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21 August 2006, Volume 26 Issue 09 Previous Issue    Next Issue
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Diagnosis of small hepatocellular carcinoma in patients with posthepatitic cirrhosis with contrast-enhanced ultrasound. Duan Hongyan,Luo Baoming，Zhang Tong. 2006, 26(09): 1-664.  Abstract ( )   PDF (506KB) ( )   Objective:To evaluate the clinical merit of contrastenhanced ultrasound (CEUS) in the diagnosis of Small hepatocellular carcinoma (HCC) in patients with posthepatitic cirrhosis. Methods:Small hepatocellular carcinoma were examined and observed by CEUS between March 2004 and October 2005,using ultrasound contrast agentSonovue.Contrast enhanced CT and or MRI were performed in all cases. Results:The accuracy of diagnosing Small HCC by CEUS were 88.2% (60/68),according to the hypoenhancement in arterial phase,isoenhancement or hyoenhancement in portal phase,hypoenhancement in delayed phase.The accuracy and false positive rate of diagnosing Small HCC by CEUS were 97.1% (66/68) and 2.9%(2/68) according to the hypoenhancement in delayed phase. Conclusion:CEUS might increase the diagnosis of small HCC.

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Comparison of the different operative approach on the cavernous liver hemangioma. Zhang Jun,Qiao Qilu,Liu Yucun,et al. 2006, 26(09): 1-648.  Abstract ( )   PDF (281KB) ( )   Objective:To determine the better choice of operative techniques for resection of the cavernous hepatic hemangioma. Methods:From January 1995 to December 2005,62 patients underwent the surgical removal of the cavernous hepatic hemangioma.Enucleation was used for 36 cases,and hepatectomy for 26 patients.The relative factors between the two different techniques were compared. Results:Enucleation was associated with fewer intraoperative bleeding,transfusion requirement and postoperative complication.And it was the only independent factor found by multiple analysis influencing postoperative complication. Conclusion:Enucleation was the first choice for resection of the cavernous hepatic hemangioma.

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Scarfliking esophagojejunal anastomosis after total gastrectomy for advanced gastric carcinoma:a report of 121 cases. Shao Yongsheng,Peng Kaiqin,Zhang Yingtian,et al. 2006, 26(09): 1-643.  Abstract ( )   PDF (406KB) ( )   Objective:To present our experience with scarfliking esophagojejunal anastomosis to decrease the anastomotic leak. Methods:An analysis of the clinical outcome of 121 consecutive patients from January 1997 to December 2005,who underwent scarfliking esophagojejunal anastomosis after total gastrectomy for advanced gastric carcinoma. Results:Two of these patients died,the operative mortality rate was 1.65%.None of the survivals developed anastomotic leak and reflux esophagitis.Anastomotic strictures occurred in four patients (3.36％) treated before December 2000,and transgastroscopy dilatation was effective treatment.There's no anastomotic stricture developed after surgical technology improved. Conclusion:The new scarfliking esophagojejunal anastomosis has more advantages to reduce anastomotic complications after total gastrectomy for advanced gastric carcinoma,is safe and effective.

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Laparoscopic Nissen Fundoplication versus Laparoscopic Toupet Fundoplication for gastroesophageal reflux disease. Yang Huiqi，Qin Mingfang. 2006, 26(09): 1-657.  Abstract ( )   PDF (452KB) ( )   Objective:Compare the operative results and incidence of dysphagia between the Nissen fundoplication and Toupet fundoplication. Methods:Retrospectively eightythreecases of Laparoscopic Fundoplication were reviewed from June eightythree cases of Laparoscopic Fundoplication we 2001 to December 2005.Laparoscopic Nissen Fundoplication was performed in 65,Laparoscopic Toupet Fundoplication was performed in 18. Results:There was no conversion and death.The symptoms disappeared completely and was no recurrence in Nissen fundoplication while two cases of recurrence in Toupet fundoplication during the period of follow up.In Nissen fundoplication,the healing rate of esophagitis was 84.6% while 66.7% in the other.The incidence of dysphagia and abdominal distension was higher in Nissen fundoplication than in Toupet fundoplication (27.7% versus 16.7%) 4 days after operation.The difference decreased significantly 1 year after operation. Conclusion:Toupet fundoplication has a lower incidence of dysphagia than Nissen fundoplication early after operation.But the difference decreased significantly 1 year after operation.Nissen fundoplication is the first choice in treatment of severe gastroesophageal reflux disease.Toupet fundoplication can be performed in patients with preoperative esophageal hypomotility.

