Publications by authors named "Ke-Jian Guo"

24 Publications

  • Page 1 of 1

Ileocecal intussusception caused by two different tumors - which is the culprit lesion? A case report.

World J Clin Cases 2020 May;8(10):2044-2049

Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China.

Background: Ileocecal intussusception caused by two different tumors is rare, according to a literature review. We describe a case of a male patient with a cauliflower-like mass in the middle of the transverse colon observed by colonoscopy before surgery. It was considered to be intussusception caused by colon cancer. However, a substantial lipomatous mass was seen in the distal end of the intussusception by computed tomography before surgery, which posed a challenge in the preoperative diagnosis.

Case Summary: We report a 72-year-old male patient with intussusception. The patient underwent right hemicolectomy and cholecystectomy in our hospital on April 29, 2019. During operation, the ileum was inserted into the ascending colon by about 15 cm, and a tumor with a diameter of approximately 3.0 cm was observed in the distal part of the intestine. An atypical liposarcoma/highly differentiated liposarcoma in the adipose tissue was suspected in the postoperative pathology, and a lipoma was diagnosed after MDM2 gene testing. A 4.0 cm × 5.0 cm polypoid mass was seen immediately adjacent to the mass, and the postoperative pathology report suggested a high-level tubular adenoma. The patient was eventually cured and discharged with an uneventful follow-up.

Conclusion: Intussusception caused by two different types of masses is extremely rare. At present, surgery is the best treatment once intussusception is diagnosed.
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http://dx.doi.org/10.12998/wjcc.v8.i10.2044DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262695PMC
May 2020

Huge peripheral primitive neuroectodermal tumor of the small bowel mesentery at nonage: A case report and review of the literature.

World J Clin Cases 2016 Sep;4(9):306-9

Zhe Liu, Yuan-Hong Xu , Chun-Lin Ge , Jin Long, Ke-Jian Guo, Department of Pancreatic Surgery, the First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China.

Extraskeletal Ewing's sarcoma/peripheral primitive neuroectodermal tumor (E-EWS/pPNET) is a rare aggressive malignant small round cell tumor. In this report, we present the case of a 15-year-old boy who suffered from acute abdominal pain accompanied by hematemesis and melena, and was eventually diagnosed with E-EWS/pPNET. To date, there have been only five reported cases of E-EWS/pPNET of the small bowel including the patient in this report. To the best of our knowledge, this is the first documentation of a pPNET of the small bowel mesentery at nonage. All these have made this report rare and significant.
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http://dx.doi.org/10.12998/wjcc.v4.i9.306DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5018631PMC
September 2016

Retropancreatic retroperitoneal tumors: a 30-year experience with 38 cases.

Am Surg 2013 May;79(5):470-5

Department of General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.

Retropancreatic retroperitoneal tumors (RRTs) are seldom encountered in clinical practice. The lack of characteristics on clinical presentation and imaging make preoperative diagnosis difficult and surgical management remains a challenge. This retrospective report surveys the presenting diagnosis and surgical management of 38 patients with RRTs presenting at our center between August 1981 and May 2012. Six patients were misdiagnosed on the basis of computerized tomography and one each by magnetic resonance imaging and magnetic resonance cholangiopancreatography. Tumors were localized posterior to the pancreatic head and uncinate process (n = 18); posterior to the neck and body of the pancreas (n = 9); or posterior to the body and tail of the pancreas (n = 11). Thirty-three patients underwent surgical resections. Operative approaches were chosen on the basis of tumor size and localization. The tumors were mostly commonly originating from neurogenic tissue (n = 16). There were 25 benign neoplasms (65.8%), 10 malignant tumors (26.3%), and three undefined tumors. The morbidity of postsurgical complications was 21 per cent (eight of 38). The number of patients who underwent follow-up was 21, and the mean follow-up time was 35 months (range, 2 to 90 months). Three patients died during follow-up. The morbility of local recurrence was 10.5 per cent (four of 38). Definitive diagnosis of RRTs is made at laparotomy. Complete resection remains the fundamental objective of disease management. Different operative approaches should be used according to tumor localization and size.
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May 2013

Silencing of the integrin-linked kinase gene suppresses the proliferation, migration and invasion of pancreatic cancer cells (Panc-1).

Genet Mol Biol 2012 Apr 17;35(2):538-44. Epub 2012 May 17.

Department of Pancreatic and Gastrointestinal Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.

Integrin-linked kinase (ILK) is an ankyrin repeat-containing serine-threonine protein kinase that is involved in the regulation of integrin-mediated processes such as cancer cell proliferation, migration and invasion. In this study, we examined the effect of a lentivirus-mediated knockdown of ILK on the proliferation, migration and invasion of pancreatic cancer (Panc-1) cells. Immunohistochemical staining showed that ILK expression was enhanced in pancreatic cancer tissue. The silencing of ILK in human Panc-1 cells led to cell cycle arrest in the G0/G1 phase and delayed cell proliferation, in addition to down-regulating cell migration and invasion. The latter effects were mediated by up-regulating the expression of E-cadherin, a key protein in cell adhesion. These findings indicate that ILK may be a new diagnostic marker for pancreatic cancer and that silencing ILK could be a potentially useful therapeutic approach for treating pancreatic cancer.
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http://dx.doi.org/10.1590/S1415-47572012005000028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3389544PMC
April 2012

The effects of genistein on transforming growth factor-β1-induced invasion and metastasis in human pancreatic cancer cell line Panc-1 in vitro.

