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Diagnosis and treatment of 35 cases of pancreatic cystic neoplasms

Ke TANG ; Zhongtao ZHANG ; Jianshe LI ; Shengqi QIN ; Peixin LI ; Yu WANG

International Journal of Surgery.2010;37(10):673-675. doi:10.3760/cma.j.issn.1673-4203.2010.10.010

Objective To investigate the diagnosis and treatment of pancreatic cystic tumors. Methods The clinical data of 35 patients with pancreatic cystic tumors were retrospectively analyzed. Results The preoperative diagnosis rate was as follows: ultrasound was 28.6% ( 10/35 ), CT 44.4% ( 12/27 ), MRI 70% (7/10). Twenty-eight cases underwent operation and were diagnosed finally by postoperative pathology. Serous cystic neoplasm (SCN) was found in 2 cases, mucinous cystic neoplasm (MCN) in 9 cases,cystic adenocarcinoma in 7 cases, intraductal papillary mucinous neoplasm ( IPMN ) in 3 cases, solid pseudopapillary tumor (SPT) in 7 cases. Twenty-three cases were followed up successfully. The post-operative 5 years survival rate was 62.5% (5/8) in pancreatic cystic adenoma without recurrence. The longest survival time in cystic adenocarcinoma after complete resection was 5 years and 8 months, while in which after incomplete resection was 6 months. The 4 cases of SPT are all alive, and one of them has survived for 4 years as the longest one. Conclusions It is difficult to diagnose the pancreatic cystic neoplasm accurately before operation. CT and MRI may be helpful to make the diagnosis. Surgical resection is the most effective treatment. The enhancement of the communication and cooperation between the related departments, the early diagnosis, and the appropriate operation are needed to improve the diagnostic and therapeutic efficacy.

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Cerebral infarction following operation of hypertensive cerebral hemorrhage

Yang SONG ; Yitian CUI ; Qing WAN ; Tingjiang CAI ; Xiaowei JIANG ; Dong WANG

International Journal of Surgery.2010;37(10):665-667. doi:10.3760/cma.j.issn.1673-4203.2010.10.007

Objective To analyze the reasons and treatment measures of cerebral infarction following operation of hypertensive cerebral hemorrhage. Methods Sixty-one patients with cerebral infarction following operation of hypertensive cerebral hemorrhage were retrospectively analyzed. Results The outcome was evaluated on basis of activities of daily lives (ADL): Ⅰ 10 cases, Ⅱ 11 cases, Ⅲ 14 cases, Ⅳ 8 cases, Ⅴ3 cases and death 12 cases. Conclusions The occurrence of cerebral infarction following operation hypertensive cerebral hemorrhage is associated with degree of the hemorrhage compression, vasospasm, hypertension,operative skill and postoperative management. The early operation, improved operative skill and hyperbaric oxygenation are the important factors for the prophylaxis and treatment of cerebral infarction.

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Comparison of HLA antibody production in living donor and cadaveric transplant

Baoxiang JIA ; Xiuhong XU ; Ye TIAN

International Journal of Surgery.2010;37(10):662-665. doi:10.3760/cma.j.issn.1673-4203.2010.10.006

Objective To compare the Panel reactive antibody (PRA) producing incidence in living and cadaveric transplant for forecasting long term survival. Methods Retrospectively analyze post-transplant PRA of 48 living transplant patients ( December 2003-Sepdtember 2007 ), and 258 cadaveric transplant patients( Feburary 2003-June 2007 ), which in both groups were all PRA negative in pre-transplant. PRA was detected using LAT-1240 (OneLambda) and QUICKSCREE&BSCREEN (GTI). Serum creatine/urea nitrogen level was provided by clinical laboratory. Results Four recipients in 48 living transplant patients showed PRA positive(8.33% ), while 62 receipients in 258 cadaveric transplant patients showed PRA positive(24.03% ) ( P ＜0.05 ). Three recipients in 35 male living donor transplant patients showed PRA positive(8.57% ) ,while 23.03% PRA positive in male cadaveric transplant patients (P ＜0.05). In females, 1out of 13 living donor transplant patients showed HLA-Ⅱ positive, whereas 20 out of 106 in cadaveric transplant patients( 18.87% ) ( P ＜ 0. 05). Conclusion The incidence of HLA antibody production was much higher in cadaveric transplant patients than that in those of living donor transplant.

