Objective To determine the clinical value of cytological diagnosis of the impressed specimens in the radical gastrectomy for patients with gastric cancer. Methods During radical gastrectomies for 52 patients with gastric cancer, 232 impressed specimens were taken from the tumor tissues,paratumor tissues, proximal and distal incision margin,and partial lymph nodes respectively, to detect if there was tumor cells by cytological examination and compared with the pathology. Results In the tumor tissues,there were no pseudo positive specimen,and the pseudo negative specimen occurred in 1.In the incision margin,there was no pseudo negative specimen,while 12 pseudo positive specimens were found.In the paratumor tissues,there were 3 pseudo negative and 10 pseudo positive specimens.In all specimens,the sensibility was 92.8%; specificity was 85.8%; accuracy rate was 87.9%. Conclusions Cytological examination of the impressed specimens in radical gastrectomy is helpful in detecting residue tumor tissue in the incision margin, especially in hospitals without rapid pathologic examination.If cytological examination is combined with rapid pathological examination,the results will be better.

Objective To explore the CT manifestations of non-functional islet cell tumor(NFICT)Methods The findings of plain and enhancement CT scanning from 17 cases with NFICT,which were confirmed by the surgeries and pathological sections,were analyzed retrospectively.Ninty ml of non-ioniodine contrast reagent with 3ml/s injection flow rate was employed as the enhancer for measuring the arteriovenous double phase CT value of the pancreas and tumor.Results Tumors were found in all the cases who received CT scan.Compared with pancreatic substance in the CT plain scan,tumors with low density were found in 2 cases,tumors with mixed low density in 11 cases and tumors with isodensity in 4 cases.Local calcification in tumor was found in 5 cases.Various degrees of strengthening were showed in 17 cases with enhancement scanning.Obvious enhancement in arterial phase presented in 5 cases,moderate enhancement in 6 cases and slight enhancement in 6 cases.Conclusions CT plain scan of NFICT shows that the tumor margins are clear and some tumors have calcification.All tumors in the CT enhancement scanning show various degrees of enhancement,the persistent enhancement from arterial phase to portal vein phase is the characteristic manifestation of NFICT.

ObjectiveTo evaluate the nutritional status of elderly Chinese operative patients with lung cancer as well as its correlation with postoperative complications through the application of modified mini-nutritional assessment (MNA) and short-form MNA (MNA-SF).MethodsOne hundred and fifty elderly Chinese patients with lung cancer underwent operation were enrolled in this study from June 2010 to June 2011.Collected information including preoperative nutritional evaluation in modified MNA and MNA-SF,general information of patients,disease status,anthropometric measurements,biochemical markers,and postoperative complications.ResultsAccording to the modified cutoff point of the full MNA in the 150patients (98 males,52 females),10.7％(16/150) patients were malnourished,32.0％(48/150) patients were at risk of malnutrition and 57.3％(86/150) patients were well nourished.MNA was (23.7 ± 3.8) scores.Positive correlations were found between MNA and body mass index (BMI),mid-arm circumference(MAC)and calf circumference (CC) (P ＜ 0.01 ).MNA-SF was ( 11.5 ± 2.4) scores.Positive correlations were found between MNA-SF and BMI,triceps skinfold (TSF),MAC,CC,MNA (P＜0.01 or ＜0.05).The incidence of postoperative complications was as following sequentially: respiratory complication was 37.4％ (55/147),cardiovascular complication was 31.3％(46/147),thoracic cavity complication was 0.7％( 1/147 ).There was no significant difference among groups in different numbers of complications (P=0.590) and among groups in different types of complications (P =0.601 ).ConclusionsModified MNA is suited to elderly Chinese operative patients with lung cancer.Evaluation shows that there is high prevalence of malnutrition among this population,and the correlations between MNA results and postoperative complications should be confirmed in further study.Positive correlations were found between MNA and body mass index (BMI),mid-arm circumference(MAC)and calf circumference (CC) (P ＜ 0.01 ).MNA-SF was ( 11.5 ± 2.4) scores.Positive correlations were found between MNA-SF and BMI,triceps skinfold (TSF),MAC,CC,MNA (P＜0.01 or ＜0.05).The incidence of postoperative complications was as following sequentially: respiratory complication was 37.4％ (55/147),cardiovascular complication was 31.3％(46/147),thoracic cavity complication was 0.7％( 1/147 ).There was no significant difference among groups in different numbers of complications (P=0.590) and among groups in different types of complications (P =0.601 ).ConclusionsModified MNA is suited to elderly Chinese operative patients with lung cancer.Evaluation shows that there is high prevalence of malnutrition among this population,and the correlations between MNA results and postoperative complications should be confirmed in further study.

