The spleen whose size reaches or exceeds third degree should be regarded as massive splenomegaly.Splenectomy for massive splenomegaly demands precise procedures.First,median incision on upper abdomen(or vertical rectus muscle splitting incision)and incision under left costal arch are preferred.Second,the spleen was freed and then 0.33 mg of epinephrine was injected via the splenic artery before splenic artery ligation.During the process,a cell saver helps to minimize blood loss and makes autoinfusion possible for patients with benign lesions.Third,preoperative administration of fibrinogen,platelet and essential styptieum combined with the cooperation between surgeons and anesthesi010gists are the key points of bloodless surgery which is important for the recovery of patients.Four common problems of splenectomy for massive splenomegaly should also be addressed,including operation discontinuance,perioperative hemorrhage,accessory injury and postoperative intractable fever.

10 h. Results 15 patients had been misdiagnosed as epididymis orchitis or acute abdomen and undergone orchiectomy because of necrosis of the testicles,including 11 cases of intrascrotal torsion (testicular torsion in scrotum with an orchiectomy rate of 79%) and 4 cases of cryptorchidism with torsion.3 cases scrotal orchidopexy has been performed and during the follow up ( 6～36 months) the testicle in 2 of which appeared viable and normal while testicular atrophy has been observed in 1.In recent years 11 adolescents underwent exploration because of acute scrotal pain,7 cases being testicular torsion and 4 acute epididymitis. Conclusions It is emphasized that in younger patients suffering suddenly from pain in scrotum, especially occurring at night,the diagnosis of testicular torsion should be considered.Differentiating cryptorchidism with torsion from incarcerated hernia or acute abdomen,testicular torsion in scrotum from acute testitis and epididymitis should be serious considered.In order to save the testicle with early surgical exploration orchidopexy might be mandatory to aviod recurrence.

With the continuous development of tumor immunology,cancer vaccines have become a hot spot of tumor immunotherapy.Companion member antigen peptide tumor vaccine attracts widely attention because of its chemical stability,easy preparation and no carcinogenic potential advantage.Companion member antigen peptide tumor vaccine may work through many kinds of ways including the function of antigen presenting,enhancing the body's non-specific line of anti-tumor mechanisms and activating the tumor-specific immune mechanism.Its different anti-tumor mechanisms merits and so on will have positive function in the tumor clinical immunity treatment.

Objective To discuss the anticancer role of arsenic trioxide (ATO) with cisplatin on human oral carcinoma HSQ-89 cells. Methods The human oral epidermoid HSQ-89 cells were chosen as the subjects. Different concentrations of ATO were added into Cisplatin(DDP)-treated cells. The inhibition rate of tumor cells was detected by MTT assay. Results Different concentrations of ATO (0,2.5,5,7.5,10,12.5 μmol/mL) were added into oral cancer HSQ-89 cells which have been treated with DDP (15 μg/mL). The inhibition rate of tumor cells were 26.9%, 67.5%, 73.0%, 88.5%, 90.4%, 98.7%respectively; The combined application of ATO with cisplatin could improve the inhibition rate of HSQ-89 cells in a dose-dependent relation. Conclusion The combined application of ATO and DDP can produce a synergistic action of inhibition on oral cancer cell.

Objective:To retrospectively investigate the regulation of cervical and posterior to level V (PLV) lymph node metastasis on clinical target delineation in radiotherapy for nasopharyngeal carcinoma (NPC). Methods:A total of 428 NPC cases from February 2013 to April 2016 were subjected to enhanced CT scan from the base of the skull to the clavicle for pathological diagnosis. A deputy chief physician and an attending physician assessed the nodal distribution in each level in accordance with the RTOG guidelines proposed in 2013. The central point of the metastatic lymph nodes of PLV in the patients were recreated proportionally on the CT images of a stan-dard patient with N0 NPC in reference to the normal anatomy of the PLV area. SPSS 19.0 was used to analyze the correlation between PLV and the other levels. Moreover, the nodal location and characteristics of PLV were analyzed. Results:Among the 428 patients, 381 (89.0%) showed nodal involvement. The top four metastatic probabilities were presented as follows:Ⅱb (75.2%),Ⅶa (60.3%),Ⅱa (59.6%), andⅢ(42.0%). Up to 21 (4.9%) patients exhibited nodal involvement of PLV with 32 nodes. The mean vertical distance of all central points of PLV from the anterior border of the trapezius was 16 mm. Correlation analysis indicated the nodal involvement of PLV with the ipsilateral level Va (P=0.001). Conclusion:NPC showed a high probability of nodal metastasis. Nodes were mostly metasta-sized from the upper to the lower level, as well as from the proximal to the distal area. The leap metastasis rate was very low. The nod-al involvement of PLV correlated with the ipsilateral metastasis of level Va. Thus, the ipsilateral delineation of the posterior border of level V should be contoured to 25 mm far from the anterior surface of the trapezius during the nodal involvement of level Va.

