Trends in mortality and life lost due to cancer in Ouhai District from 2013 to 2020 / 预防医学

Objective@#To investigate the trends in mortality and life lost due to cancer among residents in Ouhai District, Wenzhou City from 2013 to 2020, so as to provide the evidence for formulating the cancer control strategy. @*Methods@#The mortality data of cancer patients in Ouhai District from 2013 to 2020 were collected through Zhejiang Provincial Information Management System for Surveillance of Chronic Diseases. The crude mortality, standardized mortality, years of potential life lost ( YPLL ), years of potential life lost rate ( YPLLR ), standardized years of potential life lost ( SYPLL ), standardized years of potential life lost rate ( SYPLLR ), average years of life lost ( AYLL ) and annual percent change ( APC ) were estimated to analyze the trends in mortality and life lost due to cancer.@*Results@#Totally 5 435 deaths occurred due to cancer in Ouhai District from 2013 to 2020, and the crude and standardized mortality rates were 154.10/105 and 119.41/105, respectively. The crude mortality of cancer was higher in men than in women ( 196.26/105 and 111.09/105; χ2=415.623, P<0.001 ). The standardized mortality of cancer among whole populations, the crude mortality in men and the standardized mortality in men showed a tendency towards a reduction ( P<0.05 ), with APC of -3.25%, -2.18% and -4.78%, respectively. The crude mortality of cancer showed an upward trend with age ( χ2trend=9 260.583, P<0.001 ). Lung cancer, liver cancer, stomach cancer, colorectal cancer and esophagus cancer were the five leading causes of cancer-related mortality, which accounted for 66.68% of all cancer mortality. Liver cancer, lung cancer, stomach cancer, colorectal cancer and brain cancer were the five leading causes of life lost, with YPLL of 11 191.50, 8 231.00, 6 000.00, 3 892.00 and 2 693.50 person-years, respectively. Leukemia was the primary cause of AYLL ( 25.17 years per person ).@*Conclusions@#Both the standardized mortality and the life lost due to cancer showed a tendency towards a reduction in Ouhai District from 2013 to 2020, and men and the elderly were high-risk populations. Lung cancer, liver cancer, stomach cancer, colorectal cancer, leukemia, brain cancer, and female breast cancer should be listed among cancers in Ouhai District prioritized for control

Small bowel autotransplantation after resection of lesions involving the roots of mesenteric vessels / 中华普通外科杂志

Objective:To summarize our experience in 13 cases of intestinal autotransplantation (IATx) after resection of lesions involving the roots of mesenteric vessels.Methods:The clinical data of 13 patients undergoing IATx in Xijing hospital were retrospectively analyzed. The etiology, surgical procedure and complications were analyzed. The patients were followed up by telephone and regular evaluations.Results:All 13 cases of IATx were successfully completed. For 12 patients who were diagnosed with tumors involving the mesenteric roots, the tumors were removed for cure intent avoiding massive intestinal resection. Pancreaticoduodenectomy was carried out simultaneously in 11 cases. The postoperative complication rate was 85% (11/13). The autograft was resected in 1 patient on the 1st postoperative day due to necrosis from mesenteric thrombosis, leading to short bowel syndrome. One-year survival was 69% (9/13). Among 4 deaths, 1 patient died of liver metastasis, and another died of liver and lung metastases. Five patients were alive 2 years postoperatively.Conclusion:IATx while-technically challenging, avoiding short small bowel syndrome in properly selected patients after resection of lesions especially benign ones involving the roots of mesenteric vessels that were traditionally considered to be "unresectable".

Research progress of sacral neuromodulation procedure in the treatment of chronic constipation and fecal incontinence / 中华胃肠外科杂志

Sacral neuromodulation (SNM) procedure has become a new therapy to treat chronic constipation and fecal incontinence. The surgical procedure is easy and safe. It has a small incision compared with traditional surgery and is mainly used in patients whose traditional treatment was unsuccessful. Chronic constipation is one of the most common digestive symptoms. The quality of life in patients with severe constipation has decreased greatly. Although the incidence of fecal incontinence in China is not as high as that of constipation, it also seriously affects the life of the patients, resulting in a decline in the quality of life. Although the mechanism of SNM is uncertain, with more studies conducted, understanding has become more profound, and the curative effect has been recognized. SNM can improve the symptoms and the quality of life. Many studies have reported SNM treatment. Furthermore, some trials on SNM have been conducted. It is used after colorectal resections to promote symptoms of bowel dysfunction. However, few studies reported regarding SNM for constipation and fecal incontinence in China, and knowledge regarding SNM is limited. In this article, we will mainly discuss SNM in the treatment of chronic constipation and fecal incontinence, and its research progress on the mechanism and method, surgical procedure, effectiveness, complications, postoperative contraindications, and the population who need to pay attention, in order to provide reference for the treatment of SNM in China.

