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Table of Content

    20 April 2016, Volume 16 Issue 02
    论文
    The significance of Ki67 and PgR in distinguishing ER-positive and HER-2-negative Luminal breast cancers
    HU Yue, JIA Weijuan, TAN Cui, GU Ran, YANG Yaping, LIU Fengtao, SU Fengxi
    2016, 16(02):  123-126.  DOI: 10.3969/j.issn.1009-976X.2016.02.001
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    【Abstract】〓Objective〓The objective of this study was to analyze the prognostic significance of Ki67 and PgR in distinguishing Luminal breast cancers. Methods〓Patients with ER-positive and HER-2-negative invasive breast cancer who were treated from 2006 to 2012, were selected by searching breast cancer registries at Sun Yat-sen Memorial Hospital..Clinicopathologic characteristics and prognoses were collected. The primary end point was DFS (disease free survival) which was analyzed by Kaplan-Meier curve with log rank test or Breslow test. Cox proportional hazards model was used to balance the risk factors for prognosis. Results〓A total of 964 patients with invasive breast cancer were eligible for inclusion in this study. Ki67 was found to be of prognostic significance in univariate analysis and multivariate analysis, but PgR was not an independent risk factor. Patients with low-Ki67-level and low-PgR level had different prognoses with high-Ki67-level and high-PgR-level subtype. Conclusion〓In order to optimize management of ER-positive and HER-2-negative patients, we need to consult other clinicopathologic characteristics or multi-gene assay, especially for low-Ki67-level and low-PgR level subtype.
    Levels of TOPOⅡ and P53 predict the efficacy of neoadjuvant chemotherapy in breast cancer
    LUO Wei, CHEN Yi, LIANG Gehao, GONG Chang
    2016, 16(02):  127-131.  DOI: 10.3969/j.issn.1009-976X.2016.02.002
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    【Abstract】 Objective〓To investigate whether the expression of TOPOⅡ and P53 expression in breast cancer could predict the efficacy of neoadjuvant chemotherapy. Methods〓This research retrospectively analyzed 185 patients, who were diagnosed as invasive ductal carcinomas in stage Ⅱ-Ⅲ, admitted in the Breast Cancer Center in our hospital and accepted NAC from October 2011 to August 2015. Immunohistochemical assay was used to detect the TOPOⅡ and P53 protein levels of 185 breast cancer tissues obtained by core needle biopsy before neoadjuvant chemotherapy. The relationship of TOPOⅡ and P53 expression with clinicopathological characteristics as well as prognosis of neoadjuvant chemotherapy was statistically analyzed. Results〓The objective response rate (ORR) of patients with positive TOPOⅡ expression was significantly higher than that of patients with negative TOPOⅡ expression. The clinical complete response (cCR ) proportion of patients with positive P53 expression was larger than that of patients with negative P53 expression. The patients with both positive TOPOⅡ and P53 expression not only achieved a higher rate of ORR but had a larger proportion of cCR than the case in patients not with both positive TOPOⅡ and P53 expression. Conclusion〓The protein levels of TOPOⅡ and P53 showed predictive value of the efficacy of neoadjuvant chemotherapy based on anthracyclines.
    The role of mean arterial pressure and pulse pressure in parly assessment on vascular crisis after wrist replantation
    LI Peng, TAN Zhuo, WEN Li’e, OU Zhiping, ZENG Zhichao, LIU Haitang, XIE Peijun,
    2016, 16(02):  131-134.  DOI: 10.3969/j.issn.1009-976X.2016.02.003
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    【Abstract】....Objective...To discuss the role of the mean arterial pressure (MAP) and pulse pressure (PP) in early assessment on vascular crisis after wrist replantation. Methods〓A retrospective clinical data were analyzed in 8 cases from August 2014 to November 2015, who suffered from vessel crisis after wrist replantation (observation group), and 10 cases with stable vital signs in ICU as control group. Both groups received continuous brachial arterial pressure. MAP and PP were recorded at 2 h, 1 h, and 0.5 h before vessel crisis happened. All cases with vascular crisis were confirmed by digital subtraction angiography (DSA). Results〓All 8 cases with vessel crisis were handled in time and performed extremities survived after surgery. The values of MAP and PP (mmHg) recorded at 2 h,1 h,0.5 h were 70.13±4.86 and 46.88±4.84,62.00±4.48 and 51.88±4.27,66.25±1.51 and 66.13±1.16, respectively. The values of MAP and PP (mmHg) in control group were 72.5±3.3,46.4±2.8. However, only the value of PP at 0.5 h showed the significant statistical significance. Conclusion〓PP may be as an early predictor of vascular crisis after wrist replantation. However, the samples in this study was limited, as well as the measuring method of MAP and the design, which should be improved.
    Management of spontaneous rupture of hepatocellular carcinoma
    ZHONG Feng, CAI Liquan, ZHANG Jinhui, TAI Qinwen, CHEN Haiming
    2016, 16(02):  135-139.  DOI: 10.3969/j.issn.1009-976X.2016.02.004
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    【Abstract】 Objective〓To explore the management of patients with spontaneous rupture of hepatocellular carcinoma. Methods〓105 patients with spontaneously ruptured hepatocellular carcinoma between Jan. 1992 and Dec. 2013 in the Jiangmen People’s Hospital were enrolled in this retrospective review of clinical data. The first stage was from 1992 to 2002 (47 patients) and the second stage was from 2003 to 2013.(58 patients)..The patients underwent conservative treatment or emergency hepatectomy in first stage. And in second stage, conservative treatment, emergency hepatectomy and transcatheter arterial embolization was used..30-day survival rate,.1 year survival rate and the cumulative survival rate were contrasted in two stages. Results〓In first stage,.22 of 47 patients underwent conservative treatment,.and another 25 cases were performed emergency hepatectomy. Twenty-two patients died in 30 days in the first stage. In second stage of 58 patients, 12 underwent conservative treatment,.and emergency hepatectomy in 29 cases.(10 of whom received staged hepatectomy),.transcatheter arterial embolization in 17 patients..Sixteen patients died in 30 days at second stage. In two stage, the cumulative survival rate was higher in patients underwent hepatectomy than that in other treatments.(P<0.05)..The cumulative survival rate in the second stage was higher than that in the first stage.(P=0.036)..There were no difference in the cumulative survival rate of patients who received hepatectomy between two stage.(P=0.234)..Conclusion〓In present data, conservative treatment for patients with spontaneous rupture of hepatocellular carcinoma showed a poor prognosis..Transcatheter arterial embolization displayed an effective emergency hemostatic measure. Emergency hepatectomy or staged hepatectomy prolonged survival time of right patients.
