Objective To evaluate the effect of intraoperative placement of super-selective intraarterial pump and postoperative regional infusion chemotherapeutics for the treatment of laparotomy proved inoperable advanced gastrointestinal cancer. Methods Intraoperatively the major artery supplying the tumor was identified and cannulated with the placement of a pump. Postoperative regional chemotherapy was carried out in 79 cases of gastrointestinal cancer. Among them there were 42 cases of gastric cancer, 37 of colorectal cancer. Results Complete tumor remission was achieved in 1 case, partial remission in 69 cases. This therapy also enabled second stage tumor resection in 11 cases. The total effective rate reached 88.6%. The 1-, 2-, and 3- years' survival rates were 84%,28% and 9%, respectively, averaging the survival period at 20.6 months. Conclusion Super-selective intraarterial pump-insertion and postoperative regional chemotherapy is effective in the treatment of advanced inoperable gastrointestinal cancer.

Objective To evaluate the legitimate of regional artery infusion chemotherapy in the treatment of gastric carcinoma. Methods　The pharmacokinetics of 5-Fu after different route of administration was studied. Results High concentration of 5-Fu found in portal vein via left-gastric intra-artetial administration were 4-40 folds higher than the group via intravenous administration.The time of high concentrations of 5-Fu via left-gastric intra-arterial administration maintained significantly longer than by intravenous administraion. The concentration of 5-Fu in tumor tissues and paratumorous lymph tissues by intra-arterial administration were 19 times and 23 times of the group by intravenous administration. Conclusion Regional arterial infusion chemotherapy can significantly increase the concentration of chemotherapeutic drugs in the tumorous region.

Objective To evaluate the effect of internal iliac artery and portal vein chemotherapy in preventing local recurrence and hepatic metastasis after radical operation of rectal carcinoma. Methods 96 patients in PLA 309 Hospital with rectal carcinoma undergoing radical resection were divided into 2 groups: Portal vein and iliac artery perfusion chemotherapy group (pump chemotherapy group, 48 cases) and peripheral venous chemotherapy control group (48 cases). Results In the pump chemotherapy group, the 1 , 3 , and 5 year survival rates, local recurrence rate and hepatic metastasis rate were respectively 100%?83%?52%?13%? and 13%, compared with 88%?68%?32%?26% and 28% in control group (all P

Objective　To study the effect of regional arterial chemotherapy (RACT) on unresectable gastric carcinoma (URGC). Methods　The clinical data of 100 patients with URGC treated by RACT were retrospectively analysed. Results　In addition to different degree of symptoms improvement, the size of gastric cancer became smaller in 81.2% of the cases, and the survival time of patients had been prolonged (mean 29.5 months). Conclusions　RACT is more effective for treating URGC and worthly of further clinical study.

Objective To summarize the clinical experiences of diagnosis and treatment of graft versus host disease (GVHD) in patients, who had undergone liver transplantation. Methods The clinical symptoms, diagnosis, treatment and clinical effect of 2 patients with GVHD were analyzed, including the time of occurrence of GVHD after operation, the sequence of clinical symptoms, the methods of administration and the dosage of immunosuppressant, as well as therapeutic measures when the disease was confirmed. Results Both patients developed unidentified high fever, skin rash and gastrointestinal syndromes on the 19th and 20th day, respectively, after orthotopic liver transplantation, and then pancytopenia occurred. There was no obvious signs of liver dysfunction during the period. One of the two patients died of mixed infection and multiple organ failure the 34th day after the transplantation with an increased dosage of glucocorticoid and immunosuppressant. The other patient was highly suspected of having GVHD at the early period and treated with small dose of methylprednisone and immunosuppressant, or completely withheld the immunosuppressant contingent on the condition of the patient. Gamma globulin was used for upholding the immunity, nasal feeding for energy supplementation, and antibiotics, fungicide and antivirotics were administered to the patient. This patient was cured and still alive and healthy. Conclusions Patients with unidentified high fever, skin rash and gastrointestinal symptoms after liver transplantation should be suspected to have GVHD. Decrease the dose or withhold immunosuppressant, symptomatic treatment, supplementation of nutrition, prevention of combined infections, and maintenance of immune function may be the optimal treatment of GVHD.