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Diagnosis and Treatment of 15 Patients with Anal Squamous Carcinoma. Su Wei,Huang Meixiong. 2006, 26(09): 1-670.  Abstract ( )   PDF (298KB) ( )   Objective:To investigate the factors related to diagnosis and treatment,15 patients with anal squamous carcinoma were analyzed. Methods:15 patients with anal squamous carcinoma were in our hospital during 1984-1998.Only 5 patients were diagnosed as cancer of anal canal in first time.In these 15 patients,11 received radiotherapy and chemotherapy,8 received Miles operation. Results:15 patients with anal squamous carcinoma were proven by pathologic examination,6 in NCCN (2003) stage Ⅰ, 4 in stage Ⅱ, 2 in stage ⅢA, 3 in stage ⅢB.Interstitial fibrosis of tumor tissue was shown by immunohistochemistry,(+++) was in 4 patients，(++) in 7 ones，(+) in 4 ones.The patients were followed in 10 year,average of survival time was (47±27.6) months. Conclusion:Anus digital examination was emphasized for finding and diagnosis of the anal carcinoma.Radiotherapy and combined therapy including radiotherapy,chemotherapy and surgery are important treatments of the anal carcinoma.Staging,metastasis of inguinal lymph nodes,treatment,and interstitial fibrosis of tumor tissue affect the prognosis of anal squamous carcinoma patients.

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Diagnosis and treatment of huge cystic and solid tumor of pancreas. Chen Runhao,Fu Deliang,Yang Feng,et al. 2006, 26(09): 1-657.  Abstract ( )   PDF (474KB) ( )   Objective:To study the methods of preoperative diagnosis and surgical treatment of huge cystic and solid tumor of pancreas. Methods:Result of the diagnosis and treatment of patients with cystic and solid tumor of pancreas (tumor size larger than 8cm in diameter) in Huashan Hospital were analyzed retrospectively. Results:From 1999 to date,Huashan hospital has an accumulated total of 15 patients with cystic and solid tumor of pancreas of size larger than 8cm in diameter,of which 3 patients were male,12 were female and age of the patients ranged from 15 years to 73 years.The pre-operative diagnosis was based on several investigations such as ultrasonography,CT scan,DSA and serum tumor markers.All the 15 patients were treated by radical resection.The pathology diagnosis showed 9 solidpsuedopapillary tumor of pancreas（SPT）,4 cystadenoma,2 cystadenocarcinoma. Conclusion:Radical surgical resection was most effective method for the treatment of huge cystic and solid tumor of pancreas.Spiral CT scan,DSA combined with detecting of tumor markers might be helpful for the differential diagnosis and judgment of tumor respectability.

