Pre-and postoperative perfusion of thermochemotherapy was used in 25 cases of advanced malignant tumors of digestive tract.There were on significant changes in hepatic and renal functions after perfusions.The erythrocyte,leukocyte and platelet counts reduced in the second and third week after the beginningof perfusion,but rose up in the 4th week.A 2-year follow-up revealed that 23 patients were still alive without recurrence or metastases except 2cases died in the 6th and the 9th month after treatment.We claim that intraperitoneal thermochemotherapy is a simple and safe method. A prospective study is still necessaryin deciding the dose and course.
To evaluate effect of recombinant human growth hormone (rhGH) on immunologic function in patients with gastrointestinal malignant tumor (GIMT). Before and 3 weeks after surgical treatment and administration of rhGH, the amount of T lymphocyte subset (T-LS) and soluble interleukin 2 receptor (sIL-2R) level were measured in 12 patients with GIMT, which were compared with 20 cases of normal control and 18 cases of GIMT treated by surgery alone. Result: ①In all GIMT patients, the serum CD＋3, CD＋4 level and the ratio of CD＋4/CD＋8 were lower than normal control and the sIL2R level was much higher; ②After operation, the serum CD＋3, CD＋4 level and the ratio of CD＋4/CD＋8 of all patients increased, the serum sIL2R level decreased; ③In patients recieved rhGH, the serum CD＋3, CD＋4 level and the ratio of CD＋4/CD＋8 were much more increased and the serum sIL-2R level much more decreased than those of surgery alone group. Conclusion: rhGH can enhance the immunologic function of patients with GIMT.
A complex mechanism of reduced number of bile duct innervating ganglion cells, smooth muscle distribution, foregut duplications, and abnormal pancreaticobiliary duct junction, which occurs during embryonic development and after birth in a genetic context, can lead to pathological congenital biliary dilatation. As a precancerous lesion of the biliary system, irrational treatment of congenital biliary dilatation will further increase the risk of malignancy in patients. By understanding the causes, pathological features, and limitations of early detection techniques of malignant tumor secondary to congenital biliary dilatation is helpful to clarify the key points in the management of congenital biliary dilatation, reduce the incidence of postoperative adverse treatment events and avoid the medical risk of secondary malignancy.
Objective To explore the association of macrophages with carcinogenesis and development of gastric cancer. Method The related literatures at home and abroad were consulted and reviewed. Results The microenvironment of gastric cancer could induce the polarization of macrophages，and then the activated macrophages，especially the tumor associated macrophages，could in turn motivate the growth，invasion，and metastasis of tumor cells by secreting a series of active substances. Conclusions Macrophages，especially the tumor associated macrophages play an importantrole in the carcinogenesis and development of gastric cancer. Investigating the macrophages and their interaction with gastric cancer may lead to a profound understanding of carcinogenesis of gastric cancer as well as opening up a new prospectfor treatment.
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) may provide more information in diagnosis of malignant tumor compared to conventional magnetic resonance imaging (MRI). Nowadays, in order to utilize the information expediently and efficiently, many researchers are aiming at the development of computer-aided diagnosis (CAD) of malignant tumor based on DCE-MRI. In this review, we survey the research in this field and summarize the literature in four parts, i.e. ① image preprocessing——noise reduction and image registration; ② region of interests (ROI) segmentation; ③ feature extraction——exploring the image characteristics by analyzing the ROI quantitatively; ④ tumor lesion recognition and classification——distinguishing and classifying tumor lesions by learning the features of ROI. We summarize the application of CAD techniques of DCE-MRI for cancer diagnosis and, finally, give some discussion on how to improve the efficiency of CAD in the future research.
ObjectiveTo investigate the procedure and effectiveness of total femoral replacement for treating femur malignant tumor.MethodsThe clinical data of 9 patients with femoral malignant tumors who underwent total femoral replacement between July 2013 and March 2017 were retrospectively analyzed. There were 5 males and 4 females, aged 16-75 years with an average of 44.8 years. The disease duration ranged from 2 to 6 months with an average of 3.5 months. There were 5 cases of osteosarcoma (3 cases were staged as Enneking ⅡB, 2 cases were staged as Enneking Ⅲ), 1 case of malignant fibrosarcoma (staged as Enneking ⅡB), 1 case of chondrosarcoma (staged as Enneking ⅠB), 2 cases of femoral muti-metastasis of lung cancer with pathological fracture. The visual analogue scale (VAS) score and the quality of life (QOL) score of the tumor patients were evaluated before operation and at 3 months after operation. The Musculoskeletal Tumor Society (MSTS) score and Harris hip score (HHS) were evaluated at last follow-up.ResultsNine patients were followed up 11-58 months, with an average of 21 months. No complication such as wound infection, joint dislocation, and nerve injury occurred. One patient developed popliteal vein thrombosis, and 2 patients with osteosarcoma died of tumor progression. The VAS score and QOL score at 3 months after operation were 3.2±1.2 and 40.6±5.4 respectively, which were significantly improved when compared with preoperative ones (5.9±0.8 and 22.3±4.2 respectively) (t=11.314, P=0.000; t=–7.794, P=0.000). At last follow-up, the MSTS score was 15-29 with an average of 21.1, and the HHS score was 44-90 with an average of 66.5.ConclusionTotal femoral replacement is an effective limb salvage procedure for the treatment of femoral malignant tumors, which can effectively restore the weight-bearing and walking function, relieve pain, and improve the quality of life.
