About the malignant tumor in China,the hepatocellular carcinoma mortality is second only to lung cancer and serious threat to the life and health of the masses.Furthermore,because most patients has been in advanced cancer during medical treatment,so had lost the chance of one-stage surgical resection.However,the sensitivity of hepatocellular carcinoma to chemotherapy,radiotherapy and other treatments are poor.Transcatheter arterial chemoembolization is the main method of the treatment for patients those have lost the chance of operation,though the clinical effect is significant,the inadequate is also presence,such as tumor necrosis,incompletely clear,residual tumor nidus and the damage of the immune function after operation.Recombinant adenovirus p53 gene can validly infect tumor cells,transcription and expression of p53 protein,it also regulate the expression of related genes inhibiting tumor cell growth and induce cell apoptosis directly or indirectly.It is increasingly highly attention that recombincanting rAd-p53 with transcatheter arterial chemoembolization(TACE) to treat hepatocellular carcinoma.In order to evaluate the clinical value and promising future,we will make a brief summary for the research progress in this area in recent years.

Objective To investigate the adjuvant therapeutic efficacy of three-dimensional conformal radiotherapy (3D-CRT) in treating patients who underwent surgical operation for biliary drainage.Methods Clinical data on 88 clinically diagnosed advanced pancreatic head carcinoma patients who received palliative biliary drainage surgery in Tanshan Gongren Hospital from Jan 2006 to Jan 2010 were retrospectively reviewed. The cases were categorized according to the treatment into control group ( n=34 ) , chemotherapy group ( n=23 ) and radiotherapy group ( n=31 ) . The patients in control group received no chemotherapy or radiotherapy after biliary drainage surgery.The patients in chemotherapy group received chemotherapy of 1 000 mg/m2 gemcitabine intravenous infusion on day 1 and day 8, 80 mg/m2 cisplatin intravenous infusion on day 1 for each treatment cycle.Each cycle lasted for 21 days and was repeated for 3 cycles at an interval of 7 days in a treatment course.Patients in radiotherapy group received 3D-CRT for 6 successive days followed by an interval on the 7th day.The treatment course was completed within 10~15 days with the total dosage of 3 000~4 800 cGy.The therapeutic effects and survival time were analyzed.Results The incidence of cancer associated pain was 52.9%, 39.1%and 9.7%in control group, chemotherapy group and radiotherapy group, respectively, which was significantly lower in radiotherapy than that in the other two groups (both P<0.05). The incidence of mild gastrointestinal symptoms was 8.8%, 73.9% and 16.1%, respectively, and that of bone marrow suppression was 0%, 82.6% and 9.7%, respectively, which were both significantly lower in radiotherapy group than in chemotherapy group (both P<0.05).The 1-year, 2-year and 3-year survival rate was 30.1%, 8.3%, 0% in control group, 35.3%, 14.8%, 0% in chemotherapy group and 46.4%, 21.1%, 3.6%in radiotherapy group, which in radiotherapy group was significantly higher than that in control group and chemotherapy group (all P<0.05).Conclusions 3D-CRT was a palliative strategy for advanced pancreatic head cancer, which could prolong the survival of patients.

Objective:To explore the clinical application of distal and proximal bilateral lateral pre-decompression in replant of digit degloving injury.Methods:From March 2012 to May 2021, 14 patients with 29 digits had replantation surgery of degloved soft tissue and severed digits in Section II, Department of Orthopaedics, Changzhou Medical District of 904th Hospital of PLA Joint Logistic Support Force. There were 2 types of injuries: degloving injury of soft tissue but with intact digital tip, and digital tip degloving injury with intact distal phalanx and nail bed. With the technique of distal and proximal bilateral lateral pre-decompression, pre-decompression incisions were made to the subdermal on both sides of the degloved skin over the proper palmar digital arteries. From where, the distal stump of the proper palmar digital arteries and nerves for anastomosis were found and had them anastomosed with the proximal proper palmar digital arteries and proper palmar digital nerves, then anastomosed digital pulp and digital dorsal veins (11 cases were direct anastomosis and 3 cases were bridged anastomosis). Follow-up was carried out by outpatient consultation, telephone and WeChat APP. The appearance of the digit body, the shape of digital pulp, the nails grow and the motions of the digits were observed, and the Evaluation Standard of Replantation of Severed Fingers by the Society of Hand surgery of Chinese Medical Association was used to evaluate the recovery of function.Results:All 29 segments of degloving digit survived. Small necrotic areas was found in 4 digits and healed after the change of dressing. The followed-up time was lasted for 3-36 months. There was no obvious atrophy found in all the digits. Appearances of digit pulp and nails were satisfactory with good sensational recovery for TPD at 6-10 mm, 7 mm in average. Motions of all the repaired digits were good. According to the Evaluation Standard of Replantation of Severed Fingers by the Society of Hand surgery of Chinese Medical Association, 23 digits were in excellent, 4 in good and 2 in poor, with a satisfactory rate at 93.1%.Conclusion:For a distal digit injury with intact distal soft tissue and relatively mild injury of blood vessels and nerves, using the method of distal and proximal bilateral lateral pre-decompression can help to achieve good appearance in survived digital pulp, good sensational recovery and good nail growth. An individualised treatment intra-and-after the surgery could offer an ideal therapeutic effect.