Post-operative pancreatic fistula(POPF)is the most common and severe complication after pancreaticoduodenectomy,which may have significant impacts on curative effects and prognosis.It has been shown that POPF is not only closely associated with texture of pancreatic parenchyma,diameter of pancreatic duct and tumor site,but also affected by surgeon's experience and surgical techniques.Double layer pancreaticojejunostomy and external pancreatic duct stent may be beneficial to decrease POPF.

Objective To explore the influence of some factors on long-term survival of postoperative stage Ⅰ NSCLC patients. Methods 91 patients of NSCLC who underwent radical surgery of the primary tumor with dissection of the hilar and mediastinal lymph nodes were diagnosed as stage Ⅰ NSCLC postoperatively by pathology and followed up for 5 years. Its hilar and subcarinal lymph nodes were detected occult micrometastastic tumor cells by immunohistochemistry (SP method) by using the binoclonal antibody multicytokeratin (AE1/AE3) as a micrometastatic marker. To analyse the influence of micrometastasis and the clinicopathologic characteristics on long-term survivals. Results The rate of micromatastasis of stage Ⅰ NSCLC was 49 %. The five-year overall survival rate was 70.3 %. The median of survival time was 48.5months. The rate of metastasis was 32 % and the meantime of relapse and metastasis was 36.6months. Tumor size, differentiation, stage, and micrometastasis were significantly associated with relapse and metastasis (P <0.05). The tumor differentiation, stage, and micrometastasis were found to be significant independent factor on survival in multivariate analysis (P<0.05). Conclusion There was nodal micrometastasis in completely resected stage Ⅰ NSCLC, and the tumor differentiation, stage, and micrometastasis were found to be significant independent factor on survival.

Obesity is rapidly becoming a pandemic and is associated with increased carcinogenesis,especially hepatocellular carcinoma (HCC).Adipose tissue has been considered as an endocrine organ because of its capacity to secrete a wide variety of adipokines,such as leptin,adiponectin and resistin.Recently,adipokines have been demonstrated to be associated with many kinds of chronic liver diseases,liver fibrosis and cirrhosis,and carcinogenesis.Direct evidence supporting the inhibitory and/or activating role of adipokines in the process of carcinogenesis and progression of human HCC has been rapidly accumulating. This review aims to provide important insights into the potential mechanisms of adipokines in the development of HCC.Further investigations will shed light on a new therapeutic target in HCC.

Thioredoxin (Trx) is a class of small redox proteins which is widely found in all organisms.It acts as antioxidant by facilitating the reduction of other proteins by cysteine thiol-disulfide exchange.Recently,thioredoxin is found to be over-expressed in many kinds of tumor,which is closely associated with tumor cell proliferation,apoptosis and cell cycle control.Trx is also found to promote the synthesis and stabilization of the HIF-1α protein.It is also related to the control of reactive oxygen species and chemoresistance of tumor cells.Trx has been proved to play an important role in promoting the metastasis of cancer,and may become a potential target for anti-metastasis of cancer.

Objective　To study the efficiency of the treatment of experimental hepatocellular carcinoma in rats with arsenic trioxide and to elucidate the possible mechanism.Methods　Wistar rats were fed with diethylnitrosamine (DEN) to induce HCC, then treated with As2O3. The histological changes in liver tissue were observed under microscope, and the cellular dynamic parameters were studied by flow cytometry. Results　Treatment with As2O3 caused HCC cells death via both apoptotic and non-apoptotic mechanisms when the dose was high (5 mg/kg), the necrosis was seldom and apoptosis was common when the dose was appropriate (1 mg/kg). Proliferation index (PI) decreased sharply in high-dose (5 mg/kg) group (P＜0.01), but not in other two (1 mg/kg, 0.2 mg/jg) groups (P＞0.05). However, S phase fraction (SPF) decreased dramatically in all three groups (P＜0.01). Although apoptosis of HCC cells was common in all three groups, it reached the top only when the dose (1 mg/kg) was appropriate (P＜0.001), and it was obviously accompanied with accumulation of cells in G2/M (G2/M restriction). Conclusion　These date demonstrate that arsenic trioxide induces apoptosis of rat HCC cells, and it is closely associated with G2/M restriction when apoptosis reaches the top. The data also suggest that arsenic trioxide can inhibit cell proliferation, which is dose-dependent and time-dependent. The fact that continuous intermittent i.p. injection of arsenic trioxide can also be effective may afford a novel way to use the drug more safely.

