Safety and effectiveness of oxaliplatin combined with capecitabine or oxaliplatin combined with S-1 neoadjuvant chemotherapy in the treatment of advanced gastric cancer / 中华胃肠外科杂志

Objective: To explore the safety and efficacy of oxaliplatin plus capecitabine (CapeOX) or oxaliplatin plus S-1 (SOX) regimen neoadjuvant chemotherapy in the treatment of advanced gastric cancer. Methods: A retrospective cohort study was performed. Clinical data of patients diagnosed as advanced gastric cancer undergoing CapeOX/SOX neoadjuvant chemotherapy and standard laparoscopic radical operation for gastric cancer in Ruijin Hospital of Shanghai Jiaotong University School of Medicine from April 2016 to April 2019 were retrospectively collected. Inclusion criteria were as follows: (1) age≥18 years; (2) gastric adenocarcinoma was confirmed by histopathology and the clinical stage was T3-4aN+M0; (3) tumor could be resectable; (4) preoperative neoadjuvant chemotherapy was CapeOX or SOX regimen without radiotherapy or other regimen chemotherapy; (5) no other concurrent malignant tumor; (6) the Eastern Cooperative Oncology Group (ECOG) score ≤ 1; (7) no bone marrow suppression; (8) normal liver and kidney function. Exclusion criteria were as follows: (1) patients with recurrent gastric cancer; (2) patients receiving emergency surgery due to tumor perforation, bleeding, obstruction, etc.; (3) allergy to oxaliplatin, S-1, capecitabine or any drug excipients; (4) diagnosed with coronary heart disease, cardiomyopathy, or the New York Heart Association class III or IV; (5) pregnant or lactating women. A total of 118 patients were enrolled as the neoadjuvant chemotherapy group, and 379 patients with locally advanced gastric cancer who received surgery combined with postoperative adjuvant chemotherapy over the same period simultaneously were included as the adjuvant chemotherapy group. After propensity score matching was performed including gender, age, ECOG score, tumor site, clinical stage, chemotherapy regimen and other factors by 1:1 ratio, there were 40 cases in each group. The differences between the two groups in general conditions, efficacy of neoadjuvant chemotherapy, intraoperative conditions, postoperative conditions, histopathological results, chemotherapy-related adverse events, and survival status were compared and analyzed. Results: Comparison of baseline demographics between the two groups showed no statistically significant difference (all P>0.05). In the neoadjuvant chemotherapy group, 5.0% (2/40) of patients achieved clinical complete response, 57.5% (23/40) achieved partial response, 32.5% (13/40) remained stable disease, and 5.0% (2/40) had disease progression before surgery. Objective response rate was 62.5% (25/40), and disease control rate was 95.0% (38/40). There were no statistically significant differences between neoadjuvant chemotherapy group and adjuvant chemotherapy group in terms of operation time, intraoperative blood loss, number of lymph node harvested, length of postoperative hospital stay, and postoperative mortality and morbidity (all P>0.05). Postoperative complications were well managed with conservative treatment. No Clavien-Dindo IV or V complications were observed in both groups. Pathological results showed that the proportion of patients with pathological stage T1 in the neoadjuvant chemotherapy group was significantly higher than that in the adjuvant chemotherapy group [27.5% (11/40) vs. 5.0% (2/40)], while the proportion of patients with pathological stage T3 was significantly lower than that in the adjuvant chemotherapy group [20.0% (8/40) vs. 45.0% (18/40)], with statistically significant difference (χ(2)=15.432, P=0.001). In the neoadjuvant chemotherapy group, there were 4 cases of tumor regression grade 0, 8 cases of grade 1, 16 cases of grade 2, and 12 cases of grade 3. The pathological complete response rate was 10% (4/40), the overall pathological response rate was 70.0% (28/40). There was no statistically significant difference in the incidence of chemotherapy-related adverse events between neoadjuvant chemotherapy group and adjuvant chemotherapy group [40% (16/40) vs. 37.5% (15/40), P>0.05). There were no statistically significant differences in OS (43 months vs. 40 months) and 3-year OS rate (66.1% vs. 59.8%) between neoadjuvant chemotherapy group and adjuvant chemotherapy group (P=0.428). The disease-free survival (DFS) and 3-year DFS rates of the neoadjuvant chemotherapy group were significantly superior to those of the adjuvant chemotherapy group (36 months vs. 28 months, 51.4% vs. 35.8%, P=0.048). Conclusion: CapeOX or SOX regimen neoadjuvant chemotherapy is a safe, effective and feasible treatment mode for advanced gastric cancer without increasing surgical risk and can improve the DFS of patients.

Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years: A Single-center Initial Experience from China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Urolithiasis in pediatric population is a serious problem with the incidence increased these years. In the management of larger stones (diameters >2 cm), percutaneous nephrolithotomy (PCNL) is considered to be the gold standard. This study aimed to investigate the efficacy and safety of mini-PCNL under total ultrasonography in patients aged <3 years.</p><p><b>METHODS</b>We reviewed 68 patients (80 renal units) aged <3 years between August 2006 and December 2014 in Peking University People's Hospital and Beijing Tsinghua Changung Hospital, including 36 renal units with a single stone, 6 with staghorn stones, 14 with upper ureteral stones, and 24 with multiple stones. The mean age of the patients was 24.2 months (range 6-36 months), and the mean maximum stone diameter was 19.2 mm (range 10-35 mm). The puncture site selection and tract dilation were guided by Doppler ultrasonography solely. All procedures were performed using 12-16 Fr tracts. Stones were fragmented using pneumatic lithotripsy and a holmium laser with an 8/9.8 Fr rigid ureteroscope.</p><p><b>RESULTS</b>Fifty-six patients with unilateral stones underwent a single session procedure, and 12 patients with bilateral stones underwent two procedures. The mean time to establish access was 2.8 min (range 1.8-5.0 min), the mean operative time was 36.5 min (range 20-88 min), the mean decrease in hemoglobin concentration was 8.9 g/L (2-15 g/L), and the stone-free rate (SFR) at hospital discharge was 94.0%. The mean postoperative hospital stay was 7.1 days (range 3-13 days). Postprocedure complications included fever (>38.5°C) in five patients and reactive pleural effusion in one patient. Blood loss requiring transfusion, sepsis, adjacent organ injury, and kidney loss were not observed.</p><p><b>CONCLUSIONS</b>This study indicated that ultrasound-guided mini-PCNL is feasible and safe in patients aged <3 years, without major complications or radiation exposure.</p>

BRAF V600E mutation as a predictive factor of anti-EGFR monoclonal antibodies therapeutic effects in metastatic colorectal cancer: a meta-analysis / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the correlation between BRAF V600E mutation and anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (MoAbs) therapeutic effects in metastatic colorectal cancer.</p><p><b>METHODS</b>Studies were included into meta-analysis to investigate the association between BRAF V600E mutation and clinical outcome in metastatic colorectal cancer patients treated with anti-EGFR MoAbs.</p><p><b>RESULTS</b>A total of 7 studies were included in this meta-analysis. The 7 studies included 1352 patients in total, sample sizes ranged from 67 to 493. Objective response rate (ORR), progression-free survival (PFS) and overall survival (OS) were collected from included studies and were used to assess the strength of the relation. In patients with wild-type KRAS, the pooled odds ratio for ORR of mutant BRAF over wild-type BRAF was 0.27 (95% CI=0.10-0.70). BRAF mutation predicted a deterioration in PFS and OS in wild-type KRAS patients treated with anti-EGFR MoAbs (hazard ratio=2.78, 95% CI=1.62-4.76; hazard ratio=2.54, 95% CI=1.93-3.32).</p><p><b>CONCLUSION</b>BRAF V600E mutation is related to lack of response and worse survival in wild-type KRAS metastatic colorectal cancer patients treated with anti-EGFR MoAbs.</p>

