Objective To evaluate imaging diagnosis, differential diagnosis, surgery and interventional therapy of hepatic angiomyolipoma associated with tuberous sclerosis.Methods Clinical features, imaging appearances and interventional therapy for 2 cases of HAML in TS were retrospectrively analyzed. Results The features of HAML in TS are as following:(1) Two cases were female with no history of hepatitis and hepatocirrhosis, liver function test and alpha feto protein were normal. (2) the tumor was shown as a multiple hyperechoic mass with sharp margin on ultrasonography; well defined, fat density and intensity mass on computerized tomography (CT); hypervascular mass with early drainage of hepatic vein and tumor staining on angiography. (3) One case underwent interventional therapy. After 42 month follow up, the tumor was found to be diminished in size. Another case was under monitored with only the enucleating of left renal mass. The hepatic tumor showed no change after 10 months.Conclusions The imaging appearances of HAML in TS are relatively characteristic. Superselective arterial embolization is an effective treatment for HAML in TS.

Objective To evaluate the clinical outcome of total hip arthroplasty (THA) for protrusio acetabuli. Methods Between 2003 to 2008, 31 patients(35 hips) with protrusio acetabuli were treated with THA, including 16 males (18 hips) and 15 females (17 hips). The age ranged from 36 to 71 years (average age 52.2 years). The femoral heads were moved out with retrograde method when necessary via posterior-lateral hip incision. The acetabular loops and bottoms were prepared respectively. Auto-bone grafting was used to repair acetabular defects and cementless prostheses were planted with press-fit skills. At follow-up visit,the hip functions were evaluated by Harris score. The loosening, re-protrusion and the union of graft bone was judged by X-ray. Results The mean follow-up was 46.5 months (19-152 months). One patient developed DVT on the second day post-operatively who recovered well after anticoagulation treatment. One patient complained of gentle thigh pain which disappeared at 6 months. No other complication was found. The mean Harris scores had improved from 48.9±6.5 pre-operatively to 91.2±5.7 post-operatively. All prostheses acquired bone stabilization with no sign of loosening and re-protrusion and the grafts bone were healed at a mean 6 months according to X-ray. Conclusion THA with acetabular bone grafting and cementless component for protrusio acetabuli have acquired excellent results and prevented loosening and re-protrusio effectively.

Adult ; Carcinoma, Embryonal ; drug therapy ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Endodermal Sinus Tumor ; drug therapy ; metabolism ; pathology ; surgery ; Humans ; Keratin-19 ; metabolism ; Ki-1 Antigen ; metabolism ; Male ; Orchiectomy ; methods ; Testicular Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; alpha-Fetoproteins ; metabolism

0.05).The methyla tion rates were higher in tumor tissue than those in normal and adjacent mueosa(P

Aim The effect triptolide(Tri) on local stimulation was observed .Methods Tri solution in different concentrations was applied in rabbits, rats and mice and the respenses were observed .Results 1.11 ,2.22 and 4.44 mmol?L-1 of Tri induced obvious erythema and edema on both intact skin and injured skin of rabbits.The pathological histology revealed the evident inflammation in scarfskin and corium 2.22 mmol?L-1 and 4.44 mmol?L-1 of triptolide significantly induced swelling of auricle in mice.0.55 mmol?L-1 and 1.11 mmol?L-1 of Tri significantly induced swelling of planta in rats.The response of inflammation reached to peak at the third day after hypodermic injection and lasted a week.Tri also significantly induced pain reaction and enhanced the permeability of capillary after local injection in mice.Conclusion Tri has a local stimulation effect and induces inflammation which can not be antagonized by its anti-inflammation effect.

One hundred and seventeen patients with esophageal squamous cell carcinoma were treated with radical esophagectomy from January 2011 to June 2011,among whom 63 cases received early enteral nutrition (study group) and 54 received parenteral nutrition (control group).There were no differences in serum levels of albumin (ALB),prealbumin (PAB) and transferrin (TRF) before surgery between two groups.Serum PAB and TRF levels in study group were significant higher than those in control at d8 after surgery(P ＜ 0.05),and also higher than those at d1 after surgery (P ＜ 0.05).There were no differences in immune indexes in two groups before surgery,the IgA and IgM levels were rising at d8 compared those at d1 after surgery.The total lymphocytes,CD3,CD4,CD8 and CD4/CD8 in study group at d8 were significant higher than those in control group and those at d1 after surgery.The study shows that early enteral nutrition can improve nutritional index and immune function,and to promote rapid rehabilitation in esophageal cancer patients after surgery.