    Comparisons of clinical efficacy in short-term and long-term time between laparoscopic total gastrectomy combined with D2 lymph node dissection and open total gastrectomy combined with D2 lymph node dissection for patients with advanced gastric carcinoma
    LI Zhengyu, HUANG Jun, HUANG Junming
    2016, 16(02):  140-144.  DOI: 10.3969/j.issn.1009-976X.2016.02.005
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    【Abstract】〓Objective〓To compare the clinical efficacy in short-term and long-term time of laparoscopic total gastrectomy vs..open total gastrectomy combined with D2 lymph node dissection respectively in the treatment of patients with advanced gastric carcinoma. Methods〓Clinical data of 228 patients with advanced gastric carcinoma in our hospital treated by radical total gastrectomy combined with D2 lymph node dissection were retrospectively analyzed, in which observation group underwent laparoscopic total gastrectomy combined with D2 lymph node dissection and control group underwent open total gastrectomy combined with D2 lymph node dissection. Comparisons of clinical efficacy in short-term and long-term time between two groups were conducted. Results〓The operative time in observation group was significantly longer than that in control group (P<0.05), and the intraoperative blood loss was less than that in control group (P<0.05). No statistical significance in the number of lymph nodes between groups was found. The first exhaust time, recovery time of gastrointestinal function and hospitalization time in observation group were shorter than those in control group, and the differences were statistically significant (all P values were less than 0.05). There was no statistical significance on difference of tumor proximal margin and hospitalization cost between two groups. The postoperative complication rate in observation group was lower than that in control group (7.89% vs. 18.42%, P<0.05). The average follow-up time was 2.86±1.81 years. The survival rate for 1 years, 3 years, 5 years without tumor between two groups was no statistical significance. The median survival time in observation group was 3.035 (95%CI: 2.683-3.386) years, and 2.856 (95%CI: 2.669-3.044) years in control group and there was no statistically significant (P>0.05). Conclusion〓Compared with open total gastrectomy combined with D2 lymph node dissection, laparoscopic total gastrectomy combined with D2 lymph node dissection for patients with advanced gastric carcinoma has characteristics of good short-term clinical efficacy, high safety, and high long-term survival rate.
    Clinical study of laparoscopic treatment of common bile duct stones with rigid bile duct in the left hepatic section
    LUO Xiaofeng, WANG Zhenlong, HE Tao, DENG Guorong, CAI Qi, YU Yong, CHEN Boyi,
    2016, 16(02):  145-148.  DOI: 10.3969/j.issn.1009-976X.2016.02.006
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    【Abstract】〓Objective〓To investigate the clinical effects of treatment of common bile duct and left hepatic duct stones by way of laparoscopic hepatectomy and choledochotomy through the left hepatic section by rigid choledochoscopy,.and to explore the feasibility and safety. Methods〓Fifty-nine cases of common bile duct stones combined with left hepatic duct stones from Nov. 2011 to Nov. 2014 were assigned to observation group (32 cases) and control group (27 cases). The patients in observation group underwent laparoscopic left lateral external lobectomy and common bile duct exploration with rigid choledochoscope via bile duct of liver section, and those in control group received laparoscopic left lateral external lobectomy and common bile duct exploration with T tube placement. The operation time, blood loss, postoperative bleeding, postoperative anal exhaust time, postoperative hospital stay,.postoperative complications were compared between two groups..WBC score,.Child-Pugh score,.R15 ICG were also investigated. Results〓There were not statistical differences between two groups of patients in blood loss,.removal the stones,.postoperative anal exhaust time,.postoperative pain,.postoperative complications,.the WBC,.liver function Child-Pugh score, R15 ICG after the first, five days. But the average operating time, postoperative hospitalization time of observation group were less than that of control group (P<0.05). Conclusion〓The surgical procedure, common bile duct exploration via bile duct from liver cross section after left lateral lobectomy, showed a feasible and safe way for treatment of common bile duct stones and hepatic duct stone.
    Effect of different volumes of methyleneblue on detection of sentinel lymph node in one-stage breast cancer patients
    WANG Hong, CHEN Weirong, LIN Tao, LI Liudan
    2016, 16(02):  149-152.  DOI: 10.3969/j.issn.1009-976X.2016.02.007
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    【Abstract】 Objective〓To investigate the clinical application of methylene blue staining with different volume in the sentinel lymph node biopsy of one-stage breast cancer. Methods〓From January 2010 to June 2015, 76 patients with one-stage breast cancer were divided into low dose group (0.2 ml), medium dose group (2 ml) and high dose group (4 ml). 1% methylene blue was injected as tracer, and sentinel lymph node biopsy was done. Results〓Among 76 cases, 75 cases were detected sentinel lymph node biopsy. The detection rate was 98.7%, the accuracy rate was 100% and false negative rate was 0. There were significant differences in the incidence of complications in the low dose group and the other two groups. Conclusion〓As a tracer, low dose of 1% methyleneblu showed higher accuracy and less complications in detecting sentinel lymph nodes in one-stage breast cancer patients.
