Expression of NEK-6 in gastric cancer and its clinical significance / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the NEK-6 expression in gastric cancer tissue and its relationship with clinicopathological features.</p><p><b>METHODS</b>Fluorescent quantification PCR and Western blotting were used to examine the NEK-6 expression in 36 samples of fresh gastric cancer tissues and para-cancer gastric mucosal tissues, human gastric cancer cell lines(BGC-823, MKN-28, SGC-7901, MGC-803, HGC-27, AGS), and human normal gastric epithelial cell line (GES-1). Gastric cancer cell lines with the highest expression level were selected to perform the invasion and migration tests, and the effect of down-regulated NEK-6 expression by siRNA transfection on above invasion and migration tests were observed. Meanwhile NEK-6 expression in 94 paraffin samples of gastric cancer tissues was examined by immunohistochemistry and its positivity was compared among different clinicopathologic features.</p><p><b>RESULTS</b>Fluorescent quantification PCR revealed gastric cancer tissues had significantly higher NEK-6 expression than para-cancer tissues(0.002 80±0.001 36 vs. 0.001 91±0.001 48, P<0.05), NEK-6 expression was up-regulated in 31 gastric cancer tissues (86.1%), and human gastric cancer cell lines had significantly higher NEK-6 expression than GES-1 cells, among whom BGC-823 and AGS cell lines were the highest. Invasion and migration tests showed that as compared to negative siRNA control group, ability of invasion and migration in BGC-823 and AGS cells after siRNA transfection was obviously decreased. In 94 paraffin samples, positive expression rate of NEK-6 was 60.6%(57/94), and NEK-6 expression was significantly associated with gastric cancer distant metastasis, lymph nodes metastasis and TNM staging(all P<0.05).</p><p><b>CONCLUSIONS</b>NEK-6 expression is up-regulated in gastric cancer tissues, which is significantly associated with distant metastasis, lymph nodes metastasis and TNM staging. Down-regulation of NEK-6 expression can inhibit the ability of invasion and migration in gastric cancer cells.</p>

Application of home enteral nutrition and its impact on the quality of life in patients with advanced gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the application of home enteral nutrition (HEN) in patients with advanced gastric cancer and its impact on the quality of life.</p><p><b>METHODS</b>Data of 60 consecutive patients with advanced gastric cancer, who could not underwent operation and had relapse metastasis, from June 2010 to June 2012 were retrospectively analyzed. According to familial nutritional pattern, these 60 patients were divided into HEN group (25 cases) receiving home enteral nutritional support and control group (35 cases). HEN patients were supported through jejunostomy tube or nasal gastric tube. Control patients were supported through total parental nutrition or purely eating respectively. All the patients received intravenous chemotherapy and evaluated by Karnofsky index and Spitzer system in the first, third, sixth and twelfth month. In the sixth month, patients were also examined by EORTC QLQ-C30.</p><p><b>RESULTS</b>No significant differences were found between the two groups according to 8 elements containing age, sex, BMI, etc. A total of 53 patients died within one year, including 21 in HEN group and 32 in control group. The Karnofsky scales showed that HEN group scored meanly 57.4, 39.6 and 28.2 in the third, sixth and twelfth month respectively, which were significantly higher than those of control group (45.3, 29.2 and 20.1, P=0.041, P=0.012 and P=0.015 respectively). The Spitzer scales showed that HEN group scored meanly 5.12, 4.04 and 2.54 on average in the third, sixth and twelfth month respectively, which were significantly higher than those of control group (4.32, 3.01 and 1.97, P=0.048, 0.035 and P=0.024 respectively). The EROTC QLQ-C30 scales showed that HEN group scored higher than control group in functional scales (P<0.05), and lower in the symptom scales of short breathing, pain and tired (P=0.025, P=0.044, P=0.036 respectively), while higher in diarrhea (P=0.047).</p><p><b>CONCLUSIONS</b>The quality of life of patients with advanced gastric cancer declines gradually with the nutritional status deteriorating. HEN can be applied to improve the nutritional status and quality of life.</p>

Expression of phospholipase C epsilon-1 in gastric cancer and its association with prognosis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the expression of phospholipase C epsilon-1(PLCE1) and its clinical significance in gastric cancer.</p><p><b>METHODS</b>Surgical specimens were collected from 125 patients who underwent radical gastrectomy between 2005 and 2007 in the Zhejiang Provincial Peoples' Hospital. Expression level of PLCE1 protein was measured by immunohistochemistry in these 125 surgical specimens, which included primary gastric cancer and matched adjacent normal gastric mucosa tissues, and then 41 pairs of above specimens were selected randomly to examine the expression level of PLCE1 mRNA by quantitative reverse transcription PCR(qRT-PCR).</p><p><b>RESULTS</b>Immunohistochemistry and qRT-PCR showed that both protein and mRNA level of PLCE1 were up-regulated in gastric cancer compared with paired normal gastric mucosa. Univariate analysis demonstrated that the expression of PLCE1 was significantly associated with differentiation degree, invasion depth, lymph node metastasis, distant metastasis, and TNM stage (all P<0.01). The 5-year survival rate of positive PLCE1 group was significantly lower as compared to negative group (31.2% vs. 54.0%, P<0.01). However, the expression of PLCE1 was not an independent prognostic factor for gastric cancer (P>0.05).</p><p><b>CONCLUSIONS</b>PLCE1 is up-regulated in gastric cancer, which is associated with the malignant biological behaviors of gastric cancer. High expression of PLCE1 suggests poor prognosis.</p>

