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    20 February 2016, Volume 16 Issue 01
    Diagnosis and therapeutic strategies for hepatocellular carcinoma in precision medicine era
    HU Zhigang, WANG Jie
    2016, 16(01):  1-6.  DOI: 10.3969/j.issn.1009-976X.2016.01.001.
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    【Abstract】〓The updates of omic and clinical data together with the advances of testing technologies provide information and technical supports to the implementation of precision medicine. Heterogeneous diseases can be well classified into different subgroups,.which enable the precise application of diagnosis and therapeutic strategies,.and therefore the improvement of outcomes with decreased unnecessary side effects..The concept of precision medicine develops rapidly in oncology, and therefore impacts the diagnosis and therapeutic strategies for hepatocellular carcinoma (HCC), a kind of highly heterogeneous malignancy..This paper summarizes the updates and current problems about the diagnosis and therapeutic strategies for HCC, including the population prevention, high-risk population screening, early diagnosis, staging, therapeutic options, and the evaluation of therapeutic effects and prognosis, providing a new method for HCC precision medicine.

    Advance in adjuvant chemotherapy in breast cancer in 2015
    LI Qingjian,.DING Lin,.YAO Herui
    2016, 16(01):  7-10.  DOI: 10.3969/j.issn.1009-976X.2016.01.002
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    【Abstract】〓Breast cancer is the NO.1 fatal disease of Chinese females..Although the adjuvant chemotherapy in breast cancer develops rapidly,.some questions remain unknown..Such as what kinds of patients are suitable for adjuvant chemotherapy,.the optimal time for starting adjuvant chemotherapy, the status and the optimal usage of anthracycline and taxane,.the effect of enhancement of maintenance treatment and the biomarkers for predicting the prognosis..This essay demonstrates the latest progress of adjuvant chemotherapy in breast cancer by combining the common clinical questions and the meetings about breast cancer in 2015.
    An experimental study of Toll-like receptors regulation of mesenchymal stem cell in ankylosing spondylitis
    LI Yuxi, WANG Peng, XIE Zhongyu, LI Jinteng, SHEN Huiyong
    2016, 16(01):  11-15.  DOI: 10.3969/j.issn.1009-976X.2016.01.003
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    【Abstract】〓Objective〓To detect the expression of Toll-like receptors (TLRs) on mesenchymal stem cells (MSCs) from ankylosing spondylitis(AS) patients and investigate their effect on immunoregulatory function of AS-MSCs. Methods〓First, flow cytometry was used to determine whether the specific immunophenotype were expressed on the cells cultured from the bone marrow of AS patients. Then, the expression of all TLRs on AS-MSCs was detected by the RT-PCR and the TLR3 and TLR4 were further measured by the qRT-PCR. Finally, after the TLR3 and TLR4 were activated by their specific ligands, ELISA was used to detect the secretion of IL-6. Results〓The AS-MSC expressed CD29, CD44 and CD105, but not CD34, CD45 or HLA-DR. The results from RT-PCR showed that AS-MSC expressed TLR1,TLR2, TLR3, TLR4, TLR5, TLR6 and TLR8 and seldom expressed TLR7, TLR9 or TLR10. In addition, the expression of TLR3 and TLR4 in AS-MSC were respectively reduced to 47.5% and 34.8%, compared to the healthy donors. Ligation of TLR3 and TLR4 can improve the IL-6 secretion of MSCs to 8.3 folds and 13.8 folds respectively in AS patients. Conclusion〓The expression and function of TLR3 and TLR4 were abnormal in MSCs from AS patients,and they may play a key role in the immunoregulatory dysfunction of AS-MSCs.

    nHAP induced p53+Rb local nano-gene therapy and its effect on angiogenesis of hepatic metastasis in rabbit VX2 model, and the possible molecular mechanism
    DONG Shengli, PAN Jingsheng, YE Lu, ZHAO Xinbao, LI Lujing, XU Xiaolin, OU Bing, LI Gaopeng
    2016, 16(01):  16-20.  DOI: 10.3969/j.issn.1009-976X.2016.01.004
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    【Abstract】〓Objective〓This work aims to investigate its effect on angiogenesis of hepatic colorectal metastasis,and to elucidate its molecular mechanism. Methods〓Recombinant expressing plasmids harboring wild type p53 and Rb were cotransferred or transferred separately to the mice hepatic VX2 tumor by the emulsion of Pll-nHAP nanoplex and lipodiol through the hepatic artery in a tumor target manner. Subsequent co-expressions of p53 and Rb protein within the treated tumors were investigated by western blotting and in situ analysis of confocal Laser scanning microscope. The therapeutic effect on angiogenesis was evaluated by the investigation of the microvessel density of tumor tissue. Eventually, the real-time RT-PCR and ECL western bolt were applied to investigate the expressive changes of important genes related to the above. Results〓(p53+Rb) LNT showed significantly better anti-angiogenesis effect and lower expression of related CD31, CD34, VEGF genes than the control group, although no significant difference was observed compared to p53 or Rb LNT for some genes. Conclusion〓Rb work synergistically with p53 in combined therapy mediated by Pll-nHAP nanoplex to augment the antitumoral effect through the down-regulated expression of important genes related to angiogenesis. Our study revealed that LNT with p53 and Rb is a potentially effective antitumor therapy for HCC.
