Clinicopathological characteristics and prognosis of anorectal malignant melanoma / 中华普通外科杂志

Objective:To investigate the impact of the clinicopathological characteristics of anorectal malignant melanoma (ARMM) on the prognosis.Methods:The clinicopathological data of 40 ARMM patients undergoing surgery at the Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences from Apr 2012 to Apr 2022 were collected, and the impact of different clinicopathological factors and treatment modalities on the overall survival of ARMM patients was investigated using Kaplan-Meier survival analysis and multifactorial Cox proportional risk model analysis.Results:Among 40 ARMM patients , 16 were male and 24 were female. The median age of onset was 61 yr. The median follow-up period for all patients was 47 (25-69) months, with a median survival of 19 (15-23) months and 1-year and 3-year survival rates of 74.3% and 21.7%, respectively. There was no statistically significant difference in survival time between the two groups of patients receiving wide local excision and abdominoperineal resection( χ2=1.281, P=0.258). Univariate analysis showed that overall survival in patients with ARMM was related to tumour diameter, depth of infiltration, specimen margin and lymph node metastasis ( χ2=1.281, P=0.039; χ2=3.760, P=0.042; χ2=6.581, P=0.010; χ2=21.683, P<0.001), and multivariate analysis suggested that lymph node metastasis was an independent risk factor for overall survival in patients with ARMM. Conclusion:Tumour diameter, depth of infiltration, specimen margin and lymph node metastasis were important prognostic influences in ARMM, and lymph node metastasis was an independent risk factor for overall survival in ARMM patients.

Progress of clinicopathological features, diagnosis and treatment and screening of early-onset colorectal cancer / 肿瘤研究与临床

The incidence of early-onset colorectal cancer is increasing year by year, and it occupies an important position in colorectal cancer. Most of the characteristics of patients with early-onset colorectal cancer are different from those with late-onset colorectal cancer, the patients are diagnosed in a late stage, and their pathological manifestations show a type of poor prognosis. At present, there is a lack of consensus and guideline for the diagnosis, treatment and screening of early-onset colorectal cancer. A full understanding of the characteristics of early-onset colorectal cancer helps to understand its pathogenesis and guide screening and treatment to reduce the incidence and mortality of colorectal cancer. This article reviews the clinicopathological characteristics, molecular pathological mechanisms, diagnosis and treatment, and prognosis of early-onset colorectal cancer, in order to provide references for elucidating its etiology and formulating scientific and standardized screening strategies.

Long-term oncological and functional outcomes of transanal full-thickness resection after non-curative local resection of early rectal cancer / 中华普通外科杂志

Objective:To explore the safety of transanal re-excision (TAR) after positive-margin local resection for early rectal cancer.Methods:A retrospective analysis was made data of 44 patients with rectal cancer after local excision from Mar 2006 to Oct 2018 at the Department of Colorectal Surgery, Cancer Hospital of Chinese Academy of Medical Sciences. All patients had positive margin or suspicious tumor remains after local excision, and subsequently salvage TAR surgery was performed after informed consent was given.Results:Forty-four patients after local excision were with pathologically showed residual condition, including 26 cases of positive margin and 18 cases of suspicious tumor remaining. The pathological types were all adenocarcinoma. Forty-one (93%) patients with pT1 and 3 (7%) patients with pT2. The median follow-up time after salvage TAR was 100 (11-164) months. During follow-up, 3 patients (7%) developed mild anal incontinence. One patient (2%) had local recurrence, 3 (7%) patients had distant metastases, and 3 patients (7%) died of non-tumor specific deaths. The overall 5-year survival rate and disease-free survival rate were 98% and 93 %, respectively.Conclusions:Transannal full thickness tumor re-excision is safe and reliable for the salvage treatment after non-complete local resection of early rectal cancer. The long-term follow-up results show that the 5-year survival rate is comparable to that of radical surgical resection, and with a good anal function.

Effects of Blood Nourishing and Wind Expel Formulae on Learning and Memory Capabilities of Rats with Tic Disorders / 中国中医药信息杂志

Objective To observe the effects of blood nourishing and wind expel formulae on learning and memory capabilities of rats with tic disorders. Methods Intradialytic Parenteral Nutrition peritoneal injection was used to establish the rat model of tic disorders. The successful test subjects were categorized into 5 different groups, namely the model group, the Chinese medicine groups (low dosage, medium dosage and high dosage) and the western medicine group. The test groups were each given gastric perfusion of the related medicine, whereas the control and model groups were each given equal amounts of saline solution continuously for 8 weeks. Open field test and water maze test were carried out in the 1st, 4th and 8th weeks to evalute the learning and memory capabilities. Results In comparison with the control group, the model group showed obvious increase in movement across grid and decrease in vertical locomotion. Statistical significance was obtained showing an increase in vertical locomotion in the treatment groups compared with the model group. In the Chinese medicine groups, the medium and high dosage groups exhibited shorter escape latency and increased exploratory behavior (P<0.05) in the 4th and 8th weeks. Conclusion Among the blood nourishing and wind expel formula, the medium and high dosage showed ameliorating effects on the memory and learning capabilities of rats with tic disorders.

Transabdominal intramediastinal esphagogastrostomy for the treatment of gastric cordial cancer / 中国基层医药

Objective To evaluate a surgical approach and anastomosis for the treatment of carcinoma of the gastric cardia. Methods Transabdominal intramediastinal esophagogastric anastomosis covered by sero-muscular flap of gastricwall for cardial carcinoma in 187 cases. Results The method reached the satisfactory surgical result in terms of tumor free cut edge on esophagus end of the resected samples. And the morbidity rate was 5.8%. Conclusion The technique enables lymphadenectomy within the lower mediastinum and a sufficiently long enough resection of esophagus. Transabdominal incision of the crus dextrum of the diaphragm makes a clear operative field for the purpose of radical operation for carcinoma of the gastric cardia. The anastomosis effectively prevents anastomotic leakage. This procedure is indicated for cardial carcinoma cases in which the esophaged involvement is within 2cm.