Objective To discuss the effica of central venous catheter drainage in interventional treatment of abdominal surgical complications.Methods The clinical data of 72 cases of abdominal surgical diseases were retrospectively analyzed,the complications included 23 cases of ascites,19 cases of bile leakage,8 cases of pancreatic fistula,7 cases of pancreatic necrosis and 15 cases of abdominal abscess,they all underwent percutaneous central venous catheter drainage under the guidance of ultrasound or CT.Results Central venous catheter was placed in 72 cases successfully in one time,the cathetem were kept for 2 to 37 days,5 discharged cases with catheter underwent regular reexamination in the clinic.3 cases of ascites were replaced for catheter shedding; 17 cases for occlusion recieved catheter irrigation and guidewire dredging;2 cases of pancreatic necrosis and 1 case of peripancreatic abscess were cured by repeated puncture and replacement of large-bore catheter.2 cases of pancreatic necrosis,1 case of pancreatic fistula and 1 case of appendicitis underwent laparotomy finally; 1 case of postcholecystectomy bile leakage underwent endoscopic stent therapy; 1 cases of severe pancreatitis complicated with ARDS was treated in ICU.Conclusion Central venous catheter drainage guided by ultrasound or CT for treatment of abdominal surgical complications was not only safe but also effective,and is worthy of popularization and application.

Objective To study the effect of regional arterial chemotherapy (RACT) on unresectable gastric carcinoma (URGC). Methods The clinical data of 100 patients with URGC treated by RACT were retrospectively analysed. Results In addition to different degree of symptoms improvement, the size of gastric cancer became smaller in 81 2% of the cases, and the survival time of patients had been prolonged (mean 29 5 months). Conclusions RACT is more effective for treating URGC and worthly of further clinical study.

Objective To summarize the incidence,clinical presentation,diagnosis and treatment strategy of Mycobacterium tuberculosis(TB)infection in liver transplanted recipients.Methods The data of clinical situation,laboratory examination,imaging,diagnosis and management of 3 patients who were infected TB after liver transplantation were retrospectively analyzed.Results The incidence of TB infection after liver transplantation was 1.2 %(3/246).One patient had was pulmonary tuberculosis complicated by pleural tuberculosis,one had pleural tuberculosis complicated with tuberculosis in liver.Both of them had recovered after standard antituberculosis therapy and no relapse up to now.One patient was found to have tuberculous cavity in the lung died of multiple bacterial and fungous infections postoperatively.As clinical presentations of the patients with TB infection were atypical after liver transplantation,it would take about 30d to confirm the final diagnoses after the onset of symptoms.The serologic examination for TB were all negative results in the 3 patients,and the only positive result was of purified protein derivatives(PPD)skin test in one patient.Administration of antituberculous drugs could decrease the plasmic level of immunodepressant,but the level could be kept normal by adjusting the dosage of immunodepressant.In neither of the 3 patients discontinuation of drugs was necessary because of hepatotoxicity of antituberculosis drugs.Anti-TB treatment was effective,safe and feasible.Conclusion The clinical presentation,diagnosis and treatment are specific for patients with TB infection after liver transplantation.Early diagnosis and rational treatment will lead to a better prognosis.

Objective To study the correlation between liver fibroindex and prognosis of hepatocellular carcinoma after hepatectomy.Methods The clinical data of 77 patients with hepatocellular carcinoma who underwent hepatectomy at the 5th Hospital Affiliated to Sun Yat-sen University from 2009 October to 2014 December were analyzed retrospectively.Using data from preoperative Fibroindex,these patients were divided into 2 groups,Group 1:Fibroindex ≤5.4,and Group 2:Fibroindex ＞5.4.The clinical pathological parameters and postoperative disease free survival rates in these groups were analyzed.The Cox ratio risk pattern analysis was used for factors correlating recurrence.Results The parameters in the 2 groups which included sex (35/0 vs 29/13),type of cirrhosis (23/12 vs 14/28),numbers of tumor (35/0 vs 26/16),maximal diameter of tumor (31/4 vs 23/19),vascular invasion status (32/3 vs 26/16),resection margin status (35/0 vs 36/6),hepatic vein/portal vein tumor thrombus status (35/0 vs 29/13),perioperative change of HBV DNA levels (23/12 vs 15/27)were correlated with postoperative recurrence,and they all showed significant differences (P ＜ 0.05).Disease free survival rate in Group 2 was lower than Group 1 (71.4％,33.7％,22.4％ vs 94.3％,46.2％,46.2％,P ＜ 0.05).The Cox regression analysis showed Fibroindex ＞ 5.4,AFP-L3％ ≥ 10％,and number of tumor ＞ 3 to be independent predictors of poor disease-free survival after hepatectomy for hepatocellular carcinoma (P ＜ 0.05).Conclusions Preoperative Fibroindex ＞ 5.4 was an independent adverse predictor of poor disease-free survival.It was valuable to predict postoperative recurrence in hepatocellular carcinoma patients.

3 years. Conclusions Regional infusion chemotherapy via selected artery with a pump is an efficient way for unresectable cardic and fundus cancer of stomach, which can improve the survival period of patients. Moreover, some patients could get secondary resection.