The liver is a primary target organ of colorectal cancer metastases. Surgical resection is pres-ently the only approach that offers patients a substantial chance of cure. Five-year survival ranges 25% -39%. But by the time of diagnosis, only 10% -25% of patients were considered eligible for surgical directed thera-pies. New therapeutic modalities such as ablation, hepatic arterial infusion chemotherapy, neoadjuvant chem-otherapy and targeted therapy present promise for the future treatment of unresectable liver metastases. These treatments and progress in surgical therapy are reviewed in this article.

Objective To evaluate the efficacy of percutaneous laser ablation in the management of portal vein tumor thrombus(PVTT)of hepatocellular carcinoma(HCC).Methods Under ultrasound guidance,a needle was percutaneously punctured into the portal vein,through the axial of the tumor thrombus,and until the proximal end.An optic fiber was inserted through the needle and repeated pulse laser ablation was given.Results Complications included 102 cases(94.4%)of pyrexia 1～3 d after treatment(37.5～39.5 ℃),84 cases(77.8%)of incisional pain,and 3 cases(2.8%)of upper gastrointestinal bleeding.There were three types of findings of PVTT in 53 cases surviving over 1 year:①the tumor thrombus was atrophied and disappeared in 20 cases;②the thrombus was atrophied and the portal vein exhibited a honeycomb-like appearance in 18 cases;③the thrombus kept on growing and the portal vein was enlarged in diameter in 15 cases.Among 95 cases of totally occluded portal vein,color blood flow signals appeared in all of them on the first postoperative day.The signals could still be seen in 76 cases at 1 month after treatment,in 64 cases(out of 91 cases)at 3 months,in 52 cases(out of 71 cases)at 6 months,in 36 cases(out of 42 cases)at 1 year,in 10 cases(out of 14 cases)at 2 years,and in 2 cases(out of 2 cases)at 3 years.The 1-,2-,and 3-year survival rates were 55.56%,35.20%,and 20.30%,respectively.Conclusions Percutaneous laser ablation is a feasible novel option for the treatment of portal vein tumor thrombus of hepatocellular carcinoma.

Objective To evaluate the relationship between cranial CT characteristics and prognosis after first-ever primary supratentorial intracerebral hemorrhage (PSICH). Methods The data of clinic and CT in patients with first-ever PSICH were registered prospectively and followed up for 6 months. The relationship between the prognosis and the clinic data was analyzed using univariate and multivariate Logistical regression analysis.Results (1) The volume of hematoma was an independent CT predictor of death at 1st, 3rd and 6th month. (2) Both the volume of hematoma and secondary ventricular hemorrhage were independent CT predictors of death/disability at 6th month.Conclusions (1)The volume of hematoma can be used to predict death in patients with PSICH.(2)The volume of hematoma and secondary ventricular hemorrhage can be used to predict the death/disability rate of PSICH.

Objective To study the inhibitory effect of intrasplenic injection of retroviral packaging cells encoding human interleukin-2 (hIL-2) and mouse interleukin-12 (mIL-12) fusion gene on the growth of chemically induced hepatocellular carcinoma in rats. Methods The retroviral vector GCIL12EIL2PN encoding hIL-2 and mIL-12 fusion gene was constructed. The retroviral packaging cell line PA317 transfected with the vector was injected into the spleens of rats with established chemically induced hepatoma on on the 90th day (early-stage treatment) or the 105th day (late-stage treatment). The survival time and toxic effect were observed. The serum mIL-12 and hIL-2 levels were assayed with ELISA, and the cytotoxicity of the natural killer (NK) cells was measured by means of a 51Cr-release assay using YAC-1 tumor cells as the target. Results The average survival time (after chemical induction) in the early-stage treatment rats and the late-stage treatment rats were 188.1?14.2 days and 168.5?13.6 days, respectively, in IL-12+IL-2 combination gene treatment group, and it was longer than that of IL-12 gene treatment group (168.2?13.4 days and 149.1?13.8 days, respectively, P

