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Volume 26 ， Issue 6 ， 2011
- Abstract：<正>Objective:Nephron-sparing surgery（NSS） for small renal masses offers a similar functional and oncological outcome to that of radical surgery.Laparoendoscopic single-site surgery（LESS） emerges as an advanced alternative for reduced invasiveness and improves cosmesis;LESS is developing quickly and its indications have been expanded,but still in its infancy.The aim of this paper is to report our preliminary experience in transumbilical LESS partial nephrectomy（LESS-PN）,so as to assess its utility, safety and efficacy.Methods:From August 2009 to October 2010,3 patients underwent transumbilical LESS-PN via a novel multi-channel TriPort by a single experienced urologist in our institution.Patient demographics,perioperative and follow-up data were prospectively collected and analyzed.Results:All the three procedures were successfully completed.A 5-mm ancillary trocar was utilized in all 3 cases.The mean operative duration was 226.3（210-254 min） with an estimated blood loss of 56.7 ml （20-100 ml）.Mean warm ischemia time was 35.7 min（19-48 min）.One patient was transfused due to postoperative bleeding. The recovery was uneventful and mean length of postoperative stay was 13 days（12-14 days）.At the latest follow-up,all patients remained symptom-free and had normal renal function without evidence of recurrence,and they were delighted for a hidden transumbilical scar.Conclusion:Transumbilical LESS-PN is a feasible and safe procedure albeit extremely technically challenging.Surgical outcomes at a median follow-up of 2 years are promising,while currently it should be reserved for highly selected patients with favorable tumor anatomy and performed by a very experienced laparoscopic surgeon.0|4|0Updated：2026-03-12
- Abstract：<正>Objective:Percutaneous radiofrequency ablation（PRFA） is known to be as effective as hepatectomy for small hepatocellular carcinoma（HCC） in the long-term.We wished to ascertain how it is for recurrent small HCC.Methods:From January 2009 to November 2011,a series of sixty-one patients were included in the study according to the criteria:each patient had one recurrent HCC,less than 5 cm in diameter.Twenty-six of the 61 patients were treated with PRFA and the other 35 were treated with repeat hepatectomy.Results:The interval from first surgery to recurrent for repeat hepatectomy and PRFA groups were（1,239.60±1,017.00） d and（903.42±975.11） d respectively（P=0.066）.The tumor-free time after repeat hepatectomy and PRFA were（310.23±159.50） d and（278.27±123.29） d respectively（P=0.584）.Size of tumor in repeat hepatectomy and PRFA were（7.34±3.16） cm2 and（5.59±3.40） cm2（P=0.215）,the total expenditure for each patient of the two groups were（26,150.66±7,923.60） yuan and（21,135.00±1,156.76） yuan（RMB）,and the time of hospitalization for each of the two groups were（15.29±4.28） d and（7.46±2.20） d（P<0.001）.Conclusion:PRFA is proved to be as effective as repeat hepatectomy in the treatment of recurrent small HCC,and superior to repeat hepatectomy as it is less invasive.0|24|0Updated：2026-03-12
- Abstract：<正>Objective:To evaluate the efficacy and safety in patients with hepatocellular carcinoma treated with sorafenib and determine the predictive factors for survival.Methods:From April 2009 to December 2010,all patients with hepatocellular carcinoma treated with sorafenib were included in the study.Clinical data and survival time were collected.Survival analysis was conducted using the Kaplan-Meier method,and predictive factors for survival were analysed using the Cox’s model.Results:A total of 51 patients were included in the study,the median time of follow-up was 10 months（range 1-22）.All the 51 patients had one or more adverse events,of which 2 patients died of upper gastrointestinal bleeding and 6 patients discontinued treatment.The mean survival time was 11 months and 1-year survival was 60.8%.On univariate analysis,the median survival time of patients with tumors of BCLC A,B and C were 17,12.5 and 8.5 months,and 1-year survival were 71.4%,61.1%,and 23.1%, respectively（P=0.006）.Compared with those with mild and poor arterial supply tumors,patients with good arterial supply tumors had longer median survival time（12 months vs 8 months and 9 months） and higher 1-year survival（52.0%vs 30.8%and 38.5%）（P=0.037）.Patients with portal invasion had shorter median survival time and lower 1-year survival（8.5 months vs 13 months and 57.6%vs 16.7%,respectively） than those without（P=0.012）.Patients with prealbumin≥170 mg/L had longer median survival time and higher 1-year survival（13.5 months vs 9 months and 55.6%vs 36.4%,respectively） than those with prealbumin<170 mg/L（P=0.016）.Early tumor BCLC staging and high level of prealbumin were independent predictive factors for survival on multivariate analysis using Cox’s regression model,the hazard ratio were 3.69（95%CI:1.30-10.53,P=0.015） and 3.53（95%CI:1.40-8.91,P=0.008） respectively.Conclusion:Upper gastrointestinal bleeding was a severe event need to be concerned in patients with hepatocellular carcinoma treated with sorafenib.Patients with high level of prealbumin could benefit more from sorafenib treatment,and prealbumin could be a predictor for survival in HCC patients treated with sorafenib.0|16|1Updated：2026-03-12