AIM: This study was designed to investigate the apoptotic effect of doxycycline in THP-1 cells.METHODS: After differentiated by PMA, THP-1 cells were treated with doxycycline at different concentrations ranging from zero to 80 mg/L. The morphological changes of THP-1 cells were observed under light microscope. MTT assay were used to examine the effects of doxycycline on proliferation of THP-1 cells. Apoptotic THP-1 cells were measured by Annexin-V flow cytometry analysis and TdT-mediated dUTP nick end labeling assay.RESULTS: Treated with a certain concentration of doxycycline, differentiated THP-1 cells contracted and turn round, a number of cells were dead. MTT assay and positive Annexin V-FITC on cell membrane and TUNEL assay showed that doxycycline induced apoptosis in THP-1 cells in a dose-dependent manner.CONCLUSION: Doxycycline induces apoptosis in THP-1 cells in a dose-dependent manner.

Objective: To retrospectively compare the prognosis between patients with locally advanced T and N stage nasopharyngeal carcinoma (NPC), to provide a reference for the clinical treatment of NPC. Methods: A total of 264 NPC cases from December 2011 to November 2017 visiting The General Hospital of Western Theater Command were pathologically diagnosed and retrospectively analyzed. Of these, 102 and 162 were locally advanced T and N stage, respectively. Results: The two groups 5-year overall survival (OS), progression-free survival (PFS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) were compared. These were 82.8% and 75.8% (P=0.271), 73.7% and 62.8% (P=0.043), 87.6% and 91.6% (P=0.646), 87.7% and 79.5% (P=0.066), respectively. Conclusions: The DMFS, OS and PFS decreased in patients with locally advanced N stage NPC, although there was no statistical difference. The significance of systemic and stratified treatment should be emphasized in patients with locally advanced N stage NPC in order to achieve a higher OS rate and reduce distant metastasis.

Portal vein stricture complicated with superior mesenteric venous thrombosis is rarely seen in clinical practice. On December 26, 2009, a 51-year-old male patient who had a liver transplantation history was admitted to The General Hospital of Chinese People's Armed Police Forces with the chief complaint of intermittent abdominal pain and diarrhea.A plain and enhanced CT scan showed that the portal vein was constrictive and thrombosis had formed in the main trunk of the superior mesenteric vein, and varicose veins were seen in surrounding tissues of the esophagus. Edema was observed at the end of the ileum and cecum. The results of colonoscopy showed inflammatory changes and varicose veins of the colon. The patient received medical treatment. The thrombosis was dissolved 9 days later, and all symptoms disappeared 12 days later.

Objective To study the effect of ribozyme mediated inhibition on telomerase activity and cell(proliferation) of GBC-SD cells.Methods According to the hTR template two wings region sequence,the hammerhead ribozyme gene sequence was synthesized in vitro.Then,it was engineered into the eukaryon(expression) vector pTriEx-4.Lipofectamine was used to transfect the carcinoma of gallbladder.The inhibition of telomerase activity and cell proliferation in GBC-SD cell was observed,and compared with control group.(Results) Compared to control group,ribozyme can significantly inhibit telomerase activity and cell proliferation of GBC-SD cell.After ribozyme action,the cell ratio of G_0/G_1 markedly increased,and the cell ratio of S phase markedly decreased.Cellular cleavage and proliferation was markedly inhibited.The apoptosis rate was 17.10% and 31.01% on day10 and day13 after ribozyme action.Conclusions Ribozyme can inhibit(telomerase) activity of GBC-SD cells effectively and induce cell apoptosis.

Objective To analyze the clinical factors predicting long-term survival after curative resection of pancreatic head carcinoma. Methods The clinical data of 58 patients with ductal adenocarcinoma of pancreatic head who underwent curative resection of carcinoma of pancreatic head from 1996 to 2004 were collected and were analyzed by SPSS 10.0 with Cox Proportional Hazards Model. Results 58 patients, including 30 male and 28 female patients, were involved in this study. Pancreaticoduodenectomy were performed in 14 cases and extended resections were performed in 44 cases. The overall 1, 3, 5 year survival rates was 46.6%, 29.3% and 8.6%, respeclively. The 1,3, 5 year survival rates of pancreatoduodenectomy with extended regional lymphadenectomy was 43.1%, 22.7% and 6.8%, respectively. UICC staging, peri-pancreatic nerve invasion and blood infusion had significant effects on the prognosis after curative resection. Conclusions The long-term prognosis after curative resection of pancreatoduodenectomy was still dismal. Much importance should be paid to early diagnosis and comprehensive management for pancreatic head cancer.