Objective To investigate the clinical efficacy of laparoscopic hepatectomy.Methods The clinical data of 258 patients who received laparoscopic hepatectomy at the First Affiliated Hospital of Fujian Medical University from March 2010 to January 2013 were retrospectively analyzed.There were 196 patients with primary hepatic cancer,45 with hepatic hemangioma,13 with hepatic focal nodular hyperplasia,2 with hepatic metastatic cancer,1 with carcinoma of gallbladder and 1 with hepatic hamartoma.All patients were followed up via phone call or out-patient examination till March 2013.Results A total of 142 patients received single hepatic segmentectomy,98 received multiple hepatic segmentectomy,18 received multiple lesions resection.Fifty-one patients received hepatic tumorectomy + cholecystectomy.All the operations were successfully done under laparoscope without conversion to the open surgery.The mean tumor diameter and the operation time were (5 ± 3) cm (range,1.0-11.5 cm) and (113 ± 56) minutes (range,50-310 minutes),respectively.Intraoperative hepatic portal occlusion was performed on 122 patients,and the time for hepatic portal occlusion was (15 ± 7)minutes.The volume of intraoperative blood loss was (211 ± 195)mL (range,10-650 mL),and blood transfusion was not needed.The capsule of the tumor was complete.The distance between the resection margin and the malignant tumor was above 1.5 cm,and there was no residual tumor in the resection margin.The hepatic function was back to the normal level in 1 week after the operation,and no patient had hepatic failure.The duration of postoperative hospital stay was (7.2 ± 1.3)days (range,5-10 days).One patient was complicated with bile leakage,6 with slight peritoneal effusion,and other patients had no postoperative complications.The rate of follow-up was 91.47％ (236/258),and the time of follow-up was (16 ± 10) months.A total of 199 patients with malignant hepatic tumors were followed up.During the follow-up,180 patients had tumor-free survival; 18 patients had postoperative tumor recurrence; 1 patient had omental metastasis and received surgical resection.Thirty-seven patients with benign hepatic tumor survived without complication during the follow-up.Conclusion Laparoscopic hepatectomy is effective for the treatment of hepatic tumors.Multiple hepatic inflow occlusion under laparoscope in a short time may improve the safety of surgery,without prolonging the recovery time of patients.

CCAAT-Enhancer-Binding Proteins ; genetics ; Cytogenetic Analysis ; Cytogenetics ; methods ; Extremities ; Humans ; Liposarcoma ; etiology ; genetics ; Liposarcoma, Myxoid ; etiology ; genetics ; Molecular Biology ; methods ; Oncogene Proteins, Fusion ; genetics ; RNA-Binding Protein FUS ; genetics ; Retroperitoneal Neoplasms ; etiology ; genetics ; Ring Chromosomes ; Soft Tissue Neoplasms ; etiology ; genetics ; Transcription Factor CHOP ; Translocation, Genetic

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Body Weight ; Humans ; Laryngeal Muscles ; anatomy & histology ; Magnetic Resonance Imaging ; Middle Aged ; Palate, Soft ; anatomy & histology ; Pharynx ; anatomy & histology ; Sleep Apnea, Obstructive ; pathology ; Tongue ; anatomy & histology ; Young Adult

Humans ; Orthodontic Appliances ; Osteogenesis, Distraction ; instrumentation ; Palatal Expansion Technique ; instrumentation ; Sleep Apnea, Obstructive ; physiopathology ; therapy

Guided method was used in the Clinical Laboratory Instrument courses to guide students with inquiry-based learning problems,breaking the traditional"cramming"teaching,learning and giving full play the initiative and enthusiasm,stimulateing students'interest in learning to optimize the teaching process and improve the quality of teaching.

This study was aimed to observe the clinical curative effect of Qing-Re Li-Shi Hua-Y u (QRLSHY) decoction combined with acupuncture in the treatment of chronic pelvic inflammatory disease (PID) with syndrome of damp-heat and blood-stasis. A total of 120 cases were randomly divided into the acupuncture combined with traditional Chinese medicine (TCM) group, TCM group, and acupuncture group, with 40 cases in each group. The TCM group was given oral administration with QRLSHY decoction. The acupuncture group was given acupuncture on SP6-Sanyinj iao and RN6-Qihai . The acupuncture combined with TCM group was given oral administration with QRLSHY decoction and acupuncture treatment. The treatment course of each group was 2 months. The ob-servation was made on clinical efficacy, clinical symptoms, body signs, changes of laboratory indexes, and relapse rate of three groups. The results showed that compared with pretreatment, the total effective rate of the acupunc-ture combined with TCM group, TCM group and the acupuncture group was obviously increased after treatment (P< 0 . 05 ) . Compared with pretreatment , the clinical symptoms and body signs such as abdominal pain , abdominal bulge, backache, leucorrhea increased, dysmenorrhea, menstrual disorders, lassitude, appendix thickening, pelvic tenderness, and pelvic mass were significantly improved in all three groups (P < 0.05). After treatment, clinical symptoms and body signs of the acupuncture treatment with TCM group had more obvious advantages than the TCM group and the acupuncture group ( P < 0 . 05 ) . Compared with pretreatment , the cervical or vaginal mucus pu-rulent secretion, vaginal wet film mirror of white blood cells, white blood cell count, absolute neutrophil count of all three groups were significantly improved ( P < 0 . 05 ) . After treatment , the acupuncture combined with TCM group had more obvious advantages than the TCM group and acupuncture group ( P < 0 . 05 ) . The relapse rate of the acupuncture combined with TCM group was obviously lower than the TCM group and the acupuncture group 6 months, 9 months, and 12 months after treatment (P < 0.05). It was concluded that QRLSHY decoction combined with acupuncture had obvious clinical curative effect in the treatment of chronic PID with syndrome of damp-heat and blood-stasis. The effect was better than only use TCM or acupuncture. It is worth of promoting in the clini-cal practice .