ObjectiveIn light of the comprehensively implemented reform of medical insurance payments, this study analyzed the impact of the payment intervention and COVID-19 pandemic on hospitalization expenses for identical diseases between traditional Chinese medicine (TCM) and Western medicine hospitals, to provide evidence to promote high-quality coordinated development of hospitals and insurance while reducing patient load. MethodsFrom January 2014 to December 2020, we gathered data including 9 900 individual medical records of woman-related malignant tumors (WMT) from all 23 public hospitals in a district of Shanghai. We developed an interrupted time-series analysis model based on the above two interventions, to compare the inpatient average per-time expenses between different hospitals and different groups. ResultsThe average per-time expenses of WMT in Western hospitals changed from rising to declining after the policy intervention, and increased again during the pandemic. In TCM hospitals, the expenses continued to increase and fluctuated after the pandemic. ConclusionThe policy intervention has achieved a good effect on controlling the cost of Western hospitals, rather than the significant increase in TCM hospitals. Meanwhile, the COVID-19 pandemic has had a significant impact on hospitalization expenses. It’s urgent to develop a payment model that fits the development and characteristics of TCM, to control the unreasonable growth of expenses. Moreover, the financial compensation methods and supervision mechanism of public hospitals should be improved to effectively resist the threat of public health emergencies for the development of hospitals and the legitimate rights of patients.
ObjectiveTo investigate the experience in the treatment of splnic malignant tumors with laparoscopy. MethodsThe clinical data of 51 patients with splnic malignant tumor who underwent splenectomy between January 2009 and July 2015 were retrospectively reviewed. Patients were divided into two groups based on the surgical method: Open splenectomy (OS group, n=18) and laparoscopic splenectomy (LS group, n=33). The preoperative, intraoperative and postoperative data of the patients were collected and analysed, the differences of each index during perioperative period (general information), intraoperative data (operative time, estimated blood loss, the size of spleen, intraoperaive transfusion) and postoprative situation (hospital stays, the first oral intake, postoperative pancreatic fistula, rehaemorrhagia, abdominal infection or pulmonary infection and the like) were compared. ResultsLS group compared with OS group, the operative time of LS group was significantly shorter than that of OS group [(103.64±16.92) min vs. (144.44±31.10) min, P=0.000〕, the amount of bleeding of LS group [M (Q25, Q75): 60 (50, 100)〕was significantly less than the OS group [M (Q25, Q75): 150 (115, 210)〕, P=0.000. The hospitalization time of LS group was significantly shorter than the OS group [(13.61±9.91) d vs. (9.03±3.09) d, P=0.017〕, and the LS group has a lower indication of the postoprative complications of fever and pulmonary infection (P=0.010 and P=0.003). Conciusions Laparoscopic splenectomy is feasible in the treatment of splenic malignant tumors, the employment of laparoscopy can shorten the operative time, has the advantages of less bleeding, the shorten hospital stays, lower indication of postoprative complications, and being worthy of further popularization and application.
This article reviews the development and progress in the field of limb salvage treatment, surgical techniques, and function reconstruction of pelvic malignant tumors in China in the past 30 years. Based on the surgical classification of pelvic tumor resection in different parts, the development of surgical techniques and bone defect repair and reconstruction methods were described in detail. In recent years, in view of the worldwide problem of biological reconstruction after pelvic tumor resection, Chinese researchers have systematically proposed the repair and reconstruction methods and prosthesis design for bone defects after resection of different parts for the first time in the world. In addition, a systematic surgical classification (Beijing classification) was first proposed for the difficult situation of pelvic tumors involving the sacrum, as well as the corresponding surgical plan and repair and reconstruction methods. Through unremitting efforts, the limb salvage rate of pelvic malignant tumors in China has reached more than 80%, which has preserved limbs and restored walking function for the majority of patients, greatly reduced surgical complications, and achieved internationally remarkable results.
ObjectiveTo investigate the effectiveness of different free flaps in the repair of large defects after resection of scalp malignant tumors. MethodBetween March 2012 and January 2015, 18 patients with large defect after resection of scalp malignant tumors were treated with different free flaps. There were 13 males and 5 females with an average age of 49 years (range, 18-72 years). There were 17 cases of squamous carcinoma and 1 case of dermato-fibril sarcoma protuberans. The defect size ranged from 15 cm×12 cm to 22 cm×17 cm after resection of tumors. Defects were repaired with anterolateral thigh flap in 5 cases, latissimus dorsi myocutaneous flap in 6 cases, thoracodorsal artery perforator flap in 3 cases, and latissimusdorsi muscle flap plus intermediate split thickness skin graft in 4 cases. The flap size was 17 cm×14 cm to 24 cm×19 cm. The donor sites of the skin flap were covered with skin graft, while the donor sites of the muscle flap were directly sutured. ResultsOf 14 skin flaps, the other 13 flaps survived except 1 flap necrosis; all muscle flaps survived. The patients were followed up 5-33 months (mean, 20 months). Three patients died because of intracranial metastasis at 5, 7, and 13 months after operation, respectively. Two patients had local recurrence and underwent secondary operation. The results of both appearance and function were satisfactory; secondary operation of thinning the flaps was performed in 4 cases of bulky flaps. The flaps had good wear resistance, without ulceration during follow-up. No obvious impairment was observed after harvesting latissimus dorsi myocutaneous flap. ConclusionsLarge scalp defects after malignant tumor resection can be effectively repaired by proper application of different free flaps.