Chin Med J (Engl) 2012 Jun;125(11):2032-40

Department of General Surgery, College of Clinical Medical Sciences, China Medical University, Shenyang, Liaoning 110004, China.

Background: Pancreatic cancer is a devastating disease with the worst mortality rate. Therefore, a rational strategy for future drug development is critical. Genistein is a small, biologically active flavonoid that is found in high amounts in soy. This important compound supports a wide variety of biological activities, but is best known for its ability to inhibit cancer progression.

Methods: Transwell chamber assay was performed to determine the effect of genistein on the invasion of the human pancreatic cancer cell line Panc-1 induced by transforming growth factor-β1 (TGF-b1) in the different condition (5 ng/ml 24 hours and 10 ng/ml 48 hours); Reverse transcription-polymerase chain reaction (RT-PCR) was used to estimate the mRNA levels of urinary plasminogen activator (uPA), matrix metallopeptidase 2/9 (MMP-2/9), Smad4, E-Cadherin and Vimentin; Western blotting was used to detect the protein levels of uPA, E-Cadherin, ERK1/2, P38 and P-P38, and the activity of MMP-2/9 protein were detected by gelatin zymography assay method. Cells structure was observed and analyzed by microscopy.

Results: Genistein can inhibit effectively TGF-b1-induced invasion and metastasis in Panc-1 by Transwell assay, which is through regulating the mRNA and protein expression of uPA and MMP2, but not MMP9 by RT-PCR/Western blotting, and is positively correlated with the concentration of genistein. At the same time, genistein also could improve the progress of epithelial-mesenchymal transition (EMT) via morphology observation using light microscopy/transmission electron microscopy (TEM), which is mediated by the down-regulation of E-cadherin and the up-regulation of vimentin.

Conclusions: TGF-b1 mediates EMT process via numerous intracellular signal transduction pathways. The potential molecular mechanisms are all or partly through Smad4-dependent and -independent pathways (p38 MAPK) to regulate the antitumor effect of genistein.
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June 2012

[Macrocystic serous adenoma of the pancreas: a report of 5 cases].

Zhonghua Wai Ke Za Zhi 2010 Sep;48(18):1405-8

Department of Pancreatic and Gastroenterologic Surgery, the First Affiliated Hospital, China Medical University, Shenyang, China.

Objective: To investigate the diagnosis and treatment of macrocystic serous adenoma of the pancreas (MSAP).

Methods: The clinical data of 5 patients with MSAP treated from October 1999 to October 2009 were retrospectively analyzed. There were 5 female and 1 male.

Results: Of the 5 patients, 3 patients presented with abdominal pain and fullness, 1 patient with jaundice, 1 patient with asymptomatic. Ultrasonography and CT could manifest macrocystic lesion of the pancreas; all the lesion showed a well-defined border, internal septations, enhanced cyst walls, with no intramural (mural) nodule and papillary projections; the wall was smooth and thin in 4 cases; irregular lobulation could be observed in 3 cases, round or oval in 2 cases; 2 cases had pancreatic duct dilatation, 1 case had biliary duct dilatation. The tumors located in the pancreatic body and tail in 3 cases, the tumors located the pancreatic head in 2 cases. The sizes of the tumors ranged from 6.5 cm to 13.0 cm (mean, 8.8 cm). Five patients all accepted surgical intervention. The main postoperative complication was pancreatic fistula (2 cases); all the fistula was cured. Recurrence or metastasis were not found in 5 patient followed up postoperatively from 8 to 35 months.

Conclusions: MSAP has no specific symptoms. The imaging appearance of MSAP is similar to mucinous cystic neoplasm of the pancreas. The tumor can gradually grow up and produce compression symptoms. MSAP can be cured by complete resection.
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September 2010

[Indications, technique and efficacy of organ preserving pancreatectomy].

Zhonghua Wai Ke Za Zhi 2010 Sep;48(18):1375-8

Department of General Surgery, First Affiliated Hospital, China Medical University, Shenyang, China.

Objective: To discuss the proper surgical management of pancreatic benign and low-grade malignant potential neoplasm.

Methods: The experience of 72 cases who accepted organ preserving pancreatectomy from January 1990 to May 2010 was analyzed retrospectively. There were 24 male and 48 female, aged from 15 to 68 years with mean age of 46 years. There were 9 cases underwent duodenum-preserving resection of the head of the pancreas, 29 cases underwent spleen-preserving distal pancreatectomy, 11 cases underwent middle segmental pancreatectomy, 23 cases underwent tumor extirpation of huge pancreatic cancer in pancreatic head and body.

Results: Pancreatic fistula and biliary fistula in 1 case respectively were cured among who accepted duodenum-preserving resection of the head of the pancreas. Pancreatic fistula was found in 3 cases who accepted spleen-preserving distal pancreatectomy. Pancreaticobiliary anastomotic bleeding in 1 case was cured among who accepted middle segmental pancreatectomy. Pancreatic fistula was found in 5 cases among who accepted tumor extirpation of huge pancreatic cancer in pancreatic head and body, and liver metastasis was found in 3 cases at 6, 12, 16 months after surgery respectively.

