ABSTRACT
"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions. .
ABSTRACT
Objective:To explore the short-term efficacy of totally laparoscopy pancreatoduodenectomy (TLPD) and open pancreatoduodenectomy (OPD) in the treatment of periampullary carcinoma.Methods:The clinical data of 50 patients with periampullary carcinoma in the First Hospital of Shanxi Medical University from June 2016 to March 2019 were retrospectively analyzed. According to the different surgical methods, the patients were divided into TLPD group (22 cases) and OPD group (28 cases). The perioperative and postoperative related indicators between the two groups were compared.Results:Both groups had successfully received the operation. The operating time in TLPD group was longer than that in OPD group, and the difference between the two groups was statistically significant [(665±213) min vs. (447±215) min, t = -0.356, P = 0.001]. The amount of intraoperative bleeding in TLPD group was less than that in OPD group, and the difference between the two groups was statistically significant [100 ml (50-325 ml) vs. 300 ml (100-500 ml), Z = -2.230, P = 0.026]. There were no significant differences in the proportion of intraoperative blood transfusion, lymph node dissection number, resected tumor diameter, postoperative diet restriction time, postoperative extubation time, postoperative hospital stay and the incidence of postoperative complication between TLPD group and OPD group (all P > 0.05). Conclusions:TLPD and OPD has a similar short-term efficacy in the treatment of periampullary carcinoma. The operating time of TLPD is longer than that of OPD, but TLPD can effectively control the intraoperative bleeding.
ABSTRACT
Objective To evaluate the mechanical responses of human neck tissues under the influence of massage head by modeling and simulation, so as to provide guidance for the design of massage apparatus. Methods Gray images of human tissues under application of message head were obtained through CT scanning, and the three-dimensional (3D) model for these tissues was established with reverse engineering method. Changes in strain, stress and message force of muscles and cervical vertebrae under the application of message head with the radius of 15 mm and 10 mm and pressed depth from 0 mm to 10 mm, as well as its damage and influence to bones and tissues were analyzed by finite element method. Results When 15 mm-radius massage head moved in depth of 6 mm and 7 mm, the maximum local stress was 3.0 MPa and 3.4 MPa, which was beyond damage limit of the vein. In contrast, when 10 mm-radius massage head moved in depth of 6 mm and 7 mm, the maximum local stress was 3.2 MPa and 3.7 MPa, which was beyond damage limit of the vein. To derive 1 MPa stress in cervical spine, the 15 mm- and 10-mm radius massage head should move in depth of 8 mm and 6 mm, respectively. Conclusions To avoid the local tissue damages, the pressed depth of massage should not be greater than 5 mm and 7 mm with the 10 mm- and 15 mm-radius message head, respectively. The message head with a larger radius could produce a larger action range and a more moderate massage force.
ABSTRACT
Objective@#To compare the short-term efficacy of robotic distal pancreatectomy (RDP) and laparoscopic distal pancreatectomy (LDP) in treatment of pancreatic body and tail cancer, and to explore the feasibility of RDP.@*Methods@#The clinical data of 11 patients who received RDP and 26 patients who received LDP from January 2014 to May 2018 in the First Hospital of Shanxi Medical University were retrospectively analyzed. The operation indexes and the hospitalized cost of both groups were compared.@*Results@#There were no significant differences in spleen-preserving rate, postoperative hospital stay, postoperative pain, intraoperative or postoperative blood transfusion, postoperative bleeding and pancreatic fistula between the two groups (all P > 0.05), but the amount of intraoperative bleeding in RDP group was less than that in LDP group, and the difference was statistically significant [(144±51) vs. (199±65) ml, t = -2.530, P = 0.016]. Compared with LDP group, the total hospitalization cost and operation cost of RDP group was increased [(75 000±14 000) yuan vs. (107 000±12 000) yuan; (21 000±9 000) yuan vs. (39 000±16 000) yuan; both P < 0.01].@*Conclusion@#Both RDP and LDP are safe and feasible. LDP has the advantages of relative low cost and wide range of operations. RDP has obvious advantages in controlling intraoperative bleeding, but the high cost limits its further clinical promotion.
