Prevalence and genotype distribution of human papilloma virus in Guangxi / 医学研究生学报

Objective To investigate the prevalence and genotype distribution of human papillomavirus (HPV) in the region of Guangxi.Methods We retrospectively analyzed 15774 individuals from the Outpatient and inpatient Unit as well as Physical Examination Departments of the People's Hospital of Guangxi Zhuang Autonomous Region between May 2010 and March 2017.Exfoliated c ellsor swab specimens were collected,and the genotypes of HPV were determined by Polymerase Chain Reaction (PCR) and reverse blot assay.Results The prevalence of HPV infection was 38.54％ (6080/15774).The infection rate of single genotype and multiple genotypes were 25.60％ (4038/15774) and 12.95％ (2042/15774),respectively.In single infection patterns,the most common genotypes included HPV 6 (10.54％,1663/15774),52 (3.91％,616/ 15774),16 (2.16％,340/15774),11 (2.14％,338/15774),and 58 (2.00％,316/15774).While among the multiple infections patterns,HPV 52+53 (4.26％,87/2042) and 52+58 (3.23％,66/ 2042) were common,and followed by HPV 16+43 (2.40％,49/2042),16+52(2.30％,47/2042),6+42 (2.15％,44/2042) and 6+43 (2.15％,45/2042).HPV 52,16,58,51,53 and 18 were the top six high risk (HR) genotypes of HPV,accounting for 26.77％ (4222/15774,95％ CI =26.08-27.46);while HPV 6,11 and 43 were the leading low-risk (LR) genotypes of HPV,accounting for 27.77％ (4380/15774,95％CI =27.07-28.47).The overall ratio of single infection to multiple infections was 1.98 (4038 vs.2042).Conclusion HPV 6,52,16,11,58,18 were the main HPV infection genotypes,and 52+53 and 52+58 were common infection combinations in Guangxi Zhuang Autonomous region.The HPV multiple infections were increased.Apparently,more HPV low risk genotypes were seen in male patients that should be aware.

Tissue-engineering nerve repairs pelvic autonomic nerve defects in Beagle dogs / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the outcome of repairing pelvic autonomic nerve defects with the tissue-engineered nerve, in order to provide a new method and experimental evidence for solving sexual disturbance induced by pelvic autonomic nerve injury after radical resection of rectal carcinoma.</p><p><b>METHODS</b>Bone marrow stromal cells (BMSCs) were purified with density gradient centrifugation. A 10 mm defect of hypogastric nerve was created in 9 Beagle dogs and the 18 hypogastric nerves were randomly divided into three groups. Group A: nerve defects bridged with copolymer of lactic and glycolic acids (PLGA) tube containing BMSCs and collagen protein sponge. Group B: with PLGA tube only containing collagen protein sponge. Group C: with autologous nerve graft. The effect of nerve recovery was evaluated by morphology, HE staining, neurofilament immunohistochemistry staining, electron microscope scanning and measurement quantity of new axon 12 weeks after the transplantation.</p><p><b>RESULTS</b>Twelve weeks after the transplantation, degradation of PLGA tubes showed in group A and group B. The nerves regenerated through defect area to distal end. The density of regeneration nerve fiber in group A and group C were better than that in group B. The difference was significant between group A or group C and group B (P<0.05), and no significant difference was observed between group A and group C(P>0.05).</p><p><b>CONCLUSION</b>Tissue-engineered nerve, which is constructed by BMSCs mixed with collagen protein sponge and PLGA tube, can be used to bridge and repair the pelvic autonomic nerve defect.</p>

