Huang’s three-step maneuver for laparoscopic spleen-preserving No. 10 lymph node dissection for advanced proximal gastric cancer

Due to the complexity of the splenic hilar vessels, their anatomical variation and the narrow and deep space, as well as the bleeding-prone splenic parenchyma and the difficulty to manage splenic or vascular bleeding at the splenic hilum,the procedure remains challenging and technically demanding procedure for the performance of laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection. Based on our experiences, we gradually explored a set of procednral operation steps called ＂Huang＇s three-step maneuver＂. In this paper, we not only provide the concrete operation steps for the surgeon, but we also provide our recommended technique of pulling and exposure for assistants. This new maneuver simplifies the complicated procedure and improves the efficiency of laparoscopic spleen-preserving splenic hilar lymphadenectomy, making it easier to master and allowing for its widespread adoption.     

A case of simultaneous triple primary gastrointestinal tumor

Multiple primary carcinoma which is the same organ of the same patient or multiple organs, tissues has occurred two or more than two kinds of the primary malignant tumor. All cancer at the same time or 6 months from diagnosis is called simultaneous multiple primary carcinoma, In this case the patient suffering from cancer including rectal cancer, colon cancer and appendix gastrointestinal stromal tumor （GIST） three primary carcinoma, is simultaneous multiple primary carcinoma and it＇s extremely rare on the clinical cases, This report address that the incidence of the patient with operation and pathological diagnosis.     

DIFFERENCES IN EXPRESSION AND REGULATION BETWEEN TRANSFORMED CELLS OF THE HUMAN GASTRIC CARCINOMA ONCOGENE Ha-ras AND THE UNTRANSFORMED PARENT CELLS

An Ha-ras oncogene was isolated from a cell line of gastric carcinoma called BGE-823 in order to elucidate genetic control and the influence of DNA sequences. The oncogene was cloned and identified as a single nucleotide substitution of thymine for guanine in the 12th codon through the sequencing of its first axon. We compared the differences of expression and regulation between the transformed Ha-ras cells and untransformed parent cells. Data indicated that the expression of Ha-ras in the transformed cells was five-fold higher than in the untransformed cells and that the Ha-ras gene in the former was hypersensitive toward DNase I. In addition, a nuclear protein of 35 kilodaltons bound strongly to the 2.5 Kb fragment located upstream of the 6.6 Kb Ha-ras gene and contained a CC rich region. These results suggest that there might be another mechanism of activation for the ras gene besides point mutation.     

Detection of VEGF levels in ascites and peritoneal fluid

Angiogenesis is an absolute requirement for the neoplastic growth of solid tumors. It is also essential for tumor invasion and metastasis, facilitating the shedding of tumor cells into surrounding blood vessels. Tumor cells have been shown to secrete a variety of angiogenic factors and thereby induce the local formation of new blood capillaries. Among these factors contributing to angiogenesis, vascular endothelial growth factor (VEGF, also called vascular permeability factor, VPF), a bifun…     

Nonintubated thoracic surgery： a lead role or just a walk on part？

With the advent of the patient-centered health care concept, thoracic surgeons of the modern era are called to minimize at most the overall invasiveness of their performances, while increasing safety and effectiveness as much as possible. This need has driven an outstanding development of minimallyinvasive surgical approaches, which are now the standard to perform a broad spectrum of thoracic operations. A recent and fascinating evolution in this field is represented by the increasing interest toward the use of so-called ＂nonintubated＂ anesthesia protocol, which are expected to provide a further improvement in postsurgical outcomes （1-8）.     

Peng‘s Pancreaticojejunal Anastomosis（Binding Pancreaticojejunostomy） for the Pancreatoduodenectomy

Obuective To evaluate the safety and feasibility of a new operative procedure called binding pancreaticojejunostomy (BPJ) for the preven-tion of pancreatic leakage after pancreatoduodenectomy(PD). Methods Binding pancreaticojejunostomy was perfomed in 100 patients from 1996 to 2000.During the operation,the cut end of the je-junum(3 cm) was everted,the everted mucosa of the jejunum was destroyed with carbolic acid .Meanwhile 3 cm long remnant of pancreas was isolated and sutured to 3 cm away form the jejunum cut end, care being taken not to penetrate the sero-muscular layer.Then,the everted jejunum was restituted to its nomal position and the remnant of the pancreas was naturally pushed into the jejunal lumen for 3 cm.Finally,the surface of pancreatic remnant was closely in contact with destroyed jejunal mucosa surface,and a piece of absorbable thread was used to bind circumferentially this jejunum and the pancreatic remnant together,so no gap existed between the jejunal mucosa and pancreatic remnant. Results No pancreatic leakage occurred in the 100 patients with BPJ. Conclusion Binding pancreaticojejunostomy procedure can effectively prevent the occurrence of anastomatic leakage and can be applied broadly.     

