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Objective@#To explore the feasibility, safety and long-term efficacy of laparoscopic total gastrectomy combined with distal pancreaticosplenectomy for the treatment of T4b gastric cancer.@*Methods@#A retrospective cohort study was performed. Clinical data of consecutive patients with T4b gastric cancer invading pancreatic tail undergoing laparoscopic or open total gastrectomy combined with distal pancreaticosplenectomy from January 2010 to December 2014 were analyzed retrospectively. Enrollment criteria: (1) primary gastric cancer confirmed by pathology as T4b adenocarcinoma; (2) chest+abdominal+pelvic enhanced CT indicated cancer invading pancreatic tail without distant metastasis, and R0 resection was evaluated as feasible before operation; (3) physical status was ECOG score 0 to 2, and was tolerant to operation. Patients with peritoneal implant metastasis and tumor invasion of other organs during operation, or changes in surgical methods for other reasons were excluded. All the operations were performed by the same surgical team, which had the experiences of more than 100 cases of laparoscopic and 100 cases of open radical gastrectomy with D2 lymph node dissection. The choice of surgical procedure was discussed by the surgeon and the patient, and decided according to the patient′s intension. Patients were divided into the laparoscopic group and open group according to the surgical method. Intraoperative and perioperative findings were compared between the two groups. The 3-year disease-free survival rate were analyzed with Kaplan-Meier survival curve and compared by using log-rank test.@*Results@#A total of 37 consecutive patients were enrolled, including 21 in the laparoscopic group and 16 in the open group, and no one receiving laparoscopic procedure was converted to open surgery. The baseline data of two groups were comparable (all P>0.05). Compared with the open group, the laparoscopic group had significantly longer operation time [(264.0±35.1) minutes vs. (226.6±49.9) minutes, t=2.685, P=0.011], significantly less intraoperative blood loss [(65.7±37.4) ml vs. (182.2±94.6) ml, t=-4.658, P<0.001], significantly shorter time to postoperative flatus [(2.8±0.7) days vs. (4.1±0.7) days, t=-5.776, P<0.001] and significantly shorter postoperative hospital stay [(13.3±2.8) days vs. (16.6±4.3) days, t=-2.822, P=0.008]. Morbidity of postoperative complications, including anastomotic leakage, pancreatic fistula, abdominal abscess, intraperitoneal hemorrhage and duodenal stump leakage, in two groups was similar [19.0% (4/21) vs. 4/16, P=0.705]. There were no cases of anastomotic bleeding or stenosis. The 30-day postoperative mortality was 0 in the laparoscopic group and 1/16 in the open group, respectively (P=0.432). The 3-year disease-free survival rates were 38.1% and 37.5% in the laparoscopic and open group, respectively (P=0.751).@*Conclusion@#Laparoscopic total gastrectomy combined with distal pancreaticosplenectomy performed by experienced surgeons for T4b gastric cancer is safe and effective.
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Objective:To study the effect of miR-200c on the migration and proliferation abilities of breast cancer MDA-MB-231 and BT-549 cells,and to clarify the mechanism of miR-200c in inhibiting the epithelial-mesenchymal transiton (EMT) of triple negative breast cancer.Methods:The human triple negative breast cancer cell lines (MDA-MB-231 and BT-549) were chosen in this study.The cells were transiently transfected with miR-200cmimics and Lipo2000 (experimental group),miR-200c negative control and Lipo2000 (negative control group),and Lipo2000 alone (reagent control group);at the same time,blank control group was set up.The expression levels of vimentin and β-catenin mRNA and protein were detected by RT-PCR and Western blotting method.The proliferation rates and migration abilities of MDA-MB-231 cells and BT-549 cells after transfection of miR-200c were analyzed by CCK8 assay and wound healing assay.Results:The RT-PCR and Western blotting showed that the expression levels of vimentin and β-catenin mRNA and proteins in experimental group were decreased,and the differences were statistically significant compared with blank control group,negative control group and reagentcontrol group (P＜0.05).The CCK8 results showed that the proliferation rates of the cells in experimental group were lower than those in negative control group and reagent control group (P＜0.05).The wound healing assay results showed that the recovery rate of scratch width in experimental group was lower than those in negative control group and reagent control group (P＜0.05).Conclusion:miR-200c might inhibit EMT in triple negative breast cancer by regulating the expressions of β-catenin and vimentin mRNA and proteins in MDA-MB-231 and BT-549cells and decreasing the abilities of migration and proliferation of triple negative breast cancer cells.
