Publications by authors named "Xiang-Qian Zhao"

12 Publications

  • Page 1 of 1

Feasibility and safety of "bridging" pancreaticogastrostomy for pancreatic trauma in Landrace pigs.

World J Gastrointest Surg 2021 May;13(5):419-428

Faculty of Hepato-Pancreato-Biliary Surgery, Institute of Hepatobiliary Surgery of Chinese PLA, Key Laboratory of Digital Hepetobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China.

Background: In recent years, we created and employed a new anastomosis method, "bridging" pancreaticogastrostomy, to treat patients with extremely severe pancreatic injury. This surgery has advantages such as short length of surgery, low secondary trauma, rapid construction of shunts for pancreatic fluid, preventing second surgeries, and achieving good treatment outcomes in clinical practice. However, due to the limited number of clinical cases, there is a lack of strong evidence to support the feasibility and safety of this surgical procedure. Therefore, we carried out animal experiments to examine this procedure, which is reported here.

Aim: To examine the feasibility and safety of a new rapid method of pancreaticogastrostomy, "bridging" pancreaticogastrostomy.

Methods: Ten Landrace pigs were randomized into the experimental and control groups, with five pigs in each group. "Bridging" pancreaticogastrostomy was performed in the experimental group, while routine mucosa-to-mucosa pancreaticogastrostomy was performed in the control group. After surgery, the general condition, amylase levels in drainage fluid on Days 1, 3, 5, and 7, fasting and 2-h postprandial blood glucose 6 mo after surgery, fasting, 2-h postprandial peripheral blood insulin, and portal vein blood insulin 6 mo after surgery were assessed. Resurgery was carried out at 1 and 6 mo after the former one to examine the condition of the abdominal cavity and firmness and tightness of the pancreaticogastric anastomosis and pancreas.

Results: After surgery, the general condition of the animals was good. One in the control group did not gain weight 6 mo after surgery, whereas significant weight gain was present in the others. There were significant differences on Days 1 and 3 after surgery between the two groups but no differences on Days 5 and 7. There were no differences in fasting and 2-h postprandial blood glucose and fasting and 2-h insulin values of postprandial peripheral blood and portal vein blood 6 mo after surgery between the two groups. One month after surgery, the sinus tract orifice/anastomosis was patent in the two groups. Six months after surgery, the sinus tract orifice/anastomosis was sealed, and pancreases in both groups presented with chronic pancreatitis.

Conclusion: "Bridging" pancreaticogastrostomy is a feasible and safe a means of damage control surgery during the early stage of pancreatic injury.
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http://dx.doi.org/10.4240/wjgs.v13.i5.419DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167843PMC
May 2021

Agaricoglycerides Protect against Hepatic Ischemia/Reperfusion Injury by Attenuating Inflammatory Response, Oxidative Stress, and Expression of NF-κB.

Evid Based Complement Alternat Med 2015 16;2015:142736. Epub 2015 Apr 16.

Hospital & Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China.

We have investigated the effects of agaricoglycerides (AG) in a mouse model of hepatic I/R injury. I/R triggered increases/changes in markers of liver injury, hepatic oxidative stress, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and nuclear factor κB (NF-κB). AG significantly reduced the extent of liver inflammation and oxidative stress and also attenuated the NF-κB activation as well as TNF-α and IL-1β production. Our results indicate that AG may represent a novel protective strategy against I/R-induced injury and inflammatory diseases.
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http://dx.doi.org/10.1155/2015/142736DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4415680PMC
May 2015

The effects of different preoperative biliary drainage methods on complications following pancreaticoduodenectomy.

Medicine (Baltimore) 2015 Apr;94(14):e723

From the Department and Institute of Hepatobiliary Surgery (XH, BL, XQZ, FBZ, XTW, JHD), Chinese PLA General Hospital, Beijing, China; and School of Medicine (XH, FBZ, XTW), Nankai University, Tianjin, China.