Impact of width of hepatectomy margin on survival after simultaneous liver and colorectal resection for colorectal cancer liver metastasis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To elucidate an adequate hepatectomy margin for simultaneous liver and colorectal resection in colorectal cancer liver metastasis.</p><p><b>METHODS</b>Clinical data of 39 patients, undergone simultaneous liver and colorectal resection for colorectal cancer liver metastasis from August 1994 to December 2004, were analyzed retrospectively. Two groups were divided according to the width of hepatectomy margin:less than 1 cm in group A, and equal or more than 1 cm in group B. The data were analyzed and compared between the 2 groups using Kaplan-Meier survival analysis and Log-rank test.</p><p><b>RESULTS</b>There were 14 patients in group A and 25 patients in group B. No significant differences in gender, age, primary tumor invasion, lymph node metastasis, the number, distribution and size of liver metastasis, duration and blood lose of surgery were found between two groups. The median survival time was 17 months in group A, and 37 months in group B, and the overall 5-year survival rate in group B was much better than that in group A (19.8% vs 0, P<0.01).</p><p><b>CONCLUSION</b>Simultaneous liver and colorectal resection in colorectal cancer liver metastasis should be performed with a hepatectomy margin equal or more than 1 cm.</p>

Clinical results of vagina vasorum lymph node dissection and non-vagina vasorum lymph node dissection in gastric cancer after radical operation / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate and compare the results of vagina vasorum lymph node dissection (VLND) and non-vagina vasorum lymph node dissection (NVLND) in patients with gastric cancer after radical operation.</p><p><b>METHODS</b>A total of 759 cases of evaluable patients with gastric cancer, operated from June 1994 to April 2005, were retrospectively analyzed. Of which, 627 cases underwent radical gastrectomy: 215 patients received VLND and 412 cases received NVLND. The operation time, intraoperative blood loss, operative complications and survival rate were recorded and compared between the two groups.</p><p><b>RESULTS</b>The 5- and 10-year overall accumulative survival rates of VLND group and NVLND group were 55.4% and 51.2%, 39.1%and 36.8%, respectively (all P < 0.05). No significant differences in intraoperative blood transfusion (loss), operation time, operative complication rate was found between the two groups. The 5- and 10-year accumulative survival in patients with a tumor of phase N0-N2, T2-T4, Ib-IV in VLND groups were all significant higher than those in NVLND group.</p><p><b>CONCLUSIONS</b>VLND is a safe technique in advanced gastric cancer, it dose not prolong operation time or increase operative complications but improves survival.</p>

Application of GORE-TEX Dual Mesh fixing into peritoneum in sigmoid-colostomy to prevent peristomal hernia / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of GORE-TEX Dual Mesh fixing into peritoneum in sigmoid-colostomy on the prevention of peristomal hernia.</p><p><b>METHODS</b>Sixty patients undergone sigmoid-colostomy from Jan. 2003 to Jan. 2005 in the first affiliated hospital of Sun Yat-sen University were selected and randomly divided into two groups. Patients received papillary sigmoid-colostomy through rectus abdominis and peritoneum in control group and GORE-TEX Dual Mesh fixing into peritoneum during sigmoid-colostomy in observation group. Complications and recurrence rate were recorded in follow-up period.</p><p><b>RESULTS</b>Peristomal hernia occurred in eight patients (8/30) in control group (26.7%), while no hernia happened in observation group (0/30).</p><p><b>CONCLUSION</b>GORE-TEX Dual Mesh fixing into peritoneum in sigmoid-colostomy can prevent peristomal hernia.</p>

Prospective study of reconstructing pelvic floor with GORE-TEX Dual Mesh in abdominoperineal resection / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Mesh reconstruction has been proved to be an effective method in incisional hernia repairment. This study was designed to evaluate the effect of reconstructing the pelvic floor with the high-inlay expanded polytetrafluoroethylene (ePTFE) GORE-TEX Dual Mesh (WLGore And Associates, Flagstuff, USA) in abdominoperineal resection.</p><p><b>METHODS</b>Sixty patients who underwent abdominoperineal resection for rectal cancer were assigned to 2 groups. The pelvic peritoneum was closed by routine sutures in group 1 and reconstructed with ePTFE in group 2. Postoperative complications and related items were evaluated and the patients were followed up.</p><p><b>RESULTS</b>Time of confining to bed, bowel function recovery, fasting, and detaining drainage were significantly different between two groups (P < 0.05). In group 1, three patients developed bowel obstruction (10%), while no bowel obstruction was observed in group 2.</p><p><b>CONCLUSION</b>Reconstruction of the pelvic floor using ePTFE results in quicker postoperative recovery and could decrease the risk of postoperative intestinal obstruction.</p>

