Liver metastasis is one of the critical prognostic factors for colorectal cancer.Complete surgical resection of liver metastases still remains the only potentially curative treatment for patients with liver metastases.There are still some controversies in how to choose the reasonable management for resectable colorectal cancer patients with simultaneous liver metastases,although neoadjuvant chemotherapy,tumor physical ablation technique and minimally invasive technology have made progress in recent years.One case of surgical treatment of synchronous rectal cancer liver metastasis at the Shengjing Hospital with laparoscopic microwave ablation + radical resection of colorectal cancer was disused in order to provide reference for individualized treatment for patients with the same disease.

Humans ; Pulmonary Fibrosis ; metabolism ; pathology ; Signal Transduction ; physiology ; Transforming Growth Factor beta1 ; metabolism ; Wound Healing ; physiology

Objective:To evaluate the effectiveness and safety of butyl phthalide capsules combined with Xueshuantong injection in the treatment of acute cerebral infarction (ACI). Methods: Cochrane Library, Medline, Embase, SCI, CBM, CNKI, VIP and Wanfang databases were searched from the building time to May 2016. The enrolled randomized controlled trails were studied by using Cochrane system evaluation methods to perform methodological quality assessment, and RevMan 5. 2 software was used to carry out Me-ta-analysis. Results:A total of 7 randomized controlled trails including 640 patients were enrolled. The results of Meta-analysis dem-onstrated that the effective rate of butylphthalide capsules combined with Xueshuantong injection was superior to that of Xueshuantong injection (RR=1. 33, 95%CI:1. 16-1. 52, P<0. 0001), butylphthalide (RR=1. 45, 95%CI:1. 15-1. 83, P=0. 002) and blank control (RR=1. 31, 95%CI:1. 08-1. 57, P=0. 005). NHISS of butylphthalide capsules combined with Xueshuantong injection was higher than that of Xueshuantong injection (MD=4. 63, 95%CI:3. 38-5. 87, P<0. 00001) and blank control (MD=6. 85, 95%CI:4. 90-8. 80, P<0. 00001). There was no significant difference in adverse drug reactions. Conclusion: Butylphthalide capsules combined with Xueshuantong injection is effective for the therapy of ACI. However, due to the limited quantity and quality of the in-cluded studies, larger scale trials are needed.

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Objective The purpose of this study was to discuss the therapies for hemorrage caused by the fissuration of pancreatojejunal stoma and pancreatic leakage after pancreatoduodenectomy.Methods After three cases of pancreatoduodenectomy,the disruptions of pancreatojejunal stoma resulted in serious pancreatic leakage and the hemorrage in abdominal cavity.During all the second operations,the drainage-tube insertions into the main pancreatic ducts were used to lead the pancreatic juice into the neighboring loop of jejunum.Results Afer the operations,the supportive treatment,continuous irrigation of peritoneal cavity and pancreatic enzyme inhabition were given to the patients of these cases and all of the patients were successfully cured.Conclusions The bridge-crossing internal drainage which inserts drainage-tube into the main pancreatic duct was a convenient and effective therapy and method to rescue the hemorrage caused by the fissuration of pancreatojejunal stoma and pancreatic leakage after pancreatoduodenectomy.While the patients' lives were saved,their functions of pancreas were preserved and the qualities of life were improved after the operations.

To train high-qualified dental practitioner, the students in Chongqing Medical U-niversity were guided and regulated through rigorous training programs. Special attention was paid to the management of each aspect of clinical practice, the educational philosophy of early clinical expo-sure, early scientific research exposure and early contact with society have been fully implemented during the teaching practice in our stomatology college.

Objective The purpose of this study was to determine how to preserve the remaining pancreatic body and tail in the pancreatectomy. Methods In seven cases of pancreatectomy, three of them were the rupture of pancreatojejunal anastomosis, and four of them were the pancreatectomy for tumor in the pancreatic neck or body. During operations, a bridge internal drainages was used to drain the pancreatic juice into the adjacent jejunum. After the operations, the supportive treatment, continuous irrigation of peritoneal cavity and pancreatic enzyme inhibition were used. Results In all seven patients, the remaining pancreatic body and tail were successfully preserved. The endocrine functions of these patients recovered to nearly normal level and patients were discharged. Conclusions In preserving the remaining pancreatic body or tail, the bridge internal drainage has its advantage of convenience. It effectively preserves the exocrine of pancreas as well as its endocrine

OBJECTIVETo study the impact of left varicocele (VC) and varicocelectomy (VCT) on the apoptosis of spermatogenic cells and the levels of nitrogen monoxidum (NO) and interleukin 1 (IL-1) in the rat testis.

METHODSWe randomly divided 60 adolescent male SD rats into four groups of equal number: sham operation control, VC model 1 (VC1), VC model 2 (VC2), and VCT. We determined the semen quality and levels of NO and IL-1 in the testis tissue, detected the apoptosis of spermatogenic cells by TUNEL, and compared the indexes obtained among different groups.

