Synchronous colorectal liver metastases occurs in 15%-25% of patients with newly diagnosed colorectal cancer. Hepatic resoction has been accepted as the only option that offers long-term survival for patients with liver metastases. However, the optimal timing and sequence of resection for synchronous colorectal liver metastases still remain controversial. Also, the use of neoadjuvant chemotherapy which should be initiated in patients with resectable synchronous liver metastases is not consistent. In order to use evidence-based medicine to clarify indications for one-stage hepatic resection of liver metastases, a multi-center clinical trial was pedormed to normalize the surgical strategy of synchronous liver metastases. In summary, in selected patients, one-stage approach is comparable to the two-stage procedure in mortality and morbidity rates and longterm survival. One-stage procedure should be performed according to the site of primary tumor, age, the volume of residual healthy liver. Preoperative chemotherapy is effective in downstaging the tumor and reducing the resected liver volume, but it also brings damage to the liver and has adverse effect on onestage hepatic resection.

Objective To investigate the risk factors and predictors of poor outcome in full-term neonates with severe hyperbilirubinemia. Methods Data were retrospectively collected from 326 neonates with severe hyperbilirubinemia hospitalized between January 1, 2012 and December 31, 2012. Results A total of 326 full-term neonates with severe hyperbilirubinemia were included in this study (181 males and 145 females). The average gestational age was 39.12±1.17 weeks. Two hundred and sixty (260) cases were followed up successfully by phone while 66 cases were lost to follow-up. Infection (74.40%) and hemolytic disease (51.19%) were the main causes of severe hyperbilirubinemia. Multiple factors regression analysis found that threshold TSB was an independent risk factor of poor outcome (OR=2.02, 95%CI:1.13~3.62, P=0.018). The outcome of neonates with BIND scored between 0-6 had poor prognosis and some of them were reversible, and the outcome in those scored between 7-9 were of worse prognosis. Threshold TSB, USB and B/A ratio in group of poor outcome were signiifcantly higher than those in other groups and their area under the ROC curve evaluating the prognosis was 0.682, 0.671 and 0.698, respectively. With TSB at 474.5 μmol/L, UCB at 449.15 μmol/L and B/A at 0.923 mg/g, Youden index was the higest. The results of BAEP, OSE, MRI and NBNA were not signiifcantly different between groups with or without poor outcome. Conclusions Threshold TSB is an independent risk factor of poor outcome in full-term newborns with severe hyperbilirubinemia. BIND score is a very good predictor of outcome. TSB threshold, USB and B/A ratio are the predictors of outcome, but their diagnostic values are limited. NBNA, hearing screening and hyperintense globus pallidus on T1W1 in the acute phase of jaundice might not related with neurologic prognosis.

Cohesion is a degree that reflects the mutual attractions among the members in a group and pays attention to the status of members.It is association and distillation of all members'will and behavior extension in a group.The intensity of the group cohesion is the important symbol whether a group is competitive or not,and it plays an important role in the survival and the development of a group.This paper starts with the group cohesions of teachers in higher institutions and analyses the factors that affect the group cohesion in higher institution,On this basis,the paper puts forward the tactics in improving the group cohesion of higher institution.

Gastric cancer is one of the most common malignancies in China. Currently, surgical resection, chemotherapy and radiotherapy are still the main therapeutic methods.The postoperative 5-year survival of patients with gastric cancer is lower than 60%. As a means of adjuvant therapy, immunotherapy has the potential to improve the survival of patients with gastric cancer, because its therapeutic targeting and toxicity profile does not overlap with those of conventional therapies. The effector cells of the immune system (T, B and NK cells), when activated, are able to lyse and destroy tumor cells through specific recognition of tumor-associated antigens. However, most immunotherapy research in gastric cancer is still limited to the preclinical stage due to the weakness of its antigenicity. With the development of tumor immunobiology and genetic engineering, immunotherapy has become the focus of research for the treatment of gastric cancer.

Acupuncture Therapy ; Anal Canal ; pathology ; Female ; Humans ; Intervertebral Disc Displacement ; complications ; Middle Aged ; Pain ; etiology ; Rectal Diseases ; etiology ; pathology ; therapy

Colorectal Neoplasms ; pathology ; surgery ; Humans ; Liver Neoplasms ; secondary ; surgery ; Neck Dissection

Accurate preoperative staging is imperative in the treatment of gastric cancer since diseases in different stages mandate different management strategies. Multi-disciplinary therapy is important for gastric cancer. Endoscopic treatment has become the preferred treatment for patients with early gastric cancer. However, only when multiple disciplines is involved in the decision-making process, appropriate patients can be selected and benefit from the minimally invasive treatment. In China, 90% of gastric cancers are at advanced stage at diagnosis, which are associated with worse prognosis compared to early gastric cancer. The optimal treatment depends on the multi-disciplinary therapy including surgery, chemotherapy, radiotherapy, and molecular targeted therapy.
Combined Modality Therapy ; Humans ; Stomach Neoplasms ; therapy

Gastrointestinal Stromal Tumors ; diagnosis ; epidemiology ; surgery ; Humans ; Stomach ; pathology

Adult ; Aged ; Colectomy ; Colonic Neoplasms ; pathology ; surgery ; Female ; Gastrectomy ; Humans ; Male ; Middle Aged ; Rectal Neoplasms ; pathology ; surgery ; Rectum ; surgery ; Stomach Neoplasms ; pathology ; surgery ; T-Lymphocyte Subsets ; pathology ; T-Lymphocytes, Cytotoxic ; pathology ; Th1 Cells ; pathology ; Th2 Cells ; pathology

Metastatic cancer is often occurred in advanced digestive system tumors and the most involved organ is liver.Multiple therapeutic managements and strategies such as surgery,systemic chemotherapy,radiofrequency ablation,portal vein embolization and transarterial chemoembolization are used in the treatment of liver metastasis.However,the treatment of advanced digestive system tumors liver metastasis is still challenging,different therapeutic methods show different results for different tumors,comprehensive treatment should be used based on features of patients and muliidisciplinary cooperation.With the accumulation of clinical experiences,the emergence of novel chemotherapeutics,wider indications of surgical resection in treating liver metastases and accumulated evidence from randomized controlled trials,the therapeutic management of metastatic hepatic cancer should be standardized and more effective in the future.