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Endoscopic submucosal dissection (ESD) is a mature method for treating early gastrointestinal tumors. Appropriate submucosal exposure is one of the important factors for the successful operation of effective and safe dissection. This article combines domestic and foreign literature to summarize the background, procedure, prognosis, characteristics and related clinical research of magnetic anchored-guided endoscopic submucosal dissection (MAG-ESD). Generally speaking, compared with traditional ESD, MAG-ESD can shorten the operation time, simplify operation steps, reduce the incidence of complications, and improve the learning curve. Compared with other traction technologies that assist ESD, magnetic anchor-assisted technology can be used in the whole digestive tract mucosal dissection to treat early-staged cancer. The operation has a better operation triangle, is less technically difficult, and is friendly to experienced endoscope operators. It is called the "second hand" of endoscope operators. It can greatly improve the clinical treatment efficiency and patient satisfaction of early gastrointestinal cancer.
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background & objectives: Colorectal cancer (CRC) is second only to breast cancer as the leading cause of cancer-related deaths in Malaysia. In the Asia–Pacific area, it is the highest emerging gastrointestinal cancer. The aim of this study was to identify single nucleotide polymorphisms (SNPs) and environmental factors associated with CRC risk in Malaysia from a panel of cancer associated SNPs. methods: In this case-control study, 160 Malaysian subjects were recruited, including both with CRC and controls. A total of 768 SNPs were genotyped and analyzed to distinguish risk and protective alleles. Genotyping was carried out using Illumina’s BeadArray platform. Information on blood group, occupation, medical history, family history of cancer, intake of red meat and vegetables, exposure to radiation, smoking and drinking habits, etc was collected. Odds ratio (OR), 95% confidence interval (CI) were calculated. results: A panel of 23 SNPs significantly associated with colorectal cancer risk was identified (p<0.01). Of these, 12 SNPs increased the risk of CRC and 11 reduced the risk. Among the environmental risk factors investigated, high intake of red meat (more than 50% daily proportion) was found to be significantly associated with increased risk of CRC (OR=6.52, 95% CI :1.93 - 2.04, Pp=0.003). Two SNPs including rs2069521 and rs10046 in genes of cytochrome P450 (CYPp) superfamily were found significantly associated with CRC risk. For gene-environment analysis, the A allele of rs2069521 showed a significant association with CRC risk when stratified by red meat intake. interpretation & conclusions: In this preliminary study, a panel of SNPs found to be significantly associated with CRC in Malaysian population, was identified. Also, red meat consumption and lack of physical exercise were risk factors for CRC, while consumption of fruits and vegetables served as protective factor.
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ObjectiveTo investigate the prevalence of nutritional risk and perioperative nutritional support status in the gastrointestinal cancer surgical patients.Methods Adult inpatients from the gastrointestinal cancer surgery department of our hospital were consecutively enrolled from May to September 2010.Nutritional Risk Screening 2002 ( NRS 2002) was performed at admission,and data of the nutritional support and complications during hospitalization were collected.The relationship between nutritional risk and postoperative complications was analyzed.ResultsA total of 195 patients were eligible.At admission,43.6％ (85/195) patients were at riskOf the patients at risk,totally 11.7％ (10/85) patients received preoperative nutritional support,and 100％ (85/85) patients received postoperative nutritional support; of the patients not at risk,no patients received preoperative nutritional support,and 84.5％ (93/110) patients received postoperative nutritional support.The overall rates of postoperative complications were 19.1％ ( 13/68 ) in the patients at risk while 7.1％ (9/127 )in the patients not at risk ( P =0.02).ConclusionsNutritional risk in gastrointestinal cancer surgical patients was high.The application of nutritional support was inappropriate in these patients.The nutritional risk is associated with higher postoperative complications.Dissemination of evidence-based guidelines should be enhanced.
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Objective To explore the effect of cognitive therapy for gastrointestinal carcinoma postoperative pstients to relieve nausea and vomiting.Methods 80 patients with gastrointestinal carcinoma were randomly divided into intervention group(n=40)and control group(n=40).The degree of nausea and vomiting and symptom were compared between the two groups.Results The incidence of nausea and vomiting in the intervention group was lower than that in the control group.So did the degree of nausea and vomiting.The difference was significant(P＜0.05).In SCL-90,the scores of the somatization,obsessive-compulsiwe,depression and anxiety phobicanxiety,parsnoid,psychofism were significantly different with that of the Chinese normal(P＜0.05).The scores in the intervention group were lower than that of the control group after cognitive therapy(P＜0.05).Conclusion Cognitive therapy can help to alleviate psychological health score,nausea and vomiting from gastrointestinal carcinoma postoperative,so as to improve the quality of life for patients with gastrointestinal carcinoma.
