Biomedical subjects

Yu-lian Wu

Publications and source records attributed to Yu-lian Wu.

13 recordsLinked to original sources

PubMed2005

[The value of metastatic lymph nodes ratio in predicting the prognosis of patients with T3 gastric carcinoma].

OBJECTIVE: To evaluate the value of the metastatic lymph node ratio (MLR) in predicting the postoperatively survival time of patients with T(3) gastric carcinoma. METHODS: Eighty-nine patients with T(3) gastric carcinoma who underwent curative gastrectomy were analyzed retrospectively. The correlations between MLR, positive nodes and the total lymph nodes (15 or more) in histologic examination were analyzed using Spearman's correlation analysis. The influence of MLR and positive nodes on survival time of patients was identified with univariate Kaplan-Meier survival analysis and multivariate Cox proportional hazard model analysis. The predicting accuracy of MLR to death of patients within 2 years postoperatively was determined by receiver working characteristic curve and was compared with that of positive nodes. RESULTS: (1) The MLR did not correlate with the total lymph nodes in histologic examination (Spearman's correlation coefficient was -0.0022, P > 0.05), whereas positive lymph nodes did (correlation coefficient was 0.2504, P < 0.05). (2) Kaplan-Meier survival analysis identified that the MLR influenced significantly the survival time postoperatively (Log-rank chi(2) = 35.7470, P < 0.01). Cox proportional hazard model showed the high MLR was an independent poor prognostic factor (chi(2) = 7.9708, P < 0.01). (3) There was not difference between the area under the receiver working curve of MLR and positive nodes to predict the death of patients within 2 years postoperatively (P > 0.05). CONCLUSION: The MLR in T(3) gastric carcinoma is not correlated with the number of total lymph nodes examined on the condition that 15 or more lymph nodes were assessed in pathology. The predicting accuracy of MLR to death of patients with T(3) gastric carcinoma within 2 years postoperatively is same as, but not better than that of positive nodes if the extent of lymphadenectomy is optimal.

Adult↗

PubMed2005

[A prognostic scoring system for preoperative prediction of lymph node metastases in gastric cancers].

OBJECTIVE: To establish a preoperative scoring system to predict the lymph node metastases (N) in gastric cancers. METHODS: The clinicopathologic data of 291 cases with gastric cancer were analyzed retrospectively. The factors influencing significantly actual lymph node status (pN) were selected through the univariate and the multivariate analysis, and the score of each factor was identified. Scores predicting different N stages were identified using receiver operating characteristic curves. The N stages defined by the score system were compared with the actual pN status using kappa statistics and diagnostic test. RESULTS: Tumor size, depth of invasion and histopathological types were selected to establish the scoring system. According to this score system, scores 0-4 predict N0, scores 5-7 predict N1, scores 8-9 predict N2 and scores 10-13 predict N3. There was a good agreement between N stages predicted by the scoring system and the actual pN status (weighted kappa = 0.605, u = 14.548, P < 0.0001). The crude agreement, positive predictive value and negative predictive value of the scoring system were 82.8%, 65.6% and 88.5%, respectively. CONCLUSION: The scoring system can provide accurate and reliable information to predict the lymph node metastases of gastric cancers preoperatively. It is simple and practical to use in clinical work and can help surgeons to choose an optimal extent of lymph node dissection for gastric cancer.

Humans↗

PubMed2004

[In vitro immunocompatibility of a novel bioartificial liver reactor material: propylene-acidamide grafted polypropylene membrane].