Clinical experience of surgical intervention for severe acute pancreatitis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The controversy on the treatment strategy for severe acute pancreatitis (SAP) has never stopped for the past century. Even now surgical procedures play a decisive role in the treatment of SAP, especially in managing the related complications, but the rational indications, timing, and approaches of surgical intervention for SAP are still inconclusive.</p><p><b>METHODS</b>Clinical data of 308 SAP patients recruited during January 2000-January 2013, including 96 conservatively treated cases plus 212 surgically intervened cases, were comparatively analyzed. Based on the initial surgical intervention time, the surgical intervention group was split into two: early intervention group (within 2 weeks) 103 cases, and late intervention group (after 2 weeks) 109 cases.</p><p><b>RESULTS</b>In the conservative treatment group, the cure rate was 82.29% (79/96), the death rate was 13.54% (13/96), and 4 cases self-discharged, while in the surgical intervention group, the cure rate was 84.43% (179/212) and the death rate was 10.85% (23/212) with 10 cases self-discharged. The difference was of no statistical significance between these two groups (P > 0.05). In surgical intervention group, the death rate 15.53% (16/103) in the early surgical intervention group was higher than that of late surgical intervention group 6.42% (7/109), and the difference was statistically significant (P < 0.05).</p><p><b>CONCLUSIONS</b>Both conservative treatment and surgical intervention play important roles in the treatment of SAP, and the indication, timing, and procedure should be strictly followed. Surgery earlier than 2 weeks after onset of the disease is not recommended in patients with necrotizing pancreatitis only when there are specific indications, such as multiple organ failure, which does not improve despite active treatment, and in those who develop abdominal compartment syndrome.</p>

Modified orthotopic segmental small bowel transplantation in rats / 中华消化外科杂志

Objective To establish a simple and stable orthotopic segmental small bowel transplantation model in rats.Methods Eighty male SD rats were divided into donors and recipients.Orthotopic segmental small bowel transplantation was performed by end-to-side anastomosis between donor abdominal aorta tundish-shape patch with arteria mesenterica superior pedicle and abdominal aorta of the recipients; end-to-end anastomosis between the portal vein of the donors and the left renal vein of the recipients was done using the cuff technique ; the large part of the small bowel of the recipients was excised,and it was replaced by the segmental intestine of the donors.Results The operation time of the donors and recipients were (40 ± 5) minutes and (50 ±8)minutes,respectively.The warm ischemia time and cold ischemia time were (5 ± 2) minutes and (15 ± 5) minutes,respectively.The anastomosis time of arteries and veins were (5 ± 2) minutes and (4 ± 2) minutes,respectively.The survival time of 90.0％ (36/40) of rats was more than 10 days.Conclusion The modified rat model of orthotopic segmental small bowel transplantation is easy to manipulate,and has the advantages of short operation time,high survival rate and stability.

The impact of exogenous trypsin supplement on the quality of life of patients after total gastrectomy / 中华普通外科杂志

Objective To improve the quality of life in gastric cancer patients after total gastrectomy by exogenous trypsin supplement.Method In this study 106 patients were divided into two groups,with 53 patients in each group,oral pancreatic enzyme capsule was given in comparison without in control group.Patients were asked to fill in EORTC QLQ-C30 questionnaire and Korenaga questionnaire at half a year postoperation,stool sample was collected at the same time for fecal fat assay.Results A total of 86 patients completed this test at postoperation half a year.With a comprehensive assessment of quality of life in patients by the scoring system of EORTC QLQ-C30 and Korenaga and the fecal fat contents measurement.Exogenous trypsin plays a positive role in preventing weight loss,improving emotional function,alleviating loss of appetite,insomnia,fatigue,postprandial fullness,nausea,vomiting and diarrhea,and improving intestinal tolerance to fat and the overall health status of patients.Conclusions Total gastrectomy causes exocrine pancreatic dysfunction,exogenous supplement of the enzyme improves postoperative quality of life in these patients.