Conclusions: Organ preserving pancreatectomy can obviously reduce operative injury to patients, its therapeutic effect is similar to that of classical operation, it is the first option of benign and low-grade malignant potential neoplasm.
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September 2010

Adult intussusception: a retrospective review of 41 cases.

World J Gastroenterol 2009 Jul;15(26):3303-8

General Surgery Department, the First Affiliated Hospital, China Medical University. Shenyang 110001, Liaoning Province, China.

Aim: To optimize the preoperative diagnosis and surgical management of adult intussusception (AI).

Methods: A retrospective review of the clinical features, diagnosis, management and pathology 41 adult patients with postoperative diagnoses of intussusception was conducted.

Results: Forty-one patients with 44 intussusceptions were operated on, 24.4% had acute symptoms, 24.4% had subacute symptoms, and 51.2% had chronic symptoms. 70.7% of the patients presented with intestinal obstruction. There were 20 enteric, 15 ileocolic, eight colocolonic and one sigmoidorectal intussusceptions. 65.9% of intussusceptions were diagnosed preoperatively using a computed tomography (CT) scan (90.5% accurate) and ultrasonography (60.0% accurate, rising to 91.7% for patients who had a palpable abdominal mass). Coloscopy located the occupying lesions of the lead point of ileocolic, colocolonic and sigmoidorectal intussusceptions. Four intussusceptions in three patients were simply reduced. Twenty-one patients underwent resection after primary reduction. There was no mortality and anastomosis leakage perioperatively. Except for one patient with multiple small bowel adenomas, which recurred 5 mo after surgery, no patients were recurrent within 6 mo. Pathologically, 54.5% of the intussusceptions had a tumor, of which 27.3% were malignant. 9.1% comprised nontumorous polyps. Four intussusceptions had a gastrojejunostomy with intestinal intubation, and four intussusceptions had no organic lesion.

Conclusion: CT is the most effective and accurate diagnostic technique. Colonoscopy can detect most lead point lesions of non-enteric intussusceptions. Intestinal intubation should be avoided.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2710788PMC
http://dx.doi.org/10.3748/wjg.15.3303DOI Listing
July 2009

Application of retrograde distal pancreatectomy.

Hepatobiliary Pancreat Dis Int 2008 Jun;7(3):318-21

Department of General Surgery, First Affiliated Hospital, China Medical University, Shenyang 110001, China.

Background: Since conventional methods are difficult to deal with pancreatic tumors close to the portal veins, we investigated the feasibility and norms for retrograde distal pancreatectomy by cutting the neck of the pancreas first.

Method: The clinical data and surgical procedures of retrograde distal pancreatectomy given to 11 patients from July 2001 to June 2007 were analyzed.

Results: All 11 operations were completed successfully. The mean time of the operation was 143+/-71 minutes. The mean volume of hemorrhage was 239 ml. The mean time of hospitalization was 12+/-4.2 days. No blood transfusion was needed during the operation, and all patients had a good postoperative recovery. No neopathy of diabetes mellitus, pancreatic fistula or other complications occurred after the operation. The follow-up of all patients (4-60 months) showed that 3 patients survived for 14, 16 and 33 months, respectively, and the other patients are still alive.

Conclusions: Retrograde distal pancreatectomy is useful for exposing the portal and superior mesenteric veins while avoiding operative injury. Interception of the blood supply of the spleen helps to reduce the volume of hemorrhage, while making the operation easier and the operative time short. It is advantageous for tumor resection of the body of the pancreas near the portal veins.
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June 2008

[Diagnosis and surgical treatment of 98 cases with adult primary retroperitoneal malignant tumor].

Zhonghua Wai Ke Za Zhi 2007 Jun;45(11):756-8

The Department of General Surgery, First Affiliated Hospital of China Medical University, Shenyang 110001, China.

Objective: To investigate the diagnosis and surgical treatment of adult primary retroperitoneal malignant tumor (APRMT).

Methods: The clinical data of 98 cases with APRMT underwent resection from January 1990 to April 2003 were analyzed retrospectively.

Results: Among the 98 cases, complete excision were performed in 79 cases (80.6%), palliative excision in 16 cases (16.3%), tumor biopsy only in 3 cases (3.1%). Resection of involved adjacent organs were carried out in 25 cases (25.5%) and the re-operation rate for recurrence was 28.6% (28 cases). The 1, 3, 5 year survival rates for 79 cases with complete resection were 93.7%, 73.4% and 34.2%, respectively. The 1, 3, 5 year survival rate for 16 cases with palliative resection were 75.0%, 6.3% and 6.3%, respectively.

Conclusions: Certain imaging examinations are crucial to the diagnosis and preoperative evaluation of APRMT. Resection of the involved organs could improve resection rate and prognosis. For the recurrent cases, earlier reoperation is strongly recommended.
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June 2007

Surgical management of 143 patients with adult primary retroperitoneal tumor.

