The treatment of peritoneal metastasis (PM) has been a long-standing significant challenge in clinical oncology. In the past two decades, considerable progress has been made in the diagnosis and treatment of PM, due to concerted research efforts in the field. This is characterized by the development and refinement of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). In this time, China has achieved remarkable success in PM prevention and treatment, particularly by developing new treatment methods, optimizing new technologies, cultivating groups of experts who specialize in PM, establishing nationwide academic organizations, and collaborating with international organizations such as the Peritoneal Surface Oncology Group International (PSOGI). Examples of landmark progress in China include a series of clinical studies on PM associated with gastric cancer, which have been internationally adopted as reference data; the adoption and promotion of the China-HIPEC (C-HIPEC) concept; and hosting the 12th International Congress on Peritoneal Surface Malignancies in 2021. These historical achievements have contributed to China becoming one of the international leaders in the development of treatments for PM. However, because of the large number of patients requiring effective CRS and HIPEC, the prevention and treatment of PM in China requires further development. Nationwide concerted efforts among clinical oncologists should be emphasized for further advancement in this crucial area of clinical oncology.

揭开腹膜黏液瘤之面纱 面纱之下是个陌生的世界,对于笼罩在面纱下的事物,人们对其的认识与其真实面目肯定会大相径庭的.这是人类对事物认识的一个客观过程.腹膜假性黏液瘤(pseudomyxoma peritonei,PMP)病例罕见、散发又没有专业的治疗中心,因此,国内能够较为集中地收治腹膜假性黏液瘤的医院和医生几乎没有.其发病率无从统计,但本病在阑尾切除术中的发现率为0.07％～0.3％.女性多见,男女比例为1 ∶ 3.

Objective: To establish the patient derived xenograft (PDX) model of pseudomyxoma peritonei (PMP), and identify the key characteristics of tumor biology of this model, in order to provide a reliable model for studying the pathological mechanisms and new therapeutic strategies of PMP. Methods: PMP tumor tissue was obtained from surgery and cut into pieces after washing. Then tumor pieces were implanted subcutaneously in BAL B/c-nu mice for 6 stable passages. In the 7th passage, tumor tissue was implanted orthotopically into abdomen. Subcutaneous tumor and orthotopic tumor were then homogenized to make tumor cell suspension, implanted into abdomen of 10 BAL B/c-nu mice through midline laparotomy, 100 μl for each. The key experimental parameters including body weight changes in the observation period, experimental peritoneal cancer index (ePCI) score at the autopsy, histopathological and immunohistochemical characteristics, and gene expression profiles by high-throughput whole-genome exon sequencing were detected and recorded. Results: The successful rate of established orthotopic PDX model of human PMP was 100% (10/10). The animals showed smooth body weight increases after tumor inoculation until day 27, then the body weight began to decrease steadily. Widespread tumor dissemination of PMP tumor through the whole abdomen was found by autopsy, including the diaphragm, liver, spleen, stomach, kidney, parietal peritoneum, bowel and mesenterium. Gelatinous ascites was also observed in abdominopelvic cavity. The ePCI score ranged from 5 to 9, with a 8 of median ePCI. Histopathological studies showed peritoneal mucinous carcinomatosis accompanied with signet ring cells (PMCA-S), obvious tumor cell atypia and parenchymal invasion.Immunohistochemistry showed the expressions of MUC1, MUC2, MUC5AC, CEA, CA199, CK20, CDX-2 and Ki-67 were positive, MUC6, CK7 and p53 were negative. Whole-exome sequencing identified that the most significant genetic alteration is the exon10 missense mutation c. 1621A>C of KIT gene, the mutation abundance was 89.7%. Conclusion: PDX model of PMCA-S is successfully established, which displays the characters of high-degree malignancy, high proliferation and strong aggressiveness.

Objective: To analyze the efficacy and safety of cytoreduction surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for pseudomyxoma peritonei (PMP) in the early stage. Methods: The clinical data, including pathological features, recurrence and survival of 65 PMP patients in the early stage underwent CRS combined with HIPEC in Aerospace Center Hospital from January, 2011 to December, 2018 were retrospectively analyzed. Results: 65 patients with early stage PMP underwent CRS+ HIPEC. Among these patients, 25 were males and 40 were females, and the mean age was 52.5 years. The median peritoneal cancer index was 3 (0-16). The score of completeness of cytoreduction (CC) of 63 patients (96.9%) was 0, and 2 patients (3.1%) was 1. No perioperative death occurred, the incidence of surgical complications above grade 3 was 3.1%. Three patients relapsed during the follow-up period, including 1 patient with low-grade PMP, 1 patient with high-grade PMP, and 1 patient with high-grade PMP accompanied by signet ring cell. The 5-year disease-free survival rate of the whole group was 92.4%. Conclusions: PMP patients in the early stage treated by CRS combined with HIPEC can achieve benefit and safety. A close long-term follow-up is necessary.