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Objective To study the Inflammation and immune stress of obese asthmatic rats by adipocytokines.Methods Fourty C57BL/6 J mice were randomly divided into control group, obese group, asthma group and obese asthma group.Mice in the control group were fed normal diet and PBS, high-fat diet(75% normal diet, 10% egg yolk powder, lard 10%, 5% sugar)and PBS in obese group, normal diet and OVA(PBS)in asthma group and fat diet and OVA(PBS)in obese asthma group.Detect the leptin, adiponectin, resistin, IL-4, IFN-γ, IL-17 content with ELISA in serum and bronchoalveolar lavage fluid(BALF).Using Pearson correlation to analyze and evaluate these factors' correlation in plasma and BALF.Results The difference of leptin, adiponectin, resistin in plasma and BALF(excepted leptin)between four groups were statistically significant (P<0.05), the leptin levels between plasma and BALF has a positive correlation(R2=0.8215, P<0.05)in obese mice, there was no correlation between plasma and BALF for the adiponectin, resistin.The adiponectin content and IFN-γ levels were also negatively correlated(R2=0.9146, P<0.05)in BALF, while there was no correlation between IL-4,IL-17 and leptin, adiponectin, resistin.Conclusion Adipocytokines has a regulatory function of the immune response in obese asthmatic rats, and participate the inflammatory reaction.
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AIM:To investigate the effect of liraglutide ( LG) on the expression of fibronectin type Ⅲdomain-containing protein 5 (FNDC5) in the C2C12 myotubes.METHODS:The C2C12 mouse myoblast cell line was induced to differentiation.Differentiated cells were stimulated with gradient concentrations (1 ~1000 nmol/L) of LG for different time (0 ~24 h).The effects of LG on the expression of FNDC5 and the activation of adenosine 5'-monophosphate ( AMP)-activated protein kinase ( AMPK) signaling pathway were determined .After pretreated with glucagon-like peptide-1 ( GLP-1 ) receptor antagonist exendin 9-39 , the inhibitor of Ca 2+/calmodulin-dependent protein kinase kinase 2 (CAMKK2), STO609, or the inhibitor of AMPK, Compound C, the LG-induced FNDC5 expression in C2C12 myotubes was examined.The expression of FNDC5 and the activation of AMPK were determined by Western blot .RESULTS: In C2C12 myotubes, LG promoted the expression of FNDC5 in a dose-and time-dependent manner .LG also activated AMPK signaling pathway .These effects of LG were partly abolished by exendin 9-39 , STO609 and Compound C .CONCLUSION:LG promotes the expression of FNDC5 via GLP-1 receptor in the C2C12 myotubes possibly through activation of the CAMKK2/AMPK signaling pathways .
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Objective:To investigate the effect on the expression of Slug for the trasfection of miR-200c combined with the research on the ability of migration of breast cancer cell BT549.Methods:Chemically synthesized miR-200c mimic was trasfected into BT549 cells,which have high metastatic potential.The effect on the ability of migration of breast cancer cell BT549 for the transfection of miR-200c was analyzed by Transwell migration assay and Wound healing assay.The expression of Slug and E-cadherin mRNA was detected by Real-time PCR.The expression of Slug protein was detected by Western blot.Results:Transfection with miR-200c mimic significantly down-regulated the expression of Slug as compared with the control group (P<0.05).BT549 cell tranfected with miR-200c mimic had lower levels of migration capacity than cells in the control group (P<0.05).Conclusion:miR-200c inhibits Epithelial-mes-enchymal transition by suppressing Slug leading to down-regulation of migration capacity of breast cancer cell BT549.
