Analysis of prognostic factors in patients with huge primary liver cancer after surgical resection / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the prognostic factors in patients after surgical resection of a huge primary liver cancer (HPLC).</p><p><b>METHODS</b>Clinical and follow-up data of 69 cases of huge HPLC treated in our hospital from July 2001 to July 2008 were retrospectively analyzed. Sixteen clinicopathologic factors possibly influencing the survival were selected, and multivariate analysis of these parameters was performed using the Cox proportional hazards model.</p><p><b>RESULTS</b>The cumulative 1-, 3-, 5-year survival rates of 58 patients were 58.2%, 31.4% and 12.3%, respectively. Univariate analysis showed that radical resection, intrahepatic metastasis, vascular invasion and degree of hepatic cirrhosis significantly affect the postoperative survival. The Cox multivariate analysis indicated that radical resection, intrahepatic metastasis and degree of hepatic cirrhosis are independent prognostic factors.</p><p><b>CONCLUSIONS</b>Surgical resection is a major and active treatment for huge HPLC. The therapeutic efficacy depends on intrahepatic metastasis, degree of hepatic cirrhosis and radical resection. Aggressive treatment and prevention on postoperative intrahepatic recurrence and metastasis is an important strategy to improve the survival of patients with huge HPLC.</p>

Diagnosis and treatment for solitary necrotic nodule of the liver: report of 15 patients / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the diagnostic and therapeutic approach of solitary necrotic nodule of the liver (SNNL).</p><p><b>METHODS</b>Fifteen cases were diagnosed as SNNL from June 1999 to December 2005. The clinical characteristics, imaging findings, diagnosis and treatment were analyzed with related literature retrospectively.</p><p><b>RESULTS</b>The patients manifested abdominal pain and discomfort in 7 cases (46.7%), fever in 1 case (6.7%), debilitation in 1 case (6.7%). Lesions were screened as hypoechogenic patterns in B ultrasound, and CT scan confirmed that the lesion appeared slightly hypodense compared with the normal liver parenchyma without detectable enhanced graphic phases. No significant enhancement was on dynamic magnetic resonance imaging study. All of the nodules demonstrated hypointense and isointense signal relative to parenchyma of liver on both T1 and T2-weighted images. Histologically, the lesion composed mainly of coagulative necrosis with a homogeneous periphery, and the central zone had a rough patchy appearance with cellular debris. The coagulative necrosis was surrounded by a thin boundary of collagen fibers with scanty mononuclear, lymphocyte, plasmocyte inflammatory cells and elastic fibers. Preoperative laboratory examinations showed hepatic function slightly abnormal in 3 patients, and AFP level was normal in all patients. Diagnosis of SNNL was established in 4 cases (26.7%) preoperatively. All patients underwent liver resection with no recurrence within 3 months to 6 years follow-up.</p><p><b>CONCLUSIONS</b>Preoperative diagnosis of SNNL can be established via comprehensive analysis of clinical characteristics and imaging findings. Liver resection is the optimal therapeutic approach.</p>

Observation on the craniocerebral injury of sheep by high explosive shell / 第三军医大学学报

Objective　To observe the characteristics and rules of craniocerebral injury resulting from a high explosive shell to provide the bases for treating explosive injury. Methods　A total of 36 sheep were distributed at the distance 6 to 48 m away from the explosive center and the shell was exploded electrically at 7 m above the earth. At the same time, the velocity of fragments and shock wave pressure were determined. Gross and pathological observations were performed after injury. Results　Among all sheep with fragment injury, craniocerebral injury was 32%. Their immediate death rate was 75% and all died 6 h later. The incidence rates of penetrating wound and blind wound were 75% and 25% respectively. Pollution of wound track was heavy. The percentage of head lost was 50% in sheep and 50% of injured animal suffered from comminuted fracture of skull base. Bleeding was found extensively on the surface of the cerebrum, even medulla oblongata was involved. Hemorrhage, edema, rupture of small blood vessels and degeneration of neuron were found at the regions 4 cm away from the wound tract with light microscopy. Combined blast injury was found and occurred most often in the abdomen and limbs, both accounting for 62.5%, and combined thoracic injury was the third, up to 50%. All the animals of craniocerebral injury combined with lung blast injury. Conclusion　High explosive shells destroy cranium badly and extensively. Many skulls are lost and the cranial base is readily fractured. The wound track is heavily polluted. Combined injury is more often occurred.

Observation on the craniocerebral injury of sheep by high explosive shell / 第三军医大学学报

Objective　To observe the characteristics and rules of craniocerebral injury resulting from a high explosive shell to provide the bases for treating explosive injury. Methods　A total of 36 sheep were distributed at the distance 6 to 48 m away from the explosive center and the shell was exploded electrically at 7 m above the earth. At the same time, the velocity of fragments and shock wave pressure were determined. Gross and pathological observations were performed after injury. Results　Among all sheep with fragment injury, craniocerebral injury was 32%. Their immediate death rate was 75% and all died 6 h later. The incidence rates of penetrating wound and blind wound were 75% and 25% respectively. Pollution of wound track was heavy. The percentage of head lost was 50% in sheep and 50% of injured animal suffered from comminuted fracture of skull base. Bleeding was found extensively on the surface of the cerebrum, even medulla oblongata was involved. Hemorrhage, edema, rupture of small blood vessels and degeneration of neuron were found at the regions 4 cm away from the wound tract with light microscopy. Combined blast injury was found and occurred most often in the abdomen and limbs, both accounting for 62.5%, and combined thoracic injury was the third, up to 50%. All the animals of craniocerebral injury combined with lung blast injury. Conclusion　High explosive shells destroy cranium badly and extensively. Many skulls are lost and the cranial base is readily fractured. The wound track is heavily polluted. Combined injury is more often occurred.