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1Function of apoptosis and expression of the proteins Bcl-2,p53 and C-myc in the development of gastric cancer显示文摘INTRODUCTIONIn China ,the incidence and mortality of gastric cancer rank the second among all cancers. Recent development of cancer [1-20].The aim of this study was investigat the insight of apoptosis and bcl-2, p53 and C-myc protein expression in the development of gastric cancer .An Gao Xu Shao Guang Li Ji Hong Liu Ai Hua Gan Research Laboratory of Digestive Disease,Huizhou Central People’s Hospital,Huizhou 516001,Guangdong Province,ChinaDr.An Gao Xu graduated from Guangdong Medical College in 1984.He is an associate physician-in-chief,specializing in the research and treatment of gastrointestinal and liver tumors.He has published 24 papers and 1 book. 2001World Journal of Gastroenterology2001,7,3:91
2Hepatocellular Carcinoma-Cause,Treatment and Metastasis显示文摘In the recent decades, the incidence of hepatocellular carcinoma (HCC) has been found to be increasing in males in some countries. In China, HCC ranked second of cancer mortality since 1990s. Hepatitis B and C viruses (HBV and HCV) and dietary aflatoxin intake remain the major causative factors of HCC. Surgery plays a major role in the treatment of HCC, particularly for small HCC. Downstaging unresectable huge HCC to smaller HCC and followed by resection will probably be a new approach for further study. Liver transplantation is indicated for small HCC, however, some issues remain to be solved.Different modes of 'regional cancer therapy for HCC' have been tried. Systemic chemotherapy has been disappointing in the past but the future can be promising.Biotherapy, such as cytokines, differentiation inducers,anti-angiogenic agents, gene therapy and tumor vaccine will probably play a role, particularly in the prevention of tumor recurrence. HCC invasiveness is currently the major target of study. Tremendous works have been done at the molecular level, which will provide clues for biomarker of HCC progressionas well as targets for intervention.Zhao-You Tang Liver Cancer Institute & Zhongshan Hospital of Fudan University Professor of Surgery Chairman.Liver Cancer Institute of Fudan University(previous Liver Cancer Institute of Shanghai Medical University)136 Yixueyuan Road,Zhongshan Hospital,Shanghai 200032,China. 2001World Journal of Gastroenterology2001,7,4:213
3Dysfunction of peripheral blood dendritic cells from patients with chronic hepatitis B virus infection显示文摘AIM To identify the property of dendritic cella (DCs) of peripheral blood monocytes (PBMC) in patlents with chronic HBV infection.METHODS Twenty patients with persistent HBV infectlon were included in this study, 10 healthy subjects being used as a control group. The peripheral blood mononuclear cells (PBMC) of T cell-depleted populations were incubated and induced into mature dendritic cells in the RPMI-1640 medium in the presence of cytokines GMCSF, IL-4, FLt-3, TNF-α and 100 mL@ L-1 of fetal calf serum for a total of 10 - 12 days. The expressions of surface markers on DCs were evaluated using flow cytometric analysis. ELISA method was used to determine the cytokine levels of interleukin-12 (IL-12) and IL-10 in the supernatant produced by DCs. For detection of the stimulatory capacity of DCs to T cell proliferation,mytomycin C-treated DC were incubated with allogenic T cells.RESULTS A typical morphology of mature DCs from healthy subjects and HBV-infected patients was induced in in vitro incubation, but the proliferation ability and cellular number of DCs from HBV-infected patients significantly decreased compared with healthy individuals. In particular, the expression levels of HLADR, CD80 (B7-1) and CD86 (B7-2) on DC surface from patients were also lower than that from healthy individuals (0.46 vs 0.92 for HLA-DR, 0.44 vs 0.88 for CD80 and 0.44 vs 0. 