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ABSTRACT: To analyze the outcomes of simultaneous liver resection for patients who have primary colorectal cancer with synchronous hepatic metastases to see if there is any advantage for doing so.
We retrospectively analyzed the medical records (1999 - 2009) of 53 consecutive patients with synchronously recognized primary colorectal carcinoma and hepatic metastases who underwent simultaneous (40 patients) or two-stage (13 patients) colonic and hepatic resections performed at our hospital.
There was no thirty-day mortality in both groups. The two groups had significant differences in mean operation duration [(212.9 ± 72.3) min vs. (326.5 ± 140.2) min, P = 0.014], mean blood loss [(337.5 ± 298.0) ml vs. (594.6 ± 430.5) ml, P = 0.020], post-operative hospital stay [(16.2 ± 8.1) day vs. (25.8 ± 8.5) day, P = 0.001]. The incidence rates of post-operative complications were 25.0% (10/40) and 53.8% (7/13), respectively, in the two groups (P = 0.053). The 1-, 3-, 5-year survival rates in the simultaneous resection group were 95.0%, 57.0% and 37.4%, respectively, with a median overall survival of 40.0 months and median disease-free survival of 14.0 months. The 1-, 3-, 5-year survival rates in the two-stage resection group were 92.3%, 58.7% and 36.7%, respectively, with a median overall survival of 38.0 months and median disease-free survival of 13.0 months. There were no significant differences between the two groups in respect of their survivals (P > 0.05).
Simultaneous colectomy and hepatectomy are safe and efficient for colorectal cancer patients who have synchronous colorectal liver metastases, with less complications and blood loss, and shorter hospital stay compared with the two-stage resection.
Zhonghua zhong liu za zhi [Chinese journal of oncology] 01/2013; 35(1):63-6.
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ABSTRACT: ObjectiveTo discuss the effects of clinico-pathological features on lymph node metastasis (LNM) in undifferentiated EGC (early gastric
cancer), as well as identify the appropriate medical management.
MethodsFrom January 1999 to June 2011, 352 patients were treated for undifferentiated EGC in our hospital. All patients had undergone
gastrectomy with regional lymphadenectomy. We used univariate and multivariate analyses to determine the features associated
with lymph node metastasis in patients with undifferentiated EGC.
ResultsSignet ring cell carcinoma (SRC) was more common in patients with undifferentiated EGC than other undifferentiated carcinoma
(UDC). SRC had a tendency to be confined to the mucosa, with a smaller size than other UDC. The incidence of LNM for SRC was
lower than that for other UDC. Multivariate analysis showed that LNM was associated with the sex, tumor size, depth of invasion,
lymphovascular invasion, and histological type.
ConclusionComplete endoscopic resection is suitable for SRCtype intramucosal EGC, which is less than 2 cm in diameter without lymphovascular
invasion in the postoperative histological examination.
Key Wordsundifferentiated early gastric cancer–endoscopic submucosal dissection–lymph node metastasis
Clinical Oncology and Cancer Research 05/2012; 8(3):181-184.
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ABSTRACT: There has been a history of 30 years in the study of CD4(+)CD25(+) T regulatory cells (Treg) which primarily play a role of immune suppression in vivo. Many autoimmune diseases are related to the decrease and the disorder of these cells, such as multiple sclerosis, non-obese diabet (NOD) and lupus erythematosus. In the field of transplantation tolerance, the role played by Treg is also very important. All of these features have drawn the attention to the prevention of autoimmune diseases and the rejection of transplantation. However, the low frequency of Treg in vivo affected their use and study. Currently, many techniques about expansion of Treg in vitro have been established so as to overcome the problem of their limited cell numbers in vivo. Recent studies suggest that antigen-specific T regulator cells (sTreg) expanded by dentritic cells (DC) showed a superior immunosuppression in comparison with polyclonal Treg expanded by anti-CD3/CD28Ab, which is the focus of current studies. This article mainly reviews and compares the expansion techniques and the mechanism of regulatory T cells.
Zhongguo shi yan xue ye xue za zhi / Zhongguo bing li sheng li xue hui = Journal of experimental hematology / Chinese Association of Pathophysiology 01/2011; 19(1):260-8.
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ABSTRACT: To investigate the influence of combined hepatectomy with splenectomy on safety of operation for hepatocellular carcinoma patients complied with cirrhosis and hypersplenism and the best peri-operative treatment of these patients.
