The development of gastrointestinal minimally invasive surgery in China is changing during the past decade.The Chinese laparoscopic gastrointestinal surgery study (CLASS) group as the earliest and most closely cooperated organization for surgical clinical researches,under the support of Chinese Medical Association,Chinese Anti-cancer Association and Chinese Medical Doctor Association,the clinical research capacity and minimally invasive technology of the CLASS group continue to be developed.With the launch of the prospective,randomized,controlled CLASS-01 trial for the treatment of locally advanced gastric cancer in 2012 and the publication of safety results of laparoscopic surgery for gastric cancer in 2016,the international academic community is increasingly focusing its attention on China.This article attempts to review the history and development of the CLASS group in the past 7 years,aiming to prospect the future and attempt to create trends.

Purpose To investigate the correlation of the expression of Cyclin D1 and BRAF ( V600E) mutation in papillary thyroid carcinoma ( PTC) and their clinical significance, and to analyze their role in the pathogenesis of PTC. Methods The expression of CK34βE12 and MC protein was detected by immunohistochemical EnVision method in 52 cases of PTC and 52 cases of thyroid benign lesions (25 cases of nodular goiters, 15 cases of Hashimoto’s thyroiditis, 12 cases of follicular adenoma), and the mutation status of BRAF gene protein in above specimens were detected by polymerase chain reaction and DNA sequencing. Expression of Cyclin D1 and BRAF (V600E) mutation in papillary thyroid carcinoma and their correlation clinicopathologic features were also analyzed. Results The positive rate of Cyclin D1 in 88 cases of PTC was 84. 6%,and the immunoreactivity score (4. 6 ± 2. 4), compared with thyroid be-nign lesions (1. 3 ± 1. 6), was statistically significant difference (t=8. 525, P<0. 01). Expression of Cyclin D1 was closely related with lymph node metastasis, capsular invasion, tumor stage Ⅲ+Ⅳ and BRAF (V600E) mutation (P<0. 05), but not related with age, gender, number and diameter of tumor nodules. In 52 cases of PTC BRAF gene mutation rate was 63. 5%, but in thyroid benign lesions mutation rate was 0, with significant difference (P<0. 01). The BRAF mutation is closely related with lymph node metastasis, capsular invasion and tumor stage Ⅲ+Ⅳ(P<0. 05), but not related with age, gender, number and diameter of tumor nodules. The expression of Cyclin D1 in BRAF (V600E) mutation group was stronger, the positive expression rate was significantly higher than that of wild group (100% vs 57. 9%), and expression of the mean score was higher than that of the wild group (5. 7 ± 1. 6 vs 4. 0 ± 2. 5);the comparison between the two groups showed statistical difference (t=2. 652, P<0. 05). Conclusions The expression of Cyclin D1 and BRAF (V600E) mutation are positively related, which are also closely related with the occurrence and development of PTC, and can be used as an index to predict the invasion and metastasis in PTC.

Objective:To evaluate the reliability and accuracy of 3DSS-Ⅱ color structured-light scanning system for scanning and reconstructing the model of abutment tooth.Methods:5 plaster maxillary abutment tooth models were scanned and reconstructed by 3DSS-Ⅱ color structured-light scanning system,and then the 3D shapes of the models were measured by Geomagic 6.0 software and the plaster models were measured by manual with vernier caliper.The data were statistically analyzed.Results:The graphs of point-cloud were obtained from scanning surfaces of abutment tooth models.There were close correlations and no significant differences between different groups(r≈1,P

Objective To further develop SDE for structured documentation of clinical data based on medical ontology. Methods OpenSDE was customized for the broad domain of medical ontology: medical concepts and its descriptors from history taking and physical examination were modeled into a tree structure. Results An expandable EMR system with structured data entry was developed. Conclusion Structured data entry is significant to clinical decision based on EMR.

Objective To focus on the expressiveness and flexibility of OpenSDE: an application that supports recording of structured narrative data. Methods OpenSDE enabled data entry with (customizable) forms based on trees of medical concepts. The relevant scope for data entry could be tailored per medical domain by construction of a domain-specific tree. OpenSDE was intended for structuring narrative data to make these available for both care and research. Results The OpenSDE application was used at two departments in aspects of radiology, neurology, pediatrics, and child psychiatry. Conclusion OpenSDE is superior to traditional text entry method in aspects of correct and full expression and clinical decision support.

