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Objective:To compare the short-term clinical effect of gastrointestinal or enterointestinal dominant channels after radical proximal gastrectomy combined with dual-channel anastomosis for upper gastric cancer.Methods:A total of 72 patients in Hefei Second People's Hospital from Jan 2017 to Jul 2021 were retrospectively analyzed, including 29 patients in the total gastrectomy group, and 43 patients in the group of radical proximal gastrectomy+dual-channel anastomosis, and by imaging results it was futher stratified into gastrointestinal dominant channel sub-group (26 cases) and intestinal dominant channel sub-group (17 cases).Results:The number of lymph node dissection in the total gastrectomy group was more than that in the proximal stomach group (27.9±3.2 vs. 25.4±2.9, t=3.441, P<0.05). While the 12 months post operation albumin [(36.1±2.4) g/L vs. (34.1 ± 2.3) g/L, t=3.526, P=0.001], hemoglobin [(122.9 ± 6.9) g/L vs. (115.9 ± 6.0) g/L, t=4.444, P=0.000], vitamin B12 [(349.0±21.7) pmol/ml vs. (77.9±8.5) pmol/ml, t=63.931, P=0.000] level, and the body mass index [(23.01±0.78) kg/m 2vs. (21.95±0.67) kg/m 2, t=5.978, P=0.000] decline level was unfavored ( P<0.05). The 12 months post operation vitamin B12 level, body mass index, albumin and hemoglobin level had no statistical difference in the two subgroups of proximal gastrectomy (all P>0.05). Conclusions:Laparoscopic proximal gastrectomy with double tract reconstruction for proximal gastric cancer is safe and reliable, which can effectively improve the postoperative nutritional status, prevent postoperative anemia.
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Objective To investigate the interrelationship between Golgi phosphoprotein 3 ( GOLPH3 ) expression with vasculoar endothelial growth factor( VEGF) expression in the progression of human gastric cancer by detecting the expression level of GOLPH3 and VEGF. Methods Immunohistochemistry ( IHC) was used to detect the ex-pression of GOLPH3 and VEGF in 55 cases of gastric cancerous and carcinoma-adjacent tissues. Pearson correlation analysis was used to discuss the association between GOLPH3 expression with VEGF expression. Results The im-munohistochemical detection showed that the positive expression rates of GOLPH3 and VEGF were 67. 27%, 58. 18% respectively, which were significantly higher than the positive expression rates in carcinoma-adjacent tis-sues ( P<0. 05 ) . A statistical analysis revealed that the positive expression rate of GOLPH3 and VEGF in the gas-tric cancer tissues were strongly correlated with depth of invasion ( P<0. 05 ) , distant metastasis ( P<0. 01 ) and TNM stages (P<0. 01), whereas it did not significantly correlate with age or gender or size of tumor. Compared with the negative for the GOLPH3 expression, the VEGF expression in gastric cancer tissues positive for the GOL-PH3 expression was significantly higher. The protein level of GOLPH3 expression was positively correlated with VEGF expression (r=0. 508,P<0. 01). Conclusion GOLPH3 overexpression may regulate gastric angiogenesis by upregulating the expression of VEGF, which affects the invasion and metastasis of gastric cancer.
