1.Effect of transurethral ureteroscopic holmiumlaser lithotripsy on ureteral calculi
Jian-Yu WANG ; Zong-Yang HU ; Chao-Fa TAO ; Kai-Fang YOU ; Hao CHEN ; Yan GUO
Journal of Regional Anatomy and Operative Surgery 2018;27(1):44-46
Objective To explore the clinical effect of the transurethral ureteroscopic holmiumlaser lithotripsy in the treatment of ureteral calculi.Methods This study conducted a retrospective analysis of 205 patients with ureteral calculi from September 2015 to June 2017 in the affiliated hospital of Panzhihua university.According to the surgical method,all the patients were divided into control group (102 cases) who were treated with conventional pneumatic lithotripsy and observation group(103cases) who received transurethral ureteroscopic holmiumlaser lithotripsy.The surgical efficacy,renal function indexes and surgical indexes of the two groups were compared and analyzed respectively.Results The total effective rate of observation group was 97.06%,the control group was 85.00%,the difference between two groups was significantly(P < 0.05).There was no significant difference in Cr and BUN level before surgery between two groups (P > 0.05);after treatment,the Cr and BUN levels of two groups were improved significantly (P < 0.05);while the renal function improved index of observation group was significantly better than that of control group,the difference was significant(P < 0.05).The intraoperative blood loss,operative time and postoperative hospital stay of the observation group were significantly lower than those of control group (P < 0.05).Conclusion The transurethral ureteroscopic holmiumlaser lithotripsy and normal air pressure ballistic were both well treatment for ureteral calculi,but patients with the holmium laser lithotripsy have better renal function indexes and operation index.
2.Plasma polypeptide hormone levels in rats with gastric ulcer after exposure to intense noise.
Chao-qun LIU ; Tao SUN ; Zhong-xiao LI ; Zhi-fa LIU ; Shan-feng FU ; Jian-liang SHEN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2003;21(1):48-50
OBJECTIVETo observe changes of plasma polypeptide hormone levels in rats with gastric ulcer after exposure to intense noise, and to discuss their mechanism.
METHODS80 Wistar rats were used in the study. Plasma levels of rat gastrin (GAS), motilin (MTL), osteocalcin (BGP), substance P (SP), neurotensin (NT) and somatostatin (SS) in rats were measured by radioimmunoassay.
RESULTS(1) In non-noise-exposure but with gastric ulcer group, the plasma MTL [(160.70 +/- 40.34) pg/ml] and BGP [(27.63 +/- 13.13) pg/ml] levels on 10 d after gastric ulcer model operation were remarkably higher than those in control group [(89.21 +/- 49.94) pg/ml, (9.10 +/- 1.38) pg/ml respectively] (P < 0.05 and P < 0.01), while the GAS level was remarkably descended [(107.00 +/- 21.75) vs (158.48 +/- 20.92) pg/ml] (P < 0.01). (2) In noise-exposure but without gastric ulcer group, the plasma MTL [(312.80 +/- 207.42) pg/ml] and BGP [(17.76 +/- 12.33) pg/ml] levels on 10 d were also significantly increased as compared with the control group (P < 0.01 and P < 0.05 respectively), while the GAS levels didn't change. (3) In noise-exposure + gastric ulcer group, the areas of gastric ulcer on 10 d and 40 d after noise and operation [(15.33 +/- 7.26) and (15.11 +/- 12.45) mm(2) respectively] were significantly larger than those of the control [(8.22 +/- 6.66), (3.67 +/- 9.90) mm(2)] (P < 0.05). The plasma MTL levels on 10 d and 40 d [(244.44 +/- 68.11) and (191.20 +/- 60.50) pg/ml respectively] were higher than those in control group [(160.70 +/- 40.34) and (93.10 +/- 52.90) pg/ml respectively] (P < 0.01).
CONCLUSIONIntense noise exposure may make the rat gastric ulcer worsened and induce negative effect on healing of it. The gastrointestinal endocrine would be disturbed by combined effect of intense noise exposure with gastric ulcer in rats.
