ObjectiveTo overview the various molecular biological index to judge the prognosis of intrahepatic cholangiocarcinoma (ICC), in order to promote ICC patients follow-up treatment, improve survival rate, and quality of life of the patients. Methods"ICC" and "prognostic factor" were searched as key words by PubMed and CNKI series full-text database retrieval systems from 2000 to 2015. Totally 48 English papers and 15 Chinese papers were obtained. Choice criteria:the molecular biological index that affect the prognosis of ICC patients, and can effectively guide treatment. According to the choice criteria, 45 papers were finally analyzed. ResultsThe indicators of Homer1, mucin 1 (MUC1)\mucin 4 (MUC4), lactate dehydrogenase A (LDH-A), Beclin1, Smad4, protein tyrosine kinase-7 (PTK7), IMP3, cytokeratin 7 (CK7)/cytokeratin 20 (CK20), and sphingosine kinase 1 (SPHK1) could be used as prognostic factors in the survival of patients with ICC, and to determine tumor size and stage, vascular invasion, nerve injury, and lymph node metastasis, are of great clinical significance. ConclusionThese indicators have a significant meanning in the prognosis of ICC and the adjustment of the follow-up treatment.
ObjectiveTo summarize our experience and clinical effect of surgical treatment of Stanford type A aortic dissection (TAAD) involving an aberrant right subclavian artery (ARSA). MethodsFrom March 2009 to January 2016, 14 patients with TAAD involving an ARSA (acute TAAD, n=10; chronic TAAD, n=4) underwent operation under hypothermic cardiopulmonary bypass combined with selective antegrade cerebral perfusion in our center. There were 11 male and 3 female patients with a mean age of 46.07±8.45 years. A total of 13 patients (13/14, 92.86%) underwent stented elephant trunk procedure combined with total arch replacement (Sun's procedure). The remaining patient (1/14, 7.14%) underwent partial aortic arch replacement combined with Bentall procedure without ARSA revascularization. ResultsThe average operation time, cardiopulmonary bypass time, aortic cross-clamping time and selective cerebral perfusion time was 7.89±1.80 h, 208.43±28.84 min, 117.64±23.30 min, and 30.50±10.15 min, respectively. No operation-related deaths occurred. However, two (14.29%) patients died on postoperative 5 d, 7 d, respectively in hospital. One patient required repeat thoracotomy for bleeding, one suffered temporary renal dysfunction and one renal failure (this patient had renal failure before surgery). The mean follow-up was 28.42±22.52 months with a follow-up rate of 100.00% (12/12). One patient died of heart failure and renal failure at 64 months after operation. The others were free from any aortic complications during follow-up. ConclusionsTAAD involving an ARSA should be clearly diagnosed before surgery, and treated by the optimal arterial cannulation and cerebral perfusion during operation. Repair of aortic dissection with Sun's procedure and revascularization of the ARSA can obtain satisfactory clinical outcomes in patients with TAAD involving an ARSA.