The treatment strategy for colon cancer with liver metastasis has always been a great challenge for clinical surgeons.Single treatment method such as surgical resection or systemic chemotherapy can no longer meet the treatment needs of such patients.With the extensive development of the multi-disciplinary team(MDT)for colorectal cancer based on surgery,more and more patients with advanced colorectal cancer have obtained better treatment effects and survival benefits.A case of descending colon cancer with huge hepatic metastasis diagnosed and treated by a multi-disciplinary team was reported,aiming to provide reference for clinical practice.

Objective:To investigate the clinical efficacy and prognosis of simultaneous resection of synchronous colorectal liver metastasis in patients admitted in different phases.Methods:The retrospective cohort study was conducted. The clinicopathological data of 346 patients who underwent simultaneous resection of synchronous colorectal liver metastasis in the First Affiliated Hospital of Naval Medical University (Changhai Hospital of Shanghai) from January 2000 to April 2021 were collected. There were 217 males and 129 females, aged (58±12)years. Patients under-went simultaneous resection of synchronous colorectal liver metastasis. Observation indicators: (1) clinicopathological features of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021; (2) surgical and postoperative situations of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021; (3) analysis of prognosis of patients with synchro-nous colorectal liver metastasis in 2000?2010 and 2011?2021. Follow-up was conducted using telephone interview or outpatient examination to detect survival of patients. The follow-up was performed once every 3 months, including blood routine test, liver and kidney function test, car-cinoembryonic antigen (CEA) test, CA19-9 test, abdominal B-ultrasound examination, and once every 6 months, including chest computed tomography (CT) plain scan, liver magnetic resonance imaging (MRI) and/or CT enhanced scan, abdominal or pelvic MRI and/or CT enhanced scan, within postoperative 2 year. The follow-up was performed once every 6?12 months within postoperative 2?5 years including above reexaminations. Electronic colonoscopy was performed once a year after operation. The follow-up was up to November 12, 2021. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distuibution were represented as M(range). Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the rank sum test. Kaplan-Meier method was used to calculate survival rates and draw survival curves, and Log-Rank test was used to conduct survival analysis. Results:(1) Clinicopathological features of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021. Of the 346 patients, 59 cases underwent simultaneous resection within 2000?2010 and 287 cases underwent simultaneous resection within 2011?2021. The gender (males and females), cases with or without fundamental diseases, cases with the number of lymph nodes harvested in primary lesion as <12 or ≥12, the tumor diameter of primary lesion, the tumor diameter of liver metastasis lesion, the number of liver metastasis lesions, cases with or without preoperative treatment, cases with or without postoperative treatment, cases with adjuvant therapy as perioperative treatment, surgery or other treatment were 47, 12, 36, 23, 19, 40, (5.5±2.4)cm, (2.1±0.7)cm, 1.6±0.5, 59, 0, 16, 16, 0, 16, 43 in patients admitted in 2000?2010, respectively. The above indicators in patients admitted in 2011?2021 were 170, 117, 121, 166, 58, 229, (4.2±2.0)cm, (3.0±2.0)cm, 1.9±1.4, 208, 79, 34, 235, 74, 29, 184, respectively. There were significant differences in the above indicators between patients admitted in 2000?2010 and 2011?2021 ( χ2=8.73, 7.02, 4.07, t= 4.40, ?6.04, ?3.10, χ2=21.05, 28.82, 26.68, P<0.05). (2) Surgical and postoperative situations of patients with synchronous colorectal liver metastasis in 2000?2010 and 2011?2021. Cases with surgical methods as complete open surgery or laparoscopy combined with open surgery, the operation time, time to postoperative initial liquid food intake, cases with or without postoperative complications, cases with postoperative duration of hospital stay as ≤10 days or >10 days were 58, 1, (281±57)minutes, (5±1)days, 33, 26, 14, 45 in patients admitted in 2000?2010, respec-tively. The above indicators in patients admitted in 2011?2021 were 140, 147, (261±82)minutes, (3±1)days, 233, 54, 198, 89, respectively. There were significant differences in the above indicators between patients admitted in 2000?2010 and 2011?2021 ( χ2=49.04, t=2.24, 7.53, χ2=17.56, 26.02, P<0.05). There was no death in the 346 patients. (3) Analysis of prognosis of patients with synchro-nous colorectal liver metastasis in 2000?2010 and 2011?2021. Of the 346 patients, 295 cases were followed up for 47(range, 1?108)months. Of the 29 patients admitted in 2000?2010 who were followed up, there were 27 cases died. The median survival time, 1-, 3-, 5-year overall survival rates, 1-, 3-, 5-year disease free survival rates of patients admitted in 2000?2010 were 18.0 months (95% confidence interval as 12.7?23.3 months), 82.8%, 11.5%, 3.8%, 53.6%, 8.3%, 4.2%, respec-tively. Of the 266 patients admitted in 2011?2021 who were followed up, there were 109 cases died. The median survival time, 1-, 3-, 5-year overall survival rates, 1-, 3-, 5-year disease free survival rates of patients admitted in 2011?2021 were 54.0 months (95% confidence interval as 38.1?70.4 months), 93.3%, 61.8%, 47.0%, 68.2%, 33.7%, 28.3%, respectively. There were significant differences in overall survival rate and disease free survival rate between patients admitted in 2000?2010 and 2011?2021 ( χ2=47.57, 9.17, P<0.05). Conclusions:With the increase of the operation volume of simultaneous resection of synchronous colorectal liver metastasis, the operation time, time to postoperative initial liquid food intake, postoperative duration of hospital stay and postoperative complications have significantly decreased, while the overall survival rate and disease free survival rate have significantly increased.