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Objective To construct high-capacity ribosome display single-chain Fv library for selection of high affinity ScFv antibody.Methods We isolate human lymphocyte from peripheralblood(2 normal,3 gastric cancer,3 colonic cancer,1 pancreatic cancer,each 5 mL and 2 newborn,each 2 mL)and extract RNA for cloning whole human heavy chain and light chain gene by RT-PCR.VH and VL were rearranged randomly by SOEing(splicing by overlap extension,SOEing).Finally,the elements for in vitro screening such as T7 promoter and ribosome binding site were introduced while the SOEing products were amplified.Moreover,ribosome display template were verified by blue/white screening and further sequencing.Results We successfully constructed ribosome display ScFv library with a volume of 1.1?1013.Conclusion The construction of high-capacity ScFv library shed light on multiple therapeutic ScFv screening.
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Objective To observe the acute effects and symptom relief of radiofrequency hyperthermia combined with chemotherapy in treating advanced or metastatic gastrointestinal cancer.Methods 50 cases with advanced or metatatic gastrointestinal cancer that recurrent after operation or can not be resected were all treated by local radiofrequency hyper- thermia combined with chemotherapy.In every cycle of chemotherapy,radiofrequency hyperthermia was given 2 to 3 times,60 minutes per time.One case complete chemotherapy 3 to 6 cycles and the total times of radiofrequency hyper- thermia ranged from 6 to 16.Results In 50 cases,the rate of effects was 38% and the rate of symptom relief was 46%.Conclusion In the combined therapy for advanced or metastatic gastrointestinal cancer,the radiofrequency hy- perthermia has some value in relieving symptoms,improving living quality and controlling tumour.
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Objective To elucidate the effect of postoperative early enteral nutrition support (ENS) on cellular immunity function and nutritional status of gastrointestinal (GI) cancer patients.Methods Twenty patients with GI cancer were at random divided into two groups: enteral nutrition group (EN-group, 10 cases), parental nutrition group (PN-group, 10 cases). PN-group was given total parental nutrition (TPN).In EN-group,Since the 1st postoperative day Neutrinos(r) was infused, the infused volume was increasingly added from 500 ml/d to 1 500 ml/d, the infused rate was step-by-step increased from 21 ml/h to 63ml/h. T-cell subgroup, NK cell, IL-2, PA, RBP were measured in the day before operation and on the 2nd ?4th ?8th postoperative day.Results ① The serum RBP,PA levels were obviously decreased postoperatively (P
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BACKGROUND: Studies of immune response for cancer have demonstrated that the antitumor immune response plays a role in competing against the growth of cancer cells and is frequently altered in advanced cancer. METHODS: We evaluated the changes of peripheral blood lymphocytes and their subsets during preoperative and postoperative periods according to the time sequence of the postoperative condition in gastrointestinal carcinoma patients. Lymphocyte surface markers were determined in 39 stomach cancer patients and 33 colon cancer patients by using the indirect immunofluorescence technique with monoclonal antibodies. The patient's body weights, hemoglobin, hematocrits, total protein, and albumin were also measured preoperatively at and 1, 3, 6, 12, 18, and 24 months postoperatively. RESULTS: There were significant differences of clinico-laboratory findings between the preoperative and the postoperative periods except for hemoglobin, total protein, and albumin in postoperative course. The total leukocyte count significantly decreased from the postoperative 6th month. The lymphocyte count significantly increased from the postoperative 3rd month. The granulocytes decreased significantly in the postoperative 6th month. The T cells and B cells decreased in the postoperative 3rd month and 1st month, respectively. CD8 increased in the postoperative 3rd month and NK cells also increased in the postoperative 3rd, 6th and 24th months. Other peripheral lymphocytes and their subsets showed no significant differences. The changes in the lymphocyte subsets according to stage were not statistically significant (p<0.005). CONCLUSIONS: The postoperative changes in lymphocytes, granulocytes, and NK cells were significantly different compared with preoperative levels, but these results did not correlate with postoperative survival and recurrence rate because of the short postoperative follow-up periods.