World J Gastroenterol 2007 May;13(18):2619-21

Department of General Surgery, The First Affiliated Hospital of China Medical University, Heping District, Shenyang, Liaoning Province, China.

Aim: To analyze the surgical management of adult primary retroperitoneal tumors (APRT) and the factors influencing the outcome after operation.

Methods: Data of 143 cases of APRT from 1990 to 2003 in the First Affiliated Hospital of China Medical University were evaluated retrospectively.

Results: A total of 143 cases of APRT were treated surgically. Among them, 122 (85.3%) underwent complete resection, 16 (11.2%) incomplete resection, and 3 (3%) surgical biopsies. Twenty-nine (20.2%) underwent tumor resection plus multiple organ resections. Ninety-five malignant cases were followed up for 1 mo to 5 years. The 1-year, 3-year, and 5-year survival rates of the patients subject to complete resection was 94.9%, 76.6% and 34.3% and that of patients with incomplete resection was 80.4%, 6.7%, and 0%, respectively (P < 0.001). The Cox multi-various regression analysis showed the completeness of tumor, sex and histological type were associated closely with local recurrence.

Conclusion: Sufficient preoperative preparation and complete tumor resection play important roles in reducing recurrence and improving survival.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146826PMC
http://dx.doi.org/10.3748/wjg.v13.i18.2619DOI Listing
May 2007

Effects of 5-fluouracil combined with sulfasalazine on human pancreatic carcinoma cell line BxPC-3 proliferation and apoptosis in vitro.

Hepatobiliary Pancreat Dis Int 2007 Jun;6(3):312-20

Department of General Surgery, First Affiliated Hospital, China Medical University, Shenyang 110001, China.

Background: Most pancreatic carcinomas are clinically insensitive to chemotherapeutics. The exact mechanisms of their apoptosis and multiple drug resistance are obscure at present. This study was undertaken to explore the influence of chemotherapy on anti-proliferation, apoptosis and the cell cycle, and lay a fundamental basis for further research into the apoptotic mechanisms and prevention of multiple drug resistance in pancreatic carcinoma.

Methods: The human pancreatic carcinoma cell line BxPC-3 was cultured in vitro. The growth inhibition rate, cell cycle and apoptotic rate of cells treated with 5-fluorouracil (5-FU), sulfasalazine alone or a combination at different concentrations were evaluated with the MTT method and flow cytometry. Phase-contrast microscopy was used to observe morphological changes in the cells treated with 5-FU, sulfasalazine or both for 24 hours.

Results: The growth inhibition rate of the BxPC-3 cells treated with 5-FU and sulfasalazine significantly increased in a time- and dose-dependent manner. The growth inhibition rate of the cells treated with 5-FU gradually increased, but decreased at different concentrations of sulfasalazine for a prolonged period. The apoptotic rate of the BxPC-3 cells induced by sulfasalazine (200 mg/L), 5-FU (100 mg/L) or both for 12 hours were (2.68+/-0.36)%, (6.59+/-0.90)%, and (10.52+/-0.55)%, respectively, compared with the corresponding control values were (3.17+/-0.08)%, (1.50+/-0.06)%, and (4.08+/-0.31)% [(t=2.33 (P>0.05), 9.78 and 17.56 (P<0.01)]. It increased to (7.63+/-0.68)%, (40.43+/-1.79)%, and (64.69+/-0.82)% for 48 hours, in comparison with the control that was (29.20+/-2.18)%, (5.61+/-0.13)%, and (12.02+/-0.52)% [t=17.06, 33.66 and 94.51 (P<0.01)]. The apoptotic rate, proportion of cells in S-phase and proliferative index rose after use of 5-FU (12.5, 25, 50, 75, and 100 mg/L) alone for 24 hours. However, the apoptotic rate at augmented concentrations of sulfasalazine for 24 hours slowly increased from (1.47+/-0.08)% to (3.45+/-0.28)%, the proportion of cells in G0/G1-phase increased from (35.13+/-0.32)% to (54.32+/-1.45)%, the proportion of cells in S-phase decreased from (45.37+/-1.48)% to (16.67+/-2.73)%, and the proliferative index gradually lowered. The proportion of G0/G1-phase cells treated by 5-FU (100 mg/L) and sulfasalazine (200 mg/L) increased from (43.31+/-1.52)% (12 hours) to (85.05+/-0.24)% (48 hours) compared with the corresponding controls [t=7.93 (12 hours), 21.30 (48 hours), P<0.01], and the proportion of cells in S-phase decreased from (11.63+/-1.11)% (12 hours) to (4.47+/-0.68)% (48 hours) in contrast to the controls [t=37.68 (12 hours), 8.60 (48 hours), P<0.01]. Most cells after the combined use of the two agents for 24 hours displayed pyknosis and oval shape by phase-contrast microscopy. The cells treated with 5-FU (100 mg/L) for 24 hours were pyknotic and oval shaped. A few of cells in the group treated with sulfasalazine (200 mg/L) were pyknotic at 24 hours.

Conclusions: Sulfasalazine may enhance the inhibitory proliferation and apoptosis effect on BxPC-3 cells induced by 5-FU, which is closely related to synergistically the cell cycle arrested in G0/G1-phase.
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June 2007

Giant mucinous biliary cystadenoma: a case report.

