Background and purpose:In all treatments of retroperitoneal tumors,surgical operation is still the only effective method which might cure the tumors.However,the patients were always in advanced stages when they were clinically diagnosed.The inferior cava of the patients always have been invaded by tumors,which is considered to be a relative surgical contraindication.This study was to explore the surgical method in treatment of retroperitoneal tumors with major blood vessels invasion,and in order to raise the resection rate and survival rate. Methods :Retrospective analysis of twelve cases which implicate major vessels and have parallel artificial vascular reconstruction during operations of retroperitoneal tumor from January 2003 to June 2007. Results :Twelve cases of retroperitoneal tumor and implicated major vessels were integrally resected,corresponding important vascular reconstructions were done,no short-term postoperative deaths. Conclusions :Retroperitoneal tumor involving abdominal important vessels is not a contraindication of radical surgical.Integrated resection of retroperitoneal tumor and implicated major vessels and corresponding important vascular reconstruction are safe,and can improve the resection rate and reduce the relapse rate,extend the survival time.

Objective To summarize the experience in major vessels reconstruction after resection of retroperitoneal neoplasm invided major vessel. Methods Sixteen patients with retroperitoneal neoplarsm invading major vessels underwent resection of the tumor companying with the inviding major vessels, and the resected vessels were reconstructed.Of them, 13 artificial vessels were placed for the vascular reconstruction,and 3 underwent inferior vena cava partial resection and repair with or without PTFE patch;combined reconstruction of arteries and veins were performed on 6 patients,and combined resection and reconstruction of vessels and other invaded organs were performed on 3 patients. Results There was no operative mortality in this series. Fourteen patients were followed up for 3-71 months( averaged 30 months) .Five patients died,in which 3 patients died within 12 months, 1died at 64 months and 1died at 71 months after surgery,respectively.There were no obstruction of the reconstructed vessels during follow up. Conclusions Combined resection of retroperitoneal neoplasm with invided major vessel and vascular reconstruction is a safe, effective operation for retroperitoneal neoplasm companying with inviding major vessel.

Background and purpose:Radical surgery remains the main treatment for the patients with pancreatic and duodenal cancer,but resectability rate is low when clinically diagnosed,portal vein/superior mesenteric vein or inferior caval vein invaded by tumors are a few of the main reasons.How to increase resectability of pancreatic cancer and duodenal cancer still is very challenging to the clinician.This study was done to explore the feasibility of the new surgical approach for the treatment of pancreatic and duodenal cancer with portal vein/superior mesenteric vein or inferior caval vein invasion.Methods:5 patients received pancreatoduodenectomy with vascular reconstruction between February 2002 and June 2005.Three patients with pancreatic head cancer underwent pancreatoduodenectomy combined with portal vein/SMV resection and vascular reconstruction and two patients with duodenal cancer underwent pancreatoduodenectomy combined with inferior caval vein resection and vascular reconstruction.Results:There was no surgery related death.The serious complications such as artificial blood vessel infections or obstructions were not experienced.After surgery,one patient died 10 months later,one patient died 24 months later,two patients survived for over 3 years and one patient over 4 years.Conclusions:Pancreatoduodenectomy with vascular reconstruction for patients with carcinoma of the pancreatic head or duodenum invading portal vein/superior mesenteric vein or inferior caval vein has been proved to be a safe treatment,it could improve the resectability of the tumor and prolong survival.

Objective To explore the effects of insulin pump on pancreatic ?-cells in type 2 diabetes mellitus accompanied with hyperglycaemia.Methods We treated 46 cases of newly diagnosed type 2 diabetes mellitus with fasting blood glucose≥10.0 mmol/L by insulin pump for 2 weeks.Their blood sugar and insulin were determined before and after treatment by oral glucose tolerance test and insulin releasing test.We then calculated the function index,morning secretion of pancreatic ?-cells and insulin resistance index.The patients were followed up for 6 months and the blood glucose was monitored.Results After treatment,insulin,function index and the morning secretion were increased significantly,while the blood sugar and resistance index were decreased.In all the patients,16 could maintain ideal blood glucose only by alimentary control and exercise.Conclusion With the insulin pump in a short term,patients with type 2 diabetes mellitus can rapidly control blood glucose,obviously improve pancreatic ?-cells,and reduce insulin resistance.