Epidemiological characteristics of major abnormal electrocardiogram in adults from Shanghai / 中华流行病学杂志

Objective To understand the prevalence,characteristics and risk factors of major abnormal electrocardiogram (MA-ECG) in adults living in Shanghai.Methods The cross-sectional dataset of prevalence survey on diabetes and metabolic syndrome in adults,aged 20-74 years,from Shanghai,in 2007-2008,was analyzed.Demographic information,personal and,family histories of diseases were collected.Physical examination and laboratory tests were done.Subjects underwent examination on resting 12-leads electrocardiogram (ECG),ECG records were coded according to the Minnesota criteria and classified as MA-ECG or non-MA-ECG.Results A total number of 5364 subjects (2003 men,3361 women) were finally included in this analysis.(1) The standardized prevalence of MA-ECG was 7.3％ (7.0％ in men,7.7％ in women).In both genders,the age-specific prevalence of MA-ECG significantly increased with age (Ptrend＜0.01).The age-specific prevalence of MA-ECG in youths,middle aged and the elderly were 2.3％,7.7％,and 17.3％ in men,and 3.3％,8.8％ and 16.4％ in women,respectively (both Ptren＜0.01).(2) The three most common MA-ECG forms were arrhythmia (28.8％),bundle branch block (26.5％) and ST segment depression (20.0％) in men,while there appeared ST segment depression (44.6％),arrhythmia (23.0％) and combined MA-ECG (11.8％) in women.(3) Data from multivariate logistic regression analysis showed that other than age,coronary heart disease (CHD) was the only independent risk factor of MA-ECG in men,with its corresponding OR being 2.33-2.39; while in women,menopause (OR value:1.72-1.85) and hypertension (OR value:1.33-1.34) were main factors related to MA-ECG.Conclusion MA-ECG was prevalent in the middle aged and the elderly,with,arrhythmia and ST segment depression the most frequent forms of MA-ECG.Age,CHD and hypertension were the main risk factors of MA-ECG in the adults from Shanghai.

Current status and prevention of complications after laparoscopic radical gastrectomy / 中华胃肠外科杂志

It is the most important for surgeons to achieve surgical safety and oncological clearance in laparoscopic surgery for gastric cancer. With the widespread adoption oflaparoscopic surgery for gastric cancer, surgeons make great efforts to achieve better safety andlower morbidity. Common abdominal complications (intraoperative and postoperative) after laparoscopic radical gastrectomy include bleeding, anastomotic leakage, anastomotic stenosis, iatrogenic organ injury, pancreatic leakage, etc. The causes and prevention of the complications related with laparoscopic radical gastrectomy was discussed in this article.

Complications of laparoscopic gastrectomy for gastric cancer and the management / 中华胃肠外科杂志

In recent years, laparoscopic gastrectomy has developed rapidly for both early and advanced gastric cancer. Most studies showed that the operative complication rate is comparable between laparoscopic and open surgery. The common complications related to laparoscopic gastrectomy are anastomotic leakage, stenosis, intra-abdominal bleeding, pancreatic leakage, bowel obstruction, etc. This article provides insights into the reasons, classification, management, and prevention of the complications related to laparoscopic gastrectomy.

Extracts of red yolk from duck eggs inhibit metastasis of human mammary carcinoma (4T1) cells in mice

The aim of the present study was to investigate the in vivo anti-metastatic activity of the red pigments of red yolk eggs laid by the ducks dieting on Potamogeton cripus L on the mammary carcinoma (4T1). The pigments were extracted with petroleum ether and acetone (2:1, v/v). BALB/c mice were divided into three groups (n=6), fed with the extracts at 150 mg/kg body weight (BW)/day (DEYE-H) or at 50 mg/kg BW/day (DEYE-L) and identical buffer without the extract (control group). The extracts were administered for 34 days. The treatment significantly inhibited the growth of orthotopical 4T1 tumour (DEYE-H vs control, 1:2; DEYE-L vs control, 2:3) and reduced the metastasis of tumour in the lungs (DEYE-H vs control, 4:7; DEYE-L vs control, 5:7), without statistical difference of body weight among the three groups.

