Impact of nutritional risk on short-term clinical outcomes after laparoscope-assisted radical gastrectomy for gastric cancer / 中华消化外科杂志

Objective To explore the impact of nutritional risk on short-term clinical outcomes after laparoscope-assisted radical gastrectomy for gastric cancer.Methods The retrospective case-control study was conducted.The clinical data of 150 patients who underwent laparoscopic gastrectomy at the First Affiliated Hospital of Wenzhou Medical University between June 2014 and April 2016 were collected.According to nutritional risk screening 2002 (NRS 2002),42 and 108 patients were respectively divided into the nutritional risk group (NRS 2002 score ≥3) and non-nutritional risk group (NRS 2002 score ＜3).Laparoscope-assisted radical subtotal gastrectomy or total gastrectomy was performed based on tumor location.Observation indicators:(1) postoperative short-term clinical outcomes:postoperative complications,duration of postoperative hospital stay,hospital expenses,unplanned readmission within 30 days after discharging.Postoperative complications meant total complications within 30 days postoperatively,grade Ⅰ-Ⅴ of Clavien-Dindo grade was complication classification.Grade Ⅱ and above of Clavien-Dindo grade were analyzed in this research.(2) Risk factors analysis affecting occurrence of postoperative complications of patients.Measurement data with normal distribution were represented as x±s and analyzed using the independent-sample t test.Measurement data with skewed distribution were described as M (Qn) and analyzed using the Mann-Whitney U test.Categorical variables were described as number and percentage and analyzed by the chisquare test.Ranked data were analyzed by the Mann-Whitney U test.Univariate analysis was done by the chi-square test.P＜0.1 of univariate analysis was used to multivariate analysis.COX regression model in multivariate analysis was built using progressive condition method.Results (1) Postoperative short-term clinical outcomes:number of patients with total complications,number of patients with severe complications,duration of postoperative hospital stay,hospital expenses and number of patients with unplanned readmission within 30 days after discharging were 9,2,11 days (9 days,16 days),57 825 yuan (51 894 yuan,66 908 yuan),2 in the nutritional risk group and 16,3,11 days (9 days,13 days),55 067 yuan (49 395 yuan,62 423 yuan),8 in the non-nutritional risk group,respectively,with no statistically significant difference between the 2 groups (X2=0.952,0.010,Z=-1.133,-1.691,X2 =0.048,P＞0.05).Results of univariate analysis showed that age was a risk factor affecting incidence of complications after laparoscope-assisted radical gastrectomy for gastric cancer (X2 =4.468,P＜ 0.05).Results of multivariate analysis showed that preoperative hypoproteinemia was an independent risk factor affecting incidence of complications after laparoscope-assisted radical gastrectomy for gastric cancer (OR =2.797,95％ confidence interval:1.053-7.435,P＜0.05).Conclusion There is little poor impact of nutritional risk on short-term outcomes after laparoscope-assisted radical gastrectomy for gastric cancer,preoperative hypoproteinemia is an independent risk factor affecting occurrence of grade Ⅱ and above of postoperative complications.

Relationship between NMDA receptor and postoperative fatigue syndrome and its associated central mechanism / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the central mechanism of postoperative fatigue syndrome by detecting the expression of NMDA receptor and tryptophan metabolism.</p><p><b>METHODS</b>After being numbered according to the weight, ninety-six male SD rats were randomly divided into control group (bowel loop was flipped after laparotomy and received intraperitoneal injection of saline at a dose of 1 ml/kg), POFS model(70% of the length of small intestine was resected and received intraperitoneal injection of saline at a dose of 1 ml/kg), and NMDA antagonist groups(70% of the length of small intestine was resected and received intraperitoneal injection of MK801 at a dose of 1 ml/kg). Each group was divided into subgroups by postoperative 1, 3, 5 and 7 d, with 8 rats in each subgroup. The hippocampus was removed at each time point after open field test (OFT) to detect the mRNA expression levels of NMDA receptor 1 and kynurenine aminotransferase III((KATIII() by real-time PCR. Protein level of NMDA receptor 1 was detected by Western blot. High performance liquid chromatography (HPLC) was used to measure the concentrations of tryptophan (TRP), kynurenine (KYN) and kynurenic acid(KYNA). Ultra-structural changes of hippocampal neurons were observed by transmission electron microscopy(TEM).</p><p><b>RESULTS</b>As compared to control group, exercise score decreased(P<0.05), rest time and central panel residence time prolonged, periphery/central panel ratio increased (all P<0.05), mRNA and protein expressions of NMDA receptor 1 increased (P<0.05), mRNA expression of KAT III( decreased (P<0.05), KYN/TRP ratio and KYN/KYNA ratio decreased (all P<0.05) in POFS group on postoperative day 1 and 3. As compared to POFS group, central panel residence time and periphery/central panel ratio decreased on postoperative day 1, and mRNA and protein expressions of NMDA receptor 1 decreased on postoperative day 1 and 3 (all P<0.05) in antagonist group. TEM revealed that degenerated neuron was found in the hippocampus of POFS rats, while such damage was improved in antagonist group.</p><p><b>CONCLUSION</b>The increased expression level of NMDA receptor may play an important role in POFS. NMDA receptor antagonist MK801 may improve the POFS.</p>

MMP-7 gene expression in gastric cancer and its significance / 中国癌症杂志

Purpose:To study the expression of MMP 7 gene in gastric cancer tissue and different stomach cancer cell line and explore its clinical significance.Methods:Reverse transcription polymerase chain reaction (RT PCR) was used to detect the expression of MMP 7 mRNA in 35 gastric cancer samples and the surrounding normal tissues and stomach cancer cell line. The ability of the invasion was observed by Boyden Chamber invasion assay. Results:The expression rate of MMP 7 mRNA in 35 gastric cancer samples and the surrounding normal tissues was 60% and 11%, respectively. The expression level of MMP 7 gene in gastric cancer was much higher than that in the surrounding normal tissues[(0 627?0 276)vs(0 237?0 12), P

Advances in research on the expression of matrix metalloproteinases in gastrointestinal cancer and their inhibitors in treatment / 中国癌症杂志

Matrix metalloproteinase (MMP) are a family of zinc-dependent endoproteinases whose enzymatic activity is directed against components of the extracelluar matrix(ECM). Their activities are inhibited by the tissue inhibitor of metalloproteinase (TIMP). MMP exerted an important role in invasion and metastasis of gastrointestinal cancer through degrading the ECM. With further research on inhibition of MMP, synthetic MMP inhibitor will have good prospects in the treatment of tumor invasion and metastasis.

Effects of MMP-7asODN on MMP-7 mRNA expression and invasion of KATOⅢ cell / 中国病理生理杂志

AIM:To investigate the effects of MMP-7asODN on MMP-7 expression in human stomach cancer cell line KATOIII and explore the effect of MMP-7 on cancer invasion and metastasis. METHODS: A 15mer PS-asODNs targeted against the MMP-7 mRNA were introduced into KATOIII cells by FuGENE TM 6. The levels of MMP-7 mRNA was observed by reverse transcription polymerase chain reaction (RT-PCR). The ability of the invasion was observed by Boyden Chamber invasion assay. RESULTS: The MMP-7/?-actin ration was 0.31?0.02 for the PS-asODNs treated cells which is significantly lower compared with the control and PS-sODN and PS-mODN( 1.59?0.01, 1.14?0.03,1.51?0.02, respectivly.) P