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??Diagnosis and treatment of nonfunctioning islet cell tumors SUN Cheng-Yi, JIANG Jian-Xin. Department of Hepatobiliary Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550001, China
Corresponding author: SUN Cheng-Yi, E-mail: chengyisun@medmail.com.cn
Abstract Nonfunctioning islet cell tumors, malignant with a high incidence, onset occult. It is difficult to early diagnosis which mainly based on imaging examination. Ultrasound, CT, MRI can accurately locate the lesions, and can distinguish benign and malignant lesions. When diagnosed, surgical treatment should be actively. According to tumor location, size and benign or malignant tumour, different surgical approach was chosen.     

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??Value of preoperative lymphoscintigraphy in sentinel lymph node biopsy of breast cancer SUN Xiao*, LIU Juan-juan, WANG Yong-sheng, et al. *Breast Cancer Center, Shandong Cancer Hospital, Jinan 250117, China
Correcponding author: WANG Yong-sheng, E-mail: wangysh2008@yahoo.com.cn
Abstract Objectives Background Although preoperative lymphoscintigraphy for sentinel lymph nodes biopsy (SLNB) in breast cancer patients is undergone commonly, its clinical significance remains controversial. Methods Firstly, a database containing 716 consecutive breast cancer patients who received preoperative lymphoscintigraphy before SLNB was retrospectively analyzed. Secondly, 565 consecutive breast cancer patients were prospectively randomized into groups with or without preoperative lymphoscintigraphy before SLNB. Results In the retrospective study, sentinel lymph nodes (SLNs) were well imaged by lymphoscintigraphy in 86.6% patients, and negative lymphoscintigraphy results were associated with axillary node metastases. Failure of identification of SLNs by isotope alone was associated with whether axillary hot spot was imaged by lymphoscintigram (P<0.001). There were no significant differences in the false negative rate (P=0.731) of SLNB by isotope alone, in the identification rate (P=0.174) and the false negative rate (P=0.947) of SLNB by combination of dye and isotope between patients who had axillary hot spot in lymphoscintigram and those who had not. In the prospective study, 290 patients were randomized into the group with preoperative lymphoscintigraphy (82.1% patients were well imaged by lymphoscintigraphy) and 275 patients without. There were no significant differences between two groups in the identification rate (P=0.757) and the false negative rate (P=1.00) of SLNB by isotope alone, also in the identification rate (P=1.00) and the false negative rate (P=1.00) of SLNB by combination of dye and isotope. Conclusion Preoperative lymphoscintigraphy could not improve the identification rate and reduce the false negative rate of SLNB in breast cancer patients, and it is not a prerequisite for SLNB.     

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??Surgical strategies for upper gastrointestinal bleeding CHEN Lin, CHEN Shao-quan. Department of General Surgery, General Hospital of Chinese PLA, Beijing 100853, China
Corresponding author: CHEN Lin, E-mail??chenlinbj@vip.sina.com
Abstract Upper gastrointestinal bleeding (UGIB) represents a common and challenging emergency. The causes of UGIB have been classified into variceal bleeding (esophageal and gastric varices) and non-variceal bleeding (peptic ulcer, erosive gastroduodenitis, reflux esophagitis, tumor, etc). Because considerable advances have been made in both endoscopic and pharmacologic therapy, UGIB is normally treated conservatively at present. However, some patients required surgical treatment when it was impossible to achieve hemostasis by pharmacotherapy and endoscopy or if rebleeding occurred where the conservative treatment had failed. According to the causes and sources of UGIB, a surgeon should be informed about the possible need for surgery and make a decision to operate. Surgery is a treatment method of important position in multidisciplinary treatment for UGIB.