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Alpha-fetoprotein producing gastric cancer (AFPGC) is a special type of gastric cancer. AFPGC is considered to be the most highly invasive tumor with a high degree of malignancy and prone to metastasis. As a consequence, it usually causes unsatisfied treatment effect and the prognosis is poor. At present, treatment methods and monitoring indicators have limited effect on AFPGC. VEGF, HER2, AFP, GPC3 and SALL4 are cogently associated with tumor genesis and development. If we can reasonably guide the treatment and prognosis of AFPGC patients, it will greatly improve the situation of patients and improve the survival of patients. This article reviews the research progress of the genes related to the treatment and prognosis of AFPGC.
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Objective@#To build scaffold materials with different concentrations of alginate and collagen, and to observe the effects of alginate/collagen ratio on the proliferation of human adipose-derived mesenchymal stem cells (hAMSC) and osteogenic differentiation. The optimal concentration of alginate/collagen will be chosen for constructing hydrogel that will be used for bone tissue engineering.@*Methods@#Soluble hydrogel scaffold materials containing alginate/collagen were prepared, and the following groups were established based on different alginate/collagen ratio: 4∶1 (group A), 2∶1 (group B), and 1∶1 (group C). Cell proliferation on the material surface was observed using the cell counting kit-8 (CCK-8) assay, while cell viability in each material group were observed using live/dead staining. Quantitative real-time PCR(qPCR) was used to measure the differential expression of osteogenesis-related genes on and in the materials. Immunofluorescence staining was used to measure the differential gene expression of osteogenesis-related proteins in each group.@*Results@#The results from the CCK-8 assay showed increasing cell proliferation rate on the lyophilized hydrogel material surface as the collagen concentration increased, and the highest cell proliferation was observed in group C. Live/dead staining assay indicated that cells were able to proliferate in all three types of hydrogel materials, and the highest cell viability was found in material from group B ([87.50±2.65]%). qPCR showed that the expression of osteogenesis-related genes in group C was the highest, among the three groups, while the expression of osteocalcin in group B was significantly higher than those in the other two groups (P<0.05). Immunofluorescence staining was carried out for osteocalcin on and in the hydrogel material and the results were consistent with that of qPCR.@*Conclusions@#The alginate/collagen scaffold materials did not show adverse effects on the cell proliferation of hAMSC and osteogenenic differentiation. Bone tissue engineering can use 10% hydrogel material, and when the sodium alginate and collagen have a ratio of 2∶1, the hydrogel can be conducive to cell differentiation and proliferation.
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Objective To investigate the expression of calpains and calpastatin in diaphragm of a rat model of chronic obstructive pulmonary disease(COPD). Methods Fotry male Wistar rats were randomly divided into the control group and the COPD group. Rats in the COPD group were copied by expo -sing to cigarettes smoking and dripping lipopolysaccharide into trachea. Pathological changes of lung and diaphragm were deteted. Immunohis-tochemistry and RT-PCR were performed to determine protein and mRNA expression of calapins and calpastatin. Results Diaphragmatic atrophy was observed in rats in the COPD group instead of the control group. The protein and mRNA expression of calpains in diaphrag-m of COPD group were Increased than those in the control group(P < 0.05). On the contrary ,the expression of calpastatin was significantly reduced in rats in the COPD group(t =-9.38 and-2.97;P < 0.001 ,P = 0.005). Conclusions An imbalance in the expression of calpains/calpastatin in diaphragm was observed in COPD rats ,and this imbalance may be responsible for diaphragm atrophy.
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@#Capital Medical University has opened the courses of Prosthetic and Orthotics Engineering since 2003. Through a three-period development of more than ten years, the professional training scheme has met the international requirements and highlight in specialty characteristics. It needs a combination of medicine, rehabilitation, technology, prosthetic and orthotics, an enough foundation for personals and sites, teachers of bi-profession, and a comprehensive test system to practice.