在焙烤食品中应用的酶制剂主要有淀粉酶、蛋白酶、葡萄糖氧化酶、木聚糖酶、脂肪氧化酶等，这些酶制剂的使用可以增大面包体积，改善面包表皮色泽，提高面包瓤柔软度，以及延缓陈变、延长保存期限等作用。

[Objective]To discuss the feasibility of gallbladder preserved polypectomy on clinical surgery. [Method]From January 2005 through March 2009, our department of surgery operated 83 combined laparoscopic and cholangioscopy minimal invasive gallbladder preserved polypectomy on the gall bladder polypus pathlogical changed patients. [Results]We operated 83 gallbladder preserved polypectomy, in which 74 patients succeeded to keep the gallbladder, 9 cases were converted to laparoscopic cholectomy, no bile leakage, no hemobilia, no case were converted to open surgery, no expired. The operation lasted 60～200 min and the patients needed to be in hos-pital for 3～5 days after the operation. By following up the 74 patients who succeeded to keep the gallbladder, no re-currence appeared. [Conclusion]Selecting appropriate patient, combined laparoscopic and cholangioscopic gall-bladder preserved polypectomy is an easy, minimal invasive, effective and safe surgery.

健康体检越来越受人们的重视,但体检后却发现,有不少人被检查出了大大小小的胆囊息肉.于是,大家就开始紧张起来:上网查询,找专家咨询,每日胆颤心惊.那么,胆囊息肉到底是什么呢?它到底有多么可怕呢?

Objective To investigate the diagnosis and treatment of pseudomyxoma peritonei (PMP).Methods Retrospective study was made for 32 cases of PIMP.Results Main clinical presentations included abdominal pain, distention, mass and wasting of whole body.Uhrasonography showed heterogeneous ascites in 10 cases.Level of CEA elevated in 26 cases.All patients were performed an operation.Primary tumor was proved pathologically: 20 cases of appendiceal mutinous carcinoma, 2 eases of ovarian mutinous carcinoma and 1 case of descending colon mutinous carcinoma.Surgical procedure included resection of primary tumour, omenteetomy, removal of mucinous ascites and combined resection of organs involved.Postoperative adjuvant chemotherapy and/or radiotherapy was added.Conclusions PMP is a rare condition and difficult to diagnosis.Imaging examination and CEA may help make a diagnosis.Treatment of PMP is mainly surgical operation and adjuvant therapy.

Objective:To discuss the effectiveness of treating cholelithiasis in a mini-invasive operation out of peritoneal cavity by laparoscopy combined with choledochoscope for preservation of cholecyst and removal of calculus.Methods:110 patients were divided into three groups that adapted to the indicaton in our hospital during Jan.2004-Dec.2006.The first group(40 cases) underwent operations out of the peritoneal cavity by laparoscopy combined with choledochoscope.The second group(30 cases) underwent operations in the peritoneal cavity by laparoscopy combined with choledochoscope.The third group(40 cases) underwent operations with choledochoscope only.The time of operation、the time of staying in hospital after operation and complications of these three groups were compared.Results:The time of operation and the complications of the first group was less than that of the second group(P0.05),the time of staying in hospital after operation of the first group was less than that of the third group(P0.05),which was statistically significant.Conclusion:The first method is better than the other methods with a shorter time of operation,a shorter hospital stay after operation,less complications and quicker recovery.It is of great value to be recommended in clinical practice.

腹股沟疝是老年人常见病.老年患者腹壁肌肉、腱膜、结缔组织都有不同程度萎缩或退行性变,导致腹股沟管后壁组织薄弱以致不能覆盖腹股沟区的生理薄弱区和点;另外,我国腹股沟疝高龄、多合并有内科疾患、腹股沟疝分型偏重且病史长、局部解剖条件差,许多患者术前接受过保守治疗,如疝托、疝带、中药外敷甚至硬化注射等,给手术带来不便或影响治疗效果.

材料与方法 1.术前准备:选取体重15～21kg的实验用狗13条. 2.麻醉:用3%戊巴比妥以1 ml/kg剂量静脉缓慢注入.

门静脉高压症是以门静脉系统血液动力学异常变化为特点的一种症侯群,对此症的外科治疗有近一个世纪的历史,最初主要是针对腹水,以后逐渐转向针对食管静脉曲张破裂出血为主的治疗.近年来,随着对门静脉高压症病理生理及血液动力学变化认识的深入,新技术、新疗法在临床的开展,门静脉高压症的治疗有了巨大的发展.

目的探讨疝环充填式无张力疝修补术的临床应用.方法本组共收治腹外疝105例,男性103例,女性2例.平均年龄67.4岁.局麻、椎管内麻醉或硬膜外麻醉.结果术后1～2天即可下床活动,疼痛轻,无手术死亡.切口无1例感染、无出血;术后有21例出现尿潴留,其余手术并发症均未发现.无复发.结论本术式较传统的疝修补术操作简单、迅速、疼痛轻、术后恢复快,复发率低,是治疗原发或复发性腹外疝最常实施的疝修补术式.

急性肠梗阻是临床上常见、多发病,若治疗不及时,易危及生命.笔者自1990年1月～2002年8月应用口服复方大承气汤配合针刺足三里治疗本病107例,现报告如下.

随着科学技术的发展,人们对疾病的治疗要求也越来越高,不仅要治疗疾病,而且要保留或不损伤某些器官.我科为寻求一种新的治疗胆囊结石的方法,改变了传统的胆囊切除观念,设计了一套微小创伤的手术方案--微创保胆内镜取石术.既取出胆囊内结石,又保留了有良好功能的胆囊,在6年的临床应用中取得了良好效果.