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Yang C.-H.,The Second Peoples Hospital Of Anhui Province | Jiang H.,Chinese PLA General Hospital
World Chinese Journal of Digestology | Year: 2015

AIM: To summarize the experience of diagnosis and treatment of solid pseudopapillary tumor of the pancreas (SPTP). METHODS: Clinical data for 134 SPTP patients admitted to Chinese PLA General Hospital from February 2002 to July 2013 were retrospectively analyzed. RESULTS: The median age of the patients (116 females and 18 males) was 29.7 years (range 9-71 years). The tumor was located in the pancreatic head in 40 patients, in the pancreatic neck in 17 patients, in the pancreatic body and tail in 64 patients. The size of the lesions was large, and the median diameter of tumors was 6.0 cm (1.5-21.0 cm). Clinical presentation included a palpable abdominal mass in 21 patients, abdominal pain in 50 patients. Fortynine patients were asymptomatic, and their tumors were found incidentally on abdominal sonographic examination for other reasons. Low-echo solid and solid-cystic masses were found in the pancreas by ultrasonic examinations. Computed tomography (CT) or magnetic resonance imaging (MRI) found lowdensity masses in the pancreas. After dynamic contrast-enhanced scanning, the solid parts of the lesion showed progressive enhancement and the cystic parts of the lesion showed no enhancement. One hundred and twenty-six patients were treated by surgery. Of 89 patients who were followed, 4 died of tumor relapse and metastasis and the condition of one patient who did not undergo operation progressed, while no evidence of relapse or metastasis was found in other patients. CONCLUSION: SPTP occurs more frequently in young females and is potentially malignant. There is no characteristic clinical presentation. Preoperative diagnosis of SPTP depends on imaging study such as CT and MRI. Surgical resection is the first choice of treatment and is associated with a satisfactory prognosis. © 2015 Baishideng Publishing Group Inc. All rights reserved.


Guo J.-R.,Shanghai Gongli Hospital of Pudong New District | Xu F.,The Second Peoples Hospital of Anhui Province | Jin X.-J.,Wannan Medical College | Shen H.-C.,Ningbo No2 Hospital | And 3 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2014

Objective: To observe the effects of allogeneic and autologous transfusion on cellular immunity, humoral immunity and secretion of serum inflammatory factors and perforin during the perioperative period in patients with malignant tumors. Methods: A total of 80 patients (age: 38-69 years; body weight: 40-78 kg; ASA I - II) receiving radical operation for gastro-intestinal cancer under general anesthesia were selected. All the patients were divided into four groups based on the methods of infusion and blood transfusion: blank control group (Group C), allogeneic transfusion group (group A), hemodiluted autotransfusion Group (Group H) and hemodiluted autotransfusion + allogenic transfusion Group (A+H group). Venous blood was collected when entering into the surgery room (T0), immediately after surgery (T1) and 24h (T2), 3d (T3) and 7d (T4) after surgery, respectively. Moreover, flow cytometry was applied to assess changes of peripheral blood T cell subpopulations and NK cells. Enzyme linked immunosorbent assays were performed to determine levels of IL-2, IL-10, TNF-α and perforin. Immune turbidimetry was employed to determine the changes in serum immunoglobulin. Results: Both CD3+ and NK cells showed a decrease at T1 and T2 in each group, among which, in group A, CD3+ decreased significantly at T2 (P<0.05) compared with other groups, and CD3+ and NK cell reduced obviously only in group A at T3 and T4 (P<0.05). CD4+ cells and the ratio of D4+/CD8+ were decreased in groups A, C and A+H at T1 and T2 (P<0.05). No significant intra- and inter-group differences were observed in CD8+ of the four groups (P<0.05). IL-2 declined in group C at T1 and T2 (P<0.05) and showed a decrease in group A at each time point (P<0.05). Moreover, IL-2 decreased in group A + H only at T1. No significant difference was found in each group at T1 (P<0.05). More significant decrease in group ?? at T2, T3 and T4 compared with group A (P<0.05), and there were no significant differences among other groups (P>0.05). IL-10 increased at T1 and T2 in each group (P<0.05), in which it had an obvious increase in group A, and increase of IL-10 occurred only in group A at T3 and T4 (P<0.05). TNF-α level rose at T1 (P<0.05), no inter- and intra-group difference was found in perforin in all groups (P<0.05). Compared with the preoperation, both IgG and IgA level decreased at T1 in each group (P<0.05), and they declined only in Group A at T2 and T3 (P<0.05), and these parameters were back to the preoperative levels in other groups. No significant differences were observed between preoperative and postoperative IgG and IgA levels in each group at T4 (P>0.05). No obvious inter- and intra-group changes were found in IgM in the four groups (P>0.05). Conclusions: Allogeneic transfusion during the perioperative period could obviously decrease the number of T cell subpopulations and NK cells and the secretion of stimulating cytokines and increase the secretion of inhibiting cytokines in patients with malignant tumors, thus causing a Th1/Th2 imbalance and transient decreasing in the content of plasma immune globulin. Autologous transfusion has little impact and may even bring about some improvement oo postoperative immune function in patients with tumors. Therefore, cancer patients should receive active autologous transfusion during the perioperative period in place of allogeneic transfusion.


Wang J.-X.,The Second Peoples Hospital Of Anhui Province | Li C.,The Second Peoples Hospital Of Anhui Province | Wang A.-P.,The Second Peoples Hospital Of Anhui Province | Cheng L.-S.,The Second Peoples Hospital Of Anhui Province | And 6 more authors.
World Chinese Journal of Digestology | Year: 2015

AIM:To compare the rate of Helicobacter pylori (H. pylori) eradication between sequential therapy vs conventional levofloxacin containing quadruple therapy for patients with first failure of H. pylori eradication. METHODS:From September 2010 to May 2014, 167 patients with first failure of H. pylori eradication were enrolled and randomly divided into two groups. Patients in the sequential treatment group received 10-day sequential therapy: rabeprazole (10 mg, twice a day) plus amoxicillin (1000 mg, twice a day) for the first five days, followed by rabeprazole (10 mg, twice a day), clarithromycin (500 mg, twice a day) and ornidazole (500 mg, twice a day) for another five days. Patients in the quadruple therapy group were administrated rabeprazole (10 mg, twice a day), amoxicillin (1000 mg, twice a day), bismuth potassium citrate (300 mg, twice a day) and levofloxacin (200 mg, twice a day) for 12 d. Clinical effects and adverse effects were compared for the two groups. RESULTS:Four weeks after the end of treatment, 14C-urea breath test (14C-UBT) was performed again to assess H. pylori eradication status. The eradication rates in the sequential treatment group were 77.92% by per-protocol (PP) analysis and 70.6% by intention-to-treat (ITT) analysis, and the corresponding percentages in the quadruple therapy group were 84.72% and 74.4%, respectively. There was no significant difference in the eradication rates between the two groups (PP analysis: 60/77 vs 61/72, χ2 = 1.127, P = 0.288. ITT analysis: 60/85 vs 61/82, χ2 = 0.302, P = 0.582). There was also no significant difference in the rate of adverse effects between the two groups [11.7% (9/77) vs 14.7% (11/75), χ2 = 0.295, P = 0.587]. CONCLUSION:Sequent ial therapy and conventional levofloxacin containing quadruple therapy have comparable clinical effects, and neither of them are recommended as the preferred remedial option for patients with first failure of H. pylori eradication. © 2015 Baishideng Publishing Group Inc. All rights reserved.

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