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<p><b>OBJECTIVE</b>To evaluate the success rate of dental implants and the changes of sinus membrane thickness after sinus lift in cases of thickened sinus membrane.</p><p><b>METHODS</b>Sixteen patients without maxillary sinusitis and with 5-8 mm residual alveolar bone heights were included in this study. The sinus membrane thickeness of these patients were more than 2 mm. All patients received sinus lift surgery and dental implants insertion. The changes of sinus membrane was evaluated by cone-beam CT (CBCT) pre-surgery and 6 months after sinus lift surgery, and the short term success rate of dental implants was also evaluated.</p><p><b>RESULTS</b>A total of 18 implants from 16 subjects were inserted. The thickness of membrane was decreased in 14 cases after sinus lift and increased in 2 cases. All the orifice of maxillary sinus was unobstructed before surgery, one case was obstructed after surgery without inflammation. All the dental implants succeeded.</p><p><b>CONCLUSIONS</b>Sinus augmentation with thickened sinus membrane is not contraindication of sinus lift.</p>
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Humans , Cone-Beam Computed Tomography , Contraindications , Dental Implantation, Endosseous , Dental Implants , Maxilla , Maxillary Sinus , Pathology , General Surgery , Maxillary Sinusitis , General Surgery , Mucous Membrane , Diagnostic Imaging , Pathology , Sinus Floor AugmentationABSTRACT
Objective To explore the surgical techniques and key points of laparoscopic radical right hemicolectomy for colon cancer.Methods The clinical data of 84 patients with colon cancer who underwent laparoscopic radical right hemicolectomy at the General Hospital of Lanzhou Military Command from November 2012 to June 2014 were retrospectively analyzed.The tumors were located at the hepatic flexure of the colon,the ascending colon and the ileocecum.The inside-out and up-down medial approach was used as the main surgical approach,and D3 lymph node dissection based on a center of surgical trunk of the superior mesenteric vein was the key point of laparoscopic radical right hemicolectomy.The intraoperative and postoperative conditions of patients were observed.Patients were followed up by telephone interview,text message and examination of readmission till March 2015.Results Of 84 patients,82 received laparoscopic radical right hemicolectomy and 2 were converted to open operation without perioperative death.The mean operation time,volume of intraoperative blood loss,number of lymph node dissection,postoperative gastrointestinal recovery time and duration of hospital stay were 125 minutes (range,110-175 minutes),50 mL (range,30-120 mL),17 (range,13-20),52 hours (range,24-72 hours) and 6 days (range,5-10 days),respectively.There were no complications such as ureter injury,duodenal injury,anastomotic fistula,abdominal abscess and surgery-related complications.Seventy-two patients were followed up for a median time of 21 months (range,12-28 months) without the tumor metastasis of abdominal incision and sites of puncture.Conclusion Laparoscopic radical right hemicolectomy via the medial approach is safe and feasible as well as improving the prognosis of patients,and lymph node dissection based on a center of surgical trunk of the superior mesenteric vein is the key point of surgery.
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Objective: To evaluate the short-term efficacy of R-type jejunal interposition and esophagojejunostomy by delta-shaped anastomosis after totally laparoscopic radical gastrectomy for gastric stump carcinoma. Methods:Data on 10 patients with gas-tric stump cancer were analyzed retrospectively from January 2013 to August 2014. All the patients received R-type jejunal interposi-tion and esophagojejunostomy by delta-shaped anastomosis after totally laparoscopic radical gastrectomy for gastric stump carcinoma (laparoscope group) in the Lanzhou General Hospital of the Lanzhou Military Area. Laparotomy was performed on 18 cases that com-prised the control group (laparotomy group). The intraoperative and postoperative indicators between these two groups were then com-pared. All the patients were followed-up from 14 to 21 months after the operations. Results:The operations were successfully carried out in all 10 patients (laparoscope group), without performing open operation. The mean operative times, volumes of the intraoperative blood loss, numbers of dissected lymph nodes, frequencies of leaving the bed, days marking the first liquid diet intake, days marking the recovery of gastrointestinal function, and days of hospitalization of the laparoscope group and the laparotomy group were (210.0 ± 30.9) min and (283.9 ± 50.9) min, (90.0 ± 26.7) mL and (277.8 ± 79.1) mL, (19.0 ± 3.6) and (18.8 ± 3.7), (17.3 ± 3.6) h and (75.8 ± 15.7) h, (1.6 ± 0.4) d and (5.7 ± 1.3) d, (3.0 ± 0.8) d and (7.2 ± 1.3) d, and (7.6 ± 1.2) d and (20.8 ± 3.9) d, respectively. Anastomotic stricture, reflux esophagitis, bleeding, leakage, dumping syndrome, or intestinal obstruction was not detected in the laparoscope group. There was no perioperative death. All of the cases exhibited good nutrition situation, and no choking or esophagus burning was reported. Conclusion:R-type jejunal interposition and esophagojejunostomy by delta-shaped anastomosis after totally laparoscopic radical gastrectomy is safe and feasible. The operation can improve the quality of life of patients and induce positive short-term therapeutic effects. Laparo-scopic-assisted radical gastrectomy for gastric stump cancer has the same effect as laparotomy.
