Pancreatic carcinoma is a high malignancy,as radical resection is the only cure for long-term survival.In an attempt to improve outcomes and prognosis,surgeons over the decades have employed various active surgical strategies to combat this disease.Through document analyses of radical pancreaticoduodenectomy for pancreatic head carcinoma,regional lymphadenectomy,retroperitoneal nerve dissection,and combined vessel resection,the extent and disputes about radical resection for pancreatic head carcinoma are investigated.Total mesopancreas excision appears to be a novel and promising surgical procedure for the improvement of prognosis of patients with pancreatic head carcinoma.However,further studies based on the data of larger number of patients are mandatory to raise the evidence for this surgical procedure.

Pancreatic carcinoma is a common malignancy of the digestive system,which has poor prognostic results because of its characteristics of lymphatic metastasis and perineural metastasis.Radical resection is considered as the only possible way to cure this malignant disease.As a part of the radical resection,regional lymphadenectomy has gained lots of attention,while there is no consensus regarding the extent of regional lymphadenectomy and the role of combined vessel resection.Recently,the artery-first approach and total mesopancreas excision have probed a new direction for the research of regional lymphadenectomy for pancreatic head carcinoma.

Objective To explore the feasibility and evaluate its efficacy of transnasal marsupialization of maxillary cyst under nasal endoscope. Methods 15 cases of maxillary cyst were treated by endoscopic marsupialization in nasal. According to the situation of maxillary cysts, the fenestration of bottom nasal was opened in 6 cases, the fenestration of inferior nasal meatus was opened in 7 cases and inferior nasaI meatus was opened through the prelacrimal duct recess in 2 cases under the nasal endoscope. With partial removal of the cyst wall, the cyst and maxillary sinus was fused into a cavity if necessary. This ensured nasal drainage through the cyst cavity and nasal cavity or maxillary sinus. Results The operations of the 15 patients were success without complications. All patients were followed up for 6 to 24 months after operation. Operation cavity to complete epithelization in 2 to 3 months, the cyst cavity drained well with no recurrence. Conclusion Endoscopic marsupialization in nasal is a feasible alternative for management maxillary cyst. It makes the procedure simple, less traumatic, quick recovery, definite curative effect and low recurrence rate.

Objective To investigate the relationship between single nucleotide polymorphisms (SNPs) of PRKCG gene (rs2547362,rs3745406) and osteosarcoma susceptibility in the osteosarcoma patients and the normal population.Methods Sixtyone patients with osteosarcoma who had been admitted in our hospital from January 2011 to December 2012 and 63 healthy adults were enrolled in this study.A 2-ml peripheral blood sample was taken from each participant.The RT-qPCR method was used to detect the genotype and allele frequency distribution of PRKCG gene at rs2547362 and rs3745406 in osteosarcoma patients and normal population.Osteosarcoma patients were divided into several groups according to the clinical parameters such as age,gender,histology,tumor location,Enneking classification,tumor metastasis and therapy,and then we analyzed the relations between the genetic polymorphism and clinical parameters.Results 1) The genotype of PRKCG gene at rs3745406 included CC,CT and TT.The differences of genotypes (CC,CT,TF) and alleles (C,T) frequency distribution at rs3745406 were not statistically significant between osteosarcoma patients and the normal population (P=0.490,P=0.554).2) The genotype of PRKCG gene at rs2547362 included CC,CT and TT.The differences of genotypes (CC,CT,TT) and the alleles(C,T) frequency distribution at rs2547362 were statistically significant between the osteosarcoma patients and the normal population (P=0.006,P=0.007).3) The differences of genotypes (CC,CT,TT) and alleles (C,T) frequency distribution at rs3745406 were statistically significant between patients with metastasis and patients without metastasis (P=0.000,P=0.000).The CT and TT genotypes and the T allele carrier frequency at rs3745406 were higher in patients with metastasis than in patients without metastasis.SNPs at rs2547362 were not associated with clinical parameters.Conclusion The genetic polymorphism of PRKCG gene at rs2547362 is associated with osteosarcoma susceptibility.The TT genotype and T allele at rs3745406 are associated with metastasis of osteosarcoma,which may be a risk factor for metastasis in the osteosarcoma patients.

objective　To study the expression of CD44v3 and CD44v6 and its relationship with lymph node metastasis in non small cell lung cancer (NSCLC). Methods　Specimens (lung tissues) from 52 c ases of NSCLS and 12 normal lung tissue were used to detect the expression of CD 44v3 and CD44v6 by immunohistochemical method (SP method) and flow cytometry, co rrelation was analysed between the expression of CD44v3 or CD44v6 a nd lymph node metastasis of the lung cancer. Results　CD44v3 and CD44v6 were not, or weakly expressed in all normal lung tissues from 12 cases. In contrast, the expression levels of CD44v3 and CD44v6 were obviously higher in lung cancer than that in normal tissue(P<0.05). The expression of CD44v 3 and CD44v6 were much higher in patients with lymph node metastasis than those without lymph node metastasis(P<0.05). Conclusion　① CD44v3 and CD44v6 are expressed with different degree in NSCLC. ②There is a close rel ationship between high expression of CD44v6 and lymph node metastasis, and CD44v 6 may be a co-marker for predicting the potentiality of lymph node metastasis i n lung cancer.

