Objective To investigate the immunoregulatory effects of immunonutrient ω-3 polyunsaturated fatty acid (PUFA) and its applications in organ transplantation. Methods Relevant literatures of recent years were reviewed. Results The immunoregulatory effects of ω-3 PUFA can inhibit proliferation and activation of the immunocompetent cells including T cell and B cell, reduce cytokine production, modulate immunologic response, improve graft function, pro-long survival, reduce episodes of rejection, and lessen adverse reactions of immunosuppressor.Conclusion ω-3 PUFA should have wide applications in organ transplantation due to its immunoregulatory effects. However, this research should be further studied.
【Abstract】Objective To review the advances in overcoming multidrug resistance of tumors caused by mdr1 gene.Methods Different ways of overcoming multidrug resistance of tumors caused by mdr1 gene in the literatures were reviewed. Results One of the important reasons causing multidrug resistance was due to the overexpression of mdr1 gene and its product Pglycoprotein. There were two ways to overcome multidrug resistance of tumors through mdr1 genes mRNA and its product Pglycoprotein effectively.Conclusion The clinical test of the unitary way to overcome multidrug resistance of tumors is unsatisfactory, combining different ways to overcome multidrug resistance of tumors will be the hot spot of tumors research in the future.
【Abstract】ObjectiveTo report the diagnosis and treatment of hilar cholangiocarcinoma.MethodsThe relevant information about the hispathological feature, transfer ways, clinical manifestation, laboratory examination, imaging feature, immunohistochemical examination and treatment ways were gathered from previous original articles, and checking the latest issues of appropriate journals.ResultsThe clinical manifestation, laboratory examination, and imaging feature of hilar cholangiocarcinoma were due to the neoplasm obstructing bile duct and sequent infection of bile duct. The diagnosis was depanded on the combining clinical manifestation, laboratory examination and imaging feature. The value of immunohistochemical examination was not clear. Radical surgery was the best treatment of unique curing the neoplasm. By-pass surgery was used in the late phase patients to solve the obstruction of bile and digest duct. The effect of unique chemical treatment was not perfect. It did’t generally propose the treatment of orthotopic liver transplantation.ConclusionThe perfect prognosis of hilar cholangiocarcinoma is depended on early diagnosis and redical surgery.
Objective To investigate the clinical outlook of hepatic stem cells and its relations with liver cancer. Methods The literatures of recent years on the studies of hepatic stem cells were reviewed. Results Liver cancer may consist of cells of various differentiation grades and it may result from the perodifferentiated hepatic stem cells or abnormal differentiated cells. Conclusion The hypothesis of hepatic stem cells has been identified extensively. Further study maybe helpful for revealing the origin, carcinogenesis of hepatic cancer, and may also be useful for the understanding of the mechanism of metastasis.
【Abstract】Objective To review the recent advances in the use of marginal liver in liver transplantation. Methods The literatures of recent years on the use of marginal liver for liver transplantation were reviewed and summarized.Results The donors with older age, hemodynamic instability, long stay in the intensive care unit and fatty liver are significantly clinical marginal liver donors.Conclusion Though the use of marginal liver donors negatively influences the results of liver transplantation, marginal liver expands the liver source for liver transplantation with a good result.
ObjectiveTo summarize the current comparison of the efficacy of different treatments for recurrent hepatocellular carcinoma.MethodTo search the literatures about the comparative studies on the efficacy of different treatments for recurrent hepatocellular carcinoma in recent years and analyze them.ResultsIn the treatment of recurrent hepatocellular carcinoma, percutaneous arterial chemoembolization combined with radiofrequency ablation could improve the survival rate and tumor-free survival rate to some extent, compared with the single use of percutaneous arterial chemoembolization. In the short term, there was no difference in efficacy between radiofrequency ablation and surgical resection, but the local recurrence rate of radiofrequency ablation was higher than that of surgical resection group. Salvage liver transplantation offered potential opportunity to reduce the risk of recurrence and tended to improve long-term survival outcomes, but liver sources were scarce and costly. ConclusionsAt present, there is no systematic staging scheme and treatment system for recurrent hepatocellular carcinoma. At the same time, most studies are retrospective, and more prospective studies are needed to further explore the treatment of recurrent hepatocellular carcinoma.
Some complex surgical procedures allow for day surgery benefited from the advancement of the concept of enhanced recovery after surgery and minimally invasive surgical techniques. Shanghai Chest Hospital has set up thoracic day surgery ward incorporating some lung tumor surgeries into day surgery. Through process innovation, model innovation and management innovation, relying on the full-process closed-loop day surgery management system, the day surgery ward runs efficiently. It can help effectively alleviate the difficulty of admission and operation, and improve hospital operation efficiency as well as reduce the economic burden of disease. At the same time, we hope to explore an innovative development path for the possibility of day surgery in complex thoracic surgery, and create a new mode of day surgery that can be replicated and promoted.
ObjectiveTo study the clinical manifestations, pathologic characteristics, imaging features, diagnosis and treatment of adenomas of extrahepatic bile duct.MethodsTwo cases of adenomas of extrahepatic bile duct in our hospital and 14 cases reported in the literatures were analyzed retrospectively.ResultsThe patients’(male 5, female 11) mean age was 58.4 years (range 21-85). The main manifestations included jaundice (n=11), abdominal pain (n=8),fever (n=6),dyspepsia (n=4),body weight loss (n=3) and claycolored stool (n=1). The locations of tumors were in the left hepatic duct (n=1), right hepatic duct (n=3), hepatic common bile duct(n=3）,the junction of cystic duct and common bile duct (n=1），distal common bile duct (n=8). The pathologic types were tubular adenomas (n=5), papillary (villous) adenomas (n=10),and mucous adenoma (n=1). All the patients underwent surgical therapy. The tumors were identified by postoperative histopathologic examination.ConclusionIt is difficult to correctly diagnose adenomas of extrahepatic bile duct before operation, because the clinical manifestations are usually atypical. The definite diagnosis should depend on histopathologic examination. It is the key to completely resect the tumors. Postoperative followup should be done on regular basis.
Laparoscopic anatomical hepatectomy had developed considerably in recent years, but some complex sites of anatomical hepatectomy, such as anatomical resection of the right posterior lobe of the liver, still presented some technical difficulties. Combining the specific perspective of laparoscope and the particular anatomical structure of the right posterior lobe of the liver, we had proposed a strategy of anatomical right posterior lobe resection via cranial-dorsal approach. The right posterior lobe resection plane was defined by point (right hepatic vein root)—by line (ischemic line/right hepatic vein)—by plane (hepatic surface ischemic line and right hepatic vein composition) to achieve precise anatomical resection of the right posterior lobe of the liver, and could reduce intraoperative complications and comply with the principle of tumour-free. Thus, a strategy of anatomical right posterior lobe resection via cranial-dorsal approach might provide a feasible and effective option for right posterior lobectomy of the liver.
Evidence-based research is the essential method for the modernization of traditional medicine. China and Japan have made great progress in traditional Chinese medicine and Japanese Kampo medicine after years of evidence-based research, but there are also shortcomings. This paper compares the current situation of evidence-based research in traditional medicine from the aspects of the system of clinical evidence production and evaluation, standardization of clinical research report, standardization of traditional medicine in China and Japan, evaluation of the totality of clinical evidence via systematic review, application of clinical evidence via clinical practice guideline and development of research methodology. The purpose of this paper is to seek mutually complementary fields, and to provide enlightenment for future Chinese medicine and Japanese Kampo medicine evidence-based cooperation research.