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We and others have shown that Astragalus extract [AE] regulates various cellular processes including inflammation and apoptosis. It remains elusive whether and how AE modulates apoptosis in gastric cancer cells in vitro and in vivo. The objective of this study is to determine the effects and mechanisms of AE on the proliferation and apoptosis of human gastric cancer SGC-7901 cells and on tumor growth in orthotopic transplantation gastric tumor model in nude mice. Human gastric adenocarcinoma SGC-7901 cells and nude mice implanted with gastric cancer cells were treated with different concentration of AE and 5-fluorouracil as control. Cellular proliferation, apoptosis and tumor growth as well as interleukin [IL]-6/signal transducer and activator of transcription [Stat] 3 signals pathway were determined. We found that AE inhibited proliferation but caused apoptosis in human gastric cancer cells. Furthermore, the tumor growth and volume were reduced by AE administration in nude mice implanted with gastric cancer cells. In addition, treatments with AE decreased the expression of Bcl-2 proteins, whereas the expression of Bax was increased after AE treatment in tumor tissues of nude mice transplanted with human gastric cancer cells. This was associated with AE-mediated reduction of IL-6, phosphorylated Stat3, survivin and vascular endothelial growth factor. Overall, AE enhances apoptosis in gastric cancer cells in vitro and in vivo, which is associated with decreased activation of IL-6/Stat3 signals
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Objective To study the feasibility and timing of early laparoscopic cholecystectomy (LC) for the patients with mild-to-moderate acute pancreatitis with gallbladder stone.Methods 26 patients with mild-to-moderate acute pancreatitis with gallbladder stone underwent early laparoscopic cholecystectomy.The patients were initially treated with conservative treatment.When the diagnosis was confirmed and the patients were stable,LC was carried out within 48 hours of hospitalization.The results were compared with a delayed group of patients who received delayed LC for acute pancreatitis.Results All the LC operations were successfully carried out.There were no significant differences between the two groups in alkaline phosphatase,alanine aminotransferase,aspartate aminotransferase,blood amylase and urine armylase on postoperative day 1,3,5,7.Patients who received early laparoscopic cholecystectomy had a shorter hospital stay.There were no significant differences between the two groups in the operation time,intraoperative blood loss,postoperative complication rates and recurrence of acute pancreatifis.Conclusion After CBD stones have been ruled out,it is safe and feasible to carry out early laparoscopic cholecystectomy within 48 hours of hospital admission for patients with mild-to-moderate acute pancreatitis with gallbladder stone.
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Objective To determine the expression of metastasis-associated gene 2 ( MTA2 ) and p53 in colorectal cancer and non-cancerous mucosa, analyze their relationship with clinicopathological parameters, and discuss the clinical significance. Methods 120 colorectal neoplasm patients' cancer tissues and clinical information were col-lected from the first affiliated hospital of Anhui medical university. 30 patients of them were chosen to collect non-cancerous mucosa which was 5 cm away from the tumor. Immunohistochemistry staining was used to detect the ex-pression of MTA2 and p53. According to the clinicopathological parameters, the positive and negative expression of MTA2, p53 were counted each group, discussed the relationship between positive expression and clinicopathologi-cal parameters by SPSS 19.0 . Results The immunohistochemistry showed that the positive expression rate of MTA2 was 59.16%, and the positive expression rate of p53 was 61.67%. The expression of MTA2 and p53 in colorectal cancer were significantly higher than non-cancerous mucosa ( P<0.05 ) . The MTA2 expression was positively cor-related with the depth of invasion, lymphatic metastasis, distant metastasis and TNM stages (P<0.05). The p53 protein expression was positively correlated with depth of invasion and lymphatic metastasis ( P<0.05 ) . Conclu-sion MTA2 could be used as a new clinical biomarker and therapeutic target for colorectal cancer probably, which might be more effective than p53 .
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Amplification of the human epidermal growth factor receptor 2/neu (HER2/neu) gene and overexpression of the HER2 protein (HER2) have been shown to occur in gastric and gastroesophageal junction adenocarcinoma in a number of studies.With a dismal survival rate,patients with these cancers stand to benefit from the identification of possible molecular targets such as HER2 for both prognostic and therapeutic purposes.Although these and other carcinomas that overexpress HER2 may have a poorer prognosis and exhibit resistance to conventional chemo-therapy,they have also recently been shown to respond to targeted therapy with the anti-HER2 antibody Trastuzumab.Here,the author briefly review the molecular biology,histopathology,diagnostic techniques,and interpretation,as well as the clinical implications of HER2 amplification/overexpression in gastric and gastroesophageal adenocarcinoma.
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Objective To investigate the expressions of the CD13 in gastric cancer and the relationships between it and the patients' prognosis.Methods The expressions of CD13 were detected by immunohistochemical (SP method) in 104 cases of gastric cancer and 16 cases of normal gastric mucosa.Results The expressions of CD13 in 104 cases of gastric carcinoma and 16 cases of normal gastric mucosa show positive rate were 74％ (77/104) and 0％,respectively.The expressions of CD13 in gastric cancer were higher than in normal gastric mucosa and the difference was statistically significant (P ＜ 0.01).The expressions of CD13 in gastric cancer were not relative to patients' age,gender,and lymph node metastasis (P ＞ 0.05),but to be correlative with tumor sizes,clinical stage,degree of differentiation,and patients' 5-year survival rate (P ＜ 0.05).Conclusions The abnormal expression of CD13 in the gastric cancer may be correlative with the occurrence and development of gastric cancer,which can be an important indicator to evaluate the degree of malignance,guide treatment and assess uncertain prognosis of gastric cancer.
