Objective To study the feasibility and safety of laparoscopy-assisted D2 radical gastrectomy for advanced gastric cancer. Methods From June, 2006 to July 2009, 11 patients with gastric cancer received laparoscopy-assisted gastrectomy for gastric cancer. According to UICC TNM classification of gastric cancer, 6 cases were with Stage Ⅱ, 2 cases with Stage Ⅲ A, 1 case with Stage Ⅲ B, and 2 cases with Stage Ⅳ. Under the assistance of laparoscope, dissociation of the stomach and lymph nodes clearance were performed first; then gastrectomy was performed on a 6 cm incision, samples were collected, and alimentary tract was inoculated. Results Among the 11 cases, 2 cases were performed radical total gastrectomy, 1 case was performed proximal partial gastrectomy, 7 cases were performed distal partial gastrectomy and 1 case with open surgery. The mean operation time: 350 min for total gastrectomy, 320 min for proximal partial gastrectom,266 min for distal partial gastrectomy. The mean number of harvested lymph nodes was 21.3 (11-38), incisal edge was 5.6 (4.0-9.6) cm. The mean time was 72 (36-110) hrs for gastrointestinal function recovery, 59 (26-86) hrs for patients to take general activity, and 76 (48-116) hrs to take liquid food. No complication was observed. Conclusion Laparoscopy-assisted D2 radical gastrectomy for advanced gastric cancer is safe and feasible. Compared with open surgery, it also has the advantages of small wound and fast recovery.

Objective To develop an HPLC method for the determination of ginsenoside Rb1 in Jupizhuru decoction,and de-termine the amount of ginsenoside Rb1 in 10 batches of Jupizhuru decoction composed of different batch herbs. Methods The HPLC analysis was carried out on a Phenomenex Luna C18 column with column temperature at 30℃,flow rate 1.0 ml/min,detection wave-length 203 nm and mobile phase acetonitrile and 0.1%phosphoric acid by gradient elution. Results The method was found to be lin-ear within the ranges of 5-500μg/ml(r=0.9999),and the average recovery of ginsenoside Rb1 was 95.5%(RSD 1.77%,n=6). Con-clusion The determination method is suitable for the quality control of ginsenoside Rb1 in Jupizhuru decoction.

Objective To investigate the change of peripheral blooe T cell subsets,NK cells ane serum soluble interleukin-2 receptor(sIL-2R)concentration in patients with gastric cancer before ane after surgery,ane to uneerstane immune function status ane changes of perioperative gastric cancer patients. Methods One huneree ane thirty-five perioperative gastric cancer patients were selectee as our subjects who hospitalizee from May 2009 to May 2011 in Tumor Hospital of Shanxi Province,ane they were servee as treatment group,while 50 healthy subjects were selectee as controls. The number of CD3 + ,CD4 + ,CD8 + T cells,rate of CD4 + / CD8 +ane the NK cell ratio in blooe cells were eetectee by flow cytometry. ELIAS was appliee to measure serum sIL-2R concentration. Observee the above ineexes of control group at the same perioe,ane comparee the ineexes before operation of 1 e of the treatment group. Results The rate of NK cells,CD3 + T cells ane CD4 + / CD8 +ratio in patients at pre-operation were(10. 11 ± 3. 64)% ,(55. 60 ± 9. 61)% ,(30. 22 ± 6. 17)% ,1. 14 ± 0. 35,respectively,lower than that of control group(( 28. 39 ± 5. 81 )% ,( 68. 65 ± 7. 39 )% ,( 47. 87 ± 4. 85)% ,1. 82 ± 0. 24 respectively;t = - 5. 9,8. 6,8. 2,12. 7;P < 0. 01). CD8 + T positive rate of cells increasee from(27. 05 ± 7. 86)% to(34. 26 ± 6. 23)%(t = - 6. 5,P < 0. 01). At 14th eay after surgery,the cell immune function of the patients recoveree graeually,ane there were statistically significant eifferences in the above ineexes comparee with pre-operation(P < 0. 05). The eramatic changes were seen among patients with the late Gastric cancer TNM staging. Comparee with patients with stage Ⅳ,all above ineex were significant eifferent from that of patients with stageⅠ,Ⅱ(P < 0. 05),ane no significant eifferences was seen in patients with stageⅢ(P > 0. 05). The concentration of serum sIL-2R in patients with gastric cancer before operation was(575. 71 ± 34. 77)U/ L,higher than that of healthy persons((428. 26 ± 21. 77)U/ L,t = - 7. 9,P < 0. 01),ane serum sIL-2R levels in patients with stage Ⅲ,Ⅳ was lower than that of patients with stage Ⅰ,Ⅱ patients with low(P< 0. 05). Conclusion The immune function of patients with gastric carcinoma is relatee to tumor loae size ane eifferent pathological staging. The ineex of the ratio of NK cells ane T lymphocyte subsets,serum sIL-2R levels can be servee as ineicators for monitoring perioperative evaluation of prognosis of gastric cancer.

