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经腹翻肝技术治疗肾肿瘤合并Ⅱ、Ⅲ级下腔静脉瘤栓 被引量:1
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作者 李远伟 吴万瑞 +7 位作者 刘哲 卢强 陈佳 高智勇 段义星 吴金术 蒋波 沈贤波 《中国现代医学杂志》 CAS 北大核心 2015年第35期109-112,共4页
目的 评估经腹部切口结合翻肝技术治疗肾肿瘤合并Ⅱ、Ⅲ级下腔静脉瘤栓的安全性和有效性.方法 2009年1月-2015年4月采用腹部切口治疗11例肾肿瘤合并Ⅱ、Ⅲ级下腔静脉瘤栓患者,年龄5~61岁,平均45.2岁;右侧8例,左侧3例.肿瘤直径9.2~15.8... 目的 评估经腹部切口结合翻肝技术治疗肾肿瘤合并Ⅱ、Ⅲ级下腔静脉瘤栓的安全性和有效性.方法 2009年1月-2015年4月采用腹部切口治疗11例肾肿瘤合并Ⅱ、Ⅲ级下腔静脉瘤栓患者,年龄5~61岁,平均45.2岁;右侧8例,左侧3例.肿瘤直径9.2~15.8 cm,平均11.3 cm.采用Mayo Clinic的五级分类法进行瘤栓分级,其中Ⅱ级瘤栓6例,Ⅲ级瘤栓5例.术中采用背驮式肝移植技巧游离翻转肝脏,应用Pringle技术短暂阻断肝脏血流,取出下腔静脉内瘤栓并重建下腔静脉后,行肾肿瘤根治术.术后5例病理检查为透明细胞癌,予以辅助靶向治疗(舒尼替尼或索拉非尼).结果 11例完整切除瘤栓和肿瘤,手术时间280~420 min,平均310 min;术中出血220~950 ml,平均410ml.围手术期无瘤栓栓塞和患者死亡.术后予以辅助靶向治疗,其副作用患者可以耐受.结论 经腹翻肝技术能够完全切除肾肿瘤合并Ⅱ、Ⅲ级下腔静脉瘤栓,避免体外循环的并发症.术后辅助靶向药物治疗,可能改善生存率. 展开更多
关键词 翻肝技术 肾肿瘤 下腔静脉瘤栓 肾癌根治术
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翻肝技术在处理右肾巨大占位合并下腔静脉癌栓中的应用价值 被引量:1
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作者 薛蔚 陈勇辉 +5 位作者 陈海戈 陈奇 潘家骅 刘东明 黄翼然 严春寅 《上海医学》 CAS CSCD 北大核心 2013年第3期239-242,共4页
目的评估以肝移植切口结合肝脏游离技巧处理右肾中上极巨大肿瘤及下腔静脉内癌栓的安全性和有效性,总结其优越性。方法 2007年5月—2011年7月间共有8例患者行肝脏游离后的右肾癌根治术,年龄32~83岁,平均年龄为(56.8±17.6)岁。肿... 目的评估以肝移植切口结合肝脏游离技巧处理右肾中上极巨大肿瘤及下腔静脉内癌栓的安全性和有效性,总结其优越性。方法 2007年5月—2011年7月间共有8例患者行肝脏游离后的右肾癌根治术,年龄32~83岁,平均年龄为(56.8±17.6)岁。肿瘤直径9.5~15.0cm,平均直径为(11.4±2.5)cm。磁共振成像(MRI)评估癌栓所处静脉水平后,采用MayoClinic的五级分类法进行腔静脉内癌栓分级。合并腹膜后及肾门旁淋巴结转移3例;合并0级癌栓2例,合并Ⅱ级癌栓2例,合并Ⅲ级癌栓1例。术中采用背驮式肝移植技巧游离翻转肝脏,尝试应用Pringle技术短暂阻断肝脏血流以获取较清晰的手术视野,切除患肾后取尽下腔静脉内癌栓并重建下腔静脉。手术当天及术后第1天,所有患者入外科重症监护病房,监测术后患者肝、肾功能情况。结果 3例合并下腔静脉内癌栓的患者均成功取尽癌栓,重建下腔静脉。术中见患者的癌栓范围与MRI提示的癌栓范围相符。所有患者术中失血量200~900mL,平均术中失血量为(387.5±299.7)mL;0级癌栓患者术中失血量为300、200mL,Ⅱ级癌栓患者为400、500mL,Ⅲ级癌栓患者为900mL。所有患者手术时间为137~309min,平均手术时间为(210.1±67.0)min;其中Ⅰ级癌栓患者手术时间为212、137min,Ⅱ级癌栓患者为249、278min,Ⅲ级癌栓患者为309min。所有患者术中及术后均未发生严重并发症。患者术后第1天血清肌酐水平86~113μmol/L,平均为(99.3±8.7)μmol/L;丙氨酸转氨酶水平为22~35U/L,平均为(29.3±5.1)U/L;天冬氨酸转氨酶为14~38U/L,平均为(24.1±8.1)U/L。应用Pringle技术暂时阻断肝脏血流后无1例患者产生肝功能损害。结论翻肝技术可充分显露右侧腔静脉-膈肌角,暴露其间的肿瘤侧支血管、膈下血管、肝后下腔静脉及因肿瘤压迫而向上推移的右肾上腺,适用于右肾巨大占位和下腔静脉内Ⅰ~Ⅲ级癌栓的根治性切除。与此同时,放弃传统的胸腹联合切口而使用单纯经腹途径,可降低麻醉风险,减小手术创伤,同时也可避免术后留置胸腔闭式引流,为术后患者的护理和早期活动提供有利条件。 展开更多
关键词 翻肝 背驮式移植 右肾上极占位 下腔静脉内癌栓
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Detection of eukaryotic translation initiation factor 4E and its clinical significance in hepatocellular carcinoma 被引量:2
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作者 Xiao-Lin Wang Hong-Pei Cai +1 位作者 Jun-Hui Ge Xiao-Feng Su 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第20期2540-2544,共5页
AIM:To study the expression of eukaryotic translation initiation factor 4E(eIF4E),which is closely correlated with malignant tumors,and its relationship to prognosis in hepatocellular carcinoma. METHODS:Western blotti... AIM:To study the expression of eukaryotic translation initiation factor 4E(eIF4E),which is closely correlated with malignant tumors,and its relationship to prognosis in hepatocellular carcinoma. METHODS:Western blotting was performed to quantify the elF4E protein expression in the normal human liver cell line L02 and the hepatoma cell lines Hep3B, HepG2,and Huh7.Forty-six hepatocellular carcinoma samples with complete clinical data were obtained from Changzheng Hospital during the period of December 2008 to July 2009.The expression of eIF4E in the tumor samples and their adjacent tissues were detected by immunohistochemistry.The relationship between the test results and hepatocellular carcinoma(HCC) prognosis was statistically analysed by using a COX proportional hazard model. RESULTS:Western blotting analysis showed that there were distinct eIF4E protein bands in all three of the hepatoma cell lines.In particular,the HepG2 cell line had the highest level of eIF4E protein expression.The L02 cell group had a low eIF4E expression.Immunohistochemical assay showed that there were 32 cases in which the tumour tissue expression was higher than their adjacent tissues,accounting for 69.57%.There were also 14 cases in which the tumour tissue expression was lower or no significant difference was found, accounting for 30.43%.COX proportional hazards model analysis showed that HCC prognosis was related to the depth of invasion,the overexpression of eIF4E and p53, possibly as independent HCC prognostic predictors. CONCLUSION:In summary,eIF4E expression is associated with liver cancer,and patients with high eIF4E expression levels have a higher risk of recurrence. 展开更多
