Objective To explore the different characteristics of tumor recurrence after liver transplantation (LT)and hepatectomy(HC)in patients with hepatocellular carcinoma(HCC).Methods The literatures about tumor recurrence of HCC after LT and HC were reviewed and their characteristics were compared.Results There are distinctions of recurrence rates,time,common sites between the recurred tumors after LT and HC,and their correlation factors and mechanisms of recurrence are also different.Conclusion Preventive measures should be strengthened and treatments should be more targeted according to the different characteristics of tumor recurrence after LT and HC to improve postoperative life quality and increase the survival rate.

Objective To study the clinical and pathological features, diagnosis and treatment of malig-nant mesothelioma of the tunica vaginalis testis. Methods One case of malignant mesothelioma of the tuni-ca vaginalis testis was reported. The patient was a 73 years old man, presented with a history of aggravated hydrocele for 1 year. B-ultrasound showed 7.5 cm×4.1 cm liquid anechoic area around the testis. The Pubmed and CBM databases were searched for related articles, and the clinical data were reviewed. Results An operation was performed to incise the tunica vaginalis. The pathology showed fecal caneeration in the tunica vaginalis testis and the immunohistology showed CK5/6, Calretinin and E-cadlberin positive. Right or-chiectomy was performed after three weeks. Local tumor recurrence and inguinal lymph nodes metastasis were found 11 months after operation, and local tumor and lymph nodes were resected. The tumor was diagnosed as malignant mesothelioma of the tunica vaginalis testis and CK5/6 and Calretinin fecal positive. Conclu-sions Malignant mesothelioma of the tunica vaginalis is a rare disease of the testis with potentially aggres-sive behavior. Due to the lack of tumor markers and characteristic symptoms, correct preoperative diagnosis is extremely difficult. Radical surgical treatment is of major importance to the survival of the patients. Life-long follow-up should be offered to patients with malignant mesothelioma of the tunica vaginalis.

Objective To investigate.the co-stimulatory pathway of gastric cancer patients by examining the expression of co-stimulatory molecules CD28,CTLA.4(CDl 52)and B7 molecules on peripheral blood lymphocytes(PBLC)in patients with gastric cancer,and to discuss the role of costimulatory pathway in the pathogenesis of gastric cancer.Methods The expression of CD28,CD152,CD3,CD4,CD8 and B7 molecules on peripheral blood lymphocytes and T cell subpopulation were measured by flow cytometry in 56 patients with gastric cancer,and the data was compared and analyzed with that in gastric benign tumor group and healthy control group.Results The expression levels of CD3+,CD4+,CD3+ CD28+,B7-1(CD80),B7-2(CD86)and CD41/CD8+on PBLC in patients with gastric cancer was significantly lower than that of benign stomach tumor group and healthy control group.The expression levels of CD3+ CDl52+ and CD8+ on PBLC in patients with gastric cancer were significantly higher than those of gastric benign tumor group and healthy control group.Conclusion Peripheral lymphocytcs in gastric cancer patients express low level of CD28 and B7 molecules and high level of CDI 52 molecules,which results in dysfunction of B7:CD28/CTLA-4 co-stimulation pathway and in turn affects the capacity of T cell to eliminate tumor cells,which makes tumor cells evading the immune surveillance and metastasizing.

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

[Objeetive] To investigate the effect of minimally invasive V-shaped osteotomy instead of traditional operative technique for correction of ankylosing kyphosis.[Method]The C-arm X-ray was used under the local anaesthesia to select the space of osteotomy,the length of incision were 6~8 cm and only exposed one interlaminal space,the width of laminar V-shaped osteotomy were 8~10 mm.The operating table was changed from reverse V to type after finished osteotomy,the space of osteotomy would be automatica ly closed and replaced,if the space could not be automaticly closed,careful manipulation would be applied to close it.The bone mass of osteotomy was used in posterior bone graft of lamina.Postoperation,stric and standardized regulation were performed to send the patient back to ward.The fractional manual correction and external fixation of hyperextended plaster vest were performed respectivly 2 weeks after operation.[Result]Fifty patients of this group acquired more satisfied results except 1 case appeared recurrent deformity due to early removing of the plaster vest.[Conclusion]Minimal damage,lower medical expenses(without internal fixation)and satisfied results demonstrated the minimally invasive V-shaped osteotomy is a very effective method.It has advantages of Mutual intercalated V-shaped osteotomy space and better stability after reduction,posterior bone graft of lamina and external fixation of hyperextended plaster vest,therefore,all patients can acquire the bone graft fusion afer 6 months.

[Objective]To introduce the operative method and clinical experience of 200 cases with halo pelvic distraction and elastic growing rods fixation for treatment of scoliosis during growing period and comparison with pedicle screw systems. [Method]According to the principle of Harrington hook-rod system,inferior extremity was one hook hanged on the total lamina of lumbar vertebrae and superior extremity were two hooks hanged on the inferior articular process of thoracic vertebrae,rod I and rod II were connected by joint,between the end of rod I and joint set the spring cover for automatic extension followed spine growth.For the longer growing period children,the small incision could be performed between the hook and rod for fractional distraction to help the spine longitudinal grown until skeletal development and maturation.[Result]The average rate of correction of 200 cases with Scoliosis were 70.32% after 2~15 years follow-up survey,the height of the patients were increased by 5~22 cm and the preserved range of spinal motion was better than pedicle screw systems in long term follow up.Incidence of hook displacement was 2% and rod breaking was 3%.Reasons of hook displacement and rod breaking was related to unfitting installation and methods of internal fixation,incidence of hook displacement and rod breaking were decreased significantly post reform.[Conclusion]Halo pelvic distraction and elastic growing rods fixation for treatment of scoliosis during growing period which is a kind of biological method,does not affect the longitudinal growth of spine and prevent the complication of crankshaft phenomenon caused by pedicle screw systems.

