Antiviral effect of Fufang yinhua jiedu (FFYH) granules against coronavirus and its potential mechanism / 药学学报

To investigate the effect of Fufang yinhua jiedu (FFYH) granules against coronavirus and its potential mechanism, we used Huh7, Huh7.5, H460, and C3A cell lines as in vitro models to evaluate the cytotoxicity and antiviral activity of FFYH by observation of cell pathogenic effect (CPE); and then the inhibitory effect of FFYH on the transcription expression of coronavirus RNA and inflammatory factor mRNA were evaluated by quantitive reverse transcription PCR (qRT-PCR); finally, the inhibitory effect of FFYH on the expression of coronavirus protein and its underlying mechanism against coronavirus were investigated by Western blot and immunofluorescence. Our results indicated that 50% toxic concentration (TC50) FFYH on Huh7, Huh7.5, H460, and C3A cells were 2 035.21, 5 245.69, 2 935.28 and 520 µg·mL-1, respectively; 50% inhibitory concentration (IC50) of FFYH on HCoV-229E in Huh7 and Huh7.5 cells were 438.16 and 238.54 µg·mL-1 with safety index (SI) of 4.64 and 21.99, respectively; IC50 of FFYH on HCoV-OC43 in H460 cells was 165.13 µg·mL-1 with SI of 17.78. Moreover, FFYH not only could inhibit the replication of coronaviruses (HCoV-OC43 and HCoV-229E) through inhibiting the transcription of viral RNA and the expression of viral protein, but also effectively suppress the expression of inflammatory factors interleukin-6 (IL-6), tumor necrosis factor α (TNF-α) and interleukin-8 (IL-8) at mRNA level caused by coronaviruses, which might be associated with the inhibitory effect of FFYH on mitogen-activated protein kinase (MAPK) pathway and the nuclear translocation of nuclear transcription factor-κB (NF-κB). In summary, our results demonstrated that FFYH exhibited a good in vitro anti-coronavirus effect, which provides a theoretical basis for its clinical use in the treatment of anti-coronavirus pneumonia.

Optimization of ultrasonic extraction process for Xiaoqinglong granules by Box-Behnken in condition of medium scale / 中国中药杂志

This paper is to investigate the optimization conditions of ultrasonic technique for extraction process of Xiaoqinglong granules in medium scale. First of all, single factor experiment was used to determine the overall impact tendency and range of each factor； secondly, Box-Behnken method was used for optimization and detecting the content of paeoniflorin, ephedrine hydrochloride, glycyrrhizic acid of the liquid medicine. Their respective extraction rate was calculated and the comprehensive evaluation was carried out. The results were used as the evaluation basis for the efficacy of Xiaoqinglong granules ultrasonic extraction. The test results showed that the optimum extraction process of Xiaoqinglong granules by ultrasonic extraction was under the following conditions: ultrasonic power 600 W, liquid-solid ratio 10∶1, extraction for 31 min. Under this condition, the predicted value of extraction rate for Xiaoqinglong granules was 85.90%, and the test value was 85.87%. The mathematical model(P<0.01) established in this paper was significant, and can be used for the analysis and prediction of the ultrasonic extraction process of Xiaoqinglong granules.

Fingerprint analysis of Resina Draconis from different manufactuers by UPLC coupled with chemometrics / 中国中药杂志

This study is to establish an UPLC fingerprint of Resina Draconis from different manufacturers, which can provide a comprehensive evaluation for its quality control. The analysis was performed on a Phenomenex Kinetex 2.6 μ C18 100A column by agradientelution program with acetonitrile-water as mobile phase at a flow rate of 1.7 mL x min(-1). The column temperature was 40 degrees C and the detection wavelengthwas 280 nm. The fingerprints of 18 batches of Draconis Resina were further evaluated by chemometrics methods including similarity analysis (SA), hierarchical clustering analysis (HCA) and principal component analysis (PCA). As a result, there were 15 common peaks, 13 of which had been identified by LC-Q-TOF MS, and the similarity degrees of 15 batches of the samples was more than 0.9, and the samples were divided into 4 clusters by their quality difference. The method is reproducible, simple and reliablethat it can be used for quality control and evaluation of Resina Draconis from different manufacturers.