    Therapeutic value of water-soluble contrast medium in the treatment of adhesive small bowel obstruction
    WANG Liang, LIU Meibao, ZENG Deqiang, HE Shengquan, ZHANG Tao
    2016, 16(02):  153-156.  DOI: 10.3969/j.issn.1009-976X.2016.02.008
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    【Abstract】〓Objective〓To assess the therapeutic value of perfusion of water-soluble contrast medium (Gastrografin ) in the management of adhesive small bowel obstruction. Methods〓Patients with clinical evidence of adhesive small bowel obstruction were performed conservative treatment unless there was suspicion of perforation,.strangulation and peritonitis which needed emergency operation. Fifty-seven cases were divided into the treatment group and the control group. The controls received normal conventional treatment, mainly including fasting, gastrointestinal decompression, enema, intravenous fluid infusion. And those in treatment group were treated with 60-100 ml Gastrografin perfusion either orally or via nasogastric tube, in addition to normal conventional treatment. The effect of non-surgical treatment, relief time of obstruction, length of hospitalization, and complications of two groups were compared between. Results〓For the patients in the treatment group, the effect of non-surgical treatment was significantly better than that in the control group (83.3% VS 55.6%). The results of treatment group in time of bowel tunes recovery (9.56±3.47 h), anal exhaust time (11.24±3.15 h) and the length of hospitalization (5.0±1.83 d) were superior to that of control group (9.56±3.47 h, 22.6±4.14, 8.20±2.15 d, respectively). The daily amount of gastrointestinal decompression in treatment group was 179.20±68.79 ml and control group 323.33±91.31 ml. There was no severe complications in both groups. Conclusion〓In our study, Gastrografin showed effective, safe outcomes for the management of adhesive small bowel obstruction.
    Low-pressure versus standard-pressure pneumoperitoneum for laparoscopic appendectomy in older patients
    CAI Canfeng, CHEN Qingqun, ZENG Jun, XIN Haiyang, CHEN Guoxing, CHEN Xiang,
    2016, 16(02):  157-159.  DOI: 10.3969/j.issn.1009-976X.2016.02.009
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    【Abstract】〓Objective〓To investigate the clinical effect of low pressure pneumoperitoneum laparoscopic technology in the treatment of acute appendicitis in the elderly. Methods〓104 elderly patients with acute appendicitis were assigned to low pressure pneumoperitoneum laparoscopic technology(low pressure group) and the standard pressure(standard pressure group) pneumoperitoneum laparoscopic technology. The clinical effect was analyzed in two groups. And the operative time, blood loss, complications, postoperative hospital stay, PaCO2 and BNP were considered between two groups. Results〓A total of 52 patients received low pressure gas laparoscopic technology and another 52 patients received the regular pressure gas laparoscopic technology. All patients were successfully received laparoscopic surgery. The operative time was 36.6±10.3 min in low pressure group, and 33.7±11.2 min in standard pressure group (P=0.17). Blood loss in low pressure group group (40.1±5.3 ml) was more than that in standanrd pressure group (38.5±4.3 ml), but without statistics differences (P=0.09). There were also no differences in complications, with two cases in low pressure group group, and 8 cases in standard pressure group (P=0.046). However, there are significant differences in postoperative hospital stay (P<0.01), PaCO2 (P=0.016) and BNP (P=0.01) between two groups. Conclusion〓Low pressure pneumoperitoneum laparoscopic appendectomy in the elderly is feasible and safe, and with rapid recovery and less influences in respiratory and circulation system.

    Application of Endo GIATM Radia Reload intelligent curved cutter stapler on laparoscopic with the anus preserving operationin low rectal cancer
    HOU Xianqiong, LIAO Kangxiong, WEI Wenbo, XIE Rongming, CHEN Qiuwen
    2016, 16(02):  160-163.  DOI: 10.3969/j.issn.1009-976X.2016.02.010
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    【Abstract】 Objective To explore Endo GIATM radial reload intelligent curved cutter stapleron laparoscopic retention anus operation in patients with low rectal cancer. Methods〓Fifty cases of rectal cancer patients were included in the study and underwent laparoscopic total mesorectal resection byusing radial reloads intelligent arc cutter stapler of the rectal stump cutting closure.[CCS 29 mm circular staplar,Johnson & Johnson Medical (China Ltd.)] from March 2014 to June 2015. Operative complication, defecation function and local recurrence were observedand recorded. Results〓All 50 patients finished surgery smoothly. The tumor size was 6.3±1.5 cm. The operation time was 173±18 min, including placed screw 18±4 min.The tumor size 6.3±1.5 cm,and the tumor from the dentate line was 5.5±0.7 cm. The hospitalization expenses was 47 796±2138 yuan. Of 50 cases,13 cases of ultra-low rectal cancer underwent preventive ileum fistulation. All cases had no anastomotic leakage, anastomotic stenosis, anastomotic bleeding, voiding dysfunction,.infection of incisional wound..The patients were followed up for 6-21 months. There were no anastomotic bleeding and anastomotic leakage..There were no local recurrence and distant metastasis during a median follow-up postoperatively..Conclusion...Application of Endo GIATM radial reload intelligent arc cutting stapler for low rectal cancer by laparoscopic sphincter preserving surgery is safe and effective, and placing the radial reloads has certain skills.
