Objective To summarize the research progress of preoperative staging diagnosis for gastric cancer.Methods Both the domestic and international literatures involving the preoperative staging diagnosis of gastric cancer in recent years were collected and reviewed.Results Transabdominal ultrosonography,EUS,CT,MRI,PET and diagnostic laparoscopy could provide objective evidences,and enhanced the accuracy of preoperative staging diagnosis for gastric cancer.Conclusion With the development of examination methods,the assessment of preoperative staging diagnosis of gastric cancer has been improved,and operation strategy can be made according to the correct preoperative staging.

Objective To investigate main causes leading to conversions to open surgery during laparoscopic cholecystectomy (LC) in the treatment of acute cholecystitis. Methods A total of 32 cases of acute cholecystitis received LC were analyzed. Results Out of the 32 cases of acute cholecystitis, LC was successfully accomplished in 25 cases (78.1%) and a conversion to open surgery was required in 7 cases (21.9%). Major causes of the conversion included the necrosis of the gallbladder(4 cases) and the failure to expose the Calot’s triangle(3 cases). Conclusions Conversions to open surgery should be made during LC when a gangrenous cholecystitis is confirmed or the Calot’s triangle cannot be well exposed.

Objective To evaluate the curative effect of endoscopic sphincterotomy (EST) combined with laparoscopic cholecystectomy (LC) in the treatment of gallstones complicated with common bile duct stones. Methods A total of 36 cases of gallstones complicated with common bile duct stones were enclosed. First EST was performed to remove the bile duct stones. Then LC was applied to resect the gallbladder. Results EST was successfully performed in 34 cases (94.4%) and failed in 2 cases because of the terminal stricture of the bile duct that was afterwards cured by an open choledochojejunostomy. LC was performed following EST in 34 cases, 32 of which were successful (94.1%) and 2 of which required a conversion to open surgery. Conclusions EST combined with LC is the best way for treating gallstones complicated with common bile duct stones. The biliary stricture mainly accounts for the failure of EST and should be treated by choledochojejunostomy as the first choice.

Objective To observe the change of umbilical artery S/D value in the third trimester pregnant women with overt hypothyroidism(OH) or subclinical hypothyroidism(SCH).Methods We collect the data of 37-42 weeks pregnancy from January 2014 to December 2015.We devided them into OH group,SCH group and contral group.We compared the umbilical artery S/D value in these three groups and analyzed the relativity between S/D value and thyroid hormone.Results The S/D value was 2.46 ± 0.31 in OH group,2.48 ± 0.27 in SCH group and 2.32 ± 0.17 in control group.The differences were statistically significant between OH group and contral group (P =0.000),SCH group and contral group (P =0.000).There was no statistically significant between OH group and SCH group (P =0.907).The proportion of cases number during different S/D value range in these three groups had difference (P =0.000).The S/D value was positively correlated to TSH in OH group (r =0.186,P =0.037) and SCH group (r =0.146,P =0.015).There was no correlation between FT3 and S/D value(P ＞ 0.05) or FT4 and S/D value(P ＞ 0.05) in both OH and SCH group.There was no correlation between thyroid hormone and S/D value in the contral group either.Conclusion Both OH and SCH can effect umbilical artery S/D value in the third trimester pregnancy.

Objective To evaluate the efficacy of thalidomide combined with NP regimen in treatment of non-small cell lung cancer (NSCLC) and to analyse the change of VEGF and bFGF in peripheral blood in patients with advanced NSCLC. Methods 57 patients with advanced NSCLC were divided randomly into NP plus thalidomide treatment group and NP contrast group,and VEGF and bFGF were measured by ELISA. Results The response rate was 44.4 % in trial group and 23.8% in control group (P>0.05). The clinical benefit rate were 77.8% in trial group and 42.9% in control group (P>0.05). The median TIP was 5.1 months and 3.0 months for trial group and control group respectively(P=0.05). Patients in benefit in trial group had a remarkable decrease in the number of VEGF (P<0.05) while patients in benefit in control group had a little decrease in the number of VEGF (P>0.05). Patients out of benefit in trial group and control group had a increase in the number of VEGF (P<0.05). Patients in benefit in trial group and control group had a tendency of decrease in the number of bFGF (P>0.05) while patients out of benefit in trial group and control group had a remarkable increase in the number of bFGF(P<0.05). Conclusion The addition of thalidomide to NP regimen results in significantly and clinically meaningful improvement in response rate, median time to tumor progression, and clinical benefit rate compared with NP alone in advanced NSCLC patients.Thalidomide in combination with chemotherapy shows a favorable toxic profile in advanced cancer patients.VEGF and bFGF can be detected in patients with advanced NSCLC.

