Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; pathology ; therapy ; Catheter Ablation ; Humans ; Lung Neoplasms ; secondary ; surgery ; Neoplasm Recurrence, Local ; Osteosarcoma ; pathology ; secondary ; therapy ; Salvage Therapy

Objective: To analyze the experience in the treatment of intraductal papillary Mucinous tumors(IPMT) of the pancreas.Methods: We retrospectively analyzed the clinical and imageological features of 30 IPMT patients,17 males and 13 females,who underwent operations in our department from May 2003 to December 2005.The patients with intraductal papillary mucinous adenoma(IPMA) were included in the benign group,and those with intraductal papillary mucinous borderline tumor(IPMB) and intraductal papillary mucinous carcinoma(IPMC) in the malignant group.Results: There were more males than females in the malignant group(76.5% vs 30.8%,P40 mm,which were considered to be the predictors of malignancy.Conclusion: Clinical and imageological features differ signifcantly between different pathological types of IPMT.The presence or absence of mural nodules,the diameter of the main pancreatic duct and the size of the tumor may help differentiate the malignancy from benignancy of IPMT.

Objective To explore the possibility of non-discarding blood after cisplatin hyperther-mic antiblastic perfusion(HAP)in treating the patients with malignant bone tumor of lower extremity.Methods Forty patients consisted of 31osteosarcomas and9malignant fibrous histiocytomas of bone.The clinical stages were wholly classified intoⅡB stage according to Ennekings surgical staging system for muscu-loskeletal tumors.The patients were divided into three groups:group1:discarding blood group(10cases),in whom200ml of the400ml blood remaining in heart-lung machine was discarded after HAP;group2:Non-discarding blood group(25cases),the blood remaining in heart-lung machine was not discarded after HAP and re-infused into systemic circulation;group3:systemic chemotherapy group(5cases),cisplatin was infused intravenously.The regional and the systemic blood cisplatin concentrations were determined at3,30and60minutes during HAP,and the systemic blood cisplatin concentrations were determined at0,0.5,1,2,4,8,12,24,48and72hours after HAP in the group1and group2.While1h after cisplatin infusion in-tra venously in the group3,the blood cisplatin concentration were also measured.Results The regional blood cis platin concen tra tions were high er than that in systemic blood at the time during HAP.The systemic blood cisplatin concen trations after HAP,ex cept at0minute in the group2were higher than that in the group1,there were sig nificant statistic differences between the two groups.The systemic blood cisplatin con-cen trations after HAP in the group2were simi lar to that after systemic chemotherapy.No severe adverse ef-fects in the group1were found.The Ennek ings surgical stagings for the tumors were turned fromⅡB intoⅡA in all the patients.Conclusion The method of non-discarding blood after HAP is available,it is not only local treatment ,but also systemic chemotherapy in the patients with malignant bone tumor of lower ex-tremi ty for limb-salvage surgery.

Aged ; Axilla ; Axillary Vein ; surgery ; Blood Vessel Prosthesis ; Breast Neoplasms ; complications ; pathology ; surgery ; Female ; Histiocytoma, Malignant Fibrous ; complications ; pathology ; surgery ; Humans ; Jugular Veins ; surgery ; Male ; Neoplasm Recurrence, Local ; Upper Extremity Deep Vein Thrombosis ; etiology ; surgery ; Vascular Grafting ; methods