    Comparision between regular liver resection and irregular liver resection in liver cancer
    LU Tianyou, LUO Haijun
    2016, 16(02):  164-166.  DOI: 10.3969/j.issn.1009-976X.2016.02.011
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    【Abstract】〓Objective〓To compare the clinical effects of regular liver resection and irregular liver resection in liver cancer. Methods〓The retrospective study was performed in liver cancer patients with the surgical procedure of hepatic resection from June 2006 to June 2014. Of 138 cases, 83 underwent regular liver resection, and 55 were received irregular liver resection. The indicators of perioperative, intraoperative and postoperative between irregular liver resection group and regular liver resection group were compared. Results〓The operation time, intraoperative blood loss, the transfusion amount of plasma and red blood cells, length of hospital stay and the rates of complication in regular liver resection group were significantly higher than the irregular liver resection group, and the difference was statistically significant (all P values were less than 0.05). For the diameter in the removal tumor,the irregular liver resection group was significantly higher than the regular liver resection group (P<0.05). There was no statistical difference between the two groups of patients in the comparison of mortality (P>0.05). Conclusion〓In the present study, compared with the regular liver resection, irregular liver resection reflected the clear advantage in liver cancer patients.
    Comparison of MRI features between intracranial hemangiopericytoma and meningioma in the similar location: a preliminary study
    CHEN Xiaodong, GUAN Xiuhan, LUO Zebin
    2016, 16(02):  167-171.  DOI: 10.3969/j.issn.1009-976X.2016.02.012
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    【Abstract】〓Objective〓To explore the magnetic resonance imaging (MRI) features of intracranial hemangiopericytoma (HPC) and meningioma (M) in the similar location, and to help to improve the differential diagnosis and reduce the misdiagnosis. Methods MRI manifestation was retrospectively analyzed in 4 cases of intracranial hemangiopericytoma and 5 cases of meningioma in the similar location from 2011 to 2015. All cases were confirmed by surgery and pathology. Results〓In the left frontal area, there were one case of hemangiopericytoma and 2 cases of meningioma. In the left occipital area, the bottom of the left cranial fossa and the posterior fossa under the cerebellar tentorium, there were one case of hemangiopericytoma and one case of meningioma, separately. All of nine cases were with lobulated sign (HPC: 4; M: 5), and 8 cases were with necrosis and cystic changes (HPC: 4; M: 4). Vascular flowing void effect existed in 4 cases (HPC: 4; M: 0). Seven were with peritumoral edema (HPC: 3; M: 4). Four cases with bone changes including HPC in two, in which one with skull metastasis and one was adjacent bone destruction, M in two, one with adjacent osteosclerosis, another with adjacent bone destruction. Dural tail sign existed in 5 cases (HPC: 1; M: 4). Comparing with meningioma, HPC often has irregular form with obvious lobulated signal and uneven parenchyma signals which demonstrate as obvious necrosis and cystic changes. In T1-weighted imaging (T1WI), the signal of its substantial were slightly higher than that of meningioma. Vascular flowing void effect and peritumoral edema were relatively common in HPC while dural tail signs were relatively rare..Conclusion...Comparing to the meningioma,.the hemangiopericytoma appeared to have relatively more common signs of lobulated signs,.vascular flowing void effect, obvious necrosis and cystic changes and skull metastasis. This may have a certain significance in the differential diagnosis between intracranial hemangiopericytoma and meningioma in MRI.
    New exploration of arthroscopic debridement combined with sodium hyaluronate for knee osteoarthritis
    ZHENG Baisheng, LI Fengsheng
    2016, 16(02):  172-175.  DOI: 10.3969/j.issn.1009-976X.2016.02.013
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    【Abstract】〓Objective〓To evaluate the clinical efficacy of arthroscopic debridement combined with sodium hyaluronate for knee osteoarthritis (KOA). Methods〓214 cases of KOA patients from March 2013 to March 2015 in our hospital were assigned to control group (106 cases) and treatment group (108 cases). Patients in control group was treated by arthroscopic debridement, and those in treatment group underwent arthroscopic debridement combined with intra-articular injection of sodium hyaluronate. The knee function scores (Lysholm score) at preoperative,3, 6, 12 months postoperation and the clinical excellent and good rates were compared between two groups. Results〓There were no significant differences in Lysholm scores between the two groups before operation (P>0.05). The Lysholm scores in the two groups after operation were significantly higher than that of before operation (P<0.05). The Lysholm scores of the treatment group 3, 6, 12 months after operation were significantly higher than those of the control group (all P values less than 0.05). At 3, 6, 12 months of postoperation, the excellent and good rate of the treatment group was 80.56%, 87.04%, 82.41% respectively, and was significantly higher than that of 67.92%, 72.64%, 68.87% in the control group (all P values less than 0.05). There were no significant differences in the incidence rate of complications (P>0.05). Conclusion〓Arthroscopic debridement combined with sodium hyaluronate for KOA can significantly improve the knee function, it have certain advantages in short-term curative effect, but the clinical efficacy of med-term and long-term needs further study.
    Efficacy and safety assessment of multiple-level osteoporosis vertebral compression fracture treated with one-stage percutaneous vertebral augmentation
    XIAO Weikai, REN Hui, LI Zhaoguang, LIANG De
    2016, 16(02):  176-179.  DOI: 10.3969/j.issn.1009-976X.2016.02.014
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    【Abstract】 Objective To evaluate the therapeutic efficacy,safety and surgical technique and tips of one-stage percutaneous vertebral augmentation of three or more vertebral body for multiple-level osteoporosis vertebral compression fracture. Methods A retrospective study was conducted to review twenty-six osteoporotic vertebral compression fracture patients who received one-stage percutaneous vertebral augmentation of three or more vertebral body. The outcome was considered by preoperatively and postoperatively by the Visual Analogue Scale (VAS) for pain relief. Clinical and image information of pre- and post-operation also be analyzed. Results All surgical procedures were performed successfully. The number of operating vertebrae in one time was 3,4,5 in 17,8,1 patients, respectively. The VAS changed from a mean preoperative score of 8.48±1.36 to a mean score of 3.08±1.24 on postoperative two days,1.96±1.17 three months after operation and 1.65±1.25 at final follow-up. Slight cement leakage was found in seven patients and one case was found the cement was leaked into perivertebral venous plexus, but without any clinical symptoms. Conclusion One-stage percutaneous vertebral augmentation of three or more vertebral body is safe and effective. It can be used in patients who are able to tolerate the surgery followed by professional assessment.
