China ; General Surgery ; history ; History, 20th Century

Hepatocellular carcinoma (HCC) is the most common malignant cancer in China. The size of HCC can be categorized into 4 grades: (1) micro-HCC, the diameter of the HCC is ≤2 cm; (2) small HCC, the diameter of the HCC is between 2 and 5 cm; (3) large HCC, the diameter of the HCC is between 5 and 10 cm; (4) giant HCC, the diameter of the HCC is > 10 era. The new classification helps to choose the appropriate methods and to analyze the curative effect for various kinds of HCC respectively. The resection of large and giant HCC is safe and feasible. During the past 20 years, we have modified and innovated some techniques of HCC surgery, including hepatectomy without dissecting the hepatic hilus, increasing the safety time limit of portal pedicle occlusion from 15-20 minutes to 20-60 minutes, in situ bepatectomy with occlusion of hepatoduodenal ligament and infrahepatic vena cava, and double hanging maneuver techniques. The techniques mentioned above improved the bleeding control of hepatectomy, and enhanced the long-term survival rate of HCC patients.

Objective To investigate the role and expression of serum substance P (SP) in the patients with breast cancer.Methods The quantity of serum SP by using ELISA in 21 patients with breast cancer (breast cancer group) and 10 healthy women (control group) were detected,the data were analyzed according to AJCC guide line.Results The positive rate of serum SP in breast cancer group was significantly higher than that in control group [57.1％ (12/21) vs.0] (P ＜ 0.01).The level of serum SP in breast cancer group was significantly higher than that in control group [(240.14 ± 435.04) ng/L vs.(16.80 ± 11.74) ng/L](t =2.9852,P ＜ 0.01).There was no relationship between serum SP and estrogen receptor in the patients with breast cancer (t =0.1856,P ＞ 0.05).The level of serum SP showed significantly difference according to AJCC stages respectively (F =3.24,P ＜ 0.05).Conclusion The level of serum SP in the patients with breast cancer increase and may play a role in the progress of breast cancer.

China ; Surgery/*history

Objective　To improve the treatment effect of primary hepatic cancer (PHC). Methods　Analysis of the influential factors on treatment effect of PHC in China, and propose the countermeasure. Results and Conclusions　The main factors influencing the treatment effect of PHC in China are the followings: (1) Most patients with PHC of subclinical type failed to be diagnosed and treatment in time. (2) As a wrong idea PHC has been considered an “uncurable disease", so the treatment strategy is nagative. (3) Unsuitable choice of treatment resulted in some PHC unable to be resected. (4) Intraoperative massive bleeding due to unskill-operative techniques, increase the postoperative morbidity and mortality. (5) The manner of treatment is not positive for PHC patients with portal cancer thrombosis, bile duct cancer hteombosis and portal hyperlension. (6) Combined therapy can not be used or unsuitably used. The following things should be done in order to improve the treatment effect of PHC: (1) Strengthening improving the health-protective consciousness of people and regular examinaton of “high risk" population. (2) Renewing the professional knowledge in time to improve the level of diagnosis, treatment and operative techniques of medical personnel. (3) strengthening the basic medical research to make a break through in PHC treatment.

The robotic surgical system can provide a stable, clear and magnified three-dimensional view, filter the surgeon's hand tremor, and hold robotic arms with multiple degrees of freedom to ensure flexible and stable operations, which overcomes the shortcomings of traditional laparoscopy. Although the robotic surgical system has been widely used in surgical fields such as urology, obstetrics and gynecology, its role in hepatic surgery has not been fully recognized. In this article, based on the relevant literatures and their own experience, the authors briefly discuss the indications of the application of robotic surgical system in liver surgery, safety and efficacy of robotic liver resection, learning curve of robotic hepatectomy, difficult robotic hepatectomy, the cost of robotic liver resection and other issues.