ABSTRACT
Objective To analyze the clinical feasibility and effectiveness of the "G"-shaped surgical approach in robotic pancreatoduodenectomy. Methods The clinical data of 17 patients who were undergoing robotic pancreatoduodenectomy at the First Hospital of Shanxi Medical University from June 2017 to March 2018 was analyzed. Results All the 17 robotic pancreatoduodenectomy operations via the "G"-shaped surgical approach were successful. The operationtime was (499 ±146) min (350-825 min), and the blood loss was (119±38) ml (20-500 ml). All surgical margins were negative. All patients recovered well after surgeries, and the postoperative hospital stay was (21 ±6) (14-36 days). However, one patient experienced secondary surgery due to bilioenteric anastomosis fistula, fortunately the surgical process went successfully. This patient had pancreatic leakage (class B) after surgery and was discharged with tubes after a conservative treatment, another patient had gastroplegia and recovered completely after conservative treatment. Conclusion It is a safe and feasible procedure to use the robotic pancreatoduodenectomy with the"G"-shaped surgical approach.
ABSTRACT
Objective To compare the short-term efficacy of robotic distal pancreatectomy (RDP) and laparoscopic distal pancreatectomy (LDP) in treatment of pancreatic body and tail cancer, and to explore the feasibility of RDP. Methods The clinical data of 11 patients who received RDP and 26 patients who received LDP from January 2014 to May 2018 in the First Hospital of Shanxi Medical University were retrospectively analyzed. The operation indexes and the hospitalized cost of both groups were compared. Results There were no significant differences in spleen-preserving rate, postoperative hospital stay, postoperative pain, intraoperative or postoperative blood transfusion, postoperative bleeding and pancreatic fistula between the two groups (all P>0.05), but the amount of intraoperative bleeding in RDP group was less than that in LDP group, and the difference was statistically significant [(144±51) vs. (199±65) ml, t= -2.530, P= 0.016]. Compared with LDP group, the total hospitalization cost and operation cost of RDP group was increased [ (75000±14000) yuan vs. (107000±12000) yuan;(21000±9000) yuan vs. (39000±16000) yuan;both P<0.01]. Conclusion Both RDP and LDP are safe and feasible. LDP has the advantages of relative low cost and wide range of operations. RDP has obvious advantages in controlling intraoperative bleeding, but the high cost limits its further clinical promotion.
ABSTRACT
Objective To determine the correlation between phosphorylation extracellular signal-regulated kinase (p-Erk) and monopolar spindle 1 (Mps1) in colorectal cancer patients with the BRAF V600E mutation or not, and to explore the relationship between the expression of p-Erk and Mps1 with the clinicopathological features and prognosis of colorectal cancer patients. Methods Two hundred and eighty-eight paraffin-embedded tissue sections containing both the carcinoma and its adjacent non-neoplastic colorectal tissue were collected from January 2009 to June 2015 in the First Hospital of Shanxi Medical University. BRAF mutation was detected by Sanger sequencing. Kaplan-Meier survival analysis was used to analyze the correlation between BRAF V600E and prognosis. Immunohistochemistry was used to detect the expression level of p-Erk and Mps1 in colorectal cancer with wild type or BRAF V600E mutation. The correlation between p-ERK and Mps1 expression was analyzed by using linear regression analysis. Results The BRAF V600E mutation rate was 5.2 % in colorectal carcinomas. In addition, the poorly differentiated tumours and mucinous tumours had higher incidence of BRAF mutations than well differentiated tumours and non-mucinous tumours respectively [14.3 % (9/63) vs. 2.7 % (6/225),χ 2= 11.208,P = 0.001; 25.0 % (6/24) vs. 3.4 %(9/264),χ 2=16.630,P <0.001). The positive rate of p-Erk and Mps1 in colorectal carcinomas with BRAF V600E was significantly higher than that in colorectal carcinomas with BRAF WT (14/15 vs. 3/15, P <0.05; 15/15 vs. 3/15, P < 0.05]. It was found that the p-Erk expression correlated positively to the Mps1 expression (R2= 0.419,P < 0.001). The expressions of p-Erk protein in poorly differentiated adenocarcinoma was significantly higher and mucinous adenocarcinoma than those in high differentiated adenocarcinoma and non-mucinous adenocarcinoma (χ 2= 6.679, P = 0.01; χ 2= 5.735, P = 0.017), as well as in the group with lymph node metastasis than without lymph node metastasis (χ 2=5.436, P =0.02). Positive rate of Mps1 in poorly differentiated carcinoma was higher than that in well differentiated adenocarcinoma of colorectal carcinomas (χ 2=7.950, P =0.009). The Kaplan-Meier survival analysis indicated that patients with BRAF V600E had a worse survival rate than BRAF WT patients. Conclusions BRAF V600E may play an important role in specific pathological kinds of colorectal carcinomas, which is expected to be an independent prognostic factor. The expression of p-Erk is significantly correlated with Mps1 in colorectal carcinomas, suggesting that Mps1 may become a new potential target for targeted therapy.
