Sanyuan Hu

Pancreatic cancer stem cells: New insight into a stubborn disease

Resistance to conventional therapy and early distant metastasis contribute to the unsatisfactory prognosis of patients with pancreatic cancer. The concept of cancer stem cells (CSCs) brings new insights into cancer biology and therapy. Many studies have confirmed the important role of these stem cells in carcinogenesis and the development of hematopoietic and solid cancers. Recent studies have shown that CSCs regulate aggressive behavior, recurrence, and drug resistance in pancreatic cancer. Here, we review recent advances in pancreatic cancer stem cells (PCSCs) research. Particular attention is paid to the regulation mechanisms of pancreatic cancer stem cell functions, such as stemness-related signaling pathways, microRNAs, the epithelial-mesenchymal transition (EMT), and the tumor microenvironment, and the development of novel PCSCs targeted therapy. We seek to further understand PCSCs and explore potential therapeutic targets for pancreatic cancer.

The research of nanoparticles as gene vector for tumor gene therapy

With the development of molecular biology, the application of the gene therapy becomes a tendency in the development of oncotherapy. The gene therapy has been acknowledged as the major progress of modern medicine, also a focus in the oncotherapy research. Commonly vectors of the gene therapy mainly include two categories, namely, viral vectors and nonviral vectors. Nanoparticles gene vector of various different kinds of materials, which belong to non-viral carriers. It presents excellent abilities of adsorption, concentration and protection of DNA, which can be attributed as a main reason of the adsorption and operation of nano-gene vector on exogenous genes. In this article, we mainly reviewed the recent studies of the characteristics of nanoparticles, characteristics and transport mechanism of nanoparticles as gene vector, the progress on nanoparticles as gene vector in tumor gene therapy. Nano-gene vectors, as new drug and gene carriers, present characteristics such as the controlled-release, targeting, and the improvement of bioavailability. Nanoparticles for cancer imaging and therapy have evolved rapidly during the last decade and it is expected that more and more will become clinical practise. In the near future, as a new nanometer gene delivery vector will be in medical research and treatment play a bigger role.

Laparoscopic versus open proctocolectomy with ileal pouch‐anal anastomosis

In recent years laparoscopic proctocolectomy with ileal pouch‐anal anastomosis has been used as an alternative to conventional open techniques. Since many published series on proctectomy and ileal pouch‐anal anastomosis are based on open experience, in this paper we compare our laparoscopic experience on 21 patients with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) to 25 patients who had undergone open proctocolectomy with ileal pouch‐anal anastomosis. The median operative time in the laparoscopic group was significantly longer than that in the open group (325u2005min vs. 220u2005min). However, blood loss was less (115u2005ml vs.240u2005ml), bowel function returned earlier (2 days vs.4 days), and hospitalization time was shorter (9 days vs.11 days) in the laparoscopic group (all p<0.05). Early postoperative complications were encountered in five patients of the laparoscopic group and in seven patients of the open group. The median follow‐up time was 15 months (range 6–34) in both groups. Late postoperative complications were encountered in three patients of the laparoscopic group and in three patients of the open group. In conclusion, laparoscopic proctocolectomy with ileal pouch‐anal anastomosis is technically feasible. The technique described in this study provides the advantages of less blood loss, shorter hospitalization, quicker return of bowel function and more favorable cosmetic results when compared to the open technique.

Increased CD4+CD69+CD25‐ T cells in patients with hepatocellular carcinoma are associated with tumor progression

Background and Aim:u2002 A new subset of Treg cells, CD4+CD69+CD25‐ T cells, has been identified in mice. Herein, we aimed to identify this subset of T cells and to evaluate its function in patients with hepatocellular carcinoma (HCC).

Influence of CXCR4/SDF-1 axis on E-cadherin/β-catenin complex expression in HT29 colon cancer cells.