    Comparative analysis of Zero-p anterior cervical intervertebral fusion system versus locking plate combined with cage for cervical spondylosis
    HUANG Hongwei, WU Xiajun, LI Changhu, CHEN Gang, HUANG Jian
    2016, 16(02):  180-183.  DOI: 10.3969/j.issn.1009-976X.2016.02.015
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    【Abstract】〓Objective〓To compare the difference of operation time, blood loss, incidence of dysphagia,.outcome and incidence of internal fixation failure between Zero-p anterior cervical intervertebral fusion system and locking plate combines with cage for cervical spondylosis. Methods Forty-nine patients with single-level cervical spondylosis admitted in our hospital from 2012 to 2014 were included in the study and a retrospective clinical data were analyzed. Of 49 cases, 23 were treated by using Zero-p anterior cervical intervertebral fusion system (A group), 26 cases received surgical procedure with locking plate combined with intervertebral fusion device (B group). The operation time, blood loss, dysphagia, internal fixation failure were compared between two groups. Incidence of dysphagia, the incidence of internal fixation failure were assessed according to Bazaz dysphagia degree and Japan orthopedic association (JOA) score and X-ray. Results〓All patients were operated successfully and followed up. The average follow-up time was 23.5 months (range, 13-39 months). In A group, the mean operative time was 58±23 min and intraoperative blood loss was 53±25 ml. The Incidence of dysphagia was 26.09%, 8.70%, 0, 0 and 0 in 1, 3, 6, 12 month after operation and the last-time follow-up, respectively. JOA score of A group was 9.18±3.06 preoperatively, which rise up to 15.78±3.21 in 12 months after operation and the improvement rate was 57.15%±29.67%, and no internal fixation failure was found. In team B, the mean operative time was 74±28 min and intraoperative blood loss was 57±19 ml. The Incidence of dysphagia was 46.15%, 26.92%, 11.54%, 3.85% and 0 postoperative at 1 week, 3, 6, 12 months and the last time follow-up, respectively. JOA score was 9.03±3.14 preoperatively, which rise up to 15.34±3.09 after 12 months, and the improvement rate was 58.74%±31.53%. Also there wasn’t any internal fixation failure during follow-up. No significant differences between two groups were found in operation time and incidence of dysphagia in 6 months postoperatively. Conclusion〓Both Zero-p anterior cervical intervertebral fusion system and locking plate combined with cage showed a good clinical effect on cervical spondylosis, while Zero-p anterior cervical intervertebral fusion system had shorter operation time and lower incidence of dysphagia.
    Clinical study of surgical treatment of displaced acetabular fractures
    XU Chuanjin, ZHOU Renshi, RUAN Caizheng, XIAO Jufang
    2016, 16(02):  184-187.  DOI: 10.3969/j.issn.1009-976X.2016.02.016
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    【Abstract】〓Objective〓To evaluate and summarize the effect of surgery on displaced acetabular fractures. Methods〓From May 2010 to May 2015, 19 cases of displaced acetabular fractures were treated in our hospital. Case files were retrospectively analyzed. Results〓Through follow-up from an half to two years (average 1.5 years), the clinical effect in 19 cases was evaluated by the improved d’Aubigne and Postel hip score standards and results included excellent in 14 cases, good in 3 cases, fair in 1 cases, poor in 1 cases and a good rete of 89.5%. One patient was performed artificial total hip replacement due to post-operative severe traumatic arthritis and ischemic necrosis of femoral head. One patient developed heterotopic ossification. And one patient was injured sciatic nerve. All three patients were getting well. Conclusion〓Proper surgical treatment for displaced acetabular fractures is appropriate for reconstruction of the congruency and stability of the hip joint and allows the patient to do weight-bearing earlier.
    Effect of micro-percutaneous nephrolithotomy on treatment of upper urinary tract calculi
    HUANG Jiantuan, HUANG Jianmou, LIN Yaobin, OU Yongyue
    2016, 16(02):  188-190.  DOI: 10.3969/j.issn.1009-976X.2016.02.017
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    【Abstract】〓Objective〓To discuss the clinical effect of micro-percutaneous nephrolithotomy (micro-PCNL) in treatment of upper urinary tract calculi. Methods〓Fifty patients admitted from May 2014 to March 2016 in our hospital were selected and underwent micro-PCNL for treatment of upper urinary tract stones (micro-PCNL group). Another 50 patients with upper urinary tract stones who received conventional percutaneous renal stone removal served as controls. The operation success rate, debris removal rate, length of stay, VAS pain score and complications were compared between the two groups. Results〓All operation were completed successfully. The rate of debris removal in micro-PCNL group was 96%, and 80% in the control group (micro-PCNL group vs control group,P<0.05). Compared with the control group, the hospitalization time of micro-PCNL group was significantly shorter (P<0.05), and the VAS pain score was significantly lower (P<0.05). No severe complications occurred in micro-PCNL group, and five cases in control group which were Urinary infection in 3 cases and bloody urine in 2 cases. Conclusion〓In the present study, micro-PCNL showed obvious curative effect, shorter hospital stay and less complications.
    The anesthetic management of Madelung's disease:case report and analysis of literature
    ZENG Jianfeng, CHEN Shibiao, LI Li
    2016, 16(02):  191-194.  DOI: 10.3969/j.issn.1009-976X.2016.02.018
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    【Abstract】 Madelung's disease is a rare disease of abnormal fat metabolism, and recently,its most effective treatment is surgical resection. One of the major clinical manifestations is tracheal compression,so the anesthesia of Madelung's disease has its own particularity because of easy relapse after operation. There are few relative researches about the anesthesia of Madelung's disease in our country at present,and until now a united acknowledgment has not been reached. After reviewed the literature, we describe a case of Madelung's disease about its anesthetic management.

