Table of Content

28 December 2013, Volume 2 Issue 4 Previous Issue    Next Issue

Reviews

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Approaches to improvement of survival after surgery for hepatocellular carcinoma TANG Zhao-you 2013, 2 (4):  213-215.  Abstract ( 111 )   PDF (491KB) ( 377 )   Save Related Articles | Metrics

Expert forum

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Multidisciplinary comprehensive therapy  for primary liver cancer YE Shenglong 2013, 2 (4):  216-218.  Abstract ( 125 )   PDF (433KB) ( 363 )   Save References | Related Articles | Metrics

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Hepatocellular carcinoma (HCC) & liver transplantation (LT) ZHAO Ze-ming, Becker Thomas, FAN Yue-zu, Ringe Bastian, Klempnauer Jürgen 2013, 2 (4):  219-224.  Abstract ( 116 )   PDF (382KB) ( 321 )   Save Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver.Liver transplantation for hepatocellular carcinoma (HCC) in patients with cirrhosis is a radical treatment of the tumor and associated precancerous state,especially for HCC developing within an established background of chronic liver disease.Shortage of organ donors has resulted in overall increase of waiting list time with increased risk of dropout due to tumor progression.Neoadjuvant therapies,transarterial chemoembolization (TACE),radiofrequency ablation (RFA) and percutaneous ethanol injection (PEI) have emerged as bridging therapy to control tumor growth.Although expansion of selection criteria is necessary,it should be assessed in the setting of prospective well-designed studies.This research presents German experience including single-center (medical school of Hannover) of undergoing transplantation for HCC.Rational use of liver transplantation is more beneficial for humanbeing. References | Related Articles | Metrics

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Anti-HBV playing an important role in therapy of hepatocellular carcinoma WANG Jie 2013, 2 (4):  225-228.  Abstract ( 118 )   PDF (440KB) ( 443 )   Save Hepatitis B virus infection (HBV) is the major risk factor for hepatocarcinogenesis in China,and the HBV-DNA level also influences the postoperative complications ratio.A lot of research has confirmed that HBV-DNA replication could lead to the tumor recurrence after liver resection.Some clinical research aimed to find whether anti-HBV therapy can prevent the relapse of hepatocellular carcinoma (HCC).At present,majority study confirm that anti-HBV therapy can reduce tumor recurrence ratio of HCC,but some researches find it is useless for the relapse preventing,however,it can prolong the patients survival period.Above all,as for HBV related HCC,anti-HBV therapy plays an important role in the whole HCC therapy process including perioperative treatment and HCC relapse prevention.So,we must pay attention to anti-HBV therapy in HCC treatment. References | Related Articles | Metrics

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The value of sorafenib in surgical treatment of hepatocellular carcinoma WANG Wen-tao, ZHANG Peng, YAN Lü-nan 2013, 2 (4):  229-231.  Abstract ( 118 )   PDF (364KB) ( 314 )   Save The HCC (hepatocellular carcinoma,HCC) has high incidence,treatment of intractable,and the prognosis is poor,lt needs combined therapy.The radical treatment including surgical resection,liver transplantation,TACE,radiofrequency,ablation,immunotherapy and so on.In recent years with sorafenib as a representative of the molecular targeted drugs shows significant curative effect in treating HCC.This review aims to collecting the latest related researches about sorafenib in HCC in recent years,and carries on the classified analysis,in order to have a comprehensive understanding to guide its clinical application. References | Related Articles | Metrics

Original articles

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Aortic valved stent designed without influence on coronary artery CAI Jian-zhi, ZHOU Yong-xin, SHAO Jie, MEI Yun-qing, WANG Yong-wu 2013, 2 (4):  232-239.  Abstract ( 121 )   PDF (5131KB) ( 261 )   Save Objective To evaluated feasibility and safety of a new type of aortic valved stent in transcatheter aortic valve implantation (TAVI) using retrograde approach by testing and animal implantation in vitro.Methods Firstly,a new type of aortic valve stent sutured with porcine pericardium valves was made.The fluid passing test,expanding and releasing tests,static and releasing tests in tube were peformed in vitro for all stents.Then,the stents were implanted in six pigs using retrograde approach.These pigs were euthanized 12 h after implantation for anatomic evaluation.Results In vitro the tests showed that closure of new type of aortic valved stent leaflets were effective,and stents could be released through catheter,then expanded completely and could fix fast in tube.Left and right coronary artery flow rates did not change significantly when the stents were released above valve leaflets (P=0.7426,P=0.1487) after implantation.In vivo experiments indicated that TAVI was successfully performed in six pigs using retrograde approach.However,one pig died 10h after implantation because stents were not expanded completely.The leaflets in stents opened well and no valvular regurgitation was observed in the rest five pigs.And no thrombosis was found.Conclusion The new type of aortic valved stent designed in this study was characterised with good stability and could avoid the impact caused by valve leaflets on the coronary artery. References | Related Articles | Metrics