Animals ; Male ; Noise ; Peptides ; blood ; Rats ; Rats, Wistar ; Stomach Ulcer ; blood ; etiology
3.SOCS3 expression correlates with severity of inflammation in mouse hepatitis virus strain 3-induced acute liver failure and HBV-ACLF.
Yong, LI ; Mei-Fang, HAN ; Wei-Na, LI ; Ai-Chao, SHI ; Yuan-Ya, ZHANG ; Hong-Yan, WANG ; Fa-Xi, WANG ; Lan, LI ; Ting, WU ; Lin, DING ; Tao, CHEN ; Wei-Ming, YAN ; Xiao-Ping, LUO ; Qin, NING
Journal of Huazhong University of Science and Technology (Medical Sciences) 2014;34(3):348-53
Recently, suppressor of cytokine signaling-3 (SOCS3) has been shown to be an inducible endogenous negative regulator of Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathway which is relevant in inflammatory response, while its functions in acute liver failure and HBV-induced acute-on-chronic liver failure (HBV-ACLF) have not been fully elucidated. In this study, we explored the role of SOCS3 in the development of mouse hepatitis virus strain 3 (MHV-3)-induced acute liver failure and its expression in liver and peripheral blood mononuclear cells (PBMCs) of patients with HBV-ACLF. Inflammation-related gene expression was detected by real-time PCR, immunohistochemistry and Western blotting. The correlation between SOCS3 level and liver injury was studied. Our results showed that the SOCS3 expression was significantly elevated in both the liver tissue and PBMCs from patients with HBV-ACLF compared to mild chronic hepatitis B (CHB). Moreover, a time course study showed that SOCS3 level was increased remarkably in the liver of BALB/cJ mice at 72 h post-infection. Pro-inflammatory cytokines, interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α, were also increased significantly at 72 h post-infection. There was a close correlation between hepatic SOCS3 level and IL-6, and the severity of liver injury defined by alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, respectively. These data suggested that SOCS3 may play a pivotal role in the pathogenesis of MHV-3-induced acute liver failure and HBV-ACLF.
4.Reproduction of a model of heat injured keratinocyte in vitro and observation on its apoptosis rate.
Xiao-Zhi BAI ; Gen-Fa LÜ ; Song-Tao XIE ; Da-Hai HU ; Xiong-Xiang ZHU ; Chao-Wu TANG
Chinese Journal of Burns 2009;25(3):189-192
OBJECTIVETo reproduce a model of heat injured KC in vitro and explore its apoptosis rate of KC due to heat injury at different temperature.
METHODSHuman KCs were cultured in vitro, and they were incubated at 37, 41, 43, 45, 48, and 51 degrees C respectively for 10 mins in water bath. Trypan blue staining and Hoechst 33258 fluorescence staining were used respectively to determine necrosis and apoptosis of KC. Rates of apoptosis and necrosis of KC were analyzed quantitatively by flow cytometer. The proliferation activity of KC after heat injury was detected by MTT test.
RESULTSThe results of trypan blue staining, Hoechst 33258 fluorescence staining, and flow cytometer demonstrated that number of apoptotic and necrotic KC increased gradually along with a rise of water bath temperature. The rates of apoptosis and necrosis of KC were respectively (12.3 +/- 3.2)% and (14.1 +/- 1.6)% at 45 degrees C, (27.7 +/- 5.1)% and (58.0 +/- 4.2)% at 48 degrees C. Rate of KC necrosis reached up to (83.0 +/- 5.3)% at 51 degrees C. Inhibition of KC growth reached a stationary phase when the injurious temperature reached 45 degrees C as observed with MTT test.
CONCLUSIONSHeat injury can induce apoptosis and growth inhibition of KC in vitro. Incubating KC at 45 degrees C for 10 mins is a good condition to reproduce a model of heat injured KC in vitro. This model may be used to study the biological character and apoptosis of KC after burn injury.
Apoptosis ; Burns ; Cell Proliferation ; Cell Survival ; Cells, Cultured ; Flow Cytometry ; Hot Temperature ; Humans ; Keratinocytes ; cytology
5.SOCS3 expression correlates with severity of inflammation in mouse hepatitis virus strain 3-induced acute liver failure and HBV-ACLF.
