Objective To assess the change of CEA in the peritoneal lavage fluit at pre-,post-laparoscopy-assisted radical gastrectomy, and after hyperthermic perfusion chemotherapy, and to investigate the influence of laparoscopy-assisted radical gastrectomy on drop off of cancer cells, the efficiency of hyperthermic perfusion chemotherapy. To investigate whether CEA in the peritoneal lavage fluit detected by flow cytometry (FCM) is an effective predictor of intraperitoneal free cancer cells and peritoneal metastasis. Methods Peritoneal washings of 40 patients with gastric carcinoma were collected to detect CEA using FCM. The peritoneal lavage cytology examinations ( PLC)were detected by H-E staining. Results Laparoscopic surgery in patients with gastric cancer,before resection of gastric cancer the peritoneal washing CEA positive rate 35. 0% (14/40) ,and after operation, the positive rate was 40. 0% ( 16/40) .which was not significantly higher than that before operation ( P > 0. 05 ). After intraperitoneal hyperthermic perfusion chemotherapy the CEA positive rate was 7. 5% (3/40) ,which was significantly lower than that pre-operation(P<0. 05). Before operation there were 4 cases of positive PLC in the peritoneal lavage fluid, 14 CEA-positive detected by flow cytometry, and there was significant difference ( P < 0. 05 ) . All PLC-positive cases were positive for CEA, whereas 10 PLC-negative cases showed CEA-positive. None of CEA-negative cases showed PLC-positive. Conclusions Laparoscopic radical gastrectomy does not increase the intra-abdominal gastric cancer cell shedding. Intraoperative hyperthermic perfusion chemotherapy is simple and feasible approach with high efficiency.Peritoneal washing CEA detected by flow cytometry is an effective index to predictor for intraperitoneal free cancer cells and prediction of peritoneal metastasis.

Background and purpose:The morbidity of the elderly patients with hepatic portal cholangiocarcinoma is rising. Due to the characteristics of pathology,physiology and anatomy of the disease, most of the patients with cancer are not resectable, the main treatment consists of the diverting drainage and postoperative chemoradiation.We studied the clinical features and the effective therapeutic method for the elderly patients with hepatic portal cholangiocarcinoma. Methods:A retrospective analysis was performed in 28 cases of the elderly patients with hepatic portal cholangiocarcinoma who were treated between January 1995 and December 2005 in our hospital.Results:3 cases received surgery, 2 of them survived for over three years, another 3 cases were given operative exploration with 14 months of medium survival time. 22 cases were given internal or external drainage and received radiotherapy after operation, their survival time ranged from 5 months to 40 months.Conclusions:Surgery is the primary therapeutic method for elderly patients with hepatic portal cholangiocarcinoma. Internal or external drainage and radiotherapy could prolong survival time of the patients with unresectabke disease.

Objective To investigate the detection of peritoneal free cancer cells and its clinical significance. Methods The peritoneal free cancer cells,the positive rates of CK20 protein and CK20 mRNA expressions of peritoneal lavage fluid were detected by peritoneal lavage cytology (PLC),flow cytometry (FCM) and real-time fluorescent quantitative RT-PCR in 50 cases of gastric cancer patients,respectively. The sensitivity of three kinds of detection method to peritoneal free cancer cells was compared. Results The positive rates of peritoneal free cancer cells,CK20 protein and mRNA expression of peritoneal lavage fluid were 20.0% (10/50),36.0% (18/50) and 58.0% (29/50),respectively. The positive rate of CK20 mRNA expression detected by real-time fluorescencequantitative RT-PCR in peritoneal lavage fluid was significantly higher than those of the CK20 protein expression detected by FCM and peritoneal free cancer cells detected by PLC (P0.05). The positive rate of CK20 mRNA expression of peritoneal lavage fluid was related to the tumor invasion depth,differentiation degree,TNM stage,and lymph node metastasis (P

