Denervation as a Treatment for Arthritis of the Hands: A Systematic Review of the Current Literature

Joint denervation has been proposed as a less invasive option for surgical management of hand arthritis that preserves joint anatomy while treating pain and decreasing postoperative recovery times. The purpose of this systematic review was to investigate the efficacy and safety of surgical joint denervation for osteoarthritis in the joints of the hand. EMBASE, MEDLINE, and PubMed databases were searched from January 2000 to March 2019. Studies of adult patients with rheumatoid arthritis or osteoarthritis of the hand who underwent joint denervation surgery were included. Two reviewers performed the screening process, data abstraction, and risk of bias assessment (Methodological Index for Non-Randomized Studies). This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with PROSPERO (#125811). Ten studies were included, 9 case series and 1 cohort study, with a total of 192 patients. In all studies, joint denervation improved pain and hand function at follow-up (M = 36.8 months, range = 3-90 months). Pooled analysis of 3 studies on the first carpometacarpal joint showed a statistically significant (P < .001) reduction in pain scores from baseline (M = 6.61 ± 2.03) to postoperatively (M = 1.69 ± 1.27). The combined complication rate was 18.8% (n = 36 of 192), with neuropathic pain or unintended sensory loss (8.8%, n = 17 of 192) being the most common. This review suggests that denervation may be an effective and low-morbidity procedure for treating arthritis of the hand. Prospective, comparative studies are required to further understand the outcomes of denervation compared with traditional surgical interventions.

[Genetic characterization analysis of the whole genome sequence of Coxsackievirus A8 associated with hand, foot and mouth disease in China]

Objective: To study the genomic sequence of Coxsackievirus A8 (CV-A8) associated with hand, foot and mouth disease (HFMD) from 2013 to 2018 in China and to analyze the genetic evolution of each coding region of the full-length genome. Methods: The genome sequences of 11 CV-A8 strains isolated from patients with HFMD in different regions of China from 2013 to 2018 were determined. Sequence alignment and genetic evolution analysis were performed by Sequencher 5.0 and MEGA 7.0 software, etc. Results: Sequence alignment showed that the genome length of 11 CV-A8 strains ranged from 7 393 bp to 7 400 bp. There was no base insertion or deletion in the coding region compared with the prototype strain, but there were individual base insertion or deletion in the non-coding region. The nucleotide and amino acid similarities in the VP1 region of 11 CV-A8 strains were 78.3%-98.6% and 92.6%-99.7%, respectively, and the nucleotide and amino acid sequences identities with the CV-A8 prototype strain were 78.3%-98.2% and 92.6%-99.7%, respectively. Based on the phylogenetic analysis of VP1 region sequences, the CV-A8 can be divided into five genotypes: A, B, C, D and E. The 11 CV-A8 strains in this study belonged to genotypes C (1 strain), D (2 strains) and E (8 strains). The nucleotide and amino acid similarities of 11 CV-A8 full-length genomes were 81.3%-98.8% and 95.9%-99.5%, respectively. The phylogenetic tree of the P2 region showed that the eight E genotypes CV-A8 had the closest evolutionary distance with CV-A4, CV-A14, and CV-A16. The phylogenetic tree of the P3 region showed that the eight E genotypes CV-A8 had a close evolutionary distance with CV-A5, CV-A16, CV-A14 and CV-A4. Conclusions: The 11 CV-A8 stains in this study showed significant intra-genotype diversity in capsid region and recombinant diversity in non-capsid region which indicated that CV-A8 quasispecies were still undergoing dynamics variation. CV-A8 may become an important pathogen of HFMD and the monitoring of CV-A8 needs to be further strengthened.