AIMnTo study the influence of CXCR4/stromal cell-derived factor-1 (SDF-1) axis on E-cadherin/β-catenin complex expression in HT29 colon cancer cells and its underlying mechanisms.nnnMETHODSnEffect of SDF-1 on E-cadherin/β-catenin expression was detected by immunocytochemistry. E-cadherin and β-catenin mRNA expression levels were measured by reverse transcriptase-polymerase chain reaction. SDF-1-induced phosphorylation of phosphatidylinositol 3-kinase (PI3K)/AKT and β-catenin was detected by Western blotting.nnnRESULTSnThe E-cadherin and β-catenin mRNA expression levels in HT29 cells were lower 48 h after incubated with SDF-1 at the concentrations of 20 and 40 ng/mL (P<0.05). SDF-1-induced significant phosphorylation of PI3K/AKT and β-catenin. AMD3100 and LY294002 inhibited the phosphorylation of PI3K/AKT and β-catenin.nnnCONCLUSIONnSDF-1 down-regulates the E-cadherin/β-catenin complex expression in HT29 cells by decreasing mRNA synthesis and increasing β-catenin phosphorylation.

Nanoliposome-mediated FL/TRAIL double-gene therapy for colon cancer: In vitro and in vivo evaluation

OBJECTIVEnTo investigate the therapeutic effects of cationic nanoliposome-mediated gene therapy combined with immunotherapy for colon cancer treatment.nnnMETHODSnRecombinant plasmids containing green and red fluorescent protein reporter genes were constructed using gene cloning methods. Gene-carrying cationic nanoliposomes were prepared based on the electrostatic adherence principle and then transfected into dendritic cells (DC), which were transplanted into colon cancer cells.nnnRESULTSnRecombinant plasmids containing green or red fluorescent protein reporter genes were successfully constructed by gene cloning and confirmed by restriction enzyme digestion and sequencing. Gene-carrying cationic nanoliposomes were transfected into colon cancer cells, and good gene expression was detected. A better level of apoptosis was observed in the combined group of tyrosine kinase receptor 3 ligand (FL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), while the lowest level was detected in the control group. The parameters in the FL and TRAIL groups were between the above-mentioned combined group.nnnCONCLUSIONnCationic nanoliposomes have the advantage of being gene carriers. The joint therapeutic effects of the two genes are superior to those of a single gene. Gene therapy combined with immunotherapy has significant implications for cancer treatment.

Transumblical single port laparoscopic cholecystectomy with a simple technique: Initial experience of 33 cases

Abstract Transumbilical single port laparoscopic cholecystectomy is a novel laparoscopic surgical technique for cholecystectomy utilizing only a transumbilical incision, which eliminates any visible abdominal scars and improves cosmesis. As the true single port laparoscopic technique, we presented an easy and feasible method for transumbilical laparoscopic cholecystectomy. A total of 33 patients were presented for transumbilical single port laparoscopic cholecystectomy. A 1.5 cm incision was made at the umbilicus. We used one sterile glove and designed a simple method for this procedure. All the operations were completed successfully. The operative time of the first case was 189 min, the average time of the following two cases was 90 min, and the mean of the latest ten cases was 50 min. Operative blood loss was <30 ml for all patients. No drainage tube was placed and no postoperative complications such as bleeding or biliary leakage occurred after three to six months of follow-up. All the patients were discharged 24h after the operation. There were no visible scars on the abdominal wall at the second weekend. Transumbilical single port laparoscopic cholecystectomy by our designed methods was technically simple, feasible and safe. Furthermore, development of newer instruments, accumulation of experience and enhancement of operative technique may facilitate this new operative approach.

Coexpression of recombinant adenovirus carrying GDNF and EDNRB genes in neural stem cells in vitro