Yong LI ; Mei-fang HAN ; Wei-na LI ; Ai-chao SHI ; Yuan-ya ZHANG ; Hong-yan WANG ; Fa-xi WANG ; Lan LI ; Ting WU ; Lin DING ; Tao CHEN ; Wei-ming YAN ; Xiao-ping LUO ; Qin NING
Journal of Huazhong University of Science and Technology (Medical Sciences) 2014;34(3):348-353
Recently, suppressor of cytokine signaling-3 (SOCS3) has been shown to be an inducible endogenous negative regulator of Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathway which is relevant in inflammatory response, while its functions in acute liver failure and HBV-induced acute-on-chronic liver failure (HBV-ACLF) have not been fully elucidated. In this study, we explored the role of SOCS3 in the development of mouse hepatitis virus strain 3 (MHV-3)-induced acute liver failure and its expression in liver and peripheral blood mononuclear cells (PBMCs) of patients with HBV-ACLF. Inflammation-related gene expression was detected by real-time PCR, immunohistochemistry and Western blotting. The correlation between SOCS3 level and liver injury was studied. Our results showed that the SOCS3 expression was significantly elevated in both the liver tissue and PBMCs from patients with HBV-ACLF compared to mild chronic hepatitis B (CHB). Moreover, a time course study showed that SOCS3 level was increased remarkably in the liver of BALB/cJ mice at 72 h post-infection. Pro-inflammatory cytokines, interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α, were also increased significantly at 72 h post-infection. There was a close correlation between hepatic SOCS3 level and IL-6, and the severity of liver injury defined by alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, respectively. These data suggested that SOCS3 may play a pivotal role in the pathogenesis of MHV-3-induced acute liver failure and HBV-ACLF.
Adult
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Alanine Transaminase
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blood
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Animals
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Aspartate Aminotransferases
;
blood
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Blotting, Western
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End Stage Liver Disease
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genetics
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pathology
;
virology
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Female
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Gene Expression
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Hepatitis, Viral, Animal
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genetics
;
pathology
;
virology
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Host-Pathogen Interactions
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Humans
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Interleukin-1beta
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genetics
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metabolism
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Interleukin-6
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genetics
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metabolism
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Leukocytes, Mononuclear
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metabolism
;
virology
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Liver Failure, Acute
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genetics
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pathology
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virology
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Male
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Mice, Inbred BALB C
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Middle Aged
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Murine hepatitis virus
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physiology
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Reverse Transcriptase Polymerase Chain Reaction
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Severity of Illness Index
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Suppressor of Cytokine Signaling 3 Protein
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Suppressor of Cytokine Signaling Proteins
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blood
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genetics
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metabolism
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Tumor Necrosis Factor-alpha
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genetics
;
metabolism
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Young Adult
6.Induction of biliary cholangiocarcinoma cell apoptosis by 103Pd cholangial radioactive stent gamma-rays.
Gui-jin HE ; Dan-dan SUN ; Da-wei JI ; Dong-ming SUI ; Fa-qiang YU ; Qin-yi GAO ; Xian-wei DAI ; Hong GAO ; Tao JIANG ; Chao-liu DAI
Chinese Medical Journal 2008;121(11):1020-1024
BACKGROUNDIn recent years, interventional tumor therapy, involving implantation of intra-cholangial metal stents through percutaneous trans-hepatic punctures, has provided a new method for treating cholangiocarcinoma. (103)Pd cholangial radioactive stents can concentrate high radioactive dosages into the malignant tumors and kill tumor cells effectively, in order to prevent re-stenosis of the lumen caused by a relapsed tumor. The aim of the present study was to investigate the efficacy of gamma-rays released by the (103)Pd biliary duct radioactive stent in treating cholangiocarcinoma via induction of biliary cholangiocarcinoma cell apoptosis.
METHODSA group of biliary duct cancer cells was collectively treated with a dose of gamma-rays. Cells were then examined by the 3-(4, 5-dimethyl thiazol-2-yl)-2, 5-diphenyl terazolium-bromide (MTT) technique for determining the inhibition rate of the biliary duct cancer cells, as well as with other methods including electron microscopy, DNA agarose gel electrophoresis, and flow cytometry were applied for the evaluation of their morphological and biochemical characteristics. The growth curve and the growth inhibition rate of the cells were determined, and the changes in the ultrastructure of the cholangiocarcinoma cells and the DNA electrophoresis bands were examined under a UV-lamp.
