门静脉癌栓(portal vein tumor thrombus,PVTT)是影响原发性肝细胞癌治疗策略及预后的重要因素.近年与PVTT相关的分子信号通路不断被发现,但PVVT形成机制及其研究和临床诊疗仍面临较大挑战.本文就原发性肝细胞癌合并PVTT的研究进展作一综述.

Objective To investigate the correlation between patients clinical characteristics and the number and subtype of circulating tumor cells (CTCs) from peripheral blood of perioperative hepatocellular carcinoma (HCC)patients by SE-iFISH.Methods 20 HCC patients undergoing radical resection were enrolled from June 2015 to June 2016.The SE-iFISH technique was used to separate and identify circulating tumor cells.The pathology and clinical data were used to evaluate patients survival in combination with CTCs characteristics.Results A total of 347 CTCs were detected,of which 114 were triploid,64 were tetraploid,and 165 were pentaploid.The number of preoperative CTCs and the number of preoperative triploids was significantly correlated with the presence of vascular tumor emboli (Z1 =-2.080,P =0.037,Z3 =-2.321,P =0.020) and TNM staging(Z2 =-2.148,P =0.032,Z4 =-2.526,P =0.012).Postoperative patients disease-free survival in high CTCs detection group was significantly shorter than that of CTCs low expression group (x2 1 =7.486,P =0.006,x22 =12.056,P =0.001).Conclusion Detection of the number and the specific subtypes of CTCs with SE-iFISH strategy in patients with HCC help predict treatment efficacy and prognosis.

Objective: To explore the expression of cathepsin S (Cat S) and Hepatitis B virus X protein (HBx) in HBeAg(-) and HBeAg(+ ) hepatocellular carcinoma (HCC), and discuss the effects of Cat S and HBx interaction on HepG2 cell. Methods: Seventy HCC tissue specimens were collected from the surgical resection which were confirmed by pathology in the Fifth Affiliated Hospital of Guangxi Medical University. The tissue samples were separated into two groups: HBeAg(-) group and HBeAg(+ ) group according to the serology of HBeAg. The expression of Cat S and HBx in the para-carcinoma tissue and the HCC tissue was determined by immunohistochemical staining. The recombinant plasmid of pcDNA3.1-HBx and empty plasmid were constructed and transfected transiently into HepG2 cell. Cells were harvested, and Western blot assay was performed to detectthe protein expression of Cat S and HBx. The cell proliferation was measured by methyl thiazolyl tetrazolium (MTT) assay, wound healing assay and transwell migration assay. Results: Immunohistochemical staining showed that Cat S expression was up-regulated in HBeAg(+ ) HCC cancer tissues, compared with HBeAg(-)HCC cancer tissues (52.67%±0.33% vs 41.23%±0.52%, P<0.05). HBx expression was up-regulated in HBeAg(+ ) HCC cancer tissues (92.89%), but not in HBeAg(-)HCC cancer tissues. Compared with HepG2 control group, cells in HepG2-HBx group had significantly higher protein level of Cat S and HBx, more obvious proliferation and migration (21.98%±1.69% vs 58.23%±1.47%) and invasion (24.12%±1.15%vs 64.25%±1.42%) (all P<0.05). Conclusions: The expression of HBx and Cat S had a linear positive correlation in liver tissues, and increased expression of HBx can promote the cell proliferation of HepG2-HBx cell line.

目的 探讨高尔基蛋白73(Golgi protein-73,GP73)在肝细胞癌(heptocellular carcinoma,HCC)患者血清中的表达及其对HCC的诊断价值.方法 收集人外周血清62例,其中HCC 31例(HCC组),健康志愿者31名(健康对照组).采用Western blot法检测两组血清中GP73的表达,制作受试者工作特征曲线(receiver operating characteristic,ROC),以曲线下面积(area under curve,AUC)评价GP73诊断HCC的效能.结果 HCC组和健康对照组血清中GP73阳性表达率分别为74.19％(23/31)和9.68％(3/31),两组比较差异有统计学意义(P＜0.01).当设定GP73浓度82.2 ng/mL为诊断临界值时,ROC曲线下面积为0.823,其检测HCC的敏感度和特异度均达到最优,分别为90％和78％.结论 GP73诊断HCC具有较高的敏感度和特异度,是较好的HCC诊断标志物.

