This study summarized Professor Su Peiji's clinical experience in differenting and treating lumbago and leg pain.He contends that the disease involves the liver and kidney,manifesting as a syndrome of deficiency in origin and excess in superficiality,with liver-kidney deficiency and insufficiency of essence and blood as the root cause,and exogenous wind,cold,and dampness invading the meridians and then causing obstruction as the superficial manifestation.The principal pathological factors include wind,cold,dampness,blood stasis,and deficiency.In clinical practice,he follows the therapeutic principle of expelling pathogens and supporting healthy qi in accordance with the abundance or deficiency of pathogens and healthy qi,takes the therapy of tonifying the liver and kidney as the primary approach,and applies the adjuvant therapies of dispelling wind,cold,and dampness as well as relaxing tendons and activating collaterals.By incorporating the theory of collateral diseases,Professor Su Peiji proposes that the deficiency-excess of collateral diseases is closely related to the onset of lumbago and leg pain.His therapeutic approach centers around Shuji Formula,a self-formulated formula which is composed of Taxilli Herba,Achyranthis Bidentatae Radix,Stephaniae Tetrandrae Radix,Angelicae Pubescentis Radix,Clematidis Radix et Rhizoma,Aconiti Radix Cocta,Flemingiae Radix et Caulis,Millettiae Speciosae Radix,Poria,Angelicae Sinensis Radix,Paeoniae Radix Alba,Chuanxiong Rhizoma,Spatholobi Caulis,Tinosporae sinensis Caulis,and Glycyrrhizae Radix et Rhizoma Praeparata cum Melle.Modified use of herbs was performed according to the predominance of wind,cold,dampness,blood stasis,or deficiency,so as to achieve the effects of tonifying the liver and kidney,strengthening bones and tendons,dispelling wind,cold and dampness,and relaxing tendons and activating collaterals.

Background: Carbon nanoparticles show significant lymphatic tropism and can be used to identify lymph nodes surrounding mid?low rectal tumors. In this study, we analyzed the effect of trans anal injection of a carbon nanoparti?cle suspension on the outcomes of patients with mid?low rectal cancer who underwent laparoscopic resection. Methods: We collected the data of 87 patients with mid?low rectal cancer who underwent laparoscopic resection between November 2014 and March 2015 at Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College. For 35 patients in the experimental group, the carbon nanoparticle suspension was injected transan?ally into the submucosa of the rectum around the tumor 30 min before the operation; 52 patients in the control group underwent the operation directly without the injection of carbon nanoparticle suspension. We then compared the operation outcomes between the two groups. Results: In the experimental group, the rate of incomplete mesorectal excision was lower than that in the control group, but no significant difference was found (2.9% vs. 7.7%, P = 0.342). The distance between the tumor and thecircumferential resection margin was 5.8 (P = 0.001). The mean number of lymph nodes removed was 28.2 ± 9.4 in the experimental group and 22.7 ± 7.3in the control group (P and 4.5 ± 3.7, respectively (P < 0.001). Three patients in the experimental group received lateral lymph node resec?tion. Among the three patients, we retrieved three nodes (one stained node) from the first patient, three nodes (two stained nodes) from the second patient, and two nodes (no stained nodes) from the third patient. Conclusions: Injecting a carbon nanoparticle suspension improved the outcomes of patients who underwent laparoscopic resection for mid?low rectal cancer; it also improved the accuracy of pathologic staging. Moreover, for selected patients, this technique narrowed the scope of lateral lymph node dissection. ± 1.4 mm in the experimental group and 4.8 ± 1.1 mm in the control group= 0.003); the mean number of lymph nodes smaller than 5 mm in diameter was 10.1 ± 7.5 and 4.5 ± 3.7, respectively (P < 0.001). Three patients in the experimental group received lateral lymph node resection. Among the three patients, we retrieved three nodes (one stained node) from the first patient, three nodes (two stained nodes) from the second patient, and two nodes (no stained nodes) from the third patient. Conclusions: Injecting a carbon nanoparticle suspension improved the outcomes of patients who underwent laparoscopic resection for mid-low rectal cancer; it also improved the accuracy of pathologic staging. Moreover, for selected patients, this technique narrowed the scope of lateral lymph node dissection.

OBJECTIVELaparoscopic-assisted surgery for colorectal cancer has been widely spread worldwide. To avoid the invasiveness of abdominal wound and get better good-looking, incisionless laparoscopic low anterior resection with transanal natural orifice specimen extraction using prolapsing technique for rectal cancer has been developed in our center. The aim of this study was to evaluate the feasibility, safety and short-term outcomes of this technique.

METHODSFrom January 2013 to October 2013, twenty-seven patients with rectal carcinoma were treated by incisionless laparoscopic low anterior resection, and the data of these patients were collected and retrospectively analyzed to assess the value of this technique.

RESULTSAll operations were successfully accomplished without conversion to open surgery or laparoscopic-assisted surgery. The mean operation time was 135 minutes. The mean blood loss was 50 ml. The mean first bowel movement was 48 hours. The post-operative hospital stay was 9 days. All patients had clean distal margin and the mean number of dissected lymph nodes was 18. One patient had anastomotic leakage.

CONCLUSIONSIncisionless laparoscopic low anterior resection with transanal natural orifice specimen extraction using prolapsing technique for rectal cancer appears to be feasible, safe and oncologically acceptable with a satisfactory short-term outcome for selected cases.