    Value of occult pancreaticobiliary reflux on early diagnosis for patients with gallbladder cancer
    JU Banglv, CHEN Yongbing, ZHANG Weiyi, YU Conghui, YU Changzhong, NIE Hongfeng
    2016, 16(01):  21-23.  DOI: 10.3969/j.issn.1009-976X.2016.01.005
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    【Abstract】〓Objective〓To study the value of occult pancreaticobiliary reflux in the early diagnosis of patients with gallbladder cancer. Methods〓The date of 86 patients of normal pancreaticobiliary junction evidenced by operative cholangiography with gallbladder cancer in our hospital from June 2007 to April 2011 were retrospectively analyzed. The information of imageology and the bile amylase level of cystic was detected,and were compared with the intraoperative exploration findings and postoperative pathological diagnosis. The bile amylase levels of 56 consecutive patients with cholecystolithiasis and 22 hilus holangiocarcinoma were detected. Results〓The mean (SD) biliary amylase level of 86 patients of gallbladder cancer was 752.6 (341.8) U/L, and cholecystolithiasis was 76.7(68.3) U/L. 61(70.1%) of gallbladder cancer the biliary amylase level above that of normal serum. Conclusion〓The incidence of occult pancreatobiliary reflux were higher with gallbladder carcinoma,and pancreaticobiliary reflux that might play an important role in the pathogenesis of gallbladder cancer.
    Security and efficacy of laparoscopic hepatectomy for the treatment of hepatocellular carcinoma
    WU Haifeng
    2016, 16(01):  24-26.  DOI: 10.3969/j.issn.1009-976X.2016.01.006
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    【Abstract】〓Objective〓To investigate the efficacy and safety of laparoscopic hepatectomy for the treatment of hepatocellular carcinoma. Methods The clinical data of 76 HCC patients who were admitted to Affiliated Jieyang Hospital of Sun Yat-sen University from January 2010 to December 2012 were retrospectively analyzed. The patients were assigned to laparoscopic liver resection group (LH, n=27) and open hepatectomy group (OH, n=49). The clinical data were compared between two groups. Results〓The LH group had the obvious advantages in less hospital stays, less hospital costs, less blood loss and more rapid recovery in liver function, but the operative time was longer than open hepatectomy,Moreover,there is no significant difference in the complications, the recurrence rate,mortality rate and survival rate between the two groups. Conclusion〓The laparoscopic hepatectomy is safe and effective for patients with HCC by appropriate cases.
    The meta-analysis of the long-term follow-up after the two approaches for the revascularization in the treatment of the coronary disease in china
    MA Jing, Guo Jianhua, YE Wei, ZHANG Tao, ZHOU Ying, WU Jingjia, ZHANG Yueyu, FEI Qingqing, GU Qingyun
    2016, 16(01):  27-35.  DOI: 10.3969/j.issn.1009-976X.2016.01.007
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    【Abstract】〓Objective〓By retrieving the articles published in Chinese, the Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Grafting (CABG) were selected and compared between them, in whom all cases wene flowed up for more tham 24 months..The benefits and the risks of the cardiac revascularization via two different approaches were evaluated..The conclusion could be used as an evidence-based medicine base in the treatment of coronary heart disease..Methods〓The inclusion criteria, the exclusion criteria and the search strategy were made. The articles in the database of VIP Chinese Scientific & Technical Full Text Retrieval Database,.Wanfang Medical Database, CNKI and CBM were retrieved..The cohort study papers on the comparison of the cardiac revascularization via two different approaches were exacted. The quality of the papers was evaluated, and then the valid data was processed to the Meta analysis by RevMan 5.2 software..Results〓A total 33 papers were included in to the study literature with a total of 11,375 reported cases..In which,.the PCI group accounted for 6,125 cases,.while the CABG group accounted for 5,250 cases..The Meta-analysis reveals:.on the subject of the perioperative mortality,.the PCI group was significantly lower than the CABG group (1.22%, 4.12%), the OR value and the 95% CI was 0.29 (0.19-0.46), P<0.001. However the all-cause mortality during the whole follow-up period, there was no significant difference between the two groups (3.92%, 4.57%), the OR value and the 95% CI, 0.91 (0.7-1.10), P=0.33. On the revascularization rate, the PCI group was significantly higher than the CABG group (9.99%, 3.77%), the OR value and the 95% CI was 3.57 (2.62-4.87), P<0.001. On the incident of MACCE, the PCI group was significantly higher than the CABG group (17.94%, 12.35%), the OR value and the 95% CI is 1.62 (1.33-1.98), P<0.001. Conclusion〓The comparison of two methods of myocardial revascularization indicates that the PCI has the advantage in the aspects of the shorter perioperative period and the lower incidence of adverse events; however, the advantages of CABG is a better long-term prognosis and a lower incident of re-vascularization. During the decision making of the treatment of the coronary artery disease, the doctors should pay more attention to the disadvantages of each method, to choose the treatment plan with the long-term perspective.