OBJECTIVE: To evaluate the immunocompatibility of a novel bioartificial liver bioreactor material: propylene-acidamide grafted polypropylene membrane (PP-g-AAm) in vitro on peripheral blood mononuclear cells (PBMCs). METHODS: Fifty milliliters of peripheral blood were collected from 30 healthy young people. PBMCs were extracted and inoculated on the 24-well culture plate preset with sterilized PP-g-AAm membrane and ungrafted polypropylene (PP) membrane. Automatic biochemical analyzer was used to detect the lactic dehydrogenase (LDH) value of the PMBCs after 2 and 6 hours. The PMBCs on these 2 kinds of membrane were cultured for 6 hours and then added with lipopolysaccharide and cultured continually. Six, twelve, and thirty-six hours later the supernatant was collected. ELISA was used to detect the values of tumor necrosis factor (TNF)alpha, interleukin (IL)-1beta, and IL-6. Flow cytometry was used to detect the expression of CD69 antigen. Scanning electron microscopy was used to observe the adhesion of PMBCs on the materials. RESULTS: After 2 hours' epimembranous inoculation the LDH value was 43.50 U/L +/- 12.71 U/L in the PP group, significantly higher than that in the PP-g-AAm group (29.13 U/L +/- 8.74 U/L, P = 0.008) and the newly extracted PMBC group (0 h group, 19.89 U/L +/- 4.67 U/L, P = 0.000). However, the difference between the 0 h group and PP-g-AAm group (P = 0.080) was insignificant. After 6 hours' epimembranous inoculation the LDH value was 50.25 U/L +/- 13.38 U/L in the PP group, and 32.50 U/L +/- 9.21 U/L in the PP-g-AAm group (P = 0.001), both significantly higher than that in the 0 h group (P = 0.000, and P = 0.019). There was no significant difference between the values 2 hours and 6 hours after inoculation for the two groups. No expression of TNFalpha, IL-1beta, and IL-6 was found in the supernatant of the 2 groups without LPS stimulation. Expressions of TNFalpha, IL-1beta, and IL-6 could be found at a low level 12 hours after LPS stimulation for both groups and peaked 24 hours after LPS stimulation. The expressions of TNFalpha, IL-1beta, and IL-6 were lower in the PP-g-AAm group than in the PP group (P = 0.004, P = 0.003, and P = 0.022). The TNFalpha, IL-1beta, and IL-6 levels all decreased after 36 hours. The CD69 antigen expression rates were 17.20% +/- 3.45%and 12.02% +/- 2.44% respectively in the PP group and PP-g-AAm group, both significantly higher than that of the blank control group (3.38% +/- 1.30%, both P = 0.000). SEM showed that the PMBCs adhered on the PP-Aam membrane were significantly less then those adhered on the PP membrane. And the PMBCs adhered on the PP-g-AAm membrane were smaller and with less microvilli. CONCLUSION: PP-g-AAm membrane has weaker activation capability to PMBCs and has better immunocompatibility in comparison with the PP membrane.

Adult↗

PubMed2004

[Distribution of sentinel lymph nodes in gastric cancer and factors correlated with its metastasis].

OBJECTIVE: To investigate the distribution of sentinel lymph nodes in gastric cancer, and evaluate clinicopathologic characteristics leading its metastasis. METHODS: The location of metastatic lymph nodes was analyzed retrospectively in 27 patients of gastric carcinoma with solitary lymph node metastases, and in 80 cases metastasis was limited to only 1 station in Japanese nodal classification. The clinicopathologic characteristics of the patients with solitary lymph node metastases and 111 cases without lymph node metastases were compared. RESULTS: Twenty-five in 27 cases with solitary lymph node metastases were limited in level I. Skip metastasis occurred in 2 cases. Sentinel lymph nodes of 16 cases in 21 patients with the tumors in the lower and middle third stomach were located in less curvature (No. 3) and in greater curvature (No. 4). Sentinel lymph nodes of 3 cases in 6 patients in the upper third stomach were located in right cardia (No. 1). Multivariate analysis showed that the frequency of sentinel lymph node metastasis of pT(3) lesion was significantly higher than that of pT(1) lesion with an odds ratio of 4.926 (P < 0.01). The frequency of sentinel lymph node metastasis in the tumor located in the upper third stomach was significantly higher than that in lower third stomach, with an odds ratio of 4.381 (P < 0.05). Early gastric cancer had lower risk for sentinel lymph node metastasis than that in Borrmann type I cancer, with an odds ratio of 0.082 (P < 0.05). CONCLUSIONS: Majority of sentinel lymph nodes are located in the regional perigastric lymph node groups close to the tumor. Skip metastasis is rare. Depth of invasion and location of tumor are correlated with sentinel lymph node metastasis. Sentinel lymph node assessment can instruct to determine extent of lymph node dissection for gastric cancer.