    Effects of Vps4A on Wnt signaling in hepatocellular carcinoma SMMC-7721 cells
    HAN Qingfang, MIN Jun, WEI Jinxing, XIE Jiyan, LV Lihong
    2016, 16(02):  195-198.  DOI: 10.3969/j.issn.1009-976X.2016.02.019
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    【Abstract】〓Objective〓To explore the effects of Vps4A on Wnt signaling in hepatocellular carcinoma SMMC-7721 cells. Methods〓SMMC-7721 stable cell lines expressing Vps4A was generated. Then, the mRNA levels of total 19 Wnt subtypes were tested using RT-qPCR. The results were further confirmed by Western blot and investigating the downstream gene Notch2. Results〓Wnt10a and Wnt10b were highly expressed in SMMC-7721 cells, and Vps4A overexpressing significantly reduced their expression. Additionally, the levels of protein and mRNA of their downstream gene Notch2 were also obviously decreased. Conclusion〓Overexpressing Vps4A inhibits the canonical Wnt/Notch2 signaling in SMMC-7721 cell.
    Construction and identification of the human FoxA1 gene recombinant lentivirus
    JIANG Wenli, DENG Xiaogeng, WU Yaohao, ZENG Lexiang, QIU Ronglin, DENG Jiemin,
    2016, 16(02):  199-203.  DOI: 10.3969/j.issn.1009-976X.2016.02.020
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    【Abstract】〓Objective〓To construct the restructuring lentiviral expression vector FoxA1 gene and lay a foundation for us to explore the functions and mechanisms of FoxA1. Methods〓The primers were designed for the amplification of FoxA1 by polymerase chain reaction(PCR),and cDNA was constructed to the lentiviral expression vector PCDH-CMV-MCS-EF1a-GFP-puro. After PCR,double digests and DNA sequencing, the positive recombinant FoxA1 expression vector, pCMV-VSV-G and pCMV-dR8.91 were cotransfected into HEK-293T cells to produce lentiviral particles, and then the latter was transfected into 293T cells to calculate the virus titer by observing the GFP expression. Finally the mRNA expression of transfected FoxA1 in primary human skin fibroblasts HFFs was identified by real-time quantitative PCR. Results〓PCR, double digests and DNA sequencing assays demonstrated that the inserted sequences was correct. The recombinant lentiviral expression vector FoxA1 was successfully constructed with a concentration of 1×108 TU/mL of viral titer.The level of FoxA1 expression was significantly increased after infection with PCDH-CMV-FoxA1-EF1a-GFP-puro. Conclusion The lentiviral vector over-expressing FoxA1 gene was successfully constructed and highly overexpresses in HFFs. It lays an experiment foundation to explore the functions and mechanisms of FoxA1 for further study.
    Study of inhibitory effect and influence on cell cycle of quercetin and its 7-OH derivative bladder carcinoma cell
    CHEN Songning,WU Xiaoping,CHEN Jinglin,LIU Jianjun
    2016, 16(02):  204-209.  DOI: 10.3969/j.issn.1009-976X.2016.02.021
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    【Abstract】〓Objective〓To investigate the in vitro and in vivo effects of quercetin and its derivative (quercetin-7-sulphate) on human bladder cancer cells by using the BIU-87 cell line and nude mice. Methods〓The BIU-87 cells were exposed to different concentrations of quercetin and sodium quercetin-7-sulphate (SQMS). Cell proliferation and the half maximal inhibitory concentration (IC50) values were determined by MTT assay, and cell cycle was evaluated by flow cytometry. Tumor masses were weighed and tumor inhibition rate were calculated in tumor bearing mice treated with quercetin and SQMS at low, medium and high concentration respectively. Tumor tissue specimen were processed for histological analysis. The expression levels of Ki-67, Cyclin D1 and Cyclin B1 were evaluated by using immunohistochemistry..Results〓Both quercetin and SQMS showed inhibitory effects on proliferation in BIU-87 cells in a dose-dependent manner,.with no statistically significant difference observed between quercetin and SQMS groups of the same concentration.(P>0.05). Quecertin significantly arrested the growth of BIU-87 cells at G2/M phase,.while SQMS mainly arrested them at G0/G1 phase..The in vivo tumor inhibition capacity of quecertin was comparable to that of SQMS administrated at medium concentration(P>0.05)..Quecertin more potently down-regulated the expression of Cyclin B1.(P<0.05).while SQMS more potently down-regulated the expression of CyclinD1 (P<0.01). But there was no significant effect on Ki-67 expression (P>0.05). Conclusion〓Both quercetin and SQMS showed a significant anti-tumor effect not only on the BIU-87 bladder cancer cell line but also on bladder carcinoma in nude mice. Medium concentration SQMS showed similar in vivo inhibitory effect to that of quercetin. Quecertin significantly arrested bladder cancer cells at G2/M phase probably by down-regulating the expression of Cyclin B1,.while SQMS significantly arrested the cancer cells at G0/G1 phase,.at least partly,.by down-regulating the expression of CyclinD1.