Diagnostic value of 5 serum biomarkers for hepatocellular carcinoma with different epidemiological backgrounds: A large-scale,retrospective study

Objective:Hepatocellular carcinoma(HCC)is a lethal global disease that requires an accurate diagnosis.We assessed the potential of 5 serum biomarkers(AFP,AFU,GGT-II,GPC3,and HGF)in the diagnosis of HCC.Methods:In this retrospective study,we measured the serum levels of each biomarker using ELISAs in 921 participants,including 298 patients with HCC,154 patients with chronic hepatitis(CH),122 patients with liver cirrhosis(LC),and 347 healthy controls from 3 hospitals.Patients negative for hepatitis B surface antigen and hepatitis C antibody(called"NBNC-HCC")and patients positive for the above indices(called"HBV-HCC and HCV-HCC")were enrolled.The selected diagnostic model was constructed using a training cohort(n=468),and a validation cohort(n=453)was used to validate our results.Receiver operating characteristic analysis was used to evaluate the diagnostic accuracy.Results:Theα-L-fucosidase(AFU)/α-fetoprotein(AFP)combination was best able to distinguish NBNC-HCC[area under the curve:0.986(95%confidence interval:0.958–0.997),sensitivity:92.6%,specificity:98.9%]from healthy controls in the test cohort.For screening populations at risk of developing HCC(CH and LC),the AFP/AFU combination improved the diagnostic specificity for early-stage HCC[area under the curve:0.776(0.712–0.831),sensitivity:52.5%,specificity:91.6%in the test group].In all-stage HBV-HCC and HCV-HCC,AFU was also the best candidate biomarker combined with AFP[area under the curve:0.835(0.784–0.877),sensitivity 69.1%,specificity:87.4%in the test group].All results were verified in the validation group.Conclusions:The AFP/AFU combination could be used to identify NBNC-HCC from healthy controls and hepatitis-related HCC from at-risk patients.     

EFFECT OF TNF-a AND IFN-g ON THE EXPRESSION OF INDUCIBLE NITRIC OXIDE SYNTHASE GENE AND PROLIFERATION INHIBITION OF HUMAN COLON CANCER CELL LINE

Nitric oxide (NO) is an inorganic free radical gas synthesized from L-arginine by a family of three isoenzymes called NO synthase[1]. Two of these NO synthases are constitutively expressed, and expression of a third NO synthase is induced by immunologic stimuli[2]. The NO released by the constitutive enzymes acts as an important signal molecule in the cardiovascular and nervous systems. NO released by the inducible NO synthase (iNOS) lasts for long periods in cells of the immune system …     

Comparisons ofbiophysical properties andbioactivities ofmono-PEGylated endostatin andan endostatin analog

Background:Endostatin (ES) is a well-established potent endogenous antiangiogenic factor. An ES variant, called zinc-binding protein-ES (ZBP-ES), is clinically available; however, its use is limited by rapid renal clearance and short residence time. PEGylation has been exploited to overcome these shortcomings, and mono-PEGylated ES (called M2ES) as well as mono-PEGylated ZBP-ES (MZBP-ES) are developed in our study. This study aimed to compare the biophysical properties and biological effects of M2ES and MZBP-ES to evaluate their druggability. Methods:Circular dichroism and tryptophan emission lfuorescence were used to monitor the conformational changes of M2ES and MZBP-ES. Their resistance to trypsin digestion and guanidinium chloride (GdmCl)-induced unfolding was examined by Coomassie staining and tryptophan emission lfuorescence, respectively. The biological effects of M2ES and MZBP-ES on endothelial cell migration were evaluated using Transwell migration and wound healing assays, and the uptake of M2ES and MZBP-ES in endothelial cells was also compared by Western blotting and immunolfuorescence. Results:Structural analyses revealed that M2ES has a more compact tertiary structure than MZBP-ES. Moreover, M2ES was more resistant to trypsin digestion and GdmCl-induced unfolding compared with MZBP-ES. In addition, although M2ES and MZBP-ES showed comparable levels of inhibiting transwell migration and wound healing of endothelial cells, M2ES displayed an increased ability to enter cells compared with MZBP-ES, possibly caused by the enhanced interaction with nucleolin. Conclusions:M2ES has a more compact tertiary structure, is more stable for trypsin digestion and GdmCl-induced unfolding, exhibits increased cellular uptake and shows equivalent inhibitory effects on cell migration relative to MZBP-ES, indicating that M2ES is a more promising candidate for anticancer drug development compared with MZBP-ES.     

Possibility of predicting the results of the surgical treatment of cancer of the thoracic portion of the esophagus

Within a 18-year period in the clinic 273 patients were subjected to radical surgery for cancer of the thoracic esophagus. 206 patients were discharged from the clinic. The survival rate for 5 years and longer was noted in 58 patients. The data and results of the treatment depending on a sum of clinical signs were treated mathematically. It is noted that the patients' survival is influenced by such factors as sex, the stage of the disease, the morphological structure of tumor, the character of course, tumor size and spread, the type of surgical intervention. An advanced course, changes in blood presence of metastases do not seem to be the reason for cancellation of the operation.     

Cardiac tolerance of the combination paclitaxel-anthracyclines in the context of the management of cancer of the breast

Within the past decades there has been major interest in associating the paclitaxel into the management of breast cancer patients with a strong improvement of clinical results. Moreover, doxorubicin is historically one of the major chemotherapeutic agents in breast cancer treatment. So, investigations of the combination of the paclitaxel with doxorubicin have logically taken place in the strategy of breast cancer management. Also, this association became a standard of care neoadjuvantly in locally advanced breast cancer. The aim of this review of literature consists to make a special focus on cardiac toxicity occurring after doxorubicin and paclitaxel association and to give adequate directions for the next future in this promising combination.     

Improvement of the efficiency of the treatment of gastric cancer by the standardization of the treatment plan

Standardized treatment plan for gastric cancer was established in our department by which surgeons and nurses understood the treatment schedules of each gastric cancer patient as the common knowledge, and the cooperation of surgeons and nurses could be improved. Furthermore, the modality decreased the length of hospital stay from 35 +/- 15 days to 24 +/- 8 days, which indicated that the number of patients per one bed for one year increased from 10 to 15, and the efficiency of the treatment of gastric cancer patients 50% by our system.