AIM: To study the mechanism by which Helicobacter pylori (H pylori) damages human gallbladder epithelial cells (HGBEC). METHODS: H pylori isolated from gallbladder were cultured in a liquid medium. Different concentra...AIM: To study the mechanism by which Helicobacter pylori (H pylori) damages human gallbladder epithelial cells (HGBEC). METHODS: H pylori isolated from gallbladder were cultured in a liquid medium. Different concentration supernatants and sonicated extracts of H pylori cells were then added to HGBEC in a primary culture. The morphological changes in HGBEC as well as changes in the levels of alkaline phosphatase (ALP), lactate dehydrogenase (LDH) and glutamyltransferase (GGT) were measured.RESULTS: According to the culture curve of HGBEC, it was convenient to study the changes in HGBEC by adding H pylori sonicated extracts and H pylori culture supernatants. Both H pylori sonicated extracts and H pylori culture supernatants had a significant influence on HGBEC morphology, i.e. HGBEC grew more slowly, their viability decreased and their detachment increased. Furthermore, HGBEC ruptured and died. The levels of ALP (33.84 ± 6.00 vs 27.01 ± 4.67, P < 0.05), LDH (168.37 ± 20.84 vs 55.51 ± 17.17, P < 0.01) and GGT (42.01 ± 6.18 vs 25.34 ± 4.33, P < 0.01) significantly increased in the HGBEC culture supernatant in a time-and concentration-dependent. The damage to HGBEC in H pylori culture liquid was more significant than that in H pylori sonicated extracts. CONCLUSION: H pylori induces no obvious damage to HGBEC.展开更多
AIM:To investigate the role and clinicopathological significance of aberrant expression of Notch receptors and Delta-like ligand-4 (DLL4) in extrahepatic cholangiocarcinoma and gallbladder carcinoma.METHODS:One hundre...AIM:To investigate the role and clinicopathological significance of aberrant expression of Notch receptors and Delta-like ligand-4 (DLL4) in extrahepatic cholangiocarcinoma and gallbladder carcinoma.METHODS:One hundred and ten patients had surgically resected extrahepatic cholangiocarcinoma (CC) and gallbladder carcinoma specimens examined by immunohistochemistry of available paraffin blocks.Immunohistochemistry was performed using anti-Notch receptors 1-4 and anti-DLL4 antibodies.We scored the immunopositivity of Notch receptors and DLL4 expression by percentage of positive tumor cells with cytoplasmic expression and intensity of immunostaining.Coexistent nuclear localization was evaluated.Clinicopatho-logical parameters and survival data were compared with the expression of Notch receptors 1-4 and DLL4.RESULTS:Notch receptor proteins showed in the cytoplasm with or without nuclear expression in cancer cells,as well as showing weak cytoplasmic expression in non-neoplastic cells.By semiquantitative evaluation,positive immunostaining of Notch receptor 1 was detected in 96 cases (87.3%),Notch receptor 2 in 97 (88.2%),Notch receptor 3 in 97 (88.2%),Notch receptor 4 in 103 (93.6),and DLL4 in 84 (76.4%).In addition,coex- istent nuclear localization was noted [Notch receptor 1;18 cases (18.8%),Notch receptor 2;40 (41.2%),Notch receptor 3;32 (33.0%),Notch receptor 4;99 (96.1%),DLL4;48 (57.1%)].Notch receptor 1 expression was correlated with advanced tumor,node,metastasis (TNM) stage (P=0.043),Notch receptor 3 with advanced T stage (P=0.017),tendency to express in cases with nodal metastasis (P=0.065) and advanced TNM stage (P=0.052).DLL4 expression tended to be related to less histological differentiation (P=0.095).Coexistent nuclear localization of Notch receptor 3 was related to no nodal metastasis (P=0.027) and Notch receptor 4 with less histological differentiation (P=0.036),while DLL4 tended to be related inversely with T stage (P=0.053).Coexistent nuclear localization of DLL4 was related to poor survival (P=0.002).CONCLUSION:Aberrant expression of Notch receptors 1 and 3 play a role during cancer progression,and cytoplasmic nuclear coexistence of DLL4 expression correlates with poor survival in extrahepatic CC and gallbladder carcinoma.展开更多
AIM: To summarize the experience in diagnosis, management and prevention of iatrogenic bile duct injury (IBDI). METHODS: A total of 210 patients with bile duct injury occurred during cholecystectomy admitted to Hunan ...AIM: To summarize the experience in diagnosis, management and prevention of iatrogenic bile duct injury (IBDI). METHODS: A total of 210 patients with bile duct injury occurred during cholecystectomy admitted to Hunan Provincial People’s Hospital from March 1990 to March 2006 were included in this study for retrospective analysis. RESULTS: There were 59.5% (103/173) of patients with IBDI resulting from the wrong identification of the anatomy of the Calot’s triangle during cholecystectomy. The diagnosis of IBDI was made on the basis of clinical features, diagnostic abdominocentesis and imaging findings. Abdominal B ultrasonography (BUS) was the most popular way for IBDI with a diagnostic rate of 84.6% (126/149). Magnetic resonance cholangiography (MRC) could reveal the site of injury, the length of injured bile duct and variation of bile duct tree with a diagnostic rate 100% (45/45). According to the site of injury, IBDI could be divided into six types. The most common type (type 3) occurred in 76.7% (161/210) of the patients and was treated with partial resection of the common hepatic duct and common bile duct. One hundred and seventy-six patients were followed up. The mean follow-up time was 3.7 (range 0.25-10) years. Good results were achieved in 87.5% (154/176) of the patients. CONCLUSION: The key to prevention of IBDI is to follow the "identifying-cutting-identifying" principle during cholecystectomy. Re-operation time and surgical procedure are decided according to the type of IBDI.展开更多