Research on DNA Hydroxymethylation Modification in Digestive System Carcinoma / 现代生物医学进展

DNA hydroxymethylation modification is an important part of genome epigenetic regulation.The demethylation process from 5-methylcytosine (5-mC) to 5-hydroxymethylcytosine (5-hmC) is catalyzed by Tet protein.Abnormal genomic methylation leads to the occurrence of a variety of tumors.Hydroxymethylation is modified as a kind of demethylation and is inseparable from tumorigenesis.The expression of 5-hmC changes accompanied with the development and progression of digestive system tumors,which may be associated with the TET protein family and IDH mutation.It suggested that DNA hydroxymethylation is involved in the development and progression of digestive system tumors.This paper reviews the relationship between DNA hydroxymethylation and digestive system tumors,and aims to provide a new direction for the study of Hydroxymethylation modification in digestive system tumors.

Sacral neuromodulation in the treatment of intractable constipation / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To assess the efficacy of sacral neuromodulation (SNM) in patients with intractable constipation.</p><p><b>METHODS</b>A total of 7 patients with intractable constipation were treated with pereutaneous test stimulation of the S3 nerve root and were assessed by sacral never stimulation system in our department from January 2013 to January 2014. Four of these 7 patients received operation for constipation before. The efficacy was assessed by bowel habit diary, clinic constipation scores, subjective questionnaire and clinical signs.</p><p><b>RESULTS</b>The constipation symptoms were improved significantly in all the 7 patients. The frequency and volume of defecation per week were increased obviously, and the average urine was increased. Six patients underwent permanent implantation of the SNS system. After a median 4 months follow-up, the defecation frequency increased from 0.6 ± 0.5 to 8.0 ± 2.5 per week (P<0.01), and the defecation time decreased from (22.9 ± 11.5) to (3.7 ± 0.8) min (P<0.01). The Cleveland clinic constipation score decreased from 24.6 ± 4.2 to 9.0 ± 0.9 (P<0.01), and the visual analogue scale(VAS) score increased from 8.1 ± 0.9 to 82.5 ± 5.2 (P<0.01).</p><p><b>CONCLUSION</b>SNM is a clinically efficacious, minimally invasive and safe new technique, which offers an alternative treatment for the patients with intractable constipation resistant to conservative treatment, especially for the patients refractory to traditional operations.</p>

