ObjectiveTo study the epidemiologic characteristics of primary liver cancer (PLC). MethodsThe literatures about regional distribution and etiologic epidemiology of PLC were reviewed. Results PLC was mainly distributed on caostland in the south-east of China. The main cause of PLC was hepatitis B virus, aflatoxin and contamination of drinking water. Otherwise, PLS was also related with lack of some trace element, sex horemones, genealogy cause and so on.Conclusion The genesis of PLC was by multiple factors.
ObjectiveTo understand the latest progress of enrichment technology of circulating tumor cells (CTCs), and summarize the principle, advantages and disadvantages of various enrichment technologies and their applications in primary liver cancer (PLC). MethodThe literature relevant to the enrichment methods of CTCs in the PLC was reviewed and summarized. ResultsThe clinical significances of CTCs in the early diagnosis and staging, hierarchical diagnosis and treatment, and efficacy monitoring of patients with PLC had been recognized. There were many separation and enrichment technologies for CTC, which were mainly based on the differences of physical and biochemical characteristics, as well as the combination of enrichment methods with various principles. Each enrichment method had corresponding advantages and disadvantages, and few enrichment methods for CTC was applied to PLC. ConclusionsAlthough many problems need to be solved in enrichment method of CTCs at present, it is believed that the existing problems will be solved one by one with continuous improvement of technology. And CTC detection is expected to apply in clinical, so as to provide more efficient diagnosis and treatment methods for patients with PLC.
ObjectiveTo discuss the effects of diabetes mellitus (DM) on gastrointestinal hormone changes before and after hepatocellular carcinoma (HCC) operation. MethodsThe clinical data of 143 patients with HCC treated in this hospital from April 2007 to Febuary 2010 were analyzed, which 43 patients with DM (DM group) and 100 patients without DM (NDM group). Gastrin (GAS) and motilin (MTL) levels were measured on day 3 before operation and on day 1, 2, and 7 after operation. Results① The blood MTL levels decreased and GAS levels increased on day 1, 2, and 7 after operation as compared with the levels before operation (all Plt;0.05). ② The blood MTL level and GAS level before operation in the DM group was higher than that in the NDM group (Plt;0.05), MTL level decreased while GAS level increased more significantly on day 1, 2, and 7 after operation (Plt;0.05). ③ The first anus exhausting time of patients with NDM was much earlier than that with DM (Plt;0.05). ④ The first anus exhausting time with DM over 10 years and fasting plasma glucose over 10 mmo1/L was obviously extended (Plt;0.05). ConclusionDM affectes GAS and MTL level changes after HCC operation, recovery of gastrointestinal function would be delayed if patients with long course of DM and poor control of plasma glucose.
【Abstract】ObjectiveTo evaluate the value of MR imaging with a contrast-enhanced multi-phasic isotropic volumetric interpolated breath-hold examination (VIBE) in diagnosis of primary liver carcinoma. MethodsThirty-two consecutive patients with surgical-pathologically confirmed 42 foci of primary carcinoma of liver underwent comprehensive MR examination of the upper abdomen, routine two-dimensional (2D) T1WI and T2WI images were acquired before administration of Gd-DTPA for contrast enhancement. Then, contrast-enhanced multi-phasic VIBE was acquired followed by 2D T1WI images. The lesion appearances on hepatic arterial, portal venous and equilibrium phases of VIBE sequence were carefully observed along with delineation of hepatic arterial and portal venous structures. The lesion detection rates and lesion characterization ability were compared among various MR sequences. Results33(78.6%), 30(71.4%), 38(90.5%) and 42(100%) foci were displayed respectively on T2WI, non-enhanced T1WI, enhanced T1WI and enhanced 3D-VIBE images (P＜0.05). The hepatic arterial anatomy of 30 patients （93.8%） and the portal venous structure of 31 patients （96.9%） were clearly depicted on enhanced 3D-VIBE images. Using MIP and MPR reconstruction techniques, the feeding arteries of 14 foci and draining vein of 12 foci were clearly displayed.ConclusionHigh-quality 3D-VIBE images are not only better than 2D images in lesion detection and characterization for primary liver carcinoma, but also able to provide much more information about hepatic vascular anatomy.
目的探讨原发性腹膜后肿瘤行腹腔镜手术的安全性和疗效。 方法回顾性分析新疆医科大学第二附属医院普外科2008年4月至2013年4月期间行腹腔镜手术治疗的12例原发性腹膜后肿瘤患者的临床资料。 结果12例患者均行腹腔镜手术，其中1例中转开腹手术，其余行腹腔镜手术成功。平均手术时间190 min，术中平均出血300 mL，术后平均8.5 d出院。术后左下肢深静脉血栓形成1例，经保守治疗好转。围手术期无死亡患者。术后病理类型：良性肿瘤5例，其中神经鞘瘤1例，脂肪瘤1例，腹膜后囊肿2例，畸胎瘤1例；恶性肿瘤7例，其中纤维肉瘤2例，平滑肌肉瘤1例，恶性淋巴瘤2例，脂肪肉瘤2例。良性肿瘤平均直径8.1 cm，恶性肿瘤平均直径5.6 cm。随访7例恶性肿瘤患者，平均随访时间13个月，无复发及转移。 结论通过本组有限的病例资料初步得出，原发性腹膜后肿瘤的诊断主要依靠影像学检查。对于肿瘤直径≤10 cm的良性肿瘤或直径≤6 cm的恶性肿瘤且未侵犯主要血管者行腹腔镜手术治疗安全、可行。
Selectionofandinfluenceofseveralhepatovascularocclusionsonintraoperativeandpostoperativefactorswereinvestigatedinaseriesofhepatocelluarcarcinoma(HCC)patientsundergoingliverresection.Comparisonandstatisticalanalysisofseveralobservationindexeswerecarriedoutin163HCCpatientsexperiencingliverresectionwithdifferentvascularocclusions,versus65caseswithoutvascularocclusions,whichselectedfromourhospitalduringthesameperiodoverthepast5years.Results:Hepatovascularocclusionsproducedsomeliverparenchymainjury,althoughcontrollingintraoperativebleeding.Inthestudy,advantagesanddisadvantagesofthreehepatovascularocclusionsweredemonstrated,including:①simplicityandconvenienceinportaltriadclamping(PTC);butocclusiontimelimitedandresultinginsevereliverfunctioninjury;②widerliverfunctioninjuryandquickerrecoverydespitelongerocclusioninhemihepaticvascularocclusions(HVO);③limitedapplicationofnormothermichepaticvascularexclusion(NHVE)forwastetimeandcomplexity.WeconcludethatHVOisrecommendedasthefirstselectionformostliverresection,exceptportalandcentraltumors.
ObjectiveTo identify SCN9A gene mutation in a family with severe primary erythermalgia. MethodsClinical data of family were collected and the encoding exons and their flanking sequences of SCN9A gene were amplified and sequenced from genomic DNA samples. ResultsA heterozygous c.1185C→G was found in exon 9 of the proband, which resulted in N395K amino acid substitution. The mutation was not detected in the proband’s healthy mother or 50 unrelated healthy controls. ConclusionThe missense mutation of SCN9A gene is the underlying cause of the patient’s clinical phenotype.