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LIVER ANATOMY OF 40 EASES AND ITS FEASIBLE STUDIES OF CLINICAL APPLICATION

Qifa YE ; Zhixiang WEN ; Bo SHA ; Nianqiao GONG ; Shi CHEN ; Suisheng XIA

Chinese Journal of Current Advances in General Surgery.1998;0(01):-.

objective From April 1994 to April 1997, the authors anatomized and studied 40 cadaveric Livers, Which included the character, Length and diameter of the vessels and bile ducts of the first, second and third hepatic portis. This article put the emphasis on the anatomic structures and its clinical applilation. The results of the 40 cadaveric liver anatomy will play important roles on the resection and transplantation of the liver, especially the Piggy back Liver transplantation.

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INDICATION OF FNA REPLACING EXCIXION BIOPSY FOR DIAGNOSING BREAST CANCER

Jikang HU ; Rong MA ; Jingzhong SUN ; Jianping ZHANG ; Jian WAN ; Wenjun LIN

Chinese Journal of Current Advances in General Surgery.1998;0(01):-.

objective At present, most operable breast cancers are confirmed by excision biopsy during the operation. If the breast cancer was definitely diagnosed by Fine -Needle Aspiration cytology(FNA) preoperatively, the excision biopsy could be avoid. Methods We diagnosed 118 inpatients of breast mass with physical examination and FNA from September, 1995 to May, 1996. Results The sensitivity and positive predict value of FNA for diagnosing breast cancer are 95.7% and 97.1%. When the palpation and FNA are both positive, the doublepositive predict value for breast cancer is 100% in our study. It is the indication of using FNA that a breast mass was diagnosed as cancer by physical examination. We can treat a breast mass with redical operation directly without excision biopsy, if the breast mass was confirmed as breast cancer by both physical examination and FNA. Conclusion We concluded that the preoperative FNA could partially replace the excision biopsy for confirming breast cancer.

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CLINICAL STUDY OF OPTIMAL ATERIAL PATHWAY OF REGIONAL CHEMOTHERAPY IN PANCREATIC CANCER

Zhanyuan LI ; Yong CUI ; Luchuan LI

Chinese Journal of Current Advances in General Surgery.1998;0(01):-.

objective to find a proper pathway for the regional chemotherapy of pancreatic carcinoma. Method A total of 39 cases of unresectable pancreatic carcinoma was collected and divided into five groups. Ⅰ: celiac artery group, 5 cases; Ⅱ: gastroduo-denal artery group,24 cases;15 cases were directly inserted into this artery (ⅡB)and 9 cases indirectly through gastroepiploric artery (ⅡA). Ⅲ: gastroepiploric right artery group, Scases; Ⅳ: splenic artery group, 5 cases. Result. For these groups, the first group can be detected that the pancreatic head is clearly dyed; in the second group the pancreatic head was apparently dyed. The body and tail of pancreas were clearly dyed in the splenic artery group and failed in the second group. Conclusion For pancreatic head carcinoma, the gastroduodenal artery is the first choice; splenic artery is proper for the carcinoma in the body and tail of pancreas.

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THE ETIOLOGY, PREVENTION AND TREATMENT OF THE SYMPTOM RECURRENCE AFTER OPERATION FOR CHOLE-DOCHOCELE

Wejjin SHI ; Fu JI ; Jianhua SUN ; Siwen ZHANG ; Guangjie JIAG

Chinese Journal of Current Advances in General Surgery.1998;0(01):-.

objective To discuss the possible reasons responsible for the symptomrecurrence after operation for choledochocele, prevention and treatment. Methods By analyzing the symptom recurrent cases among 76cases of choledochocele who were treated in our hospital during the period from March 1966 to September 1997, we discuss the possible reasons responsible for the symptom recurrence after operation for choledochocele and its prevention and treatment. Result The possibility of symptom recurrence has no relationship with the age, sex and the type of the cyst. But it is closely related to the opportunity and method of operation (p

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THE STUDY OF NON-CYTOTOXIC CHEMOTHERAPY IN GASTRIC CANCER

Yanling ZHANG ; Guangjian HUANG ; Heming WANG

Chinese Journal of Current Advances in General Surgery.1998;0(01):-.

objective To study the inhibition effect and its mechanism of a non - cytotoxic chemotherapy drug in the growth of gastric cancer. Methods The inhibition effect was observed in the growth of xenotransplanted gastric cancer cells MKN45 with a gastrin receptor(GR) antagonist. On the basis of the determination of expressed GR in 34 patients with gastric cancer, we evaluated the preliminary clinical effect of PGL to gastric cancer with the positive GR. Results It is less tumor area, weight and gastric cancer cells DNA Index, average DNA contents and S phase fraction in PGL group than in control group. It is the least in PGL + SST group. GR is easy to be expressed in advanced gastric cancer of the body, cardia and fundus. With the 16-21 months follow- up of 14 patients with positive GR gastric cancer, we find that 2 patients died in control group of 8 patients, and all patients are alive in PGL group. Conclusion PGL can regulate the growth of gastric cancer cells MKN45. It would be able to improve the prognosis of gastric cancer.

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THE EXPERIMENTAL STUDY OF ESTROGEN EFFECT ON PRECANCEROUS LESION AND K-ras MUTATION IN RATS ' PANCREATIC ACINAR CELLULAR CANCER

Feng XU ; Nanhai SHOU ; Xihong JIANG ; Kesen XU

Chinese Journal of Current Advances in General Surgery.1998;0(01):-.