Objective To study the evolution of renal cell carcinoma treated in a single institution over the past 12 years.Methods A total of 1923 patients with renal cell carcinoma surgically treated from 1999 to 2010 were included in this study.Age at diagnosis,gender,symptoms,tumor size,TNM stage,histological subtype,Fuhrman grade and type of treatment were compared among 3 periods (Period 1:1999-2002,Period 2:2003-2006,Period 3:2007-2010).Results The number of patients grew fasty from 267 cases in the Period 1 to 1092 cases in the Period 3.The incidentally diagnosed cases increased significantly from 49.8％ to 73.6％ (P ＜0.01),while the mean age of patients at diagnosis,the male to female ratio and the proportion of young (＜40 years old) patients were not statistically different.The tumor size at diagnosis gradually decreased from 6.1 cm to 4.8 cm (P ＜ 0.01),and the proportion of small tumors less than 4 cm increased remarkably from 30.3％ to 54.4％ (P ＜ 0.01).Concerning the surgical approach,open surgery decreased from 98.5％ to 73.8％ (P ＜ 0.01),and laparoscopic surgery increased from 1.50％ to 26.2％ (P ＜ 0.01).Overall,the rate of nephron-sparing surgery increased from 5.2％ to 34.7％ (P ＜0.01) in all cases.The use of nephron-sparing surgery increased significantly from 17.9％ to 54.7％ in T1a subset and from 0.00％ to 14.8％ in T1b subset respectively (P ＜ 0.01).Furthermore,radiofrequency ablation was applied and the percent of this approach reached 2.47％ in Period 3.Conclusions The evolution of clinical-pathological characteristics and surgical treatment for renal cell carcinoma in a single institution is apparent over the last 12 years.With the increase of incidentally diagnosed cases and small renal tumors,nephron-sparing surgery has been widely performed in T1 subset instead of traditional radical nephrectomy.

ObjectiveTo analyze the incidence of benign lesions in patients undergoing surgery for presumed renal cell carcinoma (RCC) and investigate the correlation of tumor size and histopathological characteristics.MethodsFrom Jan 2003 to Sep 2010,1531 patients (1042 males,489 females with average age of 55.1 years (15 -89 years) underwent nephrectomy.There were 1123 radical nephrectomies and 408 partial nephrectomies for solitary renal cortical neoplasms presumed to be RCC in preoperative imaging study.The pathological tumor size,the percentage of benign lesions and histologic subtypes were analyzed retrospectively.The correlation of Fuhrman grading and tumor size in clear cell type RCC and papillary RCC was investigated as well.Results Pathological examinations revealed that there were 81 (5.3％)benign lesions of 1531 patients.The incidence of benign lesions was 7.8％ in renal masses smaller than 4.0cm,3.8％ in masses with 4.1 - 7.0 cm,and 1.1％ in masses larger than 7.0 cm ( P ＜ 0.01 ).Angiomyolipoma was the most predominant histologic subtype in benign renal lesions with a frequency of 69.5％,52.6％ and 33.3％ in ≤4.0 cm,4.1 - 7.0 cm and ＞ 7.0 cm subgroups,respectively.Oncocytoma was present in 13.6％,15.8％ and 33.3％ of the benign lesions in the above 3 subgroups (P =0.47).One thousand four hundred and fifty cases of malignancies (94.7％) were identified.The frequency of clear cell type RCC was 91.7％ in malignant tumors smaller than 4.0 cm,88.1％ in 4.1 - 7.0 cm malignancies,and 77.6％ in tumors ＞7.0 cm； the frequency of papillary RCC was 4.0％,4.2％ and 7.7％ in the above 3 subgroups,and the frequency of chromophobe cell RCC was 3.6％,5.2％ and 6.3％ accordingly ( P ＜0.01 ).One thousand three hundred and seventeen cases of clear cell type RCC and papillary RCC with definite Fuhrman grading were identified.The probability of high grade tumors increased with size,while the probability of low-grade lesions decreased (r =0.94,P ＜ 0.01 ),especially for tumors smaller than 11.0cm.ConclusionsPatients in the present study population show a low incidence of benign renal lesions.Benign lesions are less common in larger tumors than in smaller ones.The proportion of clear cell type RCC decreases in larger tumors,however papillary RCC and chromophobe cell RCC are increasing.The probability of high-grade tumors increases with size.The correlation between tumor size and histopathological characteristics may be helpful in patients counseling and decision-making.

