Objective To investigate the expression and clinical significance of miR-96-5p in primary hepatocellular carcinoma (HCC) at early recurrence after radical surgery. Methods 61 HCC eryopreservation tissue samples from the liver carcinoma specimens data obtained after radical surgery and banked in our hospital were divided into 2 groups: early recurrence group (33 cases) and non-early recurrence group (28 cases). Aquantitative real-time polymerase chain reaction (qRT-PCR) was performed to detect the expression of miR-96-5p. Results Compared with the non-early recurrence group , the expression of miR-96-5p was observably down-regulated [(0.634 ± 0.783) vs (5.182 ± 11.321), P = 0.043]. The expression of miR-96-5p was correlated to tumor diameter, early recurrence and vascular invasion (P<0.05). Conclusions miR-96-5p are significantly related to early liver cancer recurrence and metastasis. miR-96-5p may be a molecular marker of HCC at early recurrence as well as a target for targeted therapy of liver cancer in future.

Objective To explore the value of contrast-enhanced ultrasonography(CEUS) in brain injuries. Methods ① Models of graded brain trauma were created in brains of 10 healthy mongrel dogs after the animals were anesthetized and the cranium were removed. Conventional ultrasonography(US) and CEUS were performed to observe the characteristics of traumatic region. ② Thirteen patients with traumatic brain injuries were collected to perform intraoperative ultrasonography. The location, depth, size, internal echo and boundary of traumatic brain injuries were clearly displayed. Eight injury sites were chosen to undergo CEUS. Results ① Twelve injury sites in brains of 10 dogs were detected,and CEUS were peformed in 10 lessions, of which 1 was diagnosed with cerebral contusion, 1 with cerebral contusion and cerebral hemorrhage, 7 with intracerebral hematoma, 2 with ventricular hematoma, 1 with blood vessels in intracerebral hematoma. ② Fifteen lesions were detected by preoperative CT scan, but 18 lessions were detected by intraoperative ultrasound. During operation epidural hematomas in 4 cases were detected. After CEUS,the area of lessions was clearly revealed to be extended, the hemorrhage area was exempt from enhancement while peripheral normal cerebral tissue was homogenously enhanced. Conclusions Conventional ultrasonography could display brain injuries. In case of accurate intraoperative encephalocele, intraoperative untrasound conduces to discover delayed intracranial hematoma. Different traumatic brain injuries had their special CEUS findings.

Objective To evaluate the role of endorectal ultrasonography with coupling gel intrarectal filling in preoperative T stage of rectal cancer. Methods One hundred and fifteen patients with rectal cancer underwent endorectal ultrasonography with coupling gel intrarectal filling. The preoperative T stage according to ultrasonic manifestations was compared with histological findings. Results The total diagnostic accordance rate of preoperative T stage by endorectal ultrasonography with coupling gel intrarectal filling was 89.57%. The sensitivity of ultrasonography for T1, T2, T3 and T4 was 93.10%, 61.11%, 96.61%, 88.89%, while the specificity was 97.67%, 96.91%, 89.29%, 99.06%, respectively. The overstaging rate of ultrasonography was 6.96% (8/115), and the understaging rate was 3.48% (4/115). Conclusion Endorectal ultrasonography with coupling gel intrarectal filling is a valuable diagnostic method for T stage of rectal cancer.

Objective To investigate the effects of carboxymethytl pachymaram ( CMP ) on the methylation of SOCS-1 (suppressor of cytokine signaling-1) gene and the in vitro maturation of human mono-cyte-derived dendritic cells (DCs).Methods Human DCs were induced from the peripheral blood mono-cytes in vitro with the treatment of recombined human GM-CSF and interleukin-4 ( IL-4 ) and cultured with different concentrations of CMP (10, 50, and 100 mg/L).The methylation and expression of SOCS-1 gene were analyzed by methylation-specific polymerase chain reaction (MSP) and real-time PCR, respectively. The phenotypic markers of DCs were detected by flow cytometry .Mixed lymphocyte reaction ( MLR) and ELISA were performed to measure the lymphocyte proliferation induced by DCs and IL-12 secretion by DCs . Results CMP promoted the methylation of SOCS-1 gene, but inhibited the expression of SOCS-1 gene in dendritic cells at the concentrations of 50 mg/L and 100 mg/L.The expression of phenotypic markers (CD80, CD83, CD86 and HLA-DR), IL-12 secretion and lymphocyte proliferation induced by DCs were significantly enhanced in a dose dependent manner with the treatment of CMP .Compared with control group , the levels of methylated SOCS-1 gene and IL-12 and the lymphocyte proliferation index were increased upon the stimulation with 50 mg/L and 100 mg/L of CMP (P<0.01), but the expression of SOCS-1 gene was de-creased.The expression of CD80, CD83 and HLA-DR on DCs in the presence of 100 mg/L of CMP were higher than those of control group (P<0.05).Conclusion CMP could induce the methylation of SOCS-1 gene and the maturation of DCs derived from peripheral blood monocytes .

