Purpose: To investigate the expression of KAI1 protein and its clinicopathological significance in breast cancer. Methods: Immunohistochemical staining ( S-P method) was used to detect the expression of KAI1 protein in specimens from 107 breast cancer and 30 adjacent normal breast tissues. Results: KAI1 protein positive rate in breast cancer tissues is significantly lower than that of adjacent nomal breast( P 0. 05). Conclusions: These data suggest that in advanced breast cancer, KAI1 is down-regulated and decrease in KAI1 ecpression plays an important role in the malignant progression of breast cancer. Therefore, detection of KAI1 protein might be a potentially valuable indicator for staging human breast cancer and predicting prognosis.

Objective To investgate the methods of preoperative diagnosis and management of Mirizzi syndrome.Methods 31 cases of Mirizzi syndrome confirmed by operation were retrospectively analysed.Results The rate of preoperative diagnosis was low (38 71%).All patients were cured by different operation without complication. Conclusions We consider that the key criteria of the diagnosis of Mirizzi syndrome is gallstones cholecystitis with manifested charcot's syndrome occurrence,it could strongly suggest Mirizzi syndrome. The operative method should be selected by the typing of Mirizzi syndrome and the degree of pathological injury .

Objective:To study the relation among nm23-H 1 expression,DNA contents and lymph node metastases of head and neck squamous cell carcinoma(HNSCC).Methods:Fresh specimens from 30 previously untreated patients with HNSCC were examined for the determination of nm23-H 1 expression with immunohistochemistry, Aneuploid and S-phase fraction(SPF) with flow cytometry(FCM).The association among these parameters with lymph node metastases was studied.Results: nm23-H 1 expression was found in 18 cases (60%).and aneuploid in 20 (66.7%).Correlation was found between lymph node metastasis and nm23-H 1 protein expression (P

Objective To summarize the main early complications after pancreatoduodenectomy and analysis of the probable causes.Methods The clinical data of 576 cases who underwent pancreatoduodenectomy(PD) in our department between Feb 1990 and May 2009 were analysed retrospectively.Results There were 92 early postoperative complications occurred in 85 patients(14.8%).Gastrointestinal dysfunction,pancreatic leakage,intra-abdominal infections and hemorrhage were the most of complications,and 7 cases died during perioperative period(mortality 1.22%),among which 3 died of multiple system organ failure,2 died of hemorrhagic shock and 2 died of toxic shock.Preoperative hypoproteinemia and hyperbilirubinemia complicated with a high incidence of postoperative complications on multivariate analysis.Conclusions Meticulous preoperative preparation,delicate intraoperative technigne and close postoperative observation are the key points to decrease early complications and improve the prognosis of the patients who undergo PD.

The superoxide anion radical (Of) produced in the alkaline dimethyl sulfoxide (DMSO) system was directly measured by electron paramagnetic resonance (EPR) at low temperature. This reaction was used as a model system for generating O2-. Astragalus membranaceus, Codonopsis pilousla, Paeonia laetiflora, Angelica sincnsis and Sophora flavescens, traditional natural medicines which have the effect of delaying anility, were added into the model system to observe their intensifying or inhibiting effect on EPR signals of O2. These results suggest that these traditional natural medicines have the mostly eliminating effect on Of produced in the alkaline DMSO system.

The effects of qi-tonics and blood-activating decoction on acute myocardial infarction and ischemia-reperfusion induced arrhythmias were studied in anaesthetized open chest SD rats. Three days before coronary artery occlusion, the qi-tonics and blood-activating decoction was perfused into the stomach of the rats in the experimental group (10 ml/kg weight) once a day, and 4d later, the coronary artery was occluded in anaesthetized open chest rats. The results demonstrated that qi-tonics and blood-activating decoction could reduce significantly the incidence and severity of arrhythmias caused by myocardial infarction and ischemia-reperfusion. The qi-tonics and blood-activating decoction could decrease the amount of the superoxide anion radicals (O2-) produced in the alkaline dimethyl sulfoxide (DMSO) system measured by electron paramagnetic resonance (EPR) at low temperature. The effect of qi-tonics and blood-activating decoction on O2-may be one of the mechanisms for its antiarrhythmic effect during reperfusion.