Objective: To set up the animal model of precancerous lesion of rats' pancreatic acinar cellular cancer,and to learn estrogen's effect on this lesion's biological feature and K-ras gene mutation. Methods: male Wistar rats were injected Azaser-ine 30mg/kg(ip). Some rats received Estradiol-17 P Valerate(0.18mg/100g/2weeks, im) .4 months later, rats'pancreas were autopsied and K-ras gene mutation were detected by PCR-SSCP method. Results : The incidence of AACN were very high. The incidence of K-ras gene mutation was 42.1% in rats without estrogen and 25.6% with estrogen. Conclusion: Azaserine could induce precancerous lesion of rats' pancreatic acinar cancer successfully, K-ras gene mutation was early change during this process Estrogen could inhibit this precancerous lesion's happen and development to some degree.

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Bcl-2 AND BAX PROTEIN EXPRESSION IN HEPATOCELLUAR CARCINOMAS

Shikuan LI

Chinese Journal of Current Advances in General Surgery.1998;0(01):-.

Objective: To investigate the expression of Bcl-2, the apoptosis inhibitor, and Bax, the apoptosis promoter in hepatocellular carcinomas (HCCs). Methods: 35 formalin-fixed and paraffin-embedded samples of histologically confirmed HCC, were examined using immunohis to chemical staining for Bcl-2 and Bax protein. Results : 7 of 35 HCCs were positive for Bcl-2 protein and 13 of 35 positive for Bax protein. Immunoreactivity for Bcl-2 protein was present in 24 of 35 HCC cases and Bax protein in 25 of 35 cases. Furthermore, all positive cells were cytoplasmic stained. 6 of 7 Bcl-2 protein positive HCCs were (histological grade Ⅱ ), Bax protein expression had little association with histological grading. Co-expression of Bcl-2 and Bax protein was only present in 4 cases. At any rate, a significant high Bcl-2 and Bax protein expression was detected in small HCCs. Also, Bcl-2 protein expression tended to decrease with clinical stage. Conclusion: Bcl-2 and Bax immunohistochemical expression in HCCs seems to be associated with histological grading. Also, Bcl-2 protein seems to be relative to tumors with good prognosis. It supports the hypothesis that Bcl-2 expression has prognostic value.

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PLUG MESH HERNIA REPAIR:A REPORT OF 50 CASES

Kesen XU ; Xiaopeng WU ; Ke LI ; Xihong JIANG ; Xuting ZHI ; Xusheng JIANG ; Yong DAI ; Feng XU ; Qingdong ZENG ; Luchuan LI ; Jiguang ZHANG ; Zongli ZHANG ; Qingsi HE

Chinese Journal of Current Advances in General Surgery.1999;0(02):-.

Objective : The patients with inguinal hernia were treated with plug mesh hernia repair. Methods:The hernia sacs were isolated and dissected back to the internal ring. The unoperated sacs were allowed to drop back through the internal ring into the abdominal cavity. A cone-shaped mesh hernia plug is inserted tapered end through ring and placed into position just beneath the crura. All our repairs were reinforced a second piece of flat was placed from the pubic tubercle, overlying the direct space. Results : Com-paired with conventional suture surgical techniques, a plug repair uses less disscection and ensures tenssion free hernioplusty. Conclusion : We believe that the two factors are the most important reseasons for greater patients confort, rapit rehabilitation, decreased recurrence and lessened overall complication rates with the mesh hernia plug techniques.

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STUDY ON THE CLINICAL APPLICATION OF TELOMERASE ACTIVITY BY FINE NEEDLE ASPIRATION FOR PREOPERATIVE DIAGNOSIS OF BREAST CANCER

Jingzhong SUN

Chinese Journal of Current Advances in General Surgery.1999;0(03):-.

Objective:To investigate the value of the clinical application of telom-erase activity by fine needle aspiration from breast masses for preoperative diagnosis of breast cancer in order to provide scientific basis for its practical clinical application. Methods: 85 patients with breast masses were aspirated by fine needles in the study. The samples obtained by aspiration were detected with telomerase activity by telomeric repeat amplification protocol (TRAP) assay and observed with cytomorphology by microscope respectively. The sensitivity, specificity and Youden's index of the two detective methods in diagnosis for breast cancer were compared respectively while postoperative paraffin slice pathologic results were considered as the final standard. Results:Compared with cytomorphology by microscope,preoperative telomerase activity detection's specificity which is 73.9% versus 82.6%(P

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EXPRESSION OF E-CADHERIN IN BREAST CANCER AND ITS RELATIONSHIP TO TUMOR CELLS SHED FROM THE SURGICAL FIELD

Jun ZHANG ; Xihong JIANG ; Rong MA

Chinese Journal of Current Advances in General Surgery.1999;0(03):-.

Objective :To investigate expression of E-Cadherin(E-CD) in breast cancer cells and its relationship to clinical and pathological character and to the incidence of tumor cells shed from the surgical field. In an attempt to study more deeply about the mechanisms of invasion and metastasis of breast cancer and give some reference to the diagnosis and treatment of breast cancer. Methods: The expressions of breast carcinoma cells were studied using immunohistochemical methods(ABC methods).Semi-quantitative methods were used to judge the results. For statistical analysis, Chi-square test and the exact probability in 2 ?2 table were used. Results : E-CD positive was located on cell membranes and cytoplasms, mainly on membranes, showing different intensity of brown pellet. Of 52 cases, twenty nine percent retained normal E-CD expression, seventy one percent have reduced or even none expression. E-CD expression has significant correlation with histological grade. Reduced and lost expression rate in Grade 1(36.4%,4/11) were much lower than grade 2(77.8%,28/36)and grade 3(75%,6/8) (p

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