Lymph node mapping with carbon nanoparticles and the risk factors of lymph node metastasis in gastric cancer / 华中科技大学学报（医学）（英德文版）

The study aimed to examine the applicability of carbon nanoparticles as a tracer for lymph node mapping and the related factors of lymph node and No.8p subgroup metastasis in patients with gastric cancer. Clinical data of 50 patients with gastric cancer, who had not received treatment preoperatively and underwent gastrectomy in Department of Gastrointestinal Surgery, Wuhan Union Hospital, between October 2014 and August 2015, were retrospectively analyzed. These patients were found to have no distant metastasis preoperatively. Thirty-five out of 50 patients were subjected to lymphatic mapping technique using carbon nanoparticles as the tracer, and the rest 15 cases did not experience the lymphatic mapping and served as controls. The sensitivity, specificity, false positive rate and false negative rate were calculated according to the number of lymph nodes, and the staining and metastasis condition of lymph nodes. The diagnostic value of carbon nanoparticles on metastatic lymph nodes was evaluated. The relationship between the metastasis of lymph nodes or subgroup No.8p lymph nodes and clinicopathologic features was analyzed by χ-test or Fisher's exact test. All patients underwent D2 surgery (lymph node dissection including all the group 1 and group 2 nodes) plus the dissection of the subgroup No.8p lymph nodes. It was found that the average number of harvested lymph nodes in lymphatic mapping technique group (45.7±14.5) was greater than that in control group (39.2±11.7), but the difference was not significantly different (P=0.138>0.05). The success rate, the accuracy, sensitivity, specificity and false negative rate was 97%, 57%, 28%, 62% and 72% respectively. The metastasis of lymph nodes was correlated to the depth of cancer invasion (T stage) (P=0.004<0.05), and the metastasis of No.8p lymph nodes was correlated to the extent of lymph node involvement (N stage) (P=0.007<0.05). Six cases had lymph node metastasis in subgroup No.8p, and their TNM stages and clinical stages were as follows: T1N2M0 IIA, T3N3M0 IIIB, T4aN3M0 IIIC, T4aN3M0 IIIC, T4aN3M0 IIIC, and T4bN3M0 IIIC. In conclusion, our study indicated that carbon nanoparticles failed to show good selectivity for metastatic lymph nodes; the result of lymphatic mapping does not achieve a satisfactory performance; the incidence of lymph node metastasis may increase, accompanying with the increase of the depth of cancer invasion; No.8p lymph node metastasis tends to occur for gastric carcinoma patients with the extent of lymph node metastasis over N2 stage.

Association between RET proto-oncogene polymorphisms and Hirschsprung disease in Chinese Han population of Hubei district / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To establish the genetic background of exon2, exon13, exon11 and exon15 polymorphisms of RET proto-oncogene and study the possible involvement of RET proto-oncogene in the etiology of Hirschsprung disease (HD) in Chinese Han population surrounding Province HuBei.</p><p><b>METHODS</b>The genotype and allele frequencies of RET proto-oncogene polymorphisms were identified by polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLPS) in 94 HD patients and 122 control subjects.</p><p><b>RESULTS</b>The genotype and allele frequencies of exon2 were AA 0.17, AG 0.72, GG 0.11, A 0.53, G 0.47 in control, and AA 0.61, AG 0.35, GG 0.04, A 0.78, G 0.22 in HD, and those of exon13 were GG 0.30, GT 0.52, TT 0.18, G 0.56, T 0.44 in control, and GG 0.49, GT 0.36, TT 0.15, G 0.67, T 0.33 in HD. There were significant differences in the two polymorphisms above between HD and control. The genotype and allele frequencies of exon11 were AA 0.05, AG 0.16, GG 0.79, A 0.13, G 0.87 in control and AA 0.02, AG 0.14, GG 0.84, A 0.09, G 0.91 in HD, the differences were not found between these two groups about this site. Exon15 were all of CC genotype in spite of control or HD.</p><p><b>CONCLUSIONS</b>These data provide evidences for the contributions of exon2 and exon13 polymorphisms of RET proto-oncogene to susceptibility to HD in Chinese Han population surrounding province.</p>

Effect of the width of excisional mucosa stoma ring on postoperative results of procedure for prolapse and hemorrhoids method / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the effect of the width of excisional mucosal stoma ring on postoperative results of procedure for prolapse and hemorrhoids (PPH) in the treatment of hemorrhoids.</p><p><b>METHODS</b>Four hundred and eighty hemorrhoid patients were treated with circular stapler. Whether excisional mucosa stoma ring was regular or not, and its width were recorded. After follow-up from one month to 24 months,the outcomes were compared.</p><p><b>RESULTS</b>The mean age of the patients was (46.6+/- 5.1) years. Regular mucosa stoma ring was excited in 303 cases,while irregular ring in 177 cases. Hemorrhoids prolapse occurred in 18 cases of the patients with irregular mucosal ring excited, while only 8 cases of the patients with regular ring excited (P< 0.01). There was significant difference in the incidence of hemorrhoids prolapse between the different groups according to different width of excisional mucosal stoma ring (P< 0.01), and the patients with postoperative hemorrhoids prolapse was lest with the width of excisional mucosal stoma ring more than 3 cm.</p><p><b>CONCLUSIONS</b>The width of excisional mucosal stoma ring is one of the effecting factors of surgical outcomes. It is effective to excite mucosal stoma ring more than 2 cm,and most effective to excite mucosal stoma ring more than 3 cm.</p>

Analysis of the relationship between stoma position and postoperative effects of procedure for prolapse and hemorrhoids in the treatment of hemorrhoids / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the relationship between stoma position and postoperative effects of procedure for prolapse and hemorrhoids (PPH) in the treatment of hemorrhoids.</p><p><b>METHODS</b>Four hundred and one hemorrhoid patients were treated with circular stapler. II hemorrhoids, 45 cases; III-IV hemorrhoids, 356 cases. The position of stoma located 1 cm up dentate line, 219 cases; 1-2 cm up dentate line, 87 cases; 2-3 cm up dentate line, 60 cases; 3-4 cm up dentate line, 25 cases; > 4 cm up dentate line, 10 cases. The patients were followed from one week to two years postoperatively.</p><p><b>RESULTS</b>Postoperative effects and procidentia rates have significant association with the position of stoma. If the distance between position of stoma and dentate line is < or = 2 cm, the postoperative procidentia rate was 1.1%, lower than that of the distance > or = 4 cm.</p><p><b>CONCLUSIONS</b>The complication and procidentia rate of PPH is associated with the stoma position. The stoma position should be no more than 2 cm to dentate line.</p>