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ObjectiveTo survey the status of Helicobacter pylori (HP)infection in cholangiocarcinoma,and its relation to clinical and pathological parameters and prognosis. MethodsHP infection in 80 cholangiocarcinoma samples and 30 controls was detected by PCR,in those with positive results the expression of Cag A and its subtypes of Vac A sla,m1 and m2 was further tested by PCR.ResultsChi-square test showed that the detection rate of in HP ( + ) in cholangiocarcinoma group is 71％,higher than 20％ in control group.The positive cases of CagA and VacA sla,m1,m2 in cholangiocarcinoma group was respectively 30,40,5 and 43 cases.HP infection in cholangiocarcinoma was correlated with the location of the tumor(x2 =27.580,P ＜ 0.05 ). MultivariateLogisticanalysisshowedthat cholangiocarcinoma is over 10 times more likely in HP ( + ) patients than HP ( - ) ( OR =10.531 ).Cox regression analyses showed that the infection of HP(HR =8.105,P =0.032),the staging of TNM( Ⅱ/ⅢHR=9.141,P=0.040,Ⅳ HR =29.071,P=0.040) and surgery (HR=9.531,P =0.015) are all independent prognostic factors of cholangiocarcinoma. Life table analyses showed HP infection negatively affects the survival time of cholangiocarcinoma after a surgery ( u =10.074,P =0.002),and the median survival time is 7.25 months shorter than HP( - ) patients. ConclusionsIt is common that HP infection complicating cholangiocarcinoma,usually with the genotype of VacA sla/m2,HP infection is a risk factor for cholangiocarcinoma,and negatively affects oatients survival after surgery.
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Objective To explore the changes of the pressure of sphincter of Oddi(SO)in postoperative patients with cholangiolithiasis.Methods Sixty cases with multiple biliary calculi operation (recurrent cholangiolithiasis group),80 cases with biliary calculi operation at first time(cholangiolithiasis group)and 9 cases with external injuries of pancreas or liver(control group),who were examined in order to identify common bile duct pressure(CBDP),SO basal pressure(SOBP),amplitude of SO contractions (SOCA),frequency of SO contractions(SOF),then comparing the difference of statistics among the three groups.Results CBDP,SOBP,SOCA,SOF in recurrent cholangiolithiasis group and cholangiolithiasis group were significantly higher than those in control group[(13.78 ±9.91),(12.65 ±7.64)mm Hg(1mm Hg =0.133 kPa)vs.(12.54 ± 2.35)mm Hg,(15.27 ± 9.15),(14.89 ± 7.87)mm Hg vs.(13.63 ± 3.27)mm Hg,(106.30 ± 54.70),(98.39 ±38.29)mm Hg vs.(87.65 ±56.38)mm Hg,(6.91 ± 1.92),(6.25 ±2.17)times/min vs.(5.26 ± 2.11)times/min](P ＜ 0.05),but there was no significant difference between recurrent cholangiolithiasis group and cholangiolithiasis group(P ＞ 0.05).Conclusion SO dysfunction resides in the postoperative patients with cholangiolithiasis,and it is possible related with the formation and/or recurrence of cholangiolithiasis.
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Rectal cancer does great harm to human health which is one of the common gastrointestinal malignancies.The most effective treatment to rectal cancer is surgical resection at present.With the increasing demand on the quality of life,we minimize the surgical resection to preserve the anal function of patients while removing the tumor completely depends on the distal excision margin.But how long of the distance is safe? Lots of domestic and foreign scholars have a great controversy without a certain definition.This article reviews the progress on the distal excision margin,aiming to give help to clinical sphincter-preserving surgery.