High-solid digestion from cellulosic ethanol stillage with activated sludge of simultaneous propionate degradation and methanogenesis

High solid anaerobic digestion (HSAD) was an emerging bioconversion technology which had the advantages of small digester, less digestate and low heating energy. A one-stage anaerobic system in CSTR by inoculating activated sludge of simultaneous propionate degradation and methanogenesis was proposed to improve the high-solid digestion performance and to stabilize the reaction process. Semi-continuous mode was successfully used to perform HSAD from cellulosic ethanol whole stillage at an initial substrate loading of 15.4% (w/w) dry matter content with different OLRs from 1.5 to 5.0 gVS·L^-1 d^-1 at an HRT of 30 days. The average methane yield during whole digestion reached 349.9 mL⋅gVS^-1 with a total VS removal rate of 61.3%. The acclimation mechanism of multifunctional activated sludge was also explored by analyzing the functional property, physiological activity and microbial community structure. The results indicated the feasibility and efficiency of multifunctional activated sludge in a semi-continuous high-solid stirred tank reactor system.

[Multicenter cross-sectional investigation on the cleaning status and influencing factors of skin cleaning outside the wound in adult trauma patients]

Objective: To investigate the status and influencing factors of skin cleaning outside wound (hereinafter referred to as skin) in adult trauma patients. Methods: A multicenter cross-sectional investigation was conducted. From September 1 to 30, 2020, a total of 952 adult trauma patients who met the inclusion criteria were admitted to wound care clinics or trauma surgery wards of 13 military or local Grade Ⅲ Level A hospitals, including the General Hospital of the Eastern Theater Command of People's Liberation Army and the Army Medical Center, etc. A self-designed questionnaire on cleaning status of skin in trauma patients was released through the "questionnaire star" website to investigate basic information such as gender, age, education level, living status, and self-care ability, trauma information such as cause of injury, wound duration, trauma site, trauma depth, wound pain, wound peculiar smell, and wound cleaning solution, and skin cleaning status after injury such as whether to clean or not, cleaning method, cleaning frequency, cleaning duration in each time, or reasons for not cleaning. The patients who cleaned skin regularly after injury were included in cleaning group, and the other patients were included in no cleaning group. The basic information, trauma information, and skin cleaning status after injury of patients in 2 groups were investigated. Data were statistically analyzed with chi-square test, and binary multivariate logistic regression analysis was performed on indicators with statistically significant differences between the two groups to screen the independent influencing factors of skin cleaning in trauma patients. Results: A total of 952 questionnaires were received, and the recovery rate was 100%. Three invalid questionnaires were eliminated, and 949 valid questionnaires were obtained, with an effective rate of 99.68%. In 949 patients, there were 461 (48.6%) males and 488 (51.4%) females, aged 18-100 (50±18) years. Most patients were less than 60 years old, lived with their families, and could take care of themselves completely. Nearly half of the patients were with junior high school or below education level. The main causes of injury were sharp cutting injury and falling injury, the wound duration was 2-365 days, most of the injured parts were limbs and trunk, the wound depth was mostly full-thickness injury, and most patients had wound-related pain and no peculiar smell and used 5 g/L iodophor to clean the wound. Totally 684 (72.1%) patients cleaned their skin after injury, mainly by scrubbing with warm water, the cleaning frequency was mainly once or twice a week, and the cleaning time was mainly 10 or 15 min for each time. Totally 265 (27.9%) patients didn't clean their skin after injury, and the main causes for not cleaning were following the doctor's advice, followed by worrying about wound infection and loss of self-care ability. There were significantly statistical differences in constituent ratios of education level, self-care ability, cause of injury, wound pain, and wound peculiar smell of patients in 2 groups (χ²=12.365, 24.519, 22.820, 9.572, 92.342, P<0.01). Education level, self-care ability, cause of injury, wound pain, and wound peculiar smell were potential influencing factors of skin cleaning in patients. Binary multivariate logistic regression analysis showed that self-care ability, wound pain, and wound peculiar smell were independent influencing factors of skin cleaning in patients (odds ratio=1.51, 0.52, 3.72, 95% confidence interval=1.08-2.12, 0.42-0.89, 2.66-5.22, P<0.05 or P<0.01). Conclusions: Self-care ability, wound pain, and wound peculiar smell are independent influencing factors of skin cleaning in adult trauma patients.