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<p><b>OBJECTIVE</b>To evaluate the clinical application of carbon nanoparticles labeled lymph node staining in curative laparoscopic resection for colorectal carcinoma.</p><p><b>METHODS</b>Sixty-five patients undergoing curative laparoscopic resection for colorectal carcinoma in the Sun Yat-sen Memorial Hospital between September 2011 and June 2013 were prospectively enrolled and randomly divided into label group (with carbon nanoparticles, n=34) and control group (without carbon nanoparticles, n=31). Association between labeled lymph nodes and metastasis was analyzed. The total number of retrieved lymph nodes and lymph nodes metastatic ratio were compared between the two groups.</p><p><b>RESULTS</b>Mean number of retrieved lymph node of the label group was higher as compared to the control group (22.3±4.2 vs. 15.4±3.5, P<0.05). The total number of retrieved lymph node was 725 in the label group and 478 in the control group. Among them, lymph node < 5 mm accounted for 4.6% (33/725) in the label group, which was higher than 2.0% (10/478) (P=0.025) in the control group. The number of black stain label lymph node was 412, with black stain ratio 56.8% (412/725) in the label group. Metastatic ratio of black stain nodes was significantly higher than that of non-stain nodes [28.6% (118/412) vs. 19.5% (61/313), P=0.005].</p><p><b>CONCLUSIONS</b>The technique of carbon nanoparticles labeled lymph node staining in curative laparoscopic resection for colorectal carcinoma is easy and effective, which can increase the retrieved number of lymph nodes, especially for nodes < 5 mm. The black stain lymph nodes indicate higher risk of metastasis.</p>
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Humans , Carbon , Colorectal Neoplasms , Laparoscopy , Lymph Node Excision , Lymph Nodes , Lymphatic Metastasis , Nanoparticles , Staining and LabelingABSTRACT
Objective This study aimed to explore the clinical value of human papilloma virus ( HPV) E6/E7 mRNA tests in identifying precancerous lesions of the uterine cervix-cervical intraepithelial neoplasia 2 or more CIN2+( CINⅡand CINⅢ).Methods This study is a cross-sectional survey design , between December 2011 to December 2013.The specimens were collected from the First People′s Hospital of Huizhou and the Third People′s Hospital of Huizhou in Department of Obstetrics and Gynecology outpatient and inpatient of cervical disease suspected patients , with thin-prep cytologic test ( TCT ) and histopathological results as reference , detected 345 patients of exfoliated cervical epithelial cells by using the branched DNA (b-DNA) technology to evaluate the application value of high risk HPV E 6 /E7mRNA in the clinical diagnosis of CIN.Using spss 19.0 software for data analysis.Results (1)Compared with TCT, the positive rate of E6/E7 mRNA in 325 samples were grading by cytology as follows: no intraepithelial lesion cells (NILM) 21.1%(40/190), atypical squamous cells (ASC) 38.5%(15/39 ), low-grade squamous intraepithelial lesions ( LSIL ) 76.9% ( 30/39 ) , atypical squamous cells can not exclude high-grade intraepithelial lesions (ASC-H) (8/10), high-grade squamous intraepithelial lesions (HSIL) 72.3%(34/47), TCT grades and HPV E6/E7 mRNA positive rate showed linear association (χ2 =67.654,P<0.01;r=0.497, P<0.01 ); and with HPV E6/E7 mRNA copy number was also relevant ( r =0.511, P <0.01).(2) Compared with pathological results , the positive rate of E6/E7 mRNA in 164 women samples were grading by pathology as follows:with NILM was 27.8%(10/36), with CIN Ⅰwas 65.9%(29/44), with CINⅡwas 80.6%(54/67), and with CINⅢwas 82.4%(14/17), pathological grades and HPV E6/E7 mRNA positive rate showed a linear correlation (χ2 =26.426, P<0.01; r=0.438, P<0.01); and the number of copies correlated with the increase of pathological grades too (r=0.543, P<0.01).(3) Screening effectiveness analysis results showed , the sensitivity of HPV E6 /E7mRNA was 84.6% while TCT was 47.7%.The sensitivity and specificity were 40.0% and 91.1% respectively when HPV E6/E7 mRNA and TCT processed as sequential detection test.The CIN2 +( CINⅡand CIN Ⅲ) best diagnostic critical point of 890.26 copies/ml,was established using receiver operating characteristic ( ROC) curve.The sensitivity and specificity were 58.5% and 93.7%, respectively.Conclusions The sensitivity of HPV E6/E7 mRNA test is better than TCT, the specificity is high in HPV E6/E7 mRNA and TCT processed as sequential detection test.Using the optimal cut-off value of ROC curve to detect CIN 2+has high sensitivity and specificity, so the detection of HPV E6/E7 mRNA may have some clinical value in screening and risk assessment of precancerous lesions of the uterine cervix.