Effects of alimentary reconstruction on gastrointestinal hormones in a dog model undergoing subtotal gastrectomy / 中华普通外科杂志

Objective To evaluate effects of alimentary reconstruction procedures (integral continual jejunal interposition, Billroth Ⅱ and isolated jejunal interposition) after subtotal gastrectomy on postoperative plasma gastrin, motilin and cholecystokinin. Methods Twenty-four dogs were divided into 3 groups undergoing distal subtotal gastrectomy and three different digestive tract reconstruction (integral continual jejunal interposition, Billroth Ⅱ and isolated jejunal interposition). The concentration of plasma gastrin, motilin and cholecystokinin were detected by enzyme-linked immunosorbent assay before and after operation. Results Two months after operation, plasma gastrin level of the integral continual jejunal interposition group (2. 2 ±0. 7 ) ng/L, ( 3.9 ± 0. 8 ) ng/L was significantly lower than that of preoperative both in fasting and postprandial state (3.8 ± 1.0) ng/L, (5.3 ± 1.6) ng/L, all P ＜0.05, but was significantly higher than other two groups in postprandial state (2. 7 ± 1.0) ng/L, (3.6 ±0. 6) ng/L, P ＜0. 05. Two months after operation, plasma motilin concentration of integral continual jejunal interposition group (577 ±204) ng/L, (1003 ± 209) ng/L were significantly higher than that of preoperative both in fasting and postprandial (429 ± 128) ng/L, (854 ± 218 ) ng/L, P ＜ 0. 05. The postoperative plasma motilin of integral continual jejunal interposition group ( 1003 ± 209 ) ng/L was significantly higher than other two groups in postprandial state (840 ±205) ng/L, (986 ± 189) ng/L, P ＜0. 05. Two months after operation,plasma cholecystokinin concentration of integral continual jejunal interposition group ( 19.6 ± 2.0 ) ng/Lwere significantly higher than that of preoperative both in postprandial ( 19.0 ± 2. 0) ng/L, P ＜ 0. 05. The postoperative plasma cholecystokinin of integral continual jejunal interposition group ( 19. 6 ± 2. 0) ng/L was significantly lower than other two groups (22.2 ± 2. 1 ) ng/L, (20. 1 ± 2. 5 ) ng/L, P ＜ 0. 05. Conclusion Integral continual jejunal interposition after distal gastrectomy maintains the postoperative plasma motilin and gastrin in a relatively higher level and decreases the concentration of plasma cholecystokinin.

Transanal local excision for stage Ⅰ low rectal carcinoma / 中华消化外科杂志

Objective To assess the validity of transanal local excision for stage Ⅰ low rectal carcinoma.Methods The clinical data of 93 patients with stage Ⅰ low rectal carcinoma who underwent transanal excision (group A,n=45)or radical resection(group B,n=48)were retrospectively analyzed.Twenty-four T1 patients and 21 T2 patients in group A received postoperative adjuvant radiation therapy and adjuvant chemoradiotherapy,respectively.All patients in group B received radical surgery only.The 5-year survival rates,recurrence rates,and postoperative complications between the 2 groups were compared.Results The 5-year survival rates were 100%(24/24)for T1 patients,86%(18/21)for T2 patients in group A,and 100%(18/18)for T1 patients,93%(28/30)for T2 patients in group B,with no significantly statistical difference between the 2 groups(P＞0.05).The recurrence rates were 4%(1/24)for T1 patients,19%(4/21)for T2 patients in group A,and 0(0/18)for T1 patients,7%(2/30)for T2 patients in group B,with no significance between the 2 groups(P＞0.05).The incidence of postoperative complications in group A was 2%(1/45),which was significantly lower than that of 15%(7/48))in group B(P＜0.05).Conclusions Transanal local excision of early low rectal carcinoma,combined with postoperative chemotherapy for T1 patients or chemoradiotherapy for T2 patients, results in a low complication rate and good sphincter function,and provides satisfactory local control and 5-year survival rates.

Preliminary Study on Apoptosis of Human Gastric Carcinoma Cell line MKN45 Induced by Arsenic Trioxide and its Molecular Mechanism / 医学研究杂志

Objective To investigate the possibility of human gastric carcinoma cells apoptosis induced by arsenic trioxide and its mechanism.Methods After treatment with arsenic trioxide, the cytotoxicity to human gastric carcinoma cells MKN45 was quantified using trypan blue exclusion, and IC 50 was determined. Apoptotic cells were detected with flow cytometry, DNA cytofluorometry, DNA electrophoresis. Results Arsenic trioxide inhibited the growth of human gastric carcinoma cells MKN45 in a dose-dependent manner in a certain range of dose with a IC 50 of (11.05?0.25)?mol/L; Apoptotic peak, characteristic morphologic features of apoptosis and DNA ladder were observed in human gastric carcinoma cells MKN45 treated with 1~10 ?mol/L arsenic trioxide. Conclusions Arsenic trioxide can induce apoptosis of human gastric carcinoma cells MKN45, suggesting a great potential in the treatment of gastric carcinoma.