Extramural vascular invasion of rectal cancer is an important factor affecting the prognosis of patients with rectal cancer. Accurate diagnosis of extramural vascular invasion before surgery can guide the formulation of treatment plans, thereby improving prognosis and long-term survival of patients. Magnectic resonance imaging examination and computed tomography examination are the main examination methods for preoperative evaluation of rectal cancer. The authors review the role of imaging examinations in the evaluation of extramural vascular invasion of rectal cancer.

Objective To evaluate transcather arterial chemoembolization (TACE) with hydroxycamptothecin combined with hepatectomy in treatment of primary liver cancer.Methods 64 primary liver cancer cases admitted and treated in Shanxi Provincial Cancer Hospital were divided into two groups with 32 cases in each.The control group were treated by surgery only and in the study group patients received TACE and hepatectomy.Results 0.5-year and 1-year recurrence rate in the study group were respectively 9.38％ and 28.13％,significantly lower than those in the control group.There was no significant difference in the 2-year recurrence rate between the two groups.0.5-year,1-year and 2-year survival rate in the study group were respectively 93.75％,84.38％ and 65.63％,significantly better than those in the control group.The AST and ALT were respectively (86 ±42)U/L,(96 ±55)U/L which were lower than those in the control group.The ALB and TBiL were respectively (32 ± 10) g/L and (24 ± 9) μmol/L,which were not significantly different with the control group.Conlunsion Hydroxycamptothecinbased TACE combined with hepatectomy is better than hepatectomy only for the treatment of primary liver cancer.

Objective: To compare the clinical value of total gastrectomy and proximal gastrectomy in the treatment of gastric fundus carcinoma. Methods: 80 patients with gastric fundus cancer were divided into observation group and control group according to the random number method.The observation group was treated with total gastrectomy, and the control group was treated by proximal gastrectomy.The operation-related conditions, such as operation time, intraoperative bleeding and postoperative anal exhaust time of the two groups were compared.After surgery R0 resection rate and 2-year survival rate were analyzed. Results: The operative time in the observation group was (86.3±1.9)min, which was shorter than (102.3±2.6)min in the control group (t=31.424, P<0.05). The intraoperative blood loss of the observation group was (180.5±15.0)mL, which was less than (230.0±25.0)mL of the control group (t=10.738, P<0.05). The anal exhaust time of the observation group was (41.5±2.1)h, which was shorter than (56.9±3.3)h of the control group (t=24.900, P<0.05). The percentage of pathologic R0 resection of the observation group was 32.5%(13/40), which was higher than 5.0%(2/40) of the control group (χ²=8.205, P<0.05). The 1-year survival rate and 2-year survival rate in the observation group were 92.5%, 67.5%, respectively, which were significantly higher than those in the control group(60.0%, 42.5%, χ²=4.943, 5.051, all P<0.05). Conclusion Compared with the proximal gastrectomy, the total gastrectomy in the treatment of gastric fundus carcinoma has shorter operation time, less intraoperative blood loss, quicker postoperative recovery, higher pathologic resection rate and survival rate.

The expression of calcium binding protein S100A8 in 30 controls of normal oral tissue and 35 cases of OSCC was detected by immunohistochemical staining and Western blot respectively. The positive expression of S100A8 protein in OSCC and the controls was 68. 5％ and 36. 7％ respectively(P ＜ 0. 05). S100A8 may play a role in the development of OSCC.