Adult↗

PubMed2004

[Effect of binding pancreaticojejunotomy in prevention of post-operational anastomotic leakage: a clinical study of 200 cases].

OBJECTIVE: To explore the effect of Peng's binding pancreaticojejunotomy (PBPJ) in prevention of pancreaticojejunal anastomotic leakage. METHODS: From 1996 to 2001, 200 patients, 139 males and 61 females, aged 32 approximately 80, with carcinomas of head of pancreas, ampulla, bile duct, duodenal papilla, descending partof duodenum, gallbladder, and body of pancreas, chronic pancreatitis, polyp of lower segment of bile duct, and gastric carcinomas that invaded the head of pancreas or recurred after operation, lithiasis of pancreatic duct, and islet cell carcinoma, underwent Peng's binding pancreaticojejunotomy, devised to prevent pancreaticojejunal anastomotic leakage from the needle holes of stoma, interspace between jejunal mucosa and pancreas, high pressure of jejunum, high tension and blood circulation deficiency of pancreaticojejunal stoma, etc. The clinical data were collected and analyzed. RESULTS: While the cut end of jejunum was sutured to the pancreatic remnant the needle only penetrated the jejunal mucosa without causing a needle hole on the surface of the stoma. After the remnant of pancreas was inserted into the jejunal cavity, a piece of cat gut was bound around the entire jejunal serous muscular sheath and the pancreatic remnant so as to make them stick to each other closely. No pancreatic leakage occurred among these 200 cases after operation. CONCLUSION: The PBPJ procedure can definitively avoid anastomotic leakage following pancreatoduodenectomy.

Adult↗

PubMed2004

[Diagnosis and treatment of vasoactive intestinal peptide-secreting-tumors: one case report and 15 years review in China].

OBJECTIVE: To discuss the experiences of diagnosis and treatment for vasoactive intestinal peptide-secreting-tumors (VIPoma) by summarizing clinical informations of 15 patients with VIPoma. METHODS: To analyze Clinical manifestations, laboratory examinations, imaging features, operation, pathological findings and follow up survey of 15 patients, among them 1 case from our hospital and the other 14 cases were searched in chinese biological and medical literature database from Jan 1987 to Dec 2002. RESULTS: The main clinical manifestation include periodical secretory watery diarrhea, hypokalemia, achlorhydria, in addition, periodical backache, skin rash, and polyps of colon were presented in the case in our hospital. The immunohistochemical expression of many kinds of digestive hormone including VIP presented positive; All clinical symptoms of which except polyps disappeared after operation, elevated VIP data in serum also markedly decreased. Part resection of superior mesenteric vein was performed in the same patient. CONCLUSIONS: VIPoma is rare. Typical symptoms and the serum value of VIP were keys to diagnosis, the operation is the most effective means for treatment. Resection of tumor, Radiofrequency tissue ablation, liver transplantation can be selected for metastatic VIPoma in the liver.

Adult↗

PubMed2004

[Role and significance of extrahepatic control of hepatic vein and inferior vena cava in difficult hepatectomies for patients with liver tumors].