    The clinical value of recurrent laryngeal nerve monitoring during thyroid re-operation
    WU Jiayu, LI Honghao, LONG Miaoyun, LUO Dingyuan, HUANG Kai, PENG Xinzhi, HUANG Mingqing, LIN Shaojian, ZHU Yue, TAN Langping, CHEN Zhibo
    2016, 16(01):  36-39.  DOI: 10.3969/j.issn.1009-976X.2016.01.008
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    【Abstract】〓Objective〓To explore the clinical value of recurrent laryngeal nerve monitoring during thyroid re-operation. Methods〓NIM-Response 3.0 monitoring system was applied in 65 patients in the real-time monitoring group, and conventional exposure of RLN was implemented in 50 patients in the routine operative group. The temporary and permanent paralysis rates of RLN, time for RLN exposure, time for operation were compared between two groups. Results〓The temporary and permanent RLN injury rates in the real-time monitoring group was lower than the conventional exposure group(1.53% vs 8.0%,P<0.01; 0 vs 4.0%,<0.01). Moreover, the median time for RLN exposure and time for operation in patients of the real-time monitoring group were shorter than that of the routine operative group(5.56±1.95 mins vs 15.92±2.69 mins,P<0.01, t=-23.94;113.90±9.40 mins vs 132.40±21.40 mins,P<0.01, t=-6.23). Conclusion〓Intraoperative recurrent laryngeal nerve monitoring can reduce the temporary and permanent RLN injury rate and decreased the time for RLN exposure and operation for patients undergoing thyroid re-operation.
    The selection and timing of surgery for left-sided hepatolithiasis
    ZHANG Xiaoguan, SONG Hailiang, LI Chunqing, GUO Qiang, LI Yajun
    2016, 16(01):  40-43.  DOI: 10.3969/j.issn.1009-976X.2016.01.009
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    【Abstract】〓Objective〓To investigate the selection of the timing and methods of surgery for intrahepatic bile duct stones. Methods〓Between January 1995 and December 2014, 78 patients with left-sided hepatolithiasis were analyzed retrospectively in our hospital. This study focused on the choice of surgical methods and sugical opportunity, the complications, and long-term outcomes. Results〓Among the surgical modality, the hepatectomy was used for left-sided hepatolithiasis more generally this decade, compared with 10 years ago (87.0% vs 21.9%, P=0.009), in particular the regular left hepatectomy (54.3% vs 0.0%,(P<0.001)..The postoperative stone residual rate of hepatectomy group was significantly less than non-hepatectomy operations (67.7% vs 12.8%, P=0.013). Furthermore, the stone residual rate of regular left hepatectomy was remarkably lower than left lateral segmentectomy(22.2% vs 4.0%,P=0.026). In addition, emergency hepatectomy induced significantly more operative time,more volume of blood loss, more length of postoperative hospital stay, higher frequency of procedure-related complications, and higher postoperative stone residual rate(17.4% vs 8.3%,P=0.043),compared with selective hepatectomy. Conclusion〓As the safe and effective technique in our primary hospital, the outcome of hepatectomy for left-sided hepatolithiasis is markedly superior to non-hepatectomy operations.Moreover,regular left hepatectomy is better than left lateral segmentectomy. It is notable that emergency hepatectomy is very dangerous and has poor outcomes. So emergency hepatectomy should be avoided as far as possible.
    Expression and clinical significance of MMP-2, PTEN and VEGF-C in colorectal cancer tissues
    LI Hong, DAI Yajuan, HUANG Shaojie
    2016, 16(01):  44-47.  DOI: 10.3969/j.issn.1009-976X.2016.01.010
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    【Abstract】〓Objective〓To investigate the expression of matrix metalloproteinase (MMP-2), phosphatase gene (PTEN) and vascular epidermal growth factor C (VEGF-C) in colorectal cancer tissues. Methods〓S-P immunohistochemical method was used to detect the expression of MMP-2, PTEN, MMP-2 and VEGF-C in 50 cases of colorectal carcinoma, and the expression of, PTEN and VEGF-C were detected by immunohistochemical staining. Results〓Expression of VEGF-C and MMP-2 in colorectal carcinoma were significantly higher than that in normal colorectal mucosa tissues(P<0.05). PTEN expression was significantly lower than that in normal colorectal mucosa (P<0.05). PTEN and MMP-2 showed higher expression in lower differentiation degree, later stage of TNM, lymph node metastasis while PTEN showed a lower level of expression. Conclusion〓In the present study,the expression of PTEN and VEGF-C, MMP-2 and MMP-2 showed the regular changes in differentiation degree, TNM stage, lymph node metastasis in colorectal carcinoma tissues, and were probably associated with the development and metastasis of colorectal cancer.