Two congenital coronary abnormalities affecting heart function: anomalous origin of the left coronary artery from the pulmonary artery and congenital left main coronary artery atresia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The anomalous origin of the left coronary artery (LCA) from the pulmonary artery (ALCAPA) and congenital left main coronary artery atresia (CLMCA-A) are two kinds of very rare coronary heart diseases which affect heart function profoundly. This study aimed to retrospectively illustrate the clinical features and therapy experience of ALCAPA and CLMCA-A patients.</p><p><b>METHODS</b>From April 1984 to July 2012, in Beijing Anzhen Hospital, 23 patients were diagnosed with ALCAPA and 4 patients with CLMCA-A. We summarized the clinical data of the 27 cases and retrospectively analyzed the clinical manifestation, diagnosis, and treatments of these two kinds of congenital coronary abnormalities.</p><p><b>RESULTS</b>The 23 patients (13 males and 10 females, aged ranging from 2.5 months to 65 years) identified with ALCAPA were classified into infantile type (age of onset younger than 12 months, 16 cases) and adult type (age of onset older than 12 months, 7 cases). Four patients were diagnosed with CLMCA-A (three males and one female, aged ranging from 3 months to 2 years). The main clinical manifestations of infantile-type ALCAPA and CLMCA-A include repeated respiratory tract infection, heart failure, dyspnea, feeding intolerance, diaphoresis, and failure to thrive. And these two congenital coronary abnormalities might be misdiagnosed as endocardial fibroelastosis, dilated cardiomyopathy, and acute myocardial infarction. As for the adult-type ALCAPA, cardiac murmurs and discomfort of the precordial area are the most common presentations and might be misdiagnosed as coronary heart disease, myocarditis, or patent ductus arteriosus. In ECG examination: Infantile-type ALCAPA and CLMCA-A showed abnormal Q waves with T wave inversion in leads I, avL, and V4-V6, especially in lead avL. However, ECG of adult-type ALCAPA lacked distinct features. In chest radiography: pulmonary congestion and cardiomegaly were the most common findings in infantile-type ALCAPA and CLMCA-A, while pulmonary artery segment dilation was more common in adult type. In echocardiography, the common features of infantile-type ALCAPA and CLMCA-A included left ventricular enlargement, left ventricular systolic function normal or mildly reduced in CLMCA-A or significantly reduced in ALCAPA, and moderate to large mitral valve. It was performed in 9 of 23 cases of ALCAPA and showed the origin of the dilated right coronary artery (RCA) from the right sinus of the aortic root and absence of LCA origin in angiography. After opacification of RCA, reverse flow in the LCA and pulmonary artery was visualized through coronary artery collateral circulation. Angio was performed in three of the four cases of CLMCA-A and showed left main coronary artery was a blind end, with diameter of only 1.1-2.0 mm. Treatment and prognosis: 21 patients with ALCAPA had cardiac surgery and 6 of them died postoperatively. Fifteen postoperative patients survived without overt symptoms within the follow-up period of 6-166 months (median 17 months). As for treatment of CLMCA-A, four patients took digoxin and diuretics without undergoing cardiac surgery. Their clinical symptoms improved during the close follow-ups.</p><p><b>CONCLUSIONS</b>ALCAPA and CLMCA-A are two rare coronary artery abnormalities that affect cardiac function in infants and children. In younger patients with cardiomegaly and heart dysfunction these two congenital coronary diseases should be noticed.</p>

Effect of artesunate on acute rejection after small intestine transplantation in rats / 中国组织工程研究

BACKGROUND:As the potent, specific immunosuppressants emerge, the survival rate after intestinal transplantation is improved to some extent. However, the adverse effects of immunosuppressants and expensive treatment costs are not tolerable for many patients. Therefore, it is clinical y meaningful to choose traditional Chinese medicine which presents immunosuppressive effects. Artesunate has immune suppression effect, reduces acute rejection fol owing smal intestine transplantation, and improves the success rate of smal intestine transplantation. OBJECTIVE:To observe the effect and action mechanism of artesunate in acute rejection after smal intestine transplantation in rats. METHODS:Al ogeneic smal intestine transplantation models were established in the closed group of Sprague-Dawley rats and Wistar rats, and then were randomly divided into three groups, syngenic transplantation group (SD→SD), al ogeneic transplantation group (Wistar→SD), and artesunate treatment group (Wistar→SD+artesunate 60 mg/kg per day, intraperitoneal injection). RESULTS AND CONCLUSION:Rats in syngenic transplantation group survived for more than 10 days and they were al kil ed on day 10. The average survival of rats in al ogeneic transplantation group and artesunate treatment group was respectively (6.73±0.58) days and (8.50±0.74) days, with significant differences between the two groups (P0.05), serum interferon-gamma expression level in treatment group was higher than syngenic transplantation group (P<0.05). Artesunate can inhibit acute rejection after rat smal intestine transplantation, and its mechanism may be related to inhibition effect on the secretion and expression of interleukin-2, interferon-gamma and other cytokines.

A comparision of total laparoscopic gastrectomy and laparoscopy-assisted gastrectomy for gastric carcinoma / 中华普通外科杂志

