China ; General Surgery ; history ; History, 20th Century

China ; Surgery/*history

Hepatocellular carcinoma (HCC) is the most common malignant cancer in China. The size of HCC can be categorized into 4 grades: (1) micro-HCC, the diameter of the HCC is ≤2 cm; (2) small HCC, the diameter of the HCC is between 2 and 5 cm; (3) large HCC, the diameter of the HCC is between 5 and 10 cm; (4) giant HCC, the diameter of the HCC is > 10 era. The new classification helps to choose the appropriate methods and to analyze the curative effect for various kinds of HCC respectively. The resection of large and giant HCC is safe and feasible. During the past 20 years, we have modified and innovated some techniques of HCC surgery, including hepatectomy without dissecting the hepatic hilus, increasing the safety time limit of portal pedicle occlusion from 15-20 minutes to 20-60 minutes, in situ bepatectomy with occlusion of hepatoduodenal ligament and infrahepatic vena cava, and double hanging maneuver techniques. The techniques mentioned above improved the bleeding control of hepatectomy, and enhanced the long-term survival rate of HCC patients.

Objective To investigate the role and expression of serum substance P (SP) in the patients with breast cancer.Methods The quantity of serum SP by using ELISA in 21 patients with breast cancer (breast cancer group) and 10 healthy women (control group) were detected,the data were analyzed according to AJCC guide line.Results The positive rate of serum SP in breast cancer group was significantly higher than that in control group [57.1％ (12/21) vs.0] (P ＜ 0.01).The level of serum SP in breast cancer group was significantly higher than that in control group [(240.14 ± 435.04) ng/L vs.(16.80 ± 11.74) ng/L](t =2.9852,P ＜ 0.01).There was no relationship between serum SP and estrogen receptor in the patients with breast cancer (t =0.1856,P ＞ 0.05).The level of serum SP showed significantly difference according to AJCC stages respectively (F =3.24,P ＜ 0.05).Conclusion The level of serum SP in the patients with breast cancer increase and may play a role in the progress of breast cancer.

Objective　To study the expression of 5 multidrug-resistant genes in hepatocellular carcinoma (HCC) and establish the criteria for genetic diagnosis of multidrug resistance (MDR). Methods　The expression of mRNA and proteins of the multidrug-resistant genes were detected with reverse transcriptase polymerase chain reaction (RT-PCR) and flow cytometry (FC) respectively. IC50 of the original HCC cells was determined with MTT method. Results　MDR in HCC was associated with the genes of mdr1, MRP, LRP, Topo II α and GSTTP1. mdr1 mRNA ≥0.5, MRP mRNA ≥0.6, LRP mRNA ≥0.8, GSTP1 ≥0.7 and Topo II α mRNA ≤0.4 could be used as the criteria for genetic diagnosis of MDR in HCC. Conclusion　The complex MDR is the main form of drug resistance of HCC. Using RT-PCR to detect the mRNA expression of 5 multidrug-resistant genes is necessary and feasible for predicting sensitivity of chemotherapy for HCC.

Objective To observe the effects of octreotide combined with enzyme supplementation in treatment of pain in chronic pancreatitis. Methods Fifty-six patients were divided into two groups. Thirty-six patients in the treatment group were treated with octreotide combined with enzyme supplementation,and twenty patients in the control group were treated with enzyme supplementation alone. The pain relief rate,analgesic requirement per day and average days in hospital were analyzed between the two groups. Results Compared with the control group,the treatment group presented better improvement of abdominal pain(P〈0. 05),less requirement of analgesics(P〈0. 05),and shorter duration in hospital(P〈0. 05). Conclusion Octreotide combined with enzyme supplementation is effective in alleviating pain and improving quality of life in patients with chronic pancreatitis.

