���ٿ������Ӧ����θ���������Ի������߹���Ӱ��Meta����

??Influence of enhanced recovery after surgery for radical resection of gastric cancer on immune function??a Meta-analysis WANG Xiang-an, YU Li-ming, FAN Ji-chang, et al. Department of Gastrointestinal Surgery, the Second Affiliated Hospital, Nanchang University, Nanchang 330006, China
Corresponding author??YANG Gang, E-mail??ygrealtom@sohu.com
Abstract Objective To evaluate the influence of enhanced recovery after surgery (ERAS) for radical resection of gastric cancer on immune function. Methods The major domestic and foreign databases were searched to collect the literatures of randomized controlled trial (RCT) about the the comparison of ERAS and conventional perioperative care in radical resection of gastric cancer published by December, 2014 in both Chinese and English. After screening for inclusion, quality assessment and data extraction, Meta-analysis was conducted by the Review Manager 5.2 software. Results Sixteen studies involving 1101 patients were selected finally, with 563 patients in ERAS group and 538 patients in control group. Results of Meta-analysis showed that the levels of IL-6 on postoperative day (POD) 1, 3 and TNF- α on POD3 and CRP on POD1, 3, 7 in ERAS group were lower than those in control group significantly (all P<0.05) . Those on the rest of the days showed no significant difference (all P>0.05). The levels of IgA on POD1, 3, 7 and IgG on POD3, 6, 7 in ERAS group were higher than those in control group significantly (all P<0.05). But, the levels of IgM on POD1, 3, 7 showed no significant difference between the two groups (all P>0.05) . Conclusion ERAS for radical resection of gastric cancer can decrease the inflammatory responses and preserve immune function of bodys compared with conventional perioperative care.     

���ٰ��¸������Ƽ����ȵ�����

??Several hot issues of neoadjuvant chemotherapy for breast cancer WANG Wei, WU Jia-yi, SHEN Kun-wei. Breast Disease Center, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
Corresponding author: SHEN Kun-wei, E-mail: kwshen@medmail.com.cn
Abstract Neoadjuvant chemotherapy provides clinical outcomes equivalent to those achieved from adjuvant setting. The therapeutic response to neoadjuvant treatment may include a reduction in tumor burden that alleviates the morbidity associated with locoregional therapy. Important prognostic information can be gained based on the response to treatment and knowing the quantity and biology of the residual disease. Landmark trials and contemporary perspectives on neoadjuvant treatment regimens are the issues that surgeons should grasped and pay attention to. The standard neoadjuvant chemotherapy could improve the survival of patients with breast cancer.     

���п��������������ҽʦ��ǻ��ֱ����������ѧϰ�����о�

??Learning curve of laparscopic resection in rectal cancer for experienced surgeon ZHU Xiao-ming??LOU Zheng??GONG Hai-feng??et al. Department of Colorectal Surgery??Changhai Hospital??the Second Military Medical University??Shanghai 200433??China
Corresponding author??ZHANG Wei??E-mail: weizhang2000cn@163.com
Abstract Objective To investigate how experienced surgeons in open surgery can quickly learn laparscopic resection for rectal cancer. Methods The clinical data of 120 cases of laparscopic resection for rectal cancer performed by the same team of surgeons from August 2009 to April 2015 in Changhai Hospital of the Second Military Medical University were analyzed retrospectively. The cases were divided into three groups (40 cases in each group) by operative sequence. The time span was 36, 19, 11 months respectively. The operating time??blood loss??the rate of conversion to open operation??number of lymph nodes??the integrityof mesorectum??postoperative aerofluxus time??postoperative hospital stay and the rate of postoperative complications were compared among the 3 groups. Results The operating time in group A was ??162.9±36.7??min??which as much higher than that in group B ??147.0±36.8??min and group C (132.7±31.9)min (P<0.05). However??there was no significant difference between group B and C (P>0.05). Intraoperative blood loss??the rate of conversion to open operation and postoperative hospital stay in group A had no significant difference compared with those in group B and C (P??0.05). Also??there was no significant difference in the integrity of mesorectum??number of lymph nodes??postoperative aerofluxus time and the rate of postoperative complications among 3 gourps ??P>0.05??. Conclusion From the learning curve??surgeons with rich experience in open surgery can learn laparscopic skills for rectal cancer after performing 40 cases.     

�ӹ�Դ�Ծ�����ƽ��������7���ٴ�����

??Intravenous leiomyomatosis: A clinical analysis of 7 cases LI Xuan??XIN Shi-jie. Department of Vascular Surgery??the First Hospital of China Medical University??Shenyang 110001??China
Corresponding author??XIN Shi-jie??E-mail??sjxin@mail.cmu.edu.cn
Abstract Objective To investigate the diagnosis and treatment of intravenous leiomyomatosis (IVL). Methods The clinical data of 7 cases of IVL admitted between September 2004 and September 2015 in the First Hospital of China Medical University were analyzed retrospectively. Results Five cases of the 7 cases underwent surgical treatment, 2 cases underwent conservative treatment. All the 5 cases had pathological diagnosis of IVL. Five cases involved the uterus vein??iliac vein??vena ovarica and inferior vena cava; 4 cases involved right atrium; 1 case involved right cardiac ventrium and pulmonary artery. IVL of 5 cases originated from uterous tumor. Seven cases were followed. One case died of respiratory and circulatory failure in postoperative 2 months. Two cases of non operation died in postoperative 3 and 4 years respectively. One case of low grade endometrial stromal sarcoma recurred in postoperative 1 year. Conclusion IVL is a kind of rare and fatal diseases that should be paid more attention to the diagnosis and treatment in order to avoid misdiagnosing. A detailed operation program should be made before the operation.     

��ͷ���ݵ��������

??Surgical treatment of inverted nipple WEN Bing??XIE Kun. Department of Plastic Surgery, Peking University First Hospital??Beijing 100034,China
Corresponding author:WEN Bing,E-mail: wenzhenhe16@sina.com
Abstract The basic principles of inverted nipple correction surgery are adequate release of fibrous bands pulling the nipple retraction and nipple substrate support tissue reconstruction. The most commonly used corrective surgery includes breast tissue flap method and areola dermal flap method. In recent years, acellular allograft dermal matrix or artificial dermis filling method as a new simple minimally invasive corrective surgery has better prospects.