as a surrogate marker to assess the severity of primary biliary cirrhosis( PBC),primary sclerosing cholangitis( PSC),and several cholestatic liver diseases. This article introduces the mechanisms of action of liver ALP in the healthy population and patients with cholestatic liver disease. In case of cholestasis caused by inflammation,acidic environment and relocation of the bile capillaries cause liver ALP deactivation and an increased accumulation of lipopolysaccharide and thus lead to aggravation and delayed healing. In the treatment of PBC and PSC,promoting the restoration of hepatocyte polarity and the elimination of bile acid through the bile capillaries and using drugs capable of adjusting the p H of bile can achieve a good anti- inflammatory effect. The effect of oral intestinal ALP in the treatment of cholestatic diseases awaits further investigations in laboratories and in clinical practice.