    The application of fast track surgery in elderly gastric cancer operation by laparoscopy
    HUANG Zhengtian, XIE Zhaoxiong, CHEN Jiajia
    2016, 16(01):  48-51.  DOI: 10.3969/j.issn.1009-976X.2016.01.011
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    【Abstract】〓Objective〓To study the value of fast track surgery (FTS) in elderly gastric cancer operation by laparoscopy. Methods〓A total of 24 cases of senile gastric cancer were selected as observation group from January 2013 to February 2015. Another 24 cases were selected as control group which were cured before 2013. All patients underwent radical surgery of gastric cancer and got recovery. The observation group accepted FTS therapy while the contrast group accepted traditional therapy. All patients underwent radical surgery of gastric cancer and sot recovery. The operation condition, postoperative recovery and complications of both groups were compared betwen two groups. Results〓The observation group had less duration of anesthesia, infusion quantity, fasting time, lying in bed tim anal exsufflation time, anus defecate time, hospitalization and cost than control group. There was significance difference between them, P<0.05. But there was no significance difference of operation time, blood loss, lymph nodes and total complication between them, P>0.05. Conclusion〓FTS is fit for perioperative management of senile gastric cancer and worth to clinical expansion.
    Clinical analysis of laparoscopic radical rectectomy for low rectal cancer by sphincter preservation
    LU Xiaoyu, WEI Wenbo, LIAO Kangxiong, JIANG Shusong, XIE Rongming
    2016, 16(01):  51-54.  DOI: 10.3969/j.issn.1009-976X.2016.01.012
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    【Abstract】〓Objective〓To investigate the clinical effect of the laparoscopic surgery for low rectal cancer. Methods〓The clinical data of 186 cases with low rectal cancer who underwent radical rectectomy with sphincter preservation were analyzed retrospectively. Of 186 cases, 115 cases were treated with laparoscopic surgery (laparoscopic group), and 71 cases with traditional open surgery (open group). Results〓Operative time in open group was longer than that of the laparoscopic group. The blood loss, postoperative hospitalization stay, postoperative anal automatic exhaust time, liquid diet time and solid diet time were all shorter in the laparoscopic group than that in open group. There was no statistical difference in the occurred rate of postoperative gastrointestinal dysfunction within 30 days (diarrhea, constipation, intestinal obstruction, etc.). Conclusion〓Contrast with the traditional open surgery, the laparoscopic group takes more advantages in reducing the amount of bleeding, quickening postoperative recovery of gastrointestinal function, simultaneously. It is easier to meet the requirements of fast track surgery and to implement it.
    Investigate the relationship of helicobacter pylori with colorectal carcinoma
    TIAN Lin, LIN Yukun, TANG Xingkui
    2016, 16(01):  55-57.  DOI: 10.3969/j.issn.1009-976X.2016.01.013
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    【Abstract】 Objective To investigate the relationship of Helicobacter pylori (HP) with colorectal carcinoma. Methods〓212 cases of colorectal carcinoma specimens and 100 cases of normal colorectal mucosa specimens were studied, with routine HE staining and immunohistochemical staining for the detecting HP. Results〓Eight in 100 cases of normal colorectal mucosa tissues were detected HP, of which inoculation amount was small to moderate. Ninety-two in 212 cases of colorectal carcinoma cases were detected HP, in which small amount of HP were detected in 44 cases, moderate amount of HP in 37 cases, massive amount of HP in 11 cases. HP were independent to gender, the degree of tumor differentiation, TNM stage and related to the locations of the tumor. Conclusion〓HP may be the causative factor of colorectal carcinoma.
    Application of an adjustable arc-shaped thyroid retractor
    WU Kunyuan, SUN Guoshen, ZHANG Yi, WAN Hao, LUI Meifang
    2016, 16(01):  57-59.  DOI: 10.3969/j.issn.1009-976X.2016.01.014
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    【Abstract】〓Objective〓To introduce a new thyroid retractor and its usage. Methods〓A total of 63 cases were performed open thyroidectomy by using self-developed automatic thyroid retractor. The clinical efficacy of this new thyroid retractor was observed and summarized. Results〓All surgical operations aided by this self-developed thyroid retractor were successfully completed. The average blood loss was 13 g, and the average operation time was 88 minutes. Conclusion〓This self-developed thyroid retractor showed a good practical effect on performance of thyroidectomy due to providing a stable and sufficient operating field.
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    The clinical dianogsis and surgical treatment of hashimoto's thyroiditis complicated with thyroid nodes
    YANG Chuansheng, HUANG Zhan, Wang Meijiao, LUO, Zhihui, LEI Ruiwen, CHEN Zhuoron
    2016, 16(01):  60-62.  DOI: 10.3969/j.issn.1009-976X.2016.01.015
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    【Abstract】〓Objective〓To investigate the clinical dianogsis, operative indication, and surgical treatment of Hashimoto's disease complicated with thyroid nodes. Methods〓Clinical data of 415 patients with Hashimoto's disease complicated with thyroid nodes were retrospectively analyzed. Results The postoperative pathological results were as follow:157 cases of simple hashimoto's thyroiditis,18 cases of simple hashimoto's thyroiditis with hyperthyroidism,146 cases of simple hashimoto's thyroiditis with nodular goiter,31 cases of simple hashimoto's thyroiditis with nodenoma, and 63 cases of simple hashimoto's thyroiditis with thyroid carcinoma. Conclusion〓Hashimoto's disease complicated with thyroid cancer has no typical symptoms and often complicated with other thyroid diseases. Combined examination of anti-thyroid antibodies test, color doppler imaging, CT detection, isotope scan and core /fine needle biopsy may provide accurate diagnosis. Operations should be actively performed on these cases which are likely maligmant or easily to induce compressive symptoms. Proper surgical treatment is effective for Hashimoto's disease complicated with nodes according to the individual conditong. Normal thyroid tissue should be retained as much as possible.

