AIM： To review the experience in surgery for 508 patients with portal hypertension and to explore the selection of reasonable operation under different conditions. METHODS： The data of 508 patients with portal hyper...AIM： To review the experience in surgery for 508 patients with portal hypertension and to explore the selection of reasonable operation under different conditions. METHODS： The data of 508 patients with portal hypertension treated surgically in 1991-2001 in our centers were analyzed. Of the 508 patients, 256 were treated with portaazygous devascularization （PAD）, 167 with portasystemic shunt （PSS）, 62 with selective shunt （SS）, 11 with combined portasystemic shunt and portaazygous devascularization （PSS＋PAD）, 9 with liver transplantation （LT）, 3 with union operation for hepatic carcinoma and portal hypertension （HCC＋PH）. RESULTS： In the 167 patients treated with PSS, free portal pressure （FPP） was significantly higher in the patients with a longer diameter of the anastomotic stoma than in those with a shorter diameter before the operation （P〈0.01）. After the operation, FPP in the former patients markedly decreased compared to the latter ones （P〈0.01）. The incidence rate of hemorrhage in patients treated with PAD, PSS, 55, PSS＋PAD, and HCC＋PH was 21.09% （54/256）, 13.77 （23/167）, 11.29 （7/62）, 36.36% （4/11）, and 100% （3/3）, respectively. The incidence rate of hepatic encephalopathy was 3.91% （10/256）, 9.58% （16/167）, 4.84% （3/62）, 9.09% （1/11）, and 100% （3/3）, respectively while the operative mortality was 5.49% （15/256）, 4.22% （7/167）, 4.84% （3/62）, 9.09% （1/11）, and 66.67% （2/3） respectively. The operative mortality of liver transplantation was 22.22% （2/9）. CONCLUSION： Five kinds of operation in surgical treatment of portal hypertension have their advantages and disadvantages. Therefore, the selection of operation should be based on the actual needs of the patients.展开更多
BACKGROUND Due to the large number of operations,surgeons sometimes need to work overtime or even stay up late to perform pancreaticoduodenectomy.Fatigue and sleep deprivation can result in an increased error rate at ...BACKGROUND Due to the large number of operations,surgeons sometimes need to work overtime or even stay up late to perform pancreaticoduodenectomy.Fatigue and sleep deprivation can result in an increased error rate at work.There have been numerous studies about the effect of overtime surgery on the prognosis of patients.However,the effect of overtime work for pancreaticoduodenectomy on the prognosis of patients is unclear.This study explores the impact of overtime work for pancreaticoduodenectomy on the prognosis of patients.AIM To explore the impact of overtime work for pancreaticoduodenectomy on the short-term prognosis of patients.METHODS This was a single-center,retrospective cohort study.The patients who underwent pancreaticoduodenectomy between January 2017 and December 2019 were included.Patients were stratified by operative start time into the control group(surgery that started between 8:00 and 16:49)and the overtime group(surgery that started between 17:00 and 22:00)and compared intraoperative and postoperative parameters.The following parameters were compared between the overtime group and the control group:Operative time,blood loss,number of lymph nodes removed,duration of treatment in the Intensive Care Unit(ICU),and incidence of complications.RESULTS From January 2017 to December 2019,a total of 239 patients underwent pancreaticoduodenectomy in the Department of Hepatobiliary Surgery of our institution.Four patients were excluded from this study due to lack of clinical data.A total of 235 patients were included,with 177 in the control group and 58 in the overtime group.There was no difference between the two groups in operative time,blood loss,number of lymph nodes removed,ICU length of stay,hospital length of stay,mortality during hospitalization.Compared with the control group,the overtime group had a higher incidence of pancreatic fistula(32.8%vs 15.8%,P<0.05).Multivariate analysis showed that overtime work,higher Body Mass Index were independent risk factors for pancreatic fistula(P<0.05).CONCLUSION Overtime work for pancreaticoduodenectomy increases the incidence of pancreatic fistula.The effect of overtime surgery on the long-term prognosis of patients’needs to be further studied.展开更多