基金Supported by The National Natural Science Foundation of China, No. 39970039
文摘AIM: To study the mechanism by which Helicobacter pylori (H pylori) damages human gallbladder epithelial cells (HGBEC). METHODS: H pylori isolated from gallbladder were cultured in a liquid medium. Different concentration supernatants and sonicated extracts of H pylori cells were then added to HGBEC in a primary culture. The morphological changes in HGBEC as well as changes in the levels of alkaline phosphatase (ALP), lactate dehydrogenase (LDH) and glutamyltransferase (GGT) were measured.RESULTS: According to the culture curve of HGBEC, it was convenient to study the changes in HGBEC by adding H pylori sonicated extracts and H pylori culture supernatants. Both H pylori sonicated extracts and H pylori culture supernatants had a significant influence on HGBEC morphology, i.e. HGBEC grew more slowly, their viability decreased and their detachment increased. Furthermore, HGBEC ruptured and died. The levels of ALP (33.84 ± 6.00 vs 27.01 ± 4.67, P < 0.05), LDH (168.37 ± 20.84 vs 55.51 ± 17.17, P < 0.01) and GGT (42.01 ± 6.18 vs 25.34 ± 4.33, P < 0.01) significantly increased in the HGBEC culture supernatant in a time-and concentration-dependent. The damage to HGBEC in H pylori culture liquid was more significant than that in H pylori sonicated extracts. CONCLUSION: H pylori induces no obvious damage to HGBEC.
文摘AIM:To investigate the role and clinicopathological significance of aberrant expression of Notch receptors and Delta-like ligand-4 (DLL4) in extrahepatic cholangiocarcinoma and gallbladder carcinoma.METHODS:One hundred and ten patients had surgically resected extrahepatic cholangiocarcinoma (CC) and gallbladder carcinoma specimens examined by immunohistochemistry of available paraffin blocks.Immunohistochemistry was performed using anti-Notch receptors 1-4 and anti-DLL4 antibodies.We scored the immunopositivity of Notch receptors and DLL4 expression by percentage of positive tumor cells with cytoplasmic expression and intensity of immunostaining.Coexistent nuclear localization was evaluated.Clinicopatho-logical parameters and survival data were compared with the expression of Notch receptors 1-4 and DLL4.RESULTS:Notch receptor proteins showed in the cytoplasm with or without nuclear expression in cancer cells,as well as showing weak cytoplasmic expression in non-neoplastic cells.By semiquantitative evaluation,positive immunostaining of Notch receptor 1 was detected in 96 cases (87.3%),Notch receptor 2 in 97 (88.2%),Notch receptor 3 in 97 (88.2%),Notch receptor 4 in 103 (93.6),and DLL4 in 84 (76.4%).In addition,coex- istent nuclear localization was noted [Notch receptor 1;18 cases (18.8%),Notch receptor 2;40 (41.2%),Notch receptor 3;32 (33.0%),Notch receptor 4;99 (96.1%),DLL4;48 (57.1%)].Notch receptor 1 expression was correlated with advanced tumor,node,metastasis (TNM) stage (P=0.043),Notch receptor 3 with advanced T stage (P=0.017),tendency to express in cases with nodal metastasis (P=0.065) and advanced TNM stage (P=0.052).DLL4 expression tended to be related to less histological differentiation (P=0.095).Coexistent nuclear localization of Notch receptor 3 was related to no nodal metastasis (P=0.027) and Notch receptor 4 with less histological differentiation (P=0.036),while DLL4 tended to be related inversely with T stage (P=0.053).Coexistent nuclear localization of DLL4 was related to poor survival (P=0.002).CONCLUSION:Aberrant expression of Notch receptors 1 and 3 play a role during cancer progression,and cytoplasmic nuclear coexistence of DLL4 expression correlates with poor survival in extrahepatic CC and gallbladder carcinoma.
文摘AIM: To summarize the experience in diagnosis, management and prevention of iatrogenic bile duct injury (IBDI). METHODS: A total of 210 patients with bile duct injury occurred during cholecystectomy admitted to Hunan Provincial People’s Hospital from March 1990 to March 2006 were included in this study for retrospective analysis. RESULTS: There were 59.5% (103/173) of patients with IBDI resulting from the wrong identification of the anatomy of the Calot’s triangle during cholecystectomy. The diagnosis of IBDI was made on the basis of clinical features, diagnostic abdominocentesis and imaging findings. Abdominal B ultrasonography (BUS) was the most popular way for IBDI with a diagnostic rate of 84.6% (126/149). Magnetic resonance cholangiography (MRC) could reveal the site of injury, the length of injured bile duct and variation of bile duct tree with a diagnostic rate 100% (45/45). According to the site of injury, IBDI could be divided into six types. The most common type (type 3) occurred in 76.7% (161/210) of the patients and was treated with partial resection of the common hepatic duct and common bile duct. One hundred and seventy-six patients were followed up. The mean follow-up time was 3.7 (range 0.25-10) years. Good results were achieved in 87.5% (154/176) of the patients. CONCLUSION: The key to prevention of IBDI is to follow the "identifying-cutting-identifying" principle during cholecystectomy. Re-operation time and surgical procedure are decided according to the type of IBDI.
