Objective To investigate the comparative analysis between single-port access laparoscopic Miles surgery with jackknife position and laparoscopic Miles surgery with lithotomy position for low rectal cancer.Methods Retrospectively analyzed 36 patients with low rectal cancer (TNM stage:Ⅱ-Ⅲ) undergoing laparoscopic abdominoperineal excision.Patients were divided into two groups.Lithotomy position group:laparoscopic Miles surgery with lithotomy position.Jackknife position group:single-port access laparoscopic Miles surgery with jackknife position.The operation time,blood loss,postoperative recovery,postoperative complication,postoperative recurrence and survival rate were observed.Results Blood loss of perineal position in jackknife position group was less than that in lithotomy position group [(31.5 ± 22.4) ml vs.(53.5 ± 25.6) ml] (P =0.01),and removal of drainage tube in jackknife position group was earlier than that in lithotomy position group [(6.7 ± 1.9) d vs.(9.8 ± 1.7) d] (P ＜ 0.01).However,the operation time,blood loss in abdomen,blood loss,postoperative out-of-bed activity time,recovery of gastrointestinal function time,dermal sutures out time,postoperative hospital stay,complication,postoperative recurrence in 2 years and survival rate between two groups had no significant difference (P ＞0.05).Conclusions Single-port access laparoscopic Miles surgery is safe and feasible with better surgical outcome and cosmetic benefits.Furthermore,the blood loss and postoperative exudation at perineal region is less than that in traditional lithotomy position.

Many alimentary tumor patients are characterized by malnutrition resulting from various elements and disorders of metabolism.So it is necessary to combine together with parenteral nutrition(PN) and enteral nutrition(EN).It can improve the nutritional status and reduce morbidity and mortality in patients with alimentary tumors in perioperative period.

Two hour after LAK—like cells were co—cultured with gastric cancer cells,the mixed sus-pension was spread on slids and dyed with histochemical method.Through analysing the dyedcells,we directly confirmed what subset the LAK—like cells belonged to.The featrue of LAK—like cells adhering to cancer cell was observed under electron micrscope in our experiment.A-mong the lymphoctes which were adherent to cancer cells,the number of CD8~+ cells was in-creased.Most of adherent to cancer cells,the number of CD8~+ cells was increased.Most of ad-herent cells were TAC~+,suggesting that the expression of TAC antigen plays an important rolein cell mediated cytotoxity.

Objective To summarize the experience in diagnosis and treatment of primary splenic tumor. Methods The clinical data of 43 cases of primary splenic tumor patients treated in our hospital between January 1990 to January 2003 were retrospectively analyzed. Results The detectable rate of B-US was 95.3% and that of CT was 96.6%. All the 43 patients included 28 with benign tumors and 15 with malignant ones. The median follow-up period was 6.8 years(2 months-15 years). The 5-year overall survival of benign tumor was 100% and The 1-,3-and 5-year overall survival rates of malignant tumor were 80%, 53.3 % and 26.7%, respectively. Conclusion The image methods such as B-US and CT are the main diagnostic methods for primary splenic tumor. Early diagnosis, radical operation and combined therapy are important for improving the prognosis of the tumor.

Objective To investigate the significance of the mutation of c-kit gene in the development,(clinical) pathology and prognosis of gastrointestinal stromal tumors(GISTs).Methods The technique of(PCR-SSCP) was used to detect ckit gene mutation in 106 cases of GIST,and 57 of the cases were(followed-up).Results The c-kit gene mutation rate in the whole group was 45.3%(48/106),and(3.4)%(2/41) in benign GIST,and 70.8%(46/65) in malignant GIST.The 1-,3 and 5-year survival rates and median survival time of the mutation positive group were all markedlly lower than those of the(mutation) negative group.A comparison of the parameters that can differentiate the benign GISTs from malignant ones such as size,histological necrosis,aggressive grade,nucleus mitotic count and nuclear discrepancy,showed significant difference between the of postive and negative gene mutation(P

Objective:To explore the diagnosis and treatment of small intestine leiomyosarcoma. Methods:Ten patients with small intestine leiomyosarcoma in Changhai Hospital from 1993 to 2001 were retrospectively analyzed. Results:Radical resection was performed in 6 cases with the shortest survival time being over 1 year and the longest being 8.5 years (still in good health). One case received extirpation operation with the survival time being over 4 years.Partial resection was performed in 3 cases,and the 3 patients died 1,2,3 years after operation respectively.Conclusion:The small intestine leiomyosarcoma is rare and its diagnosis is difficult due to the lack of clinical feature. Final diagnosis should be based on pathology.The disease is not very sensitive to radiotherapy and chemotherapy,which makes surgical treatment the choice.