Hepatobiliary Pancreat Dis Int 2007 Feb;6(1):101-3

Department of General Surgery, First Affiliated Hospital, China Medical University Shenyang 110001, China.

Background: Biliary cystadenoma is a very rare cystic neoplasm of the liver. Its clinical features, diagnosis, pathologic characteristics, and optimal surgical management have not been defined clearly. In this article we describe the details of this rare disease.

Methods: A 40-year-old woman with a mass of the liver was verified by ultrasonography and LT. Ultrasonography showed a mixed echo of 18.4 cm x 14.72 cm x 15.54 cm in the left lobe of the liver. CT showed a vesicula of 19.9 cm x 13.5 cm in the right epigastrium, with a low density, clear edge, uneven density, and calcified shadow. The patient received successfully a left hepatectomy. Laboratory examination showed an elevation of CA125 to 62.62 U/ml and CA199>1000 U/ml.

Results: After the left hepatectomy, the patient was fully recovered. Her biliary cystadenoma was characterized by specific histological findings. During operation, a large cystic lesion was seen in the left hepatic lobe; its surface was dark red with abundant blood supply. Gross examination showed that the tumor almost occupied. The whole left lobe with a small amount of normal liver tissue close to the deltoid ligament. Pathologically, additional lobulated spaces were seen in the tumor with a lot of mucusa. The interior wall was lined with bile duct tissue, indicating a benign mucinous biliary cystadenoma.

Conclusions: Ultrasonography and CT are the major methods for the diagnosis of mucinous biliary cystadenoma liver. Operation is the best way of treatment.
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February 2007

Inhibitory effects of antisense phosphorothioate oligodeoxynucleotides on pancreatic cancer cell Bxpc-3 telomerase activity and cell growth in vitro.

World J Gastroenterol 2006 Jul;12(25):4004-8

Department of General Surgery, The Center Hospital of Shanghai Yangpu District (Branch Hospital of the Affiliated Xinhua Hospital of Shanghai Jiaotong University), Shanghai 200127, China.

Aim: To investigate the effect of telomerase hTERT gene antisense oligonucleotide (hTERT-ASO) on proliferation and telomerase activity of pancreatic cancer cell line Bxpc-3.

Methods: MTT assay was used to detect the effect of different doses of hTERT-ASO on proliferation of Bxpc-3 cell for different times. To study the anti-tumor activity, the cells were divided into three groups: Control group (pancreatic cancer cell Bxpc-3); antisense oligonucleotide (hTERT-ASO) group; and nosense oligonucleotide group decorated with phosphorothioate. Telomerase activity was detected using TRAP-PCR-ELISA. Cell DNA distribution was examined using flow cytometry assay. Cell apoptosis was observed by transmission electron microscope in each group.

Results: After treatment with 6 mmol/L hTERT-ASO, cell proliferation was inhibited in dose- and time-dependent manner. The telomerase activity decreased after treatment with hTERT-ASO for 72 h. Flow cytometry showed the cell number of G0/G1 phase increased from 2.7% to 14.7%, the cell number of S phase decreased from 72.7% to 51.0%, and a sub-G1 stage cell apoptosis peak appeared in front of G1 stage.

Conclusion: Telomerase antisense oligodeoxy-nucleotide can inhibit the proliferation of pancreatic cancer cell line Bxpc-3 and decrease the telomerase activity and increase cell apoptosis rate in vitro.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4087710PMC
http://dx.doi.org/10.3748/wjg.v12.i25.4004DOI Listing
July 2006

Hepatobiliary membrane transporters involving in the formation of cholesterol calculus.

Hepatobiliary Pancreat Dis Int 2006 May;5(2):286-9

Department of General Surgery, First Affiliated Hospital, China Medical University, Shenyang 110001, China.

Background: Cholecyst cholesterol lithiasis is a common disease of the digestive system; however, the cause of lithogenesis is still unclear. Although bile salt export pump (BSEP), multidrug resistance protein 2 (MRP2), and multiple drug resistance 3 (MDR3) are 3 well-known transporting proteins, their effect on lithogenesis has not been elucidated. This study was undertaken to examine the relationship between BSEP, MRP2, MDR3, and cholesterol calculus formation.

Methods: Liver tissue specimens were taken from 20 patients with cholesterol calculus and from 10 patients with normal liver. mRNA and protein expressions of BSEP, MRP2, and MDR3 were determined by reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot, respectively. This study was approved by the ethics committee of China Medical University and informed consent was obtained from all patients.

Results: mRNA and protein expressions of BSEP, MRP2, and MDR3 were significantly down-regulated in the liver tissue of the patients with cholesterol calculus compared with normal liver tissue of the controls.

Conclusion: The down-regulation of BSEP, MRP2, and MDR3 may be correlated with the formation of cholesterol calculus.
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May 2006

[Expressions of p53 and Gadd45a proteins in human pancreatic cancer and their clinicopathological significance].

Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2005 Oct;27(5):628-32

Department of General Surgery, the First Affiliated Hospital, China Medical University, Shenyang 110001, China.

Objective: To study the expressions of p53 and Gadd45a proteins and their clinicopathological significance in human pancreatic cancer.