Evaluation of risk factors associated with local recurrence after radical resection of rectal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the risk factors of local recurrence after radical resection of rectal carcinoma.</p><p><b>METHODS</b>Clinical and follow-up data of 535 patients with rectal carcinoma, received radical resection between August 1994 and July 2004 in our department, were reviewed retrospectively. The association of clinicopathological factors and local recurrence was analyzed using Log-rank test. Cox multiple variate analysis was conducted to determine the independent risk factors.</p><p><b>RESULTS</b>All the 535 rectal carcinoma patients underwent radical resections. Local recurrence occurred in 53 cases (9.9%), and distant metastasis co-occurred in 39 cases (7.3%). The time from the first operation to the recurrence was 4-54 months with a median of 12 months. The Log-rank test showed that the primary tumor site (P<0.01), differentiation(P<0.01), histological type(P=0.038), lymph node metastasis(P=0.023), Dukes staging(P=0.045), blood transfusion(P=0.001), and total mesorectum excision (TME)(P<0.001) were associated with the recurrence, but the operative style(P=0.908), invasive depth of primary tumor(P=0.735), massive pathological type(P=0.562), degree of surgeon(P=0.171) and post-operative chemotherapy (P=0.772) were not associated with the recurrence. Cox multiple variate analysis revealed that blood transfusion, primary tumor site, differentiation, lymph node metastasis, and TME principle were independent prognostic factors affecting local recurrence after radical resection of rectal cancer.</p><p><b>CONCLUSIONS</b>Blood transfusion, low position of tumor, poor differentiation, lymph node metastasis are the risk factors associated with local recurrence in rectal cancer. Application of TME principle is the key point to decrease the local recurrence rate.</p>

Clinicopathological characteristics and prognosis of patients with recurrent colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological characteristics and prognosis of patients with recurrent colorectal cancer.</p><p><b>METHODS</b>Clinicopathological characteristics and postoperative survival of 235 patients with recurrent colorectal cancer after radical resection were retrospectively analyzed, and was compared with that of 993 patients with radical resection.</p><p><b>RESULTS</b>The overall 5- and 10-year survival rates after radical resection were 67.7% and 55.8%, respectively. The 5- and 10-year survival rates in patients with recurrent colorectal cancer was 43.9% and 28.1% (P=0.000), respectively. Among patients with recurrent colorectal cancer, the 5- and 10-year survival rates of the patients underwent second radical resection were 50.2% and 32.7%, while the 5- and 10-year survival rates of the patients without second surgery were 25.8% and 0, respectively (P=0.000). On univariate analysis, postoperative recurrence was associated with age at diagnosis, cancerous ileus, ascites, lymphs nodes involvement, gross types, infiltration of tumor and Duke's stage. Multivariate analysis revealed that cancerous ileus, ascites, gross types and Duke's stage were independent predictive factors for postoperative recurrence.</p><p><b>CONCLUSION</b>Cancerous ileus, ascites, gross types and Duke's stage were independent predictive factors for recurrence and metastasis of colorectal cancer after radical resection. The 5- and 10-year survival rates and quality of life could be improved by second radical resection.</p>

The assessment of curative effect after total mesorectal excision with autonomic nerve preservation for rectal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the impact on sexual function, local recurrence and survival after total mesorectal excision (TME) with autonomic nerve preservation (PANP) of rectal cancer.</p><p><b>METHODS</b>One hundred and five patients after TME with PANP were followed by means of questionnaire on postoperative genital function [TME + PANP(+) group], and the results of 110 patients after TME without PANP [TME + PANP(-) group] were compared with, also their local recurrence and 5-year survival were retrospectively analyzed.</p><p><b>RESULTS</b>TME + PANP(+) group was compared to TME + PANP(-) group: the erection dysfunction, 33.3% vs 63.2%; the ejaculation dysfunction, 43.8% vs 70.0% (P < 0.01), there were significant differences between two groups, but no difference in local recurrent rate and 5-year survival rate (7.6% vs 5.5%; 63.4% vs 59.7%, P > 0.05).</p><p><b>CONCLUSION</b>The TME with PANP of rectal surgery ensure the radical cure of rectal cancer, at the same time reasonably save the postoperative sexual function and obtain satisfactory postoperative survival.</p>

