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Objective To investigate the recurrence and metastasis patterns of gastric cancer after curative resection and to guide target definition of prophylactic radiotherapy.Methods In the past 8 years,130 gastric cancer patients with treatment failure after radical resection were retrospectively analyzed.The failure sites were confirmed by B ultrasonography, CT or MRI imaging.Ten of 28 patients with ascites were found to have adenocarcinoma cells in the ascites.All superficial node and abdominal wall metastases were diagnosed pathologically by biopsy.And 27 patients with gastric remnant and/or anastomotic recurrence were diagnosed pathologically by biopsy.Results Of 130 patients, 53 were presented with multiple recurrences or metastases, 27 with gastric remnant and/or anastomostic recurrence, 28 with peritoneal metastases, 22 with liver metastases, 9 with pancreatic metastases, 60 with abdominal lymph node (LN) metastases, 8 with abdominal wall metastases, 5 with pelvic implantations, 6 with lung metastases, 5 with brain metastases, 5 with bone metastases, 8 with cervical lymph node metastases, 9 with mediastinal lymph node metastases and 8 with other metastases.Of 60 patients with abdominal LN metastases, 35, 16 and 9 had peri-gastric LNs,peri-pancreatic LNs and para-aortic LNs metastases.Abdominal LN metastases were found in 33 from 77 patients with primary gastric fundus or cardiac carcinoma, 20 from 40 patients with gastric body carcinoma,and 7 from 13 patients with pyloric carcinoma, respectively.Conclusions The failure sites of gastric cancer after radical resection are mainly the gastric stump/stoma, peritoneum, liver and abdominal LN.The perigastric, peri-pancreatic and/or para-aortic LN metastases are the most common failure of LNs.Thus, the peri-gastric, peri-pancreatic and para-aortic LN regions and gastric stump/stoma should be included in postoperative radiotherapy, and current chemotherapy is recommended.
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Objective To investigate the patterns for the recurrent and metastatic gastric cancer after curative resection and to indicate the strategy of treatment. Methods 162 patients who had received radical resection and presented post-operation failure during recent 9 years were analyzed. The failure patterns were confirmed by type-B ultrasonic or CT / MRI imaging. 15 of 34 patients with abdominal dropsy were diagnosed by adenocarcinoma cells in the abdominal dropsy. All superficial lymphadens and abdominal wall metastasis were diagnosed via punctuation. 31 patients with gastric remnant and (or) anastomoses recurrence were diagnosed via biopsy. Results Of 162 patients, 63 presented the recurrence or metastasis in multiple sites,including abdominal lymph node (LN) metastases in 46.9 % (76/162), peritoneum metastases in 21.0 % (34/162),gastric remnant and (or) anastomoses recurrence in 19.1% (31/162), liver metastases in 19.1% (31/162), the incidence rates of other parts were all ＜10 %. Meanwhile, out of 76 patients with abdominal lymph node metastases, 48.7 % (37/76) patients with peri-gastric LNs metastases, 31.6 % (24/76) with peri-pancreatic LNs metastases, 19.7 % (15/76) with para-aortic LNs metastases. The incidence of LN metastases was 57.7 % (56/97) in cancer arising from gastric fundus/cardia and 60.4% (29/48) in gastric body and 64.7 % (11/17) in pylorus antrum. Conclusion The regional failure sites for gastric cancer patients with radical resection were dominantly found in the gastric stump/stoma, the peritoneum and pelvic cavity implantation and abdominal cavity LN metastases, especially in the peri-gastric, peri-pancreatic and/or para-aortic LN metastases. The distant place failure sites were mainly in the liver, lung, brain, spondylus, cervical part LN and mediastinal LN metastases. Therefore, we should take chemotherapy, abdominal cavity chemotherapy and regional radiotherapy to prevent the regional district recurrences and distant metastasis after the gastric cancer patients with radical resection. Radiotherapy fields should focus on the gastric stump/stoma and the peri-gastric, peri-pancreatic and para-aortic LN regions.
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OBJECTIVE To understand the susceptibility to antituberculous agents for patients with primary and acquired drug resistance of Mycobacterium tuberculosis. METHODS M. tuberculosis positive sputum samples were collected from Jun to Dec 2006. Ameliorative Lowenstein-Jensen culture medium was used to detect bacillus-positive specimen of pulmonary tuberculosis by typing using PNB and TCH. Totally 217 samples were confirmedtobe positive by culturing. Drug susceptibility test against streptomycin (SM),isoniazid (INH),rifampicin (RFP) and ethambutol (EMB) was conducted. RESULTS The total drug resistance rate was 65.90%,the initial drug resistance rate was 39.81% and the initial multi-drug resistance rate was 16.67% ;the acquired drug resistance rate was 91.74%,and the acquired multi-drug resistance rate was 74.31%. The main causes of drug resistance were irregularit of treatment at beginning and preterm stop of the freatment course by patients own selves,which accounted for 71.6%. CONCLUSIONS The drug resistance of M. tuberculosis is caused by irregular treatment,so the key to prevent and control drug resistance is rational and whole-course treatment.
