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Objective@#To evaluate the clinical characteristics and imaging features of splenic and bone marrow metastasis from breast cancer.@*Methods@#Clinical data of one case of splenic and bone marrow metastasis from breast cancer collected from Renmin Hospital of Wuhan University on February 23, 2019 were analyzed and literatures were reviewed.@*Results@#Patient admitted to hospital with pain in the left upper abdomen, accompanied with anemia and thrombocytopenia. CT suggested spleen occupying lesions. ECT implied bone metastasis. Bone marrow biopsy indicated breast cancer metastasis. Breast biopsy showed breast cancer. After using letrozole, the lesion of left breast and thevolume of spleen was reduced. The range of the spleen was lower than before. This review showed that the lesion of left breast and the low-density lesion in spleen was reduced.Bone marrow biopsy showed extremely low myeloproliferation.@*Conclusions@#Splenic and bone marrow metastasis from breast cancer are rare. Imaging examination and bone marrow biopsy are important diagnostic methods for spleen metastases. Detailed case data, targeted examinations, and comprehensive analysis are important for reducing misdiagnosis.
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Objective To evaluate the clinical characteristics and imaging features of splenic and bone marrow metastasis from breast cancer.Methods Clinical data of one case of splenic and bone marrow metastasis from breast cancer collected from Renmin Hospital of Wuhan University on February 23,2019 were analyzed and literatures were reviewed.Results Patient admitted to hospital with pain in the left upper abdomen,accompanied with anemia and thrombocytopenia.CT suggested spleen occupying lesions.ECT implied bone metastasis.Bone marrow biopsy indicated breast cancer metastasis.Breast biopsy showed breast cancer.After using letrozole,the lesion of left breast and thevolume of spleen was reduced.The range of the spleen was lower than before.This review showed that the lesion of left breast and the low-density lesion in spleen was reduced.Bone marrow biopsy showed extremely low myeloproliferation.Conclusions Splenic and bone marrow metastasis from breast cancer are rare.Imaging examination and bone marrow biopsy are important diagnostic methods for spleen metastases.Detailed case data,targeted examinations,and comprehensive analysis are important for reducing misdiagnosis.
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Chemokines and their receptors play an important role in the occurance and development of hepatocellular carcinoma(HCC).The effects of chemokines and their receptors in HCC are different,chemokines and their receptors associated with HCC are mostly expressed in promoting tumor cell proliferation,angiogenesis and invasion,but some chemokines and their receptors play an anti-tumor role.This reviews focus on the role of chemokines and their receptors in HCC.
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Objective To evaluate the efficacy of triamcinolone acetonide injection by ganglion impar block in treating sacral nerve dysfunction syndrome.Methods Fifty-four cases of sacral nerve disorder syndrome,mainly presented with anal pendant expansion,were admitted between October 2014 to October 2016.The clinical efficacy assessed by visual analogue scale(VAS)was recorded and analyzed.Results For all patients,the symptoms were relieved in 15 minutes after ganglion impair block,and the VAS was significantly reduced after treatment.The excellent rate was 81.5％ and the total efficiency was 100.0％ in one week after surgery.Meanwhile,the excellent rate and the total efficiency were 90.7％ and 100.0％ in one month,94.4％ and 100.0％ in 3 months,83.3％ and 100.0 ％ in 6 months,respectively.Conclusions Triamcinolone acetonide injection by ganglion impar block is effective for sacral nerve dysfunction mainly presented with anal pendant expansion.
