Objective To explore the clinical efficacy of minimally invasive implantation figure-ofeight steel plate in treatment of children with lower limb angular deformity caused by a variety of reasons.Methods The clinical data of 35 lower limb angular deformity children who treated with minimally invasive implantation figure-of-eight steel plate half epiphyseal plate block method were retrospectively analyzed.During pre-operation and post-operation,the X-ray of both lower limb was shoot,the mechanical axis of lower limb and femoral tibial angle (FTA) were measured,and the clinical efficacy combining clinical results was assessed.Results All the children were completed the follow-up,the average follow-up was 15 (13-20)months.The 35 children with lower limb angular deformity achieved satisfactory correction and restored normal the mechanical axis of lower limb.All children were normal,and no complications of epiphyseal plate injury were found,except 1 child appeared incision fat liquefied and healed after secondary wound debridement and suture.Conclusions Minimally invasive implantation figure-of-eight steel plate half epiphyseal plate block method in treatment of the children with lower limb angular deformity is simple,cheap,effective,needless osteotomy,well tolerated and with less complications.It is an easily learned technique for osteology surgeons and to be worth generalization at clinical especially those hospitals without establishing special department of children' s osteology.

Objective To explore the superiority and clinical efficacy of endoscopic thyroidectomy via breast approach in treatment of thyroid diseases .At the same time evaluation of endoscopic application value in the treatment of the disease .Methods Retrospective analysis of menstrual breast approach endoscopic 20 patients with benign thy-roid tumor patient clinical data ,and with the same period in 20 cases of thyroid cancer patients underwent convention-al operation of undergraduate clinical comparativeanalysis .Results Cavity mirrors the operative time , intraoperative blood loss,postoperative flow,length of hospital stay,postoperative complications and beauty satisfaction respectively (97.2 ±15.6)min,(17.8 ±8.6)mL,(30.2 ±11.8)mL,(4.7 ±0.9)d,15%,90%;the traditional group respec-tively(70.3 ±19.0)min,(24.6 ±15.2)mL,(35.6 ±19.6)mL,(5.2 ±0.6)d,10%,30%.Two groups of postoper-ative hospital stay,led traffic,beauty satisfaction difference had statistical significance (t=-2.203,-2.427,χ2 =54.432,all P<0.05).Conclusion Laparoscopic operation for treatment of thyroid disease has the advantages of small operation wound ,fewer complications ,and without scar on the neck ,which is an ideal minimally invasive opera-tion treatment .

The mechanism of Tongmai Oral Liquid (TOL) for chronic nephritis rat model with Qi-deficiency and blood-stasis syndrome was studied.The model was established by adding Qi-deficiency and blood-stasis syndrome to the chronic nephritis rats. The experimental rats were randomly allocated to 5 groups: Group A (treated with high dosage of TOL), Group B (treated with low dosage of TOL), Group C (treated with Jinshuibao), Group D (model control group) and Group E (normal control group). After 4 weeks of treatment, general health state, biochemical indexes including T lymphocyte subgroup and blood rheology, and pathological damage of kidney tissue were much improved in Group A than Group B and Group C. It is indicated that TOL can improve the renal function and delay the occurrence of glomerular arteriosclerosis in rats by reinforcing Qi, activating blood flow, regulating immune function, lessening the hypercoagulative state and reducing renal damage.

Objective To study the expression of telomerase and its possible clinical significance in patients with condyloma acuminatum,bowenoid papulosis,Bowen's disease and vulvar squamous cell car- cinoma.Methods The human telomerase reverse transcriptase (hTERT) was detected by immunohisto- chemistry technique in all patients.Histopathological analysis was done in patients with bowenoid papulosis or Bowen's disease.Results There was a significant difference in the expression of hTERT among normal tissue,condyloma acuminatum and squamous carcinoma,and the expression rate increased successively from normal control to squamous carcinoma.In bowenoid papulosis,the expression of bTERT was significantly higher as compared to that in condyloma acuminatum,significantly lower as compared to that in squamous carcinoma,and was as the same as that in Bowen's disease.Histopathologically,the degree of cell atypia was significantly higher in Bowen's disease than that in bowenoid papulosis.Conclusions The expression of telomerase increases successively from normal skin,benign tumors to malignant carcinomas,which sug- gests that the expression of telomerase may play an important role in both cell proliferation and immortaliza- tion.

A number of reports have appeared implicating neurotoxicity of local anesthetics as a possible cause of neurologic complications after spinal anesthesia. Transient neurologic syndrome is one of neurologic complications. This article reviews the etiology, occurred mechanism, clinical symptoms, risk factors, prevention and treatment of transient neurologic syndrome.

Objective To investigate survival for primary duodenal carcinoma patients after radical resection and identify risk factors associated with overall survival.Methods Data of 51 patients with primary duodenal carcinomas who underwent radical resection between December 2003 and December 2012 at Beijing Cancer Hospital were included.Survival analysis was drawn by Kaplan-Meier method,univariate and multivariate analyses were performed to identify variables associated with survival after resection by COX regression model.Results The median overall survival time was 67 months,and the median disease-free time was 40 months,1-,2-and 3-year overall survival rates were 88％,84％ and 67％,respectively.Multivariate analysis revealed that regional lymph-node positive (P =0.032) and CA199 ＞ 37 U/ml (P =0.037) were independent risk factors of patients' overall survival.Conclusions Radical resection improves survival for primary duodenal carcinoma patients.Regional lymph-node positive and CA199 ＞37 U/ml were the most important risk factors of patients'overall survival.

