Liver resection is one of the important treatments of liver diseases,especially hepatocellular carcinoma.In China,the vast majority of liver cancer patients suffer from generalized damage of the liver parenchyma such as cirrhosis,lead to liver reserve function reducing in various degrees.Liver dysfunction or even liver failure after liver resection becomes an important reason of perioperative death and influences the patients' long-term survival.Therefore,accurate preoperative evaluation of liver reserve function is very important.Though there are seveal kinds of assessment of liver reserve function in recent years,it still lack of a clinically recognized,comprehensive assessment method.This paper reviewed the clinical commonly used preoperative liver reserve function evaluation methods,summarizes and analyzes the value and the insufficiency of several important methods,and prospects the development of evaluation methods about preoperative liver reserve function.

Objective: To evaluate the effect of open-chest surgery for cancer patients in advanced stage, in aged and with respiratory insufficiency. Methods: From May 1992 to December 2002, 637 patients with lung cancer underwent thoracotomy in out hospital. 118 of the 637 patients fit in with the standards of advanced, aged or respiratory insufficiency. RVEF was consecutively assessed in 118 before pulmonary resection by echocardiography. According to right ventricular function, the 118 patients were dicided into group A(n=77, RVEF

Objective To evaluate the outcomes of thoracoscopy-assisted mini-incision procedure in patients with lung cancer.Methods From January 2003 to June 2003,66 patients with non-small cell lung cancer were treated in our hospital by lobectomy combined with mediastinal lymph node resection using thoracoscopy-assisted mini-incision(36 patients,VATS Group)or traditional surgery(30 patients,traditional group).The clinical and follow-up data of the two groups were compared after the operation.Results No significant difference was found in the operation time between the VATS and traditional groups(114.6?47.4)min vs(123.3?43.9)min,t=-0.768,P=0.449],while the postoperative hospital stay of the VATS group was significantly shorter than that in the traditional group (9.2?1.4)d vs(10.5?1.7)d,t=-3.408,P=0.001].Log-rank test showed that the survival curve in the two groups was comparable(?2=0.270,P=0.605).Cox regression model indicated that the pathological characteristics(risk ratio:3.912,P=0.000),TNM stage(risk ratio:3.737,P=0.000),and lymph node metastasis(risk ratio:15.495,P=0.000)were independent,unfavorable prognostic factors for the disease;whereas,no relation was detected between the thoracotomy incision and prognosis(P=0.414).Conclusions Thoracoscopy-assisted mini-incision procedure is a safe and reliable approach for patients with lung cancer with satisfying outcomes.

Objective To research the feasibility and superiority of video-assisted thoracoscopic surgery(VATS) in the diagnosis and treatment of thoracic traumas.Methods Video-assisted thoracoscopic surgery was used in 40 patients with thoracic traumas,including thoracic exploration,repair of pulmonary laceration,and evacuation of clotted hemothorax.[WTHZ]Results All the 40 patients were cured,including simple VATS in 31 patients,thoracoscopy-assisted mini-incision surgery in 8 patients,and conversion to open surgery in 1 patient.The time of operation was 79.9?33.1 min.The amount of blood clots and noncondensing blood cleared was 567.5?177.8 ml.The closed thoracic drainage tube was removed at 24~48 h postoperatively,with a drainage volume of 220?45.6 ml.The length of hospital stay was 4~13 d(mean,8.7 d).The sutured wound healed by first intention in all the patients.No postoperative complications were observed.Follow-up reviews in 35 patients for 6~12 months(mean,8.6?2.6 months) revealed uneventful recovery and no trauma-related complications.Conclusions As compared with conventional open surgery,VATS has shown advantages of exact diagnosis,timely management,little invasion,and quick recovery for patients with thoracic traumas.

Adult ; Coal Mining ; Cognition Disorders ; etiology ; Explosions ; Follow-Up Studies ; Humans ; Surveys and Questionnaires ; Survivors ; Young Adult

Child ; Child, Preschool ; Epilepsy, Generalized ; complications ; epidemiology ; genetics ; Female ; Humans ; Infant ; Male ; Pedigree ; Phenotype ; Seizures, Febrile ; complications ; epidemiology ; genetics

Objective To investigate the characteristics and patterns of lymph node metastasis in lung cancer and to provide evidence for determining the range of lymph node dissection.Methods One hundred and eighteen patients with lung cancer received complete resection combined with systematic lymph node dissection according to the mapping system developed by Naruke.Results A total of 835 lymph nodes were dissected from 118 lung cancer patients.The positive ratios of N1 and N2 were 15.6% and 17.4% respectively.Fifteen patients were found with skipping N2 which were located in 2,4,5,6 and 7 lymph node groups respectively.There was no significant relationship between the size of primary tumor and lymph node metastasis.Small cell lung cancer showed the highest risk of lymph node metastasis.The metastatic rate of lymph node in adenocarcinoma was markedly higher than that of squamous cell carcinoma.Skipping mediastinal lymphatic metastasis was found more frequently in lower lobar tumors than that in upper lobar ones.Conclusion Lymph node metastasis of lung cancer may occur in multiple groups and regions,even in a skipping pattern.Systematic lymph node dissection may be routinely performed in pulmonary resection for lung cancer.

