Laparoscopic cholecystectomy plus common bile duct exploration for extrahepatic bile duct stones and postoperative recurrenceassociated risk factors

BACKGROUND There remain controversies regarding the surgical treatment of extrahepatic bile duct stones(EHBDSs)in clinical practice.AIM To explore the curative effect of laparoscopic cholecystectomy(LC)plus common bile duct exploration(CBDE)for the surgical treatment of EHBDSs and to analyze the risk factors that affect postoperative stone recurrence.METHODS Eighty-two patients with EHBDSs admitted between March 2017 and March 2023 were selected.Among them,patients treated with open choledocholithotomy plus LC or open cholecystectomy(OC)were set as the control group(n=40),and those treated with LC plus CBDE served as the observation group(n=42).The surgical outcomes of the two groups were compared,the surgical complications and Gas-trointestinal Quality of Life Index(GIQLI)scores were counted,and the one-year prognostic recurrence was recorded.Independent factors for postoperative re-currence were determined using univariate and multivariate analyses.RESULTS The two groups were comparable in the stone residual rate(P>0.05).The ope-ration time(P<0.05),intraoperative bleeding(P<0.05),and total complication rate(P=0.005)were lower in the observation group than in the control group.The observation group exhibited a marked increase in the GIQLI score,which was higher than the control group(P<0.05).A lower one-year recurrence rate was determined in the observation group vs the control group(P=0.027).Sphincter of Oddi dysfunction[odds ratio(OR)=5.712,P=0.007]and the treatment scheme of open choledocholithotomy plus LC or OC(OR=6.771,P=0.008)were the independent risk factors for one-year recurrence in patients after surgery.CONCLUSION LC plus CBDE for patients with EHBDSs can reduce stone residuals,intraoperative bleeding,complications,and postoperative recurrence.

Expression of Hpa and CD222 in bladder carcinoma and analysis of clinico-pathologic correlation

Objective: Our study aimed to investigate the relationships between the clinico-pathologic features and the heparanase(Hpa) and CD222 expressions in bladder carcinoma. Methods: The expressions of Hpa and CD222 in 95 bladder carcinoma specimens and 20 paraneoplastic bladder tissues(controls) were assessed using the immunohistochemical staining method. Results: The positive expression rates of Hpa and CD222 in bladder carcinoma were 68.42% and 61.05%, respectively. The positive rate of Hpa was significantly higher in the carcinoma specimens than in the control specimens(P < 0.01). Similarly, the Hpa expression in the invasive bladder carcinoma was significantly higher than that in the non-invasive bladder carcinoma(P < 0.01). A positive correlation was observed between the expressions of Hpa and CD222(P < 0.05). The expressions of Hpa and CD222 were significantly correlated with lymphatic invasion and TNM staging(P < 0.05). The 5-year survival rate was significantly higher in negative expression of the Hpa group than that in the positive expression group(P < 0.05). Compared with the non-co-positive expression group, the 5-year survival rate in the co-positive expression of Hpa and CD222 group was significantly lower(P < 0.05). Conclusion: High Hpa and CD222 expressions in tumor tissues were associated with the occurrence and development of bladder carcinoma. Our results provide helpful information for the further diagnosis and therapy of bladder carcinoma.

Advances in anti-tumor mechanisms of Venenum Bufonis

Venenum Bufonis is one of the traditional medical herbs,containing a variety of active ingredients such as peptides,alkaloids,lactones and sterols.In recent years,the significant anti-tumor effect of Venenum Bufonis and its active components,which are mainly composed of lipid scorpion venom,scorpion venom and scorpion venom,has become a research hotspot.Venenum Bufonis can inhibit the occurrence and development of tumor cells by inducing apoptosis of tumor cells,promoting tumor cell differentiation,inhibiting tumor microangiogenesis and reversing tumor cell resistance.Based on the chemical composition of Venenum Bufonis,this paper summarizes the mechanism of inhibiting tumors of the active ingredients in Venenum Bufonis.

Expression and Antigen Activity Determination of Human Thyroid Peroxidase in Silkworm and Yeast

In this study,we report the expression of human thyroid peroxidase（TPO） in silkworm larvae and Pichia pastoris GS115. Recombinant TPO is sequentially purified from the hemolymph of infected silkworm larvae and yeast using a Ni-NTA resin kit. The concentration of yield of recombinant TPO is 4.87 mg per thousand larvae and 40.83 mg per liter yeast culture. However,the recombinant TPO produced in silkworm show similar binding ability with the specific anti-TPO serum to standard human TPO purified from insect cells. The lower antigen activity indicates the TPO expressed in yeast is not suitable to be used as the coating antigen in enzyme linked immunosorbent assay（ELISA）. The cost of TPO expressed in B. mori is about 1/4 that of in insect cells,and the cost of TPO purified from silkworm for ELISA is only 1/8 that of TPO produced from Sf9 cells. It indicates the Bm NPV-silkworm expression system is a cost-effectiv e platform for producing TPO with high antigen activity.