Methods: The expression of p53 and Gadd45a proteins was detected with immunohistochemistry in a series of 59 pancreatic cancers. Their relationships with the clinicopathological parameters including gender, tumor site, TNM stage, histological differentiation, and the prognosis of pancreatic cancer patients were analyzed.

Results: The positive expression rate of p53 protein was 67.8% (40/59) and that of Gadd45a protein was 42.4% (25/59). The positive expression rate of p53 protein is significantly higher in patients < 65 years than in patients > or = 65 years (chi squared = 4.711, P = 0.030). Gadd45a expression was not correlated to the age of the patients. No significant difference was found between the expression of p53 proteins and histological differentiation and TNM stage of the tumors. Gadd45a expression was correlated with histological differentiation of pancreatic cancer (chi squared = 10.052, P = 0.007), but not with TNM stage of the tumors. No significant differences in the prognosis were found between the groups with and without p53 expression (chi squared = 0.09, P = 0.764) and the groups with and without Gadd45a expression (chi squared = 0.14, P = 0.704).

Conclusions: Both p53 and Gadd45a are highly expressed in human pancreatic cancer and may be associated with biological features of pancreatic cancer. Their expression alone or co-expression may be not helpful to evaluate the prognosis of patients with pancreatic cancer.
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October 2005

[Comparison of pBcl-2 and pBax expression in primary invasive ductal pancreatic cancer between Chinese and Japanese patients].

Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2005 Oct;27(5):611-4

Department of General Surgery, the First Affiliated Hospital, China Medical University, Shenyang 110001, China.

Objective: To clarify the clinicopathologic significance of the expression of the Bcl-2 protein (pBcl-2) and the Bax protein (pBax), and their clinical implications in Chinese and Japanese patients with human invasive ductal carcinomas (IDCs) of the pancreas.

Methods: The study included 59 Chinese and 65 Japanese patients with IDCs of the pancreas. pBcl-2 and pBax expression were immuno-stained with streptavidin-biotin (SAB) method.

Results: pBcl-2 (+) was seen in 35.6% of Chinese and in 23.1% of Japanese patients. pBax (+) was seen in 49.2% of Chinese and 64.7% of Japanese patients. A comparison between them showed that there were significant differences in the male patients, in the patients with the moderately differentiated cancer, and in the elderly patients (chi squared = 4.447, P = 0.035; chi squared = 4.114, P = 0.043; chi squared = 6.657, P = 0.010 respective). In both Chinese and Japanese patients, those with pBcl-2 positive expression had a significantly higher survival rate than those with negative one (chi squared = 9.99, P = 0.0016; chi squared = 7.63, P = 0.0058). The group with pBax positive expression had a significantly higher survival rate in Japanese patients (chi squared = 9.37, P = 0.0022). Japanese patients whose tumors exhibited pBcl-2 and pBax positive immunostaining survived significantly longer than Chinese patients did (chi squared = 4.48, P = 0.0342; chi squared = 5.23, P = 0.023).

Conclusions: The expressions of both pBcl-2 and pBax are high found in Chinese and Japanese patients. The pBcl-2 positive expression implies a better prognosis in both Chinese and Japanese patients with IDCs of the pancreas. The effect of pBax expression on prognosis is different between Chinese and Japanese patients.
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October 2005

[Expression of programmed cell death 4 and its clinicopathological significance in human pancreatic cancer].

Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2005 Oct;27(5):597-600

Department of General Surgery, the First Affiliated Hospital,China Medical University, Shenyang 110001, China.

Objective: To investigate the expression of programmed cell death 4 (PDCD4) protein and its clinicopathological significance in human pancreatic cancer.

Methods: Immunohistochemistry was used to examine the expression of PDCD4 protein in 69 specimens of pancreatic cancer and Western blot in 8 fresh specimens.

Results: The expression of PDCD4 protein was significantly lower in all 8 fresh pancreatic cancer tissues than that in non-cancerous tissues detected by Western blot. Compared with non-cancerous pancreatic tissue (> 80% of positive cells), low PDCD4 expression was shown in 69 pancreatic cancer tissues (< 30% of positive cells in 36 cases and 30%-80% of positive expression cells in 33 cases). In the 33 cases with 30% and 80% of positive expression cells, the expression rates of PDCD4 protein were 57.6%, 24.2%, and 18.2% in well, moderately, and poorly differentiated cancers, respectively. In the 36 cases less than 30% of positive expression cells, however, the expression rate of PDCD4 protein in well, moderately, and poorly differentiated cases were 19.4%, 41.7%, and 38.9%, respectively. 67.4% (15/23) of the moderately differentiated cases and 70% (14/20) of the poorly differentiated cases showed < 30% of positive expression cells. Only 26.9% (7/26) of the well differentiated cases, however, showed < 30% of positive expression cells, indicating that low PDCD4 expression was associated with histological grade (P < 0.01). There was no relationship between PDCD4 expression and other clinicopathological parameters including patients' sex, age, and TNM stage.

Conclusions: Expression of PDCD4 protein is low in human pancreatic cancer and is correlated with the differentiation levels of human pancreatic cancer. PDCD4 may play an important role in the occurrence and development of pancreatic carcinomas.
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October 2005

Nuclear factor-kappaB activation on the reactive oxygen species in acute necrotizing pancreatitic rats.