[Objective]To sum up the experience of wearing the halo pelvic and level traction costoplasty to treat 35 cases of severe scoliosis combined with collapsed chest. [Methods]When scoliosis of patients were corrected to a certain degree after three weeks of halo pelvic distraction, the most serious collapsed ribs of concave side of the curve underwent a transverse incision the cross ribs. A special rib bender was used to bend the exposed 3 to 6 ribs. The bent ribs were pulled up by double-stranded 10# thick silk which was extended out through the skin and fixed in the upright post of the instrument of Halo pelvic distraction with rubber membranes.[Results]Thirty-three in 35 patients underwent costoplasty. The collapsed chest was turned round, respiratory function improved significantly and cyanosis of lips and nail bed disappeared. These offered advantages for next scoliosis correction.Two patients failed to undergo costoplasty due toprimary pulmonary atelectasis and pulmonary deficiency.[Conclusion]The instrument of Halo pelvic distraction is a good and convenient fixed point. Bending and turning round ribs can provide a convenient condition for recovery of collapsed chest. Halo pelvic distraction can be used not only for scoliosis correction but also for costoplasty.

[Objective]To evaluate the value of distraction osteogenesis for treatment of deformity of spine during development.Distraction osteogenesis could be used for patients with campylorrhachia,dwarfism eccyliosis of spine or those combined with thoracocyllosis and obliquity pelvis.[Method]According to the principle of Halo-pelvic distraction apparatus which was divided into two parts of halo and pelvic,the halo was 4-nail fixation and the pelvic was 2-nail fixation.The halo and pelvic were connected by 4 standing pillar.Through the daily extending of 4 standing pillar the curved spine was extended and stretched gradually.As a result,action of 3D correction of deformity of spine was achieved.[Result]Ten patients of this group were treated by this methods.The action of 3D correction and automatic correction of deformity were showed in 70~120 days distraction that the wedge-shaped vertebra changed into squareness,curved spine was stretched and rotatory vertebra was reduced.[Conclusion]Distraction osteogenesis is a minimally invasive surgery instead of internal fixation of spine for the treatment of deformity of spine during development.

[Objective]To report the records of 185 patients in whom severe scoliosis had been treated with preoperative halo-pelvic distraction and following total spine osteotomy and internal fixation.[Method]Preoperative halo-pelvic distraction was applied to all patients to reduce the severity of curvatures and make the following treatment possible.Then total spine osteotomy and internal fixation were performed to rectify the remained deformity of the spine.Halo-pelvic distraction was maintained during the operation and postoperatively to limit the mobilization of the patients.At one day after the operation,the patients were able to get out of bed,stand up and move around,making nursing care more convenient.[Result]Between 1983 and 2003,a total of 185 cases of severe scoliosis were treated by this approach and an average correction rate of 70.32% was achieved.Complete bone fusions were achieved at the cut ends of thc bone.The average loss of correction rate was less than 5 degrees.In the late stage of postoperative duration,rod release occurred in four cases and was resolved by second surgical intervention,showing no adverse effect on the clinical outcome.At one year postoperative infective complication occurred in one case and the patient fully recovered after the removal of the inserted device.X-ray examination confirmed good healing of the hone grafts.Root pain occurred in one case and the patient gradually recovered without any medical intervention.None of the rest patients had evidence of spinal cord or nervous system complications.[Conclusion]Halo-pelvic distraction instrumenation,in combination with total spine osteotomy,is an effective treatment modality for severe spinal curvatures.Halo-pelvic distraction can facilitate the operative procedure for those cases that can not be cured by application of single instrumentation or have difficulty in the insertion of the internal fixation device.The combined total spine osteotomy can further correct the spinal curves,reduce the burden of the fixafion device and avoid the occurrence of release or break down of the rods,eventually cure the severe scoliosis effectively.

ObjectiveTo evaluate the clinical results of intracoronary implantation of the phosphorylcholine dexamethasone coated biodivysio small coronary stents. Methods Prospective analyses of long-term results of the phosphorylcholine dexamethasone coated biodivysio coronary stents, and their implantation performed on 82 coronary artery disease patients were conducted. We implanted 106 stents of which 54 were the phosphorylcholine dexamethasone coated biodivysio coronary stents, and 52 the phosphorylcholine coated biodivysio coronary stents. Results The success rate of the implantation of both groups was 100%. The major adverse cardiac events (MACE) of the 3-month follow-up in the phosphorylcholine dexamethasone coated biodivysio coronary stents group were 9.8%; and in the phosphorylcholine coated biodivysio coronary stents group were 22.0%. The restenosis rate of the 8-month follow-up in the phosphorylcholine dexamethasone coated biodivysio coronary stents group was 4.9%; and in the phosphorylcholine coated biodivysio coronary stents group was 23.0%. Conclusion The implantation of the phosphorylcholine dexamethasone coated biodivysio coronary stents is a safe and efficient interventional procedure with a high success rate and few MACE. It may reduce restenosis rate.