RESULTSThe gamma-ray released by (103)Pd inhibited cholangiocarcinoma cell growth, as demonstrated when the growth rate of the cells was stunned by a gamma-ray with a dosage larger than 197.321 MBq. Typical features of cholangiocarcinoma cell apoptosis were observed in the 197.321 MBq dosage group, while cell necrosis was observed when irradiated by a dosage above 245.865 MBq. DNA agarose gel electrophoresis results were different between the 197.321 MBq irradiation dosage group, the 245.865 MBq irradiation dosage group, and the control group.
CONCLUSIONS(103)Pd radioactive stents which provide a radioactive dosage of 197.321 MBq are effective in the treatment of cholangiocarcinoma; (103)Pd radioactive stents should be useful for the clinical treatment of cholangiocarcinoma.
Apoptosis ; radiation effects ; Bile Duct Neoplasms ; pathology ; radiotherapy ; ultrastructure ; Bile Ducts, Intrahepatic ; Cell Line, Tumor ; Cell Proliferation ; radiation effects ; Cholangiocarcinoma ; pathology ; radiotherapy ; ultrastructure ; DNA ; analysis ; Flow Cytometry ; Gamma Rays ; therapeutic use ; Humans ; Palladium ; Stents
7.A study of the effectiveness of nucleos(t)ide analogues in the treatment of HBeAg- positive chronic hepatitis B with normal alanine aminotransferase and high level of HBV DNA.
Fa Da WANG ; Jing ZHOU ; Dong Mei ZHANG ; Meng Lan WANG ; Ya Chao TAO ; Dong Bo WU ; Hong TANG ; En Qiang CHEN
Chinese Journal of Hepatology 2022;30(4):389-394
Objective: To investigate the effectiveness of nucleos(t)ide analogues in the treatment of HBeAg-positive chronic hepatitis B with normal alanine aminotransferase and high level of HBV DNA. Methods: Treatment-naïve chronic hepatitis B patients who were followed up at the Center of Infectious Diseases, West China Hospital of Sichuan University from January 2019 to January 2020 were selected as subjects. Demographic characteristics, the results of laboratory examination before treatment and one year after treatment were retrospectively collected. Patients were divided into tenofovir dipivoxil (TDF) and propofol fumurate tenofovir (TAF) treatment group according to different types of medication. The changes of serum HBV DNA level, HBeAg serological conversion and HBsAg quantitative level were analyzed and compared between the two groups. Results: A total of 38 cases were enrolled. Among them, there were 16 and 22 cases in the TDF and TAF group, respectively. There was no statistically significant difference in demographic characteristics, baseline HBV DNA levels and HBsAg quantitative levels between the two groups. Virological response was achieved in 60.5% (23/38) of patients after one year of antiviral therapy. Serum HBV DNA levels below the lower limit of detection [68.2% (15/22) vs. 50.0% (8/16), P=0.258] and higher HBeAg seroconversion rate [18.2%] (4/22) vs. 6.3% (1/16), P=0.374] was obtained in TAF than TDF group; however, there was no statistically significant differences between the two. Serum HBsAg quantitative level was significantly reduced with TDF and TAF treatment. In addition, alanine aminotransferase elevation was reduced in TAF than TDF treated group. Multivariate logistic regression analysis showed that patient age was an independent predictor of a virological response to antiviral therapy. Conclusion: HBeAg-positive CHB patients with normal alanine aminotransferase, and high HBV DNA level can obtain better curative effect after TDF and TAF treatment.
Alanine Transaminase
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Antiviral Agents/therapeutic use*
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DNA, Viral
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Hepatitis B Surface Antigens
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Hepatitis B e Antigens
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Hepatitis B virus/genetics*
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Hepatitis B, Chronic
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Humans
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Retrospective Studies
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Tenofovir/therapeutic use*
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Treatment Outcome
8.Development of Job Burden-capital Model of Occupational Stress: An Exploratory Study.
