Liver is one of the most commonly metastases in patients with colorectal cancer.Curative hepatic resection is the first choice of liver metastasis of colorectal cancer,which can improve the survival rate ranging from 30％ to 40％ in 5-year.In this article,we will review the operation indication,mode and advance on the current treatment strategies of colorectal liver metastases,and discuss the decision-making process,emphasize a surgery - centered multidisciplinary treatment for the treatment of hepatic metastases from colorectal cancer,to improve the survival rate.

Objective To investigate the expression of CCL20 and CCR6 in the patients with gastric cancer and To examine the relationship between chemokine expression and the occurrence and development of Gastric Cancer. Methods Real-time PCR , flow cytometry and ELISA are used to measure the gene transcription and protein expression levels of chemokine CCL20 and CCR6 in the serum of 50 patients with Gastric Cancer and 30 normal controls. Results The gene expression levels CCL20 and CCR6 in Gastric Cancer group are significantly higher than that in healthy controls. The level protein of CCL20 and CCR6 in peripheral blood of patients with gastric cancer are significantly higher than that in healthy peep le[ (45.4 ±10.9) pg/mL vs (18.6±4.7) pg/mL; (7.11 ±1.03%) vs (1.83±0.43%), P＜0.01. respectively],and the increase significantlyassociated with the clinical stage of Gastric Cancer. Conclusions The method for detecting the expression of CCL20 and CCR6 in patient with Gastric Cancer has been successfully established, and their expression levels were found to be correlated with the occurrence and development of Gastric Cancer. Thus, CCL20 and CCR6 may be involved in the regulatory mechanisms associated with the development of Gastric Cancer, and may be valuable in its diagnosis and prevention.

Objective To explore the diagnosis and treatment of anatomic variation of the extrahepatic biliary tree in laparoscopic cholecystectomy(LC).Methods From October 1999 to January 2008,totally 1216 cases of LC were performed in our hospital,anatomic variation of the extrahepatic biliary tree was found in 15(1.2%) of them.Among the 15 patients,3 had wide and short cystic duct with the opening at the junction of the right and left hepatic ducts;1 patient showed dislocation of a relatively thin choledoch owing to calculus incarceration;1 case was found having a cystic duct parallel to the common hepatic duct with a low-level opening;1 patient had twisted cystic duct at the right side of the common bile duct with an opening at the right hepatic duct;2 patients were suffered from massive adhesion in the cystic ampulla that covering the common bile and common hepatic ducts;3 cases showed aberrant bile ducts lying on the gallbladder bed;3 patients were found having the right posterior hepatic duct opened to the common hepatic duct;1 case was diagnosed with Mirizzi syndrome,in whom the anatomical structure was unclear.For all of the patients,the abnormal structures were separated carefully,ligated with sutures or titanium clips if necessary.Results LC was completed in 13 of the 15 cases,the other 2 patients were converted to open surgery because of the injury to the right hepatic duct or Mirizzi syndrome.None of the series had intra-abdominal bleeding or infection,bowel injury,or death.The patients were followed up for 3 months to 4 years(over 1 year in 11 cases).None of them developed biliary stenosis or residual calculus.Conclusion Identification of the Calot triangle is crucial to prevent surgical injuries to the extrahepatic biliary tree.

Objective To discuss the value of body adiposity index( BAI) in the prediction of the risk of dysglycemia,dyslipidemia and hyperuricemia.Methods Five thousand and thirty residents as the participants from Jinshan New Area and nearby of Jinshan,Shanghai were enrolled,including 2004 males and 3026 females. The receiver operating characteristic curve( ROC) was drew to predict dysglycemia,dyslipidemia and hyperurice?mia by body mass index( BMI) ,waist circumference( WC) ,waist?hip ratio( WHR) and BAI in different gender groups.Medcale soft was used to compare the area under the curve.Results According to the ROC analysis,in males the area under curve in the prediction of dysglycemia of BMI,WC,WHR and BAI was 0.553,0.556,0. 538,0.540(P<0.05),and 0.513,0.523,0.523,0.535 in females(P<0.05).The area under curve in the predic?tion of dyslipidemia of BMI,WC,WHR and BAI was 0.641,0.626,0.563,0.588(P<0.05) in males and 0.617, 0.613,0.597,0.587(P<0.05) in females.The area under curve in the prediction of hyperuricemia of BMI,WC, WHR and BAI was 0.685,0.665,0.609,0.577(P<0.05) in males and 0.730,0.708,0.656,0.649(P<0.05) in females,and BMI, WC of AUC were higher than BAI both in males and females(P<0.05).Conclusion BAI could be a predictor for the risk of metabolic disease,but less than BMI and WC.

