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Breast cancer is one of the most common malignant tumors in women,the trend of young women with breast cancer in China is obvious.Some young patients in the diagnosis of breast cancer are unmarried,so they have a certain degree of expectation of the protection of ovarian function and reali-zation of the right.In the treatment of breast cancer,the doctors should understand the effects to gonadal function.In chemotherapy,for some patients with ovarian function inhibitors have a protective effect to o-varian fuction.At present,there are some methods to protect the reproductive function,such as cryopreser-vation of oocytes,cryopreservation of embryos and preservation of ovarian tissues and so on.But thoses methods for the protection of ovarian function and reproductive function are not yet perfect.
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Formation mechanism of breast cancer mainly includes genetic factors,diet and obesity,radioactive ray and ionizing radiation,menstrual,marriage,lactation factor and mental factors.Sympathetic nerve activity is mainly to ensure the needs of the physiology of the human body in a state of tension,while when sympathetic nerve function abnormal sustained and enhanced,the various systems of the body will receive adverse effects.For the plant nerve disorder,which can cause work stress,anxiety,worry and so on.With the further research of breast cancer in recent years,it shows that the change of sympathetic nervous system is an important reason for promoting the development of breast cancer.
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Occult breast cancer is a rare disease with the primary symptom of enlarged ipsilateral axillary lymph node. At present,it is still difficult to diagnose occult breast cancer. The diagnosis is based on the core needle biopsy and following immunohistochemical staining for the enlarged lymph nodes. If the results support,the diagnosis can be confirmed after the exclusion of other primary tumors. The standard treatment of occult breast cancer is still the mastectomy and axillary lymph node dissection. Neoadjuvant chemotherapy is an independent factor affecting the prognosis,which is also recommended before the oper-ation. Chemotherapy,radiotherapy and endocrine therapy could be chosen based on immunohistochemical results after surgical treatment. The prognosis of occult breast cancer is similar to the other types of breast cancer at the same staging.
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Objective To summarize the diagnosis and surgical treatment of the cavernous transformation of portal vein (CTPV). Methods Clinical data of 63 patients with adult CTPV trea-ted in our hospital from 1976 to 2006 were retrospectively analyzed. Results The diagnosis of CT-PV was comfirmed according to (1) The main symptoms were repeated haematemesis, hemafecia, hy-persplenotrophy, hypersplenia and normal hepatic function. (2) B uhrasonography or ultrasonic Doppler manifested that portal vein thinning or obstruction or embolism, honeycomb appearance con-duit can be seen around. Portal vein frequency spectrum can be seen in the honeycomb appearance con-duit. (3) CT and MR scan materials were exhibited that the main portal vein and its branches lost the normal shape and had the shaggy edge. (4) percutaneous splenoportography or selective arteriography of superior mesenteric artery showed that occlusion of the main branch of portal vein at the porta hepa-tis was revealed, and a masslike network of tortuose veins around the porta hepatis and many small ir-regular veins radiating from the network to the liver were demonst rated. Splenectomy and devaseu-larization was performed in 23, spleneetomy and splenorenal shunt in 32, portal systemic shunt plus porta-azygous devascularization in 8. Portal hypertension was treated first in CTPV with disease of biliary tract. No death happened. The rascult of haemogram recovered in a short period of time.Conclusion Once the patients are diagnosed to suffer from adult CTPV, they should receive explora-tory laparotomy. It is important to choose the most effective treating method for the disease.
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Objective To evaluate the diagnosis and surgical treatment of primary retroperitoneal extraadrenal pheochromocytoma(PREAP). Methods Clinical data of 17 cases with PREAP from 1976 to 2006 were analyzed retrospectively. Results It was not difficult for the diagnosis of PREAP based on the primary symptoms, including paroxysmal hypertension or persistent hypertension. PREAP is usually deep, large and invading on adjacent organs. B-uhrasound was used for preliminary screening. CT and MRI with high soft tissue resolution and multi directional imaging are of great value for correct diagnosis and determination of exact extent of the tumor in diagnosis of PREAP. 24 h urinary VMA output imcreased in 12 cases (92. 3%) and urinary catecholamine level was up to 526. 1 μg- Precise location of PREAP by 123I-MIBG is superior to that by 131I-MIBG. The diagnosis was tentative in 4 cases and definite in 13 cases. Complete tumor resection was achieved in 15 cases, among them 2 cases died on table due to inadequate preparation before surgery in 1970's. In the remaining 2 cases with huge tumors partial resection, silver clips were put in during operation to locate the extent of the tumors for further management after operation. Conclusions Locating and qualitative diagnosis before operation are valuable and once the patients are diagnosed as PREAP, they should receive exploratory laparotomy after an adequate preparation.
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Objective To evaluate the diagnosis and surgical treatment of adult congenital choledochal cyst(ACCC). Methods Clinical data of 345 ACCC cases from 1974 to 2007 were analyzed retrospectively. Results There were only 110 patients (31.9%) with typical triad (abdominal pain, palpable mass and jaundice). B-ultrasound, CT, ERCP, PTC and MRCP were methods for diagnosis. Cancer arising from choledochal cysts was found in 19 cases who had undergone internal drainage and its incidence of cholangiocarcinoma is much higher than in the general population. All cases underwent surgical treatment, in which total excision of choledochal cyst and Roux-en-Y hepaticojejunostomy was main operation, 337 cases recovered well and 8 (2. 3%) died. C..ondusions Accurate diagnosis of ACCC was difficult depending on clinical symptoms only. B-ultrasound was the choice of atraumatic diagnosis. All patients with an established diagnosis of ACCC should undergo exploratory laparotomy. Total excision of eholedochal cyst and Roux-en-Y hepaticojejunostomy is most effective treatment for ACCC.