Background：Overexpression of G-protein coupled receptor 34 （GPR34） affects the progression and prognosis of human gastric adenocarcinoma,however,the role of GPR34 in gastric cancer development and progression has n...Background：Overexpression of G-protein coupled receptor 34 （GPR34） affects the progression and prognosis of human gastric adenocarcinoma,however,the role of GPR34 in gastric cancer development and progression has not been well-determined.The current study aimed to investigate the effect of GPR34 knockdown on the proliferation,migration,and apoptosis of HGC-27 gastric cancer cells and the underlying mechanisms.Methods：The expression of GPR34 in gastric cancer cell line HGC-27 was detected by quantitative real-time reverse transcription-polymerase chain reaction （RT-PCR） and Western blotting.HGC-27 cells were employed to construct the stable GPR34 knockdown cell model in this study.Real-time RT-PCR and Western blotting were applied to validate the effect of short hairpin RNA （ShRNA） on the expression of GPR34 in HGC-27 gastric cells.The proliferation,migration of these cells were examined by Cell Counting Kit-8 and transwell.We also measured expression profile of PI3K/PDK1/AKT and ERK using Western blotting.Results：The ShRNA directed against GPR34 effectively inhibited both endogenous mRNA and protein expression levels of GPR34,and significantly down-regulated the expression of PIK3CB （P ＜ 0.01）,PIK3CD （P ＜ 0.01）,PDK1 （P ＜ 0.01）,phosphorylation of PDK1 （P ＜ 0.01）,Akt （P ＜ 0.01）,and ERK （P ＜ 0.01）.Furthermore,GPR34 knockdown resulted in an obvious reduction in HGC-27 cancer cell proliferation and migration activity （P ＜ 0.01）.Conclusions：GPR34 knockdown impairs the proliferation and migration of HGC-27 gastric cancer cells in vitro and provides a potential implication for therapy of gastric cancer.展开更多
In documenting clinical experience in the diagnosis and treatment of graft versus host disease(GVHD),we retrospectively analyzed data of one case that has developed GVHD after liver transplantation.This patient exhibi...In documenting clinical experience in the diagnosis and treatment of graft versus host disease(GVHD),we retrospectively analyzed data of one case that has developed GVHD after liver transplantation.This patient exhibited fever,skin rash,and diarrhea on day 9 after liver transplantation.His liver function was normal.Skin biopsy showed scattered keratinocytes accompanied by satellite-like lymphocyte infiltration and basal cell liquefaction degeneration.After carefully analyzing the complications,we took the strategy of decreasing the dose of tacrolimus.Thereafter,the patient’s temperature decreased to normal,his skin rashes subsided,and his diarrhea was relieved.This case suggests that reducing the dosage of immunosuppressive agents can be an effective strategy for GVHD after liver transplantation.展开更多
文摘AIM： To review the experience in surgery for 508 patients with portal hypertension and to explore the selection of reasonable operation under different conditions. METHODS： The data of 508 patients with portal hypertension treated surgically in 1991-2001 in our centers were analyzed. Of the 508 patients, 256 were treated with portaazygous devascularization （PAD）, 167 with portasystemic shunt （PSS）, 62 with selective shunt （SS）, 11 with combined portasystemic shunt and portaazygous devascularization （PSS＋PAD）, 9 with liver transplantation （LT）, 3 with union operation for hepatic carcinoma and portal hypertension （HCC＋PH）. RESULTS： In the 167 patients treated with PSS, free portal pressure （FPP） was significantly higher in the patients with a longer diameter of the anastomotic stoma than in those with a shorter diameter before the operation （P〈0.01）. After the operation, FPP in the former patients markedly decreased compared to the latter ones （P〈0.01）. The incidence rate of hemorrhage in patients treated with PAD, PSS, 55, PSS＋PAD, and HCC＋PH was 21.09% （54/256）, 13.77 （23/167）, 11.29 （7/62）, 36.36% （4/11）, and 100% （3/3）, respectively. The incidence rate of hepatic encephalopathy was 3.91% （10/256）, 9.58% （16/167）, 4.84% （3/62）, 9.09% （1/11）, and 100% （3/3）, respectively while the operative mortality was 5.49% （15/256）, 4.22% （7/167）, 4.84% （3/62）, 9.09% （1/11）, and 66.67% （2/3） respectively. The operative mortality of liver transplantation was 22.22% （2/9）. CONCLUSION： Five kinds of operation in surgical treatment of portal hypertension have their advantages and disadvantages. Therefore, the selection of operation should be based on the actual needs of the patients.
基金Supported by Peking University People’s Hospital Scientific Research Development Funds,No.RDY2017-28.
