Correlation between Expression Differences of Epithelial-Mesenchymal Transition (EMT) in Cholangiocarcinoma Tissue

Background: By studying the expression of epithelial-mesenchymal transition regulators in cholangiocarcinoma and intrahepatic duct stones, the correlation between the expression of epithelial-mesenchymal transition regulators and cholangiocarcinoma was revealed. Objective: The objective is to investigate the correlation between the expression of epithelial-mesenchymal transition (EC) regulatory factors and cholangiocarcinoma in patients with intrahepatic duct stones and cholangiocarcinoma, to investigate the relationship between clinicopathological features and prognosis, and to observe the expression of molecular markers of epithelial-mesenchymal transition (EMT) in intrahepatic duct stones and bile duct carcinoma. Methods: Twenty cases of primary cholangiocarcinoma, 20 cases of intrahepatic cholangiolithiasis complicated with cholangiocarcinoma, and 20 cases of intrahepatic cholangiolithiasis specimens were collected from the Fourth People’s Hospital and the friendly medical unit of Haikou. Immunohistochemistry was used to detect the expression differences of EMT-related molecular markers Twisit1, Twisit2, E-cadherin, N-cadherin, and Vimentin in paraffin sections of normal intrahepatic bile duct tissues and patients with intrahepatic duct stones and cholangiocarcinoma. Results: Immunohistochemical staining revealed epithelial-mesenchymal transition (EMT) in intrahepatic cholangiocarcinoma tissue, intrahepatic cholangiolithiasis with cholangiocarcinoma, intrahepatic cholangiolithiasis with normal intrahepatic cholangiolithiasis, such as Sit1, Twisit2, E-cadherin, N-cadherin, and Vimentin proteins were different. The expression of E-cadherin was decreased in cholangiocarcinoma tissue and intrahepatic cholangiolithiocarcinoma combined with cholangiocarcinoma (P < 0.05), while the expression of N-cadherin and Vimentin was up-regulated (P < 0.05). The expression of Twisit1 and Twisit2 had no difference (P > 0.05). There was no difference in the expression of intrahepatic bile duct stones and EMT (P > 0.05). Conclusion: The expression of E-cadherin, the molecular marker of EMT, was down-regulated, while the expression of N-cadherin and Vimentin was up-regulated. Age, gender, depth of tumor invasion, degree of tumor differentiation and lymph node metastasis were correlated with the expression of EMT in intrahepatic cholangiocarcinoma.

Success Factors for Social Systems to Increase the Number of Organ Donations—From the Perspectives of Mechanisms and Organizational Behaviors

Deceased organ donation is much less prominent in Japan than it is in Western and other Asian countries. Because a shortage of organ donation is a serious social issue in Japan, various solutions to the issue have been considered. Although it was believed that the most critical factor in the organ shortage was the absence of a well-established social system, no prior studies attempted to analyze the issue from the perspective of the mechanisms and organizational behaviors. To identify common success factors of increasing organ donation, we conducted a qualitative survey in 5 countries promoting organ donations on a national level and increasing the number of organ donations. We found several important common factors: 1) to change from an explicit consent system to a presumed consent system with establishment of an appropriate in-hospital system, 2) to increase the level of job satisfaction of healthcare professionals and help them generating better results, 3) to demonstrate managements’ leadership for all staff to realize the importance of organ donations, 4) to establish an environment where medical professionals engaged in organ donations can appreciate autonomous working styles, the recognition of the importance of the work. It is suggested that these successful factors are introduced into Japan with long-, mid-term strategy to enhance organ donation.