Chao WANG ; Shuang LI ; Tao LI ; Shan Fa YU ; Jun Ming DAI ; Xiao Man LIU ; Xiao Jun ZHU
Biomedical and Environmental Sciences 2016;29(9):678-682
This study proposes a new framework as job burden-capital model for comprehensive assessment on occupational stress. 1618 valid samples were recruited from electronic manufacturing service industry in Hunan province by self-rated questionnaires after written consent. Structural equation model analysis was employed to verify the model by the data collected. The final fitting model has satisfactory fitting goodness (CMIN/DF=5.78, AGFI=0.937, NNFI=0.960, IFI=0.968, RMSEA=0.054). Both of the measurement model and structural model have acceptable path loadings. Job burden and capital could either directly affect occupational outcomes or indirectly influence them through personality. Multi-group structural equation model analyses indicate general applicability of the model to the basic features of such population. The job burden-capital model opens up new horizons for more in-depth study on occupational stress.
Adult
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Exploratory Behavior
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Female
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Humans
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Male
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Models, Theoretical
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Occupations
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economics
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Stress, Psychological
;
economics
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psychology
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Surveys and Questionnaires
9.Sorafenib in liver function impaired advanced hepatocellular carcinoma.
You-xin JI ; Zhong-fa ZHANG ; Ke-tao LAN ; Ke-ke NIE ; Chuan-xin GENG ; Shi-chao LIU ; Ling ZHANG ; Xing-jun ZHUANG ; Xiao ZOU ; Lei SUN ; Zong-chun ZHANG
Chinese Medical Sciences Journal 2014;29(1):7-14
OBJECTIVETo explore the efficacy and safty of sorafenib in Child-Pugh class B to class C hepatocellular carcinoma (HCC).
METHODSIn this three-center open-label study from November 2011 to May 2013, we randomly assigned 189 patients with advanced Child-Pugh class B or C HCC patients into two groups, one group with 95 patient to receive sorafenib (400 mg a time, twice a day) and the other group with 94 patients to receive best supportive care. The primary end points were progression-free survival and overall survival.
RESULTSThe median progression-free survival was 2.2 months and 1.9 months in the sorafenib group and best supportive care group respectively (Hazard ratio in the sorafenib group, 0.55; 95% confidence interval, 0.40-0.75; P=0.002). The median overall survival was 4.0 months and 3.5 months in the sorafenib group and best supportive care group respectively (Hazard ratio in the sorafenib group, 0.48; 95% confidence interval, 0.35-0.68; P<0.001). The main adverse effect of sorafenib was rash and acne of the skin (in 51.7% patients). The incidences of severe rash, diarrhea, and dry skin were 5.6%, 5.6%, and 2.2% in the sorafenib group. One patient reached partial response in the sorafenib group.
CONCLUSIONSSorafenib is safe in patients with liver function impaired advanced HCC. It is effective in terms of progression-free survival and overall survival compared with best supportive care. Liver functions are the important predictive factors.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; administration & dosage ; adverse effects ; therapeutic use ; Carcinoma, Hepatocellular ; drug therapy ; mortality ; pathology ; Cross-Over Studies ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Liver Function Tests ; Liver Neoplasms ; drug therapy ; mortality ; pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Niacinamide ; administration & dosage ; adverse effects ; analogs & derivatives ; therapeutic use ; Phenylurea Compounds ; administration & dosage ; adverse effects ; therapeutic use ; Treatment Outcome ; Young Adult
10.A multi-center retrospective study of perioperative chemotherapy for gastric cancer based on real-world data.