    The biological effect of Rock signal pathway in the Rat nucleus pulposus
    ZHU Haipeng, WANG Xiaofei, ZHENG Chaoshun, ZENG Gang, YE Wei,LI Chunhai
    2016, 16(02):  210-214.  DOI: 10.3969/j.issn.1009-976X.2016.02.022
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    【Abstract】〓Objective〓To investigate the biological effect of Rock signal pathway in rat nucleus pulposus cells. Methods〓The expressions of Cox2, MMP3, MMP13 in the rat nucleus pulposus, which was stimulated by TNF-α or Rock specific inhibitor Y-27632, were evaluated by qPCR and western blot..MTS was used to observe the proliferative effect caused by Y-27632 in the rat nucleus pulposus,.and Annexin/PI method was to explore the apoptosis effect of the inhibition of Rock signal pathway among the nucleus pulposus cells. Results〓Rock specific inhibitor Y-27632 can upregulate the expression of MMP13 both in mRNA and protein level (P<0.05). And Y-27632 also showed a pro-apoptotic effect on the nucleus pulposus (P<0.05), while it was found to have little proliferative effect on the nucleus pulposus (P>0.05). Conclusion〓Rock signal pathway may take part in the intervertebral disc degeneration by regulating the expression of MMP13 and the apoptosis of nucleus pulposus.
    Study of genistein on inducing apoptosis in prostate cancer DU-145 cells
    XIAO Congqin, HU Jianbo, ZHOU Yinan
    2016, 16(02):  215-218.  DOI: 10.3969/j.issn.1009-976X.2016.02.023
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    【Abstract】〓Objective〓To investigate the effects of genistein.(Gen).on the apoptosis of human prostate cancer DU-145 cells. Methods〓Human prostate cancer cell line DU-145 cells were treated with Gen with or without pan-caspase inhibitor Z-VAD(Z-VAD-FMK). Cell viability was examined by MTT assay..Apoptosis was determined using Annexin V-FITC/PI staining and flow cytometry..Mitochondrial membrane potential.(△ψm).was analyzed by JC-1 staining and flow cytometry. Caspase-8 activity was measured by colorimetric assay kits. Results〓Gen inhibited viability, induced apoptosis,.decreased △ψm and increased caspase-8 activity.(All P values were less than 0.05) in DU-145 cells. In addition, its effects could be reversed by Z-VAD. Conclusion〓Gen can induce apoptosis in human prostate cancer DU-145 cells by activation of both intrinsic and extrinsic apoptotic pathways.
    Expression of PTEN and Beclin1 in bladder cancer patients
    CHEN Jinglin, HUANG Yanson, ZENG Jincheng, CAI Haipeng
    2016, 16(02):  219-222.  DOI: 10.3969/j.issn.1009-976X.2016.02.024
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    【Abstract】〓Objective〓To investigate the expression of PTEN and Beclin1 in bladder cancer patients and to evaluate its clinical significance. Methods〓Immunohistochemical method was used to determine the expression of PTEN and Beclin1 in 65 cases of bladder cancer patients and the para-carcinoma tissues, and another 15 cases of normal bladder tissues. The relationship between PTEN and Beclin1 in cancer tissue was analyzed by Spearman correlation analysis. Results〓PTEN expression rate in cancer tissues,adjacent tissues and normal tissues were 53.8%,81.5% and 93.3%, respectively. Beclin1 high expression rate in cancer tissues,adjacent tissues and normal tissues were 58.5%, 84.6%and 86.7%, respectively. PTEN and Beclin1 high expression rate in cancer tissues were significantly higher than that of adjacent tissue and normal tissue (all P values were more than 0.05). PTEN and Beclin1 high expression rate in cancer tissues were correlated with histological grade and clinical staging of patients, regardless of patient gender and age. Beclin1 and PTEN expression decreased along with histological grade and clinical staging of patients increased, respectively (all P values were less than 0.05). Beclin1 expression was positively correlated with PTEN expression in cancer tissues (P<0.001). Conclusion〓The expression of PTEN and Beclin1 in bladder cancer were associated with tumor occurrence, progression.
    The mRNA expression of PinX1 in hepatocellular carcinoma tissues and its clinical significance
    XU Qiaodong, YAN Yongcong, HUANG Pinbo, YU Zhiming, XIAO Zhiyu
    2016, 16(02):  223-227.  DOI: 10.3969/j.issn.1009-976X.2016.02.025
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    【Abstract】〓Objective〓To explore the mRNA expression of Pin2/TRF1-interacting protein X1(PinX1) in hepatocellular carcinoma tissues as well as its prognostic significance. Methods〓A total of 43 paired hepatocellular carcinoma specimens and their adjacent normal tissues with corresponding patients’.clinical data were collected..The mRNA expression of PinX1 was detected by real-time quantitative polymerase chain reaction.(Q-PCR),.and its correlations with pathological features was evaluated by chi-square test,.prognosis were further analyzed by Kaplan-Meier method..Cox proportional hazard model was used to estimate relative risks resulting in a poor prognosis. Results〓In the whole specimens,.PinX1 mRNA expression was decreased in 29 tumor tissues.(67.4%),.while only 14 adjacent normal tissues were in low expression with a statistically significance(P<0.05); there was a correlation between PinX1 mRNA expression and patient’s age; low mRNA expression of PinX1 in tumor tissues were crucially associated with patients’.overall survival by univariate and multivariate Cox proportional-hazards regression analysis.(HR=5.057,P=0.005;.HR=3.761,P=0.006),.as the same results as in survival analysis..Conclusion〓PinX1 is a potential tumor suppressor gene that inhibits the onset and progression of HCC,.with a prospect that it may be an important biomarker in surveillance of prognosis and treatment.
