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
Intestinal lipomatosis is a rare disease with an incidence at autopsy ranging from 0.04% to 4.5%.Because the lipomas are diffusely distributed in the intestine,most patients are symptom-free,and invasive intervention ...Intestinal lipomatosis is a rare disease with an incidence at autopsy ranging from 0.04% to 4.5%.Because the lipomas are diffusely distributed in the intestine,most patients are symptom-free,and invasive intervention is not advised by most doctors.Here,we describe a case with intussusception due to small-bowel lipomatosis.Partial small bowel resection and anastomosis were performed because the intestinal wall was on the verge of perforation.This case indicates that regular followup is necessary and endoscopic treatment should be considered to avoid surgical procedures if the lipoma is large enough to cause intestinal obstruction.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
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 Beijing Medicine Research and Development Fund,No.20092029the Health Industry Scientific Research Fund of China,No.201002015
文摘Intestinal lipomatosis is a rare disease with an incidence at autopsy ranging from 0.04% to 4.5%.Because the lipomas are diffusely distributed in the intestine,most patients are symptom-free,and invasive intervention is not advised by most doctors.Here,we describe a case with intussusception due to small-bowel lipomatosis.Partial small bowel resection and anastomosis were performed because the intestinal wall was on the verge of perforation.This case indicates that regular followup is necessary and endoscopic treatment should be considered to avoid surgical procedures if the lipoma is large enough to cause intestinal obstruction.
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.