BACKGROUND:Nitrogen monoxide (NO) plays dual effects in the occurrence and development of tumor. High concentration of NO exerts anticancer effect through cellular cytotoxicity and inducing the apoptosis of tumor; under the changed microenvironment in tumor tissue, its effect on tumor tissue is mainly promoting the growth of tumor.OBJECTIVE: To study the effect of the nitric oxide synthase(NOS)inhibitor NG-nitro-L-arginine methyl ester(L-NAME) on invasion and metastasis of human colorectal cancer cell line LS174T.DESIGN: Single sample observationSETTING: Department of Surgery, Tumor Hospital affiliated to Harbin Medical University MATERIALS: The study was conducted in Cancer Research Institute of Harbin Medical University between January 2004 and October 2004. The human colorectal cancer cell line LS174T was purchased from Cancer Research Institute of Harbin Medical University. L-NAME was purchased from Sigma Company.METHODS: LS174T cells were treated with L-NAME of 0.2,0.4,0.8 and 1.0 mmol/L. Effect of drugs on invasion and migration of LS174T cells was observed in reconstructed basement membrane invading experiment.MAIN OUTCOME MEASRES: Inhibitory rate of L-NAME on LS174T line invading reconstructed basement membrane and the inhibitory rate of cellular migration.RESULTS: ①0.2, 0.4, 0.8, 1.0 mmoL/L L-NAME were used to treate LS174T cells for 72 hours, and the inhibitory rate in cell invading reconstructed basement membrane was 10.29%, 19.62%, 34.08%,42.23% respectively (P ＜ 0.05 or 0.01 ). ② 0.2, 0.4, 0.8, 1.0 mmol/L L-NAME were used to treate LS174T cell for 72 hours , its inhibitory rate in inhibiting cells migration was 20.76%,24.95%,39.43%,46.85% respectively(P ＜ 0.01 ).CONCLUSION: L-NAME has anti-invasive and anti-metastasic effects on LS174T cells.

Objective To reveal the average pass rate of a general hospital's ethic review and common problems.Methods The records generated by the ethics committee of a hospital in 3 consecutive years were reviewed and analysed with ridit of CMH and Bootstrap statistical methods.Results The pass rate for drug clinical trial is 36.09%,medical instruments 18.42%,and subject evaluation 14.29%.Among the problems,those concerning informed consent take up 63.59%,of protocol 14.56%,of CRF 7.77% and of the others 22.820%.The domestic applicants had more problems than those abroad.Besides,the pass rate of drug trials decreased with year from 45.83% in 2006 to 19.44% in 2008,which was statistically significant (P=0.029).In terms of drug clinical trial,the pass rate of revised projects in foreign countries was significantly higher than the domestic ones (P=0.028).ConclusionEthics Committee in a hospital plays a very important role in clinical researches.And informed consent and research protocol are very important in the ethic review.

Objective To investigate the effect of N~G-nitro-L-arginine methyl ester (L-NAME), an inhibitor of nitric oxide synthase, on the growth of colorectal cancer xenografts in vivo and on tumor-associated neovascularization. Methods Twenty BALB/c nude mice were randomly divided into control group and study group equally. Human colorectal cancer cell line SL174T was inoculated subcutaneously into nude mice to form transplantation tumors. Saline 0.2 ml was intragastric-administrated to mice in control group and L-NAME (4 mg toties guoties) was administrated orally to mice in study group three times per week for four weeks. The changes of tumors in both groups were recorded and the microvessel density (MVD) was also measured by immunohistochemistry assay. Results L-NAME significantly inhibited the growth of colorectal cancer xenografts in nude mice. The weight of transplantation tumor reduced with the inhibitory rate of 41.36%, and the inhibitory rate of tumor volume was 43.48 % in study group. MVD in the study group and control group were 14.83?2.10 and 21.04?3.11, respectively, which showed that the former was significantly lower than that of the control group (P

Forearm ; Humans ; Reconstructive Surgical Procedures ; Surgical Flaps ; Tongue ; abnormalities ; injuries ; surgery

ObjectiveTo explore the application of the Structure Equation Model on validity assessment of the evaluation indicator system,we studied Medical Capital Development Fund projects in 2007 to evaluate their construct validity.MethodsPart of the evaluation results (1200 items) were divided into two parts randomly.PART1 was used for Exploratory Factor Analysis (EFA) to explore the Indicator System' structure,and formed model F1.Confirmatory Factor Analysis (CFA) was used to assess the construct validity of model F1.With considerations of Modification Index(MI) and reality,F1 was modified into F3.At last,we take PART2 as the sample to confirm F3.ResultThe results of model F3 fit indices showed a better fit.All the path coefficients,estimated load factors and other parameters were statistically significant.ConclusionStructural Equation Model is professional,reliable and satisfactory for the evaluation of indicator system's contract validity.