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ObjectiveTo discuss the surgical treatment for patients with anastomotic stoma cancer,gastric cardial cancer or esophagus cancer after subtotal gastrectomy.MethodsThe clinical data of 21 patients with anastomofic stoma cancer,gastric cardial cancer or esophagus cancer after subtotal gastrectomy were analyzed retrospectively.There were 4 cases with anastomotic stoma cancer after operation of gastric cardial cancer,2 cases with gastric cardial cancer after subtotal gastrectomy due to gastriculcer,3 cases with upper esophagus cancer after subtotal gastrectomy due to gastric ulcer,6 cases with mid-esophagus cancer and 6 cases with distal esophagus cancer after subtotal gastrectomy due to gastric ulcer.There were 6 cases treated with partial esophagus resection,resection of remaining stomach and jejuna-esophagus anastomosis,3 cases treated with partial esophagus and stomach resection and esophagus-gastric anastomosis,12 cases with subtotal esophagectomy and colon interposition.ResultsOne case with incision infection,1 case with anastomosis leaks,1 case dead of pulmonary infection.In the 20 follow-upcases,4 cases were dead of cardiac and cerebral accidents at the third year after operation,and other 16 cases survived and had normal diet.ConclusionsReoperation is still one of the best choices for patients with anastomotic stoma cancer,gastric cardial cancer and esophagus cancer after subtotal gastrectomy when their body condition are acceptable and without distant metastasis.The organ for digestive tract reconstruction should be decided according to the situation of the first gastrectomy and the proficiency of the operator.
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Objective To evaluate mechanical radial scanning endoscopic ultrasonography (EUS) for preoperative tumor and lymph node ( TN ) staging of esophageal cancer. Methods From January 2010 to June 2010, a total of 60 patients with esophageal cancer underwent preoperative staging with mechanical radial scanning EUS. The findings of EUS were compared with postoperative pathological outcomes. Results EUS accurately predicted T stage in 80 % of cases and N stage in 71% cases. Sensitivities to T1 , T2 , T3 and T4 were 75% , 100% , 96% and 50% , respectively, and those to N0 and N1 were 55% and 100% , respectively. With exclusion of 11 patients with un-passable lesions, the accurate rate of EUS in T staging of focal and advanced cancers was 90% ( 44/49 ). Conclusion Mechanical radial scanning EUS can accurately predict T and N stages in preoperative patients with esophageal cancer, which also exhibits high differential accuracy in focal and advanced esophageal cancer.
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Objective To construct a cDNA expression library from unfed female tick Haemaphysalis longicornis for screening and cloning potential antigenic genes.Methods Total RNA was isolated from unfed female ticks,mRNA was purified and a library of oligo(dT)-primed cDNA with added directional EcoR Ⅰ/Hind Ⅲ linkers was constructed from the purified mRNA.The constructed cDNA was ligated to the EcoRⅠ/HindⅢ arms of the ?SCREEN vector.Pure phage stocks were harvested by plaque purification and converted to plasmid subclones by plating phage on host strain BM25.8.Recombinant plasmids that were subcloned to E.coli BM25.8 were isolated and transformed into E.coli JM109.Recombinant plasmids abstracted from JM109 were identified by PCR and sequencing.Rusults The recombinant phage DNA was packaged by using phage-marker packaging extracts,resulting in a primary cDNA library with a size of 1.8?106 pfu.Data showed 100% of the library were recombinant and the titer of the amplified library was 2.4?109 pfu/ml.Forty-two clones of encoding immunodominant antigens were obtained from the cDNA library.Sequence analysis revealed 12 unique cDNA sequences and the encoded putative proteins showed similarities to H.longicornis tropomyosin mRNA,Rhipicephalus annulatus unknown larval protein mRNA,chromosome 2R of Drosophila melanogaster,mitochondrial DNA of H.flava,clones HqL09 unkown mRNA and Hq05 mRNA of H.qinghaiensis,and myosin alkali light chain protein mRNA.Conclusion The cDNA expression library from unfed female H.longicornis was successfully constructed and screening of protective genes may provide candidate antigens of the tick.