Objective To explore the etiology,diagnosis and treatment of postsurgical gastroparesis syndrome(PGS)after radical gastrectomy for gastric carcinoma.Methods The data of 585 patients who had undergone radical gastrectomy for gastric carcinoma were retrospectively studied.The diagnosis was established with fiberoptic gastroscopy and biopsy before operation in all the patients,and radical subtotal gastrectomy was performed,with antero-colonic Billroth's Ⅱ anastomosis of the remnant stomach and jejunum.Results PGS occurred in 24 patients(age 46-81,mean 58.6 years)among 585 patients,the prevalence was 4.1%.In all the 24 patients,PGS occurred at the period when liquid diet was changed to semifluid diet,with the symptoms of epigastric fullness,nausea,vomiting and intractable hiccup.The vomitus contained large amount of gastric contents and a small amount of bile.The quantity of gastrointestinal decompression was 800-2000 ml/d.Upper gastrointestinal radiography using 38% meglucamine diatrizoate was performed in all the 24 patients,the contrast agent was taken orally or through gastric tube.It showed that the remnant stomach was atonic,gastric peristalsis was weak or absent,and evacuation of contrast agent was delayed.The anastomosis stoma was patent.Gastroscopy was performed in 18 patients,and a large amount of residual gastric content and anatomotic edema of anastomosis stoma were found.Howener,the gastroscope could be introenced into the duodenum or jejunal efferent loop through anastomotic stoma without difficulty,and no signs of mechanical obstruction were found.All the 18 patients were cured within10-38 days by conservative treatment.Conclusion The main causes of PGS may be the loss of gastrointestinal motility and anastomotic edema,while the risk factors may include old age,malnutrition,water-electrolyte imbalance,and peritoneal infection.Gastrointestinal radiography and gastroscopy are important diagnostic methods,and the patients can be cured by conservative treatment.

Objective To evaluate the necessity, feasibility, accuracy and clinical value of sentinel lymph node (SLN) biopsy (SLNB) in early breast cancer. Methods In 32 cases with early breast cancer, sentinel lymph nodes identified by liposomes methylence blue mixture were excised for biopsy. The patients then received operations for breast cancer, including axillary lymph nodes dissection. SLN and avillary lymph nodes (ALN) were separately examined histopathologically. Results SLN was identified in 31 cases, success rate was 96.9%. In 9 of the 31 patients, SLN was positive for metastasis, in 22 of the 31 patients, SLN was negative for metastasis. In 10 of 32 patients, ALN was positive for metastasis, and in 22 of 32 patients, ALN was negative for metastasis. The sensitivity rate of SLNB was 90%, The accuracy rate of SLN was 93.8%, with a false negative rate of 10% and a false positive rate of zero. Conclusion The SLN biopsy can accurately predict the axillary metastasis for patients with breast cancer. Liposomes methylenc blue mixture tracing may increase the success rate of SLNB.

Objective To evaluate the clinical effect of chemotherapy via both hepatic artery and portal vein on liver metastasis of colorectal cancer. Methods Forty-eight patients with colorectal cancer (admitted to our hospital from Jan, 1994 to Dec, 2000)were divided into group Ⅰ, in which 17 patients received chemotherapy via both hepatic artery and portal vein, group Ⅱ in which 16 patients received simple hepatic artery chemotherapy, and group Ⅲ in which 15 patients received simple portal vein chemotherapy. Chemotherapy was begun 2 weeks after operation. The drugs used in chemotherapy regime were 5-fluorouracil(5-FU) 500mg/m 2 + Mitomycin(MMC) 4mg/m 2 + Epirubicin(EPI) 60mg/m 2, once per week, 2-3 times as a course. The chemotherapy regime was the same for the 3 groups. Results The respective effective rate for liver metastasis was 76.5%, 62.5%, 46.7% in group Ⅰ, group Ⅱ, and group Ⅲ. The 0.5, 1 and 2 year survival rates were 100%, 82.4% and 52.9% respectively in group Ⅰ, 87.5%, 62.5% and 43.7% respectively in group Ⅱ, and 93.3%, 60% and 33.3% respectively in group Ⅲ. There were statistically significant differences between group Ⅰ and groups Ⅱ and Ⅲ (P

Objective To analyze the serum level of procalcitonin (PCT) in children with bacte-rial or viral pneumonia, explore its diagnostic value in diagnosis of bacterial pneuminia in children, and so as to provide evidence for clinical use of antibiotics. Methods A total of 42 children with pneumonia(mean age was 5.6 yrs, including 24 boys and 18 girls) were divided into viral neumonia group (n=25) and bacterial neumonia group (n=17). Semi-quantitative solid-phase immunoassay was applied to measuring serum procalcitonin. There were four PCT grades:<0.5 ng/mL,≥0.5 ng/mL,≥2 ng/mL and≥10 ng/mL. X2 test was performed. Results The serum level of PCT was more elevat-ed in bacterial neumonia group than that of viral neumonia group, and the difference was statistically significant (P<0. 01). Conclusion As a sensitive marker of bacterial pneumonia in children, serum procalcitonin contributes to diagnosis and differential diagnosis of pneumonia in children, which may provide basis for clinical use of antibiotics.