Quality control in liquid-liquid extraction of Reduning injection using near-infrared spectroscopy technology / 中国中药杂志

Quantitative models were established to analyze the content of chlorogenic acid and soluble solid content in the liquid-liquid extraction of Reduning injection by near-infrared (NIR) spectroscopy. Seven batches of extraction solution from the liquid-liquid extraction of Lonicerae Japonicae Flos and Artemisiae Annuae Herba were collected and NIR off-line spectra were acquired. The content of chlorogenic acid and soluble solid content were determined by the reference methods. The partial least square (PLS) and artificial neural networks (ANN) were used to build models to predict the content of chlorogenic acid and soluble solid content in the unknown samples. For PLS models, the R2 of calibration set were 0.9872, 0.9812, RMSEC were 0.1533, 0.7943, the R2 of prediction set were 0.9837, 0.9733, RMSEP were 0.2464, 1.2594, RSEP were 3.25%, 3.31%, for chlorogenic acid and soluble solid content, respectively. For ANN models, the R2 of calibration set were 0.9903, 0.9882, RMSEC were 0.0974, 0.4543, the R2 of prediction set were 0.9868, 0.9699, RMSEP were 0.1920, 0.9427, RSEP were 2.61%, 2.75%, for chlorogenic acid and soluble solid content, respectively. Both the RSEP values of chlorogenic acid and soluble solid content were lower than 6%, which can satisfy the quality control standard in the traditional Chinese medicine production process. The RSEP values of ANN models were lower than PLS models, which indicated the ANN models had better predictive performance for chlorogenic acid and soluble solid content. The established method can rapidly measure the content of chlorogenic acid and soluble solid content. The method is simple, accurate anc reliable, thus can be used for quality control of the liquid-liquid extraction of Reduning injection.

Hepatocellular adenoma with malignant transformation in male patients with non-cirrhotic livers / 癌症

<p><b>INTRODUCTION</b>Hepatocellular adenomas (HCAs), with a risk of malignant transformation into hepatocellular carcinoma (HCC), classically develop in young women who are taking oral contraceptives. It is now clear that HCAs may also occur in men. However, it is rarely reported that HCAs with malignant transformation occur in male patients with non-cirrhotic livers. This study aimed to characterize the malignancy of HCAs occurring in male patients.</p><p><b>METHODS</b>All patients with HCAs with malignant transformation who underwent hepatectomy at the Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 1, 1999 and December 31, 2011 were enrolled in the study. The clinical characteristics as well as radiologic and pathologic data were reviewed.</p><p><b>RESULTS</b>HCAs with malignant transformation were observed in 5 male patients with non-cirrhotic livers, but not in female patients. The alpha-fetoprotein (AFP) levels were higher in patients with HCAs with malignant transformation than in patients with HCAs without malignant transformation. The diameters of the tumors with malignant transformation were larger than 5 cm in 3 cases and smaller than 5 cm in 2 cases. The 5 patients were all alive without recurrence by the end of the study period. The disease-free survival times of the 5 patients were 26, 48, 69, 69, and 92 months.</p><p><b>CONCLUSION</b>Our results indicate that resection would be advised even if the presumptive diagnosis is adenoma smaller than 5 cm in diameter, especially in male patients.</p>

Determination of eleven major components and fingerprint chromatography for Reduning injection by UPLC / 中国中药杂志

