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??Study on related risk factors and prognosis for lymph node metastasis in patients with early gastric cancer YIN Jie, CAI Jun, ZHANG Jun, et al.Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050,China
Corresponding author: Zhang Zhong-tao, E-mail??zhangzht@medmail.com.cn
Abstract Objective The purpose of study was to analyze the risk factors for lymph node metastasis (LNM) in patients with early gastric cancer (EGC). Methods This study retrospectively reviewed 112 patients who underwent surgery. The clinical characteristics and pathological features were analyzed by using chi-square and binary logistic regression. Results Logistic regression analysis revealed that age, depth of infiltration, neoplasms histologic type and lymphatic embolus were independent risk factors for LNM. Further study has showed that no LNM was observed for patients with mucous cancer, who were over 60 years old and with a highly differentiated tumor without lymphatic embolus. However, LNM would occured if the neoplasms infiltrated within the submucous layer. Conclusion LNM of EGC is related with age, depth of infiltration, histological type of tumor and lymphatic embolus. Therefore, we believed that endoscopic En-bloc dissection might be considered as the surgical treatment for patients with over 60 years old and highly differentiated tumor which invaded mucous layer without lymphatic embolus. With respect to the patients with high risk factors, we recommend that appropriate lymphadenectomy was conducted according to the specific situation.     

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??The treatments of long-term postoperative complications of congenital choledochal cyst LIU Yuan*, LIU Bing-yang, ZHOU Yong, et al. *Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
Corresponding author??LIU Jin-gang??E-mail??liujg@sj-hospital.org
Abstract Objective To investigate the experience of treatments of long-term postoperative complications in congenital choledochal cyst (CCC). Methods Retrospective analysis of the clinical data of postoperative patients with long-term complications in 48 cases of CCC patients from January 1999 to December 2008 in Shengjing hospital of China Medical University. Results The long-term postoperative complications of CCC mainly included 31 cases of biliary lithiasis, 25 cases of repeated cholangitis, 16 cases of stoma stenosis, 3 cases of cyst cancerization. The reoperative methods included complete cyst excision and Roux-en-Y hepatojejunostomy in 28 cases, excision of hepatojejunostomy and reanastomosis in 7 cases, biliary duct exploration and calculus removed in 3 cases, biliary duct exploration and hepatic segment excision in 3 cases, cyst excision and pancreatoduodenectomy in 1 case. 6 cases of stoma stenosis and/or intrahepatic calculus were managed by percutaneous transhepatic cholangioscopy (PTCS). Conclusions The long-term postoperative complications of CCC are usually correlated with inappropriate initial operation. In order to prevent the complications of reoperation, the aims for treatment should include cyst excision, calculous focus removing, obstruction disengage, biliopancreatic shunt, and biliary drainage unobstruction.     

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??Axillary lymph node dissection with ultracision harmonic scalpel in breast cancer LIU Qian, YE Jing-ming, LIU Yin-hua. Breast Disease Center, Department of General Surgery, Peking University First Hospital, Beijing 100034, China
Corresponding author: LIU Yin-hua, E-mail??liuyinhua@medmail.com.cn
Abstract Objective Evaluate the use of ultracision harmonic scalpel in axillary lymph node dissection in mastectomy of breast cancer. Methods During September 2009 to December 2010, thirty breast cancer patients received mastectomy and axillary dissection with ultracision harmonic scalpel, the drainage duration, total volume of drainage, and other clinical factors were observed and compared with the control group which received the procedure by monopolar electro diathermy. The two groups of patients were operated by the same surgeon. Results Axillary drainage duration in ultracision harmonic scalpel group is shorter than the control group(11.4 vs.15.7 day, P=0.029), while there is no differences between operation time, hemorrhage, number of axillary lymph node dissected and total volume of axillary drainage in the two groups. Conclusion Compared to monopolar electro diathermy, the use of ultracision harmonic scalpel in axillary lymph node dissection in mastectomy of breast cancer is safe and can shorten the drainage duration.     