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Objective To study the expression of metallothioneiu (MT)and Fas ligand (FasL) in rectal carcinoma and their association with metastasis to lymph node and liver. Methods Immunohistochemistry method and quantitative RT-PCR technique were used to assay the expression of MT and FasL at protein and mRNA levels in 85 cases of rectal carcinoma. The data of each group were compared and analysed by statis-tics. Results The rates of MT expression in primary foci, normal rectal mucosa, lymph node metastasis and hepatic metastasis were 57.3% ,29.6% ,79.5% and 61.8% respectively. And the rates of FasL expression were 45.8%, 17.8% ,63.5% and 90.3%, respectively. The positive rates of MT and FasL in primary foci, hepatic and lymph node metastasis were higher than that in normal mucosa (X~2 =33. 1322,56. 7142,P < 0.01). Among clinical stages, the positive rates of MT and FasL in C and D were higher than that in A and B (X~2 = 18. 8372,21. 5823 ,P <0.01). And higher rates of MT and FasL expression were detected in low differentiation adenocarcinoma and mucus adenocarcinoma than in middle-high differentiation adenocarcino-ma(X~2 = 11.2146,9.3136,P < 0. 05). High MT mRNA level was found in lymph node metastasis and high FasL mRNA level in hepatic metastasis. Conclusions The detection of MT and FasL expression was useful in clinic to predict lymph node metastasis and early diagnosis of liver metastasis of rectal carcinoma respec-tively. Assay of MT and FasL expression has prognostic values for rectal carcinoma patients.
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Objective To evaluate the effects of the two different operations, such as open total extraperitoneal herniorrhaphy or traditional anterior approachs on tension-free repair of inguinal hernia. Methods In a prospective randomized controlled study, 165 cases with inguinal hernia were allocated randomly to either the anterior approach group (82 cases)or open total extraperitoneal herniorrhaphy group( 83 cases ).The index including the operation time, hospital stay, mean expense, time for returning to normal activity,and the recent or long-term operative complications and recurrence rate, were observed to evaluate the curative effect of open total extraperitoneal herniorrhaphy approach. Results The follow-up rate were 98.79% ,after (20.52 ± 1.54) months in average follow-up in the anterior approach group and (21.63 ± 1.76) months in the TEP group, and no significant differences were recorded between the two groups in the operation time, hospital stay, time for returning to normal activity, recurrence rate(3.66% vs 1.22% ) and urinary retention ( P > 0. 05 ), but operative complications in TEP group were significantly less than that in anterior approach group (P< 0.05). Conclusions The operative complications or postoperative unwell decrease significantly through the open total extraperitoneal herniorrhaphy approach in repairing inguinal hernias. Its curative effect was confirmed and deserves to be clinically popularized.
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Objective To explore the diagnosis and treatment of gastrointestinal stromal tumors(GISTs).Methods Clinical and pathological data of the 32 GISTs cases treated over the recent 5 years in our hospital were reviewed retrospectively.Results Stomach was the most frequent site for GISTs.Abdominal pain was the most common symptom.Before operation,81.3%(26/32) of the cases were misdiagnosed.All of the cases underwent surgical resection.10 recurrent GIST patients received a second resection,and 8 patients(underwant) three or more resections.Follow-up was made from six months to 5 years,and 8 patients died.Conclusions The diagnosis of GISTs is difficult and mainly depends on histopathology and(immunohistochemistry).Surgical resection is the principal treatment of GISTs.Reoperation is effective for the treatment of recurrent cases.