[Natural history of colorectal cancer: a Meta-analysis on global prospective cohort studies]

Objective: To acknowledge the availability and rates of annual transition of outcomes during the progression and regression stages of colorectal cancer (CRC) and related diseases, by pooling global follow-up studies on the natural history of CRC. Methods: Till March, 2017, data was collected through systematic literature review over multiple databases, including PubMed, Embase, Cochrane and Chinese Biology Medicine (CBM) disc. Information regarding the characteristics, classification system of health states, related outcomes and incidence rates on CRC or high-risk adenoma for the surveillance cohorts of the studies, were extracted and summarized. Both Meta and sensitivity analyses were performed on those outcomes if they appeared in more than 3 studies, using the random effects model. Annual transition rate with 95%CI was used to estimate each of the outcomes, Quality of the studies was assessed, using the Newcastle-Ottawa Scale. Results: A total of 29 cohort studies were included, with the mean follow-up period as 5.7 years. All studies except one, focused on adenoma-carcinoma pathway and reported the outcome parameters of adenomas by different risk, and some reported the findings on different sizes (n=6) of adenomas. These cohorts were divided into three groups (normal status, with low-risk or high-risk adenoma) according to the status of baseline endoscopic pathologic findings. Their available outcome parameters, corresponding number of involved articles, aggregated sample size and pooled annual transition rates were presented. Six parameters were obtained in the normal cohorts, including those from normal to low-risk adenoma (16 articles, 58 235, 0.030: 0.024-0.037), to high-risk adenoma (17 articles, 62 089, 0.003: 0.002-0.004), to diminutive adenoma (<5 mm, 4 articles, 1 277, 0.021: 0.013-0.029), to small adenoma (6-9 mm, 4 articles, 1 277, 0.006: 0.001-0.010), to large adenoma (≥10 mm, 7 articles, 3 531, 0.002: 0.000-0.003) and to CRC (19 articles, 104 836, 0.000 3: 0.000 2-0.000 5). Three parameters were obtained in low-risk adenoma in cohorts with polypectomy findings, including recurrence (9 articles, 4 788, 0.109: 0.062-0.157) from low-risk adenoma after polypectomy to high-risk adenoma (10 articles, 5 736, 0.009: 0.004-0.013) and to CRC (12 articles, 11 347, 0.000 6: 0.000 4-0.000 8). Three parameters were obtained on high-risk adenoma from cohorts with polypectomy findings, including recurrence (12 articles, 7 030, 0.038: 0.028-0.048) from high-risk adenoma after polypectomy to low-risk adenoma (8 articles, 2 489, 0.133: 0.081-0.185) and CRC (14 articles, 14 899, 0.002: 0.001-0.003). Except for normal to low-risk adenomas, results from the sensitivity analysis for the other parameters showed stable. Of the included studies, two presented incidence rates of CRC in different clinical stages and the another two were focusing on the parameters related to serrated pathway. Conclusions: Globally, follow-up studies reported data on natural history of colorectal cancer is of paucity. Compared to the "adenoma-carcinoma" pathway, transition parameters of the serrated lesion pathway are more limited. This Meta-analysis provided convincing evidence for optimizing the strategies regarding follow-up program on the disease, using the baseline endoscopic findings from global CRC Screening Program. These results also offered strong data-related support for Chinese population- specific interventional model on colorectal cancer.

[Efficacy and safety analysis of different dose idarubicin plus cytarabine regimen as induction chemotherapy for young patients with de-novo acute myeloid leukemia]

目的

探讨不同剂量去甲氧柔红霉素（IDA）联合阿糖胞苷诱导方案（IA）治疗年轻初发急性髓系白血病（AML）（除外急性早幼粒细胞白血病）的临床疗效、安全性和长期预后。

方法

回顾性分析2009年1月至2014年7月收治的采用IA方案治疗的149例<55岁初发AML患者临床资料，根据IDA剂量分为高标准剂量组（10~12 mg·m⁻²·d⁻¹）、低标准剂量组（8~9 mg·m⁻²·d⁻¹）和低剂量组（<8 mg·m⁻²·d⁻¹），比较各组患者的化疗反应、血液学及非血液学不良事件，并分析预后。