Merely having complete sequences of genomes is not sufficient to elucidate biological function. Proteomics is complementary to genomics because it focuses on the large scared gene products, which are the active agents in cells. As almost all the drugs are directed against proteins, proteomics have been widely used in pharmacological research.Proteomics profiling in drug target identification, toxicological and drug resistances research was reviewed.

In recent years,laparoscopic total gastrectomy (LTG) with lymphadenectomy is increasingly utilized for the management of gastric cancer located in the middle or upper third of the stomach.However,esophagojejunostomy is the key technical difficulty in operation.Compared with conventional extracorporeal esophagojejunostomy via mini-laparotomy,pioneers are attempting to perform intracorporeal anastomosis in order to gain better manipulation and minimally invasive benefits,as well as reducing the difficulties in digestive tract reconstruction.

Liver transplantation has become the most effective treatment option for end-stage liver diseases.The liver donation after cardiac death (DCD) had been increasingly used in clinical practice.Nevertheless,the DCD donated livers inevitably exposed to long-term ischemia and hypoxia makes the implanted organs with decreased function and more postoperative complications.Different from the conventional static cold storage,machine perfusion (MP) can be continuously used in vitro liver perfusion,which could simulate the in vivo liver status.Through the observation of ischemia injury status,we could evaluate the quality of donated liver,and thus reduce ischemia related complications.This review provides an overview and evaluation on the markers that have been investigated for the assessment of graft quality and viability testing during different types of MP.

Objective To investigate the repair function of extracorporeal membrane oxygenation (ECMO) in vivo for the liver after cardiac death with warm ischemia injury for 30 min from cardiac death swinc.Method Ten landraces,30 to 40 kg,randomized to experimental group and control group,were used to make 30-min cardiac death models through clamping trachea after deep anesthesia.An intravenous cannula was placed through right iliac arteries and veins,and connected to ECMO extracorporeal circulation pipes in experimental group.The balloon catheter was placed to diaphragm plane through left femoral artery.The ECMO was performed to infuse abdominal organs,and pH and electrolyte were adjusted.The circulation flow rate,intraperitoneal organ perfusion pressure,venous blood gas,electrolyte,transaminase,and bile product,etc.were monitored and recorded.The livers of control group were retrieved after 30-min cardiac arrest and stored in cold UW for 4 h.Pathological tissue was sliced and stained by HE.Result After 30-min cardiac arrest,the liver showed obvious congestion appearance; pathologically,there were hepatic sinus expansion,blood cells clog,and erythrocyte aggregation.Circulating blood gas analysis revealed severe acidosis.After the ECMO recirculation started,circulation flow rate maintained to 1 L/min,the liver gradually restored bright red,pathological biopsy showed that hepatic sinus expansion disappeared,and clogged blood cells dispelled.AST was markedly increased to (226.0 ± 28.0) U/L after 30-min cardiac arrest and reduced to (150.0 ± 30.0) U/L 4 h after the ECMO recirculation.Average bile production was 7.75 ml/h.Conclusion ECMO recirculation in vivo can repair the injured livers from cardiac death donor with 30-min cardiac arrest.

Laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection is still difficult to accomplish,which restrains its application in total gastrectomy for advanced proximal gastric cancer.Based on our anatomical understanding of pre- and retropancreatic spaces,features of splenic vessels and distribution of perigastric lymph nodes,we combined the characteristics of laparoscopic surgery and developed a novel technique for laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection through retropancreatic space.The key lies in mobilization of the splenic pedicle through retropancreatic space,dissection of peri-vascular lymph nodes in sequence of trunk-to-branch,in-sheath vascularization of the splenic vessels.From August 2009 to December 2010,this technique was performed on 6 patients in Nanfang hospital.The initial results suggested that this technique could be safe and feasible for skillful surgeons.Further studies on the application of this technique in total gastrectomy for advanced proximal gastric cancer would be needed.