Anastomotic Leak ; Colorectal Neoplasms ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Operative Time ; Rectal Neoplasms ; surgery ; Retrospective Studies

OBJECTIVETo explore the clinical characteristics, diagnosis and treatment regimens for retroperitoneal schwannoma.

METHODSClinicopathological data of 53 retroperitoneal schwannoma patients treated from January 1999 to April 2013 in our hospital were collected and analyzed using SPSS 13.0 statistical software.

RESULTSSymptoms of the retroperitoneal schwannoma were vague and nonspecific. 12 patients had interrupted abdominal pain, 9 patients had abdominal discomfort, and only 6 patients presented with abdominal mass while 24 patients were detected by health checkup. There were some characteristics but not specific findings in imaging examination such as CT, ultrasonography and MRI, so preoperative diagnosis rate was low with only 9 patients diagnosed as retroperitoneal schwannoma and 21 patients diagnosed as neurogenic tumor. S-100 immunohistochemisty was very important in pathological diagnosis, and the patients with benign retroperitoneal schwannoma got 100% tumor specific 5-year survival after complete excision while the 5-year survival of malignant retroperitoneal schwannoma was only 50.0%.

CONCLUSIONSRetroperitoneal schwannoma is a rare disease. Most of them are benign tumors, and complete surgical excision is the effective treatment.

Abdominal Pain ; Diagnostic Imaging ; Humans ; Magnetic Resonance Imaging ; Neurilemmoma ; diagnosis ; pathology ; therapy ; Physical Examination ; Retroperitoneal Neoplasms ; diagnosis ; pathology ; therapy ; Retroperitoneal Space ; Treatment Outcome

Objective To compare the short-term results of laparoscopic-assisted with open surgery for primary rectal cancer in elderly patients. Methods The medical records of forty-nine elderly patients (≥70 years) with laparoscopic-assisted resection and fifty-five cases (≥70 years) with open surgery for rectal cancer were retrospectively reviewed. Results There were no thirty-day mortality in both groups. Operative procedure and operating time did not differ significantly in laparoscopic-assisted group (LAG) and open group (OG), and blood loss was significantly greater in OG (P =0.031). The rate of postoperative complications was lower (12.2 % vs 25.5 %) in LAG than that in OG, but the difference was not statistically significant (P = 0.088). The time to faltus (3.26 d vs. 4.49 d) and time to liquid diet (3.98 d vs.5.56 d) were significantly shorter in LAG than that in OG. Both the circumferential and distal margins were negative. The number of identified lymph nodes were similar for LAG and OG (mean 13.31 vs 13.13, P =0.886). Conclusion Laparoscopic-assisted rectal resection for elderly patients is safe and feasible, with less complications and blood loss, and rapid intestinal recovery compared with open surgery.

Objective To investigate the prognosis of local resection in patients with low rectal cancer, and assess surgical indications for this procedure. Methods One hundred and twenty-four patients with low rectal cancer from Jan 1975 to Dec 2006 were analyzed, the clinicopathologic features and surgical, outcome were examined as prognostic factors. Survival rate was estimated by Kaplan-Meier method and compared by Log-Rank test, prognostic factors were analyzed by multivariate COX proportional hazards model. Results The 5-year survival rate of 124 patients underwent local resection was 90.7 %(97/107), there were 4.8 %(6/124) patients with complications and 15.3 %(19/24) ones with local recurrence.The infiltration, vascular invasion, the size of tumor and the histological grade were significant prognostic factors of overall survival, but gender, age, the tumor site and the macroscopic type were not. Multivariate analysis indicated that the tumor infiltration were independent poor prognostic factor. Conclusion Local resection is suitable for Tis and T1 low rectal cancer, and those with high local recurrence factors should undergo radical resection. Strict follow-up and adjuvant therapy is necessary for local excision.

Objective To investigate the feasibility of laparoscopic radical resection for colorectal cancer in patients with respiratory dysfunction. Methods A total of 64 patients with colorectal cancer with respiratory dysfunction simultaneously admitted in our hospital. Following the principles of en-bloc resection, thirty-six patients underwent laparoscopic radical resection, and 28 underwent open resection. Results The time of postoperative oxygen inhalation was shorter in laparoscopic group than that in open resection group (3.5 d vs 4.6 d) (P<0.05), and independently expectorating was better in laparoscopic group than that jn open resection group (P <0.05). The time to endotracheal intubation removal (21.2 min vs 23.9 min) and oxygen saturation were no significant difference between laparoscopic group and open resection group. One case got lung infection in open resection group, both groups had no atelectasis, respiratory failure and urinary infections case. Conclusion Laparoscopic surgery is feasible for colorectal cancer in patients with respiratory dysfunction.

Colorectal cancer is a threat to human health, the disease rate of stage Ⅱ colorectal cancer is increasing. Some prognostic factors have been researched, and the number of harvested lymph nodes is a very important factor. Harvesting more lymph nodes will reduce the relapse rate and increase the survival rate. It remains controversial for the minimum number of lymph nodes, and UICC and AJCC recommended that the minimum number was 12. Some factors will influence the number of harvested lymph nodes,for ex-ample, the patient's situation, tumor itself, surgeon and pathologist's skills , and so on.