Comparative study of laparoscopic-assisted radical gastrectomy versus open radical gastrectomy for early gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate laparoscopic radical gastrectomy for early gastric cancer.</p><p><b>METHODS</b>A total of 204 patients with early gastric cancer undergoing laparoscopic-assisted radical gastrectomy or open radical gastrectomy between October 2004 and December 2009 were retrospectively reviewed and analyzed. Patients were divided into laparoscopic group(LAP, n=78) and open group (OPEN, n=126). Operative time, blood loss, time to passage of flatus, postoperative hospital stay, complications and pathologic findings were compared between the two groups.</p><p><b>RESULTS</b>Compared to the OPEN group, operative time in the LAP group was significantly shorter[(202.9±45.6) min vs.(219.8±45.2) min, P<0.05], blood loss was less[(144.5±146.5) ml vs. (245.0±146.4) ml, P<0.05], time to passage of flatus was shorter[(3.1±1.1) d vs.(4.5±1.6) d, P<0.05], postoperative hospital stay was shorter[(10.8±1.2) d vs. (12.4±3.8) d, P<0.05]. However, the two groups were comparable with regard to postoperative complication rate(10.3% vs. 12.7%, P>0.05), proximal resection margin[(4.0±1.9) cm vs. (4.2±1.7) cm, P>0.05], distal resection margin [(3.6±1.7) cm vs. (3.5±1.8) cm, P>0.05], number of harvested lymph node(13.1±6.5 vs. 14.5±8.2, P>0.05). The median follow up was 22(2-64) months. There were no tumor recurrences or metastases in the LAP group. In the OPEN group, only 1 patient died from peritoneal metastasis. Total hospital costs between the two groups were similar(P>0.05).</p><p><b>CONCLUSION</b>Laparoscopic radical gastrectomy is a safe, feasible, effective, and less invasive surgery for early gastric cancer.</p>

Safety study of laparoscopic surgery for colorectal cancer in elderly patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the outcomes of laparoscopic colorectal surgery in elderly (> or = 70 years) and younger(< 70 years) patients, and to evaluate the safety of laparoscopic colorectal surgery in elderly.</p><p><b>METHODS</b>From Aug. 2007 to Dec. 2007, 25 patients with colorectal cancer undergone laparoscopic colorectal surgery were studied prospectively. Ten patients aged 70 years or older(Elder Group), and 15 patients less than 70 years(Younger Group). The parameters of perioperative hemodynamics, blood chemistry, and intraabdominal organs perfusion were recorded periodically during operation and compared between the two groups.</p><p><b>RESULTS</b>Elder group had a higher ASA degree(P<0.01). Mean age, height, weight, the classification of the disease, operative time, blood loss and complication were not significantly different between the two groups. The HCO(3) value and PaCO(2) value increased significantly intraoperatively, while the pH value decreased significantly. These parameters returned to basal line at the end of operation, with the decreased electrolytes, especially the kaliopenia and hypocalcemia. The CVP increased significantly at the beginning of operation and after fluid expansion, and decreased postoperatively. Gastric mucosal pH(pHi) decreased when the operation began. The partial pressure of gastric mucosa(PgCO(2)) increased significantly at the end of operation. Other parameters of hemodynamics including HR, CI, and SI were not significantly different during operation. The CVP of elder group was higher than that of younger group at 5 min after the beginning of the operation, while the MAP of elder group was lower than that of younger at 15 min after the end of the operation. Other parameters of hemodynamics including oxygenation, perfusion, and blood chemistry were not significantly different.</p><p><b>CONCLUSIONS</b>For laparoscopic colorectal surgery, no significant adverse response attributes to elderly patients. The compensation capacity of the elderly is lower. With the reasonable anesthesia administration, the adverse response can be controlled effectively.</p>