- Abstract：<正>Objective:A computer-based STS（simulative training system） in providing pre-hospital trauma care at a disaster site was applied to teaching nursing students in the Second Military Medical University,China.This article reports on the teaching effectiveness of this system.Methods:Among 92 participants,46 were in the study group and 46 were in the "control" group. Each student completed a multiple-choice quiz after completing 18 hours（six three-hour sessions） of the study module,and a score was recorded.The simulative training module was completed only by the study group;the "control" group was assigned in-class discussions for the same amount of time covering the same content as the study group.The final course scores,which included both comprehensive and group task-based tests were compared between these two groups.The study used a descriptive and comparative approach for quantitative data analysis.Tests of independency between the multiple choice scores and the simulation scores were also performed.Finally,anonymous surveys were conducted.Results:The study group performed better than the "control" group with a significantly higher average score for the group scenario task-based test score,and consequently the study group’s final course score was significantly higher than the "control" group.As per chi-square tests,no significant associations were found between the multiple choice scores and the simulated training scores.The final surveys showed students overwhelmingly agreed that STS training improved their knowledge and skills,their ability to recognize a potential critical event, and their initial response for trauma care at pre-hospital settings.The survey responses of the study group were noteworthy as they indicated that students recognized the importance of simulative training,appreciated the realism of the simulation,and were able to fight/adjust to the stressful feelings in order to focus on the task.Conclusion:Computer-based STS may be an effective teaching model to help students improve their capability in providing pre-hospital trauma care,and in their effectiveness in disaster response.0|25|2Updated：2026-03-12
- Abstract：<正>Objective:To describe two cases of bilateral transumbilical laparoendoscopic single-site（LESS） surgeries in a single operative session and assess the safety,feasibility and efficacy.Methods:One patient underwent right ureterolithotomy and left varicocelectomy,and the patient was performed with right simple nephrectomy for nonfunctioning kidney due to ureteral calculus and left ureterolithotomy using a novel multichannel TriPort? via a single 2-3 cm transumbilical incision. Results:The right-side ureterolithotomy and left-side varicocelectomy were finished in 229 minutes,with a total estimated blood loss of 50 ml.The right-side simple nephrectomy and left-side ureterolithotomy in the other patient were finished in 340 minutes,with a total estimated blood loss of 100 ml.There were no major complications.At the latest follow-up,both patients remained symptom-free and there were no evidences of recurrence.Both of them were delighted for the single scar. Conclusion:Synchronous LESS urologic procedure via a single umbilical incision is technically feasible,safe and efficacious with a promising potential.0|8|0Updated：2026-03-12
- Abstract：<正>A case of dermatomyositis associated with hepatocellular carcinoma is reported in a 43-year-old man,in which removal of the tumor resulted in great improvement of dermatomyositis.The patient had shown aggravating symptoms of dermatomyositis including manifestations of typical skin rashes and muscle weakness six months before he came to our hospital.He had no history of drug allergy and took no medicine in these days.When first visiting the dermatological clinic,he complained of discomforts in skin and muscle manifestation and was diagnosed as having dermatomyositis.At the same time,A CT scan discovered a resectable liver tumor in the right lobe.Then he came to our hospital and asked for surgical treatment.Removal of the tumor resulted in great improvement of dermatomyositis and recurrence of liver tumor was followed by resumption of dermatomyositis.0|16|1Updated：2026-03-12
- Abstract：<正>Brown tumour represents a serious complication of hyperparathyroidism.Definitive diagnosis is based on histological examination,clinical,radiological and laboratory data.Here we report a case of multiple brown tumours localised in collarbone,rib and in the distal ulna due to secondary hyperparathyroidism in a 37-year-old women with chronic renal failure.The clinical management of brown tumour aimed primarily to reduce the elevated parathyroid hormone levels by pharmacological treatment.In our experience,clinicians usually consider brown tumor of hyperparathyroidism is caused by giant cell lesions in maintenance hemodialysis recipients,and multiple brown tumours are rarely seen in these patients.0|14|0Updated：2026-03-12
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