Objective To investigate the survival and prognostic factors in patients with gastrointestinal stromal tumors(GIST).Methods The histopathological slides from 153 patients with GIST were reviewed. The expression of CDllT,CD34,platelet-derived growth factor receptor alpha (PDGFR-a) and Ki-67 proteins were measured by immunohistochemical staining. The factors thatinvolved in the survival and prognosis were analyzed based on the clinical features and GIST biological behavior ranking.The Kaplan-Meier and Cox model were used to evaluate the effect of variant factors on survival and prognosis.Results The survival rate of 135 patients was 94.1% 76.3% and 65.9% at 1,3 and 5 years,respectively.On univariate analysis survival was predicted by tumor size (χ2= 40.565,P＜0.01),primary tumor location (χ2=13.245,P＜0.01),mitotic count (χ2= 22.626,P＜0.01),risk ranking (χ2=19.186,P＜0.01),necrosis (χ2==28.665,P＜0.01),incomplete resection χ2=2 =29.110,P＜0.01) and Ki-67 index (χ2=15.953,P＜0.01).Multivariate analysis demonstrated that thetumor size ＞ 10 cm,primary tumor location,mitotic count＞ 10/50 HPF,high risk subgroup,tumor necrosis and Ki 67 index ＞ 5 % were poor predictors of survival.Ki-67,tumor size and mitotic count were strong poor predictors of survival.Conclusions Fletcher's biological behavior ranking is a good approach to predict prognosis of GIST patients and has significant clinical value.It's better to combine itwith other factors such as Ki-67 index and primary tumor location in order to provide evidence for therapy.

Objective To explore the classification and surgical management of pancreatic duct stones.Methods The clinical data of 54 patients with pancreatic duct stones who were admitted to the People's Hospital of Hunan Province from June 1994 to November 2009 were retrospectively analyzed. Stones were found in the head of the pancreas (type Ⅰ ) in 31 patients, in the body and tail of the pancreas (type Ⅱ ) in 7 patients, and in all the pancreas (type Ⅲ ) in 16 patients. According to the types of the pancreatic duct stones, ten patients (6 with type Ⅰ , two with type Ⅱ and two with type Ⅲ pancreatic duct stones) received opening of the main pancreatic duct + pancreaticojejunostomy or pancreaticogastrostomy ( group A). Twenty-four patients ( 16 with type Ⅰ and eight with type Ⅲ pancreatic duct stones) received pancreaticoduodenectomy (group B). Fifteen patients (nine with type Ⅰ and six with type Ⅱ pancreatic duct stones) received subtotal resection of pancreatic head preserving duodenum (group C). Five patients with type Ⅱ pancreatic duct stones received resection of the body and tail of the pancreas and the spleen (group D). All data were analyzed using the t test. Results The mean operation time, blood loss, length of postoperative stay and hospital charges of group A were (2.2 ± 1.2)hours,( 127 ±24)ml,( 11.4 ±4.3) days and (3.24 ± 1.15 ) × 104 yuan, respectively. Five out of nine patients who were followed up had stone recurrence. The mean operation time, blood loss, length of postoperative stay and hospital charges of group B were (7.6 ± 1.1 ) hours, (409 ± 37 ) ml, ( 18.9 ± 2.5 ) days and (7.93 ± 1.35 ) × 104 yuan, respectively.No stone recurrence was detected in the 21 patients who were followed up. The mean operation time, blood loss,length of postoperative stay and hospital charges of group C were (4. 1 ± 0.7 ) hours, ( 156 ± 63 ) ml, ( 10.3 ±2.1 )days and (4. 12 ± 1.22) × 104 yuan, respectively. No stone recurrence was detected in the 15 patients who were followed up. The mean operation time, blood loss, length of postoperative stay and hospital charges of group D were (3.3 ± 1.4) hours, ( 185 ± 36 ) ml, ( 9.3 ± 2.0) days and ( 3.22 ± 1.05 ) × 104 yuan, respectively. No complication was detected after the operation, and no stone recurrence was detected in the three patients who were followed up. There were significant differences in the mean operation time, blood loss, length of postoperative stay and hospital charges between patients with type Ⅰ and Ⅲ pancreatic duct stones who received pancreaticoduodenectomy and subtotal resection of pancreatic head preserving duodenum (t = 12. 143, 14. 099, 11. 550, 9. 103,P < 0.05 ). Conclusions Classification of the pancreatic duct stones is important for choosing the proper surgical procedure. Subtotal resection of pancreatic head preserving duodenum is ideal for the treatment of patients with type Ⅰ or Ⅱ pancreatic duct stones.