Objective To systematically review the prognostic factors of intrahepatic cholangiocarcinoma (ICC) and clinical significance of abdominal lymphadenectomy.Methods PubMed was queried with the terms of intrahepatic cholangiocarcinoma,survival,surgery,lymph or vascular invasion to find all studies published from January 2005 to December 2015.Authors were contacted by letters for the publications that were initially ineligible due to insufficient information for data extraction,responses were received,so these publications were included.Data were analyzed and evaluated by 2 independent researchers.Prognostic factors of ICC (vascular invasion,bile duct invasion,lymphatic vessel invasion,lymph node metastasis and peripheral nerve invasion) and related-factors of surgical method (R0 resection and lymph node dissected) were analyzed.The 3-,5-year survival rate,tumor-free survival rate and effect of lymph node dissected for prognosis of patients were extracted.Heterogeneity was analyzed by the chi-squared test and I2 test.The hazard ratio (HR) and 95％ confidence interval (CI) were transformed to Log (HR) and standard errors (SE) Log (HR).HR and 95％ CI of clinical factors associated with outcomes were done using univariate COX regression models.Publication bias was evaluated by the Egger's method,visualizing with funnel plot.Results A total of 48 publications including 7 868 patients with ICC were eligible to be included in this analysis,12 of 48 publications were included in the Mata analysis.Of 7 868 patients with ICC,vascular invasion,bile duct invasion,lymphatic vessel invasion,lymph node metastasis,peripheral nerve invasion,R0 resection and lymph node dissected were detected in 30％ (5％-98％),40％ (11％-59％),45％ (35％-65％),28％ (9％-100％),25％ (7％-55％),79％ (35％-100％) and 64％ (9％-100％),respectively.The 3-,5-year survival rate and 3-,5-year tumor-free survival rate were 39％ (16％-65％),29％(5％-60％) and 34％ (3％-60％),23％ (0-52％),respectively.The results of meta-analysis showed that lymph node metastasis and vascular invasion were factors affecting the prognosis of patients with ICC (HR =2.30,1.92,95 ％ CI:1.94-2.73,1.64-2.25,P ＜ O.05).Among the patients without lymph node metastasis,5-year survival rate in patients with and without lymphadenectomy was 17％-64％ and 15％-64％,respectively,showing no statistically significant difference (P ＞ 0.05).Among the patients with lymph node metastasis,5-year survival rate in patients with and without lymphadenectomy was 48％ and 11％,respectively,showing a statistically significant difference (P＜0.05).Conclusions Lymph node metastasis and vascular invasion are the risk factors affecting the prognosis of patients with ICC.Routine lymphadenectomy for ICC cannot show survival benefit,while routine lymphadenectomy should be applied to patients with ICC and uncertain lymph node metastasis.

Purpose:To evaluate the acute side effects an d efficacy of three-dimensional conformal radiotherapy(3-DCRT)combined with hype rthermia for locally advanced non-small-cell lung cancer(LANSCLC). Methods:From Jan.2001 to April.2003,35 patients with LANSCLC we re treated with three-dimensional conformal radiotherapy(3-DCRT) combined with hyperthermia. Results:The overall response rate(CR+PR)was 91.4%for the primar y tumor. Acute radiation esophagistis occurred in 48.6%of patients(Grades Ⅰ,Ⅱ ). Acute radiation pneumonitis was observed in 8.6% of patients (Grades Ⅰ,Ⅱ). Grade Ⅰ-Ⅱ bone marrow suppression occurred in 8.6%(3/35)of patients and Grade Ⅰ-Ⅱ myocardical injury was present in 14.3%(5/35) of patients. The median fo llow-up duration was 24(6-28) months. Conclusions:Hyperthermia combined with 3-DCRT is well tolerate d in most patients with LANSCLC. Its early responses are milder than the convent ional radiotherapy. Remote results await futher follow-up.

Objective To investigate somatostatin receptor subtype 2 (SSTR2) mRNA expression and its correlation with proliferating cell nuclear antigen (PCNA) in human colorectal cancer. Methods A total of 60 colorectal cancer samples were analyzed. The SSTR2 mRNA expression was examined by in situ hybridization (ISH) using multiphase oligoprobes. The PCNA were detected by immunohistochemical staining. A computerized image analysis system was utilized to estimate the relative contents of SSTR2 mRNA. Results The positive rate of expression of SSTR2 mRNA and relative contents in early and well-differentiated colorectal cancer were higher than those in advanced and poorly differentiated lesion. A negative correlation between SSTR2 mRNA expression and PCNA was found in colorectal cancer. Conclusion In the samples of colorectal cancer, the expression of SSTR2 mRNA is correlated with the degree of differentiation and clinical stage, and it plays an important role in reflecting the degree of malignancy and prognosis.

Objective To investigate the application of a new type internal anastomotic appliance of pouch pliers in the retention of anus operation of mesal,low rectal carcinoma.Methods The data of 65 patients with mesal,low rectal carcinoma with the technique of the anal retention using KYGW type anastomotic appliance of pouch pliers were reviewed and analyzed retrospectively.Results 65 patients were coincided success only one time. Anastomotic fistula occurred after operation in 1 case,being cured and discharged at last,no anastomotic stricture. Conclusion The internal anastomotic appliance of pouch pliers in the anal retention of mesal-low rectal carcinoma is an efficient method with better cost-effectiveness and fewer complications,which is easy to manipulate and popular- ize.