Objective To determine the correlation between HLA gene and Takayasu arteritis(TA) in the Chinese. Methods Forty four TA patients and 135 healthy controls were examined for HLA DQA 1 and HLA DQB 1 locus alleles by PCR/SSOP typing and mass genetics techniques. Results The frequency of DQA 1 0301 allele(14.8%) in TA patients was significantly decreased compared with the controls( 30.7% )(P0.05). Conclusions In Chinese, people with HLAⅡ DQB 1 0601 gene may be susceptible to TA, while people with HLAⅡ DQA 1 0301 gene may be resistant to TA.

With the development of imaging technology,the reports of spontaneous isolated superior mesenteric artery dissection become more frequently,but there is no consensus on the therapeutic plans which consist of conservative therapy,endovascular treatment and surgical treatment.Therefore,the related questions of the spontaneous isolated superior mesenteric artery dissection will be discussed in order to improve the diagnosis and treatment of vascular diseases of digestive tract with a review of literatures.

Since Reich completed the first laparoscopic hepatectomy (LH) in 1991,LH has been developed rapidly with the continuous improvement of surgeons' technique and the technological changes in devices and related processes.This article elaborates on the safety and efficacy of LH,the value of 3D visualization,3D printing technology,and 3D laparoscopic technology in guiding precise hepatectomy,control of hemorrhage during LH,and safety and efficacy of robotic hepatectomy.

Objective [WT5”BZ] To evaluate the preliminary clinical results of the endovascular grafts for the treatment of abdominal aortic aneurysms (AAA).[WT5”HZ]Methods [WT5”BZ] Fourteen patients with infrarenal abdominal aortic aneurysms underwent transluminal endovascular graft placement for the exclusion of AAA.[WT5”HZ]Results [WT5”BZ] Two patients received tubular and 12 patients received bifurcated endograft, the placement was successful in all cases. Aortography carried out immediatly after the procedure showed the AAA were completely excluded by endografts, and no endoleaks both on the proximal or distal connections. Myocardial infarction developing in a patient postoperatively was successfully treated by thrombolysis. Perioperative death occurred in 2 cases. Technical success at 30 days was 85 7%. 24 month follow up in 12 cases found migration of the graft in none and endoleaks in 2 cases.[WT5”HZ] Conclusion [WT5”BZ] Based on our initial results and a rather short follow up period of 24 months, the endovascular treatment of AAA with stent graft is safe and effective. Long term follow up is needed to evaluate the feasibity of this procedure.

Objectives To investigate the effect of tumor necrosis factor ? on skeletal muscle ischemia reperfusion injury (SMIR). Methods Twenty four healthy male Sprague Dawley rats were divided into three groups. Group A underwent anesthesia and external jugular vein cannulation only. Group B underwent 4 hours of left hind limb ischemia followed by 4 hour reperfusion. Group C ischemia and reperfusion were treated with anti TNF ? monoclonal antibody (2?mg/kg). ResultsSMIR significantly increased the transcription of TNF ? mRNA in monocyte. The increased TNF ? raised significantly the level of MDA(9 9?1 8 vs. 5 5?0 4)?CK(122?24 vs. 49?11)?NO(270?98 vs. 128?46) in plasma and MPO(skeletal muscle 4 27?0 53 vs. 1 28?0 19, lung 2 61? 0 12 vs. 0 57?0 02) in tissues respectively( P

ObjectiveTo evaluate the treatment strategy for patients with abdominal aortic aneurysm (AAA) and concomitant digestive system diseases (DSD) necessitating a surgery.Method From Mar. 1999 to Oct. 2001, clinical result of 6 cases suffering from concomitant AAA and DSD was reviewed. The AAA ranged from 4 8 to 11?cm in diameter. Cholecystectomy (for acute cholecystitis) and sigmoidectomy (for colonic cancer) were performed synchronously with AAA repair in 2 cases and 1 case respectively. Right semicolonectomy, radical subtotal gastectomy and esophagogastrectomy (all for carcinoma) were performed heterochronously with AAA endovascular exclusive grafting in one each patient, ResultGastric paresis developed postoperatively and recovered spontaneously in one patient. Esophagogastroanastomosis leakage caused a death in 1 patient. With follow up of 6～42 months the remaining 5 patients were alive, with no graft infection, nor cancer recurrence. ConclusionThe concurrent presentation of AAA and digestive tract diseases necessitating surgical intervention could be successfully managed synchronously or heterochronously.Endovascular exclusive graft of AAA is an effective therapy in patiens suffering from concomitant AAA and DSD.