Objective To evaluate the efficiency and safety of full-spectrum endoscopy for detection of major duodenal papilla. Methods Patients underwent painless gastroscopy in Chinese PLA General Hospital from March 2017 to December 2017 were enrolled and randomly divided into two groups according to random number method. The group A underwent conventional gastroscopy, and the group B underwent full-spectrum endoscopy. The detection rate of major duodenal papilla was calculated and compared between the two groups. Results A total of 100 patients were recruited in the study, including 51 in the group A and 49 in the group B. The whole detection rate of major duodenal papilla of the group B was higher than that of the group A [79. 59％ (39/49) VS 41. 18％ (21/51), χ2 =15. 366, P=0. 000]. There was no statistical difference on the whole plus partial detection rate of major duodenal papilla between the two groups [100. 00％ (49/49) VS 92. 16％ (47/51), χ2=2. 221, P=0. 136]. All patients completed endoscopy examination succesfully without bleeding, peforation or death. Conclusion With the broad view-field, full-spectrum endoscopy is useful to improve the efficiency and safety in detection of major duodenal papilla.

Objective To develop a high-definition video display system for medical endoscope based on system on chip (SoC),and meet the requirement of high-resolution and real-time video display.Method A CMOS camera was used for video data capture.A SoC chip,integrated with a dual-core ARM Crotex-A9 processor and a field programmable gate array (FPGA),was employed as the kernel of the system.The HPS part of the SoC was used to build an embedded system to realize human-computer interaction,and the FPGA part was used to store and cache video data.The HPS and FPGA part were connected through a high-performance ARM AMBA AXI bus bridge broadband system,so as to achieve encoding of the cached video data and real-time display on screen.Results A high-definition video display system was built based on SoC.This system can achieve capture,processing and realtime display of high-definition video,as well as video freeze function.Conclusions The experimental results indicate that this system is feasible and effective,and possesses the advantages of customizability,multiple-exploitation and high performance of real-time video display.

Objective To study an image display method for portable medical endoscopes using intelligent mobile devices for solving the problem of lacking medical resources in remote areas and carrying inconvenience of endoscopic workstations.Method An high-definition camera was employed for image data acquisition,which was driven by the built-in Video4Linux drive program of a embedded Linux system.A wireless network card was used to establish a point-to-point network,and to build the LAN server.The mobile devices could acquire the collected image data through accessing the local area network,which could realize the real-time display on the LCD screen.Results The resolution of a collected image was 1 024×768 pixels,the bit depth was 24 bits,the frame rate was 30 frame/s,and the actual average transmission speed was about 2 MB/s.Conclusions The proposed method is effective and feasible.The collected image is clear,and the system has advantages of simple structure,low cost and easy to carry,which can save the manufacturing cost and meet the conditions of usage in remote areas.

Objective:To study the effects of down-regulated Smad4 expression on the proliferation and apoptosis of breast carcinoma MCF-7 cells,and to explore their mechanisms.Methods:The human breast carcinoma MCF-7 cells and MDA-MB-231 cells were cultured in vitro.RT-PCR method was used to detect the expression levels of Smad4 mRNA in MCF-7 cells and MDA-MB-231 cells.The Smad4-shRNA plasmid and Scramble-shRNA plasmid were respectively stably transfected into the MCF-7 cells with high expression of Smad4.The experiment was divided into non-transfected MCF-7 cells (normal control) group,Smad4 gene silencing group,Scramble(negative control) group.The proliferation abilities of the cells in various groups were detected by CCK-8 method.The apoptotic rates of the cells in various groups were detected by flow cytometry.Real-time PCR method wasused to detect the mRNA expression levels of the proliferation-related genes CDKN1A,CDK1 and CDK2 and the apoptosisrelated genes Suvivin,bcl-2,caspase 3 and caspase 9.Results:The proliferation abilities of cells had no statistical significance between various groups (P＞0.05).The mRNA expression levels of CDKN1A,CDK1 and CDK2 in the cells had no statistical significance between various groups (P＞0.05).Compared with normal control group and negative control group,the apoptotic rate of the cells in Smad4 gene silencing group was significantly decreased (P＜0.01),the expression levels of Suvivin and bcl-2 mRNA in Smad4 gene silencing group were significantly increased (P＜0.01),and the mRNA expression levels of caspase 3 and caspase 9 in Smad4 gene silencing group were significantly decreased (P＜0.05).Conclusion:Smad4 could induce the apoptosis of MCF-7 cells by downregulating the expressions of Suvivin and bcl-2 and up-regulating the expressions of caspase 3 and caspase 9.