Objective To compare the clinical efficacies of totally laparoscopic and laparoscopy-assisted radical total gastrectomies.Methods The retrospective cohort study was conducted.The clinicopathological data of 373 patients with gastric cancer who underwent totally laparoscopic or laparoscopy-assisted radical total gastrectomies from the 7 medical centers in China (82 patients in the Affiliated Hospital of Qinghai University,80 in the Traditional Chinese Medicine Hospital of Guangdong Province,60 in the First Affiliated Hospital of Xiamen University,51 in the Hangzhou First People's Hospital,46 in the First Affiliated Hospital of Xi'an Jiaotong University,30 in the Second Affiliated Hospital of Jilin University and 24 in the Xijing Hospital of the Fouth Military Medical University) between January 2015 and December 2016 were collected.Of 373 patients,the 183 and 190 patients were respectively divided into the totally laparoscopic group (undergoing totally laparoscopic radical total gastrectomy) and laparoscopy-assisted group (undergoing laparoscopy-assisted radical total gastrectomy),including 63 and 19 in the Affiliated Hospital of Qinghai University,36 and 44 in the Traditional Chinese Medicine Hospital of Guangdong Province,25 and 35 in the First Affiliated Hospital of Xiamen University,20 and 31 in the Hangzhou First People's Hospital,10 and 36 in the First Affiliated Hospital of Xi'an Jiaotong University,17 and 13 in the Second Affiliated Hospital of Jilin University,12 and 12 in the Xijing Hospital of the Fouth Military Medical University.Routine five-port method was applied for laparoscopic radical total gastrectomy and D2 lymphadenectomy.Roux-en-Y anastomosis was applied for digestive tract reconstruction,and digestive tract reconstruction was performed under laparoscopy in the totally laparoscopic group and via upper abdominal median incision in the laparoscopy-assisted group.Observation indicators:(1) operation and postoperative situations;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative overall survival and tumor recurrence or metastasis up to March 2017.Measurement data with normal distribution were represented as x±s.Comparison between the groups was analyzed by the t test.Measurement data with skewed distribution were represented as M (range).Comparisons of count data were analyzed using the chi-square test and Fisher exact probability.Results (1)Operation and postoperative situations:all the patients in the 2 groups underwent successful operations,without perioperative death.Esophagojejunostomy methods of 183 patients in totally laparoscopic group:conventional circular stapler method were performed in 28 patients,anti-puncture circular staplar method in 6 patients,OrVilTM method in 5 patients,functional end-to-end esophagojejunostomy method in 65 patients and peristalsis side-to-side esophagojejunostomy method in 79 patients.Conventional circular stapler method was applied to 190 patients in the laparoscopy-assisted group.Operation time,time of esophagojejunostomy,length of assisted incision,using time of analgesics and expenses of digestive tract reconstruction were (238± 55)minutes,(29±9)minutes,(5.1 ± 1.1)cm,(2.2±l.0)days,(18 332±2 141)yuan in the totally laparoscopic group and (217±39)minutes,(26±7)minutes,(7.8 ±2.0)cm,(2.7± 0.9)days,(16 237 ± 1 923)yuan in the laparoscopy-assisted group,respectively,with statistically significant differences between the 2 groups (t =4.324,3.455,-16.835,-5.561,9.949,P＜0.05).The cases with postoperative overall complications,anastomosis leakage,anastomosis stricture,anastomosis bleeding and expenses of esophagojejunostomy were respectively 24,9,7,5,(9 668±2 814)yuan in the totally laparoscopic group and 24,8,9,6,(9 331 ±2 067)yuan in the laparoscopy-assisted group,with no statistically significant difference between the 2 groups (x2 =0.036,0.107,0.189,0.059,t=1.322,P＞0.05).All the patients with postoperative complications were cured by symptomatic treatment.(2) Follow-up and survival situations:of 373 patients,336 were followed up for 4-26 months,with a median time of 13 months,including 166 in the totally laparoscopic group and 170 in the laparoscopy-assisted group.During the follow-up,cases with overall survival,tumor recurrence and tunor metastasis were respectively 150,10,16 in the totally laparoscopic group and 154,9,16 in the laparoscopy-assisted group (10 and 9 patients in the totally laparoscopic and laparoscopy-assisted groups with simutaneous tumor recurrence and metastasis),showing no statistically significant difference between the 2 groups (x2 =0.075,0.010,P＞0.05).Conclusions Total laparoscopic and laparoscopyassisted radical total gastrectomies are safe and feasible,with equivalent overall outcomes and effects of esophagojejunostomy.Compared with laparoscopy-assisted radical total gastrectomy,the postoperative pain time of patients in total laparoscopic radical total gastrectomy is less,but there are longer time of esophagojejunostomy and higher expenses of digestive tract reconstruction.