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Objective To investigate the preoperative biliary drainage on the effect of surgical treatment for hilar cholangiocarcinoma patients.Methods A total of 52 hilar cholangiocarcinoma patients who underwent resection operation in Renmin Hospital of Wuhan University from January 2005 to December 2015 were divided into preoperative biliary drainage group (24 cases) and non-preoperative biliary drainage group (28 cases).To compare the operation time,intraoperative blood loss,hospital stay,perioperative changes in liver function,and incidence of postoperative complications,tumor recurrence rate,1-,3-,and 5-year survival rate and some other indicators.The data was analyzed using SPSS 19.0 software.The patients of two groups were followed up by telephone,out-patient review and hospital examination.Patients were followed up for 8-60 monthes.Results The hospital stay for biliary drainage group was longer than that in non-preoperative biliary drainage group and the difference was statistically significant (P ＜ 0.05).The differences of operation time,intraoperative blood loss,postoperative tumor recurrence rate,postoperative complications (including bile leakage,blooding,fever,pleural effusion,abdominal infection,wound infection,pulmonary infection,liver failure and some others) and 1-,3-,and 5-year survival rate were not statistically significant (P ＞ 0.05).Alanine aminotransferase,aspartate aminotransferase,total bilirubin and direct bilirubin in preoperative biliary drainage group before biliary drainage were(98.0 ± 51.7) U/L,(94.2 ± 44.2) U/L,(177.5 ± 64.1) μmol/L and (160.2 ± 61.9) μmol/L,respectively,and after biliary drainage were (71.2 ± 13.8) μmol/L,(60.0 ± 12.1) μmol/L,(93.5 ± 20.7) μmol/L and (76.3 ± 18.1) μmol/L,respectively.The differences of the above parameters before and after biliary drainage were statistically significant (P ＜ 0.05).However,the changes of albumin before and after biliary drainage were not significant (P ＞ 0.05).The follow-up patients of biliary drainage group were 21 cases and the follow-up patients of non-preoperative biliary drainage group were 25 cases.The differences of 1-,3-,and 5-year survival rate between the two groups were not statistically significant (P ＞ 0.05).Conclusions Preoperative biliary drainage for hilar cholangiocarcinoma patients may improve the liver function to a certain extent.However,preoperative biliary drainage cannot improve the prognosis of the hilar cholangiocarcinoma patients.Therefore preoperative biliary drainage is not suggested for patients with good general conditions.
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Objective To investigate risk factors related to postoperative death of patients with rectosigmoid junction tumor perforation.Methods The clinical data of 76 cases with rectosigmoid junction tumor perforation confirmed by laparotomy from January 2000 to October 2015 were collected.Results Of the 76 cases,17 patients died postoperatively,the mortality rate was 22％,the single factor analysis showed that age(x2 =4.649,P =0.031),duration of abdominal pain(x2 =8.218,P =0.016),severe heart and lung diseases(x2 =11.996,P =0.007),circulatory and renal function(x2 =10.360,P =0.016),serum albumin(x2 =7.252,P =0.027),white blood cell count(x2 =7.633,P =0.022),Perforation diameter (x2 =9.770,P =0.008),Geroge grade of intraperitoneal contamination (x2 =10.086,P =0.006) were related to postoperative death (P ＜ 0.05).Multivariate analysis showed that complicating severe heart and lung diseases,preexisted circulatory and renal dysfunction,white blood cell count ＜ 4 × 109/L,size ＞ 3 cm,intraperitoneal contamination larger than one quadrant were independent risk factors for postoperative death.Conclusion Risk factors related to postoperative death of rectosigmoid junction tumor perforation were preoperative important organ dysfunction and intraperitoneal infection.
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Objective To investigate the curative effect between liver resection combined with microwave ablation during operation and simple liver resection in the treatment of primary liver cancer.Methods From January 2005 to December 2013,a total of 84 patients diagnosed as primary liver cancer in our hospital were collected and divided into combination group(42 cases) and simple group(42 cases) according to the surgical method.Combination group were treated by combining liver resection with microwave ablation during operation,simple group by simple liver resection.Results The intraoperative blood loss for combination group was (323.9 ± 93.1) ml and simple group was (524.5 ± 119.2) ml,P ＜ 0.05.postoperative tumor recurrence rate for combination group was 14.2％ and simple group was 33.3％,P =0.040.1-,3-,and 5-year survival rate for combination group was 96.5％,67％ and 51％,and simple group was 84％,49.5％ and 36.5％,P =0.036.The differences of the above parameters between the two groups were statistically significant.The operation time for combination group was (177.7 ± 30.7) min and simple group was (165.1 ± 29.5) min,P =0.058.The postoperative hospital stay for combination group was (15.5 ± 3.7) d and simple group was (14.0 ± 4.0) d,P =0.068.The changes of ALT,AST,ALB,TBIL on the first postoperative day and the incidence of postoperative complications (including bile leakage,fever,pleural effusion,blooding,abdominal infection and some others) between the two groups had no statistical significances (P ＞ 0.05).Conclusion The curative effects of liver resection combined with microwave ablation during operation are superior to pure liver resection in the treatment of primary liver cancer.
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Objective To systematically the efficacy of transcatheter arterial chemoembolization (TACE) conbined with percutaneous microwave coagulation therapy (PMCT) in treatment of advanced liver cancer.Methods A search was performed by retrieving the domestic and foreign literature database,including WanFang Data,VIP,CNKI,PubMed,Cochrane Library,CBM,EMBASE,Medline,between January 2005 and May 2015.These documents were about the analysis of the efficacy of TACE combined with PMCT in treatment of advanced liver cancer,including complete response(CR),partial response(PR),total effective rate,the levels of AFP declining,1,2,and 3 year survival rate and all the trials must be randomized controlled trials.Meta-analyses were conducted using the Cochrane Collaboration's RevMan 5.2 software.Results Fourteen documents were retrieved,including 989 patients,conbined treatment group 470 patients,simple treatment group 519 patients.The results of Mete-analysis shows that the total effective rate of TACE combined with PMCT is higher than TACE alone in treatment of advanced liver cancer.AFP declining ＞ 50％ of TACE combined with PMCT more obvious than TACE alone.1,2,and 3 year survival rate of TACE combincd with PMCT higher than TACE alone.These differences were statistically significant.Conclusion TACE combined with PMCT might be more effective than TACE alone in treatment of advanced liver cancer.
