Objective To investigate the value of laparoscopy in the diagnosis and treatment of unexplained chronic abdominal pain.Methods From January 2014 to February 2016, clinical data of 56 unexplained chronic abdominal pain undergoing laparoscopic surgery were analyzed retrospectively.Laparoscopic exploration was performed firstly and then the corresponding abnormalities were diagnosed and dealt with accordingly.Results The disease causes were explicit in 48 cases (85.7%), including 25 cases of abdominal adhesions, 8 cases of chronic appendicitis, 2 cases of small intestinal diverticulum, 2 cases of intestinal tuberculosis, 2 cases of lymphoma, 5 cases of endometriosis, 2 cases of tubal adhesions, 1 case of peritoneal metastasis of gastric cancer after surgery, and 1 case of appendiceal mucinous adenocarcinoma.Surgical treatment was performed in 43 cases, 3 of whom were converted to laparotomy.There were no postoperative complications in the 56 cases.The follow-up rate was 92.9% (52/56), and lost of follow-up was in 4 cases.The follow-up duration was from 3 months to 3 years (median, 19.4 months).There was 1 death case (peritoneal carcinomatosis).There were 35 cases (62.5%) of complete relief of abdominal pain (no recurrence of preoperative abdominal pain symptoms) and 12 cases (21.4%) of pain relief (preoperative pain decreased or interval extended).The total effective rate was 83.9% (47/56).Conclusion Laparoscopy is of high value in the diagnosis and treatment of unexplained chronic abdominal pain.

Objective To discuss the angiogenic e ffects on tumor micrometastasis. Methods Literatures on the relation between tumor angiogenesis and micrometastasis were reviewed. Results Tumor angiogenesis was a basis of the devel opment of micrometastasis.Conclusion Micrometastic dependence on angiogenesi s gestates a novel revolution of tumor treatment.

Objective To evaluate the safety and efficacy of endoscopic techniques for diagnosis and treatment of breast diseases. Methods Related literatures of recent years were reviewed. Results A minimally invasive endoscopic technique can be performed through small incisions. This can contribute greatly to reducing postoperative pain, shortening recovery time, and achieving a good cosmetic outcome. Under endoscopy, meticulous dissection and hemostasis can be achieved. Endoscope assisted subcutaneous mastectomy, immediate mammary reconstruction, sentinel lymph node biopsy and axillary lymph node dissection, for breast cancer can be performed safely. Endoscopic surgery can also be applied for the diagnosis and treatment of benign breast tumor and transaxillary removal of glandular tissue in gynecomastia. In addition, fiberoptic ductoscopy can be used to diagnose patients with nipple discharge. Endoscopic surgery for patients with breast diseases can offer an excellent cosmetic outcome and maintain normal physiologic functions without a noticeable scar. It helps to give the patients confidence and improve the quality of life. Conclusion Breast surgery is a good candidate for endoscopic techniques.

Objective To explore the clinical efficacy of early breast cancer patients underwent breast-conserving surgery with postoperative chemotherapy and radiotherapy.Methods A retrospective analysis of 128 early breast cancer patients underwent routine breast-conserving surgery was conducted.The clinical effect and cosmetic results were analyzed by the follow-up results of 128 cases.Results (1) The 5-year follow-up rate was 100％,overall survival rate was 95.3％,1-year survival rate was 100％ (128/128) ;3-year survival rate was 98.4％ (126/128) ;5-year survival rate was 95.30％ (122/128).Postoperative follow-up 6 patients died,3 patients died of liver metastases,2 patients died of lung metastases,1 patient died of non-cancerous reasons.The local recurrence rate was 2.34％ (3/128),axillary lymph node recurrence rate was 1.56％ (2/128).The average recurrence time was three years and two months after operation,distant metastasis rate was 3.91％ (5/128).(2) Beauty evaluations of 128 patients with breast-conserving surgery were excellent in 71 cases (55.5％),good in 55 cases (43.0％),and poor'in 2 cases (1.6％).Good,acceptable as acceptance criteria,the acceptance rate was 98％.Conclusion Breast-conserving surgery is not only to a certain extent to solve the pursuit of female beauty,but also improve their quality of life.But only the complete elimination of residual lesions in order to truly ensure that no recurrence of tumor.Therefore,the appropilate survival rate of patients for radiotherapy and chemotherapy can be extended so that the patient's breast to maintain a good shape.Breast-conserving surgery combined with radiotherapy and chemotherapy is superior to the modified radical surgery,and popularization in the hospital.