Background and purpose: Recent studies have shown that, the new gene PRR11 had abnormal expression in lung cancer, stomach cancer, speculated that it might be correlated with tumor progression. This study aimed to detect the expression of PRR11 protein in human pancreatic carcinoma, and to analyze the relationship between PRR11 protein level and the clinical pathological parameters of pancreatic carcinoma. Methods: Immunohistochemistry (SP) method was used to detect the expression of PRR11 protein in 32 cases of human pancreatic cancer tissues, 20 cases of paracancerous tissues and 6 cases of normal pancreatic tissue. Chi Square test was used to analyze the relationship between the expression levels of PRR11 protein and the clinical pathological parameters (age, gender, the size of tumor, the location of tumor, differentiation, lymph node metastasis and TNM stage). Results:The positive expression rates of PRR11 protein in pancreatic cancers, paracancerous tissues and normal pancreatic tissues were 78.1%(25/32), 5.0%(1/20) and 0.0%(0/6), respectively. The expression level of PRR11 in pancreatic cancer tissues was significantly higher than those in paracan-cerous tissues or normal tissues. The positive expression rate of PRR11 protein in pancreatic carcinoma was significantly associated with cell differentiation degree and TNM stage (P<0.05), but not associated with patient age, gender, the size of tumor, the location of tumor and lymph node metastasis (P>0.05). Survival analysis demonstrated that the survival rate in the patients with PRR11 protein positive expression was significantly lower than the patients with negative expression (P<0.05). Conclusion:PRR11 protein can be a possible prognostic indicator of pancreatic cancer.

Objective:To study the indications and clinical efficacy of video assisted small incision in treatment of infected pancreatic necrosis.Methods:A retrospective study was conducted on 27 patients with infected pancreatic necrosis treated by video assisted small incision at the Department of Pancreatic and Splenic Surgery, Hunan Provincial People's Hospital, from January 2018 to December 2019. The surgical approach, operation time, intraoperative blood loss, postoperative hospital stay and complications were analysed. Postoperative follow-up was carried out at outpatients’ clinic, and the patient's time to full recovery and long-term complications were studied.Results:The 27 patients successfully underwent the operations. There were 22 males and 5 females, aged (50.6±6.2) years. The treatment results were analyzed according to the different surgical approaches: the retroperitoneal approach group ( n=4); the omental sac approach group (n=14); the intercostal space approach group ( n=2); and the combined approach group ( n=7). The operation time was (85.3±31.6)min. The intraoperative blood loss was 65.0(45.2, 121.4)ml. The postoperative hospital stay was 23.0(12.5, 36.1)days. The incidence of complications (Clavien-Dindo grade Ⅲ and above) was 14.8%(4/27). There were 2 patients in this study who were admitted to the intensive care unit due to postoperative hemorrhage: 1 patient responded well to conservative treatment and the remaining patient required interventional treatment. Another patient because of poor results, underwent debridement by laparotomy 2 weeks after the operation. There was 1 patient who developed grade C pancreatic fistula which was cured by surgical treatment 6 months later. On follow-up, 2 patients developed colonic fistula 2 weeks after surgery and 2 patients gastric fistula 1 week and 3 weeks after surgery. These patients responded to conservative treatment. Conclusion:With proper case selection, video assisted small incision could safely and effectively be used to treat infected pancreatic necrosis.