Résumé
Objective To clarify the effect of esophageal valve forming esophageal and gastric sleeve joint surgery for preven‐ting postoperative anastomotic complications of esophageal cancer .Methods A randomized controlled trial was designed to incorpo‐rate a total of 394 patients with esophageal cancer from January 2010 to June 2013 .This study has been registered in the Chinese clinical trial center and received a registration number :ChiCTR‐TRC‐13003817 .Among them ,9 cases (2 .3% ) were excluded be‐cause of the non line esophageal cancer radical operation .The remaining patients were randomly divided into two groups ,191 cases in group A and 194 cases in group B ,according to the principle of random grouping .Group A was experimental group ,patients ac‐cepted esophageal valve forming esophageal and gastric sleeve joint surgery ,and group B was the control group ,patients received conventional anastomosis .Results The incidence of anastomotic leakage after operation in group A and group B were 4 .1% and 3 .6% ,thse results were not statistically significant (P=0 .768) .In the observation of anastomotic stenosis ,7 patients died after sur‐gery .In the remaining cases ,there were 13 cases (6 .9% ) and 25 cases (13 .2% ) in group A and group B ,respectively ,the differ‐ence was statistically significant (P=0 .044) .Furthermore ,reflux oesophagitis and Barrett′s epithelium were found in 105 patients (55 .3% ) in group B ,and 54 (28 .7% ) patients in group A ,the difference was statistically significant (P<0 .01) .Conclusion E‐sophageal valve forming esophageal and gastric sleeve joint surgery can effectively prevent postoperative gastroesophageal reflux , but also can reduce the postoperative incidence of anastomotic stenosis .
Résumé
Aim To study relationship between expressions of apoptosis-related gene bax and bcl-x in heopatocellular carcinoma (HCC) tissues and its clinical feature. Mothods The expression of Bax and Bcl-x were determined by immunohistochemistry with EnvisionTM system. Results Bcl-x and Bax proteins were detectable in 20 and 19 out of 40 HCCs, respectively. Their expressions in HCC cells were lower than those in cirrhosis(P＜ 0.05), The expression of Bax and Bcl-x in highly or intermediatly differentiated HCC cells were highed than that in low-diffe-rehtiated HCC cells suggesting that there was significant relationship among bcl-x and bax expressions and differential degree， clinical stages of HCC cells， and AFP level. However, the expression of this proteins showed no relationship with patient's sex and age(＞ 60 or ＜ 60 years old) (＞ 0.05). Conclusion Apoptosis-related genes bcl-x and bax participate partially in apoptotic regulation of HCC cells, and show that their expressions have correlation with differential degree, clinical stage of HCC cells and AFP levels.