Analysis of clinical outcomes of simplified treatment of lumbar spondylolisthesis with adjacent segment degeneration by MAST Quadrant / 中国骨伤

<p><b>OBJECTIVE</b>To explore the method and clinical effect of MAST Quadrant for lumbar spondylolisthesis with adjacent segment degeneration.</p><p><b>METHODS</b>From April 2014 to January 2016, 36 cases of lumbar spondylolisthesis with adjacent segment degeneration were treated by MAST Quadrant(target nerve decompression and transforaminal lumbar interbody fusion or articulationes zygapophysiales fusion by unilateral fixation with MAST Quadrant). Twenty-three cases were degenerative lumbar spondylolisthesis and 13 cases were isthmic lumbar spondylolisthesis. According to Meyerding grade of spondylolisthesis, 16 cases were grade I, 17 cases were grade II, and 3 cases were grade III. Visual analogue score (VAS), Oswesty Disability Index (ODI) and JOA score were used to evaluate the clinical outcome.</p><p><b>RESULTS</b>The amount of intraoperative bleeding was 230 to 480 ml with an average of 340 ml and the amount of postoperative blood loss was 15 to 80 ml with an average of 43 ml. Operative time was 176 to 240 min with an average of 193 min; X-ray exposure time was 2 to 6 s with an average of 3.6 s. Two cases were complicated with dural tear without nerve injury during operation. Thirty cases were followed up from 12 to 17 months with an average of 15.2 months. VAS scores for preoperative, 5 days, 3 months after surgery were 7.6±1.7, 1.9±0.4, 0.8±0.4 respectively, and there was significant difference before and after operation(<0.05). The ODI scores for preoperative and 3 months after surgery were 35.9±1.2 and 3.7±0.7 respectively, and there was significant difference before and after operation(<0.05). JOA scores for preoperative, 5 days, 1 months, 3 months after surgery were 13.2±0.4, 24.4±0.4, 27.4±0.1, 27.9±0.5 respectively, and there was significant difference before and after operation(<0.05).</p><p><b>CONCLUSIONS</b>MAST Quadrant can be applied to treat lumbar spondylolisthesis with adjacent segment degeneration, and the minimally invasive sugical technique is a safe and effective method, with the advantage of simple operation, fast recovery.</p>

Study on the early liver metastasis forecast of colorectal neoplasms / 中华外科杂志

<p><b>OBJECTIVE</b>To obtain some effective objective markers used to predict the early liver metastasis of colorectal tumor, the relationship of liver metastasis of colorectal tumor with associate detection three markers such as CK20mRNA, CD44v6 and VEGF was studied.</p><p><b>METHODS</b>The expression of CK20mRNA in patrol venous blood from 30 colorectal cancer patients was detected by fluorescent quantitative RT-PCR, and the results of CD44v6 and VEGF in colorectal cancer tissue were determined by means of immunohistochemistry, and then compared with those in control groups.</p><p><b>RESULTS</b>The rate of positive expression of CK20mRNA in colorectal cancer patients' patrol venous blood was obviously superior to the level of benign pathological changes controls (P < 0.01), and significantly higher than that of normal controls (P < 0.01). The rate of positive expression of CD44v6 and VEGF in colorectal tumor tissue was distinctly superior to the level of benign pathological controls, and remarkable higher than that of normal controls (P < 0.01). The positive expression of liver metastasis was also clearly higher than that of no liver metastasis (P < 0.05). The rate of positive expression of CK20mRNA in patrol venous blood was evidently correlated to the expression of CD44v6 and VEGF in tumor tissue (r(1) = 0.933, r(2) = 0.906, P < 0.05). The results of associate detection of CK20mRNA, CD44v6 and VEGF were closely related to the incidence of liver metastasis.</p><p><b>CONCLUSIONS</b>If combined detecting these markers of CK20mRNA, CD44v6 and VEGF to forecast liver metastasis of colorectal tumor, the sensitivity and specialty of prediction will be improved, there were highly clinical values in predicting in early diagnosis liver metastasis of colorectal tumor.</p>

The significance of pepsinogen with its subgroup and CA72-4 associate detect applied to early diagnostic and prognosis judgment on gastric cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To find out the connection of serum pepsinogen and it's subgroups (PGI, PGII) with CA72-4 to early diagnosis and postoperative recurrence on gastric cancer.</p><p><b>METHODS</b>RIA was applied to detect the results of serum PGI, PGII and CA72-4 on gastric cancer and other stomach diseases, then the clinic value of associating detection on gastric cancer diagnosis and prognosis judgment were assessed.</p><p><b>RESULTS</b>The serum PG levels of GC patients were significantly lower comparing to those of healthy controls (P < 0.01), apparent changes had taken place on earlier period GC (P < 0.05), and aggressive GC were even lower (P < 0.01). On the earlier period of GC diagnosis, CA72-4 levels were not apparently different to healthy controls (P > 0.05), and aggressive GC were significantly higher (P < 0.01). Compared preoperative with postoperative, the serum PGI and PGII and CA72-4 levels were significantly different (P < 0.01). In the patients underwent total gastrectomy, both of pepsinogen levels were lower than those of subtotal or large partial gastrectomy (P < 0.05). The serum PGI, PGII and CA72-4 levels of patients with recurrence of GC after total gastrectomy were significantly higher than those without. Compared before recurrence patients with after ones, the serum PGI and PGII levels of partial gastrectomy were no apparent difference (P > 0.05), however apparent changes had taken place on CA72-4 levels. The associate detection had even higher specificity (P < 0.01).</p><p><b>CONCLUSIONS</b>Apply to detect the serum PG levels on crowds, especially pGI, PGI/II levels decrease, which may be expected to become the index to earlier period GC screening. The associating detection to PG and CA72-4 levels may significantly improve sensitivity and specificity, which have chances to be applied to monitoring to postoperative gastrectomy.</p>

Effects of mFOLFOX7 neoadjuvant chemotherapy protocol on advanced gastric cancer / 中国现代普通外科进展

Objective: To observe the effect of mFOLFOX7 protocolon advanced gastric cancer. Methods: Forty-eight patients with advanced gastric cancer were randomly divided into two groups: conventional treatment group (24 cases, surgery-adjuvant chemotherapy)and synthesized treatment group (24 cases, mFOLFOX7 neoadjuvant chemotherapy-surgery-adjuvant). The effect and toxic reaction of mFOLFOX7 on the patients with advanced gastric cancer were observed, and the R0 resection rate, complications incidence, survival rate were compared between two groups. Results: In synthesized treatment group, total effective rate was 58.3% . Fourteen patients (58.3%)achieved R0resection in synthesized group were compared with 7 patients (29.2%)achieved R0 resection in conventional group (P0.05).Conclusion: mFOLFOX7 neoadjuvant chemotherapy protocol is low toxic reaction. It can improve R0 resection rate of advanced gastric cancer, complications correlated with surgery are not increased. But it can’t improve the survivalrate.