84 for CD86, P< 0.05). The stimulatory capacity and production of IL-12 of DCs from patients in allogenic mixed lymphocyte reaction (AMLR) significantly decreased, but the production level of nitric oxide (NO) by DCa simultaneously increased compared with healthy subjects (86± 15 vs 170±22 μmoI@L 1, P<0.05).CONCLUSION The patients with chronic HBV infection have the defective function and immature phenotype of dendritic cells, which may be associated with the inability of efficient presentation of HBV antigens to host immune system for the clearance of HBV.Fu-Sheng Wang Li-He Xing Ming-Xu Liu Chuan-Lin Zhu Hui-Gang Liu Hui-Fen Wang Zhou-Yun Lei Division of Biological Engineering,~2 Fourth Department of Liver Diseases,Beijing Institute of Infectious Diseases,Beijing Hospital of Infectious Diseases,Beijing 100039,China 2001World Journal of Gastroenterology2001,7,4:131
4Establishment of cell clones with different metastatic potential from the metastatic hepatocellular carcinoma cell line MHCC97显示文摘ALM To establish clone cells with different metastatic potential for the study of metastasis-related mechanisms. METHODS Cloning procedure was performed on parental hepatocellular carcinoma (HCC) cell line MHCC97. andbiological characteristics of the target clones selected by in vivo screening were studied.``RESULTS Two clones with high MHCC97-H and IowMHCC9--L1 metastatic potential were isolated from theparent cell line. Compared with MHCC97-L. MHCC97-H hadsmaller cell size average cell diameter 43 um vs 50 μmand faster in vitro and in vivo growth rate tumor celldoubling time was 34.2 h vs 60.0 h. The main ranges ofchromosomes were 5.5 58 in MHCC97-H and 57 62 inMHCC97-L. Boyden chamber in vitro invasion assay demonstrated that the number of penetrating cells through the artificial basement membrane was 137.5 - 11 .0) cellsfield for MHC_C99--H vs 17.7 - 6.3) field for MHCC97-L.The proportions of cells in GO Gl phase. S phase, and G_ M phase for MHCC97-H MHCC97-L were 0.56 6.65.0.28 0.25 and 0.l6 0.10, respectively, as measured by flow cytometry. The serum AFP levels in nude mice 5 wk after orthotopic implantation of tumor tissue were ( 24666 μg. L for MHCC97-H and (91- 66) μg' L 1 for MHCC97L. The pulmonary metastatic rate was 100% (10-10) vs40% 4- 10).``CONCLUSION Two clones of the same genetic background but with different biological behaviors were established, which could be valuable models for investigation on HCC metastasis.Yan Li Zhao-You Tang Sheng-Long Ye Yin-Kun Liu Jie Chen Qiong Xue Jun Chen Dong-Mei Gao Wei-Hua Bao Liver Cancer Institute and Zhongshan Hospital of Fudan University (Former Liver Cancer Institute of Shanghai Medical University),Shanghai 200032,China 2001World Journal of Gastroenterology2001,7,5:111
5非酒精性脂肪性肝病诊疗指南显示文摘非酒精性脂肪性肝病(NAFLD)是指除外酒精和其他明确的损肝因素所致的,以弥漫性肝细胞大泡性脂肪变为主要特征的临床病理综合征,包括单纯性脂肪肝以及由其演变的脂肪性肝炎(NASH)和肝硬化,胰岛素抵抗和遗传易感性与其发病关系密切。随着肥胖和糖尿病的发病率增加,NAFLD现已成为我国常见的慢性肝病之一,严重危害人民健康。为进一步规范NAFLD的诊断、治疗和疗效评估,中华医学会肝病学分会脂肪肝和酒精性肝病学组组织国内有关专家,在参考国内外最新研究成果的基础上,按照循证医学的原则,制定了《非酒精性脂肪性肝病诊疗指南》(以下简称(《指南》)。其中推荐的意见所依据的证据共分为3个级别5个等次,文中以括号内斜体罗马数字表示,推荐意见的证据分级,参见Ⅸ酒精性肝病诊疗指南》表1。Fatty Liver and Alcoholic Liver Disease Study Group of the Chinese Liver Disease Association. 2006中华肝脏病杂志2006,14,3:1509
6酒精性肝病诊疗指南显示文摘酒精性肝病是由于长期大量饮酒所致的肝脏疾病。初期通常表现为脂肪肝,进而可发展成酒精性肝炎、酒精性肝纤维化和酒精性肝硬化,严重酗酒时可诱发广泛肝细胞坏死甚或肝功能衰竭,该病是我国常见的肝脏疾病之一,严重危害人民健康。为进一步规范酒精性肝病的诊断和治疗,中华医学会肝病学分会脂肪肝和酒精性肝病学组组织国内有关专家,在参考国内外最新研究成果的基础上,按照循证医学的原则,制订了本《指南》。其中推荐的意见所依据的证据等级共分为3个级别5个等次,见表1,文中以括号内斜体罗马数字表示。Fatty Liver and Alcoholic Liver Disease Study Group of the Chinese Liver Disease Association. 2006中华肝脏病杂志2006,14,3:271