OBJECTIVE: To explore the role of extrahepatic control on blood flow of hepatic vein and inferior vena cava in hepatectomy, and observe its effect on minimizing hemorrhage. METHODS: From 2001 to April 2003, 33 patients who had liver tumors involving segment IV, VII, VIII or half liver underwent major hepatectomies that required exposure of the inferior vena cava and main trunks of hepatic veins, during which the major hepatic veins and inferior vena cava were isolated and taped to control blood flow when necessary. RESULTS: In 33 attempts, 32 were successful and all tumors were resected successfully. The placement of occlusion tape was unsuccessful in 1 case. 7 cases did not need blood transfusion during operation. The amount of blood transfusion for other cases were form 0 to 1 600 ml. there was no operative mortality. CONCLUSIONS: Appropriate control of main truck of hepatic vein and inferior vena cava is effective in reducing blood loss during hepatectomies. It is also very helpful for performing difficult hepatectomies.

Adult↗

PubMed2003

[The role and significance of retrohepatic tunnel and the liver hanging tape passed through the tunnel in difficult hepatectomies].

OBJECTIVE: To explore the role and significance of liver hanging tape passed through the retrohepatic tunnel developed by dissecting the tissue plane between anterior surface of the inferior vena cava (IVC) and caudate lobe, in order to be substitute for control of in- and out-flow blood vessels in difficult hepatectomies. METHODS: Retrohepatic tunnel was developed by dissecting the anterior surface of the retrohepatic portion of the IVC, 7 difficult hepatectomies were performed with the use of liver hanging tape and hemostatic plate. RESULTS: Liver hanging tape was placed successfully in 7 cases. VIII segmentectomy, right hemihepatectomy, left hemihepatectomy and right trilobectomy plus complete caudate lobectomy were performed, there was no complication related to this maneuver. CONCLUSION: It is feasible for placing liver hanging tape through the retrohepatic tunnel. In addition, it has extensive indications and minimal influence on hemodynamic response. It is a better way for the difficult hepatectomy and for harvesting the liver graft in living related liver transplantation.

Adolescent↗

PubMed2003

[Overexpression and genomic amplification of decoy receptor 3 in hepatocellular carcinoma and significance thereof].

OBJECTIVE: To investigate the mRNA expression and genomic amplification of decoy receptor 3 (DcR3) in hepatocellular carcinoma (HCC) and the significance thereof. METHODS: RT-PCR was used to examine the expression of DcR3 mRNA in 48 cases of HCC tissues and the normal tissues adjacent to the tumor resected in operation and proved pathologically. The DcR3 gene amplification in the cancer tissues was examined by quantitative genomic PCR. The correlation between the DcR3 mRNA expression and genomic amplification of HCC was analyzed statistically. The differences in DcR3 expression and amplification in HCC with different clinical and pathological features were compared. RESULTS: DcR3 mRNA was detected in 29 out of the 48 HCC cases with a positive rate of 60.4%. No DcR3 mRNA expression was detected in the 48 cases of normal tissues adjacent to tumor. DcR3 mRNA was expressed significantly higher in HCC > 5 mm, at stages and, and with infiltration and metastasis than those 0.05). The DcR3 gene amplification in 48 cases of HCC ranges from 0.18 to 3.86-fold. Seven of the 48 cases of HCC showed significantly higher DcR3 gene amplification than the normal control tissues. The positive rate of DcR3 mRNA expression was 40% in the 25 HCC patients with the amplification fold < 1.0 (10/25), significantly lower than that in the 23 patients with the amplification fold > 1.0 (82.6%, 19/23), P < 0.01. The average DcR3 gene amplification fold was 1.53 +/- 0.82 in the patients with positive mRNA expression, significantly higher than that in those with negative expression (0.75 +/- 0.33, P < 0.01). The DcR3 gene amplification in HCC showed no relationship with the clinical and pathological feature of the patients (all P > 0.05). Sequencing analysis showed 3 point mutations in the DcR3 gene mRNA of HCC in one case of positive amplification product. CONCLUSION: DcR3 mRNA is overexpressed in HCC, but not in the normal tissues adjacent to the tumor. The expression of DcR3 gene is related to the size, clinical stage, infiltration, and metastasis of HCC. DcR3 gene amplification occurs in HCC and is correlated with the mRNA expression. Point mutation of the DcR3 gene exists in HCC.

Adult↗

PubMed2003

Surgical management of transected injury to the pancreatic neck.

