Radical resection is crucial in the surgical treatment of adenocarcinoma of the body and tail of pancreas.It usually refers to negative resection margin and dissection of regional lymph nodes.In recent reports,the definition of R0 margin has been updated,and radical antegrade modular pancreatosplenectomy (RAMPS),which was first described by Strasberg et al,contributes to achieving negative tangential margins.In some cases,extended radical resections were adopted in an attempt to achieve R0 margin.However,it would increase operation related morbidity and mortality,which should be taken into account before the procedure.Lymph nodes metastasis is an important prognostic factor.Extended lymph nodes dissection does not seem to bring survival benefits,while itg helpful in assessing the tumor stages and patients' prognosis.Laparoscopic distal pancreatectomy (LDP) has been applied in the treatment of ductal adenocarcinoma of the pancreas in reports with small sample sizes.But it remains controversial whether LDP is superior comparing to conventional open methods in regards to oncological outcomes.Curently,surgery is the promising method that may cure adenocarcinoma of the body and tail of pancreas.Highlighting radical resection will bring more survival benefits to patients.

Objective: To investigate the level of MMP-3 in the serum of gastric cancer pa-tients and to examine the expression of VEGF-C in gastric cancer, to evaluate the effects of the two factors on the development process of cancer. Methods: The enzyme linked immunosorben assay (ELISA) method was used to detect the serum levels of MMP-3 in 50 patients with gastric cancer. The immunohistochemical method was utilized to analyze the expressions of VEGF-C and MMP-3 in 50 resected specimens. Results: The preoperative serum level of MMP- 3 (30.96?9.75 ng/mL) was significantly higher than that of postoperative group (16.29 ?5.92 ng/mL) and control group (14.43?4.82 ng/mL) (P

Objective To investigate the effect of S100A8/A9 protein complex on the surface morphology and the F-actin network in human cervical carcinoma cell line,CasKi cells.Methods After being cultured with 20 ?g/ml S100A8/A9 protein complex,the cell skeleton of the CasKi cells were observed under a confocal scanning fluorescence microscope by staining the F-actin network.Atomic force microscopy(AFM) was employed to reveal the change of ultrastructure of the cell surface in vivo.ResultsAfter being cultured with the S100A8/A9 protein complex for 24 hours,the F-actin network disorder was revealed.Most of the F-actins distributed peripherally.The OD value of the F-actin decreased significantly from 92.42?5.16 to 57.67?3.70 after been treated with the S100A8/A9(t=5.268,P=0.000).The AFM showed a withdrawing morphology with reduced pseudopodia and destruction of stress fibers. Conclusion S100A8/A9 protein complex can change the ultrastructure of the surface of CasKi cells and its stress fibers by re-distributing of the F-actin in the cells.

The met-enkephalin (MEK), leu-enkephalin (LEK) and ?-endorphin (?-EP) immunoreactivities were detected in the circulating lymphocytes of 64 guinea pigs by PAP immunohistochemical method under the conditions of electroacupuncture, naloxone or exogenous opioid like peptides (OLP). Subsequently the ?-naphthyl acetate esterase (ANAE)was demonstrated on partial immunostained lymphocyte samples. The results showed that the OLP immunoreactivity with different intensity was found in approximate 96％ of the lymphocytes. There was a positive correlation between the ANAE-focal pattern lymphocytes and MEK-IIRL (intense immunoreactivity lymphocytes)or ?-EP-IIRL; whereas there was no significant correlation between the ANAE-focal pattern lymphocytes and LEK-IIRL. The MEK-IIRL, LEK-IIRL and ?-EP-IIRL were all increased markedly in the guinea pigs which underwent electroacupuncture at "Zusanli" points. There was no significant difference in MEK-IIRL, LEK-IIRL and ?-EP-IIRL, when the acupuncture group, naloxone group and control group were compared with each other. However, the LEK-IIRL, MEK-IIRL and ?-EP-IIRL could be depressed by naloxone, when the lymphocytes were preincubated with 10~(-7)mol/L of MEK, LEK or ?-EP in vitro. Hence, the naloxone group had a significant difference in MEK-IIRL, LEK-IIRL or ?-EP-IIRL when compared with the acupuncture group. A high peak of the lymphocyte MEK-IR among the range of 10~(-10)—10~(-8)mol/L of MEK preincubation in the acupuncture group when compared with the control group. It suggests that electroacupuncture may enhance activity of the unbound MEK receptor.

In recent years, with the application and exploration of fluorescence imaging technology in pancreatic surgery, it has brought new changes and new hope for the intraoperative treatment of pancreatic diseases. Intraoperative fluorescence imaging with indocyanine green (ICG) as probe is increasingly applied in identify neoplasms, real-time margin assessment, tissue perfusion, lymph node detection, anastomotic leakage and so on, which provides a new means for intraoperative decision-making. This article reviewed the progress in the application of ICG fluorescence imaging in pancreatic surgery.