Objective:To study the efficacy of closed reduction with a self-developed T-frame plus robotic navigation in the treatment of supracondylar humeral fractures of Gartland type Ⅲ in children.Methods:A retrospective study was conducted to analyze the data of 67 children with supracondylar fracture of Gartland type Ⅲ who had undergone surgery at The Fifth Hospital of Harbin from January 2023 to March 2024. There were 35 males and 32 females with an age of (5.6±1.2) years. The children were divided into 2 groups according to different surgical methods. The control group (33 cases) was treated by closed reduction and internal fixation with percutaneous K-wire and the study group (34 cases) by closed reduction with a self-developed T-frame plus robotic navigation for internal fixation with percutaneous K-wire. The operation time, anatomical reduction, intraoperative fluoroscopy frequency, intraoperative needle adjustment, Flynn score at the last follow-up and complications were compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). All children were followed up for (6.3±2.5) months after surgery. There were no significant differences in operation time, Flynn score at the last follow-up or incidence of complications between the study and the control groups ( P>0.05). The rate of anatomical reduction in the study group (97.1%, 33/34) was significantly higher than that in the control group (54.5%, 18/33), and the intraoperative fluoroscopy frequency [(11.6±2.5) times] and needle adjustment (5.6±1.2) times in the study group were significantly lower than those in the control group [(37.2±2.1) times and (28.7±3.9) times] ( P<0.05). Conclusions:In the treatment of supracondylar humeral fractures of Gartland type Ⅲ in children, our self-developed T-frame can play a good role in fracture reduction and temporary fixation, avoiding iatrogenic secondary injuries caused by freguent reduction and adjustment of needle threading in the course of robotic navigation.

Objective:To investigate the clinical value of outpatient screening in department of general surgery during the Corona Virus Disease 2019 (COVID-19) outbreak.Methods:The retrospective and descriptive study was conducted. The clinical data of 57 patients who visited surgery clinic and emergency department of Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology between February 1st and 26th in 2020 were collected. There were 30 males and 27 females, aged (53±16)years, with a range from 17 to 87 years. All the 57 patients were measured score of outpatient screening in department of general surgery. The score ≥3 indicated high risk and the score < 3 indicated low risk. Observation indicators: (1) clinical data of patients; (2) score of outpatient screening for COVID-19 of patients. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed by the t test. Measurement data with skewed distribution were described as M (IQR), and comparison between groups was analyzed by the rank sum test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Results:(1) Clinical data of patients: of the 57 patients, there were 12 males and 14 females of the 26 confirmed or suspected cases, versus 18 males and 13 females of the 31 non-infection cases, showing no significant difference between the two groups ( χ2=0.805, P>0.05). The 26 confirmed or suspected cases of COVID-19 had an age of (57±16)years, and 31 non-infection cases had an age of (50±16) years, with no significant difference between the two groups ( t=-1.646, P>0.05). (2) Score of outpatient screening for COVID-19 of patients: the score of outpatient screening for COVID-19 of the 26 confirmed or suspected cases was 3.0(4.0), versus 1.0(1.0) of the 31 non-infection cases, showing a significant difference between the two groups ( Z=-3.695, P<0.05). There were 17 and 9 of the 26 confirmed or suspected cases with high risks and low risks, respectively, versus 3 and 28 of the 31 non-infection cases, with a significant difference between the two groups ( χ2=19.266, P<0.05). Conclusion:During the COVID-19 outbreak, outpatient screening in department of general surgery can effectively screen out high-risk patients.

Objective:To investigate the efficacy and safety of combining venetoclax (VEN) with hypomethylated drugs (HMA) in the treatment of higher-risk (IPSS-R score >3.5) myelodysplastic syndromes (MDS) .Methods:From March 2021 to December 2022, forty-five MDS patients with intermediate and high risk were treated with VEN in combination with HMAs. Clinical data were collected and analyzed retrospectively, including gender, age, MDS subtype, IPSS-R score, treatment regimen, and efficacy, etc. Kaplan-Meier method and Cox regression model were used to analyze univariate and multivariate of survival prognosis.Results:①Forty-five patients with MDS, including ninety-one percent were classified as high or very high risk. According to the 2023 consensus proposal for revised International Working Group response criteria for higher-risk MDS, the overall response rate (ORR) was 62.2% (28/45), with the complete response rate (CR) was 33.3% (15/45). For twenty-five na?ve MDS, the ORR was 68% (17/25) and the CR rate was 32% (8/25). In nonfirst-line patients, the ORR and CR were 55% (11/20) and 35% (7/20) respectively. The median cycle to best response was 1 (1-4). ②With a median followup of 189 days, the median overall survival (OS) time was 499 (95% confidence interval, 287-711) days, and most patients died from disease progression. Responders had a significantly better median OS time than nonresponders (499 days vs 228 days, P<0.001). Multifactor analysis revealed that IPSS-R score and response to treatment were independent prognostic factors for OS; the presence of SETBP1 gene mutations was associated with a longer hospital stay (51.5 days vs 27 days, P=0.017) . Conclusions:There is clinical benefit of venetoclax in combination with hypomethylated agents in patients with higher-risk MDS, but adverse events such as severe hypocytopenia during treatment should be avoided.