Objective To evaluate the efficacy of cervical esophagogastric side-to-side stapled anastomosis in minimally invasive resection

of esophageal carcinoma. Methods We retrospectively analyzed the clinical data of 110 patients with esophageal carcinoma underwent completely minimally invasive esophagectomy and left cervical esophagogastromy from March 2014 to March 2015. Sixty-five patients underwent cervical esophagogastromy using circular stapler as control group，and the rest 45 patients were treated by cervical esophagogastric side-to-side stapled anastomosis as experimental group. The anastomosis time，postoperative anastomotic leakage，anastomotic stricture and gastroesophageal reflux were compared between the two groups. Results All the patients underwent minimally invasive resection，and no death happened during perioperative period. The time of anastomosis in experiment group was（16.1±2.5）min，shorter than（27.5±1.9） min of control group（P=0.000）. The incidence of anastomotic leakage and gastroesophageal reflux 6 months after operation had no significant difference（P＞0.05）. The incidence of anastomotic stricture 6 months after operation in experimental group was 4.4％，lower than 24.6％ of control group（P=0.005）. Conclusion The technique of cervical esophagogastric side-to-side stapled anastomosis can shorten the anastomosis time and reduce the incidence of anastomotic stricture 6 months after operation，and have no tendency to increase anastomotic leakage and gastroesophageal reflux 6 months after operation. It is a satisfactory technique for the treatment of esophageal carcinoma.

Objective To investigate the sonographic and CT features of hepatic masses caused by liver involvement in hematological

malignancies in order to improve diagnostic acurracy. Methods From April 2012 to May 2015，16 patients with hepatic masses caused by liver involvement in hematologic malignancies were respectively analyzed. Hepatic masses were present in patients with non-Hodgkin's lymphoma（9／16），Hodgkin's disease（2／16），multiple myloma（1／16），acute myeloblastic leukemia（2／16），acute lymphocytic leukemia（1／16）and chronic lymphocytic leukemia（1／16）. Results The most frequent sonographic appearance was multiple small focal lesions，and less frequent appearance was single lesions. Most lesions showed regular round，round like or oval shapes，while few lesions showed irregular shapes. The hypoechoic lesions were found in 13 cases，while mixechoic and hyperechoic lesions were found in 1 and 2 cases，respectively. Poor or no color flow signal was found in the lesions.Unenhanced CT showed that multiple focal hypoattenuating lesions were in most cases.Enhanced CT showed no evident enhancement or slight enhancement. More lesions were found in right hepatic lobes than in left lobes. The sonographic and CT features of hepatic masses caused by liver involvement in hematological malignancies，including non-Hodgkin's lymphoma，Hodgkin's disease，multiple myloma，acute and chronic leukemia，are similar. Conclusion Ultrasound and CT show certain featrures in hepatic masses caused by liver involvement in hematological malignancies. The combination of ultrasound and CT is preferred as non-invasive imaging diagnostic method.

Objective To explore the diagnosis，treatment of cancer pain in primary hospitals of Guangzhou， analyze possible disadvantages,

and provide basis to improve the management of cancer pain. Methods By holding training course of cancer pain standardized treatment of primary hospitals and surveying to all attendees，120 questionnaires were collected and analyzed. Results The mean score in basic knowledge of cancer pain management was 12.2±3.5. There were no significant differences of mean score among doctors，nurses and other medical staff（P＞0.05）.There was no statistical differences between the mean score of medical staff who participated in cancer pain training course and who did not（P＞0.05）. The common bad habits of using analgesic drugs were invasive administration and opioids agent inproper use. Barriers to optimal treatment of cancer pain in primary hospitals included insufficient knowledge and education of physicians，concern about side effect of opioids, and shortage of opioids agent. Conclusion Strengthening the training of medical physicians about analgesia，supplying sufficient opioids agent and educating patients is a suitabe way to promote standardized cancer pain management in primary hospitals.

Objective To investigate the value of fiberoptic ductoscopy-guided intraductal biopsy in combination with the detection of

biomarker CA153 in diagnosis of early ductal pathological changes. Methods From May 2012 to October 2014，fiberoptic ductoscopy was performed on 123 nipple discharge patients, and patients diagnosed as breast intraductal neoplasm were given intraductal biopsy. The biopsy results were compared with pathology of duct excision. Nipple lavage fluid were collected from patients with intraductal neoplasm for the test of CA153，and 30 patients of intraductal dilatation were enrolled as control. Results Fifty-six patients who were found brest intraductal neoplasm among 123 patients underwent 64 times of fiberoptic ductoscopy-guided intraductal biospy and ductal lesions were removed. Among 56 patients underwent fiberoptic ductoscopy-guided intraductal biopsy，there were intraductal papilloma in 28 cases，mutiple intraductal papilloma in 7 cases，ductal hyperplasia in 6 cases，severe atypical ductal hyperplasias in 2 cases，and breast cancer was found in 7 cases. Biopsy failed in 6 patients， and the success rate of biopsy was 89.3％. All the patients underwent breast duct dissection. There were solitary intraductal papilloma in 29 cases，multiple intraductal papilloma in 11cases，ductal hyperplasia in 8 cases，atypical ductal hyperplasia in 1 case，intraductal carcinoma in 4 cases，invasive ductal carcinoma in 2 cases and intraductal papilloma carcinoma in 1 case. CA153 level of nipple lavage fluid in intraductal dilatation patients was（26.90±2.76）U／ml，lower than（31.91±22.95）U／ml of G3 grade（P＞0.05）,（52.67±33.63）U／ml of G4（P＜0.05）and（85.68±21.13）U／ml of G5 grade（P＜0.05）. Conclusion Fiberoptic ductoscopy-guided intraductal biopsy is microinvasive，safe，convenient with high success rate，and in combination with CA153 level in nipple lavage fluid shows certain values in diagnosing early ductal malignant changes.

Exosomes are membrane vesicle-like structures of 30-100 nm in diameter，existing in various body fluids，which are released from a variety of different cell types. Exosomes have emerged as a noval mode of intracellular communication，participating in the progression of oncogenic processes. Gastric cancer derived exosomes can regulate PI3K／Akt，and MAPK／ERK signaling pathways by shuttling key molecules including miRNA，cytokines and protiens，which may influence tumor proliferation，invasion，metastasis and immune escape in gastric cancer. In this review，we discuss the mechanism of exosomes in gastric cancer， which may provide new ideas on diagnosis and treatment of gastric cancer.

Recently，high expression of long non-coding RNA urothelial carcinoma antigen 1（UCA1）has been found in various human carcinomas（bladder urothelial carcinoma，gastric cancer，hepatocellular carcinoma，ovarian cancer，etc）acting as proto-oncogene. UCA1 is playing an important role in the development and progression of tumors. As a novel biological marker，it is indispensible during the process of diagnosis，therapy and prognosis. In this view，we summarize the latest progress，both domestic and overseas，on the advance of UCA1 in tumor research.