Objective To improve the prognosis and radical resection of the extended pancreaticoduodenectomy for patients with pancreatic cancer in the ucinate process involving mesentery mot. Methods From Jan. 2004 to Dec. 2007, a total of 23 ( 14 male and 9 female, aged between 30 and 72 years old) patients with pancreatic cancer in the ucinate process involving mesentery root were treated in our department. Curative resection was performed for all patients by the extended pancreaticoduodenectomy with superior mesenteric artery (SMA) isolation and mesentery root resection. The surgical procedure, the safety and prognosis were analyzed retrospectively. Results 12 patients underwent the procedure, among them 11 also underwent combined SMV partial resection and reconstruction. The operation time was (4.2 ± 1.1 ) hours, and the blood loss was ( 1 635 ± 1 362) ml with the blood transfusion of ( 1 609 ± 1 462 ) ml. There was no operation related death in this case series, and mild to severe diarrhea occurred in 6 cases. The post-operative stay ranged 9 to 30 days. The pathological examination showed that the tumor size was (5.3 ± 1.4) cm. 13 patients (57%) had one or more lymph nodes metastasis. 20 patients (87%) had nerve involvement. Among 11 patients with SMV partial resection and reconstruction, 10 patients had endangium involvement. 22 patients had negative surgical margins for all specimens. Rapid intra-operative frozen pathological examination showed negative surgical margins in one patient, however, post-operative paraffin section pathological examination revealed nerve involvement between SMA and celiac trunk. After a follow-up of 5 to 42 months, liver metastasis occurred in 4 patients, and local recurrence occurred in 3 patients. The 1-year and 2-year accumulated survival rates were 77.2% and 42.5%, respectively. Conclusions Isolation SMA and the mesentery resection in extended pancreaticodudenectomy were safe and useful. Using this modified technique, Radical operation resection could be achieved in the treatment of pancreatic cancer in uncinate process.

Objective To observe and analyze clinical characteristics of diabetes patients suffering from pancreatic cancer . Methods We recruited 107 cases of pancreatic cancer(66 without diabetes and 41 with diabetes) and 100 diabetes patients without pancreatic pancreas as control .Patients′ demographic information ,degree of tumor differentiation ,serum markers etc .were com‐pared in order to find out the relevant clinical features of diabetes patients suffering from pancreatic cancer .Results (1)Patients with pancreatic cancer mostly were middle‐aged males .55 .1% of them suffering from dysglycemia ,18(16 .8% ) and 41(38 .3% ) of whom had impaired fasting glucose and diabetes ,respectively .(2)Compared with their without diabetes counterparts ,pancreatic cancer with diabetes were more prone to be asymptomatic and weight loss(P< 0 .05) .(3)Compared with their without diabetes counterparts ,pancreatic cancer with diabetes had significantly higher levels of fasting blood glucose(FBG) andγ‐glutamyltranspep‐tidase(γ‐GT)(P<0 .05) .(4)When compared with diabetes control ,pancreatic cancer with diabetes were older and shorter duration and lower body mass index(BMI)(P<0 .05) .They were more prone to weight loss(P<0 .05) .Moreover ,serum CA19‐9 and CEA levels in them were significantly higher than those in the diabetes control(P<0 .05) .Conclusion Older age ,shorter duration ,low BMI are all risk factors for diabetes patients to develop pancreatic cancer .Being asymptomatic and weight loss are their clinical characteristics .CA19‐9 and CEA are both sensitive serum markers to detect pancreatic cancer patients with diabetes .

Objective To explore the clinical values of the modified thoracic drainage devices that were applied in treatment of primary spontaneous pneumothorax patients who underwent single-port video-assisted thoracoscopic surgery. Methods Clinical data of 82 primary spontaneous pneumothorax patients who underwent single-port video-assisted thoracoscopic lung wedge resection and pleurodesis from January 1st, 2015 to August 31st, 2016 was analyzed retrospectively. These patients, according to the thoracic drainage devices, were divided into traditional group (Group A, n = 42) or modified group (Group B, n = 40). These statistical data, including duration of thoracic drainage, lengths of hospital stay, duration of using antibiotic, amounts of pleural drainage, scales of pain, and complications of the two groups of patients in postoperative stage, were compared. Results There was no significant differences (P > 0.05) in volumes of thoracic drainage while there were significant differences (P < 0.05) in duration of thoracic drainage, lengths of hospital stay, duration of using antibiotic, scales of pain, and complications in postoperative stage between the two groups. And patients in group B had shorter time of thoracic drainage, hospital stay, and using antibiotic, lower scales of pain and rates of complications when compared with group A. Conclusion There are some clinical values of application of modified thoracic drainage devices in treatment of primary spontaneous pneumothorax underwent single-port video-assisted thoracoscopic surgery, because of it could give the patients fast recovery and made the operations simpler.