Objective To investigate the relation of the peripheral blood C-reactive protein (CRP)and procalcitonin (PCT) and multiple organ dysfunction syndrome( MODS ) for patients with multiple trauma.Methods A total of 136 patients with multiple trauma were divided into MODS group (49 cases) and non MODS group (87 cases),and 50 healthy volunteers were chosen as control group. Peripheral blood CRP and PCT concentration were detected at different times. Results The highest concentration of peripheral blood CRP in MODS group was appeared on 48 h [(38.7 ± 2.7) mg/L], CRP concentrations in MODS group were significantly different with non MODS group and control group (P ＜0.05). The highest concentration of peripheral blood PCT in MODS group was appeared on 24 h [(20.3 ± 1.7)μ g/L], PCT concentrations in MODS group were significantly different with non MODS group and control group (P＜ 0.05). Conclusions CRP and PCT are relevant to the occurrence of MODS in trauma acute stage. The observation of peripheral blood CRP and PCT concentrations can predict the occurrence of MODS.

Objective To evaluate the clinical effect of tension-free mesh-plug repair in inguinal strangulated hernia. MethodsUsing the mesh-plug materials (Perfix-Plug) of Bard surgical product company, we performed operation on 19 patients suffering from strangulated indirect inguinal hernia. In these cases,14 patients were older than 60,17 patients had other severe diseases,and 5 cases had small intestine necrosis. ResultsThere was no postoperative mortality. The only complication was scrotal haematoma which occurred in one patient. All the patients retrieved motility two days after operation except those who had intestinal necrosis and underwent intestinal anastomosis. The length of hospital stay was 2 to 4 days or 6 to 7 days respectively in patients without or with intestinal necrosis. The follow-up period ranged from 3 to 16 months, and no recurrence was observed. ConclusionTension-free mesh-plug repair has the advantages of safety, minimal invasion and rapid recovery. Meanwhile, this method can be applied to those with intestinal necrosis with satisfactory results.

Objective:To search for a better RT-PCR method for detecting CK19 mRNA. Methods: RT-PCR methods were used to detect the expression of CK19 mRNA in the tumor tissues and in the peripheral blood of patients with gastric cancer and in the peripheral blood of healthy subjects. Results: The influence of pseudogene and genome was observed through nonreversely transcripted RNA controls and comparison of several pairs of primers.The interference could be effectively eliminated by regulating the annealing temperature based on mismatched primers. Conclusion: The presence of pseudogene and genome interferes the experimental protocol in RT-PCR,which can be resolved with the method introduced in our paper.

Objective To explorer the safety of D2 lymphadenectomy in open distal gastrectomy for distal gastric cancer with the surgical approach from bottom to top,from left to right and from surrounding to middle.Methods 100 advanced distal gastric cancer patients selected from General Surgery Department of Chang Hai Hospital from December 2012 to November 2013 were analyzed retrospectively.All the patients were performed D2 lymphadenectomy in open distal gastrectomy with surgical approach from bottom to top,from left to right and from surrounding to middle.The operation time,amount of bleeding,the number of lymph nodes,postoperative complications and follow-up observation were recorded.Ruselts All patients had successful operation.The operation time was 90 to 190 mins,the average (125.00 ± 21.43) mins;intraoperative blood was 90 to 400 ml,the average (178.00 ± 73.74) ml;number of lymph node dissection was 17 to 41,the average (26.00 ± 6.72).One patient suffered from abdominal hemorrhage,recoverd and discharged after conservative treatment.Conclusions Surgical approach from bottom to top,from left to right and from surrounding to middle can improve the safety of D2 lymphadenectomy for distal gastric cancer.