The objective of this study was to investigate the effects of different preoperative biliary drainage (PBD) methods on complications in jaundiced patients following pancreaticoduodenectomy. We retrospectively analyzed 270 extrahepatic bile duct cancer patients who underwent pancreaticoduodenectomy. A total of 170 patients without PBD treatment were defined as the non-PBD group. According to different PBD methods, 45, 18, and 37 patients were classified into the percutaneous transhepatic biliary drainage (PTBD), endoscopic nasobiliary drainage (ENBD), and endoscopic retrograde biliary stent (ERBS) groups, respectively. Clinical characteristics and complications were compared among the 4 groups. Preoperative cholangitis occurred in 14 (8.2%) and 8 (21.6%) patients in the non-PBD and ERBS group, respectively (P = 0.04). Compared with the non-PBD group, delayed gastric emptying (DGE) and wound infection occurred significantly more often in the ERBS group. The incidence of severe complications was significantly lower in the PTBD group than the non-PBD group (P = 0.03). Postoperative hospital stay and complication rates were significantly higher in the ERBS group than the PTBD group. There were no significant differences in complications between ENBD and other groups. In conclusion, PTBD can improve surgical outcomes by reducing severe complication rate in jaundiced patients following pancreaticoduodenectomy. ERBS increased the rates of DGE and wound infection due to high incidence of cholangitis before operative intervention and should be avoided. ENBD carried no special effect on complications and needs further analysis.
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http://dx.doi.org/10.1097/MD.0000000000000723DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554051PMC
April 2015

Osteopontin promoter polymorphisms at locus -443 are associated with metastasis and poor prognosis of human intrahepatic cholangiocarcinoma in Chinese population.

Int J Clin Exp Pathol 2014 15;7(10):6914-21. Epub 2014 Sep 15.

Department of Hepatobiliary, PLA General Hospital No. 28 Fu Xing Road, Beijing 100853, China.

Purpose: Osteopontin (OPN) is known to be a secreted adhesive glycoprotein. Role of OPN in human intrahepatic cholangiocarcinoma (ICC) has not been well understood. This study explored whether genetic variations in the osteopontin gene are associated with ICC risk, progression and metastasis.

Material And Methods: 260 patients with stages I to IV between 2008 and 2013 were recruited in this study and same number healthy persons were used as control. OPN-66 T/G, -156 G/GG and -443 C/T variants were genotyped using DNA from blood lymphocytes. Chi-square test and a Fisher's exact test were used to analyze the genotype distribution between healthy subjects and patients, and further its distribution among TNM stages and incidence metastasis in patients.

Results: For the variant at nt- 443 (CC), there was a significant difference between the number of patients with stage IV and those with all other stages of ICC (P < 0.01). Patients with -443 (CC) variant had significant higher incidence of lymph and distant metastasis development compared to other genotypes. For the variant at nt- 443 (CT), there was a significant difference between the number of ICC patients with stage III + IV and those with stage I + II (P < 0.01). The survival rates for ICC patients with the C/C genotype were significantly lower than for patients with the other two genotypes (C/T, T/T).

Conclusion: OPN -443 C/T polymorphism is a potential predictive marker of metastasis and poor prognosis in ICC patients.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230109PMC
July 2015

Comparison of percutaneous transhepatic biliary drainage and endoscopic biliary drainage in the management of malignant biliary tract obstruction: a meta-analysis.

Dig Endosc 2015 Jan 24;27(1):137-45. Epub 2014 Sep 24.

Department of Hepatobiliary Surgery, Hainan Branch of Chinese PLA General Hospital, Sanya, China.

Background And Aim: To compare percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD) for management of malignant biliary tract obstruction (MBTO).

Methods: PubMed, Google Scholar, and the Cochrane database were searched to 31 December 2013. Main outcome measurements were therapeutic success rate, 30-day mortality rate, overall complications, cholangitis, and pancreatitis.

Results: Eight studies (five retrospective and three randomized controlled trials) were included in the meta-analysis with a total of 692 participants. Combined odds ratio (OR) = 2.18 revealed no significant difference in therapeutic success between PTBD and EBD (95% confidence interval [CI] = 0.73-6.47, P = 0.162). However, after excluding two studies that appeared to be outliers, PTBD exhibited a better therapeutic success rate than EBD (pooled OR = 4.45, 95% CI = 2.68-7.40, P < 0.001). Patients who underwent PTBD were 0.55 times as likely to have cholangitis as those who underwent EBD, whereas the overall complication rate, pancreatitis rate, and 30-day mortality were similar between the two procedures.

Conclusions: PTBD may be associated with a better therapeutic success rate and lower incidence of cholangitis than EBD, but the overall complication rate, pancreatitis rate, and 30-day mortality of the two procedures are similar.
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http://dx.doi.org/10.1111/den.12320DOI Listing
January 2015

"One-off" complete radiofrequency ablation for hepatocellular carcinoma in a "high-risk location" adjacent to the major bile duct and hepatic blood vessel.