Clinical data of 177 hepatocellular carcinoma patients complied with cirrhosis and hypersplenism admitted from January 1999 to December 2009 were analyzed retrospectively. Among which, 71 patients received concomitant splenectomy with hepatectomy (splenectomy group), 106 patients only receive a hepatectomy (non-splenectomy group). The safety of operation, complications, liver function and WBC and PLT counts were compared between the two groups.
There was no significant difference of general conditions, counts of WBC and PLT between the two groups before operation. The counts of PLT at 1, 10, 30 day after operation were (88.4 ± 23.6) × 10⁹/L, (345.3 ± 98.2) × 10⁹/L and (210.8 ± 92.2) × 10⁹/L respectively in splenectomy group, which were significantly higher than that of non-splenectomy group (P < 0.05). The operation time of splenectomy group was (216 ± 105) min, which was longer than that of non splenectomy group (P < 0.05), but the blood loss and transfusion rate had not significantly difference between the two groups. The complication rates of splenectomy group and non-splenectomy group were 11.3% and 6.6% respectively, there was no significant difference between the two groups.
Combined hepatectomy with splenectomy will be safe for hepatocellular carcinoma patients complied with cirrhosis and hypersplenism as if the operative indication and increase the ability of peri-operative treatment are strictly obeyed.
Zhonghua wai ke za zhi [Chinese journal of surgery] 10/2010; 48(20):1539-41.
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ABSTRACT: Anorectal malignant melanoma was a rare disease with extremely poor prognosis. The aim of this study was to explore the clinical characteristic, diagnosis and treatment strategies of anorectal malignant melanoma.
The data of 57 patients with anorectal malignant melanoma was collected and retrospectively analyzed.
Rectal bleeding and anal mass were found to be common symptoms of anorectal malignant melanoma. The preoperative diagnosis rate of anorectal malignant melanoma was 48.6%. The overall 3-year and 5-year survival rate was 38.0% and 21.3% respectively. The 3-year survival rates of stage I and II patients were 63.0% and 16.7% respectively (P = 0.000), and the 5-year survival rates were 33.3% and 11.1% (P = 0.001), which both had significant statistic differences. The 3-year survival rate of patients undergone abdmoninoperineal resection and patients undergone wide local excision were 36.7% and 53.0% respectively (P = 0.280), while the 5-year survival rate were 24.1% and 23.1% (P = 0.642), which both had no significant statistic differences.
This study identified no survival advantage to abdominoperineal resection in treatment of anorectal malignant melanoma, and we propose that wide local excision could be considered as the initial treatment of choice.
Chinese medical journal 03/2010; 123(5):585-8. · 0.86 Impact Factor
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ABSTRACT: To explore the clinical characteristics, diagnosis and treatment regimens for the primary gastric lymphoma (PGL).
The data of 98 PGL patients treated from January 1994 to December 2006 were collected and analyzed retrospectively.
Abdominal pain was the common symptom of PGL. All the patients were at stage I or stage II, and the preoperative diagnosis rate was 56.5%. The overall 1-, 3- and 5-year survival rates were 95.1%, 86.0% and 73.0% respectively. The 5-year survival rates of stage I and stage II patients were 89.5% and 66.7% respectively, and the difference was significant. The 5-year survival rate of patients received operations was 77.2% and that without operation was 75.0%, the difference was not significant.
The therapy based on chemotherapy is preferred for the treatment of PGL. In the cases of serious gastrointestinal complications, indefinite pathological diagnosis or non-effective chemotherapy, operations should be considered.
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 07/2008; 11(4):326-30.
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ABSTRACT: To explore the diagnosis, treatment, and prognostic factors of liver sarcoma.
The clinical data of 16 liver sarcoma patients, 9 males and 7 females, aged 46.7 (12-73), treated 1980-2005, were analyzed retrospectively.
The most common symptoms were right upper quadrant pain (56.3%) and mass in the right upper abdomen (56.3%). Alpha fetoprotein (AFP) was negative in all the patients. None was correctly diagnosed by imaging examination preoperatively. Fifteen patients underwent surgical treatment, including radical operation in 7 patients (46.7%) and palliative resection/biopsy in 8 patients. 1 patient took transcatheter hepatic arterial chemo-embolization rather than operation because of multifocal tumor. Pathological analysis diagnosed 6 patients (37.5%) as with leiomyosarcoma, 5 patients (31.25%) with angiosarcoma, 2 patients (12.5%) with fibrosarcoma, 1 patient (12.5%) with epithelioid hemangioendothelioma, 1 patient (12.5%) with myxoid liposarcoma, and 1 patient (12.5%) with undifferentiated embryonal sarcoma. The 1-year, 3-year, and 5-year survival rates were 71.4%, 41.7%, and 33.3% respectively. The 1-year, 3-year, and 5-year survival rates of the patients who received R0 were 100.0%, 83.3%, and 66.7% respectively, all significantly higher than those of the patients who did not receive R0 (all P = 0.011). The 1-year, 3-year, and 5-year survival rates of the patients with the tumor size < 5 cm were 100%, 100%, and 75% respectively, all higher than those of the patients with the tumor size > 5 cm, however, not significantly (all P = 0.084).