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Double end-to-side neuroanastomosis for repairing bilateral proper digital nerve defects JIANG Qi-ting, WANG Yu, YANG Li-na, JIANG Zhi-wei 2013, 2 (4):  240-242.  Abstract ( 114 )   PDF (400KB) ( 280 )   Save Objective To provide the new method for repairing bilateral proper digital nerve defects.Methods From March 2010 to January 2013,17 patients with bilateral proper digital nerve defects were admitted to our center.During operation,the injured digital nerve was excised,then bilateral distal ends and proximal ends were sutured,respectively; consequently,the distal and proximal nerve bows were formed.A cutaneous antebrachii lateralis nerve was freed and obtained from the homolateral forearm,then divided equally to 2 parts which were used to bridge the 2 nerve bows.Results All the patients achieved primary healing of wound after operation,17 fingers recovered uneventfully.Postoperative follow-up interval ranged from 3.5 to 6.8 months,with an average of 4.7 months.The sensation of fingertip recovered ranged from S2 to S4 (mean S3 ) and the two point discrimination ranged from 5.2 to 8.5 mm (average,6.45 mm) in 17 cases.According to the total active movement (TAM) evaluation system introduced by the American Society for Surgery of the Hand in 1975,the results were excellent in 11 cases,good in 4 cases,and fair in 2 case,and the excellent and good rate was 88.2%.Conclusion The arched nerves of double end-to-side neuroanastomosis is valuable method for repairing bilateral proper digital nerve defects. References | Related Articles | Metrics

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Prospective cohort study of the proximal oblique osteotomy of first metatarsal stabilized with plate and screws LI Qian-ming,LI Shou-min, HUANG Wei, XU Wei, KONG Rong 2013, 2 (4):  243-247.  Abstract ( 130 )   PDF (1333KB) ( 279 )   Save Objective A prospective cohort study of the proximal oblique osteotomy of first metatarsal,stabilized with either lag screws or a locking plate,was undertaken to investigate the efficiency and complications.Methods From May 2008 to April 2010,involving patients were treated for hallux valgus with IMA greater than 16.All patients were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score before and after surgery.The cohort included 71 procedures in 63 patients,44 (69.84%) of which were xated with lag screws and 19 (30.16%) with locking plates.The overall mean patient age was (57.5±13.7) years.Results No statistically signicant differences were found between the xation groups relative to age,preoperative and postoperative AOFAS scores.Postoperatively,the mean AOFAS score for the lag screw group was 78.9±13.6 and that for the locking plate group was 73.3±19.0 (P＜0.05).In both groups,the AOFAS scores improved signicantly (P<.005) after surgery.Overall,7(11.11%) recurrent hallux valgus deformities were observed,6 (9.52%) in the lag screw group and 1 (1.59%) in the locking plate group.All of the 7 recurrences were older than 60 years.Conclusion In the treatment of hallux valgus with IMA greater than 16,there is no significant difference in clinical efficacy and complications with proximal oblique osteotomy of the first metatarsal stabilized by lag screws and locking plate.Further follow-up is needed to get the long-term results. References | Related Articles | Metrics

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Clinical study on sclerotherapy and anoplasty in the treatment of rectal prolapse GUO Song-Ming, LIU Wen-Huang, TONG Hong-Bin 2013, 2 (4):  248-250.  Abstract ( 184 )   PDF (420KB) ( 295 )   Save Objective To observe the effect of injection sclerotherapy+anoplasty in the treatment of rectal prolapse.Methods 42 cases of Ⅱ,Ⅲ degree of complete rectal prolapse were randomly divided into treatment group (n=22) and control group (n=20).Patients in treatment group were received Xiaozhiling injection and anoplasty,patients in control group were only treated by Xiaozhiling injection.Results After 12 months of follow-up recurrence rate in treatment group was significantly lower than the control group (P<0.05),while there was no significant difference in complication and cure rate.Conclusion Sclerosing injections+anoplasty are less pain and more effective therapy for Ⅱ,Ⅲ degree rectal prolapse References | Related Articles | Metrics