The effect of PTC1 transfection on the growth and apoptosis of human pulmonary adenocarcinoma cell A549 / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of the tumor suppressor gene PTC on the growth inhibition and down-regulation of epidermal growth factor receptors (EGFR) in pulmonary adenocarcinoma cell A549.</p><p><b>METHODS</b>Pulmonary adenocarcinoma cell A549 were divided into wild type group, mutant type group, blank group and control group. They were transfected with wild-type PTC1 plasmids, mutant-PTC1 plasmids and blank plasmids, respectively. After transfection, the cell growth curve was drown every day for a week. The expression of PTC1 and EGFR were detected by western blot. Flow cytometry was used to analyze apoptosis and cell cycle of the transfected cells.</p><p><b>RESULTS</b>After transfected with wild-type PTC1, the growth rates of A549 cells were slow down, but the other groups of cells had no change. Compared with the control group, the expression of EGFR were down-regulated. The apoptosis rates in wild type group was 24.5%, and the mutant type group was 8.3% (P < 0.01). But the apoptosis rate of blank group has no change.</p><p><b>CONCLUSION</b>Wild-type PTC1 could induce apoptosis and inhibitory effect on A549 cells.</p>

Laparoscopic surgery for gastric and small intestinal stromal tumors / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate laparoscopic surgery for gastric and small intestinal stromal tumors.</p><p><b>METHODS</b>The clinical data of patients with laparoscopic resection of gastric and small intestinal tumors, admitted to our center from Dec. 2003 to Jul. 2006, were retrospectively analyzed. The data included the surgical procedure, operative time, blood loss, length of incision, time for passage of flatus, postoperative length of stay, operative complications, pathology and the results of follow-up.</p><p><b>RESULTS</b>All the 33 patients with gastric and small intestinal stromal tumors were treated by laparoscopic procedures successfully, including 8 laparoscopic gastric wedge resections, 8 laparoscopic transgastric tumor-everting resections, and 17 laparoscopic segmental resections of small intestine. The mean operative time was (73.1+/-27.0) min, the mean blood loss was (19.8+/-14.0) ml, the mean length of incision was (3.3+/-1.1) cm, the mean time for passage of flatus was (2.2+/-1.0) d and the postoperative length of stay was (8.1+/-2.0) d. The bleeding of intestinal anastomosis and gastric mucosa occurred on 3 patients (9.1%), who were healed with conservative therapy. No recurrence was found during 2-33 months follow-up.</p><p><b>CONCLUSION</b>Laparoscopic surgery is an effective, safe, less invasive procedure for treatment of gastric and small intestinal stromal tumors.</p>

Prospective randomized controlled trial of bilingual education in surgery / 上海第二医科大学学报

Objective To explore the feasibility of "immersion program" in French-taught surgical lessons,as to provide multiple educational methods and practical experiences for the application of bilingual education in clinical medicine.Methods Twenty-nine senior students of French-taught class were randomly divided into group A(n=15) and group B(n=14)."Immersion program" and "transitional bilingual education" were employed for group A and group B,respectively for the first half of teaching session,and "transitional bilingual education" and "immersion program" for the second half,respectively.The differences between the two bilingual education models were compared through quiz.Results In the prior 2 of the 4 quiz,the scores of French quiz and the total scores were much higher in "immersion program" group,and there were significant differences between the two groups(P0.05). Conclusion "Immersion program" helps to improve the ability of presentation,comprehension and application of French in the precondition of equal educational content,and it will be more beneficial when accessing the "immersion program" on the basis of "transitional bilingual education".