Objective To evaluate the diagnostic efficiency of full-spectrum endoscopy(FUSE) versus conventional colonoscopy for colonic polyps and adenoma. Methods Patients who underwent colonoscopy were randomly allotted into two groups according to randomization and self-control criteria. Patients in group A underwent conventional endoscopy firstly and then to FUSE. Patients in group B were opposite performed the examinations. The polyps and adenomatous polyps were resected or biopsied for pathological examination. Miss rate of colonic polyps as well as adenomatous polyps was calculated. Results A total of 100 patients were recruited for the study,including 45 in group A and 55 in group B. FUSE was significantly superior compared to conventional endoscopy with lower miss rate of polyps(6.52% VS 34.04%,χ2=17.685,P=0.000)as well as adenomatous polyps(5.00% VS 34.38%, χ2=11.774, P=0.001). For the first endoscopic examination,the adenomatous polyps which were found out by FUSE were more than that of ordinary colonoscopy in the right colon(χ2=5.153,P=0.023). The size of adenoma found by ordinary colonoscopy and FUSE was no statistically different whether in the first(t=0.334,P=0.739)or second(t=1.297,P=0.219)endoscopic examinations. Conclusion FUSE is useful to improve the quality of endoscopic examination because of its broad view-field.

Objective To determine the optimum harvest time of Scutellaria barbata D.Don with flavonoids contents as the index. Methods The content of total flavonoids in Scutellaria barbata D. Don was determined by ultraviolet-visible spectrophotometry with scutellarin as standard control, and scutellarin and cosmosiin in Scutellaria barbata D. Don were determined by HPLC. Results The contents of total flavonoids and scutellarin in Scutellaria barbata D.Don of different harvest time were complied with the quality standards in the China Pharma Copoeia, and reached the peakin blossom . The contents of total flavonoids, scutellarin and cosmosiin were (45.74±0.95) ,(5.58±0.16 ) and (17.39±0.42) mg?g-1 , respectively. Conclusion The Scutellaria Barbata D.Don may be collected at the flowering time with luxuriant foliage.

Objective To explore the value of virtual touch tissue quantification (VTQ ) in the diagnosis of pancreas early damage of patients with hyperuricemia(HUA) .Methods Sixty‐five cases of patients with normal glucose tolerance and HUA (HUA group) and 42 cases of patients with HUA and impaired glucose tolerance (IGT group) were included in the study ,and other 150 health subjects were taken as control group .After routine ultrasound examination ,the pancreas shear wave velocity values (Vs) of different groups were measured by VTQ technology ,and the results were analyzed .Results Compared with the control group ,the rate of the abnormai ultrasonogram of pancreas in IGT group showed obvious increasing trend but there was no significantly difference between the other groups(both P >0 0.5) .The Vs of the normal control group ,HUA group ,and IGT group were (1 2.1 ± 0 1.5)m/s ,(1 4.1 ± 0 1.3)m/s and (1 5.9 ± 0 1.5)m/s ,respectively .The Vs of HUA group and IGT group were higher than that of the control group (both P <0 0.5) ,and the Vs of IGT group was significantly higher than that of HUA group ( P <0 0.5) .Conclusions Hyperuricemia may cause pancreas damage ,and with the disease progress ,the pancreas damage became more serious ,and VTQ technology may play an important role on the diagnosis of pancreas early damage in HUA patients .

Objective To explore the expressions and significances of p 53、bcl-2、Ki-67 and apopto-sis in keratoacanthoma(KA)and well differentiated squamous cell carcinoma (WDSCC).Methods The expres-sions of p53、bcl-2、Ki-67 were detected by immunohistochemical technique in 44 cases of KA and 20 cases of WDSCC.Apoptosis was identified by using terminal deoxynucleotidyl transfers ( TdT) -mediated dUTP -biotin nick and labelling(TUNEL)method.Results The positive expressive rates of p53 in proliferative、mature and re-gressive of KA were 22.23%、26.18% and 6.52%, which was lower than the positive rate of WDSCC (41.82%).Significant differences were found between every period of KA with WDSCC in p 53 expression;The intensity of expression and pattern were similar in KA of Ki -67 and p53.There were a positive correlation be-tween p53 and Ki-67 expression rate(r=0.986,P<0.001).The bcl-2 staining showed weak expression in 1 case in WDSCC and 2 cases in KA ,but only a few positive tumor cells was limited to basal cell layer in KA .The average apoptosis rate in KA was 21.72%,which was apparently higher than in WDSCC (9.925%).There were a negative correlation between the apoptosis rate and proliferation rate of Ki -67(r=-0.824,P<0.001).Con-clusion The proliferation and apoptosis in KA can coexist .However ,the apoptosis will occupy a dominance posi-tion in regressive phase ,which results in the regression of tumor .The expressions of p53、Ki-67 and apoptosis would be a certain significance in differentiated KA and WDSCC .