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Diagnosis and treatment of pancreatic sinistral portal hypertension:review of literature and a report of 67 cases. Sun Bei，Kong Rui，Jiang Hongchi,et al. 2006, 26(09): 1-648.  Abstract ( )   PDF (449KB) ( )   Objective：To investigate the diagnosis and treatment of pancreatic sinistral portal hypertension （PSPH）. Methods：15 cases of PSPH treated in our hospital from Jan 2000 to Dec 2004 and 52 cases reported in the last 10 years in domestic literature were analyzed retrospectively. Results：PSPH was diagnosed mainly by ultrasonography (US),computerized tomography(CT),magnetic resonance angiography (MRA),endoscopy and celiac arteriography.All the patients underwent surgery, including splenectomy in 8 cases（8/67）;splenectomy + management of primary pancreatic disease in 23 cases（23/67）;splenectomy +pericardial devascularization in 13 cases（13/67）;splenectomy+pericardial devascularization+management of primary pancreatic disease in 21 cases（21/67）and splenic artery embolization+varices veins phlebosclerosis in 2 cases（2/67）.The postoperative followup rate was 89.6%（60/67）and followup duration ranged from 12 months to 53 months,average 33.1 months.Haematemesis in one case of splenectomy without pericardial devascularization occurred at the 13th month postoperatively.No rehaemorrhagia occurred in the other 59 cases. Conclusion：Therapeutic options of PSPH should abide by “individualized principle”.The simple splenectomy refer to the patients without upper gastrointestinal hemorrhage;For patients with upper gastrointestinal hemorrhage,appropriate therapeutic methods should be selected according to the specific circumstance,including splenectomy+pericardial devascularization,splenic artery embolization,varices phlebosclerosis，et al.Meanwhile,the management of primary pancreatic disease should also be emphasized.

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Study of early stage breast cancer clinical characteristic and diagnostic methods. Wang Pilin,Zhi Yinghui,Zhang Tie,et al. 2006, 26(09): 1-648.  Abstract ( )   PDF (293KB) ( )   Objective:In order to improve the diagnostic rate,this article analyzed the clinical characteristic and diagnostic methods of early stage breast cancer. Methods:A total of 30 early stage breast cancer patients data were surveyed retrospectively. Results:Of the 30 patients,18 （60％）appeared to be thickening locally on mammary glands,another 11（37%）can be felt nodules when palpation.Besides,symptoms of 22（73.3％）patients with mammary glands hyperplasia became heavier not long before visiting.12（40％）presented calcification merely on mammography,mass reflection was detected with mammography in 5 （17％）patients. Ultrasound preoperative examination showed irregularity boundary low levelecho tubercles in 24（80％）patients,and blood flow signal was detected within or around the tubercles in 79％ patients.11 patients was diagnosed through hollow needle aspiration biopsy,and another 19 patients reached the final diagnosis with operational biopsy after ultrasound allocation. Conclusion:Symptoms increasing of mammary glands hyperplasia or developing local thickening of mammary glands in high risk aged women always suggest the possibility of early stage breast cancer.The diagnostic value of Color Doppler Ultrasound outweighs mammography for early stage breast cancer.In order to raise the diagnostic rate of early stage breast cancer,it is necessary to perform needle aspiration or operational biopsy by ultrasound or mammography allocation promptly for patients with mammary glands nodules、local thickening or pyknic image on mammography.

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In vitro Studies of cytotoxicity of interleukin2 gene transfection conjugating specific cytotoxic T lymphocyte to hepatocarcinoma cell. Ye Xiaoming,Zuo Jidon,Zu Yifan. 2006, 26(09): 1-690.  Abstract ( )   PDF (283KB) ( )   Objective:To investigate cytotoxicity of conjugation of interleukin-2 (IL-2) gene transfection and specific cytotoxic T lymphocyte to human hepatacarcinoma cell (HepG2),to seek a new way of immunegene therapy for hepatocarinama. Method:IL-2 gene were transfected to HepG2 cell mediated by polycationic lipid.Efficiency of transfection was observed by detecting changes of culture medium’s IL-2 concentration.Cytotoxicity of conjugation of IL-2 transfection and specific CTL was determined by MTT assay. Result:After transfected IL-2 mediated by polycationic lipid, HepG2 can continuously secrete IL-2 for 30 days;and at 2nd~3rd day,its peak of secretion presence;and at 7th day, its secretion descent obviously.The best transfection ratio is 5∶1 in vitro.IL-2 transfection conjugating specific cytotoxic T lymphocyte can occurrence obvious synergistic effect in cytotoxictiy to HepG2. Conclusion:After transfected IL-2 gene mediated by lipid,HepG2 can continuously secrete IL-2 for 30 days,and this can maintenance activity of specific CTL effectually.The conjugation of IL-2 transfection and specific CTL can show the obvious synergistic killing effect to hepatocarcinoma cell.