Value of endoscopy combined with laparoscopy in treatment of colorectal polyps and polyp canceration / 上海第二医科大学学报

Objective To investigate the value of endoscopy combined with laparoscopy in the treatment of colorectal polyps and polyp canceration.Methods Different combinations of endoscopic and laparoscopic procedures were employed and the clinical efficacies were compared.Results From January 2004 to September 2006,46 cases with colorectal polyp were treated with endoscopy combined with laparoscopy.Among them,5 cases(10.87%)underwent laparoscopic-assisted endoscopic polypectomy,30(65.22%)endoscopic-assisted laparoscopic resection,6(13.04%)synchronously endoscopic and laparoscopic resection.Five cases were performed further operation after endoscopic polypectomy.According to the pathological findings,21(45.7%)were proved to be polyp canceration,among which 6 were advanced carcinoma,and 3 were found metastasis to the lymph nodes.Among the 41 cases of laparoscopic resection,there was no conversion to an open surgery.Anastomotic leakage was found in 2 cases and anastomotic bleeding in 1.In the 5 cases of laparoscopic-assisted endoscopic polypectomy,no complication was observed.During the period of follow-up(1 to 21 months),no recurrence was detected.Conclusion Endoscopy combined with laparoscopy extends the safety and indications of endoscopic polypectomy,and is minimally invasive to the patients.It is an ideal procedure in the treatment of colorectal polyps and poly carceration.

Application of laparoscopic local resection for gastric tumors / 上海第二医科大学学报

Objective To evaluate the clinical application of laparoscopic local resection for gastric tumors.Methods Twenty-three patients with gastric tumors who were performed laparoscopic gastric local resection were retrospectively analyzed with the size of tumor,location of tumor,operative time,blood loss during the operation,time for passage of flatus,post-operative hospital stay,operative complications,post-operative pathological findings and result of follow-up.Results Twenty-three patients were successfully performed laparoscopic local resection,including 8 laparoscopic wedge resection(LWR)and 15 intragastric mucosal resections(IGMR),with no conversion to open surgery.The mean size of gastric tumor was(2.8?1.3)cm,the mean operative time was(82.2?35.5)min,the mean blood loss was(26.5?15.3)mL,the length of incision was(3.1?1.1)cm,the time for passage of flatus was(2.1?0.9)d,and the mean post-operative hospital stay was(7.8?2.0)d.Two patients(8.7%)were found with postoperative gastric mucosal blee-ding and were recovered well through non-operative treatment.The median time of follow-up was 12 months(2-45 months),and no recurrent tumor was observed.Conclusion Laparoscopic local resection is a feasible,safe,effective and less invasive procedure for gastric tumors.

Laparoscopic diagnosis and treatment for small intestinal stromal tumors / 上海第二医科大学学报

Objective To evaluate the laparoscopic management in diagnosing and treating small intestinal stromal tumors.MethodsSeventeen patients with small intestinal stromal tumors,who underwent laparoscopic diagnosis and surgical procedures,were retrospectively analyzed with the size of tumor,operative time,blood loss,length of incision,time for passage of flatus,post-operative hospital stay,operative complications and result of follow-up.Results All the 17 patients were diagnosed and treated by laparoscopic partial intestinal resections.The mean diameter of tumors was(3.6?1.3)cm,operative time(62.1?25.7)min,blood loss(17.1?15.2)mL,length of incision(3.4?1.1)cm,time for passage of flatus(2.2?1.2)d and post-operative hospital stay(7.8?2.0)d.As for the complications,one(5.9%)anastomosis bleeding was found and was treated by non-surgical procedure.After follow-up for 2-34 months,no recurrent tumor was found.Conclusion Laparoscopic exploration is useful to diagnose small intestinal stromal tumor accurately,and laparoscopic partial intestinal resection is a safe,effective and less invasive procedure for small intestinal stromal tumors.