Objective Bisegmentectomy Ⅶ-Ⅷ can be an alternative option for the tumor localized in segments Ⅶ and Ⅷ and infiltrating the main trunk of RHV instead of a right hemihepatectomy.This study was to evaluate the safety and practicability of the removal of segments Ⅶ and Ⅷ of the liver with the resection of the main trunk of RHV without vascular reconstruction.Method 13 consecutive patients underwent bisegmentectomy Ⅶ-Ⅷ with the resection of the RHV between Nov.2006 and Dec.2012 at Beijing Cancer Hospital 1st Department.of HPB Surgery.Results Bisegmentectomy Ⅶ-Ⅷ with the resection of the RHV was performed in all 13 patients successfully without the distal vein reconstruction.The duration of the operations was 90-215 min.Mean blood loss was estimated to be 200 ml (100-700 ml).Indications for a bisegmentectomy Ⅶ-Ⅷ included hepatocellular carcinoma in 6 cases,intrahepatic cholangiocarcinoma in one,liver metastasis in 4 and hepatic hemangioma in 2 as confirmed pathologically.All patients recovered without severe complications.The atrophy of segment Ⅵ due to the venous drainage obstacle was observed in 3 patients without the dysfunction of liver postoperatively.Conclusions It is safe and practicable to perform Ⅶ and Ⅷ bisegmentectomy with resection of the right hepatic vein without vascular reconstruction for liver tumors.

Objective To study the survival outcome and the survival-related factors in patients who received liver resection for multiple (≥4) liver metastases of colorectal cancer.Method The results for patients who received partial hepatectomy for four or more colorectal hepatic metastases carried out in the 1 st Department of HPB Surgery,Peking University Cancer Hospital were studied retrospectively.Results Between 2002 and 2013,of 239 patients,60 patients with four or more colorectal hepatic metastases received partial hepatectomy.The median overall survival was 35.2 months and the 5-year survival was 28.2％ (17/60).There were two actuarial 5-year survivors.The median disease-free survival was 6.9 months,with 1 actuarial disease-free survivor at 5 years.There were no perioperative deaths,and the perioperative morbidity was 36.7％ (22/60).Major (hemi-liver or more) liver resection and 7 or more metastases were independently associated with poor survival outcome.Perineural Invasion (T4) of the primary tumor,size of the largest metastasis (≥4 cm),neoadjuvant chemotherapy,and resection of recurrent disease were also associated with survival outcome.Conclusions Long-term survival could be achieved after resection of multiple colorectal liver metastases.Minor resection for multiple colorectal metastases was superior in survival compared with major resection.Additional survival advantage could be achieved by resection of recurrent disease.

Objective To evaluate the correlation between postoperative complications and prognosis after radical hepatic resection for colorectal liver metastasis (CRLM).Methods We retrospectively summarized patients' clinicopathological data and postoperative complications.Postoperative complications were graded using Dindo-Clavien system of classification.Then we investigate the relation between these data and prognosis.Results One hundred and seventy-three patients were recruited.Postoperative complications developed in 59 (34.1％) cases.37 patients had minor complications and 22 patients had major complications.On univariate (x2 =8.106,P =0.004) and multivariate analysis (x2 =8.006,P =0.005),complication was an independent predictor of overall survival (OS).However,in a subgroup of patients with minor compications,morbidity was not associated with a significant reduction in both OS (x2 =3.199,P =0.074) and disease-free survival (x2 =1.313,P =0.252).Conclusions Postoperative complications are an independent factor for long-term outcomes after hepatic resection for CRLM.

Objective To analyze the clinical data of patients with post-hepatectomy haemorrhage (PHH) and to discuss the treatment strategies.Method The clinicopathologic data of patients with PHH between 2005-2014 in the HPB Surgery Ward I,Peking University Cancer Hospital,were studied retrospectively.Results In the study period of 10 years,25 of 1 548 patients who underwent hepatectomy suffered from PHH,and 76％ (19/25) of these patients had underlying liver diseases.The common surgical operations followed by PHH were right hemihepatectomy (11/25),and segment Ⅶ/Ⅷ resection (8/25).The median time for PHH to be diagnosed was 27 h,and the median time from diagnosis of postoperative bleeding to reoperation or intervention was 3.5 h.Using the classification of PHH by the International Study Group of Liver Surgery (ISGLS),there were 1 patient in grade A,16 patients in grade B,and 8 patients in grade C.The perioperative mortality of PHH was 8％ (2/25).The most common bleeding site was from the hepatic artery.Conclusions PHH is a serious complication after liver resection,with low occurrence but high mortality.Most patients with PHH can be managed by conservative treatment.Emergency reoperation is required when instability in vital signs appears.Careful evaluation before operation,strict hemostasis during operation,and close monitoring after operation can effectively reduce the incidence and mortality of PHH.