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??The practice and development of translational medicine in the diagnosis and treatment of gastrointestinal malignancy ZHU Zheng-gang. Department of Surgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Institute of Digestive Surgery, Shanghai 200025, China
Abstract Translational medicine is aiming at transforming scientific discoveries arising from the laboratory or experimental research into clinical applications including prevention, diagnosis and treatment. Translational medicine emphasis that new treatment and research knowledge could actually reach the patients or populations for whom the novel therapeutic strategies developed through experimentation ( from bench to bedside ) could be efficiently optimized to promote health practices and improve guideline as well as health policy ( from bedside to population ). In recent years??some encouraging achievements of translational medicine have been applied in the clinical practice of gastrointestinal malignancies such as the search of sensitive tumor biomarker??the study of molecular classification and target biotherapy etc. It is without any doubt that the results of clinical practice for patients with gastrointestinal malignancy will be continually improved if the theory and application of translational medicine could be developed.     

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??Specialized treatment of transferred severe pancreatic trauma:A report of 8 patients BAI Xue-wei??CHEN Hua??LIU Jie??et al. Department of Pancreatic and Biliary Surgery??the First Affiliated Hospital of Harbin Medical University??Harbin 150001??China
Corresponding author??SUN Bei??E-mail??sunbei70@tom.com
Abstract Objective To analyze the clinical characteristics and transferal regulation of severe pancreatic trauma??and summarize the experience of specialized treatment. Methods The clinical data of 8 patients with severe pancreatic trauma transferred from other hospitals between June 2013 and June 2014 in the First Affiliated Hospital of Harbin Medical University were reviewed in terms of the situation of pancreatic trauma??process of treatment and causes of transferal to recapitulate the main and difficult points of specialized treatment as well as major complications during treatment and the managing strategies. Results All of 8 paitients were combined with associated injury. Among them??2 patients with 4th-degree trauma??5 patients with 3rd-degree trauma and 1 patient with 2nd-degree trauma. Six patients were transferred into the First Affiliated Hospital of Harbin Medical University because of uncontrolled peritoneal/retroperitoneal infection after operation. After transferal??3 patients were cured by minimally invasive approach such as PCD??stent drainage of pancreatic duct and endoscopic necrosectomy. Five patients underwent re-operations. The major complications contain traumatic pancreatitis??intestinal fistula??intra-abdominal hemorrhage and delayed gastric emptying. All of 8 patients were healed after specialized treatment??and the mean hospital stay was 87 days. Conclusion The pathogenesis of pancreatic trauma is concealed??and the treatment is quite difficult. Timely referral to the regional pancreatic center contributes to further treatment. Professional team of pancreatic surgery has advantages in estimating patients’conditions??selecting and performing individualized and minimally invasive surgical interventions??and improving the overall cure rate of severe pancreatic trauma.     

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??Centric relation is a vital factor in the prosthodontics of full denture?? occlusion reconstruction?? checkup and treatment of occlusion dysfunction?? dental prosthodontics?? orthodontic treatment?? temporomandibular joint disorder and so on. Traditional methods to construct the centric relation mainly include gothic arch tracing??swallowing and occluding method??retroflex licking method ??functional reflex method??Chin-point guidance method??bimanual manipulation method??recording of mandibular movement?? Myo-monitor?? and so on. All of them are quite flexible and difficult to repeat the same position??which is not suitable for the beginners. Patients' active cooperation is also necessary. This review summarized traditional methods to construct the centric relation?? and introduced a new tool named Leaf Gauge which can be used to record the accurate centric relation. It does not need sufficient clinical experience and is easy to grasp.     