Summaries

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Treatment strategies based on evaluation of staging systems for hepatocellular carcinoma ZHAN Wan-guang, ZHANG Bi-xiang 2013, 2 (4):  251-254.  Abstract ( 111 )   PDF (380KB) ( 617 )   Save A accurate staging system for hepatocellular carcinoma(HCC) should address all of these issues to help predict survival outcomes and decide optimal treatment strategies.In this review article,currently available integrated staging systems including the Okuda classification,the American Jiont Committee on Cancer and International Union on Against Cancer TNM stage (TNM),the Cancer of the Liver Italian Program (CLIP),the French classification,the Barcelona Clinic Liver Cancer (BCLC),Japan Integrated Scoring (JIS),Chinese University Prognostic Index (CUPI) are presented,and their characteristics and applicability for current HCC patients are assessed.This will be important for us to use those classifications rationally when we treat HCC patients and analysis prognostic evaluation system,and also facilitate to compare with similar foreign data.We hope to establish a new staging systems for common use in China based on other currently classification systems. References | Related Articles | Metrics

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Multi-disciplinary treatment for recurrent hepatocellular carcinoma after hepatectomy:current status and prospect ZHANG Yao-jun, CHEN Min-shan 2013, 2 (4):  255-258.  Abstract ( 119 )   PDF (435KB) ( 376 )   Save Hepatectomy remains the main radical treatment for hepatocellular carcinoma (HCC), but the recurrences after surgery is frequent and most of them are intrahepatic recurrences. Effective treatment for recurrent tumors can prolong the long-term survival. There are many therapeutic methods, including re-hepatectomy, liver transplantation, local ablation, transcatheter arterial chemoembolization (TACE), molecular target therapy and systemic chemotherapy, available now for recurrent tumors. However multi-disciplinary treatment or combined treatments are always needed for these tumors. In present paper, the current status and prospect of multi-disciplinary treatment for recurrent HCC are reviewed. References | Related Articles | Metrics

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Advances in research on prediction for early postoperative metastasis and recurrence in patients with hepatocellular carcinoma LI Yun-tong, LUO Shun-feng, LIU Jing-feng 2013, 2 (4):  259-261.  Abstract ( 123 )   PDF (330KB) ( 361 )   Save Recurrence and metastasis of the tumor is an important prognostic factor in patients with cancer. Early detection of postoperative recurrence and metastasis in patients with hepaocellular carcinoma (HCC) has an important significance for improvement of prognosis of HCC patients. This article reviews advances in research on prediction for early postoperative recurrence and metastasis of HCCs including recurrence time and prognosis after hepatectomy for HCC, molecular prediction for early recurrence and metastasis of HCC and its mathematical model. References | Related Articles | Metrics

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Cellular immunotherapy of hepatocellar carcinoma YANG Fan, ZHANG Qi, CHEN Gui-hua 2013, 2 (4):  262-266.  Abstract ( 124 )   PDF (512KB) ( 375 )   Save At present,surgery-based comprehensive therapy plays a dominant role in the treatment of hepatocellular carcinma (HCC).However,the majority of patients had no opportunity to undergo surgical treatment when diagnosis was confirmed.Furthermore,there is a high risk of tumor recurrence for patients with HCC even after surgical resection.The overall curative effect of HCC is far from satisfaction.Cancer biotherapy has now truly matured into the fourth modality of cancer treatmnet and proved to be useful in conjunction with surgery,chemotherapy and radiotherapy.The purpose of this article is to review the current status and progress of cellular immunotherapy for HCC References | Related Articles | Metrics