Xue Wei DING ; Zhi Chao ZHENG ; Qun ZHAO ; Gang ZHAI ; Han LIANG ; Xin WU ; Zheng Gang ZHU ; Hai Jiang WANG ; Qing Si HE ; Xian Li HE ; Yi An DU ; Lu Chuan CHEN ; Ya Wei HUA ; Chang Ming HUANG ; Ying Wei XUE ; Ye ZHOU ; Yan Bing ZHOU ; Dan WU ; Xue Dong FANG ; You Guo DAI ; Hong Wei ZHANG ; Jia Qing CAO ; Le Ping LI ; Jie CHAI ; Kai Xiong TAO ; Guo Li LI ; Zhi Gang JIE ; Jie GE ; Zhong Fa XU ; Wen Bin ZHANG ; Qi Yun LI ; Ping ZHAO ; Zhi Qiang MA ; Zhi Long YAN ; Guo Liang ZHENG ; Yang YAN ; Xiao Long TANG ; Xiang ZHOU
Chinese Journal of Gastrointestinal Surgery 2021;24(5):403-412
Objective: To explore the effect of perioperative chemotherapy on the prognosis of gastric cancer patients under real-world condition. Methods: A retrospective cohort study was carried out. Real world data of gastric cancer patients receiving perioperative chemotherapy and surgery + adjuvant chemotherapy in 33 domestic hospitals from January 1, 2014 to January 31, 2016 were collected. Inclusion criteria: (1) gastric adenocarcinoma was confirmed by histopathology, and clinical stage was cT2-4aN0-3M0 (AJCC 8th edition); (2) D2 radical gastric cancer surgery was performed; (3) at least one cycle of neoadjuvant chemotherapy (NAC) was completed; (4) at least 4 cycles of adjuvant chemotherapy (AC) [SOX (S-1+oxaliplatin) or CapeOX (capecitabine + oxaliplatin)] were completed. Exclusion criteria: (1) complicated with other malignant tumors; (2) radiotherapy received; (3) patients with incomplete data. The enrolled patients who received neoadjuvant chemotherapy and adjuvant chemotherapy were included in the perioperative chemotherapy group, and those who received only postoperative adjuvant chemotherapy were included in the surgery + adjuvant chemotherapy group. Propensity score matching (PSM) method was used to control selection bias. The primary outcome were overall survival (OS) and progression-free survival (PFS) after PSM. OS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the last effective follow-up or death. PFS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the first imaging diagnosis of tumor progression or death. The Kaplan-Meier method was used to estimate the survival rate, and the Cox proportional hazards model was used to evaluate the independent effect of perioperative chemo therapy on OS and PFS. Results: 2 045 cases were included, including 1 293 cases in the surgery+adjuvant chemotherapy group and 752 cases in the perioperative chemotherapy group. After PSM, 492 pairs were included in the analysis. There were no statistically significant differences in gender, age, body mass index, tumor stage before treatment, and tumor location between the two groups (all P>0.05). Compared with the surgery + adjuvant chemotherapy group, patients in the perioperative chemotherapy group had higher proportion of total gastrectomy (χ(2)=40.526, P<0.001), smaller maximum tumor diameter (t=3.969, P<0.001), less number of metastatic lymph nodes (t=1.343, P<0.001), lower ratio of vessel invasion (χ(2)=11.897, P=0.001) and nerve invasion (χ(2)=12.338, P<0.001). In the perioperative chemotherapy group and surgery + adjuvant chemotherapy group, 24 cases (4.9%) and 17 cases (3.4%) developed postoperative complications, respectively, and no significant difference was found between two groups (χ(2)=0.815, P=0.367). The median OS of the perioperative chemotherapy group was longer than that of the surgery + adjuvant chemotherapy group (65 months vs. 45 months, HR: 0.74, 95% CI: 0.62-0.89, P=0.001); the median PFS of the perioperative chemotherapy group was also longer than that of the surgery+adjuvant chemotherapy group (56 months vs. 36 months, HR=0.72, 95% CI:0.61-0.85, P<0.001). The forest plot results of subgroup analysis showed that both men and women could benefit from perioperative chemotherapy (all P<0.05); patients over 45 years of age (P<0.05) and with normal body mass (P<0.01) could benefit significantly; patients with cTNM stage II and III presented a trend of benefit or could benefit significantly (P<0.05); patients with signet ring cell carcinoma benefited little (P>0.05); tumors in the gastric body and gastric antrum benefited more significantly (P<0.05). Conclusion: Perioperative chemotherapy can improve the prognosis of gastric cancer patients.
Chemotherapy, Adjuvant
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Female
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Gastrectomy
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Humans
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Male
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Neoadjuvant Therapy
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Neoplasm Staging
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Prognosis
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Retrospective Studies
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Stomach Neoplasms/surgery*