Objective To study the significance of repeated washing in reducing the positive rate of intra-abdominal exfoliated cancer cells. Methods Sequential intraoperative peritoneal lavages were performed in each of the 160 patients with gastric cancer one time before tumor resection,three times after excision.Four sub-peritoneal washing fluid was assayed for cytology smears with routine pathology.The results were then compared. Results Exfoliated tumor cells were positive in the intraoperative peritoneal lavages of 56 patients before resention.Exfoliated tumor cells were positive in the first three intraoperative peritoneal lavages of 64 patients before resention,42 at the second,3 at the third.Tumor cells positive and forward setting lotion shed after the first time,with the number of detected cases increased but had no significant statistical significance.Compaving the positive result of the 3rd exfoliated cancer cells with the first 1,we found that the difference was statistically significant. Conclusion Sequential intraoperative peritoneal lavages is an useful method in reducing the positive rate of peritoneal exfoliated tumor cells in patients with gastric cancer.

Objective To investigate the expression of calpains and calpastatin in diaphragm of a rat model of chronic obstructive pulmonary disease(COPD). Methods Fotry male Wistar rats were randomly divided into the control group and the COPD group. Rats in the COPD group were copied by expo -sing to cigarettes smoking and dripping lipopolysaccharide into trachea. Pathological changes of lung and diaphragm were deteted. Immunohis-tochemistry and RT-PCR were performed to determine protein and mRNA expression of calapins and calpastatin. Results Diaphragmatic atrophy was observed in rats in the COPD group instead of the control group. The protein and mRNA expression of calpains in diaphrag-m of COPD group were Increased than those in the control group(P < 0.05). On the contrary ,the expression of calpastatin was significantly reduced in rats in the COPD group(t =-9.38 and-2.97;P < 0.001 ,P = 0.005). Conclusions An imbalance in the expression of calpains/calpastatin in diaphragm was observed in COPD rats ,and this imbalance may be responsible for diaphragm atrophy.

Objective To observe the distribution of sentinel nodes(SN) in gastric cancer,and investigate their clinical significance.Methods The extent and features of intraoperatively stained sentinel nodes in 288 cases of gastric cancer were analyzed retrospectively.Methylene blue was injected intraoperatively into the(subseral) muscle and submucosa of the normal gastric wall adjacent to the neoplasms,then lymphadenography was performed,and the nodes were resected for histopathological examination.Results The pathological(diagnosis) of the 288 cases with gastric cancer was T_1 in 102 cases,T_2 106 cases and T_3 60 cases.Stained nodes were detectable in 270 cases(success rate: 93.8%).One hundred and two cases were found to have lymph node metastasis;66 cases had metastasis in both SNs and non-SNs;18 cases in SNs alone;and 18 cases in non-SNs alone.Conclusions Sentinel lymph nodes can accurately predict the lymph node metastatic status of gastric cancer patients during operation.Intraoperative sentinal lymph node mapping can avoid routine lymph node dissection in patients with gastric cancer with negative lymph node metastasis.

Objective: To evaluate the therapeutic efficacy of acupuncture plus Dang Gui Bu Xue Qu Feng Tang for benign essential blepharospasm (BEB). Methods: A prospective randomized controlled trial was performed. A total of 105 participants were randomized 1:1:1 into an acupuncture group, a herbal medicine group and an acupuncture plus herbal medicine group. Participants in the acupuncture group received manual acupuncture treatment, twice a week. Participants in the herbal medicine group received Dang Gui Bu Xue Qu Feng Tang, oral administration, once a day. Participants in the acupuncture plus herbal medicine group received both treatments. The therapeutic effects of the three groups were evaluated after four weeks of treatment. The primary outcome was the Jankovic rating scale (JRS) score, and the secondary outcome was the blepharospasm disability index (BSDI) score. Results: After four weeks of treatment, the JRS total scores significantly decreased in all three groups versus baseline (P<0.05). A greater reduction in the JRS total score was reported in participants in the acupuncture plus herbal medicine group (P<0.05), but there was no significant difference between the acupuncture group and the herbal medicine group (P>0.05). The acupuncture plus herbal medicine group had a greater decrease in the JRS severity score than the herbal medicine group (P<0.05). The reduction in the JRS frequency score was not significantly different among the three groups (P>0.05). The BSDI scores significantly decreased in all three groups versus baseline (P<0.05), but the reduction in the BSDI score was insignificantly different among the three groups (P>0.05). Conclusion: It is effective in the treatment of BEB either to use acupuncture and Dang Gui Bu Xue Qu Feng Tang alone or in combination. The combination therapy shows a more significant effect than either of the treatment alone.

