Caudate lobectomy is still a great challenge for surgeons due to unique anatomy of caudate lobe.A 38-year-old male patient with a huge recurrent hepatic cancer (diameter =16 cm) in caudate lobe received caudate lobectomy with portal triad and inferior vena cava clamping.The operation was paused due to hemorrhage (volume of blood loss =1000 ml).After heat preservation and blood transfusion,the caudate lobectomy was completely removed with inferior vena cava clamping.The patient gradually recovered,and no tumor recurrence was detected during the follow up (14 months).Caudate lobectomy could be safely carried out under the condition of accurate preoperational estimation,clear indication for surgery and precise hepatectomy.

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.

Objective To summarize and analyze the examination result of serum specific IgE in patient with allergic skin disease,and seek the cause of disease for the allergic skin disease patient and provide the clinical treatment basis.Methods The serum specific IgE of ingestion and inhalation were detected by enzyme-linked immunoassay in 529 patient with allergic skin disease.Results In 529 cases,the serum specific IgE of inhalation and ingestion were positive in 336 cases,and simple positive of inhalation were in 92 cases,and simple positive of ingestion were in 51 cases.In the inhalation group,D1,1D2 (dust mites,mites) was highest,followed by T3,T8,T11,T18,T70 (birch,elm,eucalyptus,and indus,and the mulberry tree) and H1 (house dust).In the ingestion group,F13,F17 (peanut,hazelnut) was highest,followed by F3,F40,F37 (COD,tuna,scallop),F47,F48,F263 (garlic,onion,green pepper).In 14 items,more than one item were positive in 96.2％.Concluslon Detecting allergic skin disease patients serum allergen specific IgE can guide patient awareness of their allergen and clinical treatment,which has effect on allergic skin disease prevention and treatment.

ObjectiveTo explore the influence of different hemostatic measures of laparoscopic ovarian cyst removed on ovarian function.MethodsSeventy patients with ovarian cyst who performed laparoscopic ovarian cysts removed between January 2009 and December 2010 were randomly divided into group Ⅰ (23 cases) and group Ⅱ (47 cases) by mechanical sampling.Group Ⅰ with bleeding electrocautery,group Ⅱ with suture.Estradiol,follicle puncture hormone (FSH),luteinizing hormone (LH),number of sinusoidal follicles,normal ovarian function and the number of declining ovarian reserve were compared in two groups before operation and after 6 months operation.ResultsAfter operation,the proportion of group Ⅱ with normal ovarian function was significantly higher than that of group Ⅰ[80.9％(38/47) vs.39.1％(9/23),P ＜ 0.05 ],estradiol and number of sinusoidal follicles were significantly higher than those of group Ⅰ [( 198.4 ± 24.4) pmol/L vs.( 153.4 ± 16.8) pmol/L,7.1 ± 2.4 vs.5.8 ± 0.9](P＜ 0.05),FSH and FSH/LH were significantly lower than those of group Ⅰ[ ( 10.58 ± 4.57) U/L vs. ( 13.72 ± 2.58) U/L,2.34 ± 1.32 vs.2.82 ± 0.88 ] (P ＜ 0.05).ConclusionDuring laparoscopic ovarian cyst removed,using electrocautery can significantly reduce residual ovarian function,but using suture hemostasis can effectively protect residualovarian function.

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.

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

Objective To analyze the imaging appearances of the deep-lobe parotid tumors involving the parapharyngeal space (PPS).Methods The CT and MRI data of 23 cases with deep-lobe parotid tumors involving PPS were analyzed retrospectively.The neoplasms included pleomorphic adenomas (n=1 9),basal cell adenomas (n =2),neurilemmomas(n = 1 )and malignant myoepi-thelioma(n=1).Results The lesions presented as oval(n=1 7)or irregular (n =6)masses.None of the 23 cases showed visible fat space between the tumors and deep-lobe of parotid glands.Fat Cap Sign was found in 9 cases.Parotid Pedicle Sign was demonstrated in 8 cases.The styloids were displaced posteriorly(n=4)or surrounded(n=4)by the tumors.Five masses were found to be situated at the superficial side to the posterior belly of the digastric muscle.Carotid sheaths were shifted anteromedially (n=7)or postero-medially(n= 1 1 )by the tumors.Conclusion The deep-lobe parotid tumors involving PPS have some imaging features which are helpful in the differential diagnosis between the deep-lobe parotid tumors and PPS primary tumors.