Objective:To compare the quality of life following total gastrectomy(TG) with that folliwng subtotal gastrectomy(SG) in patients with gastric carcinoma.Methods:Sixty-six patients underwent gastrectomy between 2003 and 2005 at the Department of General Surgery of the Qilu Hospital were enrolled into this study.Among them,15 underwent TG,42 accepted distal end subtotal gastrectomy(DSG) and 9 underwent proximal end(PSG) .The EORTC quality of life questionnaire QLQ-STO20 was used in the present retrospective study to assess follow quality of life of thes patients.The food-intake,local symptom and quality of life of the 3 groups were compared.Results:Patients recovered worse in short term after TG compared with PSG,but there was no statistical difference in the near future.But both of them were not as good as DSG.The contraflow was common and serious after PSG.The incidence rate of abdominal distension was high.Conclusion:The indication of TG for carcinoma of the superior part of stomach can be extented properly.Evidence-Based Medicine should be used to screen better reconstruction mode.On the base of radical cure,quality of life should be improved as far as possible.

Objective To investigate effects of low shear stress on atherosclerosis,the development of atherosclerosis and expression of ?actin and cMyc proteins were studied in VSMC of common carotid artery under low shear stress. Methods We established the atherosclerotic model of left common carotid artery that presented low shear stress by the operation of ligating the left external carotid artery in rabbits.The histomorphology of the carotid arteries was examined by light microscopy.The expression of ?actin and cMyc was studied by immunohistochemistry. Results The typical atherosclerosis was observed and the atherosclerotic lesion was obviously accelerated under low shear stress.The expression of ?actin was downregulated and the phenotype of VSMC converted from contractile phenotype into synthetic phenotype,and expression of cMyc increased in VSMC of the artery under low shear stress.Conclusion This new model of atherosclerosis under low shear stress was successfully established,which provides a new tool for studying the effects of low shear stress on atherosclerosis.The results show that the atherosclerotic lesion is obviously accelerated and VSMC tends to proliferate in response to low shear stress.

Objective To assess the feasibility of chondrocyte and osteoblast composites in vitro cultured in bioreactor in repairing cartilage defects.Methods Marrow mesenchymal stem cells were isolated and cultured in vitro,and then were induced to chondrocytes and osteoblasts by growth factor.Chondrocytes and osteoblasts were cocultured in bioreactor for 21 days to form the composites.The adhesion,extension and proliferation of chondrocytes and osteoblasts were observed under scanning electron microscope.The cartilage defects on canine model were repaired with the chondrocyte and osteoblast composites.Results The induced chondrocytes and osteoblasts had fine adhesion,extension and proliferation in the β-TCP scaffold.The repaired tissues in experimental group maintained their thickness to the full depth of the original tissues.A statistical difference was observed between negative control group and experimental group(q=12.337 0,P ＜ 0.01)and between blank control group and experimental group (q=31.539 3,P ＜0.01).Conclusion Perfusion bioreactor makes chondrocyte and osteoblast survive and proliferate in a three-dimensional scaffold and increases the composition rate of the chondrocyte and osteoblast.

Objective To evaluate the short-term curative effect and the safety of transcatheter arterial chemoembolization (TACE) therapy by using microspheres and lipiodol for hepatocellular carcinoma (HCC).Methods A total of 87 patients with pathologically proved HCC were randomly divided into the study group (n=44,using embospheres of 100-300 μm in diameter together with lipiodol) and the control group (n=43,using gelfoam particles of 350-560 μm in diameter together with lipiodol).Postopertaive biochemical (liver function and AFP) findings and imaging (CT and/or MRI) manifestations were recorded,and the clinical efficacy and adverse reactions were analyzed.Results TACE was performed in all 87 patients.After the treatment,both the disease benefit rate and the postoperative reduction in AFP level in the study group were remarkably better than those in the control group (P＜0.05),but postoperative liver function indexes were not significantly different from the preoperative ones (P＞0.05).The average number of interventional therapy within the follow-up period of 6 months in the study group was smaller than that in the control group (P＜0.05).No statistically significant differences in 6-,12-and 18-month survival rates existed between the two groups (P＞0.05).Conclusion In treating HCC,TACE by combination use of microspheres and lipiodol is safe,its short-term curative effect is more obvious than TACE by combination use of gelfoam particles and lipiodol,and it can reduce the times of interventional procedure.Before TACE,careful planning of the pre-treatment of hepatic artery-portal vein fistula and the superselective catheterization with micro catheter should be taken into consideration.

Objective To discuss the security and reliability of preoperative thoracoscopic pericardial exploratory and to evaluate of the surgical indications.Methods Video full-assisted thoracoscopic pericardioscopy has been implemented in 41 central type lung cancer cases before radical resection.Results Video assisted pericardioscopy group underwent thoracotomy lung resection with procession of intrapericardial pulmonary artery in 8 cases (partial pericardial resection in 2 cases),with pulmonary vein in 10 cases,and out-pericardial lung resection in 9 cases.Spiral CT projections were consistent with surgery was only 65.8 ％.The average time of explorationa was (23±10) min.Conclusion Except for widely used in pulmonary wedge resection and lobectomy,video-assisted thoracoscopic pericardial exploration can improve resection rate and survival rate in central type lung cancer patients which can reduce the need for exploratory thoracotomy.