Objective Inquiry the influences of melittin and silence Cathepsin S (CTSS) to MHCC97H cell for cell proliferation and apoptosis.Methods Prepared by the silence CTSS MHCC97H cell lines(Silence CTSS cell lines marked PLVT1150, normal cell lines wich expressing CTSS marked PLVT8),Using different concentrations of melittin intervention two cell lines,then two groups cell apoptosis was detected by flow cytometry.Then the silence CTSS MHCC97-H tumor-bearing nude mice model was made. Experimental groups of nude micetreated with melittin 80μg / (kg * day), the control group was treated with PBS instead.Observe and record the growth of tumor in nude mice.Use immunohistochemistry to detect caspase-3, cleved-caspase-3 expression in tumors.Result We detected PLVT8 and PLVT1150 cells's apoptosis after melittin(0,4,8ug/ml)intervention 30 minutes by flow cytometry. The experiment was repeated 3 times,the results were expressed as x±s. After melittin(0,4,8 ug / ml)intervention the two cells group apoptosis rate were (PL VT1150:18.9%±2.1,36.7%±2.2,53.0%±1.5;PLVT8:4.27%,15.32%,28.86%).The same concentration of cells group were statistically analyzed, P <0.05.Through the observation of nude mice, we found that compared with group 1 (PLVT1150 + PBS), group 2 (PLVT1150+ melittin) tumor-bearing nude mice volume appeared larger statistical difference at day 14,the same as group 4(PLVT8+melittin)to group 3(PLVT8+PBS).P<0.05;compared with group2, group4 tumor-bearing nude mice volume appeared larger statistical difference at day22,P<0.05 and group1 to group 4 appeared larger statistical difference at day 31,P<0.05.We detect the 4 groups caspase-3 expression in tumor by immunohistochemistry experiments found that 4 groups Caspase-3 positive expression rate were 40%,20%, 80%, 40%,through comparison of the gray value: group 1 compared with group 2,P <0.05; group 3 compared with 4 group,P <0.05.The 4 groups cleved-caspase-3 positive expression rate were 40%,80%,20%,60%,through comparison of the gray value: group 1 compared with group 2, P<0.05; group 3 compared with 4 group,P<0.05.Conclusion Lentiviral-mediated silencing CTSS promote MHCC97-H apoptosis,and melittin can promote apoptosis of MHCC97-H cell after silence CTSS;Combined silence CTSS and melittin treatment may add a new research direction for biological treatment of hepatocellular carcinoma.

Objective To construct a lentivirus expression vector to drive stable Cat S overexpression in the hepatocellular carcinoma (HCC)cell line MHCC97H,and to investigate the effects of overexpression on cell proliferation and migration. Methods The Cat S gene was inserted into the lentiviral expression vector pLVX-EGFP-3FLAG-Puro using Age I and EcoR I restriction enzymes and transfected into 293T cells to generate recombinant lentivirus. This virus was used to infect MHCC97H cells,and positive cells were selected using puromycin. Real-time quantitative PCR,Western blots,MTT assay,the transwell migration assay and the wound healing migration assay were used to assess the effects of Cat S overexpression on proliferation and migration of MHCC97H cells. Results A lentiviral vector containing the Cat S gene was constructed,and an MHCC97H cell line stably overexpressing Cat S was established. Cat S overexpression was associated with significantly shorter cell doubling time,as well as significantly greater invasion and migration abilities. Conclusions Lentivirus-mediated Cat S overexpression can increase MHCC97H proliferationand migration,opening the door&nbsp;to future studies of molecular mechanisms of liver cancer invasion and metastasis.

Objective To explore the effect of different mode of intervention in the treatment of hepatocellular carcinoma. Methods 120 randomly selected from 2012 January-2013 year in June to our hospital treatment of HCC patients as the research object, it will be randomly divided into A, B, C three groups, the A group of patients with hepatic artery chemotherapy embolism operation(TACE) for treatment of patients in the B group, using the Hepatic artery ligation and embolization operation. C group of patients with hepatic artery chemotherapy embolism operation combined with hepatic portal vein chemoembolization with operation and percutaneous transhepatic ethanol ablation(PEI) treatment, examination of liver function of the three groups were compared after the end of treatment, and the treatment efficiency. Results The treatment group three patients were 32.5%, 35%, 45%, of which C group treatment effect is much better than A, B group, and the changes of alpha fetoprotein values than the other two groups of high. Conclusion The liver cancer patients were treated withthe Hepatic artery ligation and embolization operation and TACE operation with PEI, can get better treatment effect, plays a positive role in disease suppression, can be extended and adopted in clinical practice.