    The biomechanics research of direct approach of PMMA bone cement with the addition of pedicle screws
    CHEN Chao, GUAN Honggang, OU Xingzhi, WANG Gang, XUAN Tianhang
    2016, 16(01):  63-66.  DOI: 10.3969/j.issn.1009-976X.2016.01.016
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    【Abstract】〓Objective〓To analyze the effect of direct injection approach of PMMA (polymethyl methacrylate) on strengthening the stability of the screw. Methods〓A total of 24 fresh cadaver vertebrae were used for research and were randomized into treatment group and control group for study of biomechanics by load-displacement, torque, and twisting stiffness tests. The treatment group were used direct approach of PMMA bone cement with the addition of pedicle screws fixation on one side of the pedicles, while the control group were only used conventional pedicle screws fixation on the other side of the pedicles. Then two groups'biomechanical test results of maximum axial pull output experiment, maximum spin the torque test and periodical anti-bending test were compared. Results Through vertebral specimens underwent injection of PMMA in treatment group, the stability of the screws was significantly better than that in control group by the only conventional pedicle screws(all P values were less than 0.05). Conclusion〓The vertebrae strengthened by PMMA and pedicle screws fixed showed more advantage to enhancing the holding force of the pedicle screws, preventing the pedicle screws from loosing and falling off.
    The clinical feature and surgical treatment of cervical spondylosis in young adults
    HUANG Lingzhi, CHEN Yeguang, HUANG Kai, XIE Weiwen, ZENG Zhanquan
    2016, 16(01):  67-71.  DOI: 10.3969/j.issn.1009-976X.2016.01.017
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    【Abstract】〓Objective〓To investigate the clinical feature of cervical spondylosis in young adults and analyze the effect of surgical treatment. Methods〓From Jan 2009 to Jan 2015, there were 26 young patients were confirmed as cervical spondylosis and underwent surgical treatment, including 14 male and 12 female cases of 28 to 40 years old (average 36.7 years), and 10 staff and 7 workers, 1 surgeon, and 8 cases without regular employment. Of 26 cases, 21 cases of cervical myelopathy, 3 cases of nerve root cervical spondylosis, 2 cases of myelopathy mixed sympathetic. The time from onset to the operation time was 3 to 36 months, averaging 10 months. The possible causes of clinical symptoms, course of treatment were analyzed and evaluated through JOA and VAS score. Results〓The operation was performed in 19 cases through anterior surgery, 2 cases through posterior surgery and 5 cases through the combined surgery. All symptoms were significantly alleviated. A total of 21 cases of cervical spondylotic myelopathy were followed up for 3 to 47 months, averaging 19 months, and JOA score ranged from of 15 to 17, improving rate was from 65% to 100%. Three cases of nerve root cervical spondylosis were followed up 6 months, 13 months and 15 months, respectively, and VAS score decreased to 0. Two cases of myelopathy mixed sympathetic patients were followed up for 7 months and 25 months, the JOA score was 17 points. No fixation loosening, fracture, bone graft fusion failure and spinal cord damage caused by internal fixation were found during follow-up. Conclusion〓Surgical treatment can achieve a satisfactory effect on young adults cervical spondylosis, but long-term effects still need to continue to closely follow-up.
    The application experience of negative pressure drainage in management of calcaneal fracture
    XU Guohua, HUANG Xinyu, FENG Jiawei, XU Honghao, HE Weidong, YANG Mingming
    2016, 16(01):  72-75.  DOI: 10.3969/j.issn.1009-976X.2016.01.018
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    【Abstract】 Objective To analyze the curative effect on using the closed negative pressure drainage in the treatment of calcaneal fractures and summarize up the experience. Methods〓The clinical and follow-up data of 62 patients (62 feet) with calcaneal fracture from May 2009 to June 2015 were retrospectively analyzed. Of 62 cases, 32 cases (32 feet) were received closed negative pressure drainage (VSD group) and another 30 cases (30 feet) were treated with the film drainage (film drainage group). The clinical outcome and postoperative skin necrosis, wound infection, postoperative swelling degree, postoperative pain were compared between two groups. Results Two patients of VSD group had skin necrosis on Incision edge, and 9 cases in film drainage group (P<0.05). Wound surface infection occurred in one patient in VSD group and 7 cases in film drainage group(P<0.05). The foot swelling degree of film drainage group was more serious than that of VSD group in the first three days after surgery. The postoperative pain degree of VSD group was significantly alleviative than of film drainage group (P<0.05). Conclusion〓The negative pressure drainage technology has obvious advantages of reducing postoperative complications of the calcaneal fractures,decreasing the postoperative skin swelling and relieving the postoperative pain.