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Objective To explore the relationship between cholelithiasis and the function of sphincter of Oddi (SO). Methods To identify the existence of calculi, choledochoscopy was performed in patients 6 weeks after exploration of the common bile duct (CBD) and T tube drainage, in which 71 were patients with stones in gall bladder, CBD or intra-hepatic bile duct, and 9 with trauma of pancreas or liver.Biliary manometry was performed after choledochoscopy, and an additional manometry was applied after calculus removal if calculi were detected. The indices measured included SO basal pressure ( SOBP), amplitude of SO contractions (SOCA), frequency of SO contractions (SOF) and CBD pressure (CBDP). The patients with cholelithiasis were classified into cholecystolithiasis group, choledocholithiasis group, and hepatolithiasis group according to the position of calculi. Patients with trauma were assigned as the control group.Results All variables in 50 patients with choledocholithiasis were similar before and after the procedure.The variables in patients with cholecystolithiasis and choledocholithiasis had no difference from those of the control (P ＞ 0. 05 ). The SOBP and SOCA of patients in hepatolithiasis group were lower than those of the control group ( P ＜ 0. 05 ), while no difference in SOF was detected (P ＞ 0. 05 ). Conclusion The function of SO in patients with hepatolithiasis is abnormal ( decrease in SOBP and SOCA). Biliary manometry cannot be the reliable evidence for the existence of calculi in bile duct.
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Objective To explore the role of endogenous and exogenous β-glucuronidase( β-G) in the development of primary common duct stones.Method Using modified Fishman method to test the activities of the endogenous and exogenous β -G in 35 patients with primary common duct stones(experimental group) and 11 patients with cystic polypus (control group) respectively.Results The activities of endogenous β -G in the bile of experimental group and control group were (7859.1 ± 738.5 ),(2174.9 ± 348.4 ) U/L(P ＜0.01).While the activities of exogenous β-G in experimental group and control group were (6786.1 ±544.3),(1504.7 ±655.7) U/L (P ＜0.01).In experimental group,there were significant statistical differences in the activities of the exogenous β -G in the sample obtained on the day of operation and 7 days after operation from 13 cases with the acute inflammation [(8935.7 ± 845.9),(2176.1 ± 956.7) U/L]and from 22 cases with the chronic inflammation [(5137.2 ±540.7),(1838.8 ±733.3) U/L],and there were significant higher in the activities of the exogenous β -G in the sample obtained on the day of operation from the acute inflammation compared to those from the chronic inflammation (P ＜ 0.05 ).Conclusions There is obvious correlation between either endogenous or exogenous β -G with primary common duct stones.And the endogenous β -G might be one of the fundamental cause in the development of primary common duct stones.
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Objective To evaluate the causation and management of complications caused by enteral nutrition (EN)after stomach cancer surgery.Methods The clinical data of 195 gastric cancer patients which used EN after surgery were analyzed retrospectively from September 2002 to April 2008 in our hospital.Results Among the 195 patients,29(14.87%)developed abdominal distention,17(8.71%)diarrhoea,Six(3.07%)metabolic complica tions,three anastomotie leakage,1 patient with colon perforation.Conclusion These complications caused by EN after stomach cancer surgery associated with the stress of surgery,the speed and concentration of nutrition infusion, patients'metabolic conditions and other related factors.
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Objective To investigate the changes and significance of the contents of cholecystokinin (CCK) acceptors and nitric oxide synthase (NOS) in sphincter of Oddi and the contents of CCK and nitric oxide (NO) in the blood of the patients with calculus of bile duct. Methods The contents of CCK acceptors and NOS in sphincter of Oddi and the contents of CCK and NO in the blood were determined in 41 patients with gallstone and 6 controls. Results The contents of CCK and NO in the blood of patients with gallstone were significantly higher than that in control [ ( 38.91±4.85 ) pmol/L vs ( 30.67±1.81 ) pmol/L; (40.84±4.74 ) pmol/L vs ( 32.81±1.11) pmol/L] ;The contents of CCK acceptors and NOS in sphincter of Oddi in the patients with gallstone were signifi-cantly lower than in the controls [ (67.59±5.87 ) ng/L vs ( 78.99±1.71 ) ng/L; ( 457.52±45.40 ) ng/L vs ( 519.61±11.38 ) ng/L] ;The contents of CCK and NO in the blood in the different groups with calculus of bile duct were significantly different from those in the controls. Conieusion The degree of the decrease of the contents CCK acceptors and NOS in sphincter of Oddi leads to the decrease of Oddi sphincter function,resuting in cholestasis and promoting the formation of bile duct stone.