结果

高标准剂量组34例，低标准剂量组53例，低剂量组62例。三组第1个疗程完全缓解（CR）率分别为79.4%、75.5％和46.8%，第1个疗程有效率分别为97.1%、94.3％和64.5%，总CR率分别为85.3%、81.1％和54.8%，高标准剂量组、低标准剂量组均显著高于低剂量组（P值均<0.05），前两者间差异无统计学意义（P值均>0.05）。多因素分析证实标准IDA剂量的确在诱导缓解疗效上优于低剂量（P<0.05）。在不良反应方面，化疗期间WBC最低值三组间差异有统计学意义（P=0.002），其余差异均无统计学意义。低标准剂量组在总生存（OS）上显著优于低剂量组（P=0.030），高标准剂量组与低剂量组相比，OS也有改善的趋势（P=0.054）。三组间在无事件生存、无复发生存差异均无统计学意义（P值均>0.05）。

结论

对于年轻（<55岁）初发AML患者，标准剂量IA方案可显著提高CR率，且患者的耐受性良好。标准剂量IA方案在一定程度上能改善年轻（<55岁）AML患者OS。

Novel Heating-Induced Reversion during Crystallization of Al-based Glassy Alloys

Thermal stability and crystallization of three multicomponent glassy alloys, Al₈₆Y₇Ni₅Co₁Fe_0.5Pd_0.5, Al₈₅Y₈Ni₅Co₁Fe_0.5Pd_0.5 and Al₈₄Y₉Ni₄Co_1.5Fe_0.5Pd₁, were examined to assess the ability to form the mixture of amorphous (am) and fcc-aluminum (α-Al) phases. On heating, the glass transition into the supercooled liquid is shown by the 85Al and 84Al glasses. The crystallization sequences are [am] → [am + α-Al] → [α-Al + compounds] for the 86Al and 85Al alloys, and [am] → [am + α-Al + cubic Al_xM_y (M = Y, Ni, Co, Fe, Pd)] → [am + α-Al] → [α-Al + Al₃Y + Al₉(Co, Ni)₂ + unknown phase] for the 84Al alloy. The glass transition appears even for the 85Al alloy where the primary phase is α-Al. The heating-induced reversion from [am + α-Al + multicomponent Al_xM_y] to [am + α-Al] for the 84Al alloy is abnormal, not previously observed in crystallization of glassy alloys, and seems to originate from instability of the metastable Al_xM_y compound, in which significant inhomogeneous strain is caused by the mixture of solute elements. This novel reversion phenomenon is encouraging for obtaining the [am + α-Al] mixture over a wide range of high temperature effective for the formation of Al-based high-strength nanostructured bulk alloys by warm working.

[Evaluation of estimation of prevalence ratio using bayesian log-binomial regression model]

To evaluate the estimation of prevalence ratio (PR) by using bayesian log-binomial regression model and its application, we estimated the PR of medical care-seeking prevalence to caregivers' recognition of risk signs of diarrhea in their infants by using bayesian log-binomial regression model in Openbugs software. The results showed that caregivers' recognition of infant' s risk signs of diarrhea was associated significantly with a 13% increase of medical care-seeking. Meanwhile, we compared the differences in PR's point estimation and its interval estimation of medical care-seeking prevalence to caregivers' recognition of risk signs of diarrhea and convergence of three models (model 1: not adjusting for the covariates; model 2: adjusting for duration of caregivers' education, model 3: adjusting for distance between village and township and child month-age based on model 2) between bayesian log-binomial regression model and conventional log-binomial regression model. The results showed that all three bayesian log-binomial regression models were convergence and the estimated PRs were 1.130(95%CI: 1.005-1.265), 1.128(95%CI: 1.001-1.264) and 1.132(95%CI: 1.004-1.267), respectively. Conventional log-binomial regression model 1 and model 2 were convergence and their PRs were 1.130(95% CI: 1.055-1.206) and 1.126(95% CI: 1.051-1.203), respectively, but the model 3 was misconvergence, so COPY method was used to estimate PR, which was 1.125 (95%CI: 1.051-1.200). In addition, the point estimation and interval estimation of PRs from three bayesian log-binomial regression models differed slightly from those of PRs from conventional log-binomial regression model, but they had a good consistency in estimating PR. Therefore, bayesian log-binomial regression model can effectively estimate PR with less misconvergence and have more advantages in application compared with conventional log-binomial regression model.