RESULTSAn experimental VC model was successfully established by partially ligating the left renal vein of the rats. Sperm concentration and motility were significantly decreased in the VC1 ([1.54 ± 1.16] x 10⁶/ml and [44.23 ± 15.46]%) as compared with those in the sham operation group ([2.80 ± 1.62] x 10⁶/ml and [72.34 ± 12.62]%) (P < 0.05), but remarkably higher in the VCT ([1.82 ± 1.34] x 10⁶/mI and [51.21 ± 12.62]%) than in the VC2 group ([1.04 ± 1.21] x 10⁶/ml and [39.23 ± 13.21]%) (P < 0.05). The levels of NO and IL-1 in the left testes were markedly elevated in the VC1 ([0.172 ± 0.030] ng/ml and [1.468 ± 0.080 ] mg/ml) in comparison with those in the sham operation group ([0.134 ± 0.021] ng/ml and [0.782 ± 0.079 ] mg/ml) (P < 0.05), and significantly higher in the VC2 ([0.198 ± 0.020] ng/ml and [1.994 ± 0.090] mg/ml) than in the VCT group ([0.141 ± 0.010] ng/ml and [0.781 ± 0.036] mg/ml) (P < 0.05). However, the NO and IL-1 levels in the right testis showed no statistically significant differences between the two groups, and the two levels were positively correlated (r = 0.492, P < 0.01). The rats of the VC1 group exhibited remarkable apoptosis of spermatogenic cells in the bilateral testes, with significant differences in the apoptosis index ( AL) between the two sides (P < 0.05) as well as in the same side in comparison with the sham operation group (P < 0.01). The Als of spermatogenic cells in the bilateral testes showed statistically significant differences in the VCT (P < 0.05) but not in the VC2 group (P > 0.05), and those in the same side manifested dramatic differences between the VCT and VC2 groups (P < 0.01).

CONCLUSIONVaricocele induces changes of the NO and IL-1 levels in the testis tissue and increases the apoptosis of spermatogenic cells, which might be one of the causes of testis damage and spermatogenic dysfunction.

Animals ; Apoptosis ; Germ Cells ; pathology ; In Situ Nick-End Labeling ; Interleukin-1 ; analysis ; Ligation ; Male ; Nitrogen ; analysis ; Random Allocation ; Rats ; Semen Analysis ; Spermatogenesis ; Testis ; chemistry ; Varicocele ; complications ; surgery

Objective To investigate the efficacy and safety of hypertonie saline enhanced radiofrequency ablation (RFA) in the treatment of liver cancer. Methods The clinical data of 42 patients with primary liver cancer (n = 28) or metastatic liver eancer (n = 14) who had been admitted to First Affiliated Hospital of Nanjing Medical University from September 2001 to December 2007 were collected. Forty-eight lesions were detected with a diameter ranging from 1.2 cm to 7.5 cm. RFA electrode and 20G needle were pricked into the target lesion under the guidance of B ultrasound or computed tomography (CT) through percutaneoas puncture or open approaches. An amount of 5-10 ml hypertonie saline was infused through the needle at regular intervals during RFA. All patients were followed up for 3-79 months. Contrast-enhanced ultrasound and CT scanning were performed postoperatively to determine the efficacy of RFA. The levels of alpha-fetoprotein (AFP) before and after treatment were compared using t test, and the survival of the patients were analyzed using a Kaplan-Meier survival curve. Results The AFP expression changed to negative in 14 out of the 18 AFP-positive patients, with statistical difference (t =7.703, P <0.05). The complete necrosis rate of tumors was 94% (45/48), and the necrosis rate of tumors with diameter of ≤4.0 cm reached 100% (35/35). The incidence of complication was 5% (2/42). No perioperative mortality occurred. The 1-, 2-, 3-year survival rates were 91%, 85% and 70%, respectively. Conclusions Hypertonic saline enhanced RFA in the treatment of liver cancer was proved to be safe and effective.

Objective To study dosimetric characteristics of helical tomotherapy (HT) by comparing its treatment plans with linear accelerator-based step-and-shoot intensity modulated radiation therapy (IMRT) for nasopharyngeal carcinoma(NPC). Methods Targets on CT images of 10 NPC patients were delineated and transferred to HT and IMRT treatment plan systems. The prescription dose was 70 Gy/33 f for pGTV and GTVnd,60 Gy/33 f for FTV1 ,and 54 Gy/33 f for PTV2. The limit dose of organ at risk was parotid V35 ＜50% ,brain-stem＜54 Gy,spinal cord ＜45 Gy and lens ＜9 Gy. Data of the two groups were compared by paired t-test. Results The dose distribution, conformality and homogeneity were good in both groups.But the homogeneity index(HI) and Dmean of PTV1 in HT group were better than IMRT group( P ＜ 0.01 ).The Dmean of PTV1 in HT group(63.84 Gy)was lower than IMRT group(70.30 Gy). The Dmean, V35 and V30 of parotids,and the Dmax of larynx-esophagus were lower in HT group than IMRT group. Conclusions Helical tomotherapy treatment plan has a better homogeneity, steeper dose gradient, and a better protection for organs at risk.