Cell Biochem Biophys 2014 Jul;69(3):605-17

Institute & Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical School, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China,

Radiofrequency ablation (RFA) is an effective, minimally invasive treatment option for unresectable hepatocellular carcinomas (HCCs) located in high-risk areas or for patients with poor hepatic functional reserve. However, for tumors adjacent to major bile ducts and hepatic blood vessels, complete ablation is difficult to achieve for fear of causing a postoperative bile leak, bilioma or bile duct stenosis. Therefore, RFA is often combined with multiple alcohol injections to eliminate residual tumor tissues in adjacent bile duct or blood vessels; however, the injections directly affect the efficacy and prognosis of RFA. This study reports three successful "one-off" cases of complete ablation of HCCs adjacent to major bile ducts and blood vessels in neighboring hepatic segments or hepatic lobes, highlighting both the efficacy and safety of RFA for HCC tumors in these high-risk locations.
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http://dx.doi.org/10.1007/s12013-014-9840-8DOI Listing
July 2014

Comparison between two types of local resection in the treatment of ampullary cancer.

ANZ J Surg 2014 Apr 25;84(4):255-9. Epub 2013 Jan 25.

Hospital & Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China.

Background: This study aims to compare the effects of two different local resection procedures on the prognosis of ampullary cancer.

Methods: We carried out a retrospective study using clinical and pathological data from patients with ampullary cancer who underwent local resection between February 1996 and February 2009 in the PLA General Hospital. In these participants, we carried out a comparative analysis between the transduodenal (the transduodenal group) and the extraduodenal (extraduodenal group) surgical approaches.

Results: No significant differences in gender, age, preoperative bilirubin levels, CA19-9 values, biopsy results, tumour size, differentiation status, degree of invasion, surgical margins, recurrence, metastasis and complication rates, and intraoperative blood loss were found. As compared to the transduodenal group, the extraduodenal group showed a longer duration of surgery and higher survival rates.

Conclusions: Even though the operation time for the extraduodenal resection of ampullary cancer was longer, the survival rate was higher than in patients who underwent transduodenal resection. For certain patients, the extraduodenal approach may be more appropriate when technical conditions allow it.
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http://dx.doi.org/10.1111/ans.12047DOI Listing
April 2014

Complete radio frequency ablation of hepatocellular carcinoma adjacent to the main bile duct and blood vessels between the first and the second hepatic portal.

Cell Biochem Biophys 2013 Jun;66(2):397-402

Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, China.

In cases where hepatocellular carcinoma cannot be surgically removed either due to the capacity of hepatic functional reserve or the special location of the tumor, a radiofrequency ablation (RFA) is recognized to be an effective and minimally invasive treatment. However, when the tumor is adjacent to the main bile duct and blood vessels, it is feared that due to the "heat-sink effect" of the blood and the possible damage to the duct and blood vessels, complete tumor ablation is hard to achieve. We report here a case of complete RFA of hepatocellular carcinoma, adjacent to the main bile duct and blood vessels between the first and the second hepatic portal, with emphasis on the safety of the approach for complete ablation of the tumor.
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http://dx.doi.org/10.1007/s12013-012-9480-9DOI Listing
June 2013

Prognosis of ampullary cancer based on immunohistochemical type and expression of osteopontin.

Diagn Pathol 2011 Oct 13;6:98. Epub 2011 Oct 13.

Hospital & Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.

Background: Ampullary cancer (AC) was classified as pancreatobiliary, intestinal, or other subtype based on the expression of cytokeratin 7 (CK7) and cytokeratin 20 (CK20). We aimed to explore the association of AC subtype with patient prognosis.

Methods: The relationship of AC subtype and expression of Osteopontin (OPN) with the prognosis of 120 AC patients after pancreaticoduodenectomy was investigated.

Results: The patients had pancreatobiliary (CK7+/CK20-, n = 24, 20%), intestinal (CK7-/CK20+, n = 29, 24.2%) or other (CK7+/CK20+ or CK7-/CK20-, n = 67, 55.8%) subtypes of AC, and their median survival times were 23 ± 4.2, 38 ± 2.8 and 64 ± 16.8 months, respectively. The survival times of 64 OPN- patients (53.3%) and 56 OPN+ patients (46.7%) were 69 ± 18.4 and 36 ± 1.3 months, respectively. There was no significant effect of AC subtype on survival of OPN- patients. For OPN+ patients, those with pancreatobiliary AC had a shorter survival time (22 ± 6.6 months) than those with intestinal AC (37 ± 1.4 months, p = 0.041), and other AC subtype (36 ± 0.9 months, p = 0.010); intestinal and other AC subtypes had similar survival times.