Objective To evaluate the feasibility of retroperitoneal laparoscopic adrenalectomy for large (≥6 cm in diameter) adrenal tumors. Methods Between June 2002 and June 2008,30 patients with large adrenal tumors underwent retroperitoneal laparoscopic adrenalectomy in our hospital. With the patients being placed in the lateral position at the uninjured side,a self-made balloon was used to dilate the retroperitoneal space. Afterwards,3 trocars were inserted via the costal margin at the posterior axillary line and the anterior axillary line,and 2 cm above the anterior superior iliac spine at the middle axillary line to remove the tumors. After resection of the tumor,an drainage tube was indwelled. Results Retroperitoneal laparoscopic surgery was performed successfully in the 30 cases without conversion to open surgery. The mean operation time was 100 min (range,65 to 185 min),and the mean blood loss was 80 ml (range,50 to 250 ml). Over a mean of 18.5-month follow-up (range,3 to 36 months) was achieved in the cases,during which no one had local recurrence. Conclusions Retroperitoneal laparoscopic adrenalectomy is feasible and safe for patients with large adrenal tumors as long as no contraindication of the surgery is found. The diameter of the tumor does not play a role when determining the surgery.

OBJECTIVE To prepare the Graves disease (GD) mouse model through porcine thyroid globulin (PTG) injection and investigate the morbidity and stability of the model. METHODS C57BL6/N mice in model group received multi-point subcutaneous injection of PTG 25μg each week,six times in all. After the end of immunization,their heart rate and oxygen consumption were measured and serum triiodothyronine(T3)level was determined every two weeks. A model was considered successful if serum T3 level was higher than x+3s of the control group. Observation of the model lasted 12 weeks. At the 12th week,spleen and thymus gland indices,serum thyroid globulin antibodies and thyroid peroxidase antibodies were measured,and the thyroid glands were taken for pathological observation. RESULTS After six times of immunization,mice in model group showed increased heart rate(P<0.01),oxygen consumption(P<0.01)and T3 level(P<0.01)compared with control group. The morbidity was 77.7%for male mice and 88.8%for females. In addition,T3 level in model group remained higher than that in control group within 12 weeks after immunization. The T3 level tended to decrease in male mice,but remained at a relatively stable higher level in females. CONCLUSION This method is suitable for GD modeling due to its short model-making time,high morbidity and long durability.

BACKGROUND: A skull defect is inevitable after decompression treatment for traumatic brain injury. Titanium mesh as the most recognized skull repair material has good biocompatibility and has been widely used in clinical practice. However, the timing for skull repair after brain injury is still in dispute.OBJECTIVE: To compare the changes of brain perfusion and the recovery of neurological function in patients with skull defects before and after early and late-stage titanium mesh repair based on CT perfusion technique.METHODS: This was a single-center, prospective, observational clinical trial that was completed at the Taihe Hospital,Hubei University of Medicine in Hubei Province, China. Eighty-six patients with craniocerebral injury who had undergone decompression with removal of bone flap from January 2013 to January 2016 were recruited and subjected to skull repair using titanium mesh. All the patients were randomized into two groups: test group (n=40) with early skull repair within 1-3 months after decompression and control group (n=46) with late-stage skull repair within 6-12 months after decompression. CT perfusion technology was used to observe changes of brain perfusion at 3 days operatively and at 10 days postoperatively. The Barthel index was evaluated at 30 days postoperatively. The trial was registered with ClinicalTrial.gov (identifier: NCT03222297) on July 12th, 2017. The study protocol was approved by the Ethics Committee of Taihe Hospital with the approval No. 2012 (08), and performed in accordance with the Declaration of Helsinki,formulated by the World Health Organization and the hospital's ethical requirements for human research. All the patients and their families were voluntary to participate in the trial, were fully informed of the trial process, and then signed the informed consent prior to the initialization of the trial.RESULTS AND CONCLUSION: The postoperative cerebral blood volume and cerebral blood flow at the parietal cortex on the side of skull defect and at the cortex in the defect region were significantly higher in the two group than the baseline (P < 0.05), while the time to peak was lower than the baseline (P < 0.05). Compared with the control group,significantly higher cerebral blood volume and cerebral blood flow as well as shorter time to peak were observed in the test group (P < 0.05). The Barthel index of the test group was also significantly higher than that of the control group at 30 days postoepratively (P < 0.05). Overall, early skull repair with titanium mesh is helpful to improve the cerebral blood perfusion at the affected side and the recovery of neurological function. In addition, CT perfusion technology is a safe and effective method to monitor hemodynamic changes in the brain.