Objective: To observe the clinical efficacy of electroacupuncture (EA) in controlling myopia in children and its effect on retinal blood flow. Methods: Sixty-eight myopic children were randomly divided into an observation group and a control group, with 34 cases in each group. The control group was given auricular acupressure treatment alone, and the observation group was treated with EA once a week in addition to the treatment used in the control group. The spherical equivalent refraction (SER) and axial length (AL) were measured at baseline, and after 3 months and 6 months of treatment. Optical coherence tomography angiography was used to measure the vessel density (VD) and perfusion density (PD) in the surface layer of the retina. Results: After 3 months and 6 months of treatment, the changes in SER between the two groups were not statistically significant (P>0.05). After 3 months of treatment, the changes in AL between the two groups were not statistically significant (P>0.05); after 6 months of treatment, the change amount of AL in the observation group was smaller than that in the control group (P<0.05); after 3 months and 6 months of treatment, the changes in VD and PD in the surface layer of the retina in the observation group were significantly greater than those in the control group (P<0.01). Conclusion: EA treatment once a week for 6 months can delay the increase of AL and improve the retinal surface blood flow in myopic children.

Objective:To observe the effect of acupuncture in the treatment of accommodative myopia in children.Methods:A total of 76 children with accommodative myopia who met the inclusion criteria were divided into a control group or a test group according to the random number table method,with 38 cases in each group.The control group was given education on eye hygiene,and the test group was treated with acupuncture twice a week for 2 months in addition to the intervention used in the control group.The patient's uncorrected visual acuity(UCVA),refraction,and axial length(AL)were measured before treatment and 1 month and 2 months after treatment.Results:After 1 month of treatment,there was no significant difference in the UCVA between the two groups(P＞0.05);after 2 months of treatment,the UCVA of the test group was better than that of the control group(P＜0.05).After 1 and 2 months of treatment,the refraction of the two groups was significantly different from that before treatment(P＜0.01),but there was no significant difference between the two groups(P＞0.05).After 1 and 2 months of treatment,the AL in the control group was increased compared with that before treatment(P＜0.05),while there was no significant change in the test group(P＞0.05),and there was no significant difference between the two groups(P＞0.05).Conclusion:Acupuncture treatment can improve UCVA in children with accommodative myopia.

Objective To study the clinical efficacy and adverse reactions of the preoperative neo-adjuvant chemotherapy with oxaliplatin plus fluorouracil and calcium folinate (FOLFOX) in the treatment of advanced gastric carcinoma that was difficult to undergo radical operation. Methods We enrolled 16 patients with advanced gastric carcinomas that were unable to undergo radical operation admitted to our hospital from April 2008 to October 2009. The neo-adjuvant chemotherapy regimen was oxaliplatin 130 mg/m~2 for first one, fluorouracil 500 mg/m~2 and calcium folinate 200 mg/m~2 from first day to fifth day,and one treatment course was three weeks and the patients underwent two courses.The changes of the primary lesion and the adverse reactions of the patients were observed. Results Carcinomas of 13 patients were degraded after the treatment, of which, 11 patients underwent radical resections after 4-6 weeks after operation.There were two cases of complete remission (CR) , 10 cases of partial remission (PR), three cases of stable disease(SD) and one case of progress disease(PD) , and the total effective rate was 75.0% (12/16). Adverse reactions included bone marrow suppression, diarrhea, nausea and vomiting and paresthesia, which were relieved after appropriate symptomatic treatment. Conclusions Neoadjuvant chemotherapy with FOLFOX can improve the resection rate of the advanced gastric carcinoma that is unable to undergo radical resection, and the patients' tolerability to this regimen is favorable.Thus, the regimen is worthy of generalizing.