Objective To investigate the expressions and correlations of Kiss-1 and matrix metalloproteinases-9 (MMP9) proteins in the colorectal cancer (CRC) tissues of patients with synchronous colorectal liver metastasis (SCRLM),and the association with the clinicopathologic factors and prognosis of patients.Methods The retrospective case-control study was adopted.The clinicopathological data of 96 patients with SCRLM and 69 patients with CRC and no metastasis who were admitted to the Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University from January 2000 to May 2013 were collected.The 96 CRC tissues and 50 adjacent normal tissues (distance from resection margin ≥ 5 cm) were collected from 96 patients with SCRLM,and 69 CRC tissues were collected from 69 patients with CRC and no metastasis.Expressions of Kiss-1 and MMP9 protein were detected by immunohistochemistry (IHC).The follow-up of outpatient examination and telephone interview was performed to detect survival of patients till August 2014.Comparison of count data and correlation between expressions of Kiss-1 or MMP9 protein and clinicopathological factors were analyzed by the chi-square test and Fisher exact probability.Survival curve was drawn using the Kaplan-Meier method,and survival analysis was done using the Log-rank test.Correlation analysis was done by the Pearson correlation.Results Expression of Kiss-1 protein was located in the cytoplasm of tissue cells.The positive expression rates of Kiss-1 protein in CRC tissues of patients with SCRLM and with CRC and no metastasis and in adjacent normal tissues were 24.0％ (23/96),43.5％ (30/69) and 52.0％ (26/50),respectively,with a significant difference among the 3 tissues (x2 =14.307,P ＜ 0.05) and no significant difference between CRC tissues of patients with CRC and no metastasis and patients with SCRLM (x2 =0.845,P ＞ 0.05).The positive expression rate of Kiss-1 protein in CRC tissues of patients with SCRLM was significantly different from that in CRC tissues of patients with CRC and no metastasis and in adjacent normal tissues (x2 =0.702,11.594,P ＜ 0.05).Expression of MMP9 protein was located in the cytoplasm of tissue cells.The positive expression rates of MMP9 protein in CRC tissues of patients with SCRLM and with CRC and no metastasis and in adjacent normal tissues were 67.7 ％ (65/96),62.3 ％ (43/69) and 36.0％ (18/50),respectively,with a significant difference among the 3 tissues (x2=14.203,P ＜0.05) and no significant difference between CRC tissues of patients with CRC and no metastasis and patients with SCRLM (x2=8.038,P ＞ 0.05).The positive expression rate of MMP9 protein in CRC tissues of patients with SCRLM was significantly different from that in CRC tissues of patients with CRC and no metastasis and in adjacent normal tissues (x2 =13.475,13.475,P ＜ 0.05).The positive expression rates of Kiss-1 protein in CRC tissues of patients with SCRLM were 66.7％,21.9％ and 17.6％ in the high-,mederate-and low-differentiated tumor,50.0％,28.6％ and 17.5％ in the muscular layer of tumor invasion,outside of serosa and serosal layer,44.0％ and 16.9％ in patients with and without lymph node metastasis,respectively,showing significant differences among the tumor differentiation degree,depth of tumor invasion and lymph node metastasis (x2=6.546,6.172,7.453,P ＜0.05).The positive expression rates of MMP9 protein in CRC tissues of patients with SCRLM were 25.0％,66.7％ and 76.2％ in the muscular layer of tumor invasion,outside of serosa and serosal layer,44.0％ and 76.1％ in patients with and without lymph node metastasis,respectively,showing significant differences between the depth of tumor invasion and lymph node metastasis (x2 =12.094,8.690,P ＜ 0.05).All the 96 patients with SCRLM were followed up for a median time of 68 months (range,12-176 months).The median overall survival time,median tumor-free survival time,5-year cumulative survival rate and 5-year tumor-free survival rate were 31 months,26 months,69.6％ and 26.1％ in patients with SCRLM and positive expression of Kiss-1 protein and 26 months,19 months,24.7％ and 12.3％ in patients with SCRLM and negative expression of Kiss-1 protein,respectively,showing significant differences between the overall survival and tumor-free survival (x2=16.578,14.436,P ＜ 0.05).The median overall survival time,median tumor-free survival time,5-year cumulative survival rate and 5-year tumor-free survival rate were 31 months,19 months,24.6％ and 12.3％ in patients with SCRLM and positive expression of MMP9 protein and 28 months,16 months,58.1％ and 22.6％ in patients with SCRLM and negative expression of MMP9 protein,respectively,showing significant differences between the overall survival and tumor-free survival (x2=14.073,8.532,P ＜0.05).Of 96 patients with SCRLM,there were 23 patients with positive expression of Kiss-1 protein (10 with positive expression of MMP9 protein and 13 with negative expression of MMP9 protein) and 73 with negative expression of Kiss-1 protein (55 with positive expression of MMP9 protein and 18 with negative expression of MMP9 protein),with a negative correlation between expressions of Kiss-1 protein and MMP9 protein (r =-0.291,P ＜ 0.05).Conclusions The reduced expression of Kiss-1 protein and elevated expression of MMP9 protein are closely associated with invasion and metastasis of CRC and prognosis of patients.A combination detection of Kiss-1 and MMP9 proteins is expected to become a marker for predicting the prognosis of patients with SCRLM based on the negative correlation between them.