目的 观察原发性肝癌患者手术前后舌象特征变化,探讨肝癌围手术期患者证候特征.方法 收集103例拟行手术的原发性肝癌患者,于术前1天及术后1、3、5天上午6:30-8:00观察患者舌象,填写中医舌象调查表,用数码照相机留取舌体图片,采用中医舌诊综合信息处理系统分析舌质及舌苔颜色平均RGB各分量值.结果 定性及定量结果均提示,术前患者以青紫舌为主,术后1天以红舌为主,术后3、5天青紫舌占居首位(P＜0.05);术后舌质颜色R分量值升高,以术后第1天最明显,术后3、5天舌质颜色R分量值逐渐下降(P＜0.05).术后3、5天较术前1天舌苔R、G、B各分量值逐渐下降(P＜0.05).术后舌形胖大、齿痕、点刺舌有增多趋势(P＜0.05).手术前后皆以厚腻苔为主,且术后较术前比例逐渐上升(P＜0.05).术后1、3、5天较术前1天舌下络脉宽度明显降低(P＜0.05).结论 血瘀、水湿、气虚证舌象贯穿原发性肝癌患者围手术期,术后5天内阴虚内热舌象比例有所增加.

Objective:To observe the therapeutic efficacy of modified Dachengqi decoction combined with electroacupuncture in the treatment of early postoperative inflammatory ileus(EPII).Methods:Ninety EPII patients were randomly divided into first control group,second control group,and treatment group.The first control group received modified Dachengqi decoction,the second control group received acupuncture,and the treatment group received modified Dachengqi decoction combined with electroacupuncture.The treatment outcomes of the three groups were observed.Results:The total effective rates were 96.67% in the first control group,96.67% in the second control group,and 100% in the treatment group,without significant differences among the three groups(P>0.05).However,the treatment group had significantly shorter mean time to recovery of bowel sound,mean time to recovery of passage of gas by anus,and time to disappearance of nausea and vomiting than the first and second control groups.Conclusion:Modified Dachengqi decoction combined with electroacupuncture have good therapeutic efficacy in the treatment of EPII.

目的观察中医、中西医结合、西医三种方案治疗甲型病毒性肝炎(简称甲肝)疗效的差别.方法将广西某中学甲肝患者76例随机分为 三组,分别采用中药、中西药联合、西药治疗.结果(1)三组治愈率均为100%.三组平均住院时间分别为中药组(18.88±5.41)天,中西药组 (22 57±6.15)天,西药组(20.24±5.65)天,差异无显著性(P>0.05).(2)三组平均症状缓解时间分别为(4.85±1.86)天、(9.68± 7.40)天、(8.15±4.56)天,差异具有显著性(P<0.05).(3)各组治疗5天,治疗12天肝功能改善程度不同,但组间比较差异无显著性 (P>0.05).结论三种方案治疗甲肝均有效,对肝功能改善疗效相当,纯中药治疗方案在症状缓解方面优于其他方案.

目的比较中医分期辨证治疗与西医治疗急性黄疸型甲型病毒性肝炎(简称甲肝)的疗效.方法将36例患者分成治疗组和对照组,治疗 组经辨证按证型分期先后分为肝胆湿热证和湿邪困脾证,分别予清热祛湿方药和温中祛湿方药治疗18天,对照组以单纯西药降酶退黄等治疗18 天.结果(1)治疗组的治愈率为95%,对照组的治愈率为93.75%,差异无统计学意义(P>0 05);(2)两组治疗前后肝功能指标治疗组较对 照组明显改善,差异有统计学意义(P<0.05);(3)两组中医症候积分比较,治疗组治疗前后积分比较差异有统计学意义(P<0.05),治疗组 与对照组同期积分比较差异有统计学意义(P<0.05).结论中医分期辨证治疗甲肝改善肝功能的疗效与西医治疗相当,但中医治疗能显著改善 患者症状、体征.

ObjectiveTo observe the expression of cathepsin S(Cat-S)in hepatoma carcinoma cell and normal hepatic cell,so as to investigate the relationship between expression of Cat-S and occurrence and development of hepatocellular carcinoma(HCC).MethodsHuman HCC with high metastasis potential MHCC97-H,with low metastasis potential MHCC97-L and normal hepatic cell LO2 were cultured in vitro,then the Cat-S mRNA expression level were detected by Fluorecence quantitative PCR.ResultsCat-S mRNA was at low level in cell lines LO2,but significantly higher in cell lines MHCC97-H and cell lines MHCC97-L(P0.05);and which in in cell lines MHCC97-H was significantly higher than that in cell lines MHCC97-L(P0.05).ConclusionsCat-S expression in HCC cells with high or low metastasis potential and normal hepatic cell are different,which maybe correlated with occurrence and development of HCC;Cat-S maybe used as a biologic maker for HCC diagnosis and treatment.