A reliable method for simultaneous determinition of eleven representative components (neochlorogenic acid, chlorogenic acid, cryptochlorogenic acid, isochlorogenic acid B, isochlorogenic acid A, isochlorogenic acid C, shanzhiside, geniposidic acid, genipin-1-β-D-gentiobioside, geniposide and secoxyloganin) in combination of chromatographic fingerpint analysis for Reduning injection was developed by ultra high-performance liquid chromatography (UPLC). The method was performed on an Agilent ZORBAX SB-C18 anlytical column (3. 0 mm x 100 mm, 1. 8 µm) with a guard column of Agilent UPLC Guard ZORBAX SB-C18 (3.0 mm x 5 mm) at the column temperature of 30 °C. The gradient mobile phase consisted of acetonitrile (A)-0. 1% phosphoric acid (B) with a flow rate of 0. 4 mL . min-1. The injection volumn was 2 µL. The detection wavelengths were set at 324 nm and 238 nm for quantit tive analysis and 225 nm for fingerpint chromatography. Neochlorogenic acid, chlorogenic acid, cryptochlorogenic acid, isochlorogenic acid B, isochlorogenic acid A, isochlorogenic acid C, shanzhiside, geniposidic acid, genipin-1-β-D-gentiobioside, geniposide and secoxyloganin were baseline seperated with good linearity relationships (r >0. 999) between concentration and peak areas over the linear ranges. The average recoverys of the investigated compounds were 103.5%, 100. 2%, 103. 3%, 102. 8%, 101. 3%, 102. 8%, 97. 36%, 99. 62%, 98. 16%, 102. 8%, 99. 27%, respectively. Reduning injection of forty-five batches was analyzed by UPLC finge print chromatography. Thirty batches were selected to generate the reference fringerprint chromatography with fourteen common peaks. The similarity values between the reference fringerprint chromatography and the remaining fifteen batches were higher than 0. 99. The developed method was fast, accurate and sensitive. It could be used as a reference for the quality control of multiple components determination and fingerprint chromatography for Reduning injection in future.

Application of quantitative fingerprint to amino acids composition analysis of Xingnao Tongluo injection / 中国中药杂志

<p><b>OBJECTIVE</b>To control the quality of the product, quantitative fingerprint was used to evaluate the composition of the amino acids in the Xingnao Tongluo injection.</p><p><b>METHOD</b>The method of the quantitative fingerprint to the amino acids composition was established through AccQ Tag precolumn derivatization. The quality was evaluated by the quantitative test of the amino acids and the similarity in ten batches.</p><p><b>RESULT</b>The Xingnao Tongluo injection contained 12 amino acids and the contents of these amino acids were stable. All the ten batches of the samples had similarity of more than 0.90.</p><p><b>CONCLUSION</b>The method was accurate, feasible and could be a simple and effective way to evaluate the quality of the traditional Chinese medicine.</p>

Application of near-infrared spectroscopy technology in extraction and concentration process of Reduning injection / 中国中药杂志

<p><b>OBJECTIVE</b>To establish a rapid quantitative analysis method for the content of chlorogenic acid and solid content in the extraction liquid concentration process during the production of Reduning injection by using the near-infrared (NIR) spectroscopy, in order to reflect the concentration state in a real-time manner and really realize the quality control of concentrating process of the extraction and concentration process.</p><p><b>METHOD</b>The samples during the Jinqing extraction liquid concentration process were collected. After the removal of abnormal samples, the spectra pretreatment and the wave band selection, the quantitative calibration model between NIR spectra and chlorogenic acid HPLC analytical value and solid content was established by using PLS algorithm, and unknown samples were predicted.</p><p><b>RESULT</b>The correlation coefficients between the chlorogenic acid content and the solid content were respectively 0.992 1 and 0.994 0, and the correlation coefficients of the verification model were respectively 0.994 4 and 0.998 4, with the root mean square error of calibration (RMSEC) of 0.814 6 and 2.656 1 and the root mean square error of prediction (RMSEP) of 0.704 6 and 1.876 7 respectively, and the relative standard errors of predictions (RSEP) were 6.01% and 2.93% respectively.</p><p><b>CONCLUSION</b>The method is simple, rapid, nondestructive, accurate and reliable, thus could be adopted for the fast monitoring of the chlorogenic acid content and the solid content during the concentration process of Reduning injection extraction liquid.</p>