7肝衰竭诊疗指南显示文摘肝衰竭是临床常见的严重肝病症候群,病死率极高。多年来,各国学者对肝衰竭的定义、分类、诊断和治疗等问题不断进行探索,但迄今尚无一致意见。2005年美国肝病学会发布了对急性肝衰竭处理的建议,国内迄今尚无肝衰竭的诊断治疗指南。为适应临床工作需要,规范我国肝衰竭的诊断和治疗活动,中华医学会感染病学分会和中华医学会肝病学分会组织国内有关专家,制订了我国第一部《肝衰竭诊疗指南》(以下简称《指南》)。本指南的制定遵守了循证医学原则,借鉴了国内外最新研究成果,力求与国际接轨。其中推荐意见所依据的证据共分为3个级别5个等级(表1),文中以括号内斜体罗马数字表示。Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association 2006中华肝脏病杂志2006,14,9:827
8肝纤维化中西医结合诊疗指南显示文摘肝纤维化在国际疾病分类(ICD-10)中可作为一种病名(K74-001),但主要是一种组织病理学概念。肝纤维化指肝组织内细胞外基质(ECM)成分过度增生与异常沉积,导致肝脏结构或(和)功能异常的病理变化,结构上表现为肝窦毛细血管化与肝小叶内以及汇管区纤维化;功能上可以表现为肝功能减退、门静脉高压等。其形成机制主要由于肝炎病毒、乙醇、药物与毒物、血吸虫、代谢和遗传、胆汁淤积、自身免疫性肝病等多种损伤因素长期慢性刺激肝脏,使肝窦内肝星状细胞的活化,胶原等ECM成分代谢失衡,生成大于降解,促使肝脏ECM沉积与组织结构重构。Liver Disease Committee,Chinese Association of Integrative Medicine. 2006中华肝脏病杂志2006,14,11:269
9肝衰竭诊疗指南显示文摘Liver Failure and Artficial Liver Group,Chinese Society of Infectious Diseases,Chinese Medical Association 2006实用肝脏病杂志2006,9,6:188
10非酒精性脂肪性肝病诊疗指南显示文摘Fattly Liver and Alcoholic Liver Disease Study Group of the Chinese Liver Disease Association. 2007实用肝脏病杂志2007,10,1:145
11The prognostic molecular markers in hepatocellular carcinoma显示文摘The prognosis of hepatocellular carcinoma (HCC) stillremains dismal, although many advances in its clinicalstudy have been made. It is important for tumor control toidentity the factors that predispose patients to death. Withnew discoveries in cancer biology, the pathological andbiological prognostic factors of HCC have been studied quiteextensively. Analyzing molecular markers (biomarkers) withprognostic significance is a complementary method. A largenumber of molecular factors have been shown to associatewith the invasiveness of HCC, and have potential prognosticsignificance. One important aspect is the analysis ofmolecular markers for the cellular malignancy phenotypeThese include alterations in DNA ploidy, cellularproliferation markers (PCNA, Ki-67, Mcm2, MIB1, MIA, andCSE1L/CAS protein), nuclear morphology, the p53 geneand its related molecule MDM2, other cell cycle regulators(cyclin A, cyclin D, cyclin E, cdc2, p27, p73), oncogenesand their receptors (such as ras, c-myc, c-fms, HGF, c-met, and erb-B receptor family members ), apoptosisrelated factors (Fas and FasL), as well as telomeraseactivity. Another important aspect is the analysis ofmolecular markers involved in the process of cancerinvasion and metastasis. Adhesion molecules (E-cadherin,catenins, serum intercellular adhesion molecule-1, CD44variants), proteinases involved in the clegradation ofextracellular matrix (MMP-2, MMP-9, uPA, uPAR, PAl), aswell as other molecules have been regarded as biomarkersfor the malignant phenotype of HCC, and are related toprognosis and therapeutic outcomes. Tumor angiogenesisis critical to both the growth and metastasis of cancersincluding HCC, and has drawn much attention in recentyears. Many angiogenesis-related markers, such as vascularendothelial growth factor (VEGF), basic fibroblast growthfactor (bFGF), platelet-derived endothelial cell growth factor( PD-ECGF ), thrombospondin ( TSP ), angiogenin,pleiotrophin, and endostatin (ES) levels, as well asinratumor microvessel density (MVD) have been evaluatedand found to be of prognostic significance. Body fluid(particularly blood and urinary) testing for biomarkers iseasily accessible and useful in clinical patients. Theprognostic significance of circulating DNA in plasma orserum, and its genetic alterations in HCC are otherimportant trends. More attention should be paid to thesetwo areas in future. As the progress of the human genomeproject advances, so does a clearer understanding of tumorbiology, and more and more new prognostic markers withhigh sensitivity and specificity will be found and used inclinical assays. However, the combination of some items, i.e., the pathological features and some biomarkersmentioned above, seems to be more practical for now.Lun-Xiu Qin Zhao-You Tang,Liver Cancer Institute and Zhongshan Hospital,Fudan University,Shanghai,China 2002World Journal of Gastroenterology2002,8,3:162
