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Application experiences of the ultrasonic scalpel in D2 radical resection of gastric carcinoma

Hongbin HAN ; Baowei HAN ; Zhaohui LI ; Shuaijun DONG ; Shuaifeng LIU

International Journal of Surgery.2012;39(4):240-242,289. doi:10.3760/cma.j.issn.1673-4203.2012.04.008

ObjectiveTo investigate the ultrasonic clinical value of scalpel in abdominal surgery for D2 radical gastrectomy for gastric cancer.MethodsA retrospective analysis was made in Zhengzhou University Affiliated Luoyang Central Hospital from September 2008 to September 2010 gastric group.The patients were divided into ultrasound knife group and normal operative in 136,including 75 cases using ultrasonic scalpel,61 using cases electric knife.The lymph node dissection time,intraoperative blood loss,the drainage 72 h after were compared between the two groups.Results The average operation time ultrasound knife group was ( 114 ± 35 ) min,the surgery blood loss was ( 110.4 ± 32) mL.The drainage 72 h after operation was (180 ± 24) mL,which were significantly reduced compared with the normal operative group.The difference in detection rate between the two groups was not statric cancer can improve efficiency,reduce trauma,accelerate postoperative recovery,showing good application prospect in radical resection of gastri cancer.ConclusionsUltrasound knife used in D2 radical gastrectomy for gastric cancer can improve efficiency,reduce trauma,accelerate postoperative recovery,showing good application prospect in radical resection of gastric cancer.

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Observation of laparoscopic choledochoduodenstomy in hepatobiliary surgery

Zhihong WU ; Xianjie SHI ; Lei LIU ; Lei LEI ; Zaisheng LUO ; Youfu LIU

International Journal of Surgery.2012;39(4):230-232,289. doi:10.3760/cma.j.issn.1673-4203.2012.04.005

ObjectiveTo explore the clinical application of laparoscopic choledochoduodenstomy in Hepatobiliary Surgery Department.MethodsTwenty-six patients of laparoscopic choledochoduodenstomy were retrospectively analyzed between January 2007 and September 2011 in Hepatobiliary Surgery Department of PLA General Hospital,including 8 cases of choledochalcyst,11 cases of bile duct stone and 7 cases of bile duct cancer.ResultsAll of patients were successfully performed operation of total laparoscopic choledochal cyst excision.The operation time was 60 to 110 minutes.And the time of hospital stay was 3 to 7 days.One patient was found anastomotic stoma stricture,the other cases had no post-operative complication.There was no patient dead.ConclusionLaparoscopic choledochoduodenstomy needs mastering the indication of operation and laparoscopic anastomosis technique.Under this condition,the operation will be safe and feasible.

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Expression and clinical significance of CD13 in gastric cancer

Qing ZHOU ; Xiangling MENG

International Journal of Surgery.2013;(2):-. doi:10.3760/cma.j.issn.1673-4203.2013.02.009

Objective To investigate the expressions of the CD13 in gastric cancer and the relationships between it and the patients' prognosis.Methods The expressions of CD13 were detected by immunohistochemical (SP method) in 104 cases of gastric cancer and 16 cases of normal gastric mucosa.Results The expressions of CD13 in 104 cases of gastric carcinoma and 16 cases of normal gastric mucosa show positive rate were 74％ (77/104) and 0％,respectively.The expressions of CD13 in gastric cancer were higher than in normal gastric mucosa and the difference was statistically significant (P ＜ 0.01).The expressions of CD13 in gastric cancer were not relative to patients' age,gender,and lymph node metastasis (P ＞ 0.05),but to be correlative with tumor sizes,clinical stage,degree of differentiation,and patients' 5-year survival rate (P ＜ 0.05).Conclusions The abnormal expression of CD13 in the gastric cancer may be correlative with the occurrence and development of gastric cancer,which can be an important indicator to evaluate the degree of malignance,guide treatment and assess uncertain prognosis of gastric cancer.

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Experimental study of the effect of portal blood flow on rat' s liver with prehepatic portal hypertension

Chongbin ZHOU ; Tingchong ZHANG ; Yajun CHEN

International Journal of Surgery.2012;39(7):453-457,505. doi:10.3760/cma.j.issn.1673-4203.2012.07.008