Objective: To determine the HIV infection of a 13-year-old leukemia patient Wei using molecular tracing technique. Methods: Three blood samples were collected from the persons who were associated with HIV positive blood donation member Lang. The viral load was tested and pol gene was sequenced and analyzed. At the same time using HyPhy2.2.4 and Cytoscape 3.6.1 to establish the molecular network with these 3 samples sequences and other HIV subtypes sequences obtained from Luzhou. Results: The HIV-1 viral load test result of the three patients were: Lang 933 CPS /ml (treated, blood donor), Wei (blood recipitent) 89 813 CPS /ml, Deng (blood recipitent) 85 158 CPS /ml. The subtype of HIV-1 of these three samples were all recombinant HIV CRF01_AE, and the pol gene similarity was 98.8% (Lang and Wei), 99.7% (Lang and Deng), and 99.1% (Wei and Deng), respectively. The gene sequences of the three samples were linked into clusters (the gene distance was less than 0.004). Conclusions The patient Wei with leukemia was infected with HIV-1 due to blood transfusion during the seroconversion period, and the three patients were more likely to be infected with the same HIV-1 strain. It is necessary to popularize the use of high-sensitivity nucleic acid detection method in blood collection and supply institutions, which can effectively improve the safety of blood use.

OBJECTIVE: To evaluate the utilization of functional neck dissection for treatment of recurrent branchial cleft anomalies. METHOD: Fifteen patients with recurrent branchial cleft anomalies (fistula and cyst) undergoing functional neck dissection were retrospectively analyzed. RESULT: Complications included 2 incisions secondary healing, 1 postoperative choking persisting for 1 months and 1 Horner's syndrome. There was no recurrence after a follow up from 2 months to 6 years,except 2 cases were lost to follow-up. CONCLUSION Functional neck dissection is an effective and safe surgical management for recurrent second and third branchial cleft anomalies(fistula and cyst).
Adolescent ; Adult ; Branchial Region ; abnormalities ; surgery ; Child ; Female ; Humans ; Male ; Neck ; surgery ; Neck Dissection ; methods ; Recurrence ; Retrospective Studies ; Young Adult

Summary: The expression of CD44v6 and its relationship with the development, progress, invasion and metastasis of laryngeal carcinoma was investigated. The expression and content of CD44v6 mRNA in tissuess were detected by both RT-PCR and FCM which were respectively extracted from normal laryngeal mucosa, leukoplakia of larynx, laryngeal papilloma, polyp of vocal cord, tissues of laryngeal carcinoma, metastatic and nonmetastatic lymph nodes of neck, and tissues close to carcinoma. The outcome of RT-PCR indicated that the expression rate of CD44v6 mRNA involved in tissues of laryngeal carcinoma and metastatic lymph nodes of neck was the highest (90 %-100 %) compared with that of leukoplakia of larynx, laryngeal papilloma, tissues close to carcinoma by 0.5 cm (55.56 %-60.00 %) and that of normal laryngeal mucosa, polyp of vocal cord, nonmetastatic lymph nodes and tissues close to carcinoma by 1.0 cm was the lowest ( 13.33 %-20 %). The result from FCM was highly consistent with that from RT-PCR. It was suggested that CD44v6 was closely related with the development, progress, invasion and metastasis of laryngeal carcinoma. The outcome from the tissues close to carcinoma by different distance could do help to the determination of incisal edge in surgery abstractly.

