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Objective To investigate the clinical values of laparoscopic radiofrequency ablation in liver cancer and its impacts on serumal VEGF and MMP-2. Method From Jan, 2012 to Dec, 2013, a series of patients with primary liver cancer were studied, patients were randomly signed into LAFA group or control group. During the study period, LRFA group were treated with laparoscopic radiofrequency ablation combined with FOLFOX4 chemotherapy while patients in control group were treated with PIAF chemotherapy only. The primary outcomes were the Health related quality of life score (HRQL), the degree of solid tumors classification, progression-free survival duration and 2-year mortality. The secondly primary outcomes included the level of serumal VEGF and MMP-2. Result When compared with the control group, patients in LRFA group got a significantly lower rate of disease progression (28.33 % vs 50.00 %, P = 0.015); a longer progression-free survival duration (500 vs 380 d, P = 0.013); a higher HRQL (80.33 ± 5.84 vs 65.87 ± 9.59, P = 0.000); a significantly lower level of VEGF at 7 days, 14 days, 28 days and 6 months after the clinical intervention were started (all P values were 0.000); a significantly lower level of MMP-2 at 14 days, 28 days and 6 months after the clinical intervention were started (the P values were 0.003, 0.001 and 0.000). Conclusion Laparoscopic radiofrequency ablation improved the long-term clinical outcomes and decreased the serumal level of VEGF and MMP-2.
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Objective To investigate three-dimensional localization for sentinel lymph node (SLN) of breast cancer,and by which we can remove the SLNs directly.Methods The ipsilateral axillary lymph nodes of 40 patients were inspected by B-ultrasound and axillary artery and subscapular artery bifurcation point and its trend with Doppler B-ultrasound in the preoperation,then located them in the surface.We found SLNs using methylene blue as the mapping agent with endoscope during the operation,determined which lymphatic group the sentinel lymph node belonged and the spatial location and the surface projection according to the anatomical location.Results We found the three-dimensional location of SLNs in the group of 39 in 40 patients with endoscope,of which 34 cases located in central group,accounting for 87.18％ ;while 4 cases located in the subscapular group,accounting for 10.26％,and their spatial location was as follows:set the root of subscapular artery in this location as a starting point,the subscapular artery as a diameter,and made a diameter of 5cm circle to the bottom,then let the latissimus dorsi as the end,and made a quasi-cylinder through the circle to the axillary central.The height of the quasi-cylinder got up to the surface of the intercostal brachial nerve.Then set the nerve as the diameter of circle of quasi-cylinder,and the centre of circle was crosspoint of subscapnlar artery's surface projection with intercostal brachial nerve.The height of quasi-cylinder varies with somatotypes of the patients,its height was less than or equal to 5cm.What's more,the fiften enlarged lymph nodes located by B-ultrasound in the preoperation were all in the quasi-cylinder,and they were SLNs.Conclusion SLN lies in quasi-cylinder consisting of spatial location of subscapular group and central group lymph nodes.If the enlarged lymph nodes found by B-ultrasound are in above mentioned quasi-cylinder,they can be considered as the SLNs.Make a 5cm-incision parallelling the intercostal brachial nerve and intersecting the surface projection of subscapular artery in the surface of quasi-cylinder,then dissect toward the origin of the subscapular artery,you can find SLNs.
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<p><b>OBJECTIVE</b>To discuss the feasibility of terminal intestinal exteriorization (exteriorization without ileostomy) in laparoscopic anterior resection for rectal cancer.</p><p><b>METHODS</b>Clinicopathological data of 77 patients undergoing laparoscopic anterior resection for low rectal cancer in our department from January 2011 to December 2013 were retrospectively analyzed. After laparoscopic rectal resection, 32 patients received terminal intestinal exteriorization (exteriorization group) and 45 patients received preventive ileostomy (ileostomy group). Anastomosis-related, stoma-related and intestinal stoma closure-related morbidity was compared between the two groups.</p><p><b>RESULTS</b>There were no significant differences in operative time, blood loss and overall hospital stay between the two groups (all P>0.05). The total hospital cost was (5.39±1.74)×10(4) yuan in the exteriorization group, and (6.98±1.37)×10(4) yuan in the ileostomy group(P<0.01). The incidences of postoperative anastomotic fistula was not significantly different between the two groups(P>0.05). Three patients(9.4%) developed anastomotic leak in the exteriorization group and 2(4.4%) in the ileostomy group. The anastomotic leak was managed by opening the external intestinal wall and maturating an ileostomy under local anaesthesia. All these 5 patients were cured with nutritional support, antibiotics, continuous local drainage. In the exteriorization group, 5 patients had complications related to stoma and intestinal stoma closure operation(15.6%), which was lower than(42.2%) in the ileostomy group(P=0.013).</p><p><b>CONCLUSION</b>Terminal intestinal exteriorization in laparoscopic anterior resection is a safe and feasible surgical procedure with little trauma and less hospital cost, which can be an alternative as a prophylactic treatment for patients with high risk of anastomotic leak.</p>
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Humans , Anastomosis, Surgical , Anastomotic Leak , Drainage , Ileostomy , Laparoscopy , Length of Stay , Postoperative Complications , Rectal Neoplasms , Retrospective Studies , Surgical StomasABSTRACT
Objective: To explore the effects of ligustrazine on the secretion of hydrogen sulfide in the ventricular tissues of rats under physiological condition.Methods:32 rats were divided into control group,high dose group of ligustrazine(150?g/ml),medium dose group of ligustrazine(15?g/ml) and low dose group of ligustrazine(1.5?g/ ml) at random.The left and right ventricular tissues were incubated in 37℃ thermostatic water bath for 4 hours with Krebs solution as supernatant.After incubation of the ventricular tissues,the sensitive electrode-based method was used to detect the content of H2S in the supernatant.Results: In the left ventricular tissues,there were on dif-ference of the H2S level betweenthe 1.5?g/ml ligustrazine group(0.17?0.03),15?g/ml ligustrazine group(0.17?0.03)and control group.However,compared with control group, the H2S level in hige dose group of ligustrazine decreased obviously(P0.05),but the H2S level in the 150?g/ml ligustrazine group(0.46?0.09)was significantly lower than that in the control group(0.64?0.13)(P