Objective To investigate the impact of hepatectomy combined with splenectomy on hepatitis B virus (HBV) reactivation in patients with hepatocellular carcinoma (HCC) ≤5 cm and with hypersplenism.Methods This is a retrospective case-control study on 167 patients with HCC ≤5 cm and with hypersplenism who underwent hepatectomy combined with splenectomy at the Shengli Oilfield Central Hospital between May 2008 and June 2015.64 patients underwent hepatectomy combined with splenectomy,and 103 patients hepatectomy alone.The patients were assigned to the hepatectomy combined with splenectomy group (the combined group,n =61) or the hepatectomy alone group (the control group,n =61) using propensity score matching (PSM).Logistic regression was used to evaluate the relative clinical factors associated with HBV reactivation.The stratified Chi-squared test was utilized to determine the impact of the surgical procedure and preoperative anti-viral therapy on postoperative hepatitis B virus reactivation of these patients.Results The serum PLT level,Child-Pugh grading,tumor diameter and surgical procedures were shown to be independent risk factors associated with postoperative HBV reactivation (P ＜ 0.05).To study the impact of preoperative anti-viral therapy on postoperative HBV reactivation:-the incidence of HBV reactivation was higher in the control group than in the combined group (19.7％ vs.6.6％,P ＜ 0.05).In the combined group,there was no significant difference between patients who received anti-viral therapy and those who were treatment-naive (5.3％ vs.7.1％,P ＞0.05).In the control group,a higher incidence of HBV reactivation was found in patients with treatment-na(i)ve than in patients who received anti-viral therapy (26.1 ％ vs.0,P ＜ 0.05).For the patients who received anti-viral therapy,there was no significant difference between the combined group and the control group (5.3％ vs.0,P ＞ 0.05).In patients with treatment-na(i)ve,a higher incidence of HBV reactivation was observed in the control group than the combined group (26.1％ vs.7.1％,P ＜ 0.05).Conclusions In patients who were not treated with antiviral therapy,hepatectomy combined with splenectomy decreased the incidence of postoperative HBV reactivation in patient with HCC ≤5 cm and with hypersplenism.For the patients who received preoperative anti-viral therapy,the incidence of postoperative HBV reactivation was not decreased with hepatectomy combined with splenectomy.

Actins ; metabolism ; Calcium-Binding Proteins ; metabolism ; Desmin ; metabolism ; Female ; Humans ; Leiomyoma ; metabolism ; pathology ; Microfilament Proteins ; metabolism ; Middle Aged ; Sex Cord-Gonadal Stromal Tumors ; metabolism ; pathology ; Uterine Neoplasms ; metabolism ; pathology

From June 2007 to June 2009, 133 patients underwent esophageal resection, among them 64 cases received esophageal reconstruction with narrow gastric tube (NGT) and 69 received esophageal reconstruction with whole stomach (WS).The postoperative quality of life (QOL) in 6 months of both groups was investigated.The study found that there were 3 cases in WS group having leakage, while no one in NGT group, the weight loss, regurgitation and chest-stomach syndrome in NGT group were superior to those in WS group, there were no statistical differences in activities of daily life, emotional functions, food intake, dysphagia between two groups.The study indicates that the quality of life in NGT group is superior to that in WS group.