This is a retrospective study of 103 cases of early gastric cancer undergoing surgery during the years of 1974-1988 with a special discussion on surgical treatment.The lesions were localized to the mu-cosal layer in 54.3%,to submucosal layer in 45.7%,In 10% of patients there was lymphnode metastasis,all of them were in the first station.Operation consisted of radical subtotal gastrectomy in 94.2%.and total gastrectomy in 5.8%.The extent of lymphatic excision was:Ro in 12.6%,R1 in 61.2% and R2 in 26.2% Postoperative chemotherapy was given in 61.2%.However no statistical difference of 5 years survival rate was found in respect to the extent of lymphatic excision as well as postoperative chemotherapy.Since 60.2% of EGC lesions were of minute,multiple and plane type,preoperattve en-doscopy and intraoperative biopsy of gastric mucosa,if necessary,should be carefully done to ascertain that no lesion was overlooked in the remnant of the stomach.Follow-up rate was 96%,and the survival rates of 3 and 5 years were 97% and 93.7%.This makes the authors believe that a radical operation of R1 is justified and routine postoperative chemotherapy is unnecessary.

Objective To explore the effect of atorvastatin on postoperative complications after the burr hole drainage of chronic subdural hematoma (CSDH). Methods The clinical data of 172 CSDH patients who had underwent the burr hole drainage were retrospectively analyzed. Among them 82 patients were given atorvastatin (atorvastatin group), and 90 patients were not given atorvastatin (control group). The postoperative complications were compared between 2 groups. Results All patients were followed up for 6 months. The total incidence of postoperative complications in control group was significantly higher than that in atorvastatin group:47.78%(43/90) vs. 31.71%(26/82), and the recurrent rate of subdural hematoma and incidence of subdural effusion in control group were significantly higher than those in atorvastatin group: 22.22% (20/90) vs. 8.54% (7/82) and 28.89% (26/90) vs. 12.20%(10/82). There were statistical differences (P<0.05). There were no statistical difference in the incidences of pneumocephalus, acute epidural/subdural hematoma and brain damage induced by drainage tube (P>0.05). Conclusions Atorvastatin can improve the prognosis of CSDH patients, especially in reducing the incidence of recurrent subdural hematoms and subdural effusion.