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??Objective    To study the effect of different concentrations of ozone water on the expression of IL-6 in periodontal tissues of rat with periodontitis. Methods    A total of 70 male Wistar rats weighing??200 ± 20??g were chosen??randomly select five as normal control group??executed by cervical dislocation method????and the rest of the rats were made model of periodontitis. When the model was established??five periodontitis rats were randomly selected as no-treatment group??executed by cervical dislocation method??. The rest of periodontitis rats were randomly divided into ozone water treatment group and control treatment group for periodontal pocket rinsing. The general conditions and pathological changes of the periodontal tissues were observed. Immunohistochemical staining was conducted to determine the expression of IL-6 in the periodontal tissues. Results    The level of IL-6 in periodontal tissues of rats of no-treatment group was much higher than that in the normal control group??P < 0.05??. The level of IL-6 in the treatment groups was much lower than that in the no-treatment group??P < 0.05??. In each period of rinsing??at 15mg/L of ozone water treatment group??the expression of IL-6 in periodontal tissue was lower than that in other concentration groups ??5mg/L??10mg/L????P < 0.05????but there was no significant difference compared with the control treatment group. Conclusion    The ozone water can reduce the IL-6 level in periodontal tissues in rats and the effect is more obvious in concentration of 15mg/L??which has certain treatment effect on periodontitis.     

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??Abstract??Non-resolving inflammation may initiate cancerazation and is involved in cancer occurrence?? development?? metastasis?? drug resistance and various pathological processes. Previous Studies suggested that critical network nodes in regulation of carcinogenesis were closely associated with signaling pathways related to stimulation?? immunization?? stress and inflammation. Particularly??NF-κB pathway in non-resolving inflammation and cancer metastasis plays a key regulatory role in carcinogenesis. In carcinogenesis of oral mucosa?? upstream regulatory networks of miRNAs play a critical role. Using the non-resolving (chronic) inflammation malignant transformation models?? such as oral lichen planus and multiple-step carcinogenesis models?? it will establish malignant transformation spatiotemporal nodes and miRNA or mRNA expression patterns related to the processes of carcinogenesis?? promoting and development. It will also investigate the dynamic relationship between non-resolving inflammation and oral cancer through the comprehensive utilization of medical statistics?? biological informatics analysis and the integration analysis on epigenetics and genetics levels. No doubt?? to determine the basic regulatory network of malignant transformation nodes and key factors of carcinogenesis?? the novel cancer treatment model?? "anti-inflammatory"?? will provide rationale and effective interventions targeting in the future.     

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??Therapeutic effect comparison between endovascular and open surgery of celiac artery and its branches arteries aneurysms GUO Jian-ming, GU Yong-quan, YU Heng-xi, et al. Department of Vascular Surgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China
Corresponding author: GU Yong-quan, E-mail:guyq66@sina.com
Abstract Objective To analyze surgical treatment methods of celiac artery and its branches arteries aneurysms. Methods The clinical data of 20 patients performed surgery because of celiac artery and its branches arteries aneurysms from February 2002 to December 2012 in Xuanwu Hospital Capital Medical University were analyzed retrospectively. The celiac artery and its branches arteries aneurysms consist of 1 celiac trunk??11 splenic??1 right hepatic??2 left gastric??3 pancreaticoduodenal and 2 gastroduodenal aneurysms. Rupture occurred in 10 patients. Transcatheter arterial embolization was performed in 14 patients and other 6 patients were performed laparotomy. Results Four patients suffered from recurrent bleeding after first embolization. One patient received exploring surgery to stop bleeding. Another 3 patients were performed second embolization. Bleeding was controlled rapidly in 7 patients in danger of rupture associated with shock. Duodenum incomplete obstruction developed in 1 patient after pancreaticoduodenal artery embolization. Another 4 patients suffered from partial splenic infarct after splenic artery operation. Nineteen patients were followed up for 4 to 130 months. No aneurysms recurred. Conclusion Both endovascular and open surgery for celiac artery and its branches arteries aneurysms are safe and effective. Endovascular procedure can get shorter length of stay.