ObjectiveTo observe the effect of portal blood flow on rat's liver with prehepatic portal hypertension.MethodsSixty-six male Wistar rats were randomly divided into five groups:partial portal vein transfixation group( A,n =20),hepatic artery transfixation after partial portal veins transfixation group( B,n =20),hepatic artery transfixation group (C,n =10),SO group( D,n =10 ),hepatic artery and partial portal vein transfixation group ( E,n =6 ).The mortality as well as the biochemical examination wereobserved at the 12th week after operation.Then the density of the microvascular in portal area and proliferating cell nuclear antigen expression of intro-hepatic bile duct epithelium were determined by immunohistochemical staining method.The ultra microstructure changes of hepatocytes were observed under transmission electron microscope.Results Biochemical examination,including glutamic-oxa-lacetic transaminase,glutamic-pyruvic transaminase and total protein,showed no significant differences anong all groups (P ＞0.05) at the 12th week after operation.Glutamie-oxalacetic transaminase in group A,in group B,in group C and in group D are (132.69±21.03) U/L,(154.40±28.73) U/L,(125.84±26.60) U/L,(134.02±18.42) U/L; glutamic- pyruvic transaminase in group A,in group B,in group C and in group Dare (39.33±8.62) U/L,(44.84 t9.47)U/L,(40.41±8.04) U/L,(38.47±7.29) U/L.Compared with groups C and D,the mortality rate (group A 20％ ; group B 25％),and the microvascular number in portal area increased obviously in group B and A(P ＜0.05).The proliferating cell nuclear antigen expressions of intra-hepatic bile duct epithelium increased significantly in group B (mean optical density 0.345±0.027 compared with the rest groups mean optical density in group A,in group C and in group D are 0.264 ± 0.015,0.258±0.022,0.249±0.021 ) ( P ＜ 0.01 ) ; fat accumulation in the hepatocytes and mitochondria vacuolization were observed under transmission electron microscopic in group A and group B.ConclusionsThe portohepatic collateral circulation still has its significance in liver blood supply of prehepatio portal hypertensive rat; the epithelium of intra-hepatic bile duct was mildly damaged and the microvascular number in hepatic portal area increased as well as the fat accumulated in hepatocytes of prehepatic portal hypertensive rat; if the hepatic artery blood supply is lost,these changes would become more obviously.

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Diagnosis and treatment of 27 patients with redundant colon

Changping YANG ; Hongrong GUO ; Jinlin CAO ; Renrong YANG ; Haiying GUO ; Guibao LIU

International Journal of Surgery.2012;39(7):450-452,505. doi:10.3760/cma.j.issn.1673-4203.2012.07.007

ObjectiveTo explore the early diagnosis and effective treatment of redundant colon,and to reduce the misdiagnosis and shorten the medical treatment time before the diagnosis.MethodsClinical data of twentyseven patients with redundant colon from February 2005 to December 2011 were retrospectively analyzed in General Surgery Department of 117th and 322th People's Liberation Army Hospital.ResultsThe clinical symptoms of 27 patients nainly as early recurrent intractable constipation,bloating,abdominal pain,weight loss and other symptoms,were likely to be in a misdiagnosis.In addition to three patients with redundant sigmoid colon concurrent reverse came to hospital emergency with surgery,twenty-four cases' symptoms persisted and came to many hospitals with medical treatment up to 32 years,diagnosed by the out-patient barium enema.After surgical resection disease bowel,7-11 months follow-up,patients abdominal distension,abdominal pain,constipation,weight loss and other systemic unwell symptoms disappeared.ConclusionThis disease is rare,we must raise the medical staff's awareness of this disease.X-ray examination with barium enema is the best way to diagnose this disease.After diagnosis,surgery is the most effective treatment.

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The comparative analysis of two approaches in breast augmentation

Qingwei LI ; Zunqi SHENG ; Shengjian TANG ; Xiaohua YU

International Journal of Surgery.2009;36(1):29-32,封3. doi:10.3760/cma.j.issn.1673-4203.2009.01.012

Objective To compare the curative effects of two different approaches in the surgical treatmentof small breast.Methods Fourty-seven patients with small breast were treated at our department.Twenty-eight sides of patients adopted an approach of prosthesis while the nineteen sides of patients were treated in the approach of autologous fat granules injection.Clinical assessment was done by analyzing operation time,blood loss volume,hospitalization duration and recent and long-term complications in breasts.All the pa-tients were followed up for thirty-two months on average.Results During follow-up period the appearance ofbreast was satisfied.Silicone gel breast prosthesis was well tolerated and the whole operation time was about (35±5 )min,the amount of blood loss was (35±5 ) mL,hospitalization duration was (2±1 ) days,during thefollow-up period prosthesis capsular contracture after hematoma occurred in one patient.The use of autolo-gous fat granules injection to breast augmentation was found limited,and the whole operate time was about (35±5 ) rain,the amount of blood loss was (15±5 ) mL,hospitalization duration was (1±1 ) days.With in-jection(2±l)times.During the follow-up period,one patient had infection,one patient liquefied fat,andone patient the induration.Conclusion Each treatment approach has its own advantages and disadvanta-ges.The approprite one should be selected according to the special situation of patients.