Application of selective and timely regional hepatic vascular occlusion for resection of large centrally located liver tumors: report of 133 cases / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To improve the resection rate and increase operation safety for large centrally located liver tumors.</p><p><b>METHODS</b>Clinical data from 133 patients with large centrally located liver tumors confirmed by surgery were analyzed retrospectively. Selective and timely regional hepatic vascular occlusion was used during the operation procedure.</p><p><b>RESULTS</b>The resection rate was 100%. Perioperative death occurred in one patient. During operations, Forty-four patients underwent regional hepatic inflow occlusion ranging from 12 to 33 minutes. Twenty-three patients underwent left and right inflow occlusion, respectively, ranging from 8 to 50 minutes. One patient had right half-hepatic vascular exclusion for 40 minutes. The blood loss of 132 patients was (665 ± 424) ml (one patient experienced diffuse blood oozing and died in the next day). Among them, the blood loss of patients with liver cirrhosis was (723 ± 479) ml. On the contrary, those without liver cirrhosis was (458 ± 223) ml (P < 0.01). Liver function in 92.4% (122/132) patients recovered to Child-Pugh A within one week. No liver failure occurred. After operation, 3 patients presented ascites. Among them, two patients had liver cirrhosis and hepatocellular jaundice, one patient was accepted for transcatheter arterial chemoembolization preoperatively. Four patients had biliary fistula, one patient had gastroparesis, one patient had thrombus in the superior mesenteric vein and portal vein, and five patients had right pleural effusion. The 1-, 3- and 5-year survival rates of 112 patients were 89.1%, 57.7% and 36.9%, respectively.</p><p><b>CONCLUSIONS</b>Selective and timely regional hepatic vascular occlusion is useful for the resection of large centrally located liver tumors. This kind of procedure can effectively control the blood loss during the operation and shorten the ischemic reperfusion time, beneficial for protecting the liver cell function. This procedure is a safe hepatic flow occlusion method.</p>

Progressive increase of serum circulating immune complexes and its significance in patients during the progression from chronic hepatitis B to hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the significance of increasing circulating immune complex (CIC) in patients during the progression from chronic hepatitis B to hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>Serum levels of CIC from 20 hospitalized patients diagnosed by pathology with primary HCC, and 13 with hepatic hemangioma, and from 45 subjects with chronic HBV infection who finally developed into HCC (45 cases), and age- and gender-matched 45 subjects who kept the chronic HBV infection after consecutively followed up for 10 - 13 years by June of 2009 were quantified by ELISA. The serum levels of anti liver-kidney microsomal (anti LKM-1) antibodies were also measured by ELISA, and that of HBV-DNA were quantified by Taqman probe-based real time PCR in the followed up chronic HBV infection subjects. In the 45 chronic HBV subjects who finally developed into HCC and the 45 controls, serum samples were collected and determined at 3 time points: the baseline when the subjects were recruited, the middle point during the follow-up, and the end of follow-up.</p><p><b>RESULTS</b>The serum level of CIC was significantly higher in the 20 HCC patients than that in the 13 hemangioma cases (P < 0.001). When HCC was diagnosed, the CIC concentration was significantly higher than that in the baselines (P < 0.001) in the 45 chronic HBV subjects who finally developed into HCC after the consecutively follow-up for 5 - 13 years. Of them, 36 patients (80.0%) showed progressively increased CIC during the follow-up (P < 0.001). In the controls, the CIC levels were kept relatively stable during the follow-up. Among them, 17 patients (37.8%) showed CIC slightly increased (P = 0.046). Kaplan-Meier survival analysis indicated that elevated serum CIC during the follow-up increased cumulative HCC incidence (HR = 2.77, 95%CI 1.47 - 5.22). In addition, the serum levels of anti-LKM-1 and HBV-DNA were also significantly higher in the patients who finally progressed into HCC than that in the controls and maintained at a high level during the follow-up tested at all the 3 time points. Further analysis indicated that the serum level of CIC was correlated with that of serum HBV-DNA only when HCC was diagnosed (r = 0.344, P = 0.026).</p><p><b>CONCLUSION</b>Progressive increase of serum CIC level may be one of risk factors reflecting HCC development from chronic HBV infection.</p>

Multicenter cross-sectional study of anemia in patients with gastric and colorectal cancer before and after the operation / 中华外科杂志