Objective To explore the clinical application value of prognostic nutritional index (PNI)for predicting overall survival(OS)in patients with advanced colorectal cancer.Methods Seventy-two patients with histologically confirmed colorectal cancer were enrolled in this study, and their clinical and laboratory data were reviewed.The PNI was calculated, and univariate and multivariate analysis was used to identify the potential prognostic factors for advanced colorectal cancer. Results PNI of the 72 colorectal cancer patients was 45.07 ± 5.98.PNI was significantly associated with age, weight loss and pleural effusion (P < 0.05). However, PNI showed no correlation with sex, clinical stage, smoking, bloody stool, abdominal mass, intestinal obstruction, histological type, radiotherapy and KPS scores (P>0.05).The median OS of the 72 patients was 12.9 months.The medium OS in the higher PNI group (PNI≥45.07)and lower PNI group(PNI≤45.07)was 15.7 months and 11.2 months, respectively.The 1-year survival rates were 78.4% and 60.5%, and 2-year survival rates were 53.1% and 20.8%, respectively(P<0.01).Univariate analysis showed that PNI, ages, and weight loss were related to the OS of the advanced colorectal cancer(P<0.05).Multivariate analysis identified PNI was an independent prognostic factor for OS of advanced colorectal cancer (P < 0.01). Conclusions PNI can be easily calculated, and may be used as a relatively new prognostic indicator for advanced colorectal cancer in clinical practice.

Objective To study the morbidity,pathogenesis,diagnosis and treatment of winged scapula.Methods The key words about "winged scapula" have been used to search articles which include winged scapula patients in English and Chinese literature databases from 1958 to 2017.The articles have been filtrated by title,abstract and full text.There are 36 articles used for this study.All the patients are objects of this study,but the same patients' data in different articles have not been used repeatedly.The patients' data have been collected as much as possible,including age,sex,causes,treatment,follow-up and so on.All the patients' data have been used for systematic analysis.Results All of 356 patients with winged scapula were selected from 36 literatures for systematic analysis.There were 213 cases of anterior saw muscle paralysis,among which 16 cases were physical exercise,11 cases were excellent and 5 cases were poor,with an excellent rate of 68.8％.There were 70 cases of neurolysis and transplantation,50 cases were excellent and 20 cases were poor,with an excellent rate of 71.4％.There were 3 cases of scapulectomy,1 case excellent and 2 cases poor.There were 124 cases of pectoralis major tendon metastasis,88 cases were excellent,36 cases were poor,and the excellent rate was 71％.There were 46 cases of trapezius paralysis,among which 14 cases were physical exercise,12 cases were excellent,2 cases were poor,and the excellent rate was 86％.1 case of scapulopexy and 1 case of superior,with an excellent rate of 100％;There were 31 cases of Eden-Lange 31 cases,27 cases of excellent and 4 cases of poor.One case of rhomboid myoplegia was treated,including 1 case of rehabilitation training (ultrasound guidance),1 case of excellent,with an excellent rate of 100％.There were 96 cases of muscular dystrophy,including 96 cases of scapulectomy,76 cases of excellent and 20 cases of poor,with an excellent rate of 79.1％.Conclusion Winged scapula is rare and its incidence is unknown,different causes determine different treatments:Anterior saw muscle palsy is more suitable for thoracolumbar tendon transfer,and modified Eden-Lange is more suitable for trapezius palsy.