Comparison of inflammatory response after laparoscopic and conventional surgery for colorectal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the systemic and local inflammatory response after laparoscopic and conventional surgery for colorectal carcinoma.</p><p><b>METHODS</b>From April 2004 to August 2004, 51 colorectal cancer patients undergoing laparoscopic (n=25) and conventional open (n=26) colorectal resection were enrolled in the study. The general clinical data,and inflammatory response were compared between the two groups.</p><p><b>RESULTS</b>There were no significant differences in age, sex, pre-operative levels of haemoglobin and albumin, Dukes stage and surgical procedure between the two groups (P > 0.05). Laparoscopic surgery had more advantages over conventional open surgery such as incision, operating time, recovery time of bowel function, and hospitalization. On postoperative day (POD) 1, WBC count [(7.30+/- 2.62)x10(9)/L], and the serum levels of IL-10 [(19.46+/- 3.31)pg/ml] and C-reactive protein (CRP) [(2.76+/- 2.17)mg/dl] were significantly lower in laparoscopic group than those in conventional group (P< 0.05), but there were no differences on POD 4 between the two groups (P > 0.05). There were no significant differences in the volume of peritoneal drainage fluid, and levels of IL-10, TNF and CRP in it on POD 1 between the two groups, but the volume of peritoneal drainage fluid decreased significantly from POD 2, and the level of IL-10 in it was significantly lower on POD 4 in laparoscopic group than that in conventional group.</p><p><b>CONCLUSIONS</b>In early stage after operation,intra- peritoneal inflammatory response caused by laparoscopic surgery is similar to that by conventional open surgery, but systemic inflammatory response is slighter than that by conventional open surgery for colorectal carcinoma.</p>

Laparoscopic diagnosis and treatment in small intestinal tumors / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical use of laparoscopy in diagnosis and surgical treatment in small intestinal tumors.</p><p><b>METHODS</b>Clinical data of 42 patients with small intestinal tumor undergoing laparoscopic diagnosis and surgical procedure from Sep. 2003 to Dec. 2005 were analyzed retrospectively. The operative time, blood loss,length of incision, time for passage of flatus, post-operative hospital stay and operative complications were evaluated.</p><p><b>RESULTS</b>All the patients were diagnosed and treated by laparoscopic procedure successfully, including 4 laparoscopic local resection of the tumors, 36 laparoscopy-assisted partial intestinal resections, 1 right hemicolectomy, and 1 laparoscopic exploration. The mean operative time was (73.1+/-32.9) min, the mean blood loss was (20.7+/-31.2) ml, the mean length of incision was (3.7+/-1.2) cm, the mean time for passage of flatus was (2.2+/-0.8) d, and the post-operative hospital stay was (8.0+/-3.1) d. Postoperative complications occurred in 2 patients (4.8% ) including anastomosis bleeding and adhesive intestinal obstruction in one case respectively. After follow-up from 3 to 30 months, no recurrent tumor was found except one patient with advanced intestinal carcinoma.</p><p><b>CONCLUSION</b>Laparoscopic exploration can diagnose small intestinal tumors accurately, and laparoscopy-assisted surgical treatment is safe with less trauma and fast recovery.</p>

Experience of laparoscopic salvage surgery for locally recurrent rectal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of the laparoscopic salvage surgery for locally recurrent rectal cancer.</p><p><b>METHODS</b>Seven cases with recurrent rectal carcinoma treated by laparoscopic salvage surgery from February 2004 to July 2005 were retrospectively analyzed. Among them, four were males and 3 females, and the median age was 60 years (range 37-74). Three cases of recurrence were after conventional anterior resection, 2 after laparoscopic-assist anterior resection, 1 after laparoscopic-assist Parks' procedure, and 1 with pars sacral fistula after per-sacral-local resection for three times. Image examination (CT scanning) was taken preoperatively to evaluate the locally recurrence and exclude the distant metastases. The laparoscopic-assist procedure with or without a hand-assist technique was used in this study.</p><p><b>RESULTS</b>Six cases with the recurrent lesion of central type were treated by salvage surgical procedure as follows: 3 laparoscopic-assist anterior resection, 1 laparoscopic-assist abdominoperineal resection, 1 laparoscopic-assist posterior exenteration, and 1 laparoscopic-assist proctocolectomy with a terminal ileum stoma. All of them were R0 resection confirmed by postoperative pathological examination. The other one with the lesion of combination type was treated with the procedure of laparoscopic-assist sigmoid colostomy. A hand-assist technique was used in 2 cases. The mean operation time, bleeding and hospital day was (211 +/- 13) min, (200 +/- 91) ml, and (15 +/- 10) d, respectively. No conversion and complication occurred.</p><p><b>CONCLUSION</b>Laparoscopic salvage surgery for locally recurrent rectal cancer is safe and feasible when taken by experienced laparoscopic colorectal surgeon to the cases with the recurrent lesion of central type.</p>