<p><b>OBJECTIVES</b>To determine the prevalence of cancer-related anemia and iron deficiency anemia (IDA) in patients with gastric and colorectal cancer in North of China.</p><p><b>METHODS</b>A cross-sectional study of 262 inpatients diagnosed with gastric or colorectal cancer admitted to eight general hospitals in Beijing from August 2009 to December 2009 was performed. The blood samples were took on the day after admission and the seventh day after operation for the tests of hemoglobin, serum iron and ferritin. The morbidity of cancer-related anemia and IDA before and after the surgery was also compared respectively.</p><p><b>RESULTS</b>The preoperative morbidity of cancer-related anemia was 36.6% in 131 patients with gastric cancer, and the morbidity of IDA was 52.1%. The mean age of the anemic patients was higher than that in cases without anemia [(62 ± 11) yrs vs. (57 ± 12) yrs, P < 0.05]; the postoperative morbidity of IDA increased to 72.6% (P < 0.05). In the 131 cases with colorectal cancer, the preoperative incidence of cancer-related anemia and IDA was 37.4% and 61.2%, respectively. About 45% of the cases with anemia had a tumor in the right colon. Postoperative incidence of IDA was significantly higher than that before the surgery (76.7%, P < 0.05). Only 10.3% of the anemic patients were treated with chalybeate therapy before surgical procedures, and the proportion was 22.7% after the operation. More than 50% of anemic patient received blood transfusion.</p><p><b>CONCLUSIONS</b>Cancer-related anemia is a common clinical manifestation in patients with gastrointestinal cancer, and anemia occurs more frequently in elder and patients with right colon tumor. The treatment to cancer-related anemia is insufficient and a systematic therapy is needed to be established.</p>

Analysis of surgical treatment of 30 cases of small hepatocellular carcinoma in special position / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the resection technique for small hepatocellular carcinoma (SHCC) in special sites and discuss their outcome.</p><p><b>METHODS</b>Clinicopathological data of 30 patients with SHCC in special sites undergone liver resection were reviewed. There were 29 cases of hepatocellular carcinoma and 1 case of cholangiocarcinoma, confirmed by pathology. The tumor was close to the first porta hepatis in 8 cases, colse to the second porta hepatis in 15 cases, and close to the third porta hepatis in 7 cases. Twenty-five patients had one lesion, 4 patients had two and the other had three. The tumor diameter was (2.7 ± 1.2) cm.</p><p><b>RESULTS</b>No perioperative death occurred. The operation time was (279 ± 101) min, the mean intraoperative blood loss was 566 ml, and the postoperative hospitalization was (10.5 ± 2.7) days. The 1- and 3-year survival rates were 100% and 83.3%, respectively, and the 1- and 3-year disease free survival rates were 85.0% and 41.3%, respectively.</p><p><b>CONCLUSION</b>Although the surgery for SHCC in special sites is quite difficult and risky, surgical treatment is still safe with good perioperative management and is an effective treatment of SHCC in special sites.</p>

Prognostic implication of common bile duct infiltration in adenocarcinoma of the ampulla of Vater after pancreaticoduodenectomy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the prognostic implication of common bile duct infiltration in the adenocarcinoma of the ampulla of Vater after panreaticoduodenectomy.</p><p><b>METHODS</b>A retrospective study was conducted on clinical manifestation, pathological behavior and survival data in 102 patients with Vater's ampulla adenocarcinoma, who underwent pancreaticoduodenectomy from Jan 1980 to Dec 2003. The result of patients with the common bile duct infiltration were compared with that of those without.</p><p><b>RESULTS</b>There were 42 cases in stage I (41.2%), 32 in stage II (31.3%), 27 in stage III (26.5%), and 1 in stage IV (1.0%). As for T stage: 9 cases in stage T1 (8.8%), 40 in T2 (39.2%), 25 in T3 (24.5%), and 28 in T4 (27.5%). As regarding to N stage: 76 cases in stage N0 (74.5%) and 26 in N1 (25.5%). Of these 102 cases, microscopic infiltration in the common bile duct (25.0%) was identified in 26 cases. A significant difference was observed between the patients with bile duct infiltration and those without, in the proportion of pancreatic medullae infiltration: 84.6% (infiltration group) versus 34.2% (non-infiltration group, P < 0.001). Twenty-five cases (24.5%) had recurrence and/or metastases postoperatively, with a median survival of 20 months (range, 2 to 93 months). The overall median survival of the whole group was 46.0 months (2 approximately 192 months), with a significant difference between the common bile duct infiltration group (36 months) and the non-infiltration group (49 months, P = 0.0061). The median non-recurrence survival of the whole group was 43 months (2 approximately 192 months), and a significant difference was observed between the common bile duct infiltration group (35 months) and non-infiltration group (47 months, P = 0.0002).</p><p><b>CONCLUSION</b>If the adenocarcinoma of the Vater's ampulla infiltrated the common bile duct, the invasion to the pancreatic medulla is likely developed, and usually with a poor non-recurrence and overall survival. Therefore, postoperative chemotherapy/radiotherapy is suggested.</p>