Objective To evaluate the diagnostic value of serum cardiac fatty acid binding protein (H-FABP), high sensitivity C-reactive protein (hs-CRP) and cardiac troponin T (cTnT) in the diagnosis of myocardial infarction. Methods From August 2015 to July 2016, 50 patients with myocardial infarction were treated as group A, and 48 patients with chest pain caused by other factors were treated as group B, and 53 patients were selected in our hospital physical examination of patients without chest pain as C group. The levels of H-FABP, hs-CRP and cTnT were compared between the three groups. The levels of H-FABP, hs-CRP and cTnT in patients with myocardial infarction at 5 h, 10 h, 24 h and 3 d after admission were compared . Results The positive rate of serum H-FABP, hs-CRP and cTnT in group A was significantly higher than that in group B, group C[(82.00％, 41.00), 68.00％ (34/50), 76.00％ (38/50) VS 8.33％(4/48), 14.58％(7/48),10.42％(5/48) VS 0.00％(0/53),0.00％(0/53),0.00％(0/53)], and the difference was statistically significant (P<0.05). The positive rate of H-FABP and hs-CRP was higher than that of admission at 10 h, 24 h and 3 d at 5 h after admission. The positive rate of cTnT was higher than that at 5 h, 24 h and 3 d at admission (P<0.05). The positive rate of H-FABP was significantly higher than that of the control group (P<0.05). Conclusion Combined detection of serum H-FABP, hs-CRP and cTnT can improve the diagnostic value of myocardial infarction and reduce the misdiagnosis rate.

Objective:To retrospectively study the effect and curative effectiveness of ethanol in treating HCC with portal vein tumor thrombus(PVVT) through transcatheter fed arterial super selective infusion and super selective arterial embolization of main tumor,appraise the effect of ethanol in local treatment,in order to improve the clinical curative effects on the patients. Methods:The data of study from 86 cases of HCC with PVVT in our hospital between 2001~2004 year,to the fed artery of portal vein tumor thrombus super selective infusion ethanol or ethanol and gelfoam or ethanol and lipiodol,also through transcatheter super selective embolizing the fed arterys of main tumors including TACE or ethanol and lipiodol in 86 cases HCC. The course of observation was between 2001 and 2007year. Results:The super selective fed arterial embolization of PVVT and main tumors were successful in all cases;After treatment,ascites disappeared or obviously reduced in 66.3%(57/86) of cases,reduce in 23.2%(20/86),did not reduce in 10.5%(9/86);After 7~10d,hepatic function obviously improve or improve in 71%(61/86),did not obviously change in 11.6%(10/86),lowered in 6%(5/86),with no obvious lowering of hepatic function or hepatic function failure.The survival rates at 3,6,12,24,36months were 97.7%(84/86),95.5%(82/86),72.7%(62/86),47.7%(41/86) and 16.3%(14/86) respectively. Conclusion:The therapy of ethanol through catheter super selective PVVT fed arterial infusion is safe and effective,combined with super selective TAE or TACE to the fed artery of main tumor,could obviously improve the quality of life of the patients and could improve the survival rate.

Objective:To modify the method of making oral impression and improve the successful rate.Methods:Rubber band was used to fill in the brackets before making oral impression.Two kinds of ways,the modified and the traditional,were used for each patient.Then the successful rate was compared between two groups.Results:There is statistically significant difference in the successful rate between the traditional group and the modified group ( P