Expression of gastrin, somatostatin, PCNA and Fas-L in the mucosa of gastric antrum of children with chronic gastritis and duodenal ulcer / 中华儿科杂志

<p><b>OBJECTIVE</b>Since application of pediatric gastroscopy in the mid-nineteen nineties, there has been a trend that the prevalence rates of pediatric gastritis and duodenal ulcer (DU) are increasing. The diagnosed rate of pediatric gastritis has accounted for 85% - 95% of the total number of children who received gastroscopy, and the rate of DU accounted for 8% - 22%. Such a high rates of the diseases may influence the development of the children severely. However, the etiology and pathogenesis of pediatric chronic gastritis and DU have not been completely elucidated. The disordered gastrointestinal hormones play a crucial role in the pediatric chronic gastritis and DU. This study focused on the expression of gastrin (GAS), somatostatin (SS) in the mucosa of gastric antrum and PCNA and Fas-L in the sinus ventriculi and their possible roles in the pathogenesis of pediatric chronic gastritis and DU.</p><p><b>METHOD</b>The sinus ventriculi mucosal samples of 83 cases were collected via gastroscopic biopsy from the hospital during the recent two years and the cases were divided into five groups: group A, chronic superficial gastritis, Helicobacter pylori (Hp)(+); group B, chronic superficial gastritis, Hp(-); group C, DU, Hp(+); Group D, DU, Hp(-); Group E, normal sinus ventriculi mucosa, Hp(-). Immunohistochemical staining (En Vision) was carried out for GAS, SS, PCNA and Fas-L, and positive cells of each slide were counted (x 400). Statistically significant differences among groups for continuous data were assessed with the software SPSS10.0.</p><p><b>RESULTS</b>The expressions of GAS and SS in the groups A through E had no significant difference. The expression of PCNA in group A was significantly higher than that in group B (P < 0.05), and no significant differences were found among the other groups. There were no significant differences in expressions of Fas-L among the five groups.</p><p><b>CONCLUSION</b>There seems to be an increasing tendency in the expressions of GAS and SS in children with chronic gastritis and duodenal ulcer. Hp infection promotes the multiplication of the sinus ventriculi mucosal epithelium cells in the pediatric chronic gastritis.</p>

Effect of Helicobacter Pylori Infection on Emptying of Gallbladder in Children with Functional Dyspepsia / 实用儿科临床杂志

Objective To study emptying of gallbladder in children with functional dyspepsia(FD),and to investigate correlation of their helicobacter pylori(Hp) status and gallbladder emptying rate.Methods Sixty children with FD were studied,including 30 Hp-ne-(gative) and 30 Hp-positive children.Thirty Hp-positive children received triple eradication therapy 1 week.After 4 weeks,the Hp tests were taken again,27 children became Hp-negative,and the others were still positive eliminated from the study.The difference between the above groups in gallbladder volumes before breakfast and postprandial gallbladder emptying rate were compared.Results The gallbladder volumes before breakfast were bigger and the emptying rate of postprandial gallbladder of children with FD were lower than those of normal controls(P0.05).Conclusions Delayed emptying of gallbladder may cause FD in children.Hp infection isn′t associated with the gallbladder emptying rate.