Objective To develop a special seismic trauma database that could record and analyze the data including injuries, trauma cares and outcomes. Methods (1) The items and content of the database were determined based on the method of evidence-based medicine. (2)The fields, tables, items and options of the seismic trauma database were designed. (3) The database software was developed based on dot net framework platform, with C# as programming language. (4)The database was used to record and manage data of injuries caused by 5.12 earthquake. Results The Seismic Trauma Database Version 1.0 was developed with 728 fields (including 380 inner fields) and normative content and structure. The database software could record 10 aspects of the seismic patients including basic information, injuries, transfer and evacuation, clinical medical care, outcome and discharge. The database software had combination, custom queries and meta-analysis functions. Conclusions This database software can conveniently and normally record and manage the information of the seismic patients, can systemize and analyze the data conveniently and is an excellent data platform for trauma care research and epidemiologic study of seismic injuries.

AIM: To study the protective effects of basic fibroblast growth factor (bFGF) on myocardial ischemia in rats and their underlying mechanism. METHODS: A rat myocardial ischemic injury model was established by left coronary artery ligation. The rats were killed at 2 h, 4 h, 8 h after coronary artery occlusion. The samples of blood and myocardium were collected for observing the expression of Bcl-2 and Bax in myocardial cells and the changes of superoxide dismutase (SOD) or myocardial enzymes. RESULTS: The amount of Bcl-2 protein expression of myocardial cells in ischemia + bFGF group was significantly higher than that in ischemia+saline group (P

Objective To investigate and analyze the military operation ability and influence factors of soldiers alongthe border in an extremely cold environment and to provide a scientific basis for effectively improving the combat effective -ness of the army stationed the cold regions.Methods According to relevant standards, recruits(the length of service <1month) and old soldiers(the length of service >1 year) were randomly selected to investigate their military operationfactors, physical condition, sleep condition, mental health and cognitive ability.Results Cold was the main factor whichaffected military operation capability in cold regions.According to physical standards,border troops were in poor physicalcondition.Results of SCL-90 showed that the total score, the number of positive items , the score of each factor of the 130recruits were significantly lower than those of the Chinese army model and 46 veterans (P <0.05).There was nosignificant difference in these aspects between the 46 veterans and Chinese army model.Recruits were in better sleepcondition and had better instantaneous memory(P <0.05).Birthplace had no effect on these factors .Recruits from Centraland South China were in poorer sleep condition than those from cold regions (P <0.05).Results of SCL-90 showed that thetotal score,the factors of somatization, coercion, depression and anxiety of communication veterans were significantly higherthan those of the Chinese army model (P <0.05).The sleep condition of communication veterans was poorer than that ofmotorized infantry and patrol veterans (P <0.05).Conclusion Cold is the main factorthat impacts the ability of militaryoperations in cold regions.The physical work capacity of border guards in cold regions was significantly below the militarystandard, so the level of military training should be strengthened .Research on cold-protection equipment for special tasks should be strengthened.