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Background and purpose: E-cadherin (EC) is a type of glycoprotein, which could maintain epithelial polarity and cell-cell junction. It is thought to be associated with the development and progression of hepatocellular carcinoma (HCC). The study aimed to detect expression of uniting detection sEC and AFP before and after operation in patients, and to monitor recurrence of postoperative. Methods:The levels of sEC and AFP in 105 HCC patients were tested by enzyme linked immunosorbent assay (ELISA) and radioimmunoassay (RIA) before and after operation as well as in 70 healthy controls. Theirs correlation with clinical and pathological factors was analyzed. We analyzed the level of plasma sEC and AFP of 47 patients who had been suffered from the hepatocellular carcinoma operation and relapse. Results: The levels of sEC and AFP in HCC patients before operation were significantly higher than in controls, which declined significantly one week after operation. The sEC level before operation showed significant correlation with TNM staging (P0.05). While AFP only correlation with TNM staging (P0.05). When the recurrence was confirmed, the level of sEC was much higher significantly than the level postoperation (P<0.01). Conclusion:The levels of sEC in HCC patients before operation are closely related with prognosis and recurrence of HCC. The unites detection of sEC+AFP may be a predictive factor for recurrence of postoperation.
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Objective To investigate the effects of 17-β estradiol on hepatocyte apoptosis and the expression of Bcl-2 and Bax in hepatic tissue after reduced-size ischemia reperfusion injury and its mechanism in liver protection.Methods A rat model of reduced-size hepatic ischemia-reperfusion injury was established in 75 male Sprague-Dawley rats.They were randomly allocated into three groups:Sham group,ischemia-reperfusion(IR)group,and 17-β estradiol(E2 + IR)group.Liver functions,liver histology and hepatocellular apoptosis rates were observed after reperfusion.Hepatocellular ap optosis was determined by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL)method and the expression of Bcl-2 and Bax were determined by Western blotting.Results The levels of ALT and AST were higher and peaked after 12 h of reperfusion in the IR group compared with the sham group.The histological changes in the liver of the IR group consisted of hepatocyte swelling,hepatic sinusoids narrowing,inflammatory cell infiltration and hepatocyte necrosis in some areas of the livers.The IR group also exhibited an increased rate of hepatocellular apoptosis at 12 h after reperfusion.The protein expression of Bcl-2 decreased while the expression of Bax increased.In the 17-β estradiol group,the levels of ALT and AST were lower,the pathological changes were milder and the rate of hepatocellular apoptosis was lower at 12 h in comparison to those of the IR group.The expression of Bcl-2 was higher and the expression of Bax was lower in the 17-β estradiol group in comparison to those of the IR group.Conclusions 17-β estradiol can relieve the hepatic ischemia reperfusion injury in rat livers.17-β estradiol may inhibit apoptosis in hepatic tissue by up regulating Bcl-2 and down-regulating Bax,thus producing a protective effect on hepatic ischemia-reperfusion injury.
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Objective To evaluate the preoperative diagnosis and treatment of internal abdominal hernia.Methods The clinical data from 38 patients with internal abdominal hernia,admitted to our hospital during the period from Jan.2001 to Dec.2011 were retrospectively analyzed.Results There were 50％ (19/38) patients of internal abdominal hernia caused by adhesion.Positive rate of CT detection was 65％ (13/20) and the correct percent of preoperative diagnosis was 73.7％ (28/38).Average time from admission to surgery was 18 h (3-78 h).There were 44.7％ (17/38) patients with intestinal necrosis and the average length of intestinal removal was 53 cm (15-170 cm).The rate of serious complication was 5.3％(2/38).Conclusions Atypical hernia was the main cause of internal abdominal hernia,and it is hard to diagnose early for the poorly positive rate of equipment inspection.Early diagnosis and treatment is possible when we correctly understood of the clinical features of internal abdominal hernia,then we can reduce the occurrence of serious complications.