World J Gastroenterol 2005 Jul;11(27):4277-80

Department of Surgery, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning Province, China.

Aim: To investigate the potential role of nuclear factor kappa-B (NF-kappaB) activation on the reactive oxygen species in rat acute necrotizing pancreatitis (ANP) and to assess the effect of pyrrolidine dithiocarbamate (PDTC, an inhibitor of NF-kappaB).

Methods: Rat ANP model was established by retrograde injection of 5% sodium taurocholate into biliopancreatic duct. Rats were randomly assigned to three groups (10 rats each): Control group, ANP group and PDTC group. At the 6th h of the model, the changes of the serum amylase, nitric oxide (NO), malondialdehyde (MDA), superoxide dismutase (SOD) and pancreatic morphological damage were observed. The expressions of inducible nitric oxide (iNOS) were observed by SP immunohistochemistry. And the expressions of NF-kappaB p65 subunit mRNA were observed by hybridization in situ.

Results: Serum amylase and NO level decreased significantly in ANP group as compared with PDTC administrated group ((7 170.40+/-1 308.63) U/L vs (4 074.10+/-1 719.78) U/L, P<0.05), ((76.95+/-9.04) micromol/L vs (65.18+/-9.02) micromol/L, P<0.05) respectively. MDA in both ANP and PDTC group rose significantly over that in control group ((9.88+/-1.52) nmol/L, (8.60+/-1.41) nmol/L, vs (6.04+/-1.78) nmol/L, P<0.05), while there was no significant difference between them. SOD levels in both ANP and PDTC group underwent a significant decrease as compared with that in control ((3 214.59+/-297.74) NU/mL, (3 260.62+/-229.44) NU/mL, vs (3 977.80+/-309.09) NU/mL, P<0.05), but there was no significant difference between them. Though they were still higher than those in Control group, pancreas destruction was slighter in PDTC group, iNOS expression and NF-kappaB p65 subunit mRNA expression were lower in PDTC group as compared with ANP group.

Conclusion: We conclude that correlation among NF-kappaB activation, serum amylase, reactive oxygen species level and tissue damage suggests a key role of NF-kappaB in the pathogenesis of ANP. Inhibition of NF-kappaB activation may reverse the pancreatic damage of rat ANP and the production of reactive oxygen species.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4615459PMC
http://dx.doi.org/10.3748/wjg.v11.i27.4277DOI Listing
July 2005

Clinicopathological significance of Bcl-2 and Bax protein expression in human pancreatic cancer.

World J Gastroenterol 2005 May;11(18):2744-7

Department of Surgery, First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning Province, China.

Aim: To assess the clinicopathological significance of the expression of the apoptosis-inhibitory Bcl-2 protein (pBcl-2) and the apoptosis-promoting Bax protein (pBax) in human invasive ductal carcinomas (IDCs) of the pancreas.

Methods: Fifty-nine surgical specimens of IDCs of the pancreas were stained immunohistochemically to detect pBcl-2 and pBax expressions whose correlation to tumor classification, staging, and prognosis was analyzed by univariate and multivariate analyses.

Results: The expression of pBcl-2 and pBax was detected in 21 of 59 (35.6%) and in 29 of 59 (49.2%) patients with IDCs of the pancreas, respectively. Neither pBcl-2 nor pBax alone was correlated to TNM staging and differentiation degree of IDCs of the pancreas according to univariate analysis. By Mantel-Cox test, the median survival time after surgery for pBcl-2(+) and pBcl-2(-) groups were 14.3 and 7.3 mo, respectively (chi(2) = 9.357, P = 0.002) and that for pBax(+) and pBax(-) groups were 12.9 and 10.2 mo, respectively (chi(2) = 0.285, P>0.05). Contingency coefficient between pBcl-2 and pBax expression was 0.298, indicating that there was correlation between them (chi(2) = 5.74, P<0.05). The median survival time after surgery for pBcl-2(+)pBax(+) and pBcl-2(+)pBax(-) groups were 14.3 and 14.1 mo, respectively, and that for pBcl-2(-)pBax(+) and pBcl-2(-)pBax(-) groups were 5.9 and 9.9 mo, respectively. There was a significant difference between pBcl-2(+)pBax(+) and pBcl-2(-)pBax(+) (chi(2) = 5.06, P<0.05), such was the case for pBcl-2(+)pBax(+) and pBcl-2(-)pBax(-) (chi(2) = 7.18, P<0.01). Cox proportional hazards model for multivariate analysis was applied, indicating that pBcl-2, TNM staging, age and pBax were high risk factors of post-surgical survival time.

Conclusion: Both pBcl-2 and pBax have high expression in IDCs of the pancreas, indicating that co-expression of pBcl-2 and pBax is a good indicator of favorable prognosis in IDCs of the pancreas.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4305908PMC
http://dx.doi.org/10.3748/wjg.v11.i18.2744DOI Listing
May 2005

Clinicopathological significance of p53 and mdm2 protein expression in human pancreatic cancer.

World J Gastroenterol 2005 Apr;11(14):2162-5

Department of Surgery, First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning Province, China.