Objectives:To investigate the differentiation of human hepatocellular carcinoma cell line Bel-7404 induced by Matrine in vitro,and discuss its mechanism.Methods:After dealing human hepatocellular carcinoma cell line Bel-7404 with different concentrations of Matrine,we drew cell growth curve by MTT colorimetry,and cell morphology was examined by light microscope.Then we evaluated the tumor cell biological characteristics changes through improved soft agarose clone forming test,cell adhesion assay,cell movement assay and cell invasion assay.Also we detemined cell cycle distributing by flow cytometry.Results:After 72 hours being treated with 0.5,0.75,1.0g/L,in the Matrine test groups,the cell proliferation was inhibited significantly,and cell shape transformed to normal.The amounts of clone were remarkably reduced.The cell adhesion ability increased in different level.At the same time cell ability of movement and invasion differently weakened.Analysis of cell cycle shown that along with rising of Matrine concentration,the cell amounts in G1 phase increased accordingly and cell amounts in G2 and S phase remarkbly decreased.Conclusion:During the appropriate concentration range,Matrine not only inhibited Bel-7404 growth and proliferation,but also induced tumor cell to differentiate.Its probably mechanism may related to cell cycle regulation.

Objective To evaluate ‘Cool-tip nee dl e’ radiofrequency ablation (RFA) for the treatment of solid tumors. MethodsIn this study, 102 patients w ith 157 tumors underwent RFA. Tumor size varied from 1.0cm to 20.0cm in d iameter. Result The comple te ablation(CA) rate was 83.5%(91/109)in tumors less than 5cm in diameter , and 35.4%(17/48)when tumors were larger than 5cm. RFA significantl y ameliorates symptoms in most lung cancer patients, and in 40%(4/10)patient s of pancreatic tumors. In the group receiving percutaneous RFA , no patients we re shifted to celiotomy, nor skin burn, or pneumothorax occurred. RFA for hepa tic tumors was complicated with abdominal pain in 13.4%(11/82), nausea in 6 .1%(5/82), jaundice in 9.7%(8/82), fever in 23.2%(19/82), and biliary leak age in 1.2%(1/82). Post RFA complications for pulmonary tumors included pain in 14.3%(1/7)and hypodermal gas accumulation in 14.3%(1/7). For pancrea tic tumors, pancreatic leakage in developed 20%(2/10), elevated blood amylas e in 70%(7/10), GI bleeding in 20%(2/10). Con clusions Treating solid tumors with ‘Cool-tip needle ’ RFA is efficient, reliable and safe, but great care should be taken in case o f pancreatic tumors.

Hepatectomy ; methods ; Humans ; Liver ; surgery

Objective To explore the management strategy for liver trauma combined with juxla-hepatic venous injury and discuss relating factors leading to postoperative deaths. Methods The clini-cal data of 11 patients with juxtahepatic venous injury were retrospectively analyzed in aspects of prefer-ence of irregular hepatectomy and vein repair.There were 8 males and 3 females,at age range of 22-65 years(mean 33.7 years).Injury causes included traffic injury in 7 patients,fall-from-height injury in 3 and crush injury in 1.Of all,9 patients were combined with other abdominal organ injury and 7 with over one part fractures.All patients showed symptom of shock on admission. Results No patient died dur-ing operation but 3 died after operation.The complications included bleeding in 6 patients,severe infec-tion in 2.liver function failure in 3, acute renaI function failure in 2.bile-1eakage in 4,abdominal ab-scess in 4 and incision infection in 6. Conclusion Low blood pressure in the operation is the main cause for death.It is safe and effective to treat liver trauma combined with juxtahepatic venous injury with irregular hepatectomy and vein repair.

Objective To investigate the variations of mtDNA from high and low metastatic mouse hepatocarcinoma cell sublines Hca-F and Hca-P, and the relationship between mutations of mtDNA and carcinogenesis. Methods The variations of D-loop, ND3 and tRNA Met+Glu+Ile gene fragments of mtDNA from Hca-F and Hca-P cells were analyzed by PCR-RFLP and sequencing techniques. Results No amplification fragment length polymorphism and restriction fragment length polymorphism were observed in tRNA Met+Glu+Ile , ND3 and D-loop of mtDNA from the 2 cell sublines. Sequence difference between these 2 cell sublines were found in mtDNA D-loop region by sequencing. Conclusions Genetic alteration of mtDNA non-coding region in tumors, which may reflect the environmental and genetic influences operative during tumor progression, can be linked to their tumorigenic phenotype.