Surgical treatment for colorectal cancer with simultaneous hepatic metastasis / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the indication of surgical treatment for primary colorectal carcer with simultaneous hepatic metastasis.</p><p><b>METHODS</b>116 colorectal cancer patients with simultaneous hepatic metastasis underwent surgery from January 1990 to December 2001. The data were analyzed using Statistical Package for the Social Sciences (Release 11.5, SPSS, Inc). The survival was estimated using Kaplan-Meier method, and the survival comparison was carried out using the log-rank test. Multivariate analysis was performed using Cox regression.</p><p><b>RESULTS</b>Totally, 116 patients received surgical resection for primary colorectal tumor, 18 of them underwent liver metastasis resection simultaneously. Postoperative complication developed in 14.7% of these patients with postoperative death in two patients. The overall 5-year survival rate was 14.29%. The 5-year survival rate of those who had liver metastasis resection was 32.12%. Multivariate analysis showed that liver metastasis resection, abdominal carcinomatosis, chemotherapy and intervention treatment were the most important prognostic factors.</p><p><b>CONCLUSION</b>Surgical resection of primary colorectal cancer with simultaneous resection of liver metastasis or with combined modality therapies such as chemotherapy and intervention treatment is effective to prolong patient's survival for primary colorectal cancer patient with simultaneous hepatic metastasis.</p>

Surgical effect of malignant tumor of body and tail of the pancreas: compare with pancreatic head cancer / 中华外科杂志

<p><b>OBJECTIVES</b>To investigate the clinical-pathological characteristics and surgical prognosis of malignant tumor of pancreatic body and tail.</p><p><b>METHODS</b>A retrospective study was accomplished on clinical manifestation, pathological behavior and postoperative survival in 106 patients with malignant tumor of pancreatic body and tail in single institution from Jan 1980 to Dec 2003, and compared these with 451 patients with malignant pancreatic cancer.</p><p><b>RESULTS</b>There were significant differences in the following parameters (malignant tumor of the body and tail vs those of the head) between the two tumors: (1) the complaints of pain (0.74:41, chi(2) = 37.035, P < 0.01) and jaundice (0.04:0.75, chi(2) = 155.509, P < 0.01); (2) serum SGPT [(27.33 +/- 3.98) U/L: (118.60 +/- 4.59) U/L, F = 89.351, P < 0.01], total bilirubin [(1.46 +/- 0.46) mg/dl: (14.11 +/- 0.60) mg/dl, F = 105.341, P < 0.01] and albumin [(4.20 +/- 0.45) g/L: (3.91 +/- 0.03) g/L, F = 26.642, P < 0.001]; (3) CEA (0.40:0.24, chi(2) = 6.148, P = 0.046) and CA-19-9 positive rate (0.57:0.86, chi(2) = 24.132, P < 0.01); (4) the concomitant total metastasis (0.38:0.20, chi(2) = 14.266, P < 0.01), including liver metastasis (0.30:0.17, chi(2) = 9.003, P < 0.01). Postoperative median survival, resection of non-metastatic pancreatic body and tail cancer was longer than resection of metastatic disease significantly (15 vs 7 months,chi(2) = 21.63, P < 0.01), which the latter was the same as those who didn't remove (6 months,chi(2) = 0.22, P = 0.64).</p><p><b>CONCLUSIONS</b>The predominant problem is distant metastasis (especially liver metastasis) in the malignant tumor of the body and tail of the pancreas in comparison with pancreatic head cancer. Resection of the body and tail could not increase postoperative survival if metastasis exists. The major way to improve the prognosis is to prevent and manage the distant metastasis.</p>