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Humans , Antibodies, Monoclonal , B-Lymphocytes , Body Weight , Colonic Neoplasms , Fluorescent Antibody Technique, Indirect , Follow-Up Studies , Granulocytes , Hematocrit , Killer Cells, Natural , Leukocyte Count , Lymphocyte Count , Lymphocyte Subsets , Lymphocytes , Postoperative Period , Recurrence , Stomach Neoplasms , T-LymphocytesABSTRACT
This study was performed to evlauate the usefulness of red ginseng extract as an adjuvant therapeutic agent to improve immune function in immune compromizing gastrointestinal carcinoma patients. We treated 48 patients with two regimens after we undertook the curative resection for gastrointestinal carcinoma: 1) only chemotherapy and immunotherapy (control group), 2) chemotherapy and immunotherapy with 4500-5400mg red ginseng for 6 months (study group). For investigating the immunologic alternations alongside the numerical changes in peripheral blood lymphocyte and their subsets in the gastrointestinal carcinoma patients, lymphocyte surface markers were determined by monoclonal antibodies on the preoperative 1st day, and postoperative 5th day, 1 month, 3 month and 6 month in 28 controls and 20 red ginseng groups in gastrointestinal carcinoma patients which were recruited at Korea University Hospital from March, 1995 to December, 1995. The mean value for body weight was increased in the ginseng group than in the control group. There were no significant differences of serum hematocrit, hemoglobin, total protein and albumin in both groups. The total lymphocyte count was much more increased in the ginseng group than in the control group. The number of T cell, B cell, CD8, CD4, NK cell and activated T cell were increased in ginseng group more than in control group. The T cell was significantly increased on postoperative 5th day, 3 month and 6 month, and B cell on postoperative 6 month in ginseng group than in control group. The CD8 was significantly increased on postoperative 3 month and 6 month, CD4 on postoperative 5th day, and NK cell and activated T cell also on postoperative 6 month in ginseng group than in control group. In conclusion, red ginseng may be useful as a longterm adjuvant therapeutic agent for improving the immune function and anticarcinogenic effect after curative operation for immune compromizing gastrointestinal carcinoma patients.
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Humans , Antibodies, Monoclonal , Anticarcinogenic Agents , Body Weight , Drug Therapy , Hematocrit , Immunotherapy , Killer Cells, Natural , Korea , Lymphocyte Count , Lymphocytes , PanaxABSTRACT
Objectives:To observe the role of peri operational nutritional support in the old patients with gastrointestinal carcinoma. Methods: One hundred and seventeen cases of aged patients with gastrointestinal carcinoma were divided into two groups: nutritional support (NS) group and normal therapy(NT) group. The therapeutic effects of peri operational nutritional support were studied. Results: All patients survived. The rate of complication in group of NT was higher than that of NS group. The recovering time of the gut function after operation and average duration in the hospital of the NT group were longer than that in the NS group. The recovery of body weight, level of plasma albumen and nitrogen balance in NS group was faster than that of NT group. Conclusions:Peri operational nutritional support in the aged patients with gastroenterological carcinoma is of significance, improving the nutritional condition,enhancing the endurance from the surgical trauma and decreasing the rate of postoperative complication.
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Objectives:In order to study the immune function after postoperative parenteral nutrition enriched with arginine in patients with gastrointestinal carcinoma. Methods:Forty patients who underwent radical operation of gastrointestinal carcinoma were randomly divided into experimental group( n= 20),in which patients received TPN enriched with arginine,and control group (TPN, n =20).At day 1 before operation,day 1 and day 8 after operation,IgG,IgA,IgM,T cell subgroups.NK cell activity and IL 2 were dectected. Results:The immune function of patients with gastrointestinal carcinoma was depressed at different levels.At day 1 after operation,IgG,IgM,IgA,CD4 +,CD4 +/CD8 +,Nk cell activity and IL 2 decreased more significantly than those before operation.The immunefunction recovered rapidly and exceeded the level before preoperation in experimental group.The difference was significant( P
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Objectives:To study the effects of parenteral nutrition in postoperative gastrointestinal carcinoma during perichemotheraputic period. Methods:80 patients with gastro intestinal carcinoma were divided into two groups.One group patients received chemotherapy and the other group patients received both chemotherapy and parenteral nutrition during first chemotharapy period.Then breatments changes each other between groups. Results:The nutritional condition,the concentrations of immunoglobumins and WBC in chemotherapy and parenteral nutrition group were significantly improved than those in chemotherapy group. Conclusions:It is helpful for the patients with gastrointestinal carcinoma to receive parenteral nutrition during postoperative perichemotheraputic period.
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Localization of MG_7 antigen was investigated in situ by immunohistochemic and immunoclectron microscopic technique in 62 cases of gastrointestinal carcinoma (GICA). The detective rate of MG_7 antigen was 80. 77% in gastric carcinoma (21/26 cases) and 94.44% in colorectal carcinoma (34/36 cases). Its expressing intensity and distribution were associatcd with the differentiation of tumor cells. Most of the poorly differentiated tumors showed much stronger MG_7 antigen expression and cytoplasmic staining, while most of the differentiated tumors showed membranic or mixed staining, mainly distributed in lumen side. Immunoelectronimicroscopic study revealed that MG_7 antigen predominantly existed in lumen margin microvilli, cell membrane and cytoplasm bencath the cell membrane in well differentiated tumor cells, existed in secretory granules, Golgicomplex and endoplasmic reticulum in poorly differetiatd tumor cells. The finding suggest that MG_7 antigen be a kind of secretory substance syntheszed by GICA cells. The mutual relationship between MG_7 antigen localization and tumor cell differetiation as well as its clinical significance were also discussed.