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Bile duct stone is the common and frequently-occurring disease, its incidence upwards trend. In recent years, people realize that Oddi sphincter movement disorders play an important role in the inci-dence of bile duct stones. NO, CCK, VIP and theie interactian have effects on sphincter function and dis-charged from the regulation of bile. These factors are necessary to conduct an in-depth study to investigate the cause of bile duct stone and its treatment.
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Objective To explore the experience in treatment of primary retroperitoneal tumors (PRPT).Methods The clinical data of 62 cases with primary relroperitoneal tumors from 2001 to 2007were studied retrospectively.Results The abdominal mass was the main symptom in PRPT.There were 29 cases of benign tumors and 33 cases of malignanat tunlors respectively.Complete resections were performed in 47 patients(76%),partial resection was conducted for 10 patients.Resection could not be performed in 5 patients so only biopsy was conducted,12 patients accepted combined organ resections,2 patients died.Conclusion Adequate preoperative preparation and excellent surgical technique are the keys to compele tumour resection.
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Objective To investigate the effects of cholecystokinin (CCK) on diabetes mellitus with cholecystolithiasis. Methods Relevant literatures of recent years were reviewed. Results CCK exists widely in human body.On the one hand, CCK enhances cholecystolithiasis by causing diabetes. On the other hand, its pathological changes can also lead to cholecystolithiasis. Besides, it is possibility that the CCK-related gene abnormality is the common cause of diabetes and cholecystolithiasis. Conclusion CCK plays an important role in diabetes mellitus complicated with cholecystolithiasis. However, there is much yet to be known about CCK.
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Objective To study the effects and mechanism of Octreotide to inhibit the proliferation of human gastric cancer cells in vitro . Methods Human gastric cancer cell line SGC 7901 was treated with Octreotide. Human fibroblast cell line HF and 5 FU were used as control. MTT assay and fluorescent microscopy as well as flow cytometry were performed in this study. Results Octreotide inhibited the growth of SGC 7901 in vitro within certain concentrations. The suppression was quantity dependent but did not occur when up to a certain concentration. There was no difference between Octreotide and 5 FU in their inhibition on SGC 7901. Octreotide had no effects on normal human fibroblast cell line HF. When SGC 7901 was treated with Octreotide, the typical apoptotic bodies were identified by flow cytometry and fluorescent microscopy. Conclusion Octreotide can inhibit the proliferation of human gastric cancer cell line SGC 7901 in vitro . The induction of apoptosis by Octreotide might be the primary mechanism.
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The relationship between PGE2 and sIL-2R and ca rcinoma of large intestine and the development of its immunological study is de scribed briefly.
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Objective To evaluate the diagnosis and surgical management for pancreatic duct stones (PDS). Methods The clinical data of 19 PDS patients admitted to our hospital from Jan. 1985 to Sep. 2003 were analyzed retrospectively. Results Epigastric pain was the first symptom in all patients,and chronic pancreatitis was associated, pancreatic carcinoma coexisted in 6 cases. Fifteen cases were found to have PDS or pancreatic duct dilation by B-type ultrasonography. Twelve patients underwent pancreatolithotomy plus side to side Roux-en-Y pancreaticojejunostomy. Pancreatoduodenectomy was performed on four patients ,caudal pancreatectomy and pancreatolithotomy on three patients. Six pancreatic carcinoma patients died during follow-up of 9～26 months. Abdominal pain was relieved completely in 11 cases and partially in 1,stones and pain recurred in one patient. Conclusions B-type ultrasonography、CT and endoscopic retrograde cholangiopancreatography(ERCP) are most useful diagnostic methods;Surgical procedures should be selected according to the following factors: (1) location of the pancreatic duct stones. (2) stenosis of the main pancreatic duct.(3) pancreatic duct stones associated with or without pancreatic carcinoma.