12Multimodality treatment in hepatocellular carcinoma patients with tumor thrombi in portal vein显示文摘AIM To compare the therapeutic effect andsignificances of multimodality treatment forhepatocellular carcinoma (HCC) with tumorthrombi in portal vein (PVTT).METHODS HCC patients (n = 147) with tumortrombi in the main portal vein or the first branchof portal vein were divided into four groups bythe several therapeutic methods. There wereconservative treatment group in 18 out ofpatients (group A); and hepatic artery ligation(HAL) and/or hepatic artery infusion (HAl)group in 18 patients (group B), in whompostoberative chemoembolization was doneperiodically; group of removal of HCC with PVTTin 79 (group C) and group of transcatheterhepatic arterial chemoembolization (TACE) orHAl and/or portal vein infusion (PVI) afteroperation in 32 (group D).RESULTS The median survival period was 12months in our series and the 1-, 3-, and 5-yearsurvival rates were 44.3%, 24.5% and 15.2%,respectively. The median survival times were 2,5, 12 and 16 months in group A, B, C and D,respectively. The 1-, 3- and 5-year survival rateswere 5.6%, 0% and 0% in group A; 22.2%,5.6% and 0% in group B; 53.9%, 26.9% and16.6% in group C; 79.3%, 38.9% and 26.8% ingroup D, respectively. Significant differenceappeared in the survival rates among the groups(P<0.05).CONCLUSION Hepatic resection with removalof tumor thrombi and HCC should increase thecurative effects and be encouraged for theprolongation of life span and quality of life forHCC patients with PVTT, whereas the besttherapeutic method for HCC with PVTT is withregional hepatic chemotherapy orchemoemblization after hepatic resection withremoval of tumor thrombi.Jia Fan Zhi Quan Wu Zhao You Tang Jian Zhou Shuang Jian Qiu Zeng Chen Ma Xin Da Zhou Sheng Long Ye Liver Cancer Institute, Zhongshan Hospital, Fudan University Medical Center (Former Shanghai University), 136 Yixueyuan Road, Shanghai 200032, China 2001World Journal of Gastroenterology2001,7,1:80
13酒精性肝病诊疗指南显示文摘Fatty Liver and Alcoholic Liver Disease Study Group of the Chinese Liver Disease Association. 2007实用肝脏病杂志2007,10,1:73
14EASL Clinical Practice Guidelines: Management of chronic hepatitis B virus infection显示文摘European Association for the Study of the Liver 2012Journal of Hepatology2012,,1:62
15The prognostic significance of clinical and pathological features in hepatocellular carcinoma显示文摘The prognosis of patients with HCC still remains dismal. The life expectancy of HCC patients is hard to predict because of the high possibility of postoperative recurrence. Many factors, such as patient's general conditions, macroscopic tumor morphology, as well as tumor hictopathology features, have been proven of prognostic significance. Female HCC patient often has a better prognosis than male patient, which might be due to the receptor of sex hormones. Younger patients often have tumors with higher invasiveness and metastatic potentials, and their survival and prognosis are worse than the older ones. Co-existing hepatitis status and hepatic functional reserve have been confirmed as risk factors for recurrence. Serum alpha-fetoprotein (AFP) is useful not only for diagnosis, but also as a prognostic indicator for HCC patients. AFP mRNA has been proposed as a predictive marker of HCC cells disseminated into the circulation and for metastatic recurrence. Many pathologic features,such as tumor size, number, capsule state, cell differentiation, venous invasion, intrahepatic spreading, and advanced pTNM stage, are the best-established risk factors for recurrence and important aspects affecting the prognosis of patients with HCC. Marked