MoO2-CoO coupled with a macroporous carbon hybrid electrocatalyst for highly efficient oxygen evolution

Cost-effective electrocatalysts for oxygen evolution reactions are attractive for energy conversion and storage processes. A high-performance oxygen evolution reaction (OER) electrocatalyst composed of 3D ordered microporous carbon and a MoO2 skeleton modified by cobalt oxide nanoparticles (MoO2-CoO-Carbon) is produced through a template method. This unique 3DOM structure finely combines the larger surface area of the 3D carbon skeleton and MoO2 as well as stablizes anchoring sites for CoO nanocrystals on the skeleton. The synergistic effect between the catalytic activity between MoO2 and CoO as well as the enhanced electron transport arising from the carbon skeleton contributed to superior electrocatalytic OER properties of MoO2-CoO-Carbon. The M200-C-Carbon hybrid with an overpotential as low as 0.24 V is among the best reported Mo-based OER catalysts. Moreover, the turnover frequency at an overpotential of 0.35 V is 6 times as high as that of commercial RuO2.

Enhanced Capacitance of TiO2 Single Crystals Through Chemically Deposited Graphene Films

Single-crystals of titanium oxide (TiO2) were wrapped in a graphene (G) film by chemical deposition. The morphology, composition and structure of the resulting composite were subsequently characterized by SEM, TEM, XRD and FT-IR analysis. The electrochemical properties of the composites were studied by cyclic voltammetry, which showed that the introduction of graphene enhances the electrode conductivity, thereby improving the supercapacitive behavior of TiO2. Galvanostatic charge-discharge tests demonstrated that a supercapacitor device fabricated from TiO2 crystals wrapped in graphene (G-TiO2) exhibits a good cycle life, with 94% stability even after 1000 cycles.

Design of a highly sensitive ethanol sensor using a nano-coaxial p-Co3O4/n-TiO2 heterojunction synthesized at low temperature

In this paper, we describe the design, fabrication and gas-sensing tests of nano-coaxial p-Co3O4/n-TiO2 heterojunction. Specifically, uniform TiO2 nanotubular arrays have been assembled by anodization and used as templates for generation of the Co3O4 one-dimensional nanorods. The structure morphology and composition of as-prepared products have been characterized by SEM, XRD, TEM, and XPS. A possible growth mechanism governing the formation of such nano-coaxial heterojunctions is proposed. The TiO2 nanotube sensor shows a normal n-type response to reducing ethanol gas, whereas TiO2-Co3O4 exhibits p-type response with excellent sensing performances. This conversion of sensing behavior can be explained by the formation of p-n heterojunction structures. A possible sensing mechanism is also illustrated, which can provide theoretical guidance for the further development of advanced gas-sensitive materials with p-n heterojunction.

Inheritance and fine mapping of a restorer-of-fertility (Rf) gene for the cytoplasmic male sterility in soybean

The cytoplasmic male sterility (CMS) line FuCMS5A and its restorer line FuHui9 were crossed to produce a segregating F(2) population for pollen fertility assay and the genetic mapping of restorer-of-fertility (Rf) gene. Results showed that the individual F(2) plants were fertile or semi-fertile based on their pollen fertility characteristics. The average ratios of viable pollen were 96.90% and 50.00% for each class of individuals. The segregation of F(2) plants showed a good fit to a 1:1 ratio, which reflects a typical heredity pattern of gametophytic CMS with fertility restorer being controlled by a single dominant gene. Using bulk segregation analysis (BSA) and genetic mapping, the Rf gene was mapped on molecular linkage group J (chromosome 16), between the simple sequence repeat (SSR) makers BARCSOYSSR-16-1064 and BARCSOYSSR-16-1082 with the distances of 0.59 and 0.83 cM, respectively. Four SSR markers (BARCSOYSSR-16-1070, Sctt011, BARCSOYSSR-16-1076 and BARCSOYSSR-16-1077) were cosegregating with this Rf gene in the mapping population. These makers will greatly facilitate the maker assisted selection procedures in CMS breeding programs and it lays a foundation for further map-base cloning of the Rf gene.