OBJECTIVETo evaluate the safety and effectiveness of transumbilical single port laparoscopic cholecystectomy (TSPLC).

METHODSA retrospective analysis was conducted for the 141 patients, who received TSPLC by DR. Jian in our hospital since April 2011 to October 2012, and the operative and postoperative effects of these patients were evaluated by comparing with that of the conventional laparoscopic cholecystectomy (CLC).

RESULTSIn the total of 141 TSPLC cases that included in the study, 3 cases converted to CLC. 2 cases converted to open cholecystectomy. Additionally, 1 case was diagnosed as an unexplained bowel perforation after operation, fat liquefaction occurred in 2 patients. When comparing with these cases to 306 CLC patients, there was no obvious statistical difference in the terms of patients age, gender, BMI and abdominal surgery history (P>0.05). Meanwhile, There were similar effects of the two groups of patients on the operation time (28.5∓19.3 min vs 33.4∓14.2 min, P=0.001), estimate blood loss (6.4∓18.9 ml vs 9.8∓20.6 ml, P=0.06), the time needed for closing abdomen (5.1∓3.8 min vs 5.8∓4.3 min, P=0.06) and postoperative complications (3/141 vs 5/306, P=1.00). However, the TSPLC group was superior to CLC group in the terms of the conversion rate (2/141 vs 25/306,P=0.001), and postoperative hospitalization (1.2∓1.4 d vs 2.6∓1.7 d,P<0.01), meanwhile, TSPLC was also superior to LC on the satisfactory degree of operative effect through the one week follow-up (8.5∓1.1 vs 7.9∓0.7, P<0.01).

CONCLUSIONSTSPLC is both safer and more effective than that of CLC, and thus it is worth adopting in selected hospitals.

Adult ; Cholecystectomy, Laparoscopic ; adverse effects ; instrumentation ; methods ; Female ; Gallbladder Diseases ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Objective To investigate the safety and feasibility of the modified terminal cannula ileostomy in laparoscopic anus-preserving operation of low rectal cancer (RC).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 15 patients who underwent laparoscopic radical resection of RC + terminal cannula ileostomy in the Subei People's Hospital of Jiangsu Province between September 2016 and June 2017 were collected.The patients underwent laparoscopic low anterior resection of RC,intra-abdominal sigmoid colon-rectum end-to-end anastomosis after extracting tumor specimens,and terminal cannula ileostomy in vitro.Observation indicators:(1) intraoperative situations:operation time,time of cannula ileostomy,volume of intraoperative blood loss,number of lymph node dissected,surgical margin;(2) postoperative situations:time to initial anal exsufflation,recovery time of defecation,time of tube removal,closing time of stoma,postoperative complications,duration of hospital stay;(3) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the anastomotic leakage-related complications up to December 2017.Measurement data with normal distribution were represented as (x)±s.Results (1) Intraoperative situations:all the 15 patients underwent successful laparoscopic radical resection of RC + terminal cannula ileostomy,without conversion to open surgery and death.The operation time,time of cannula ileostomy,volume of intraoperative blood loss and number of lymph node dissected were respectively (170 ± 34) minutes,(23 ± 4) minutes,(59 ± 27)mL and (13 ± 5) per case.No residual cancer cells were found in resection margins.(2) Postoperative situations:time to initial anal exsufflation and recovery time of defecation in 15 patients were respectively (6± 1) days and (7 ± 1) days.The stoma was automatically closed after tube removal,and time of tube removal and closing time of stoma after tube removal were respectively (23 ± 2) days and (3 ± 1) days.The incidence of postoperative complications was 1/15.One patient with catheterization-related complications was improved by strengthening dressing and antibiotic use,and the stoma was healed at 8 days after tube removal.There was no anastomotic leakage-related complications and death.The duration of hospital stay was (15±3) days.(3) Followup situations:all the 15 patients were followed up for 6-12 months.During the follow-up,there were no anastomotic leakage-related complications and death.Conclusion The modifyied terminal cannula ileostomy is safe and feasible,and is also an ideal surgical method for preventing anastomotic leakage in the laparoscopic anuspreserving operation of low RC.

