With the era of precision hepatic surgery coming,the hepatic surgery has been promoted to brand-new level,which would be more accurate and meticulous.However,all those advances,such as super-thin computed tomography scan,three-dimensional imaging and the technology of threedimensional printing,have not promoted the clinic results for patients overtly.The optimal curative effect could be attained,if there is a perfect combination of operators' experience and those advanced imaging.For two issues,the time of vascular inflow occlusion and residual hepatic volume,operators could flexiblely use of clinic existing researches with surgical team and instruments according to the medical condition of patients.Precision hepatic surgery could be promoted to a higher level through constantly clinical research and innovations.

Objective:To observe the therapeutic effect of scalp acupuncture combined with body acupuncture in treating cancer patients with intractable hiccups after radiochemotherapy. Methods:Thirty-two cancer patients with intractable hiccups after radiochemotherapy who met the inclusion criteria were selected. The Line 2 Lateral to Forehead (MS 3) of scalp stimulation areas as well as body acupoints including Danzhong (CV 17), Zhongwan (CV 12), bilateral Cuanzhu (BL 2), Neiguan (PC 6), Zusanli (ST 36) and Taichong (LR 3) were punctured. The treatment was given once a day, 5 treatments constituted a course, and the efficacy was evaluated after 2 treatment courses. Results:After 10 treatments, 26 cases were cured, 4 cases were improved, and 2 cases were invalid, and the total effective rate was 93.8%. Conclusion:Scalp acupuncture combined with body acupuncture in treating intractable hiccups in cancer patients after radiochemotherapy has reliable therapeutic effect, and it is easy-to-operate and can effectively alleviate the suffering of patients with less adverse reaction.

In order to observe the clinical effect of Tuina therapy for vertigo, 47 cases of the patients with vertigo were treated by massaging Triple Energizer Meridian and Gallbladder Meridian on the head, and the results showed cure in 36 cases, improvement in 11 cases and the total effective rate was 100%.

Purpose To investigate the expressions of costimulation molecules PD-L1 and PD-L2 in human breast cancers and their association with clinical and pathologic characteristics of the patients.Methods The expressions of PD-L1,PD-L2 in 10 cases of normal human breast tissue,18 cases of ductal carcinoma in situ,and 40 cases of breast cancer were detected by immunohistochemistry SP two-step staining,and the relationship between their expressions and clinical and pathologic characteristics was evaluated.Results There was no PD-L1 or PD-L2 expression in normal breast tissue,faint expressions of PD-L1 and PD-L2 were determined in ductal carcinoma in situ.45％ (18/40) PD-L1 and 35％ (14/40) PD-L2 were detected in breast cancers.PD-L1 and PD-L2 expression in cancer cells were related to the lymph node metastasis,ER and PR (P ＜ 0.05).High expression of PD-L1 and PD-L2 in breast cancer patients were correlated with negative ER,PR and HER-2 (P ＜ 0.05).Conclusion PD-L1 and PD-L2 express aberrantly in breast cancer and are closely associated with the lymph node metastasis of breast cancer.PD-L1 and PD-L2 may be the potential immunotherapy targets of breast cancer.

Objective To seek the least damage to tooth structure and method of treatment to obtain the minimal microleakage.Methods 600 posterior teeth in vitro constant,according to the random number table method,were divided into 6 groups:A,B,C,D,E,F,l00 cases in each group.The pigmentation of deep pit and fissure or pit and fissure caries of the suspicious isolated human premolar were selected as observation objects,respectively.a Er:YAG laser,a high-speed diamond bur and clean cup brush were used to prepare for isolated anterior molar occlusal pit and fissure.And the performance of each sample was filled with light curing composite resin and fluid,Six different filling conditions of filling body and fissure between microleakage and bonding interface were observed by dye penetration method and scanning electron microscopy.Results The efficiency of F group was 99％,which was significantly higher than 87％ of C group (χ2 =5.84,P ＜0.05),55％ of D group(χ2 =7.21,P ＜0.05) and 87％ of E group (χ2 =11.65,P ＜ 0.05).The efficiency of C group was 87％,which was significandy higher than 43％ of A group (χ2 =3.97,P ＜ 0.05) and 61％ of B group (χ2 =8.35,P ＜ 0.05).The efficiency of B group was 61％,which was significantly higher than 43％ of A group (χ2 =6.25,P ＜ 0.05).Conclusion Er:YAG laser with fluid resin filling is the most effective way for the clinical treatment of pit and fissure deep narrow,already susPicious pit and fissure caries pit and fissure sealant failed teeth.

Biliary cystic tumors (BCTs) are rare cystic tumors and are accounted for less than 5％ of liver cysts.BCTs are very common in middle-aged and elderly women,and depend on diagnosis of imaging including papillary projection or multilocular cystic liver mass.BCTs are frequently misdiagnosed due to the absence of specific diagnostic indicators,which should differentiate from diagnosis of hepatic cystic.Complete surgical resection is the first choice for BCTs with a good out-come,in addition to low recurrence.Once recurrence was identified in follow-up,BCTs can be treated by reoperation with a good outcome.

Hematopoietic cell transplantation is frontline treatment of multiple myeloma (MM).Autologous hematopoietic stem cell transplantation (auto-HSCT) could improve remission rate,prolong survival time,the tandem auto-HSCT is able to make patients get further benefits for patients not achieving at least very good partial remission after the first auto-HSCT.Allologous hematopoietic stem cell transplantation (alloHSCT) is potentially able to cure multiple myeloma,but patients achieve less benefit because of high transplant-related mortality (TRM).The TRM is low after reduced-intensity conditioning allo-HSCT,but which exhibit no survival benefit.Moreover,patients achieve no survival benefit after tandem auto-HSCT and allologous reduced-intensity conditioning transplantation.This paper reviewes recent studies about HSCT in MM.

Caudate lobectomy is still a great challenge for surgeons due to unique anatomy of caudate lobe.A 38-year-old male patient with a huge recurrent hepatic cancer (diameter =16 cm) in caudate lobe received caudate lobectomy with portal triad and inferior vena cava clamping.The operation was paused due to hemorrhage (volume of blood loss =1000 ml).After heat preservation and blood transfusion,the caudate lobectomy was completely removed with inferior vena cava clamping.The patient gradually recovered,and no tumor recurrence was detected during the follow up (14 months).Caudate lobectomy could be safely carried out under the condition of accurate preoperational estimation,clear indication for surgery and precise hepatectomy.

Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Chronic Disease ; Humans ; Macrolides ; administration & dosage ; therapeutic use ; Sinusitis ; drug therapy

Combined Modality Therapy ; Endoscopy ; Humans ; Intraoperative Period ; Rhinitis ; therapy ; Sinusitis ; therapy