Characterization of self-organized TiO2 nanotubes on Ti-4Zr-22Nb-2Sn alloys and the application in drug delivery system

In this study, the self-organized TiO(2) nanotubes grown by anodization of Ti-4Zr-22Nb-2Sn at different potentials, concentration of NH(4)F and anodization time was investigated. The morphology of nanotubes was observed by FE-SEM. The drug-loaded nanotubes were also fabricated in aqueous media containing minocycline hydrochloride. They were characterized by SEM, XPS and FT-IR. The results showed that the drug of minocycline hydrochloride (MH) was loaded in the nanotubes. The release effects were studied in phosphate buffer solution (PBS). The release rate of MH from TiO(2) nanotubes with shorter tube length in PBS was lower than the one of MH from longer nanotubes. The sustaining release time could last at least 150 h. Hence, it is a promising method to eliminate the harmful reactions by carrying drug in the tubes when the titanium alloys were used as biomedical implants.

Parity-violating photoproduction of pi(+/-) on the delta resonance

We analyze the real-photon asymmetry A(gamma)(+/-) for the parity-violating (PV) pi(+/-) production on the Delta resonance via the reactions (-->)gamma + p --> Delta(+) --> pi(+) + n and (-->)gamma + d --> Delta(0) + p --> pi(-) + p + p. This asymmetry is nonvanishing due to a PV gamma N Delta coupling constant, d(Delta)(+/-). We argue that an experimental determination of this coupling would be of interest for hadron dynamics, possibly shedding light on the S-wave/ P-wave puzzle in the hyperon nonleptonic decays and the violation of Hara's theorem in weak radiative hyperon decays.

Nonadiabatic noncyclic geometric phase and ensemble average spectrum of conductance in disordered mesoscopic rings with spin-orbit coupling

We generalize Yang's theory from the U(1) gauge field to the non-Abelian U(1)xSU(2)(spin) gauge field. Based on this generalization and taking into account the geometric Pancharatnam phase as well as an effective Aharonov-Bohm (AB) phase in nonadiabatic noncyclic transport, we calculate the ensemble average Fourier spectrum of the conductance in disordered mesoscopic rings connected to two leads. Our theory can explain the experimental results reported by Morpurgo et al. [Phys. Rev. Lett. 80, 1050 (1998)] more satisfactorily. We indicate that the observed splitting stems from the nonadiabatic noncyclic Pancharatnam phase and the effective AB phase, both being dependent on spin-orbit coupling.

The results of transplant livers from selected non-heart-beating cadaver donors

The clinical experience following transplantation of livers obtained from non-heart-beating cadaver donors (NHBD) with the use of core cooling method is presented here. Six livers procured from such cadavers were transplanted into 6 recipients with hepatoma involving right and left lobes but without distant metastases. The first liver subjected to 75 minutes of warm ischemia had insufficient function after transplantation. The recipient died of graft failure 54 days later. The other 5 livers with 32 to 45 minutes of warm ischemia had a good or excellent immediate function. These 5 recipients died of tumor recurrence, acute rejection or septicemia 131 to 261 days after transplantation. The utilization of selected NHBD is suggested by our practice as a possible approach to help alleviate the acute organ shortage in the areas where heart-beating cadaver donors of brain death are not available.

Comparisons of diet and biochemical characteristics of stool and urine between Chinese populations with low and high colorectal cancer rates

In an investigation of the roles of diet and stool biochemistry in human colorectal carcinogenesis, 24-hour food, urine, and stool samples were collected from randomly selected participants from two populations with a fourfold difference in colorectal cancer risk: Chinese in Sha Giao, People's Republic of China (low risk), and Chinese-Americans of similar ages in San Francisco County, Calif, in the United States (high risk). The findings supported the hypotheses that colorectal cancer risk is increased by the consumption of high-fat, high-protein, and low-carbohydrate diets and is associated with high levels of cholesterol in stool as well as increased daily outputs of 3-methyl-histidine and malonaldehyde in urine. However, risk does not increase with low stool bulk and low total stool fibers.