Conclusions: The prognosis of AC patients can be estimated based on immunohistochemical classification and OPN status.
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http://dx.doi.org/10.1186/1746-1596-6-98DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3213044PMC
October 2011

[Determinants of long-term survival after pancreaticoduodenectomy for ampulla of Vater carcinoma].

Zhonghua Yi Xue Za Zhi 2009 Dec;89(48):3409-12

Department of Hepatobiliary Surgery, General Hospital of PLA, Beijing 100853, China.

Objective: To investigate the determinants of long-term survival for ampulla of Vater carcinoma treated by pancreaticoduodenectomy.

Methods: A total of 77 patients with ampulla of Vater carcinoma undergoing pancreaticoduodenectomy were reviewed. Kaplan-Meier method was used to analyze the survival rate. Independent t test was used for statistical comparison and COX regression model for multivariate analysis.

Results: No patient died as a result of surgery. The overall 5-year survival was 40.7%. Univariate analysis showed that perioperative serum carcinoembryonic antigen (CEA) level (P = 0.012), tumor invasion depth (P = 0.000), UICC stage (P = 0.000) and tumor size (P = 0.001) were significant prognostic factors of ampulla of Vater carcinoma; in multivariate analysis, only the tumor size (P = 0.000) was an independent prognostic factor of ampulla of Vater carcinoma.

Conclusion: Pancreaticoduodenectomy is associated with significant survival. Tumor size is the most important influencing factor of outcome after pancreaticoduodenectomy; in addition, perioperative serum CEA level, tumor invasion depth and UICC stage may also influence the survival rate, there exists a need for further follow-up studies.
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December 2009

[Experience from surgical resection for 48 cases of hilar cholangiocarcinoma].

Zhonghua Wai Ke Za Zhi 2009 Aug;47(15):1138-41

Department of Hepatobiliary Surgery, General Hospital of People's Liberation Army, Beijing 100853, China.

Objective: To summarize the methods, safety and efficiency of surgical resection for hilar cholangiocarcinoma.

Methods: The clinical and follow-up data of 48 patients with hilar cholangiocarcinoma underwent surgical resection from January 2003 to December 2007 were analyzed retrospectively. There were 26 male and 22 female, aged from 38 to 72 years old with a mean of 63.6 years old.

Results: Perioperative management including percutaneous transhepatic biliary drainage applied in 19 cases and portal vein embolization applied in 2 cases. Eight patients were treated with extrahepatic bile duct resection with or without parital hepatic segment II resection, 10 cases with perihilar hepatic resection (segment IVB, partial V, partial VIII, I), 28 cases with extended hemihepatectomy and 2 cases with central hepatic resection (segment IVB, V, VIII, I). R0 resection rate was 89.5% and the operative mortality was 2.1%. The 1-, 3- and 5-year survival rate were 93.5%, 51.8% and 36.5%, respectively. Patients undergoing extended hepatic resection survived significantly longer than those undergoing partial hepatic resection (P = 0.034).

Conclusions: Extended hepatic resection for hilar cholangiocarcinoma offers good outcomes with an acceptable mortality rate.
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August 2009

[Construction of a genetic map based on ILP markers in rice].

Yi Chuan 2008 Feb;30(2):225-30

College of Agriculture and Biotechnology, Zhejiang University, Hangzhou 310029, China.

Intron length polymorphism (ILP) is a new type of PCR-based molecular markers with many advantages. We had previously developed 172 ILP markers in rice using the published genome sequence data of indica cultivar 93-11 and ja-ponica cultivar Nipponbare. In order to examine the reliability and the applicability of these ILP markers to genetic map-ping, we constructed a rice genetic map consisting of 172 ILP and 13 SSR markers with a total length of 1 905.7 cM using a BC1F1 (Nipponbare/93-11//Nipponbare) population. Comparison showed that the order of the markers in this map was ex-actly the same as their physical order, verifying the feasibility and efficiency of using ILP markers for genetic mapping. We also investigated the phenomenon of marker segregation distortion and found a region of serious segregation distortion in the short arm of chromosome 6.
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http://dx.doi.org/10.3724/sp.j.1005.2008.00225DOI Listing
February 2008