文摘BACKGROUND Due to the large number of operations,surgeons sometimes need to work overtime or even stay up late to perform pancreaticoduodenectomy.Fatigue and sleep deprivation can result in an increased error rate at work.There have been numerous studies about the effect of overtime surgery on the prognosis of patients.However,the effect of overtime work for pancreaticoduodenectomy on the prognosis of patients is unclear.This study explores the impact of overtime work for pancreaticoduodenectomy on the prognosis of patients.AIM To explore the impact of overtime work for pancreaticoduodenectomy on the short-term prognosis of patients.METHODS This was a single-center,retrospective cohort study.The patients who underwent pancreaticoduodenectomy between January 2017 and December 2019 were included.Patients were stratified by operative start time into the control group(surgery that started between 8:00 and 16:49)and the overtime group(surgery that started between 17:00 and 22:00)and compared intraoperative and postoperative parameters.The following parameters were compared between the overtime group and the control group:Operative time,blood loss,number of lymph nodes removed,duration of treatment in the Intensive Care Unit(ICU),and incidence of complications.RESULTS From January 2017 to December 2019,a total of 239 patients underwent pancreaticoduodenectomy in the Department of Hepatobiliary Surgery of our institution.Four patients were excluded from this study due to lack of clinical data.A total of 235 patients were included,with 177 in the control group and 58 in the overtime group.There was no difference between the two groups in operative time,blood loss,number of lymph nodes removed,ICU length of stay,hospital length of stay,mortality during hospitalization.Compared with the control group,the overtime group had a higher incidence of pancreatic fistula(32.8%vs 15.8%,P<0.05).Multivariate analysis showed that overtime work,higher Body Mass Index were independent risk factors for pancreatic fistula(P<0.05).CONCLUSION Overtime work for pancreaticoduodenectomy increases the incidence of pancreatic fistula.The effect of overtime surgery on the long-term prognosis of patients’needs to be further studied.
基金This study was supported by grants from the National Natural Science Foundation of China，the Peking University People＇s Hospital Research and Development Foundations
文摘Background：Overexpression of G-protein coupled receptor 34 （GPR34） affects the progression and prognosis of human gastric adenocarcinoma,however,the role of GPR34 in gastric cancer development and progression has not been well-determined.The current study aimed to investigate the effect of GPR34 knockdown on the proliferation,migration,and apoptosis of HGC-27 gastric cancer cells and the underlying mechanisms.Methods：The expression of GPR34 in gastric cancer cell line HGC-27 was detected by quantitative real-time reverse transcription-polymerase chain reaction （RT-PCR） and Western blotting.HGC-27 cells were employed to construct the stable GPR34 knockdown cell model in this study.Real-time RT-PCR and Western blotting were applied to validate the effect of short hairpin RNA （ShRNA） on the expression of GPR34 in HGC-27 gastric cells.The proliferation,migration of these cells were examined by Cell Counting Kit-8 and transwell.We also measured expression profile of PI3K/PDK1/AKT and ERK using Western blotting.Results：The ShRNA directed against GPR34 effectively inhibited both endogenous mRNA and protein expression levels of GPR34,and significantly down-regulated the expression of PIK3CB （P ＜ 0.01）,PIK3CD （P ＜ 0.01）,PDK1 （P ＜ 0.01）,phosphorylation of PDK1 （P ＜ 0.01）,Akt （P ＜ 0.01）,and ERK （P ＜ 0.01）.Furthermore,GPR34 knockdown resulted in an obvious reduction in HGC-27 cancer cell proliferation and migration activity （P ＜ 0.01）.Conclusions：GPR34 knockdown impairs the proliferation and migration of HGC-27 gastric cancer cells in vitro and provides a potential implication for therapy of gastric cancer.
文摘In documenting clinical experience in the diagnosis and treatment of graft versus host disease(GVHD),we retrospectively analyzed data of one case that has developed GVHD after liver transplantation.This patient exhibited fever,skin rash,and diarrhea on day 9 after liver transplantation.His liver function was normal.Skin biopsy showed scattered keratinocytes accompanied by satellite-like lymphocyte infiltration and basal cell liquefaction degeneration.After carefully analyzing the complications,we took the strategy of decreasing the dose of tacrolimus.Thereafter,the patient’s temperature decreased to normal,his skin rashes subsided,and his diarrhea was relieved.This case suggests that reducing the dosage of immunosuppressive agents can be an effective strategy for GVHD after liver transplantation.