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Objective To investigate the treatment effects of chrono-chemotherapy (CC) with radiotherapy on advanced esophageal carcinoma. Methods Eighty patients with advanced esophageal carcinoma were randomly divided into two groups: a radiotherapy group (R) and a chrono-chemotherapy plus radiotherapy group (CC+R). 40 patients received radical radiotherapy alone and the radiation dose was 64-70 Gy for 6-7 weeks (R). 40 patients were treated by chrono--chemotherapy plus radiotherapy. Patients were chrono-introvein infusion with cisplatin and 5-fluorouraeil. Patients were given cisplatin 20 mg/m2 infusion on 10-hour-22-hour and 5-fluorouracil 500 mg/m2 by infusion from 22:00 to 10:00 next day. The period of treatment was 5 days. Treatment was repeated on the 29th day. The radiation dose was 50-60 Gy, for 5-6 weeks (CC+R). The treatment effects and X images of all patients were observed and followed up for 6 to 20 months. Results The improvements of clinical symptoms were 92.5% (37/40) in CC+R group and 75.0% (30/40) in R group, with an obvious difference between the two groups (P <0.05). The 1-, 2-year survival rates were 75.0% (30/40) and 52.5% (21/40), 47.5% (19/40) and 30.0% (12/40) in two groups, with significant difference in 1-year survival rate between the two groups (P <0.05). Conclusion Radiotherapy combined with chrono-chemotherapy was an effective method for advanced esophageal carcinoma.
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Objective To study the hemoprotective effects of a rotary magnetic field (RMF) to radiation-injured mice. Methods 132 male BALB/c mice were randomly divided into four groups: a normal group (N), a magnetic treatment group (M), an irradiation group(R) and an irradiation combining magnetic treatment group (R + M). Mice in the N group received no treatment. Mice in the R and R + M groups received total body irradiation with 6.0 Gy 60Co γ/rays. Mice in the M and R + M groups were treated with a RMF for one and half an hour at a time, twice a day, totally for 30 days. The survival rate was observed for 30 days. On days 0, 5, 9, 15, 21, 30, the subjects' peripheral blood cells were counted. On day 9, 23 and 30, the number of bone marrow nucleated cells (BMNCs), colony forming unit-spleen (CFU-S), spleen-body ratio, the cell cycle and apoptosis of bone marrow cells were measured. The pathological sectioning of the femur was performed and the expression level of bone morphogenetic proteins (BMP2/4) in the bone marrow was evaluated. Results ①No mice died in the N and M group. The RMF treatment increased the survival rate and survival days among the irradiated mice (P < 0.01). ②The RMF treatment increased the number of blood cells in their peripheral blood of the R + M group. ③The number of BMNCs, CFU-S and the proportation of G2 + M stage in the R + M were markedly higher than that of the R group, but the proportation of the apoptosis was lower than that of the R group on the 9th day (P < 0.05). Furthermore, the spleen index in the R + M group was also higher than that of the R group on the 23rd day (P < 0.05). ④RMF could improve the expression level of BMP2/4 in the radiation-injued mice. Conclusion The RMF treatment had an obvious protective effect against the effects of irradiation and it accelerated the recovery of hematopeiesis and the hematopoietic microenvironment in mouse bone marrow.
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AIM: To study the alteration of expression of iNOS mRNA and ecNOS mRNA in peripheral leukocytes of Wistar rats fed with fructose. METHODS: Wistar rats were randomly divided into the control group ( n =10) and the fructose feeding group( n =10). The fructose feeding group drank 12% fructose water for 6 months. The blood glucose, blood insulin, and the expression of iNOS mRNA and ecNOS mRNA in peripheral leukocytes of rats were determined. RESULTS: The levels of blood insulin ( P
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We have observed the effects of five alga polysaccharides on rabbit's blood platelets aggregation. We found that the polysaccharides could inhibit aggregation of blood platelets in vitro. The strongest effect was observed in the polysaccharides from the following,in decreasing order of strength: Scytosiphon lomentarius, Codium fragile,Laminaria japonica and Ulvalactuca. The same effect was not observed in polysaccharides from Cladophra. We also found a positive correlation between the effects of anti-aggregation and the ratio of vitriol radicles in these five polysaccharides.