    Clinical observation of acute lower limb cellulitis treated with wet dressing of the herbal yellow-water combined with benzylpenicillin sodium injection
    CHEN Jia, HUO Jingshan, WU Minhan, HAN Xinfeng
    2016, 16(01):  76-79.  DOI: 10.3969/j.issn.1009-976X.2016.01.019
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    【Abstract】〓Objective〓To investigate the effect of the herbal yellow-water (traditional Chinese medicine) combined with benzylpenicillin sodium injection on acute lower limb cellulitis. Methods Totally 80 cases of acute lower limb cellulitis patients were randomized into a treatment group and a control group,with 40 cases in each group.Both groups were treated with 6.4 million U of benzylpenicillin sodium for intravenous drip,Q8h. At the same time, the patients in treatment group were given herbal yellow-water wet dressing, and the patients in control group were treated with 50% magnesium sulfate for wet dressing. Leucocyte count, the symptom relief time, the healing time, the local pain score and the clinical efficacy in two groups were collected and analyzed. Results The clinical efficiency in treatment group and control group were 95% (38/40) and 90% (36/40), the difference was statistically significant (P<0.05). Symptom relief time, healing time in treatment group were shorter than that in control group (P<0.05). Local pain scores on the 3rd, 7th day in treatment group were significantly lower than those in control group..No significant difference was found between the two groups in leucocyte count. Conclusion In our study,the traditional Chinese medicine,herbal yellow-water combined with Benzylpenicillin Sodium Injection showed good clinical efficacy in the treatment of acute lower limb cellulitis.
    A case of primary cranio-orbital lymphoma and literature review
    ZHONG Xiaopo, LI Xuesong, LIU Jianbo, ZENG Yeyu,ZOU Wei, ZHONG Yu, ZHU Gang
    2016, 16(01):  80-83.  DOI: 10.3969/j.issn.1009-976X.2016.01.020
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    【Abstract】〓Primary central nervous system lymphoma is a clinically rare non-Hodgkin lymphoma with lymph node external invasion, which only has an involvement of brain, spinal cord and their accessory structures. Because this disease is characterized by low specificity in clinical imaging performance, difficult diagnosis and high misdiagnosis rate, the author reported a case of primary cranial-orbital lymphoma. The clinical presentation, diagnostic procedure, treatment, and outcome of this case were presented with a review of the related literature, aiming at providing references and recommendations for the clinical treatment of similar diseases.
    Treatment for adult male urethral stricture complicated with calculus of lower urinary tract by using both renal sheath dilators and holmium laser under ureteroscope
    MAO Zhouzhou, DING Junping, ZHAO Shubin, PENG Jinjian, ZHU Jiantan, LONG Dianxi, CHU Mingyan
    2016, 16(01):  84-86.  DOI: 10.3969/j.issn.1009-976X.2016.01.021
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    【Abstract】〓Objective〓To explore the efficacy and security of urethral dilatation therapy for adult male urethral stricture complicated with calculus of lower urinary with renal sheath dilators and holmium laser under ureteroscope. Methods〓Eight cases with urethrostenosis complicated with calculus of lower urinary tract underwent dilatation and lithotripsy of urethra with renal sheath dilator and holmium laser. Under ureteroscope, the zebra guide wire was placed directly through stenosis into bladder,and with its guide,the urethral stenosis was dilated with F8-F18 renal sheath dilators gradually and with holmium laser urethrotomy, then holmium laser lithotripsy. Results〓The operation succeeded in all eight cases, and no severe complication such as urethral false passage occured. All cases were followed up from 3 to 12 months and no urethrostenosis recurred and stone recurrence. The maximum flow rates increased from 3.5~9.0 ml/s to 14-22 ml/s. Conclusion〓Dilatation of the urethrostenosis and lithotripsy with renal sheath dilators and holmium laser under ureteroscope is an efficient and safe method in the treatment of adult male urethrostenosis.
    Increased expression of tribbles pseudokinase 1 (TRIB1) mRNA and protein predicts malignant progression and adverse clinical outcomes in patients with prostate cancer
    WAN Yueping, XI Ming, WAN Song, HUA Wei, ZENG ZhaoChang, LIU Yuanling, LIN Zhuoyuan, WU Yongding, YANG Shengbang, HAN Zhaodong
    2016, 16(01):  87-91.  DOI: 10.3969/j.issn.1009-976X.2016.01.022
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    【Abstract】〓Objective〓To study the expression and significances of TRIB1 in benign prostate hyperplasia(BPH) tissues and prostate cancer tissues, and to illustrate the correlation with clinical significance and outcomes. Methods〓The dataset of whole genomic expression profiles got from the prostate tissues were obtained from gene expression omnibus (GEO) database. The samples were derived from benign prostatic tissues and prostatic carcinoma tissues of the patients with BPH or prostatic cancer..Immunohistochemistry analyses were conducted to detect the expression of TRIB1 protein in both prostate cancer and BPH tissues,.and further statistically analyzed the correlations with clinic pathological characteristics and outcomes of the patients with prostate cancer. Results〓The expression of TRIB1 protein was significantly increased in prostate cancer tissues compared with BPH tissues (P<0.01)..The expression rate of TRIB1 protein was in relation with Gleason score (P<0.01) and clinical stage (P=0.02). The upregulation of CENPF mRNA expression in the PCa tissues significantly correlated with a higher Gleason score.(P=0.02),.an advanced pathological stage.(P=0.01).and poor biochemical recurrence.(BCR)-free survival.(P=0.047). Conclusion〓Our study showed the increased expression of both TRIB1 protein and mRNA levels plays an important role in the progression of PCa. More importantly, the increased expression of TRIB1 may efficiently predict poor BCR-free survival in patients with PCa.