Analysis of long-term results of radical gastrectomy combining splenectomy for gastric cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the influence of radical excision combining splenectomy on prognosis of the patients with gastric cancer.</p><p><b>METHODS</b>Between June 1994 and March 2004, 692 patients were operated on for gastric cancer and registered into gastric cancer database. Radical excision (D2, D3 or D4) combining splenectomy for gastric cancer was performed in 45 cases. 343 cases were selected simultaneously for comparison according to the resembling rules in sex, age, tumor size, location, serosa invasion, Borrmann type and range of lymph node dissection. Clinicopathological factors affecting lymph node metastasis, patterns of lymph node metastasis, 5-year survival rate after radical excision combined with splenectomy for gastric cancer were compared.</p><p><b>RESULTS</b>Lymph node metastasis rate of splenic hilus was 15.6 percent. Among them, upper, middle and lower domain is 11.5 percent, 33.3 percent and zero respectively. It was significantly different between gastric adenocarcinoma in proximal and body of stomach and that in distal stomach, poor differentiation and adenocarcinoma anaplastic and well and moderately differentiation adenocarcinoma, Borrmann III and IV types and Borrmann I and II types, infiltrated depth in T(3) and T(4) and infiltrated depth in T(1) and T(2), clinical stages III and IV and clinical stages I and II. The average and median survival time between radical gastrectomy only and radical gastrectomy combining splenectomy for gastric cancer at stage I and II patients were significantly different, but at stage III and IV patients not significantly different.</p><p><b>CONCLUSIONS</b>Spleen should be reserved for patients with gastric cancer at stage I and II, and radical excision combining splenectomy could only be performed at stage III and IV patients with cancer infiltrating body and tail of the pancreas, or lymph nodes metastasis in the splenic hilus. Indication of radical excision combining splenectomy for gastric cancer must be further study to clarify its efficacy.</p>

Relationship between heparanase mRNA expression in human gastric cancer and its clinicopathological features / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the relationship between heparanase mRNA expression and clinicopathological parameters in human gastric cancer.</p><p><b>METHODS</b>RT-PCR was used to detect the expression of heparanase mRNA in 43 human gastric carcinomas and 10 adjacent normal gastric tissues.</p><p><b>RESULTS</b>Heparanase mRNA was expressed in 29 of the 43 cases of gastric cancer with a positive rate of 67.4%, which was significantly higher than that in adjacent normal gastric tissues (P = 0.013). The expression level was higher in late-stage tumors (stage III and IV) than in early-stage tumors (stage I and II) (P = 0.001), in tumors with invasion to serosa than those without serosal invasion (P = 0.009), in tumors with lymph node metastasis than those without lymph node metastasis (P = 0.018), and in large-sized tumors than in small-sized ones (P = 0.009). The expression was not correlated with patients' age, sex, tumor location, histologic types, differentiation, peritoneal dissemination and liver metastasis (P > 0.05).</p><p><b>CONCLUSION</b>Heparanase might play an important role in the development of invasion and metastasis of gastric cancer.</p>

Multi-variate regression analysis of clinicopathological characteristics and prognosis of colorectal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the relationship between clinicopathologic features and prognosis of colorectal cancer after surgical treatment.</p><p><b>METHODS</b>The clinical characteristics, pathologic features and survival rate of 761 patients with colorectal cancer after surgical treatment were univariately and multivariately analyzed.</p><p><b>RESULTS</b>The overall 3- and 5-year survival rates of patients with colorectal cancer after surgical treatment were 62.9% and 60.7% with a median survival of 1,825 days. The factors of gross findings, degree of differentiation, infiltration, nodal and distant metastasis and neoplastic intestinal obstruction influenced the survival rate by univariate analysis. The factors of Dukes stage, gross tumor configuration, intramural spread and differentiation degree were available independent prognostic factors through multivariate analysis.</p><p><b>CONCLUSION</b>Dukes stage, as the most important available independent prognostic factor (P < 0.0005), is able to assess the postoperative survival.</p>