Analysis of Influencing Factors of Preoperative Anxiety or Depression in Patients with Lung Cancer Surgery / 中国肺癌杂志

BACKGROUND@#Preoperative anxiety/depression can bring physical and mental harm to the patients with lung cancer. There is little study on whether hospital waiting time before surgery can increase the psychological burden of patients with lung cancer. The aim of this study was to investigate the preoperative anxiety and depression of patients with lung cancer in our hospital, and to analyze the related influencing factors.@*METHODS@#A total of 135 lung cancer inpatients in the Department of Thoracic Surgery of Beijing Friendship Hospital were studied. Their general information and anxiety/depression were recorded by general questionnaire, Zung self-rating anxiety scale (SAS) and self-rating depression scale (SDS).@*RESULTS@#The score of SAS was 36.25 (30.00, 42.50) on the day of admission, and 37.50 (31.25, 43.75) on one day before operation. The score of self-rating depression scale (SDS) was 46.25 (40.00, 52.50) on the day of admission, and 47.50 (41.25, 53.75) on one day before operation. Compared with the Chinese norm, there were 0 patient suffered from anxiety on the day of admission, and one day before operation. There were 2 patients suffered from mild anxiety; 6 patients suffered from mild depression on the day of admission, and this number went up to 8 on the day before operation. Single factor analysis showed that the hospital waiting time before surgery was positively correlated with preoperative anxiety and depression, and the results were statistically significant (P<0.05). The generalized linear model analysis showed that other factors such as knowledge, gender, age and marital status had no significant correlation with preoperative anxiety and depression.@*CONCLUSIONS@#The occurrence of preoperative anxiety in hospitalized patients with lung cancer is positively correlated to the hospital waiting time before surgery. The longer they stayed in the hospital before operation, the greater their risk of anxiety/depression. So medical staff should actively focus on the psychological condition of the patients with lung cancer, and it is strongly recommended that patients complete preoperative examination and preparation in the outpatient department, in order to reduce the waiting time before operation and reduced the risk of adverse psychological problems such as anxiety and depression.

Evaluation of the rationality of current T staging of gastric cancer with transverse mesocolon invasion / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the rationality of T staging of gastric cancer with transverse mesocolon invasion.</p><p><b>METHODS</b>Data of 808 patients with primary gastric cancer undergoing surgical treatment was screened from the Data base of Gastric Cancer of Sun Yat-sen University, from April 1996 to October 2009. According to the information of transverse mesocolon invasion, all cases were divided into groups NOI (T4a stage, non organ invasion, n = 638), NTMI (T4b stage, non transverse mesolon invasion, with organ invasion, n = 126), and TMI (transverse mesocolon invasion, n = 44). The clinicopathological features, surgical procedure and prognosis were compared among the three groups.</p><p><b>RESULTS</b>No significant difference was found in gender, age, lymph node metastasis, hepatic metastasis, tumor's Borrmann type, histological type, differentiation degree, value of serum CEA among the 3 groups (all P > 0.05). In the groups NOI, NTMI and TMI, the ratio of mean tumor diameter ≥ 5 cm was 39.0% (249/638), 61.1% (77/126) and 54.5% (24/44), respectively; the ratio of distal metastasis was 11.9% (76/638), 30.2% (38/126) and 43.2% (19/44), respectively; the ratio of peritoneal metastasis was 8.2% (52/638), 26.2% (33/126) and 38.6% (17/44), respectively; the ratio of TNM IV stage was 25.4% (162/638), 84.7% (107/126) and 93.7% (41/44), respectively; and the ratio of radical resection was 92.0% (587/638), 69.8% (88/126) and 77.3% (34/44), respectively; all with significant differences (P < 0.01), and the results of pairwise comparisons (Bonferroni correction, significant level α = 0.05/3 = 0.0167) showed that these parameters were significantly different between groups NOI and TMI (P < 0.0167), but non-significant between groups NTMI and TMI (P > 0.0167). The median survival time was 42.0, 16.4 and 19.0 months in the groups NOI, NTMI and TMI, respectively (P < 0.01), and the results of pairwise comparison showed that the prognosis were significant different between the groups NOI and TMI (P < 0.01), but non-significant between the groups NTMI and TMI (P > 0.05). In the cases who received radical resection, the median survival time was 47.9, 23.5 and 21.4 months in the groups NOI, NTMI and TMI, respectively (P < 0.01), and the results of pairwise comparison showed that the prognosis was significantly different between the groups NOI and TMI (P < 0.05), but not significant between groups NTMI and TMI (P > 0.05).</p><p><b>CONCLUSIONS</b>The tumor size, distal meatastasis, peritoneal metastasis, TNM stage, surgical procedure and prognosis of gastric cancer with transverse mesocolon invasion are similar to that of T4b gastric cancer, but are significantly different from that of T4a gastric cancer. Gastric cancer with transverse mesocolon invasion should be reclassified as T4b stage.</p>

