Detection of micrometastasis in perioperative primary esophageal cancer patients using real-time quantitative reverse transcrtption-PCR / 肿瘤研究与临床

Objective To establish a desirable quantitative assay system to evaluate the correlation between surgical manipulation and micrometastasis in primary esophageal cancer patients.Methods 118 pe- ripheral blood samples from 40 esophageal cancer patients undergoing radical resection were collected before surgery(B-1),immediately after surgery(B0)and at the third day postoperatively(B+3).Based on real-time quantitative reverse transcription-PCR,carcinoembryonic antigen(CEA)mRNA gene was used in the detec- tion.12 patients with benign tumor and 13 healthy volunteers were collected as negative control groups.Re- sults The median of CEA mRNA copies at B-1,B0 and B+3 were 1592,13 314 and 6221 copies/ml blood, respectively.CEA mRNA expression levels were found to be significantly higher at both B0 and B+3 than that of B-1(P=0.0001 and 0.0209,respectively).No significant difference was found between B0 and B+3(P= 0.4396).Conclusion Surgical manipulation on esophageal cancer patients increases the probability of mi- crometastasis.Therefore,adjuvant therapy is needed during perioperative stage.

Treatment Results of the New Microsurgery in Hemifacial Spasm

Hemifacial spasm is painless uncommon disorder characterized by involuntary paroxysmal movement of one side of face. Microvascular decompression at root exit zone of the facial nerve has become the standard treatment for hemifacial spasm. An alternative hypothesis, proposed for the relieve of hemifacial spasm with microvascular decompression, actually result from minor trauma or circumferential fibrosis to a sensitive zone of the facial nerve. Upon the base of this hypothesis, author have treated patient with hemifacial spasm with surgical manipulation in addition to microvascular decompression. During last fifteen years, 250 patients with hemifacial spasm underwent this operation. The age at operation ranged from 18 to 71 years, with mean over 45.7 years and the duration of symptoms averaged 5.8 years. The spasms occurred predominantly right side, 5 cases were bilateral. The common offending vessels were AICA in 127 cases(50.8%) and PICA in 50 cases(20%). The remainder were 17 cases in vertebral artery, 9 cases in labyrin-thine artery(3.6%) and multiple offending vessels were found in 29 cases(11.6%). In two hundred fifteen cases, the spasm was completely relieved within 5 days after operation. Among 25 cases whose spasm unrelieved initially after surgery, 19 cases was relieved within 3 weeks and 6 cases within 3 months. Complications following surgery is approximately 22.8%: the most commonly encountered deficit is facial weakness(16 cases) followed by CSF leak (12 cases), and some degree of hearing loss(12 cases). Other complications include wound infection, ataxia, pneumocephalus and focal hemorrhage. Surgical manipulation in addition to microvascular decompression for hemifacial spasm(a new combined approach) produces better results of improvement approximately up to 96%.

The Effect of Surgical Manipulation on the Bacterial Translocation from the Gut

The bacterial translocation is defined as the passage of viable bacteria or its toxin from the lumen of the gastrointestinal tract through the intestinal mucosa to other site of host. It is believed that bacterial translocation may lead to systemic infection and septicemia. The purpose of this study was to determine what factors in experimental surgical trauma lead to bacterial translocation. Two-nonth-old Wistar albino rats were divided into three groups: A-control; B-anesthesia only and C-anesthesia and surgery. After 24 and 48 hours, caval blood, mesenteric lymph nodes, liver, lung and spleen were harvested aseptically and cultured for aerobic organism. To exclude the possibility of contamination during surgical manipulation and harvesting, swab culture of peritoneal surface was performed. The bacterial translocation seldom occurred 24 hours after surgical manipulation. There was a significant increase in the number of animals with bacterial translocation in group C, 48 hours after manipulation and harvesting, swab culture of peritoneal surface was performed. The bacterial translocation seldom occurred 24 hours after surgical manipulation. There was a significant increase in the number of animals with bacterial translocation in group C, 48 hours after surgical manipulation. The majority of translocating bacteria was E. coli.