Objective To evaluate the clinical significance of CEA mRNA expression in gallbladder bile for early diagnosis of liver metastasis from primary colorectal cancer. Methods [WT5”BZ] A CEA specific nest RT PCR assay was used to detect CEA mRNA expression in the gallbladder bile of 46 patients with colorectal cancer. Results The positive rate of CEA mRNA in gallbladder bile was 74%. The rate was directly proportional to that of live metastasis. Liver metastasis developed in 33% of patients with positive CEA mRNA expression. Conclusions The positive expression of CEA mRNA in gallbladder bile is a proof of prospective liver metastasis.

ObjectiveTo explore the recurrence inhibition of colorectal cancer by adenoviral transducted endostatin gene. Methods The recombinant adenovirus expressing endostatin was constructed. Its biological activities were observed. The levels of endostatin in mice peripheral blood, tumor local recurrence and tumor cell apotosis were analyzed after the endostatin gene transduction by adenovirus. Results The infecting supernatant of recombinant adenovirus significantly inhibited HUVEC proliferation. After the injection of the recombinant adenovirus, persistent high serum levels of endostatin in peripheral blood was observed, local recurrence rate decreased, and apotosis of recurrence tumor cells increased.Conclusions The intraveneously injection of recombinant adenovirus mediated endostatin gene produces high concentration and stable expression of endostatin,which effects prevention of local recurrence after surgical resection of colorectal cancer.

Objective To study the clinical feasibility and effect of totally endoscopic resection of axillary accessory breast.Methods Totally endoscopic resection of axillary accessory breast was performed in 48 cases(59 sites).On the basis of liposuction,a camera port and two 5-mm working trocars were made.By using forceps,dissecting scissors,or harmonic knife,were inserted.The cobweb-like fibropartition around the accessory breast was dissected.Results Postoperatively,there were 1 case of subcutaneous liquid accumulation and 2 cases of subcutaneous petechia,and no hematoma or infection developed.All wounds healed by first intention.Follow-up observations for 2～58 months(mean,23.6 months) showed good appearance and satisfactory effects.Conclusions Totally endoscopic resection of axillary accessory breast is safe,offering good cosmetic effects and being worthy of recommendation.

Objective To explore the diagnosis and treatment of abdominal cocoon. Methods This article retrospectively summarized clinical data of 6 cases of abdominal cocoon. Results All the 6 cases of abdominal cocoon were misdiagnosed preoperatively: 5 cases were diagnosed as having intestinal obstruction and 1 case,abdominal mass.Partial or total capsule resection was adopted in all the 6 cases,1 of which simultaneously underwent intestinal arrangement. Conclusions Abdominal cocoon is not specific,which is difficult to diagnose preoperatively.Upper digestive tract radiography,B-ultrasonography and CT scanning help to make the diagnosis.Partial or total capsule resection,intestinal arrangement,intestinal resection and release for intestinal adhesion are usually adopted as the treatment.

Objective To probe the effect of transareolar or mastoscopy assisted breast-conserving surgery combined with open axillary lymph node dissection in the treatment of breast cancer. Methods Nineteen patients, with breast cancer of a diameter cm from the nipple, were treated by transareolar or mastoscopy assisted breast-conserving surgery from August 2001 to November 2003.After the lipolysis and suction of axillary fat,open axillary lymph node dissection was performed. Results Intraoperative frozen pathological examination had showed positive margin in 1 case, in which an enlarged excision was required to obtain a negative result. Postoperative subcutaneous edema underlying the operated site occurred in 2 cases and was cured by needle aspiration and pressure dressing. Excellent cosmetic outcomes were obtained with symmetrical breast development and all the patients were satisfied with the treatment. Postoperative follow-up for 2～19 months (mean, 10.6 months) found no recurrence in the breast or the axillary fossa. Conclusions Breast-conserving surgery can be expediently carried out by means of transareolar incision or with the help of mastoscopy. The combination with open axillary lymph node dissection may give favorable effect.

Objective　 To study the significance of monitoring postoperative hematogenous micrometastasis of colorectal cancer．　 Methods　 The micrometastatic cancer cells in peripheral blood and bone marrow of the perioperative patients were investigated by CK20 mRNA RT-PCR.　 Results　 The positive rates(16.3%) of hematogenous dissemination without relapse or metastasis after operation were significantly lower than that(88.9%) in patients with postoperative relapse or metastasis. There were four types of hematogenous dissemination. (1) Postoperative temporary negatives.(2)Consistant positives. (3) CK-20 turned positive postoperatively. (4) Consistant negatives. All the 6 patients that died had positive CK-20 preoperatively.　 Conclusions　 The hematogenous dissemination of colorectal cancer plays an important role in postoperative relapse. The dynamic monitoring of CK-20 predicts hematogenous dissemination of colorectal cancer.