Objective:The study focused on detecting the expression of Twist,HIF-1? and HBx in primary liver cancer(PLC) and assessment their relativity.Methods:The expression of Twist,HIF-l? and HBx in 33 cases of PLC and thein paracancerous tissues were examinated with immunohistochemical location technique.Seventeen health control subjects were included in the study. Results:The incidence of Twist,HIF-1?and HBx expression was 93.9%,72.7% and 81.8% in 33cases of PLC,respectively.The positive percentage of Twist in paracancerous tissues was 54.5%.A significant difference was found between the expression of tumor and paracancerous tissures (P

A 4-year-old girl presented with generalized papules, erythema, desquamation, subcuta-neousnodules around large joints, as well as a 3-year-history of progressive eye damage. Three months after her birth, papules developed on the lower limbs, and gradually spread to involve the whole body. Eye damage appeared after a high fever and she was diagnosed with keratoleukoma, old iritis, and posterior synechia. Physical examination revealed sharply demarcated corneal opacity, shallow anterior chamber, obscure irides, and posterior synechia; pupils were not round. No superficial lymphadenectasis was observed. Dermatological examination showed ichthyosis-like coarse skin with generalized papules, erythema and desquamation, increased wrinkles and absence of sweat. Skin temperature was higher than normal. There were soft, irregu-larly sized, non-tender, movable subcutaneous masses at the wrist, ankle and knee joints without inflamma-tion or warmth. Type-B uitrasonography of both eyes disclosed vitreous opacification, posterior detachment of vitreous, extravasation at the posterior vitreous membrane, and decreased intraocular pressure. Histopathology of lesions on the back, waist, and back of hands as well as subcutaneous nodules on the wrists showed epidermal acanthosis and infiltration with a large number of histiocytes, foam cells and multi-nucleated giant cells in the dermis. No abnormal findings were observed from other examinations. This case was diagnosed as Blau syndrome, which is an autosomal dominant inherited disease; currently, there is no effective therapy for it.

Breast cancer is one of the most common malignant tumor for women, and early and accurate diagnosis of the breast diseases may improve the therapy and prognosis. MRI gains advantages in the diagnosis of the breast diseases, and thus is an important tool for the imaging diagnosis of the breast. The examination modes of MRI were introduced for the diagnosis of the breast cancer, especially the application in high risk population. The limit and research progress of MRI were analyzed for breast cancer staging, pre-operative examination, therapeutic effect assessment for radiotherapy and chemotherapy, the relationship between the markers and imaging findings.

To observe the effects of Danshen on the growth of hepatocellular carcinoma in the SD rats, a model of malignant obstructive jaundice was established by inoculation of transplanted tumor into the hepatic portal with the walker-256 hepatocarcine line, which resulted in the obstruction by the infiltration and metastasis of hepatocellular carcinoma. SD rats were divided into 4 groups: the rats were treated by 0.9 % NS (n=24, control group), inosine+vitamin C (n=40, InV group), Danshen (n=40, DS group) and 5-FU (n=40, 5-FU group), respectively. The liver function, morphological changes and the expressions of PCNA, VEGF and ICAM-1 in carcinoma foci, peri-carcinoma tissues, adjacent lobe (left-internal lobe) and lung tissues were observed after the treatment with the 4 agents. Our results showed that the protective effect of Danshen on liver function was significantly better than that of NS and 5-FU (P<0.01). No significant difference in protective effect was observed between DS group and InV group (P>0.05). Danshen also provided protective effect on the morphological damage of liver caused by obstructive jaundice. The rates of carcinoma-inhibition and metastasis inhibition were significantly higher than those of NS and inosine+vitamin C (P<0.01). No significant difference in this regard existed between DS group and 5-FU group (P>0.05). The expressions of PCNA,VEGF and ICAM-1 PCNA, VEGF and ICAM-1 in carcinoma foci, peri-carcinoma tissues, adjacent lobe (left-internal lobe) and lung tissues were lower than those in control group and InV group, with the differences being significant (P<0.01). No significant differences were found between DS group and 5-FU group in the expression levels of PCNA and VEGF (P>0.05) but ICAM-1 (P<0.05). It is concluded that Danshen injection not only has protective effects on liver injury caused by obstructive jaundice, but can inhibit the proliferation and growth of hepatocarcinoma, interfere with the vascularization of tumors, prevent recurrence and metastasis of hepatocarcineoma.