Objective To state operative details of lip-shaped hepatectomy (LSH) and evaluate its advantage in treatment of primary liver cancer (PLC).Methods LSH is one of the irregular hepatectomies. The key lies in the following five operative kinks: ①adequately mobilizing perihepatic ligaments; ②designing lip-shaped hepatic incision; ③laying sutures on both sides of the hepatic incision for traction; ④wedge-shapedly resecting the tumor and the surrounding liver; ⑤closely sewing up the hepatic cutting surface.Results Two hundreds and thirty three patients with PLC were treated by LSH between Oct. 1991 and Dec. 1997 in Zhongshan hospital, Shanghai medical university. Among them 8 cases underwent initial hepatectomy and resection for recurrence of the tumor. The operative mortality rate was 1.2%, 2 died of hepatic failure and 1 renal failure. In addition to bile leakage in 3 cases and hydropsy at the operative area in one case, no severe postoperative complications were found, such as intraperitoneal bleeding, subphrenic abscess and so on. The 1-,3-,5-year survival rates were 89.8%, 64.3% and 55.9% respectively, in 233 patients with 241 LSHs. 25 patients survived more than 5 years. The result indicated that the most advantage of LSH was to increase operative safety on the basis of guarantee of radical resection of PLC, especially to decrease some complications from hepatic cutting surface.Conclusion LSH is a relatively simple, safe, reasonable and recommendable hepatectomic modality.
Objective To give an individualized treatment to a young woman with primary dysmenorrhea. Methods According to the basic principle and methods of evidence-base medicine, we searched The Cochrane Library (Issue 1, 2009), MEDLINE (PubMed, January 1950 to May 2009), ACP Journal Club (OVID, January 1991 to May 2007) for systematic reviews and randomized controlled trials (RCTs) to acquire the best clinical evidence on the treatment of primary dysmenorrhea. Results A total of 11 systematic reviews and 1 RCT were identified. A reasonable treatment plan was made through combining the patient’s will with her family members’. Conclusion The treatment effect on primary dysmenorrhea of the young woman is improved by an individualized treatment plan based on an evidence-based method.
ObjectiveTo systematically review the impact of different electronic health technologies on weight loss outcomes in overweight and simple obesity populations. MethodsThe Cochrane Library, Embase, PubMed and WOS databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to May 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.4 and Stata 18 software. ResultsA total of 9 RCTs involving 2 416 patients with overweight or simple obesity were included. The meta-analysis results showed that body weight (MD=−0.81, 95%CI −1.1 to −0.52, P<0.001), BMI (MD=−0.63, 95%CI −0.89 to −0.37, P<0.001), waist circumference (MD=−1.06, 95%CI −1.70 to −0.42, P<0.001) and energy intake (SMD=−0.44, 95%CI −0.75 to −0.13, P=0.005) in the e-health technology group were significantly improved compared with the control group. But there was no statistically significant difference in physical activity between two groups. ConclusionThe available evidence suggests that e-health technology is an effective tool for weight loss. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
We have devised a highly sensitive, specific, and quantitative assay for multidrug resistance (mdr1) mRNA expression based on the reverse transcription-polymerase chain reaction (RT-PCR). mdr1 mRNA levels were detected in 30 human primary hepatocellular carcinoma (PHC) tissue and adjacent liver tissue. Five of the patients had received chemotherapy before hepatectomy. The results show that the level of expression of mdr1 gene is higher in tumor tissue than in adjacent liver tissue. mdr1 gene is overexpressed in PHC after chemotherapy. Furthermore, mdr1 gene expression in the treated tumor adjacent liver tissue is higher than that in untreated tumor adjacent liver tissue. Our results indicated that overexpression of mdr1 gene may be responsible for the intrinsic and acquired drug resistance of PHC.
Objective To study the association and the effect of the expression of p16 and p53 protein on the occurence and development of gallbladder carcinoma. Methods The expression of p16 and p53 protein were detected in 40 cases of gallbladder carcinoma with immunohistochemical method. Results The expressions of p16 and p53 protein were closely correlated to the tumor pathological grade, lymph mode metastasis and prognosis. p16 protein was correlated to the Nevin classifications. Conclusion The results indicate that the low expression rate of p16 protein occurred in the advanced stage of gallbladder carcinoma. The expression of p16 and p53 protein are helpful in judging the malignant degree and prognosis of primary gallbladder cancer.
Objective To summarize the role of the relationship between liver cancer and cellular immunological function, and the role of immune therapy in clinical application. Methods To analyze the relationship between liver cancer and cellular immunological function, and the present research situation of immune therapy for liver cancer in clinical application retrospectively via review the related domestic and foreign literatures. Results The cellular immune dysfunction existed in all liver cancer patients. The state of body’s cellular immunological function is closely related with the arising and development of liver cancer, and the lowness of cellular immunological function is an important factor of hepatocellular carcinoma hard to cure or recurrence and metastasis. Immune therapy plays an important role in the treatment of liver cancer by adjusting the body’s cellular immunological function. Conclusions Liver cancer is closely related with the body’s cellular immunological function. Immune therapy is expected to offer a new way for the treatment of liver cancer, which can also be used as an important auxiliary treatment way.