Allergenicity of orange juice and orange seeds: a clinical study

Oranges are considered to be common allergenic fruits in China. They may induce severe food allergy in sensitive individuals. Allergic histories were analyzed in 26 orange-sensitive patients. Intradermal tests with extracts of orange juice and seeds were performed in 16 out of the 26 patients. P-K test was performed in one patient. The allergic history analysis suggested that clinical symptoms of some orange-allergic subjects were different from other fruit allergies but similar to nut and other oil plant seed allergies. The skin test and P-K test showed that the major allergenic components of orange reside in orange seeds instead of orange juice. Systemic reactions developed in 5 patients after intradermal tests with 1:20-200 (w/v) orange seed extracts. We considered that orange seed contains high potent allergens which may induce orange sensitivity due to careless chewing of orange seeds.

Evaluation of partial hepatectomy for primary liver carcinoma

From 1964 to 1985, 120 cases of primary liver carcinoma had undergone hepatectomy in our hospital. Seven of these cases underwent hepatic lobectomy, 28 cases had palliative hepatic resection, and 85 cases had partial hepatectomy. We introduced different surgical modes and compared the mortality, survival rates, and complications between the hepatic lobectomy and partial hepatectomy groups. The mortality rates of these two groups were 14.3 and 3.5%, respectively, and the 1, 3, and 5 year survival rates were 83.3, 33.3, and 16.7 and 68.8, 48.1, and 20%, respectively. In the palliative hepatectomy group (28 cases), ten cases received combined radiotherapy postoperation. Most of these cases died during the first year postoperation. Primary liver cancer in Asia is commonly associated with hepatic cirrhosis. We suggest that partial hepatectomy is suitable for such patients. The results of the present series showed that the outcomes of the hepatic lobectomy and partial hepatectomy groups did not differ, but in partial hepatectomy, the operative mortality and complications were reduced, bleeding minimized, and operation time also shortened.

[Surgical resection of 48 patients with malignant disease of the pancreas and periampullary region]

Fourty-eight patients with malignant disease of pancreas and periampullary region treated by surgery from Jan. 1966 to June 1985 are analyzed. Of these patients, 44 underwent pancreaticoduodenectomy, 2 had resection of the body and tail of pancreas, 1 had total pancreatectomy and 1 had tumor resection only. The operative mortality was 12.5%. The overall 5-year survival rate was 48.2%. The 5- and 10-year survival rates of the 44 patients by pancreaticoduodenectomy were 46.4% and 37.5%, respectively. Experience and technique on the postoperative complications were analyzed. The prevention of massive bleeding during operation were suggested. Apart from the cigarette drain to the pancreaticoduodenal bed, an easy and effective method for draining the digestive juice from the lumen near anastomosis of the pancreaticojejunostomy and choledochojejunostomy is suggested.

[Evaluation of irregular hepatectomy for primary liver carcinoma]

From 1964 to 1985, 120 patients with primary liver carcinoma were treated by operation in our hospital. Regular hepatectomy was done in 7 patients, palliative irregular hepatectomy in 28 and radical irregular in 85. The operation mortality was 4.2% in irregular hepatectomy group (113 cases) but 14.3% in regular hepatectomy group (7 cases) (P greater than 0.05). The 1, 3 and 5 year survival rates were 68.8%, 48.1% and 20.0% in radical irregular hepatectomy group but 83.3%, 33.3% and 16.7% in regular hepatectomy group. 10 of 28 patients treated by palliative hepatectomy were added with radiation. Majority of these patients died in 1 year after operation but 2 patients survived for more than 2 years and 1 for more than 7 years. The data show that in Asia, the incidence of primary liver carcinoma concurrent with liver cirrhosis is high and irregular hepatectomy is a suitable treatment. There is no difference between irregular and regular hepatectomy groups in the prognosis. But the former could reduce the operative time, mortality and the possibility of bleeding and complications.