    Comparison of the efficacy between transurethral resection of prostate and 1470 nm diode laser in the treatment of benign prostatic hyperplasia
    CHEN Ning, CAO Fenghong, ZHANG Ligguo, GAO Haiyang
    2016, 16(01):  92-95.  DOI: 10.3969/j.issn.1009-976X.2016.01.023
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    【Abstract】〓Objective〓To compare the clinical efficacy of transurethral resection of prostate and 1470 nm diode laser for treatment of benign prostatic hyperplasia. Methods〓100 cases of benign prostatic hyperplasia were assigned to 1470 nm semiconductor laser vaporization group (treatment group, n=50) and transurethral resection of the prostate (TURP) group (control group, n=50). The preoperative clinical parameters of the two groups were comparable not statistically significant. Then operation condition, follow-up and complication rate were compared between two groups. The clinical effect of two group was recorded and analyzed. Results The operation time, intraoperative blood loss, postoperative indwelling catheter time and postoperative hospital were statistically significant between two groups(P<0.05). After 3 months follow-up, there were statistically significant differences in IPSS, Qmax, RUVs between two groups (P<0.05). The complications in the treatment group and the control group were 6% and 26%, respectively(P<0.05). Conclusion Both surgical approaches of 1470 nm diode laser and TURP showed good effect for treating BPH, but the 1470 nm diode laser vaporization demonstrated better efficacy with less blood loss, shorter catheter indwelling time, lower complication rate.
    Analysis of the result of laparoscopic resection of colorectal cancer with synchronous liver metastasis
    ZHANG Rixiong, ZHANG Chong, WU Zuguang LIU Hongtao, LI En, CHEN Kai, ZHANG Zhuoxin, ZENG Haijing
    2016, 16(01):  95-98.  DOI: 10.3969/j.issn.1009-976X.2016.01.024
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    【Abstract】〓Objective〓To explore the clinical effect and feasibility of laparoscopic resection of colorectal cancer with synchronous liver metastasis. Methods〓From November 2010 to June 2015, 34 patients who were performed laparoscopic hepatectomy and primary colorectal resection were assigned to the therapeutic group and another 34 patients who underwent open resection of liver metastases from colorectal cancer were defined as the control group.The intraoperative blood loss,operation time, exhaust time, length of stay and postoperative complications were analyzed in two groups. Results〓The patients in therapeutic group underwent less blood loss,shorter operation time and hospital stay,when compared with those in control group (P<0.05). No significant differences were found in postoperative complications between the two groups(P>0.05). Conclusion〓Laparoscopic radical resection of colorectal cancer with synchronous liver metastasis showed more effective clinical results than open operation.
    Clinical study of nickel-titaulmn shape memory alloy embracing fixator in flail chest patients with multiple injuries
    SERIGELENG Hulun Buir, YANG Chunhua
    2016, 16(01):  99-101.  DOI: 10.3969/j.issn.1009-976X.2016.01.025
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    【Abstract】〓Objective〓To explore the clinical effect of nickel-titanium shape memory alloy embracing fixator for the treatment of flail chest with multiple injuries. Methods〓Twenty-nine flail chest patients with multiple injuries were treated by using nickel-titanium shape memory alloy embracing fixator. The clinical effect was retrospectively analyzed. Results〓Among 29 cases, 28 patients were cured and one patient died. The chest pain and respiratory function were significantly improved. The average hospitalization duration was 19 days. All the patients were followed up for 3 to 12 months, and no severe complications were found. Conclusion〓Nickel-titanium shape memory alloy embracing fixator is a simple and effective method for the treatment of flail chest, and is helpful early functional exercise after surgery.
    Laparoscopic radical resection of rectal carcinoma retain prostate nerve be conductive to sexual function after surgery
    HE Chaoxiong, ZHAO Haisheng, HUANG Minghua, YE Junhua
    2016, 16(01):  102-104.  DOI: 10.3969/j.issn.1009-976X.2016.01.026
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    【Abstract】〓Objectives〓To investigate the effects of laparoscopic rectal carcinoma surgery with pelvic autonomic nerve preservation on the sexual functions of male patients. Methods〓Eighty patients with colorectal cancer were collected and received laparoscopic colorectal cancer resection, tried to keep the prostate nerves. The observation group kept this nerve while the control group not. The postoperative functional recovery of sexual arousal and ejaculation were compared. Results〓The postoperative sexual arousal and ejaculatory dysfunction of observation group were significant differences with the control group(P<0.05). Conclusion〓Laparoscopic rectal carcinoma surgery with pelvic autonomic nerve preservation can effectively alleviate the suffering of patients while improve the life quality of patients, worth of promoting in the primary hospital.