Objective To investigate the clinical value of a preoperative predictive scoring system established by National Cancer Center Hospital (NCCH) for postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD).Methods The clinical data of 100 patients with periampullary tumor who underwent PD in the Cancer Hospital of Tianjin Medical University from October 2008 to January 2012 were retrospectively analyzed.Five indexes including gender,pancreatic cancer,main pancreatic duct index,portal invasion and intra-abdominal fat thickness were in the NCCH preoperative predictive scoring system.Patients with score ＞ 4 were defined as with high risk of POPF,and those with score≤4 were defined as with low risk of POPF.Factors associated with POPF were analyzed using the Pearson chi-square test.The sensitivity and specificity of the predictive scoring system were determined by receiver operating characteristic (ROC) curve analysis.Results Of the 100 patients,20 had POPF,including 9 in grade A,6 in grade B and 5 in grade C.Gender,pancreatic cancer,portal invasion,texture of pancreas and method of pancreaticojejunostomy were closely correlated with POPF (x2=5.613,4.785,15.479,7.145,7.050,P ＜ 0.05).The incidence of POPF was 86.4％ (19/22) for patients with high risk of POPF,and 1.3％ (1/78) for patients with low risk of POPF,with significant difference (x2=77.637,P ＜ 0.05).The results of ROC curve analysis showed that the sensitivity and specificity of the predictive scoring system were 95.0％ and 96.3％,respectively.The nomogram showed an area under the curve of 99.0％ (P ＜ 0.05).Conclusion The NCCH preoperative predictive scoring system could accurately predict the occurrence of POPF.

Objective:The present study discussed the clinical diagnosis and treatment of pancreatic body and tail carcinoma. Methods:The data of 52 patients with pancreatic body and tail carcinoma treated in Tianjin Medical University Cancer Institute and Hospital from January 2008 to December 2012 were reviewed retrospectively. The data included historical materials of perioperative examination and therapy. The data of 49 cases were reviewed retrospectively, and the median survival was calculated by the Kaplan-Meier method. The effects of the clinicopathologic parameters on the prognosis of patients with pancreatic body and tail carcinoma were examined by the log rank test. Results:Thirty-eight patients underwent exploratory surgery among which 24 had surgical resection, and the standard procedure was distal pancreatectomy plus splenectomy. The tumor staging was stage I in five patients (13.16%), stage II in nineteen patients (50%), stage III in five patients (13.16%), and stage IV in nine patients (23.67%). The median survival time was 18.0 ± 1.23 months for patients who received radical resection and 10.0 ± 2.71 months for patients who underwent nonspecific treatment or palliative therapy. The radical resection was associated with a longer survival period than the nonspecific treatment or palliative therapy (P<0.01). Conclusion:Early diagnosis is the key to achieving long-term survival. The radical resection plays an important role in improving the surgical treatment.

Asaresult,establishinganimalmodelsoflivercancerisofhighvalue.Therearetwoparts of the establishment of animal models-the selection of laboratory animals and the source of tumors.The animal models could be classified into different patterns due to difference sources of tumor,and these different patterns possess distinctive characters and limitations.The ideally animal models should satisfy the general requirements of biological habits,biochemical properties,and pathological features which are similar with human hepatocel-lular and easy to establish.

Objective To develop a PDA-based wireless electrocardiographic monitoring system meeting the requirements of doctors in mobile work.Methods ECG signals were received from hospital monitor center through mobile network,and then were analyzed with digital signal processing technology and electrocardiographic information processing technology.The results were sent to patients as soon as the data were diagnosed by doctors,thus realizing the real-time monitoring.Results PDA-based wireless electrocardiographic monitoring system applied many advanced technologies such as mobile communication technology,blue-tooth technology,embedded database technology,etc.so that doctors could examine patients' records and electrocardiogram at any place and in any time.Conclusion Clinical experimental results show that the system fulfils doctors' requirements and improves their work greatly.

Studies show that metformin inhibits the proliferation of several types of cancer cells.All evidences,therefore propose the anti-tumor effect of metformin.Metformin can repress the oxygen consumption of tumor cells,and suppress hypoxia-inducible factor-1α (HIF-1ct) accumulation through the translational and posttranslational mechanisms,and suppress the expression of HIF-1α by activating AMP-activated protein kinase (AMPK).