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The experiment was conducted between February 2004 and May 2006 at The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang province, China. Forty hybrid pigs were used in the experiment, 20 were used as donors and the other 20 were used as recipients. Donor operation: Abdominal aorta was lavaged in situ with 500 mL 4℃ heparinized saline (lavage pressure 7.8-9.8 kPa), intestinal canal cut from donor was conserved in 4℃ physiological saline.Recipient operation: Orthotopic small intestine transplantation and heterotopic small intestine transplantation were conducted according to exploring results, and abdominal cavity was washed with 40-45℃ physiological saline until the flush out liquid became warm.Periprocedural management: Preoperative discussion and postoperative discussion were done, and body temperature of pigs was monitoring and controlled. Early-stage feeding was used, 4 pigs could drink water freely after transplantation and took food normally at the second day, while other 16 pigs began to drink water 2 days after transplantation. Evaluation after the operation: No experimental animal had anastomotic leakage after taking food. Sixteen pigs survived over 7 days, average 9 days, the longest over 14 days. The success rate of the small intestine transplantation is 80% (16/20). Failure reasons: One with phlebothrombesis, one with blood loss and two with unknown reasons. Results showed that experience of periprocedural management had got relatively satisfactory effects through a great quantity of small intestine transplantation practices.
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BACKGROUND: Recently,the technique of isolation procedure of viable islets cell from large animals has been mature and used in clinical islet cell transplantation. Some study results indicate that low yields of pig islet cell isolations is probably not due to the presence of higher or more aggressive enzyme activities during the porcine isolation procedure. Therefore, the causative factors resulting in the inconsistent results should be sought for the intrinsic properties of the pancreatic islet and pancreas. The purpose of the study is to get more pancreatic islet cells for diabetic patients.OBJECTIVE: To investigate the effect of single enzymatic solution (SES)and multi-enzymatic solution(MES) on adult porcine pancreatic islet cell isolation,and to provide the theory base for diabetic patients rehabilitation.DESIGN: A completely randomized and controlled experiment based on animals.SETTING: General surgery and gerontology department in a university hospital.MATERIALS: The experiment was conducted in the Second Affiliated Hospital of Harbin Medical University from June 2003 to May 2004. Twenty consecutive random-bred adult pigs, 12 - 24 months old, weighing average 100 kg,were selected for experiment from Hada Slaughterhouse of Harbin.INTERVENTIONS: After slaughtering,the spleentic lobe of the pancreas was excised using sterile surgical gloves and surgical instruments. Each was immediately transported in 500 mL of sterile RPMI1640 solution at 4 ℃ to the laboratory for processing. After removal of fat peritoneum and superficial blood vessel,each pancreas was first immersed in 1:5 000 Liquor chlorhexidine for 3 minutes,then washed three times with cold RPMI1640, next mechanically minced into 1 mm×1 mm×1 mm fragments,weighed,and equally divided into two groups. Adult porcine islets were isolated with two different collagenase solutions(SES and MES).MAIN OUTCOME MEASURES: Islet count was performed with DTZ-staining. The viability was assessed by trypan-blue staining. Porcine islet insulin-secretory function was assessed by insulin content of cultured porcine islets and by insulin release. Islet morphological integrity was finally established by electron microscope examination.RESULTS: Overall islet cell content were statistically different between the two methods[(1 782 ±427) IE/g vs (1 293 ±451) IE/g,P<0.05]. No significant difference was found in viability,function or morphology of islet between MES and SES(P>0. 05).CONCLUSION: An average of isletisolated with MES method represents a uniquely massive yield in comparison with that by SES method. A good viability was also confirmed by static incubation and culture. The transplantation of those pancreatic islet cells can help to control the syndromes of diabetes.
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Objective To summarize the experience on clinical diagnosis and treatment for cervical neurilemmoma. Methods The clinical data of 77 cases of cervical neurilemmoma from 1976 to 2005 were retrospectively analyzed. Results The diagnosis was dependent on the anamnesis, clinical presentations, ultrasonography, CT and cytology of fine needle aspiration. Correct preoperative diagnosis was abtained in 51 cases (66. 2% ) , and the misdiagnosis rate was 33. 8% (26/77). All patients underwent surgical resection. The postoperative diagnosis was benign neurilemmoma by pathological examinations. The postoperative complications included recurrent laryngeal nerve injuries (6 cases) , Horner syndrome (4 cases) , tongue deviation (3 cases), neck pain or numbness (2 cases) and reffered pain in limb (1 case). Sixteen patients were followed up, and these symptomes disappeared after 3-11 months. Nerve dysfunction remained in 2 out of 3 patients in whom the vagus was wrongly amputated during the operation. Intraoperative inadvertent sympathetic nerve amputation caused permanent nerve dysfunction. Conclusion B-mode ultrasonography, CT and fine needle aspiration cytology are useful for the diagnosis of cervical neurilemmoma. Surgical resection is most effective among all available therapies.