AIM:To evaluate the efficacy and safety o integrated traditional Chinese and Western medicine in the treatment of early postoperative inflammatory intestinal obstruction. METHODS:The CBM (1979/2011-03),CNKI(1980/2011-03), VIP (1989/2011-03), Wanfang (1998/2011-03),PubMed (1980/2011-03), Embase (1979-2011-03), and Cochrane library were searched. No language restrictions were applied. Randomized controlled trials (RCTs) evaluating the efficacy and safety of integrated traditional Chinese and Western medicine in patients with early postoperative inflammatory intestinal obstruction were included. The quality of included studies was evaluated and a meta-analysis was performed using the RevMan 5.0 software.RESULTS:Sixteen RCTs, encompassing a total of 1 405 patients, were included. The results of meta-analysis showed that the cure rate was significantly higher in integrated traditional Chinese and Western medicine treatment group than in Western medicine treatment group in eleven studies (OR=4.54,95%CI:2.91-7.06,P <0.00001). The time required for restoration of anus exhaust was significantly shorter in the integrated treatment group than in the Western medicine treatment group in eight studies, and the hospitalization duration was significantly shorter in the integrated treatment group than in the Western medicine treatment group in six studies [WMD=-5.59, 95%CI:(-9.20)-(-1.98), P=0.002]. CONCLUSION: Compared to treatment with Western medicine alone, treatment with integrated traditional Chinese and Western medicine can effectively improve the cure rate and shorten the time required for restoration of anus exhaust and hospitalization time in patients with early postoperative inflammatory intestinal obstruction. However, the evidence obtained was not strong enough because of the low quality of included studies.

目的研究高转移肝癌MHCC97细胞中Twist基因表达与Wnt信号通路的关系。方法取对数生长期MHCC97细胞分为五组,A、B组分别加入0.05 mol/L氯化锂分别培养12、24 h,C、D组予0.1 mol/L氯化锂分别培养12、24 h激活Wnt通路,E组不干预。采用RT-PCR和荧光定量PCR方法观察各组Twist mRNA表达情况。结果两种检测方法均显示Twist mRNA在A、B、C、D组表达均明显高于E组,P<0.05;A、B组,C、D组,A、C组,B、D组间比较,P均>0.05。结论MHCC97细胞中Wnt通路激活后Twist基因表达明显升高未激活,即Twist基因表达与Wnt信号传导通路激活关系密切,Wnt传导通路激活与氯化锂浓度及作用时间无明显相关性。

目的:通过观察原发性肝癌患者手术前后中医证候分布与转变情况,初步揭示肝癌患者手术前后的中医证候变化特点,为手术后肝癌的辨证论治提供科学依据.方法:采用自身前后对照的方法,对符合纳入标准的63 例肝癌手术患者手术前后证候进行采集.结果:(1)基本证候分布变化结果:手术后血瘀证、气虚证变化最大,血瘀证较手术前减少6.3%,气虚证较手术前增加5.3%,差异有统计学意义;其余各证手术前后差异无统计学意义.(2)基本证候量化评分结果:手术后气虚证增多,气虚证手术前后差异有统计学意义;其余各证手术前后差异无统计学意义.结论:肝癌患者手术前后均呈现血瘀和气虚的症状,因此需重视活血化瘀、健脾益气,但术后血瘀证有所减少,气虚证增多,应该对活血化瘀和健脾益气力度有所调整;肝癌术后中医治疗应更重视健脾益气.