ABSTRACT
Objective To investigate the feasibility and safety of "G"-shaped surgical approach in laparoscopic pancreaticoduodenectomy.Methods The clinical data of 33 patients who received " G"-shaped laparoscopic pancreaticoduodenectomy in the First Hospital of Shanxi Medical University from April 2015 to March 2018 were retrospectively analyzed.Results All patients underwent surgery successfully.The time required for surgery ranged from 340 to 498 min,the blood loss ranged from 150 to 800 ml,and the specimen resection time ranged from 135 to 270 min.There were 10 cases of biochemical leakage,3 cases of B grade pancreatic fistula and 1 case of bile leak.Postoperative pathology confirmed lower bile duct adenocarcinoma in 17 cases,duodenal papillary adenocarcinoma in 11 cases and poorly differentiated adenocarcinoma of the pancreatic head in 5 cases.Conclusions " G"-shaped approach as a simple,effective and safe way for LPD,is particularly helpful for inexperienced hands.
ABSTRACT
Objective To study the postoperative recovery of different surgical approaches for patients with cardia cancer.Methods From January 2011 to March 2016,174 cases of patients with cardia cancer were selected and divided into observation group (76 cases) and control group (98 cases).The patients of control group received via thoracic approach surgery,while those of observation group were given abdominal approach surgery.The operationtime,intraoperative blood loss,dissected lymph node numbers,postoperative hospital stay,hospitalization expense,positive rate of surgical margin,radical operation rate,perioperative mortality,pulmonary complications,operative incision infection rate and anastomotic fistula rate of two groups were compared.Results There were no significant differences of intraoperative blood loss and operation time,positive rate of surgical margin,radical operation rate,perioperative mortality,postoperative pneumothorax rate,hydropneumothorax rate,pyothorax rate,operative incision infection rate and anastomotic fistula rate between two groups (P ＞ 0.05).There were significant differences of the dissected lymph node numbers,postoperative hospital stay,hospitalization expense,postoperative hydrothorax rate,postoperative pneumonia rate,total pulmonary complications rate and total complications rate between two groups (P ＜ 0.05).Conclusions Abdominal approach for patients with cardia cancer,compared to via thoracic approach surgery,presents advantages in terms of dissected lymph nodes,postoperative hospital stay,hospitalization expense,postoperative pneumonia rate,hydrothrax rate,total pulmonary complications rate and total postoperative complications rate.
ABSTRACT
Objective To investigate the safety and feasibility of laparoscopic pancreaticoduodenectomy (LPD). Methods Clinical data of 9 patients who underwent LPD operation from September 2014 to February 2017 in the first hospital of Shanxi Medical University were analyzed retrospectively. Results 9 patients attempted LPD, while one required conversation to open procedure. Two cases underwent hand assisted laparoscopic surgery .The average operative time was (553 ± 86.1) minutes, the average amount of bleeding was (333.3 ± 304.1) ml, and the average hospitalization time after operation was (25.3 ± 8.9) d. Postoperative bowel sound recovery time was (3.5 ± 1) d. Postoperative complications included pancreatic leakage in 4 cases (A grade pancreatic leakage in 1 cases, B grade in 3 case), lymph leakage in 1 case, abdominal hemorrhage in 1 case , gastric emptying in 2 cases , and bile leakage in 1 case. All patients with postoperative complications were cured by non operative treatment. Postoperative pathological examination showed that 5 cases had duodenal papillary adenocarcinoma, 1 case had pancreatic ductal carcinoma, 2 cases had common bile duct disruption differentiation of carcinoma, and 1 case had pancreatic head retention cyst. Patients were followed up 3 to 24 months after operation. 1 case of pancreatic duct died 17 months after operation. One case of middle bile duct carcinoma 12 months after surgery had liver and retroperitoneal lymph node metastasis. The remaining 7 cases had no complications. Conclusions laparoscopic pancreaticoduodenectomy is minimally invasive, safe and feasible.
ABSTRACT
Objective To explore the surgical techniques in laparoscopic distal pancreatectomy for benign and low malignant tumors in the body or tail of the pancreas.Methods The clinical data of 21 cases of benign and low-malignant tumors in the body or tail of the pancreas undergoing LDP from Jan 2015 to Mar 2017 in the First Hospital of Shanxi Medical University were analyzed retrospectively.Results One patient was converted to open surgery(4.76％),13 patients underwent laparoscopic spleen-preserving distal pancreatectomy (Kimura procedure).The other 7 patients underwent LDP with splenectomy.The average size of the tumor was (6.0 ±3.1)cm;the operation time was 190 to 421 mins with mean time of (288.4 ± 56.9)min;the intraoperative blood loss was 30 to 800 ml with the mean volume of(235.7 ± 202.6)ml;Postoperative hospital stay was 6 to 17 days with the mean time of (8.9 ± 3.1) days.Six patients suffered from type A pancreatic fistula,and were cured by conservative treatment.Conclusions Laparoscopic spleen-preserving pancreatectomy for benign or low-grade malignant body and tail pancreatic tumors is feasible and safe.