    Expression and significance of AKIP1 and P65 in breast carcinoma
    HE Zhuocheng, LIN Zhiwen, LIN Xu, YANG Jun, LIANG Hui
    2016, 16(02):  227-230.  DOI: 10.3969/j.issn.1009-976X.2016.02.026
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    【Abstract】 Objective To investigate the expression and cinical significance of AKIP1 and P65 in breast carcinoma. Methods〓Eighty-nine tissue specimens of breast carcinoma and 30 tissue specimen of paraneoplastic mammary gland were selected and stained with immunohistochemistry with SP ways. The express disparity of AKIP1 and P65 were contrasted between breast carcinoma and paraneoplastic mammary gland. The correlation of AKIP1 expression and P65 expression with biological behavior of breast carcinoma and correlation of AKIP1 expression with P65 expression in breast carcinoma were analyzed. Results〓The expression of AKIP1(56.2%) was lower in breast carcinoma than in paraneoplastic mammary gland(93.3%,P<0.01). The expression of P65 (85.4%) was higher in breast carcinoma than in paraneoplastic mammary gland(55.0%,P<0.01). The expression of AKIP1 and P65 was negative correlation in breast carcinoma(r=-0.704, P<0.01). The expression of AKIP1 and P65 were discrepant in breast carcinoma with different differentiation and lymph node metastasis(P<0.01). Conclusion〓The expression of AKIP1 and over-expression of P65 in breast carcinoma tissue may be early and high malignant in breast carcinoma.
    Recent advances in the surgical treatment of acute infectious necrotizing pancreatitis
    ZHANG Qing, LI Zhiwei
    2016, 16(02):  231-234.  DOI: 10.3969/j.issn.1009-976X.2016.02.027
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    【Abstract】〓Infection necrotizing pancreatitis(INP) is a partial pancreas inflammation, infection and necrosis,.which is common acute abdominal disease in clinic,.characterized by acute onset, severe illness,.rapid progress in treatment for a long time,.spend more,.high mortality..In recent years,.statistical research literature at home and abroad found that management of necrotizing pancreatitis has made great progress,.from the initial peripancreatic drainage to do simple surgical resection of pancreatic necrotic part,.from the traditional open surgical pancreatic necrosis debridement of progression to invasive surgery, the mortality rate remains high, the best treatment is still controversial clinic..Non-surgical treatment of acute necrotizing pancreatitis has been fully affirmed..Necrotizing infection is now recognized as indications of surgical treatment of acute pancreatitis. In this article, we review the surgical treatment of necrotizing pancreatitis.
    Current status and prospects of single incision laparoscopic colorectal resection
    TAN Li,CHEN Weiqiang
    2016, 16(02):  235-238.  DOI: 10.3969/j.issn.1009-976X.2016.02.028
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    【Abstract】〓With the continuous minimally invasive surgery, single incision laparoscopic surgery (SILS) is supposed to be the result of multiport laparoscopy’s further development. The feasibility and safety of SILS for both benign and malignant colorectal disease has already been proved..It has the advantages of improving the cosmetic effect, reducing postoperative pain and recovery time, as well as improving the quality of life..However,.its disadvantage is that the higher requirement to the technology and equipment. In this paper,.we reviewed previous studies and evaluated the advantages and limitations of SILS in colorectal surgery through the published articles.
    Research progress of subacromial impingement syndrome
    ZHENG Lei, HUANG Degang
    2016, 16(02):  238-241.  DOI: 10.3969/j.issn.1009-976X.2016.02.029
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    【Abstract】〓Subacromial impingement syndrome is a common shoulder joint disease. Though there are different causes of diseases like scapulohumeral periarthritis, the clinical symptoms, treatment and prognosis of Subacromial impingement syndrome are quite different. As a result, these diseases are often mixed up in clinical practice. Through cadaver studies, Neer first put forward the concept of subacromial impingement syndrome and divided into three phases according to pathology. In phase I and phase II, conservative treatment is commonly applied, for example, taking non-steroid anti-inflammatory drug and partial closure could achieve good results. However, for phase III patients or patients to whom phase I and phase II treatment are ineffective. Surgery is required. With the development of science and technology, acromioplasty raised by Neer as a surgical method has been replaced by arthroscopic subacromial decompression.
    The changes of coagulation and nursing care in septic patients treated with continuous renal replacement therapy using anticoagulations in the intensive care unit
    LIN Yuzhen, LIN Yinhua, ZHANG Lishan, LUO Yuzhen, GAO Mingzhu, WANG Haiqin, LIN
    2016, 16(02):  242-245.  DOI: 10.3969/j.issn.1009-976X.2016.02.030
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    【Abstract】〓Objective〓To explore the changes of coagulations and properties of nursing care in septic patients treated with continuous renal replacement therapy (CRRT) using regional citrate anticoagulation (RCA) in the intensive care unit. Methods〓According to our including criteria, 76 patients were included in this retrospective analysis from March 2012 to June 2015. There were 40 patients using RCA (RCA group) and 36cases using low molecular weight heparin as anticoagulations (low molecular heparin group) in CRRT, respectively. Coagulation, arterial blood gas analysis, biochemistry, bleeding and endurance time of filters before and 3 days after treatments were compared between two groups. Results〓Although the serum levels of ureanitrogen (BUN), creatinine (Cr) and lactate (Lac) were significantly decreased in both groups (all p-values were less than 0.05), and no difference was detected between two groups. Notably,no significant changes of prothrombintime (PT), activated partial thromboplastin time (APTT) and platelets (PLT) were found in RCA group, while first two indicators were prolonged and the number of last indicator was decreased in low molecular weight heparin group(all p-values were less than 0.05). The ration of bleeding was significantly reduced and endurance time of filters was obviously increased in RCA group (all p-values were less than 0.05). Conclusion〓In our study, compared with management of low molecular heparin group usedduring CRRT, regional citrate anticoagulationexisted better clinical effects and less side-effects.
    Clinical application of an improved abdominal binder on artificial anus after abdomen ostomy
    YAN Juan, TUO Qinghua, CHEN Yuanyuan, MA Jie, LI Weiyun
    2016, 16(02):  246-247.  DOI: 10.3969/j.issn.1009-976X.2016.02.031
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    The investigation and nursing strategy of preoperative fasting time for the patients waiting for surgery
    ZOU Yanxian, XIE Hongyan, LIAO Lili
    2016, 16(02):  248-封三.  DOI: 10.3969/j.issn.1009-976X.2016.02.032
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