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Peripheral blood stem cells transplantation for treatment of chronic lower limb ischemia

Guokai YANG ; Xiaoming HE ; Yan BAO ; Yong YANG ; Jia WAN

International Journal of Surgery.2010;37(10):657-659. doi:10.3760/cma.j.issn.1673-4203.2010.10.004

Objective To investigate the efficiency of autologous transplantation of peripheral blood stem cell for treatment of patients with chronic lower limb ischemia. Methods Forty-six patients with chronic lower limb ischemia were treated by autologous peripheral blood stem cell transplantation. Results Fortytwo patients had pain relief on legs, and cold and cool feelings in lower limbs disappeared. Thirty-five patients had pain relief on feet, and 29 of them had disappearance of cold and cool feelings. Due to necrosis in middle and lower part of leg, 4 patients took extremity amputation after 4 weeks of the transplantation. In the 42 patients who kept their legs 3 months after transplantation, the distance of anginacruris extended from (87. 45 ±41.22) m to (348.52 ± 147.24) m, skin temperature increased from(28.52 ±0.51 ) ℃ to(33.56±0.62) ℃ ,and ankle-brachial index (ABI) increased from(0.48 ±0.06)to(0.75 ±0.07). There were statistical differences, and the scores of the distance of anginacruris, skin temperature, and ABI after transplantation were better than before. six months after transplantation autobiography of lower extremity was used, and neonatal lateral vessels of different degrees were found in 37 patients. Conclusion Autologous transplantation of peripheral blood stem cell is a simple, safe, and effective method, especially in treating patients with lower limb ischemia in which no arterial reconstruction is feasible.

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Relationship between inflammatory cytokines and traumatic brain injury

Zhansheng ZHU ; Shijie CHEN ; Mingcan WU ; Yuan YAO

International Journal of Surgery.2010;37(10):700-702. doi:10.3760/cma.j.issn.1673-4203.2010.10.019

A medical studies have indicated that there would be a defense response from human body after TBI,which mainly comes with inflammatory reaction. Human body's resistance seems likely to be enhanced,during this process, by inflammatory cytokines leading to rehabilitation of the cellular organization.However,a strong Inflammation from the whole human body may be caused due to the excessive activation,which, instead, worsens secondary brain injury. This article discusses the relationship between cytokines and traumatic brain injury.

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CXC chemokine subfamily and its biological relationship with tumor

Qingchao ZHU ; Yu WANG

International Journal of Surgery.2010;37(10):693-697. doi:10.3760/cma.j.issn.1673-4203.2010.10.017

Chemokines are a class of functional chemotactic peptide. CXC chemokine class is a large family of chemokines in a sub- tribe. In the occurrence and development of tumor cells, there often accompanied by a series of molecular and biology change. CXC chemokine subfamily is closely related to the body' s immune response to tumor and biological behaviors of tumor. In this paper, CXC chemokine sub-Several members of the tribe and their receptor and tumor biological relationship are reviewed.

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PTEN and thyroid tumor

Fengyan YIN ; Detao YIN

International Journal of Surgery.2010;37(10):687-690. doi:10.3760/cma.j.issn.1673-4203.2010.10.015

A tumor suppressor gene at 10q23.3, designated PTEN, encoding a dual specificity phosphatase with lipid and protein phosphatase activity, has been shown to play an important role in the pathogenesis of a variety of human cancers and sporadic tumor. In this paper, we reviewed the construction and function of PTEN, and the mechanism of activation in cancer especially in thyroid carcinoma.