Aim: To study the clinicopathological significance of p53 and mdm2 protein expression in human pancreatic cancer.

Methods: To investigate the expression of p53 and mdm2 in pancreatic cancer by immunohistochemistry, and the relationships between the p53 and mdm2 protein expression and clinicopathological parameters in pancreatic cancer.

Results: The positive expression of p53 protein was found in 40 of 59 patients (67.8%) and that of mdm2 protein in 17 of 59 patients (28.8%). No obvious relationships were found between p53 as well as mdm2 expression and sex, tumor site, TNM staging and histological differentiation. p53 expression was increased in patients younger than 65 years old, while mdm2 had no relationship with age. The survival time of the patients with the positive expression of p53 and mdm2 proteins was obviously shorter than the other groups.

Conclusion: Both p53 and mdm2 presented relatively high expression in human pancreatic cancer. The overexpression of p53 and mdm2 might reflect the malignant proliferation of pancreatic cancer and their co-expression might be helpful to evaluate the prognosis of the patients with pancreatic cancer.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4305788PMC
http://dx.doi.org/10.3748/wjg.v11.i14.2162DOI Listing
April 2005

Common bile duct obstruction due to fibrous pseudotumor of pancreas associated with retroperitoneal fibrosis: a case report.

World J Gastroenterol 2004 Oct;10(20):3078-9

Department of General Surgery, First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning Province, China.

One 63-year-old woman, who presented with cholestatic jaundice due to common bile duct compression produced by primary retroperitoneal fibrosis, is studied. The patient was operated six years ago because of hydronephrosis, when the disease was first diagnosed. Magnetic resonance cholangiopancreatography (MRCP) revealed the presence of extrahepatic bile duct obstruction, which once was considered to be pathognomonic of pancreatic cancer. CT-scan demonstrated the change of retroperitoneal fibrosis around left kidney, atrophy of right kidney, and obstruction of extrahepatic bile duct (pancreatic head). An explorative laparotomy was performed, and the retroperitoneum and pancreas were grayish-white and hard, the fibrotic pancreatic head compressed the common bile duct. Bile duct stricture was managed by Rouxen-Y hepatocholangio-jejunostomy. To the best of our knowledge, few similar cases of retroperitoneal fibrosis have been reported.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4576278PMC
http://dx.doi.org/10.3748/wjg.v10.i20.3078DOI Listing
October 2004

Surgical treatment of nonfunctioning islet cell tumor: report of 41 cases.

Hepatobiliary Pancreat Dis Int 2004 Aug;3(3):469-72

Department of Surgery, First Affiliated Hospital, China Medical University, Shenyang 110001, China.

Background: Nonfunctioning islet cell tumor (NIT) as a rare pancreatic endocrine neoplasm is characterized by unspecific clinical symptoms and is hard to diagnose. In China, NIT accounts for 15%-41% in pancreatic endocrine neoplasms just next to insulinoma. In this study, we evaluated the surgical modalities of NIT.

Methods: From January 1978 through February 2002, 41 patients with NIT were treated at the Department of Surgery of the First Affiliated Hospital, China Medical University, Shenyang, China. Tumors in the head of the pancreas were noted in 28 patients, and in the body or in the tail in 13 patients. The mean diameter of the tumors was 10.7 cm. Fifteen patients underwent enucleation and 21 received pancreatectomy. Tumors were unresectable in 5 patients because of extensive infiltration. The mean diameter was 9.6 cm in patients treated by enucleation, 13.1 cm in those by pancreaticoduodenectomy, 9.9 cm in those by distal pancreatectomy, and 11.6 cm in those with unresectable tumors.

Results: The curative resection rate was 88% (n=36), and the complication rate after enucleation and pancreatectomy was 33% (n=5) and 14% (n=3), respectively. No local recurrence was found after both enucleation and pancreatectomy. Liver metastases occurred in 3 patients treated by enucleation.

Conclusions: Both enucleation and pancreatectomy are effective for NIT of the pancreas. No local recurrence has been found in patients treated by the two surgical procedures. The complication rates of the two modalities are comparable.
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August 2004

Hepatitis A virus polyprotein processing by Escherichia coli proteases.

J Gen Virol 2002 Feb;83(Pt 2):359-368

Department of Microbiology1 and Department of Animal and Plant Cell Biology2, University of Barcelona, Av. Diagonal 645, 08028 Barcelona, Spain.

Hepatitis A virus (HAV) encodes a single polyprotein, which is post-translationally processed. This processing represents an essential step in capsid formation. The virus possesses only one protease, 3C, responsible for all cleavages, except for that at the VP1/2A junction region, which is processed by cellular proteases. In this study, data demonstrates that HAV polyprotein processing by Escherichia coli protease(s) leads to the formation of particulate structures. P3 polyprotein processing in E. coli is not dependent on an active 3C protease: the same processing pattern is observed with wild-type 3C or with several 3C mutants. However, this processing pattern is temperature-dependent, since it differs at 37 or 42 degrees C. The bacterial protease(s) cleave scissile bonds other than those of HAV; this contributes to the low efficiency of particle formation.
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http://dx.doi.org/10.1099/0022-1317-83-2-359DOI Listing
February 2002