Expression and significance of miR-125a and Mcl-1 in intestinal tissue after massive small bowel resection in rat / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the expression and significance of miR-125a and anti-apoptotic protein Mcl-1 in intestinal tissue after massive small bowel resection in intestinal adaptation.</p><p><b>METHODS</b>Sprague-Dawley rats (54 male rats, 8-week old) were divided into 3 groups randomly, including two control groups. Rats in the experiment group were subjected to 70% massive small bowel resection. Rats in the resection group underwent simple intestinal resection and anastomosis. Rats in the control group underwent laparotomy alone. A 5 cm intestine approximately 1 cm distal to the anastomosis was harvested a week after operation. Expression of Mcl-1 was assessed by immunohistochemistry and real-time PCR was used to detect the expression of miR-125a in intestinal tissue.</p><p><b>RESULTS</b>The positive expression of Mcl-1 in the experiment group was 18.8%(3/16), significantly lower than that in the control group(76.5%, 13/17) and the resection group (83.33%, 15/18)(both P<0.01). The expression of miR-125a in the experiment group was 1.92, significantly higher than that in the control group (1.01) and the resection group (1.05)(both P<0.01).</p><p><b>CONCLUSION</b>miR-125a and anti-apoptotic protein Mcl-1 may play an important role in intestinal adaptation process and they may regulate each other through a certain pathway.</p>

Expression of glutathione-S-transferase-π, P-glycoprotein, topoisomerase Ⅱ and thymidylate synthase in gastric adenocarcinoma tissues and their clinical significances / 肿瘤研究与临床

Objective To explore the expression of glutathione-S-transferase-π(GST-π),P-glycoprotein (P-gp),topoisomerase Ⅱ (Topo Ⅱ) and thymidylate synthase (TS) in gastric adenocarcinoma tissues and the clinical significance.Methods Envision method of immunohistochemistry was used to detect the expression of GST-π,P-gp,Topo Ⅱ and TS in sample of 64 gastric adenocarcinoma tissues and 12 normal gastric mucosas,and their corresponding clinical data were comprehensive analyzed.Results The expression positive rates of GST-π,P-gp,Topo Ⅱand TS were respectively 76.6 ％(49/64),64.1％ (41/64),84.4 ％ (50/64) and 53.1％ (34/64),that were all higher than in gastric mucosa [8.3 ％ (1/12),8.3 ％(1/12),16.7 ％ (2/12),0],the differences were statistically significant respectively (P ＜ 0.01).Their positive expression rates were closely relevant to the degree of differentiation (P ＜ 0.05),but not to the patients' gender,age,tumour size,clinical staging,invasive depth and lymph node metastasis (P ＞ 0.05).The expressions of GST-π,P-gp and TS in high and middle differentiation adenocarcinoma were high.er than in low differentiation,but the expression of Topo Ⅱ in high and middle differentiation adenocarcinoma was lower than in low differentiation (P ＜ 0.05).Conclusion GST-π,P-gp,Topo Ⅱ and TS are over-expressed in gastric adenocarcinoma,which is related to the multidrug resistance of gastric adenocarcinoma.The joint detection of the expression of GST-π,P-gp,Topo Ⅱ and TS in gastric adenocarcinoma can be looked as an important symbol for guiding its chemotherapy drug and prognosis.

Fast track surgery in elective operation for colorectal carcinoma / 中华普通外科杂志

Objective To investigate the clinical application of fast track surgery in patients undergoing elective colorectal carcinoma surgery. Methods Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups: fast-track group (35 cases) and conventional care group (35 cases). Results Sixty-two patients finished the study, 32 cases in fast-track group and 30 cases in conventional care group. The median and average time to the first passage of flatus (2±1 vs. 4±2, P<0.01), the first passage of stool (3.8±1.6 vs. 6.4±2.5, P=0.0007), resumption of normal diet [(4±2) vs. (8.2±2.2), P<0.01] and the length of postoperative stay (6±1 days vs. 11.7±3.8 days, P<0.01) were much shorter in the fast-track group than in the conventional care group. The preoperative incidence of thirst (2/32 vs. 23/30, P<0.01), hunger (5/32 vs. 20/30, P<0.01) and postoperative infectious complications (2/32 vs. 8/30, P=0.04) were much lower in the fast-track group than in the conventional care group. Conclusion Fast track surgery in patients undergoing elective colorectal resection was safe and effective.