Tibetan medicineLiu-Wei Mu-Xiang(LWMX) pill, a traditional compound medicine, has special therapeutic effects in the treatment of gastrointestinal anabrosis, especially chronic gastric ulcer. It has been widely applied in the clinics in Tibetan region. Nevertheless, the current standards for quality control are insufficient and incomplete, which makes it difficult to ensure its quality. This review focused on two closely related perspectives, which were the effective material basis and quality control, to summarize and review the recent advancement in relevant studies. This review also pointed out that the burning questions for Tibetan medicine standards were the origin confusion and“different medicines with the same name”. It offered meaningful suggestions for the consideration to improve its quality standards.

Objective The patients with non-syndromic deafness in Shanxi Province were retrospectively an_alyzed for the common deafness gene mutations and frequency of mutations carrying rate ,to understand the molecu_lar pathogenesis of deafness in Shanxi area .Methods Genomic DNAs of 800 patients of non -syndromic deafness within Shanxi were obtained from peripheral blood .Genes GJB2 ,GJB3 ,SLC26A4 and mitochondrial 12SrRNA 1494 and 1555 loci were sequenced after polymerase chain reaction (PCR) amplification and compared with the NCBI website for the analysis of the formation of mutations .ResuIts Among 800 patients ,353 cases (44 .13% ) showed detected deafness related mutations and the genetic etiology was found for 294 patients (36 .75% ) .Among them , 153 cases (19 .13% ) carried double allele mutations in the GJB2 gene .The most frequent mutation of GJB2 gene was 235delC ,and the carrying rate was 13 .5% (216/1 600) .The double mutant allele of SLC26A4 gene was detec_ted in 123 cases (15 .38% ) ,and the most common mutation was IVS7-2A>G ,identified in 7 .44% (119/1 600) of patients .Homogenic mitochondrial 12S rRNA 1494C> T mutation in one patient and 1555A> G mutation in 15 patients were detected .GJB3 gene c .538C > T heterozygous mutation was found in two patients .Altogether , 36 .75% (294/800) of patients with deafness were caused by gene mutations .ConcIusionThe data containing GJB2 gene and SLC26A4 gene carrying rate are consistent with the published data of non-syndromic deafness in the Northwest region of China ,but the carrying rate of mitochondrial gene mutations is lower than the average level of China .Our data show that the gene mutations contribute to 36 .75% of etiology in patients with deafness .This study reflects the importance of deafness related genes screening in Shanxi area for early diagnosis and genetic con_sultation .

Objective To observe the effect of resveratrol on arterial remodeling in spontaneous hypertensive rats.Methods Spontaneous hypertensive rats (SHRs, n=20) and Wistar-Kyoto rats (WKYs, n =10) were randomly assigned to three groups: control group, model group and resveratrol group.Systolic blood pressure (SBP) and pulse wave velocity (PWV) of the three groups was observed.Morphological observations were obtained by hematoxylin and eosin or victoria blue and picrosirius red.The content of nitric oxide (NO) and endothelin-1 (ET-1) were determined to assess the endothelial function.Oxidative stress was assessed by malondialdehyde (MDA), hydrogen peroxide (H2O2) , and activities of antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT).Results Compared with control group, SBP, PWV, wall thickness, wall-lumen ratio,vascular cross-sectional area (VCSA), luminal cross-sectional area (LCSA) and collagen-elastic ratio were increased, and the levels of NO, SOD, CAT in rat aortic tissues were decreased, while ET-1,MDA, H2O2 levels in rat aortic tissues were enhanced in model group at the end of 22 weeks.After the treatment of resveratrol, SBP had no significantly difference between model and resveratrol groups, while PWV, aortic wall thickness, wall-lumen ratio, VCSA, LCSA and collagen-elastic ratio were decreased in resveratrol group as compared with model group [(6681.1 ± 2154.9) cm/s vs.(4283.1±946.1) cm/s, (234.7±51.8) μm vs.(123.4±21.5)μm, (10.3±2.3) ％ vs.(5.8±1.4) ％, (6.4±0.4) mm2 vs.(4.8±0.6) mm2, (4.1±0.1) mm2 vs.(3.2±0.4) mm2, (1.1±0.3) vs.(0.4±0.2), P＜0.05 or 0.01].Compared with model group, the expressions of NO, SOD, CAT in rat aortic tissues were increased and levels of ET-1, MDA, H2 O2 in rat aortic tissues were decreased in resveratrol group after treatment of resveratrol (P＜0.01 or P＜0.05).Conclusions Resveratrol has an antioxidant effect, and it could attenuate arterial remodeling by improving oxidative stress.