Liver sarcoma is difficult to be diagnosed preoperatively. Surgical resection is the mainstay of the treatment of liver sarcoma. R0 and tumor size are of prognostic values.
Zhonghua yi xue za zhi 06/2008; 88(22):1537-9.
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ABSTRACT: To evaluate the veracity of the C1 lateral mass screw insertion in the atlantoaxial fixation using plate and screw method without A-P fluoroscopic guiding.
In the atlantoaxial fixation, without A-P fluoroscopic guiding, we probe lateral mass edge and identify the entrance point of C1 lateral mass screw indirectly. 159 patients treated with atlantoaxial fixation using plate and screw method were studied. Postoperative CT was used for analysis, and the position of the lateral mass screws in atlas was identified by coronary and axial CT scan. Three areas were delimited in and around the lateral mass of atlas in the axial CT scan, so as to analyze the location of screws: area A (inside the joint face), area B (outside the joint face but still in lateral mass), and area C (outside the lateral mass).
Among the 318 screws, 308 (96.9%) were located in area A, 5 in area B (1.6%), and 5 in area C (1.6%). All cases got atlantoaxial union at 4 months after operation.
Probing lateral mass edge and identifying the lateral mass indirectly is reliable for identifying the path of screw in atlas.
Zhonghua wai ke za zhi [Chinese journal of surgery] 02/2008; 46(2):115-7.
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ABSTRACT: A retrospective study of surgical outcome of 33 patients with irreducible atlantoaxial dislocation (IAAD).
To evaluate the safety efficacy of one stage anterior release and posterior fixation and fusion to reduce and stabilize IAAD.
The traditional treatment of symptomatic IAAD is ventral decompression by transoral approach. This procedure is accompanied with high morbidity and mortality. It does not correct the swan neck deformity, which could precipitate the degenerative changes in the lower cervical spine. Our hypotheses were that it is the contraction of the muscles, ligaments, and capsules of atlantoaxial joint that prevent reduction, and that most of IAADs might be reduced by anterior atlantoaxial joint release without the odontoid resection, and that further reduction and stabilization might be achieved by special posterior fixation.
A consecutive series of 33 patients with IAAD were surgically treated. Dislocation or reduction was assessed before surgery, immediately after surgery, and at the final fol5786-up. Etiology, instrumentation, levels fused, and complications were documented. All patients were assessed clinically for neurologic recovery by Odom's method.
The mean age was 32 years (range, 7-63 years). The pathology included os odontoideum in 8 patients, occipitalization of C1 in 19 patients, malunion of odontoid fracture in 5, and relaxation of transverse ligament of atlas in 1. Twenty five patients presented neurologic signs and symptoms. Anterior release was performed without odontoid resection in all cases. Four patients underwent transarticular C1-C2 screw fixation, 3 had C1-C2 pedicle screw and plate fixation, and 26 required occipitocervical fixation. Twenty-five cases resulted in an anatomic reduction, 8 had partial reduction. Complication included one dysphagia and two nasal phonations. The mean follow-up period was 33.7 months (range, 24-55 months). There was no pseudarthrosis, and all but 1 of the patients with neurologic deficit showed improvement.
This series has demonstrated the safety and efficacy of the transoral anterior atlantoaxial release in the reduction of IAAD. Most of the so-called irreducible/fixed AAD could become reducible after anterior release without odontoid resection. The posterior short-segment atlantoaxial or occipitocervical fixation, especially the plate screw instrumentation, could achieve further reduction and provide immediate stabilization. One-stage anterior release and posterior instrumentation and fusion are a safe and reliable operation in experienced hands.
Spine 06/2006; 31(11):E306-13. · 2.08 Impact Factor
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ABSTRACT: To evaluate the accuracy and reliability of atlantoaxial transarticular screw insertion (Magerl's technique) in atlas under lateral fluoroscopic monitoring without anteroposterior view.