Risk factors for recurrence and metastasis after radical anterior resection for rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the risk factors for local recurrence and distant metastasis after radical anterior resection for rectal cancer.</p><p><b>METHODS</b>Clinicopathological data of 957 patients who underwent radical anterior resection for rectal cancer from 1983 to 2000 were reviewed retrospectively. The risk factors for local recurrence and distant metastasis were analyzed.</p><p><b>RESULTS</b>There were 150 recurrent or metastatic cases (15.7%) after radical resection during a median follow- up of 71 months. Recurrence and metastasis sites included pelvics(6.0%, n=57), liver (4.9%, n=47), lung (4.2%, n=40) and other sites (0.6%, n=6). The median recurrent interval was 18 months (2-85 months),with a median survival of 8 months (1-62 months) after recurrence. Re-resection of the tumors was performed in 23 patients(15.3% ), and the median survival of such patients was 30 months with a 5- year survival rate of 13.0%. There were significant differences in recurrence and metastasis considering age,family history of tumor,CEA level,T staging,lymph node metastasis,venous cancerous emboli and signet cell carcinoma or mucinous adenocarcinoma. Logistic regression analysis revealed that family history (P=0.001), high CEA level (P=0.033), T3- 4 (P=0.000), lymph node metastasis (P=0.000),venous cancerous emboli (P=0.001),and signet cell carcinoma or mucinous adenocarcinoma (P=0.012) were risk factors for recurrence and metastasis.</p><p><b>CONCLUSIONS</b>There are several risk factors for recurrence after radical anterior resection for rectal cancer. The main recurrent or metastatic sites are pelvis,liver and lung. Resection of recurrent tumor can prolong the survival.</p>

Characteristics of metastasis and recurrence following curative resection for colonic carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the characteristics of metastasis and recurrence following curative resection for colonic carcinoma,and analyze the prognosis.</p><p><b>METHODS</b>The clinicopathological and follow-up data of 310 patients with colon carcinoma undergoing curative resection were analyzed retrospectively.</p><p><b>RESULTS</b>The recurrence rate after curative resection was 23.2% (72/310). The 5-year survival rate was 64.6%. Hepatic metastasis accounted for 38.9% of the cases. Gross classification,histological type, differentiation, lymph node metastasis were correlated with metastasis/recurrence. Univariate analysis revealed that gross classification, histological type, differentiation, lymph node metastasis, blood vessel invasion, TNM Stage, postoperative chemotherapy, portal chemotherapy were prognostic factors. Cox regression analysis revealed that only gross classification, lymph node metastasis, postoperative chemotherapy, portal chemotherapy were independent prognostic factors.</p><p><b>CONCLUSIONS</b>Liver is the most common metastatic site after curative resection for colonic carcinoma. Gross classification, lymph node metastasis, postoperative chemotherapy, and portal chemotherapy are independent prognostic factors.</p>

Diagnosis and treatment of patients with cholangiocarcinoma / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the diagnosis and treatment of the cholangiocarcinoma.</p><p><b>METHODS</b>Forty one patients with cholangiocarcinoma who were enrolled in our hospital from January 1970 to January 2005 were retrospectively analyzed.</p><p><b>RESULTS</b>Among these 41 patients, the 1, 3, and 5-year survival rate was 82.3%, 45.8%, 45.8%, respectively, with radical operation, and was 11.0%, 0, 0 with non-radical operation (chi2 = 21.38, P < 0.01). The 1-year and 3-year survival rate was 11.0% and 0 in 9 patients treated with laparatomy, which was not significantly different from those treated with non-radical operation (chi2 = 0.02, P = 0.89). Four patients did not receive operation and all died within one year. Among 25 patients who did not experience lymph node metastasis, the 1, 3, and 5-year survival rate was 58.4%, 27.3%, and 27.3%. Among 16 patients who were found lymph node metastasis, the 1-year and 3-year survival rate was 61.8% and 0 (chi2 = 13.85, P < 0.01).</p><p><b>CONCLUSION</b>Operation is the most effective treatment for cholangiocarcinoma. Radical operation is the only curative treatment.</p>