OBJECTIVE: To present a batch of data of transected pancreatic neck injuries and to sum up the experience in surgical interventions for the injuries. METHODS: We analysed 13 patients with a transected injury to the pancreatic neck from Jan. 1995 to Dec. 2000. External drainage was performed in all patients. Pancreatoduodenectomy was conducted in 2 patients with a transected injury to the pancreatic neck associated with duodenal ruptures, and TPN was administered immediately after operation. Proximal closure of the transected margin and distal pancreaticojejunostomy was performed in 4 patients. Proximal closure of the transected margin and distal pancreaticojejunostomy plus splenectomy was performed in 7 patients associated with contusion of pancreatic body or tail plus spleen rupture. RESULTS: 12 patients healed and one patient died of anesthetic accident during the course of restoration of the dislocation of his right hip joint. Complications occurred in 7 patients. CONCLUSIONS: The operation should be performed according to the degree of the injuries and associated duodenal injuries. Routine drainage and nutrient support should be recommended.

Adolescent↗

PubMed2003

[Surgical intervention of hepatocellular carcinoma with bile duct thrombi].

OBJECTIVES: To summarize the experience of surgical intervention for hepatocellular carcinoma (HCC) with bile duct thrombi (BDT), and to evaluate the influence on prognosis. METHODS: From 1994 to 2002, 15 patients with HCC and BDT who underwent surgical intervention were retrospectively analyzed. RESULTS: The operative procedures included hepatectomy with removal of BDT (n = 7), hepatectomy combined with extrahepatic bile duct resection (n = 4), thrombectomy through choledochotomy (n = 3), and piggy-back orthotopic liver transplantation (n = 1). The 1- and 3-year survival rates were 73.3% and 40%, respectively. Two patients survived over 5 year. The survival rate of patients with portal vein invasion was significantly lower than that of patients without portal vein invasion (P < 0.05). CONCLUSIONS: Surgical intervention was effective for patients with HCC and BDT. Operation after recurrence can prolong the survival time. Liver transplantation is a new operative procedure worthy of study.

Adult↗

PubMed2003

[Integrative therapy for postoperative intractable enterococcus faecium infections].

OBJECTIVE: To assess the treatment of patients with infection of enterococcus faecium after surgery who failed to respond to antibiotics. METHODS: Five patients after surgery were proved to have Enterococcus faecium infection by bacterial culture. They were treated by sensitive antibiotics but failed. Comprehensive treatment prescribed included immunoenhancements, enteral nutrition, and traditional Chinese medicines. RESULTS: Four patients were discharged from the hospital after recovery, and was cared else where after 1 month treatment. CONCLUSION: Comprehensive treatment is a better way to treat patients with refractory enterococcus faecium infection after surgery.

Aged↗

PubMed2003

[Clinical significance and correlation between elevated serum TR6 and lympho-metastasis in gastric cancer].

OBJECTIVE: To evaluate the value of serum TR(6) for the diagnosis and TNM classification in patients with gastric carcinoma. METHODS: Serum TR(6) levels were measured using ELISA method in 31 gastric cancer patients, 19 patients with nonmalignant conditions and 29 healthy individuals. TR(6) expression in tumor mass was studied with immunohistochemistry. TR(6) gene copy number in tumor tissues was evaluated by real time PCR. RESULTS: Ninety-seven point nine percent (47 of 48 cases) of healthy individuals and patients with nonmalignant conditions were serum TR(6)-negative. In contrast, 71% (22 of 31 cases) of gastric cancer patients were serum TR(6)-positive. Serum TR(6) positiveness was closely correlated with tumor differentiation status and TNM classification. TR(6) gene amplification did not occur in gastric carcinoma. CONCLUSIONS: Serum TR(6) levels were correlated significantly with TNM stage and histopathological type of tumor. This can help to determine the pre-operative TNM classification and to choose the optimal extent of lymph node dissection for gastric cancer.

Humans↗