关键词 Hepatocellular carcinoma Eukaryotic translation initiation factor 4E Western blotting IMMUNOHISTOCHEMISTRY PROGNOSIS
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Alcohol-induced protein hyperacetylation: Mechanisms and consequences 被引量:3
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作者 Blythe D Shepard Pamela L Tuma 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第10期1219-1230,共12页
Although the clinical manifestations of alcoholic liver disease are well-described, little is known about the molecular basis of liver injury. Recent studies have indicated that ethanol exposure induces global protein... Although the clinical manifestations of alcoholic liver disease are well-described, little is known about the molecular basis of liver injury. Recent studies have indicated that ethanol exposure induces global protein hyperacetylationo This reversible, post- translational modification on the E-amino groups of lysine residues has been shown to modulate multiple, diverse cellular processes ranging from transcriptional activation to microtubule stability. Thus, alcohol- induced protein hyperacetylation likely leads to major physiological consequences that contribute to alcohol-induced hepatotoxicity. Lysine acetylation is controlled by the activities of two opposing enzymes, histone acetyltransferases and histone deacetylases. Currently, efforts are aimed at determining which enzymes are responsible for the increased acetylation of specific substrates. However, the greater challenge will be to determine the physiological ramifications of protein hyperacetylation and how they might contribute to the progression of liver disease. In this review, we will first list and discuss the proteins known to be hyperacetylated in the presence of ethanol. We will then describe what is known about the mechanisms leading to increased protein acetylation and how hyperacetylation may perturb hepatic function. 展开更多
关键词 ETHANOL HEPATOTOXICITY ACETYLATION DEACETYLASES ACETYLTRANSFERASES
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A novel strategy to inhibit the reproduction and translation of hepatitis C virus
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作者 DUAN AiPing NING LiMin +4 位作者 LI Chao HOU YaFei YANG NaNa SUN LiZhou LI GenXi 《Science China(Life Sciences)》 SCIE CAS 2013年第4期293-297,共5页
Hepatitis C virus (HCV), a positive single-stranded RNA virus, is a major cause of liver disease in humans. Herein we report a novel strategy to inhibit the reproduction and translation of HCV using a short RNA, named... Hepatitis C virus (HCV), a positive single-stranded RNA virus, is a major cause of liver disease in humans. Herein we report a novel strategy to inhibit the reproduction and translation of HCV using a short RNA, named an Additional RNA, to activate the endonuclease activity of Argonaute 2 (Ago2). In the presence of the Additional RNA, the HCV genome RNA has the requisite 12 nucleotides of base-pairing with microRNA-122. This activates the endonuclease activity of Ago2, resulting in cleavage and release of the HCV genome RNA from Ago2 and microRNA-122. The free HCV genome RNA would be susceptible to intracellular degradation, effectively inhibiting its reproduction and translation. This study presents a new method to inhibit HCV that may hold great potential for HCV treatment in the future. 展开更多
关键词 hepatitis C virus reproduction and translation Argonaute 2 protein electro-analysis biosensor
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