inflammatory cell infiltration in the tumor could predict a better prognosis. Clinical stage is still the most important factor influencing on the prognosis. Extratumor spreading and lymph nodal metastasis are independent predictors for poor outcome. Soma new predictive systems have recently been proposed. Different strategies of treatment might have significant different effects on the patients'prognosis. To date, surgical resection is still the only potentially curative treatment for HCC,including localized postoperative recurrences.Extent of resection, blood transfusion, occlusion of porta hepatis, and blood loss affect the survival and prognosis of HCC patients. Regional therapies provide alternative ways to improve the prognosis of HCC patients who have no opportunity to receive surgical treatment or postoperative recurrence. The combination of these treatment modalities is hopeful to further improve the prognosis. The efficacies of neoadjuvant ( preoperative ) or adjuvant ( postoperative )chemotherapy or chemoembolization in preventing recurrence and on the HCC prognosis still remain great controversy, and deserve further evaluation.Biotherapy, including IFN-alpha therapy, will play more important role in preventing recurrence and metastasis of HCC after operation.Lun-Xiu Qin Zhao-You Tang,Liver Cancer Institute and Zhongshan Hospital,Fudan University,Shanghai,China 2002World Journal of Gastroenterology2002,8,2:77
16胆汁淤积性肝病诊断治疗专家共识:2015年更新显示文摘胆汁淤积性肝病是一组以胆汁淤积为主要表现的临床常见疾病。近年来,对该病的诊断治疗取得迅速进展。2009年及2013年《中华实验和临床感染病杂志(电子版)》与《中国肝脏病杂志(电子版)》编辑部组织国内部分专家分别对相关资料进行整理分析,形成了《胆汁淤积性肝病诊断治疗专家共识》的2009版及2013版。近2年来,胆汁淤积性肝病诊断治疗的资料进一步积累。Expert Committee on the 2015 update of expert consensus on the diagnosis and treatment of cholestatic liver disease 2015临床肝胆病杂志2015,31,10:65
17Hepatocellular carcinoma with obstructive jaundice: diagnosis, treatment and prognosis显示文摘Obstructive jaundice as the main clinical feature is uncommon in patients with hepatocellular carcinoma (HCC). Only 1-12 %of HCC patients manifest obstructive jaundice as the initial complaint. Such cases are clinically classified as 'icteric type hepatoma', or 'cholestatic type of HCC'. Identification of this group of patients is important, because surgical treatment may be beneficial. HCC may involve the biliary tract in several different ways: tumor thrombosis, hemobilia,tumor compression, and diffuse tumor infiltration. Bile duct thrombosis (BDT) is one of the main causes for obstructive jaundice, and the previously reported incidence is 1.2-9 %.BDT might be benign, malignant, or a combination of both.Benign thrombi could be blood clots, pus, or sludge.Malignant thrombi could be primary intrabiliary malignant tumors, HCC with invasion to bile ducts, or metastatic cancer with bile duct invasion. The common clinical features of this type of HCC include: high level of serum AFP; history of cholangitis with dilation of intrahepatic bile duct; aggravating jaundice and rapidly developing into liver dysfunction. It is usually difficult to make diagnosis before operation, because of the low incidence rate, ignorant of this disease, and the difficulty for the imaging diagnosis to find the BDT preoperatively. Despite recent remarkable improvements in the imaging tools for diagnosis of HCC, such cases are still incorrectly diagnosed as cholangiocarcinoma or choledocholithiases. Ultrasonography (US) and CT are helpful in showing hepatic tumors and dilated intrahepatic and/or extrahepatic ducts containing dense material corresponding to tumor debris. Direct cholangiography including percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography (ERCP)remains the standard procedure to delineate the presence and level of biliary obstruction. Magnetic resonance cholangiopancreatography (MRCP) is superior to ERCP in interpreting the cause and depicting the anatomical extent of the perihilar obstructive jaundice, and is particularly distinctive in cases associated with tight biliary stenosis and along segmental biliary stricture. Choledochoscopy and bile duct brushing cytology could be alternative useful techniquesin the differentiating obstructions due to intraluminal mass,infiltrating ductal lesions or extrinsic mass compression applicable before and after duct exploration. Jaundice is not necessarily a contraindication for surgery. Host patients will have satisfactory palliation and occasional cure if appropriate procedures are selected and carried out safely, which can result in long-term resolution of symptoms and occasional long-term survival. However, the prognosis of icteric type HCC is generally dismal, but is better than those HCC patients who have jaundice caused by hepatic insufficiency.Lun-Xin Qin Zhao-You Tang Liver Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai, China 2003World Journal of Gastroenterology2003,9,3:68
18Preventive treatments for recurrence after curative resection of hepatocellular carcinoma-A literature review of randomized control trials显示文摘To review the inhibitory effect of preventive approaches on recurrence after operation in patients with hepatocellular carcinoma (HCC), we summarized all available publications. reporting randomized control trial indexed in PubMed. The treatment approaches presented above included preoperative transcatheter arterial chemoembolization (TACE),post-operative TACE, systemic or locoregional chemotherapy,immunotherapy, Interferons and acyclic retinoic acid Although no standard treatment has been established,several approaches presented promising results, which were both effective and tolerable in post-operative patients. Preoperative TACE was not effective on prolonging survivals,while post-operative TACE was shown with both diseasefree survival and overall survival benefits in some papers,however, it was also questioned by others. Systemic chemotherapy was generally not effective on prolonging survival but also poorly tolerated for its significant toxicities.Adoptive immunotherapy using LAK cells was proved to be beneficial to patients' survival in a recent paper. Interferon and Interferon β can inhibit recurrence in HCC patients with HCV infection background, though the mechanism is not fully understood. Acyclic retinoic acid was shown to decrease multi-centric recurrence after operation, which was reported by only one group. In conclusion, several adjuvant approaches have been studied for their efficacy on recurrence in HCC patients in randomized control trials; however, multi-centric randomized control trial is still needed for further evaluation on their efficacy and systemic or local toxicities;in addition, new adjuvant treatment should be investigated to provide more effective and tolerable methods for the patients with HCC after operation.Hui-Chuan Sun Zhao-You Tang Liver Cancer Institute and Zhong Shan Hospital,Fudan University,Shanghai 200032,China 2003World Journal of Gastroenterology2003,9,4:63
19甘草酸制剂肝病临床应用专家共识显示文摘甘草酸制剂是当前肝病领域中用于抗炎保肝治疗的一线药物之一。追溯其历史,甘草酸制剂在20世纪40年代即应用于肝病的治疗,70年代开始有明确的科学性研究论述[1]。目前市场上已经出现甘草酸单铵、复方甘草酸苷、甘草酸二铵、甘草酸二铵脂质体及异甘草酸镁等多种形式的产品。随着研究的不断深入,学术界对甘草酸制剂在各类肝病中的临床应用已积累了较多的循证医学证据,国内外多部肝病相关指南也对甘草酸二铵脂质体及异甘草酸镁等多种形式的产品。Expert Committee on Clinical Application of Glycyrrhizin Preparation in the Treatment of Liver Diseases 2016临床肝胆病杂志2016,32,5:51
20EASL–EORTC Clinical Practice Guidelines: Management of hepatocellular carcinoma显示文摘European Association for the Study of the Liver European Organisation for Research and Treatment of Cancer 2012Journal of Hepatology2012,,4:41
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