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Hepatic seginentectomy by regional vascular occlusion at hepatic hilum

Jinshu WU ; Chuang PENG ; Xinmin YIN ; Xianhai MAO

International Journal of Surgery.2009;36(6):387-390,封3. doi:10.3760/cma.j.issn.1673-4203.2009.06.011

Objective To study the experience on a variety of hepatectomy by occluding the branches of hepatic artery and portal vein to the liver lobe,segment at hilar H fissure.Methods A total of three hun-dred and ninteen patients accepted hepatectomy in Hunan provincial people's hospital from Decemember 2006 to Decemember 2007 were involved in this study for retrospective analysis.Results There were no perioperative deaths and liver function failure in this series of patients.The average amount of blood loss was 70 15ml,and 302 (95 %)cases did not receive transfusion.Postoperative complications such as liver necro-sis,bile leaking,bleeding were not found.Subphrenic abscesses were found in 3 cases,which were cured conservatively.Conclusion Selective regional occlusion of hepatic blood flow during bepatectomy avoided the risk of ischemia-reflow injury of remnant liver,which is safe and effective to prevent massive bleeding and to reduce the incidence of liver failure.

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Expression of Shh and Ptch gene in gallbladder carcinoma

Xingyuan JIAO ; Yize HU

International Journal of Surgery.2008;35(5):306-308,封3.

Objective Shh and Ptch have been known to play critical roles in the hedgehog pathway and the hedgehog pathway activation occurs in the gastrointestinal cancers. This study was to detect the expression of Shh and Ptch in gallbladder carcinoma, and explore their correlation to gallbladder carcinoma. Methods The expression of Shh and Patch protein in 41 specimens of primary gallbladder carcinoma, 20 specimens of normal gallbladder and 21 specimens of adenoma tissue were assessed by immunohistochemistry.Results The positive expression rate of Shh and Ptch in gallbladder carcinoma was 75.6% (31/41) and 78.0% (32/40) respectively, in normal gallbladder mucous was 5% ( 1/20 ) and 5% ( 1/20 ) respectively,in gallbladder adenoma was 4.7% ( 1/21 ) and 9.6% (2/21) respectively, and there was significant differenee between the three groups in Shh and Patch expression values(P ＜0.001 ). However, there was no significant difference between age group, histological grade group, histologic type group, Nevin stage group,lymph node or distal organ metastasis group, and gallstone presence group in Shh and Ptch expression value (P ＞ 0.05, respectively). The expression of Shh was positively correlated to Ptch (r = 0.72, P ＜ 0.01 ).Conclusion These data support our hypothesis that Hh signaling is dysregulated in human gallbladder carcinognesis.

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Recent development in nude mice model of thyroid cancer

Fan YANG ; Youben FAN ; Xiuyan HUANG

International Journal of Surgery.2010;37(6):400-403,封3. doi:10.3760/cma.j.issn.1673-4203.2010.06.014

Nude mice can be used as important animal models to study thyroid cancer because of their deficiency of immunitv,The model is helpful study the sensitivity of thyroid cancer to drugs.The tumor cells may come from primary tumor tissue,or from the cell lines existed.There are three methods to transplant the tumor,including orthotopic transplantation,heterotopic transplantation and tail vein injection.

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Effect of metformin on the expression of Cyclin Dl in human gastric cancer Cells

Deqiang WEI ; Bing WANG ; Lie WANG

International Journal of Surgery.2010;37(3):171-174,封3. doi:10.3760/cma.j.issn.1673-4203.2010.03.010

Objective To investigate the effect of metformin on human gastric cancer line SGC-7901 in vitro, trying to explore the mechanism involved. Methods Human gastric cancer SGC-7901 cell was cultured in vitro, MTT was used to study the effects of metformin on cell growth with different concentration or different time. Western blot was used to investigate the influence of metformin on the expression of Cyclin Dl in cell line . Results The result of MTT showed human gastric cancer SGC-7901 cell was cultured in vitro and was exposed to metformin in different concentration (50 mmol/L, 100 mmol/L) for 24 h,48 h,72 h. The inhibitory rates of 50 mmol/L metformin on the effects of metformin on cell growth was 32.93% ,48.64% and 61.40% and the inhibitory rates of 100 mmol/L metformin on the effects of metformin on cell growth was 35.34% , 75.44% and 88.30%. The proliferation of SGC-7901 cell was inhibited by different concentration (50 mmol/L, 100 mmol/L) metformin and,the inhibitory rates were significantly decreasing compared with the control group(P < 0.05).The inhibitory rate treated with 100 mmol/L metformin was significantly decreasing compared with 50 mmol/L metformin group (P < 0.05). The inhibitory rate treated with metformin at different time(24 h,48 h, 72 h) was significantly different(P <0.05). Metformin could inhibit the proliferation of SGC-7901 cells, with dose and time-related effects. Cyclin Dl expressed in high level in SGC-7901 and metformin significantly decreased the expression of Cyclin Dl, with dose and time-related effects. Conclusion metformin could inhibit the proliferation and lower the expression of Cyclin Dl in human gastric cancer line SGC-7901 in vitro.

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