Indocyanine green (ICG) fluorescence imaging technology has been applied in laparoscopic surgery. It is possible to highly visualize the tumor cutting edge and liver segment boundary during laparoscopic hepatectomy. Although the application of this technique in liver tumor surgery has become more and more mature, the factors affecting the quality of fluorescence imaging are still not completely clear. In this paper, we analyzed and summarized the effects of different factors such as ICG administration scheme, imaging acquisition, tumor characteristics of patients and preoperative liver function indexes on the quality of intraoperative ICG imaging, in order to provide new ideas and practical experience for clinical practice and research.

Objective To describe the demographic and clinical characteristics of patients with the diagnosis of multiple myeloma(MM)and to analyse the outcome of difierent regimens for the treatment of MM.Methods The study reviewed 332 MM cases diagnosed within the period from January 1,2002 to December 31,2002.These patients were tracked via their records to a total period of three years.Results First-line treatment:Totally 332 patients were included,among them 325(97.9%)patients received chemotherapy and 7(2.1%)patients received stem cell transplantation(SCT);Second-line treatment:197 patients were included,among them 190(96.5%)patients received chemotherapy and 7(3.6%)patients received SCT;Third-line treatment:92 patients were included,among them 88(95.7%)patients received chemotherapy and 4(4.4%)patients received SCT.Major adverse effects were follows:severe infection 19.3%,severe anaemia 19.3%,phlebothrombosis 1.2%,thrombocytopenia 16.9%,fever associated with neutropenia 18.1%.Conclusions Some curative effects can be achieved by using traditional treatment plans to treat patients suffering from MM,but new methods are expected to improve the prognosis.

OBJECTIVETo evaluate the early hematologic, cytogenetic and molecular responses in newly diagnosed patients with chronic myelogenous leukemia in chronic phase（CML-CP）and initially treated with a generic imatinib（Xinwei）, manufactured by Jiansu Hansoh Pharmaceutical Group Co., Ltd.

METHODS107 newly diagnosed patients of CML-CP, whose ages were above 18- year- old and who had never received any tyrosine kinase inhibitor（TKI）were treated with Xinwei 400 mg QD. The hematologic, cytogenetic and molecular responses were assessed at 3- and 6-month, and adverse effects were evaluated throughout the study.

RESULTS107 patients were treated with Xinwei for at least 3 months, 54 of them were treated for 6 months or more. At 3- month, the complete hematologic responses（CHR）rate were 98.1%（105/107）; 47/57（82.5%） patients achieved major cytogenetic response（MCyR）, and 20/57 （35.1%） patients complete cytogenetic response（CCyR）; BCR- ABLIS was ≤10% in 77/106 patients （72.6%）, 11 of them（10.4%）achieved major molecular response（MMR, BCR-ABLIS was ≤0.1%）. At 6-month, the CHR rate was 100%（54/54）; 28/39 patients（71.8%）achieved CCyR; BCR-ABLIS was ≤1% in 37/54 patients （68.5% ）, 18 of them （33.3% ） achieved MMR. The grade Ⅲ leukopenia, thrombocytopenia and anemia rates were 19.5%, 23.0% and 13.8%, respectively. No grade Ⅳ hematologic toxicity occurred. The common non- hematologic toxicities were edema（74.7%）, nausea（48.3%）, bone pain（42.5%）, rash（36.8%）, diarrhea（34.5%）, fever（23.0%）, cramp（11.5%）and impaired liver function （3.4%）. No patient experienced grade Ⅳ non- hematologic toxicity. No adverse effects related death occurred.

CONCLUSIONOur results revealed the excellent early haematology, cytogenetic and molecular responses and safety of Xinwei in treating patients with CML-CP.

Anemia ; Antineoplastic Combined Chemotherapy Protocols ; Cytogenetics ; Drugs, Generic ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Prospective Studies ; Protein Kinase Inhibitors ; Remission Induction ; Thrombocytopenia ; Treatment Outcome