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.
Objective To understand the current situation of medical service and management in Luxi township health center (LxC) in Yongxin county of Jiangxi province, so as to provide baseline data about drug allocation, logistic key techniques research and products development for township health centers. Methods By means of questionnaire and focus interview, the LxC was investigated from the following aspects: general information, human resources, medicine list, basic device configuration, medical service and management, as well as service efficiency. Results a) Yongxin county including 13 village committees covers an area of 86 km2, with the population of 22 300 in 2009, and it pertains to a backward area with the annual per capita income of RMB 4 100 yuan; b) Among the total 28 staffs in LxC, 78.6% were health workers; the general practitioner (GP)/nurse ratio was about 1?0.58; the proportion of GP, nurses, medical technicians, other staffs was 54.55%, 31.82%, 9.09% and 4.54%, respectively; the proportion of bachelor degree, junior college graduation and secondary technical school graduation was 9.1%, 13.6%, and 77.3%, respectively; and the ratio of elementary, middle, and high professional title of health workers was 15?5?1; c) There were 625 species of drugs in LxC in 2009, and the hospital beds approved by government were 0.69 per thousand agricultural persons, which, however, were 1.15 in fact. The rate of 51 basic equipments shown in national regulation was actually 76.5%, and the readiness and utilization rate of existing 40 equipments was 92.5%; and d) In 2009, the outpatients were 12 150 person-time, with the average cost of RMB 29.39 yuan; the hospital discharge was 1 589 person-time, with the average stay of 12 days and the average cost of RMB 490.05 yuan; the vaccine inoculations were 5 053 person-time; among the total income, the medical service income accounted for 73.2%, while the drug income accounted for 53.7%; the personnel expenditure was 31.0% of the total, and the balance of income and expenditure was RMB –263 500 yuan. Conclusion The hardware condition of LxC is not so good owing to the financial difficulties of Yongxin county and Jiangxi provincial government. In comparison with the whole country, although the professional title structure is ok, health workers are still not enough, with unreasonable specialty structure and low educational background. The rate of basic equipments and the approved hospital beds per thousand agricultural persons are low. There are 625 species of drugs, containing 218 species shown in 2009 national essential medicine list. And the other conditions are as follows: no information system, lack of public health service, short of financial input, high ratio of “running hospital by selling drugs”, and low efficiency of medical service. So the top priority of LxC construction should be figuring out all of the above issues, and better serving the people.
ObjectiveTo investigate the expression of gasdermin (GSDM) gene family in primary liver cancer and its clinical significance. MethodsThe Gene Expression Profile Data Dynamic Analysis (GEPIA2) database was used to analyze the expression levels of GSDM gene family in primary liver cancer and normal tissues, and survival analysis was performed to explore its relationship with prognosis; GEPIA2 database was used to explore the relationship between GSDM gene family and TNM staging of patients with primary liver cancer. We used GeneMANIA database to predict genes that may interact with GSDM gene family, and used Metascape website for functional enrichment analysis. Finally, we used TIMER database to explore the relationship of expression of GSDM gene family and immune cell infiltration in the tumor microenvironment of primary liver cancer. ResultsCompared with normal liver tissues, GSDMA, GSDMC, GSDMD, and GSDME were highly expressed in primary liver cancer (P<0.050), and GSDMB and DFNB59 were low expressed (P<0.050); results of univariate Cox proportional hazard regression model showed that the differential expressions of GSDMD, GSDME, and DFNB59 were related to the overall survival of patients (P<0.050), and the results of the multivariate Cox proportional hazard regression model showed that GSDME could be used as an independent predictor of the prognosis of liver cancer patients (P<0.050). With the increase of TNM staging in patients with liver cancer, the expressions of GSDMA and GSDMC also gradually increased (P<0.050). Further enrichment analysis showed that the GSDM gene family was involved in pyrolysis and various immune-related biological processes. ConclusionThe GSDM gene is differentially expressed in primary liver cancer, participates in immune-related biological processes, and its expression is related to clinicopathological staging and patients’ prognosis.
Objective To evaluate the efficacy of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treating primary hepatocellular carcinoma (HCC). Methods From March 2004 to March 2006, 137 patients with primary HCC underwent TACE alone (n=87) and TACE+RFA (n=50), respectively, after the interventional treatment, all patients periodically received CT reexaminations and alpha fetoprotein (AFP) measurement. The therapeutic efficacy, AFP level and survival rate between two groups were compared with each other. Results In TACE group the effective rate (CR+PR) was 34.5%, AFP decreasing amplitude was 54.2%, and 2 years survival rate was 43.7%. While in TACE+RFA group, the effective rate (CR+PR) was 70.0%, AFP decreasing amplitude was 78.0%, and 2 years survival rate was 62.0%, there were significant differences between two groups (P＜0.05). Conclusion Combined application of TACE and RFA is significantly superior to TACE alone in treatment of primary HCC.