ABSTRACT
OBJECTIVE: To retrospectively evaluate the short-term outcomes and safety of computed tomography (CT)-guided percutaneous microwave ablation (MWA) of solitary adrenal metastasis from lung cancer. MATERIALS AND METHODS: From May 2010 to April 2014, 31 patients with unilateral adrenal metastasis from lung cancer who were treated with CT-guided percutaneous MWA were enrolled. This study was conducted with approval from local Institutional Review Board. Clinical outcomes and complications of MWA were assessed. RESULTS: Their tumors ranged from 1.5 to 5.4 cm in diameter. After a median follow-up period of 11.1 months, primary efficacy rate was 90.3% (28/31). Local tumor progression was detected in 7 (22.6%) of 31 cases. Their median overall survival time was 12 months. The 1-year overall survival rate was 44.3%. Median local tumor progression-free survival time was 9 months. Local tumor progression-free survival rate was 77.4%. Of 36 MWA sessions, two (5.6%) had major complications (hypertensive crisis). CONCLUSION: CT-guided percutaneous MWA may be fairly safe and effective for treating solitary adrenal metastasis from lung cancer.
Subject(s)
Humans , Disease-Free Survival , Ethics Committees, Research , Follow-Up Studies , Lung Neoplasms , Lung , Microwaves , Neoplasm Metastasis , Retrospective Studies , Survival RateABSTRACT
Objective To summarize the clinical experiences of liver transplantation.Methods Of the nine patients, four operation was standard orthotopic liver transplantation,the latter five were the piggyback liver transplantation.The immunosuppressive protocols included methylprednisolone FK506 and mycophenolatemofeti. Meanwhile intravenous antihepatitis B immunoglobulin and Lamivudine were used to prevent hepatitis B recurrence.Results All patients were cured.Conclusion Liver transplantation can be employed for liver disease both cirrhosis and carcinoma as a conventional surgery.It is an effective way for the treatment of no metastatic liver carcinoma.The immunosuppressive protocols included methylprednisolone FK506 and mycophenolatemofeti,it can prevent immune rejection.
ABSTRACT
@#Objective To explore the effect of early rehabilitation on function recovery in stroke patients.Methods 70 patients were divided into two groups, rehabilitation group (38 cases) and control group (32 cases). Rehabilitation group was given clinical treatment and early rehabilitatio therapy, while control group was given clinical treatment and unguided self-training, and the evaluation was done in pre-treatment and eight weeks after the treatment respectively. Motor function of limbs was assessed in Brunnstrom grade and Fugl-Meyer Assessment (FMA), Neurological Function would be assessed with the scale of Clinical Neurological Function Defects (CNFD), and Activities of Daily Living was assessed in Modified Barthel Index(MBI). Results All scores in the rehabilitation group were superior to that in the control group (P< 0.05). Conclusion Early rehabilitation training on stroke patients may obviously improve motor function, promote neurological function and increasing the activities of daily living.
ABSTRACT
@#Objective To explore the effect of early rehabilitation on function recovery in stroke patients.Methods 70 patients were divided into two groups, rehabilitation group (38 cases) and control group (32 cases). Rehabilitation group was given clinical treatment and early rehabilitatio therapy, while control group was given clinical treatment and unguided self-training, and the evaluation was done in pre-treatment and eight weeks after the treatment respectively. Motor function of limbs was assessed in Brunnstrom grade and Fugl-Meyer Assessment (FMA), Neurological Function would be assessed with the scale of Clinical Neurological Function Defects (CNFD), and Activities of Daily Living was assessed in Modified Barthel Index(MBI). Results All scores in the rehabilitation group were superior to that in the control group (P< 0.05). Conclusion Early rehabilitation training on stroke patients may obviously improve motor function, promote neurological function and increasing the activities of daily living.
ABSTRACT
Objective To observe the change on living blood cells of peripheral bloodstream in patients with TIA.Methods To observe the behavior of living blood cells in the peripheral bloodstream of 18 patients with TIA using high magnification microscopy system, and compared with 20 healthy individuals.Results Erythrocyte aggregation rate, leukocyte activation rate, thrombocyte activation rate, and the extent of those changes were higher in the TIA group than in the control group. This difference was statistically significant ( P