Seventy-five consecutive patients with atlantoaxial instability, 48 males and 27 females, aged 35.1, were treated by Magerl's technique. The screw path in atlas was achieved by direct probing the isthmus of axial vertebrae then identifying its position through the atlantoaxial joint correlation. Postoperative transoral X ray and CT film were used for analysis of the position of the 150 screws in the mass of atlas. Three areas were delimitated in and around the lateral mass of atlas: area A (inside the joint face), area: B (outside the joint face but still in lateral mass), and area C area (outside the lateral mass) so as to analyze the location of screws.
Among the 150 screws 139 (92.7%) were located in area A, 8 in area B(1) and 3 in area B(2) (7.3%), and none in area C. All cases got atlantoaxial union 3 months after operation.
The method of "direct probing" is reliable for identifying the path of screw in atlas.
Zhonghua yi xue za zhi 03/2006; 86(5):325-8.
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ABSTRACT: To study the effect of inhibited E-cadherin expression on invasion of cancer cells.
We designed the nucleotide sequence of siRNA corresponding to 5' non-coding and coding sequence of E-cadherin. 21-nucleotide dssiRNA was synthesized by in vitro transcription with Ambion Silencer TM siRNA Construction Kit. siRNA was transfected into gastric cancer MKN45 using TransMessenger transfection Kit. RT-PCR and immunofluorescent assay were used to investigate the inhibition of the expression of mutated E-cadherin. Invasive ability of cancer cells was determined by Transwell assay.
The synthesis of E-cadherin mRNA rather than protein expression was suppressed dramatically 7 d after interference. Decreased protein expression was observed on d 10 after interference. On d 11, invasion ability was enhanced significantly.
siRNA targeted at non-coding and coding sequence of E-cadherin showed significant inhibition on mRNA and protein expression. Inhibited E-cadherin expression results in increased invasion ability of cancer cells.
World Journal of Gastroenterology 05/2005; 11(13):2000-3. · 2.47 Impact Factor
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ABSTRACT: To observe the clinical effect of a occipitocervical fixation systems using C(2) pedicle screws and plates.
An occipitocervical fixation system was designed. Since June 2001 to March 2003, 38 patients with instability of atlantoaxial joint underwent reconstructive surgery using this systems. Twenty-four patients were associated with congenital occipitalization. The pedicle screws were inserted into C(2) pedicles in the direction as its axis. The occipitocervical plate was slightly bent to fit the occipital contour and fixed onto the occiput. Hyperflexion alignment of the occipitoatlantoaxial complex was corrected by application of extensional force created by tightening of the nut on the pedicle screws. The autogenous cancellous bones were grafted between the occiput and the axis.
In this series, neither vertebral artery nor spinal cord was injured. 36 of 38 cases were followed up for an average of 18 months, all cases achieved solid bony fusion. No implant failure was found.
Occipitocervical reconstruction by the combination of C(2) pedicle screws and occipitocervical plate systems can provide sufficient correction of malalignment in the occipitoatlantoaxial region and achieve high fusion rate.
Zhonghua wai ke za zhi [Chinese journal of surgery] 07/2004; 42(12):707-11.
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ABSTRACT: To study the distributive character of safflor yellow A in mice.
A RP-HPLC method for the determination of safflor yellow A in tissues was established and applied to determine safflor yellow A in biological samples.
After iv injection of Safflor yellow A in mice, the AUC of safflor yellow A was hightest in plasma, followed by kidney, liver, lung, heart, spleen. But it was not found in the brain.
The distribution of safflor yellow A in the body is abroad and the speed of its process is swift.
Yao xue xue bao = Acta pharmaceutica Sinica 04/2004; 39(3):217-9.
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ABSTRACT: A reversed-phase high performance liquid chromatographic method for simultaneous determination of 18 amino acids is described. The sample was mixed with norleucine as the internal standard, then derivatized with phenylisothiocyanate (PITC) and analyzed on a Kromasil C18 column at 38 degrees C, using gradient elution with detection at 254 nm. The correlation coefficients between the ratios of peak area of amino acid to that of the internal standard and the amino acid concentrations were above 0.99, except for cysteine(Cys)(0.962). The recoveries of amino acids added were 96.0%-102.4%. Detection limit of leucine was 0.5 mg/L. The method was applied to analyze free amino acids in deproteinized calf blood injection and good results were obtained.
Se pu = Chinese journal of chromatography / Zhongguo hua xue hui 08/2002; 20(4):369-71.