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Objective To investigate the clinical efficacy of open abdomen management for severe abdominal infection.Methods The clinical data of 36 patients with severe abdominal infection who were admitted to the General Hospital of Lanzhou Military Command from January 2009 to January 2014 were retrospectively analyzed.After examination,patients received resuscitation and debridement according to the principle of damage control surgery.The surgery was divided into 2 stages.Open abdomen management was applied during the first stage,and 14 days later second stage surgery for abdominal closure was carried out when the abdominal infection was under control.Abdominal pus was collected during the operation for bacterial culture.Antishock,anti-infection,organ function protection,nutritional support and symptomatic treatment were applied after the operation.Patients were followed up via phone call and out-patient examination till March 2014.Results All the patients successfully received the first and the second stage surgeries.Six patients died of septic shock and multi-organ dysfunction syndrome,and 30 patients were cured.Eight patients underwent operation for 2 times.The operation time,volume of intraoperative blood loss,time for gastrointestinal function recovery,duration of postoperative hospital stay were (157 ±26) minutes,(230 ±64)mL,(44 ± 7) hours and (16 ± 5) days,respectively.Forty-eight bacterial strains were separated,including 31 gram-negative bacterial strains and 17 gram-positive bacterial strains.According to the results of drug sensitivity test,antibiotics including imipenem and cefoperazone were selected.Thirty patients were followed up with the median time of 6 months.Six patients were complicated with adhesive intestinal obstruction and 2 with incisional hernia,and they were cured after enterodialysis and hernia repair.No complications were detected in the other 22 patients.Conclusion The efficacy of open abdomen management and debridement is satisfactory for the treatment of severe abdominal infection in patients who can bear surgery.
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Colorectal cancer is one of the most common malignant tumors.With the improvement of living condition and peoples' life-span,the incidence rate of colorectal cancer has been ascending year by year.In developed countries and developed district of China,colorectal cancer has become the second common malignant tumor.More than one million people were diagnosed as with colorectal cancer,and 500,000 of them died yearly.Colorectal cancer is one of the most common reasons of the death of cancer patients.With the development of molecular targeted agents research,the therapeutic effects for colorectal cancer patients have been improved,and the current status and prospect of targeted therapy for colorectal cancer patients were introduced in this review.
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Gastric stump carcinoma (GSC) generally refers to the primary cancer in the remnant stomach,which occurs 5 years or latter after subtotal gastrectomy for gastric or duodenal ulcer,or 10 years or latter after gastric cancer resection.Laparoscopic radical gastrectomy for GSC is difficult with low resection rate.Although laparoscopic gastrectomy is technically mature in recent years,there is still few reports about laparoscopic resection for GSC.From January 2009 to June 2012,18 patients with GSC received laparoscopic radical gastrectomy at the General Hospital of Lanzhou Military Area of PLA.Laparoscopic gastrectomy for GSC is technically feasible and safe with satisfactory short-term outcome.Surgeons who have mastered laparoscopic D2 dissection could perform this procedure.