Gene therapy and nerve stem cells isolated from the developing human enteric nervous system (ENS) are significant. They may open the route for the cell therapy of Hirschsprungs disease (HD). We have constructed the recombinant adenovirus‐carrying glial cell line‐derived neurotrophic factor (GDNF) and endothelin receptor B (EDNRB) gene, and investigated the exosomatic coexpression in neural stem cells. The recombinant adenovirus Ad‐GE coexpressing GDNF and EDNRB gene was constructed by the AdEasy system and confirmed by the reverse transcription polymerase chain reaction (RT‐PCR) method. Expression of exogenous genes in neural stem cells after transfection was confirmed by the flow cytometry and real‐time fluorescence quantitative PCR. Fragments of pAd Track‐CMV‐GE were consistent with GDNF and EDNRB. The green fluorescence of the positive cells was followed by fluorescence microscopy at 24u2009h after NSCs had been transfected, reaching a peak at 72u2009h after transfection. Flow cytometry showed that the efficiency of transfection was 15.0, 23.6, and 25.4% at 24, 48 and 72u2009h respectively. Real‐time fluorescence quantitative PCR showed the expression levels of mRNA of GDNF and EDNRB in 48 and 72u2009h groups were obviously higher than that in 24 and 96u2009h groups. Recombinant adenovirus carrying GDNF and EDNRB genes are coexpressed in neural stem cells, which may offer the possibility of a novel approach to local combination gene therapy for Hirschsprungs disease.

Endoscopic thyroidectomy: the development in a Chinese center.

BACKGROUNDnEndoscopic thyroidectomy (ET) precludes the long cervical incision of the open procedure. Although endoscopy is an essential tool taught to almost every surgeon, its effective use with regard to thyroidectomy requires understanding its limitations pertaining to trauma and cancer, as well as an understanding of the advantages and disadvantages of the different endoscopic approaches. The development of an ET center in China is discussed here.nnnMETHODSnOverall, 235 patients who had undergone attempted ET in Qilu Hospital of Shandong University in China from August 2001 to September 2010 were evaluated.nnnRESULTSnOf the 11 men and 224 women on whom the procedure had been attempted, all but seven successfully underwent ET, 145 (63.6%) via a modified anterior chest approach, and 83 (36.4%) via a breast approach. Age ranged from 17 to 52 years, with a mean of 34.5 years. Surgery was limited, in the case of masses, to lesions smaller than 6u2009cm ultrasonographically. All patients were followed for at least 3 months. The 24 and 48 hours Visual Analog Scale postoperative measurements were low. Complications included four cases of cutaneous emphysema, five seromas, four episodes of anterior chest discomfort, three transient laryngeal nerve palsies, and four episodes of hypocalcemia. The seven procedures that had been converted to an open procedure comprised two patients discovered at frozen section to have poorly differentiated thyroid carcinoma, two with tumors larger than 5u2009cm, and three with thyroiditis.nnnCONCLUSIONSnET is readily learned, provided the surgeon is competent at both laparoscopic technique and open thyroidectomy. Procedural advantages of an endoscopic approach include superior cosmesis and decreased invasiveness.

Endoscopic thyroidectomy by a modified anterior chest approach: A single institution`s 5-year experience

Endoscopic thyroidectomy embodies the features of both minimally invasive surgery and aesthetic surgery. However, none of the established approaches is minimally invasive and meanwhile maximally cosmetic. Here we applied a modified anterior chest approach to achieve excellent cosmesis with reduced physical invasion. Fifty-six patients with benign thyroid diseases accepted this procedure. A 10mm longitudinal incision was made about one-fourth of the distance from the xiphoid to the sternal notch. Bilateral transversal incisions (5mm and 10mm) were performed about one-third of the distance from the nipple to the sternoclavicular joint. The subfascial space was maintained with CO2 insufflation. Endoscopic lobectomy or subtotal thyroidectomy was performed according to the diseases. Fifty-four of the 56 procedures were successfully performed endoscopically, including 41 unilateral lobectomies and 13 subtotal thyroidectomies. The mean operative time for uni- and bilateral procedures was 117.2 min and 184.5 min, respectively. Conversion occurred in two cases due to bleeding and malignant frozen section analysis, respectively. Postoperative complications included one temporary recurrent nerve palsy, one transient hypocalcemia, and one subcutaneous emphysema. 96.2%(50/52) of the patients were extremely satisfied or satisfied with the cosmetic effect. This procedure is more likely to be accepted by patients older than 30 years. Endoscopic thyroidectomy by the modified anterior chest approach is an effective procedure with both excellent aesthetic benefits and reduced physical injury.