To observe the effects of Danshen on the growth of hepatocellular carcinoma in the SD rats, a model of malignant obstructive jaundice was established by inoculation of transplanted tumor into the hepatic portal with the walker-256 hepatocarcine line, which resulted in the obstruction by the infiltration and metastasis of hepatocellular carcinoma. SD rats were divided into 4 groups: the rats were treated by 0.9 % NS (n=24, control group), inosine+vitamin C (n=40, InV group), Danshen (n=40, DS group) and 5-FU (n=40, 5-FU group), respectively. The liver function, morphological changes and the expressions of PCNA, VEGF and ICAM-1 in carcinoma foci, peri-carcinoma tissues, adjacent lobe (left-internal lobe) and lung tissues were observed after the treatment with the 4 agents. Our results showed that the protective effect of Danshen on liver function was significantly better than that of NS and 5-FU (P<0.01). No significant difference in protective effect was observed between DS group and InV group (P>0.05). Danshen also provided protective effect on the morphological damage of liver caused by obstructive jaundice. The rates of carcinoma-inhibition and metastasis inhibition were significantly higher than those of NS and inosine+vitamin C (P<0.01). No significant difference in this regard existed between DS group and 5-FU group (P>0.05). The expressions of PCNA,VEGF and ICAM-1 PCNA, VEGF and ICAM-1 in carcinoma foci, peri-carcinoma tissues, adjacent lobe (left-internal lobe) and lung tissues were lower than those in control group and InV group, with the differences being significant (P<0.01). No significant differences were found between DS group and 5-FU group in the expression levels of PCNA and VEGF (P>0.05) but ICAM-1 (P<0.05). It is concluded that Danshen injection not only has protective effects on liver injury caused by obstructive jaundice, but can inhibit the proliferation and growth of hepatocarcinoma, interfere with the vascularization of tumors, prevent recurrence and metastasis of hepatocarcineoma.

Breast cancer is one of the most common malignant tumor for women, and early and accurate diagnosis of the breast diseases may improve the therapy and prognosis. MRI gains advantages in the diagnosis of the breast diseases, and thus is an important tool for the imaging diagnosis of the breast. The examination modes of MRI were introduced for the diagnosis of the breast cancer, especially the application in high risk population. The limit and research progress of MRI were analyzed for breast cancer staging, pre-operative examination, therapeutic effect assessment for radiotherapy and chemotherapy, the relationship between the markers and imaging findings.

Objective To improve the treatment effect of primary hepatic cancer (PHC). Methods Analysis of the influential factors on treatment effect of PHC in China, and propose the countermeasure. Results and Conclusions The main factors influencing the treatment effect of PHC in China are the followings: (1) Most patients with PHC of subclinical type failed to be diagnosed and treatment in time. (2) As a wrong idea PHC has been considered an “uncurable disease", so the treatment strategy is nagative. (3) Unsuitable choice of treatment resulted in some PHC unable to be resected. (4) Intraoperative massive bleeding due to unskill-operative techniques, increase the postoperative morbidity and mortality. (5) The manner of treatment is not positive for PHC patients with portal cancer thrombosis, bile duct cancer hteombosis and portal hyperlension. (6) Combined therapy can not be used or unsuitably used. The following things should be done in order to improve the treatment effect of PHC: (1) Strengthening improving the health-protective consciousness of people and regular examinaton of “high risk" population. (2) Renewing the professional knowledge in time to improve the level of diagnosis, treatment and operative techniques of medical personnel. (3) strengthening the basic medical research to make a break through in PHC treatment.

ObjectiveTo study the relationship among serum levels of interleukin-12 (IL-12), interleukin-2 (IL-2), and soluble interleukin-2 receptor (sIL-2R) in patients with hepatocellular carcinoma (HCC).Methods60 patients were randomized into two groups, group A (n=30) received IL-2 (1 MIU?day -1 for seven days), group B (n=30) served as control. Venous blood levels of IL-12?IL-2 and sIL-2R in all patients were measured by enzyme-linked immunosorbent assay (ELISA) before and after the IL-2 administration. Results There was positive correlation between serum levels of IL-2 and IL-12, negative correlation between serum levels of IL-2 and sIL-2R and no correlation between that of IL-12 and sIL-2R. Mean serum levels of IL-12,IL-2 and sIL-2R significantly (P