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<p><b>OBJECTIVE</b>To study the changes in surface morphology of cobalt-chromium alloy, pure titanium and high-cobalt chromium molybdenum alloy immersed in artificial saliva with different concentrations of fluoride, and to analyze the corrosion resistance of these metals.</p><p><b>METHODS</b>The three kinds of metal were polished and then were immersed in artificial saliva with different concentrations of fluoride (0%, 0.05%, 0.2%). All specimens were immersed for 3 weeks at (37.0 +/- 1.0) degrees C. Metal surface roughness before and after immersion were measured and analyzed by scanning electron microscope (SEM).</p><p><b>RESULTS</b>Metal surface roughness was increased with the concentration of fluoride. The surface roughness of the Co-Cr group and Ti group had a statistically significant difference between before and after immersion at the fluoride concentration of 0.05% (P<0.01), and the difference between Co-Cr group and vitallium2000 group, Ti group and vitallium2000 group were statistically significant difference (P<0.01). The differences of three groups before and after immersion were statistically significant at the fluoride concentration of 0.2% (P<0.01), and the difference among three groups was statistically significant (P<0.01).</p><p><b>CONCLUSION</b>Patients who frequently use fluoride products should not use pure titanium or cobalt-chromium alloy prosthesis. Patients with these three metal prostheses are not advised to use high concentration fluoride products.</p>
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Humans , Chromium Alloys , Corrosion , Dental Alloys , Fluorides , Materials Testing , Phosphates , Saliva, Artificial , Surface Properties , TitaniumABSTRACT
Objective To investigate the relationship between impulsive behaviors and the errorrelated negativity (ERN) component of event-related potentials of error processing in heroin addicts.Methods Using the paradigms for psychological experiment,the Iowa gambling task (IGT) was performed both in heroin addiction group (HA group,20 cases) and healthy control group (HC group,20 cases),and the inspection of electroencephalography was underwent in all subjects concurrently.Following the collection of data,the amplitude and latency of ERN were compared between the two groups,and then the relationship between the amplitude of ERN and the scores of Barratt Impulsiveness Scale (BIS-11) was analyzed separately.Results Decision-making course had no effect on the net score remarkably in HA group (F =1.21,P ＞0.05).Compared with HC group(64.3 ±8.4,73.8 ± 16.4),BIS score as well as the numbers of high frequency loss cards were significantly higher in HA group(75.2 ±7.6,105.5 ±22.2; t =-5.39,-9.24 ; P ＜ 0.05),while both the two groups had visible waveforms of ERN,and the amplitude was markedly lower in HA group(HA:(4.23 ±0.87) μV,HC:(6.11 ± 1.09) μV; t =5.96,P ＜0.05),but no statistical difference was found in latency of these two groups(HC:(102.1 ±28.2) ms,HA:(107.8 ±24.2) ms;t =-0.62,P =0.54),and the amplitude of the two groups was negatively associated with BIS score respectively in both two groups (HC:r =-0.66,HA:r =-0.78 ; both P ＜ 0.05).Conclusion The reduced capability of error processing maybe partly contribute to both addiction and relapse to heroin addict,and the ERN event-related potential could be regarded as an indicator of impulsive behaviors and the capability error processing.
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Objective To assess the change of CEA in the peritoneal lavage fluit at pre-,post-laparoscopy-assisted radical gastrectomy, and after hyperthermic perfusion chemotherapy, and to investigate the influence of laparoscopy-assisted radical gastrectomy on drop off of cancer cells, the efficiency of hyperthermic perfusion chemotherapy. To investigate whether CEA in the peritoneal lavage fluit detected by flow cytometry (FCM) is an effective predictor of intraperitoneal free cancer cells and peritoneal metastasis. Methods Peritoneal washings of 40 patients with gastric carcinoma were collected to detect CEA using FCM. The peritoneal lavage cytology examinations ( PLC)were detected by H-E staining. Results Laparoscopic surgery in patients with gastric cancer,before resection of gastric cancer the peritoneal washing CEA positive rate 35. 0% (14/40) ,and after operation, the positive rate was 40. 0% ( 16/40) .which was not significantly higher than that before operation ( P > 0. 05 ). After intraperitoneal hyperthermic perfusion chemotherapy the CEA positive rate was 7. 5% (3/40) ,which was significantly lower than that pre-operation(P<0. 05). Before operation there were 4 cases of positive PLC in the peritoneal lavage fluid, 14 CEA-positive detected by flow cytometry, and there was significant difference ( P < 0. 05 ) . All PLC-positive cases were positive for CEA, whereas 10 PLC-negative cases showed CEA-positive. None of CEA-negative cases showed PLC-positive. Conclusions Laparoscopic radical gastrectomy does not increase the intra-abdominal gastric cancer cell shedding. Intraoperative hyperthermic perfusion chemotherapy is simple and feasible approach with high efficiency.Peritoneal washing CEA detected by flow cytometry is an effective index to predictor for intraperitoneal free cancer cells and prediction of peritoneal metastasis.