To evaluate the effect of local resection plus axillary dissection in the treatment of early breast cancer, 112 cases of early breast cancer were divided into 2 groups: quadrant resection plus axillary dissection group(66 cases) and Halsted′s method group(46 cases).Their survival rate, local recurrence rate, metastasis rate,cosmetic effect of breast were observed for a prolonged period. The results showed that the 3,5,8 year survival rates in the first group were respectively 97 0%,87 9% and 71 2%. The 3,5,8 year survival rates in the second group were respectively 97 8%,80 5%,76 1%. The rate of local recurrence was 6 1% in the first group and 4 3% in the second group.The metastasis rate of the first group was 16 7%,and that of the second group was 21 6%.In 83 8% of patients in the first group,the breasts retained a satisfactory cosmetic form.It suggested that similar to the Halsted's method,the quadrant resection plus axillary dissection method is an ideal method to treat early breast cancer.

To evaluate the value of chemotherapy via portal vein pump implantation in preventing hepatic metastasis from colorectal cancer after a radical resestion. Patients after a radical resection were divided into two groups: the portal vein pump implantation chemotherapy group (Group A 32 cases), chemotherapy via peripheral vein(Grounp B 22 cases). The results showed that hepatic metastasis rate was 15 4% in group I and 36 4% in group 2. The survival rates of 1, 2, 3 years in group A were 98%, 83%, 61% respectively, while in group B they were 90%, 68%, 42%, respectively. The results suggested that portal vein pump chemotherapy was an effective treatment modality to prevent hepatic metastasis from colorectal cancer. Its clinical results were better than conventional chemotherapy via peripheral vein.

Objective To evaluate role of double stapling technique in anus-saving operations for patient with low rectal carcinoma.Method The double stapling technique was used for anus-saving in colorectal anastomosis after anterior resection in 52 patiens with rectal cancer from 1994 to 1999,and the results were evaluated.Results 2 cases were failed to close rectal.4 cases were failed to anastomose.2 cases had anastomotic fistula(3.8%).3 cases had anastomotic stenosis (5.8%).2 cases had waund infection.1 case had anastomotic bleeding.There was no operative death.Conclusion The double stapling technigue provided a safe alternative for anus-saving operation in patients with rectal cancer.

Objective Through the qualitative study of surgical field free cancer cells of patients with breast cancer,to evaluate theprevention effects of intraoperative hot hypotonic solution soaking chemotherapy on cancer recurrence after resection of breast cancer.Methods 94 cases with breast cancer divided in to study group (n=48)and control group (n=46).Before the operation wound closed,both group surgical field washing solutions were collected for examination of free cancer cell,then the wounds of study group were treated with Hyperthermic soaking chemotherapy (41℃～42℃normal saline solutions 3000 ml+5-fluorouracil 1.0 g),once five minutes,total 3～4 times.While the wound of control group were soaked with normal saline solutions only.The soaking solutions were collected for examination of free cancer cell.The rates of free cancer cell in the surgical field and local recurrence rates in the both group were compared.Result The rates of washing solutions and the rates of soaking solution and the localy recurrent rates in the study group were 29.2%,8.3%,6.3%,which in the control group were 26.1%,19.6%,15.2%.Conclusions There are free cancer cells in the surgical field of breast cancer.Hyperthermic soaking chemotherapy can kill free cancer cell and reduce localy recurrent rate.

Objective To evaluate the surgical treatment for patients with malignant colorectal mesenchymoma, and to analyze the clinical data, pathological features and the common presenting symptoms and its immunohistochemical staining property. Methods The clinical data and the pathological findings, including immunohistochemical staining, of 17 patients with malignant colorectal mesenchymoma admitted from Jan 1990 to Mar 2005 were retrospectively analyeed. All the patients were followed up carefully. Results All the patients underwent operation, and all the tumors were proved malignant pathologically. In 6 cases left hemicolectomy was done, in 3 cases right hemicolectomy was done, in 2 cases the treatment was local resection from the rectum, and 6 patients received Mile's resection. The 1, 3 and 5-year overall survival rates for 17 patients with the total resection of tumor were 100%, 70.6% and 47.1%, respectively. The median survival time for 17 patients was 52 months. The final diagnosis of malignant GIST depended on the pathological examination, but the most worthwhile diagnostic criterion was the presence of CD117 and CD34 cells. Conclusion Since the prognosis is very poor, radical hemicolectomy is the principal treatment, and comprehensive treatment is necessary to improve clinical result.

Objective To study the prevention and treatment of the local and hepatic recurrence after advanced gastrointestal(G1) carcinoma operation.Methods 282 patients were divided into treatment group and control group.The treatment group (hyperthemic peritoneal perfusion plus intraarterial infusion chemotherapy)had 169 patients.The control group (systemic chemtherapy)had 113 patients. The peritoneal and hepatic recurrence and 3 year survival rate were compared between the 2 groups.Results The local and hepatic recurrence and 3 year survival rate in the treatment group were 21.9%,12.4% and 74.6%;those in the control group were 46.0%,27.4% and 46.8%,respectively ( P