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Research progress in risk factors of complications after coronary artery bypass grafting XU Feng, MEI Yun-qing 2013, 2 (4):  267-271.  Abstract ( 118 )   PDF (679KB) ( 271 )   Save With the speeding up of China's aging society and the improvement of the living standard,the incidence of coronary atherosclerotic heart disease increased year by year.At present,coronary artery bypass grafting is one of the most effective means of treatment of coronary heart disease.As a kind of operation method,postoperative complications of CABG is an important factor influencing the prognosis.According to the relevant research,postoperative complications of CABG are the result of various factors affecting.To make clear the relationship among the various relevant factors is beneficial to choose the correct treatment measures.It can improve the operation prognosis. References | Related Articles | Metrics

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A review of progress of glaucoma drainage devices forthe treatment of refractory adult glaucoma LIU Si-wei, RONG Ao 2013, 2 (4):  272-276.  Abstract ( 174 )   PDF (587KB) ( 272 )   Save Glaucoma is a serious disease which causes blindness,especially the refractory glaucoma,the types of which could hardly be treated by medicine or filtering surgery.The emergence of glaucoma drainage devices(GDD) becomes a breakthrough in the therapy of glaucoma,but there are many problems need to be resolved as well.Since GDD have been invented,numbers of scholar contribute to that problem ,especially how to reduce complications,improve surgery success rate and so on.Recent years the new progress emerges endlessly,this article is an overview of the progress of glaucoma drainage devices used in treatment of adult glaucoma. References | Related Articles | Metrics

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Trauma treatment time windowin emergency treatment progress HUA Shang-bo, GU Mao-lin, HUANG Yong-gang, HU Tian-ping, GUO Lv 2013, 2 (4):  277-281.  Abstract ( 160 )   PDF (645KB) ( 314 )   Save The article aims to eualuate and introduce the importance of trauma emergency time,fluid resuscitation life support and pre hospital treatment in emergency and rescue;the trauma score system and regulations;the concept of the golden hour;prospect of emergency medical cause of in China. References | Related Articles | Metrics

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Application progress of 11-βHSD in the human placental barrier effect of glucocorticoid WEI Lai, DUAN Tao 2013, 2 (4):  282-284.  Abstract ( 241 )   PDF (384KB) ( 349 )   Save 11β-hydroxysteroid dehydrogenase(11β-HSD) is the GC metabolic enzymes secreted by the human placenta.It works on glucoeorticoids(GC) which has a great regulating effect between placenta and fetal membranes.Meanwhile,11β-HSD is keeping the fetus away from large amout of GC that may result in fetal physical deterioration or diabetes.As known,11β-HSD has two subtypes,11β-HSD1 and 11β-HSD2.11β-HSD1 is a kind of oxidordeuctase with low affinity and it mainly performs its reductase activity.11β-HSD1 mainly activates the inert cortisone,E to become viable cortisol,F.So regeneration and efficiency of GC is activated; 11β-HSD2 is a kind of dependency dehydrogenase with high affinity and it mainly performs a single oxidase.The main function is transforming catalytic cortisol from its active state into the inactive state,which blocks the matrix concentration above the level of the fetal 5 ~ 10 times of GC into the placenta,then forms the GC barrier protection of the normal growth and development of fetus. References | Related Articles | Metrics

Medical case analysis

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Lessons from gastroparesis treated improperly CHEN Quan 2013, 2 (4):  285-286.  Abstract ( 147 )   PDF (299KB) ( 271 )   Save Based on the analysis on a medical malpractice case caused by gastroparesis treated improperly,to clarify that surgeon should not only focus on operation,but also broaden the prevention of the risks of complications after operation. References | Related Articles | Metrics

Specific nursing

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Analysis of rapid rehabilitation method for patients with tibiofibula fractures ZENG Xue qun 2013, 2 (4):  287-285.  Abstract ( 129 )   PDF (405KB) ( 289 )   Save Objective Clinical outcome of rapid recovery approach applied to the patients with tibiofibula fractures is analtsed in this paper. Methods 100 patients with tibial and fibular fracture were randomly divided into treatment group and control group,50 cases in each.Treatment group were given rapid recovery nursing approach,the control group was given routine nursing care. Results In the treatment group,the postoperative complication rate was 6%,significantly lower than that of the control group,26%; 24 h and 72 h after admission,in the treatment group pain scores were remarkedly reduced,and was significantly lower than that in the control group (P<0.05).Conclusion Tibiofibula fracture before and after the rapid recovery nursing approach can effectively relieve pain,reduce complications,worthy of promotion. References | Related Articles | Metrics