    Effect of midazolam in combination with propofol on agitation and hemodynamic changes in elderly patients during general anesthesia
    YANG Bomei
    2016, 16(01):  105-108.  DOI: R614.2
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    【Abstract】〓Objective〓To investigate the effect of midazolam combined with propofol on controlling emergence agitation and influencing hemodynamic changes in the awaking stage of general anesthesia. Methods〓From January 2014 to February 2015, 80 patients (more than 65 years old) undergoing abdominal and orthopaedic surgery were included in the study, and were assigned observation groups (n=40) and control group (n=40). The patients of control group were treated midazolam combined fentanyl to induce and maintain general anesthesia, and those of observation group received midazolam in combination with propofol. The emergence agitation and hemodynamics in general anesthesia patients were observed and compared in two groups, including before anesthesia induction (T0), 1 min after induction (T1), (T2) before the endotracheal intubation, endotracheal intubation (T2) immediately 1 min (T3), endotracheal intubation, endotracheal intubation, 5 min (T4), endotracheal intubation, 10 min (T5), endotracheal intubation, 20 min (T6). Results〓The levels of MAP and HR in T1, T2, T3, T4, T5, T6 in observation group were lower than that in control group (P<0.05). Case number of stir class I and stir class Ⅲ during the awakening period in observation group was less than that in control group (5.0% vs 22.5%, 2.5% vs 17.5%, respectively, P<0.05). Conclusion The present study showed that midazolam in combination with propofol was more advantageous to maintain hemodynamic stability of the aged patients with general anesthesia, reduce the incidence of general awakening period agitation.
    The application of single port video-assistant thoracoscopic surgery for lung cancer
    CHEN Guohai
    2016, 16(01):  108-110.  DOI: 10.3969/j.issn.1009-976X.2016.01.028
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    【Abstract】〓Objective〓To report the experience of single port video-assistant thoracoscopic surgery for non-small cell lung cancer. Methods〓Eighty patients with early stage non-small cell lung cancer were selected and received surgical treatment in our hospital from Jan 2013 to Dec 2015. Among them, 40 patients underwent single-port video-assistant thoracoscopic surgery and 40 patients underwent traditional thoracotomy. The amount of bleeding during operation,time of pulling out the drainage tube, total drainage volume,number of lymph node dissection, postoperative hospital stay and postoperative complications were compared between the two groups. Results〓All the surgical procedures were successfully completed,no death occurred. Compared with thoracotomy group, the number of lymph node dissection and the time of surgery were not significantly different in the single port video-assistant thoracoscopic surgery group. And the amount of bleeding during operation, time of pulling out the drainage tube, total drainage volume and postoperative hospital stay were significantly different between the two groups. Conclusion〓Single port video-assistant thoracoscopic surgery showed less damage and faster recovery when compared with thoracotomy. This technique is safety and worth clinical promotion.
    Development of necroptosis in malignant tumor
    YU Yongsheng, LI Jin, HUANG Hai, LAI Yiming, CHEN Xianju, GUO Zhenghui
    2016, 16(01):  111-114.  DOI: 10.3969/j.issn.1009-976X.2016.01.029
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    【Abstract】 According to traditional theory, cell death is clarified into apoptosis and necrosis. However, a range of researches reveal that necroptosis contribute to a plenty of human disease, especially tumorigenesis, progression and chemoresistance. Necroptosis is the programed necrosis which is independent of caspase activation. This review summarizes the research progress on mechanism of necroptosis, the role of necroptosis in cancer and and its value in drug targets, in order to achieve an improvement of necroptosis in cancer research.

    The development of medical adhesive for vascular anastomosis and repair
    HOU Biao, XIE Songlin
    2016, 16(01):  115-118.  DOI: 10.3969/j.issn.1009-976X.2016.01.030
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    【Abstract】 Vascular anastomosis is the cornerstone of vascular, microsurgery, cardiovascular and transplant surgery. The quality of anastomosis determines the success of the whole surgery. The main aim of performing a vascular anastomosis is to achieve maximal patency rates. An important factor to achieve that goal is to minimize damage to the vessel walls. In recent years, many new methods of vascular anastomosis and materials are being reported, and the utilize of medical adhesives in vascular anastomosis and vascular repair has certain advantages.Because of no permeability damage of vessel wall,small effect of anastomosis haemodynamics,endothelialization are more easily to complete. Compared to other methods of vascular anastomosis,using medical adhesives in vascular anastomosis and vascular repair can shorten the operation time,reduce perioperative bleeding,has better histocompatibility.According to its source,bonding mechanism,clinical application and research progress, the present article make a brief review.
    Associating liver partition and portal vein ligation for staged hepatectomy: a review
    SHI Yufeng, CHEN Nianping
    2016, 16(01):  119-121.  DOI: 10.3969/j.issn.1009-976X.2016.01.031
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    【Abstract】〓Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a new surgical approach proposed in recent years. The most critical step is the rapid growth of future liver remnant, which is primarily used for the treatment of parents with advanced liver cancer or liver tumor, in whom remaining liver volume is not enough to accept a wide range liver resection. But there are some controversies about ALPPS, and the long-term effect of the surgical approach is unclear. This article reviews the research progress of ALPPS.