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Objective To study the clinical efficacy and adverse reactions of the preoperative neo-adjuvant chemotherapy with oxaliplatin plus fluorouracil and calcium folinate (FOLFOX) in the treatment of advanced gastric carcinoma that was difficult to undergo radical operation. Methods We enrolled 16 patients with advanced gastric carcinomas that were unable to undergo radical operation admitted to our hospital from April 2008 to October 2009. The neo-adjuvant chemotherapy regimen was oxaliplatin 130 mg/m~2 for first one, fluorouracil 500 mg/m~2 and calcium folinate 200 mg/m~2 from first day to fifth day,and one treatment course was three weeks and the patients underwent two courses.The changes of the primary lesion and the adverse reactions of the patients were observed. Results Carcinomas of 13 patients were degraded after the treatment, of which, 11 patients underwent radical resections after 4-6 weeks after operation.There were two cases of complete remission (CR) , 10 cases of partial remission (PR), three cases of stable disease(SD) and one case of progress disease(PD) , and the total effective rate was 75.0% (12/16). Adverse reactions included bone marrow suppression, diarrhea, nausea and vomiting and paresthesia, which were relieved after appropriate symptomatic treatment. Conclusions Neoadjuvant chemotherapy with FOLFOX can improve the resection rate of the advanced gastric carcinoma that is unable to undergo radical resection, and the patients' tolerability to this regimen is favorable.Thus, the regimen is worthy of generalizing.
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Objective To investigate the detection of peritoneal free cancer cells and its clinical significance. Methods The peritoneal free cancer cells,the positive rates of CK20 protein and CK20 mRNA expressions of peritoneal lavage fluid were detected by peritoneal lavage cytology (PLC),flow cytometry (FCM) and real-time fluorescent quantitative RT-PCR in 50 cases of gastric cancer patients,respectively. The sensitivity of three kinds of detection method to peritoneal free cancer cells was compared. Results The positive rates of peritoneal free cancer cells,CK20 protein and mRNA expression of peritoneal lavage fluid were 20.0% (10/50),36.0% (18/50) and 58.0% (29/50),respectively. The positive rate of CK20 mRNA expression detected by real-time fluorescencequantitative RT-PCR in peritoneal lavage fluid was significantly higher than those of the CK20 protein expression detected by FCM and peritoneal free cancer cells detected by PLC (P0.05). The positive rate of CK20 mRNA expression of peritoneal lavage fluid was related to the tumor invasion depth,differentiation degree,TNM stage,and lymph node metastasis (P
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Objective To study the significance of repeated washing in reducing the positive rate of intra-abdominal exfoliated cancer cells. Methods Sequential intraoperative peritoneal lavages were performed in each of the 160 patients with gastric cancer one time before tumor resection,three times after excision.Four sub-peritoneal washing fluid was assayed for cytology smears with routine pathology.The results were then compared. Results Exfoliated tumor cells were positive in the intraoperative peritoneal lavages of 56 patients before resention.Exfoliated tumor cells were positive in the first three intraoperative peritoneal lavages of 64 patients before resention,42 at the second,3 at the third.Tumor cells positive and forward setting lotion shed after the first time,with the number of detected cases increased but had no significant statistical significance.Compaving the positive result of the 3rd exfoliated cancer cells with the first 1,we found that the difference was statistically significant. Conclusion Sequential intraoperative peritoneal lavages is an useful method in reducing the positive rate of peritoneal exfoliated tumor cells in patients with gastric cancer.
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Objective To observe the distribution of sentinel nodes(SN) in gastric cancer,and investigate their clinical significance.Methods The extent and features of intraoperatively stained sentinel nodes in 288 cases of gastric cancer were analyzed retrospectively.Methylene blue was injected intraoperatively into the(subseral) muscle and submucosa of the normal gastric wall adjacent to the neoplasms,then lymphadenography was performed,and the nodes were resected for histopathological examination.Results The pathological(diagnosis) of the 288 cases with gastric cancer was T_1 in 102 cases,T_2 106 cases and T_3 60 cases.Stained nodes were detectable in 270 cases(success rate: 93.8%).One hundred and two cases were found to have lymph node metastasis;66 cases had metastasis in both SNs and non-SNs;18 cases in SNs alone;and 18 cases in non-SNs alone.Conclusions Sentinel lymph nodes can accurately predict the lymph node metastatic status of gastric cancer patients during operation.Intraoperative sentinal lymph node mapping can avoid routine lymph node dissection in patients with gastric cancer with negative lymph node metastasis.