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Objective To compare the differences between MELD and Child-Pugh grading in assessing of hepatic functional reserve in patients with cirrhosis,and analyse the correlation of two systems.Methods Retrospective analysis was made on 92 cases of hepatitis cirrhosis hospitalized with the MELD and Child-Pugh score by ROC curve,the difference and relation between two systems were compared.Results MELD and Child-Pugh system were significantly correlated(r=0.669,P < 0.000),3-month survival in patients with two systems ROC curve areas was significantly different(P < 0.05),while the MELD in patients survived more than 6 months was not significantly different compared with Child-Pugh(P>0.05).ConclusionMELD and Child-Pugh can accurately assess the prognosis of survival for patients with hepatic cirrhosis,and MELD is suitable for assessment of risk,heavy patients,not for those survived more than 6 months.
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A series of gene function devitalized increase gradually because of tumnr-suppressing gene endogenous deactivation while not classic mutation or absence. Unlike mutation devitalizalion, methylation devitalization is reversible.Gene silencing because of high methylation of promoter has many potential clinical uses.For example, it's in favor of early diagnosis, prognosis and therapy of tumors such as lung caneer, breast cancer,renal cancer, gastric cancer, bladder cancer and so on. RASSF1A belongs to the gene thatalways due to methylation deactivation not mutation deactivation. And this gene is similar to Ras receptor of mammalian. RASSF1A suppressed tumor growth in vivo and in vitro. This further supports it could be one tumor-suppressing gene. It plays an important role in cell cycle regulation, apoptosis, and micropipe stabilization. This review mainly summarizes information and advancement about RASSF1A tumor-suppressing gene in genetic structure, endogenous gene inactivation, and functional analysis.
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Objective To explore protective effects of curcumin on lung injury in the early hepatic ischemia/reperfsion (reperfusion for 1 and 3 hour) inrats. Methods Wistarratswererandom]y divided into the fo]]owinggroups: GroupA (shamoperation), group B (control group) and group C (cureumin applied). Contents of superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), myeloperoxidase (MPO) in lung tissues were determined to evaluate the protective effect of eurcumin on lung injury in the injury of isehemia/ reperfusion. Results Curcumin relieved edema of diaphragmatic wall and exudation of blood cell and white cell in pulmonary alveoli. Curcumin increased the contents of SOD, CAT and decreased contents of MDA, MPO in lung tissue. Conclusion By repressing the generation of oxygen free radical and infiltration of polymorphonuclear leukocyte in lung tissue, curcumin can relieve lung injury in the early hepatic ischemia/repeffusion.
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Objective To study the relationship between the microvessel damage and the death rate of tumor cells and determine role of microvessel damage in the tumoricidal effect of hyperthermia.Methods H22 hepatoma cells were inoculated in the right hind legs of KM mice with immunosuppression.Local hyperthermia was administered to these mice which were divided randomly into 10 groups (8 in each group),which included groups of 3,6,12,24,48,72 and 96 h after hyperthermia for 30 min and groups of hyperthermia for 15,30 and 45 min.The tumor tissues were analyzed by flow cytometry(FCM)and immunohistochemistry.The cultured H22 cells were also given hyperthermia for 15,30,45 min and analyzed by FCM.Results The apoptotic rate(0.115±0.008)was higher in the initiation phase of hyperthermia in vitro,then the necrotic rates rose gradually.The difference between in vivo and in vitro was significant in hyperthermia of the same time about death rate(P＜0.05).A strong positive linear correlation(r=0.844)was observed between the death rate of tumor cells and MVD.Conclusion Microvessel damage plays the cardinal role in tumoricidal effect of hyperthermia.
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Objective To study the significance of ?-catenin expression in human gastric carcinomas, colorectal carcinomas and human hepatic carcinomas.Methods S-P immunohistochemical method was used to detect ?-catenin expression in 80 cases of human carcinomas of alimentary system and corresponding tumor-adjacent normal tissues by ?-catenin polyclonal antibody. The results were analyzed using densitometrically semiquantitated .Results ?-catenin were normally expressed in all tumor-adjacent normal tissues of digestive system. ?-catenin expression was reduced or negative in human carcinomas of alimentary system (P
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Objective To investigate appropriate use of radiofrequency thermal ablation (RFA) in treatment of liver cancer.Methods Fouty-one patients with hepatic cancer were entered into two trials. The liver tumors were treated with percutaneous radiofrequency ablation (PRFA) or intraoperative radiofrequency ablation (IRFA). All patients were followed up postoperatively to assess complications, treatment response, and local recurrence of tumor.Results PRFA and IRFA were performed on 32 tumors in 18 patients and 43 tumors in 23 patients, respectively. Treatment-related complications occurred in 6 of the 18 patients treated with PRFA (33.3%). In contrast, there was only 1 complication after IRFA (4.3%, P