Objective To evaluate the effect of preoperative radiotherapy and postoperative brachy radiotherapy (POBRT) on patients with primary liver cancer(PLC). Methods 50 patients with PLC were randomly divided into 2 groups:(1)Radiotherapy group, 25 patients who underwent preoperative radiotherapy 14～17 days before hepatectomy and POBRT 3～10 days after hepatectomy ;(2)Control group,25 cases who underwent hepatectomy only. In radiotherapy group, before heptectomy, the single-dose 6Gy per time and 3 sessions were given to each patient. 3～6 ductus were placed for POBRT during operation,and 10Gy of POBRT per time and 2～4 sessions were given postoperatively. In control group,no radio cherapy was given before and after hepatectomy. Results In radiotherapy group, the cancer shrank significantly after preoperative radiotherapy (P

AIM: To investigate the feasibility of reendothelialization of the injured arterial wall by autologous endothelial cell transplantation and their influences on neointima proliferation. METHODS: New Zealand white rabbits (n=30) were subjected to bilateral iliofemoral artery balloon injury. Cultured, autologous venous endothelial cells were immediately transplanted into one vessel(transplantation group), whereas the contralateral artery received medium only(control group). Reendothelialization of the injured arterial wall was analysed 4 hours or 4 days after cell transplantation by fluorescent tracing、scanning electron microscope(SEM) and Evans blue staining. Pathology analysis was employed 28 days after cell transplantation to evaluate neointima proliferation. RESULTS: The transplanted endothelial cells had adhered into the aterial wall 4 hours after transplantation and began to attach and spread 4 days later. A number of fluorescent labeling endothelial cells were observed in the endothelial injured arterial wall. The vessels in control group were stained nearly completely by Evans blue, whereas about 60% area was not stained in transplantation group. Pathological examination demostrated that neointimal area and maximal intima thickness in transplantation group significant decreased than those in control. CONCLUSION: Autologus endothelial cells were effectively transplanted into the injured arterial wall by balloon catheter, and it can relieve neointima proliferation in the long time.

Objective To establish abdominal aortic dissection model in ApoE-/-mice, and to evaluate the ability of 7.0T MR to detect the abdominal aortic artery aneurysms in ApoE-/-mice in vivo. Methods ApoE-/-mice aged 10 months were infused with angiotensin Ⅱ with 14 days Osmotic minipump after 10 weeks of high lipid diet. Two different doses of angiotensin Ⅱ were given to mice, i.e. 1000 ng/(kg·min) and 500 ng/(kg·min), respectively. The contrast group was infused with saline water. The abdominal aortic artery was observed in vivo with MR before and within 14 days infusion. At last, the pathological changes of the abdominal artery were compared with MRI findings. Results After 6 or 7 days higher dose of angiotensin Ⅱ infusion, aortic dissection was seen. MR T2WI showed crescent-shaped high signal in the vessel wall of one side，the pathological study identified the hematoma between media and adventitia. Abdominal aortic dissection aneurysms were also found in the mice 13 or 14 days after lower dose of angiotensin Ⅱ infusion, which were consistent with pathological studies. Besides, the signal of the vessel wall was significantly higher in both T2WI and PDWI sequences. There was excellent agreement between MR and histopathology. 〖WTHZ〗 Conclusion Abdominal aortic dissection aneurysms model can be successfully established with different doses (1000 ng/(kg·min) and 500 ng/(kg·min)) of angiotensin Ⅱ infusion into ApoE-/-mice fed with high lipid diet. High-resolution MR is able to visualize the abdominal aortic dissection aneurysm formation in vivo.