OBJECTIVE:To study the spatial distribution characteristics of liver cancer in Guangxi so as to provide evidence for the development of control and prevention on liver cancer.METHODS:The average eight year morbidity was computed, using the rates of liver cancer in 2000-2007. The spatial statistics module of GIS was used to conduct spatial autocorrelation analysis, and the disease mapping was drawn, using the Map Info 8.0 software.RESULTS:The average morbidity rate was clustered in Guangxi in the past eight years, with Moran's I index as 0.34 and P value below 0.01. G index appeared to be 0.77 and the P value was below 0.01. Moran's I correlogram lifted up in four spaces, specifically, the cluster took place in both macro-scale (one to three spatial intervals, 45 to 135 km real scale) and micro-scale (16 to 18 spatial intervals, 720 to 800 km real scale). When the spatial interval became 14 and real scale was 60 km, the spatial distribution of liver cancer showed the most intensive autocorrelation. Most of the regions with high morbidity would be clustered in the southwest and southern parts, along the coastal areas of Guangxi while the regions with low morbidity clustered in the northern part of Guangxi.CONCLUSION:Liver cancer was found un-randomly distributed and geographically clustered in Guangxi in 2000-2007.

Objective To analyze retrospectively the overall situation of medical rescue in the First A liated Hospital of Guangxi Medical University after the Wenchuan earthquake, so as to provide references for the emergency preparation for the disaster of earthquake. Methods Analysis was based on the data provided by the Department of Information, the Medical Record Library, the Department of Emergency, the Department of Orthopaedics and other related departments of the hospital. The software Microsoft EXCEL was used for data management, and SPSS 13.0 was used for statistical analysis. Results From May 22 to May 26, 91 cases from the disaster area had been treated in the hospital, of which 90 were from Mianyang and 1 from Chengdu. These patients included 44 males with a median age of 38 (27, 53) years old and 47 females with a median age of 51 (33, 62) years old. Most patients were sent to the hospital within the rst 10 or 11 days after the earthquake, with 86.8% hospitalized after 10 days and 22.0% after 11 days. The number of outpatients reached its peak of 37.1% of all the outpatients (33 cases) within 34 days after the earthquake. The wounded were mainly admitted into the Department of Orthopaedics, with 34.81% of the patients having lower limb fracture, 18.26% having spine fracture, and 12.59% su ering pelvis fracture. Only 2 out of the 89 patients died. One death was due to 60% burning injury and 1 died of multiple catastrophic injuries. Conclusion Based on the data, it is important to develop an emergent plan for medical rescues after an earthquake disaster and to strengthen the reserve of medical supplies, personnel training, scienti c eld triage and the construction of information platforms.

Objective To investigate the relationship of Twist mRNA and WNT signaling pathway in liver cancer cells.Methods Human hepatoma cell line SMMC7721 cells were cultured with with 0.05 mol/L chloride lithium for 2 h,then cultured separately for 6,12,24 h,respectively,for A1,A2,A3 groups;human hepatoma cell line SMMC7721 cells were cultured with 0.1 mol/L chloride lithium for 2 h,then cultured separately for 6,12,24 h,respectively,for B1,B2,B3 Group;In addition,a blank control group was set up.The expression of Twist mRNA in SMMC7721 was detected respectively when the WNT pathway was activated and not activated by RT-PCR and real time PCR.Result The value of Twist mRNA measured by RT-PCR method in A1,A2,A3 group were 0.38±0.05、0.60±0.08、0.69±0.06,B1,B2,B3 group were 0.56±0.05、0.59±0.06、0.69±0.04,compared with the control group(0.18±0.03),P0.05.The value of Twist mRNA measured by real time PCR method in A1,A2,A3 group were 0.43±0.01、0.56±0.01、0.67±0.01,B1、B2、B3 were 0.52±0.01、0.58±0.00、0.65±0.00,compared with the control group(0.21±0.00),P0.05.Conclusion The expression of Twist gene in liver cancer may be related to WNT pathway.

Twist蛋白是属于碱性的螺旋-环-螺旋蛋白家族中的高度保守的转录因子,在胚胎的发生和发展中发挥着重要作用.近年来,Twist被认为是一种癌基因蛋白, 能编码凋亡抑制蛋白,与恶性肿瘤细胞的凋亡关系密切.一些学者推测,Twist的激活可能与恶性肿瘤的生长、侵袭和转移过程有关.本文主要综述近年来Twist与恶性肿瘤细胞凋亡的关系以及在恶性肿瘤的侵袭、转移中的作用.

电视腹腔镜胰十二指肠切除术是一种技术难度较大的手术.目前国外已报告110多例[1],国内10余例[2-3 ].我们自开展腹腔镜下胰十二指肠切除术至今已成功进行13例.在手术技术上,从肿瘤的可切除判断到胰腺、胆道、胃肠的离断及周围淋巴结的清扫等都有许多值得探讨之处,而胰十二指肠切除术后消化道重建方法是手术成功的关键.