Objective To investigate the inhibitory effects of IL-18 gene on HCC growth in vivo. MethodsThe recombinant adenovirus vector containing IL-18 gene was constructed and cotransfected into 293 cells together with EcoT22 I-digested Ad5 DNA-TPC, the recombinant adenoviruses were generated, and injected into a rat model bearing HCC. Results The recombinant adenovirus vector containing IL-18 gene inhibited the proliferation of HCC cell line CBRH 3. The rats receiving IL-18 gene injection within 3 days after inoculation of CBRH 3 all had long term survival, while those injected at day 5 or 7 survived a limited longer period than control groups (P

Six patients with ST segment elevated acute myocardial infarction (AMI), who were 52.5 years old in average, were enrolled and performed the treatment at Tongren Hospital from November 2003 to June 2004. Following percutanecus transluminal coronary angioplasty and stent revascularization, autologous bone marrow stem cell (BMSC) transplantation was performed after informed consent was obtained. Patients were subcutaneously injected with granulocyte colony-stimulating factor (G-CSF) at 1 week before transplantation. When CD34+ cells going up to 1%-3% in peripheral blood, mononuclear cells in peripheral blood were harvested,purified, and further infused into the infarcted related coronary artery with an over-the-wire balloon catheter. Following up was performed every half a year. Four years later, the infarcted area of these patients was further decreased by 8.03%, in the basic descent of 42.7% at 3 months averagely; total infracted area descent was 50.73%, but ejection fraction increased by 4.6% from 50.8%. There was no serious coronary artery restenosis and/or stenosis formation which need revascularization upon angiography.

Objective:To analyze the clinical characteristics of primary acute myeloid leukemia (AML) (non-M3 type) in children suffering from different levels of platelet count(PLT).Methods:In the Tumor Hospital of Zhengzhou University from January 2014 to December 2018, laboratory and clinical data of 247 de novo primary AML pediatric patients were retrospectively reviewed.According to the PLT before treatment, patients were divided into very low platelet group (VLG), low platelet group (LG) and non-lowing platelet group (NLG), with<50×10 9/L, ≥50×10 9/L but <125×10 9/L and ≥125×10 9/L as the boundaries.All patients were followed up until June 30, 2019.Meanwhile, the follow-up data was obtained by consulting medical records or by telephone.SPSS 17.0 software was applied for data analysis. Results:In general clinical features, a different group of hemoglobin (Hb) content, fusion gene AML- ETO and clinical risk stratification were statistically significant in different PLT groups ( χ2=11.270, 12.115 and 12.848, respectively, all P<0.05). However, the differences of other indicators in different groups of PLT were not statistically significant (all P>0.05). There were no statistically significant differences in terms of 3-year disease-free survival(DFS) rate (59.3%, 36.3%, 50.4%) among the 3 groups (all P>0.05). The median total survival(OS)time(40.5 months)and 3-year OS rate(41.0%) of NLG patients were significantly higher than those of VLG(23.1 months, 30.1%)and LG(14.1 months, 18.2%)patients, with statistically significant differences( χ2=7.798 and 6.553, respectively, all P<0.05). The univariate analysis of gender, white blood cell(WBC), Hb, PLT, lactic dehydrogenase(LDH), FLT3-ITD, NPM1, DNMT3A, CEPBA, C-KIT, AML-ETO, molecular genetic prognosis, complete remission(CR), and hemopoietic stem cell transplantation(HSCT) displayed that DNMT3A mutation was an adverse factor that affects patients′ OS ( χ2 =5.834, P<0.05), and the positive factors that influences OS were non-reducing PLT before treatment, and obtaining CR and subsequent HSCT ( χ2=7.798, 79.168, and 31.337, respectively, all P<0.05). Multi-factor analysis revealed that the independent protective factors that affect patients′ OS were the non-reducing PLT before treatment, and obtaining CR and subsequent HSCT( Wald=42.760, 15.918, and 10.183, respectively, all P<0.05). Conclusions:Before treatment, non-reducing PLT is a protective factor for primary childhood AML patients, and the prognosis is satisfying.