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The effect of cytokines on endothelial progenitor cells during angiogenesis

Jinhai LI ; Chengjin LI ; Changjun CHEN ; Lie WANG

International Journal of Surgery.2010;37(10):684-687. doi:10.3760/cma.j.issn.1673-4203.2010.10.014

Endothelial progenitor cells play a significant role in neovascularization of ischemic tissues and in reendothelialization of damaged blood vessels. Cytokines, an important components of micro-environment of angiogenesis,play an important role in regulation of endothelial progenitor cells. The effective application of cytokines can significantly argument the number, enhance the biological function and improve the therapeutic effect of endothelial progenitor cells, which play a positive role in regulation of endothelial progenitor cells.This article briefly reviewed the regulating mechanisms of the vascular endothelial growth factor and other cytokines in a total of 7 endothelial progenitor cells.

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The comparison of the GlideScope and direct laryngoscopy in snoring surgery under general anesthesia endotracheal intubation

Qimin WANG ; Qiong SONG

International Journal of Surgery.2010;37(10):678-680. doi:10.3760/cma.j.issn.1673-4203.2010.10.012

Objective To compare effect of the GlideScope and direct laryngoscopy in snoring surgery.Methods Fourty patients scheduled for orotracheal intubation of general anesthesia in snoring surgery wererandomly divided into GlideScope group ( A group) and direct laryngoscope group ( B group). Two groups were recorded values of heart rate (HR),systolic blood pressure (SBP), diastolic blood pressure (DBP)before induction (T1), after induction (T2), intubation (T3) and 1 (T4), 3 (T5), 5 (T6) min after intubation and plasma norepinephrine (NE) concentrations in T1, T5, T6. Results ( 1 ) Values of HR, SBP and DBP of two groups were compared in T1 and T2, the difference was not significant ( P ＞ 0.05 ); Values of SBP and DBP of two groups compared T1 to T2, and the difference was significant ( P ＜ 0. 05); (2) Values of HR, SBP and DBP of two groups compared in T3, T4 and T5, and the difference was statistically significant (P ＜0.05);(3 ) Values of the concentration of plasma NE of two groups compared in T1 ,T5 and T6, and the difference was statistically significant ( P ＜ 0. 05 ). Conclusion Cardiovascular response and stress response of orotracheal intubation using a videolaryngoscope is lower than using ordinary laryngoscope in snoring surgery.

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Clinical analysis of solid-pseudopapillary tumor of the pancreas in 16 cases

Jie LI ; Liushun FENG ; Wenzhi GUO ; Shouhua ZHENG ; Shuijun ZHANG

International Journal of Surgery.2010;37(10):676-678. doi:10.3760/cma.j.issn.1673-4203.2010.10.011

Objective To summarize the experience in diagnosis and treatment for solid-pseudopapillary tumors of the pancreas (SPT). Methods A retrospective clinical analysis about clinical, imaging and pathologic data was made on 16 cases of SPT admitted from January 2005 to December 2009. Results Five had SPT in the head of the pancreas, 5 in the body of the pancreas, 6 in the tail of the pancreas. The first symptom was intermittent epigastric pain ( n = 7), abdominal aponia mass ( n = 3), Pancreatic tumor found by chance (n =4), weight loss (n =2). Solid and Solid-cystic masses of low echo were found in US. Masses of low density in pancreas were found on CT scan, while irregular enhancement appeared in the circumference of all tumors in enhanced CT scan sequences. Tumor markers in patients' erum were all negative.9 patients underwent distal pancreatectomy and spleen resection, including 1 patient also underwent left hemicolectomy. Local excision of tumor was performed in 4 cases. Pancreatic local excision and pancreaticojejunostomy were performed in 3 cases. 14 cases were followed up with an period of from 3 to 48 months. No evidence of relapses and metastasis in these cases was found. Conclusion SPT primarily affects young women, and it may be located in any part of pancreas. Surgical resection is recommended as the treatment of choice. The prognosis is good.

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