Objectives To compare total laparoscopic gastrectomy with intracorporeal hand-sewn Gl reconstruction and laparoscopy-assisted gastrectomy for gastric cancer. Methods Between July 2009 and July 2010, 21 patients of gastric cancer underwent total laparoscopic D2 radical gastrectomy with intracorporeal hand-sewn reconstruction and 28 did laparoscopy-assisted D2 radical gastrectomy in Xijing Hospital of Digestive Diseases. All patients were operated on by an experienced surgeon. Patient demographics, TNM stage, location of tumor, the intraoperative and postoperative details of the two groups were compared. Results In the 21 patients undergoing total laparoscopic gastrectomy, there were 15 of distal gastrectomy and 6 of total gastrectomy, compared with 21 and 7 in laparoscopy-assisted group. In total laparoscopic group, intracorporeal hand-sewn technique was used for gastro-jejunal and jejuno-jejunal (J-J)anastomosis, and 25 mm circular stapler was used for esophago-jejunal anastomosis. The operation time was significant longer in total laparoscopic group than in laparoscopy-assisted group of (279 ± 65 ) min vs.(232 ±40) min (P ＜ 0.05 ). No significant difference was observed between the two groups in proximal margin [(5.7 ± 1.5 )cm vs. (5.1 ± 1.4) cm, P ＞ 0.05] and distal margin [( 3.1 ± 0.9 )cm vs. ( 2.9 ±0.9) cm,P ＞0.05]. The iv narcotic use in laparoscopy-assisted group was 1.8 d but it was not used in total laparoscopic group. The first passing flatus was on day 3 in total laparoscopic group compared with 4.8 d in laparoscopy-assisted group. Both groups had 2 postoperative early complications, one intra-abdominal infection and one lung infection in total laparoscopic group compared with one wound infection and one lung infection in laparoscopy-assisted group. There was no anastomosis-related complications after 4 months of follow-up. Conclusions The operation time and postoperative early complication was acceptable for selected patients treated by total laparoscopic D2 radical gastrectomy with intracorporeal hand-sewn GI tract reconstruction in hands of experienced laparoscopic surgeon.

Effects of Apr-1 gene on cell cycle regulation of cholangiocarcinoma QBC939 cell lines / 中华普通外科杂志

Objective To investigate the role and the mechanism of Apr-1 gene on cholangiocarcinoma QBC939 cell lines proliferation and cell cycle regulation. Methods Apr-1 gene was transfected into QBC939 cells by using liposomes to establish a QBC939 cell model ( QBC939-Apr-1 ) stably expressing Apr-1 gene. Apr-1 mRNA expression and the changes in cell cycle and cell growth of QBC939 cells were analyzed by RT-PCR, flow cytometry ( FCM ) and growth curve before and after transfection. The regulatory effect of Apr-1 gene on the expression of cell cycle-related genes was investigated in QBC939 cells before and after Apr-1 transfection using cell cycle gene microarrays. Results Significant suppression of cell growth was observed with the cell model stably expressing Apr-1 gene. Apr-1 over-expression caused cell arrest from 9% to 13% (P ＜0. 01 ) increase in G2 population. Cell cycle gene microarrays demonstrated that the expression of Skp2 、UBE1 was up-regulated, while the expression of MRE11A 、CKS2 、CDK8 、CDC45 was down-regulated by more than 3 folds. Conclusions Apr-1 gene suppresses QBC939 cell proliferation in vitro, QBC939 cells presented with differences in the expression of cell cycle-related genes after Apr-1 gene transfection.

Effect of alanyl-glutamine on immune function of patients with gastric cancer / 中国康复理论与实践

@#ObjectiveTo investigate the effect of alanyl-glutamine supplemented total parenteral nutrition (TPN) on immune function of patients with gastric cancer.MethodsFifty gastric cancer patients with radical gastrectomy were randomly divided into the control group (n=25) and experiment group (n=25). Patients in the control group received conventional TPN support, and patients in the experiment group received TPN support and alanyl-glutamine (0.34 g/kg). All patients were observed for 7 days. The levels of IgG, IgA, IgM, CD3, CD4, CD8 and CD4/CD8 were measured before operation and on first and eighth day after operation.ResultsAll the levels of immune function were decreased on first day after operation in two groups. But the levels of IgG, IgA, IgM, CD3, CD4 and CD4/CD8 were significantly different between two groups on eighth day after operation (P<0.05). No serious infectious complication occurred in both groups.ConclusionTPN supplemented with alanyl-glutamine can improve the immune function of patients with gastric cancer radical gastrectomy.

Overexpression of Bax up-regulates the sensitivity of HCC-9204 cell apoptosis induced by adriamycin / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate whether Bax could regulate the sensitivity of human HCC-9204 cells to adriamycin.</p><p><b>METHODS</b>Overexpression of Bax was induced through inducible system and MT-II regulatory system, with addition of ZnSO(4) (100 micro mol L(-1)) as external inducer. Stable transfecting inducible expression vector containing Bax gene was performed. Apoptotic cells were measured by morphological criteria, and detection of apopto tic DNA fragmentation by TUNEL assay and flow cytometry. The ability of Bax to lower clonogenic cell survival rate was studied by colony-forming assay, while decrease of cell viability was assessed by MTT assay.</p><p><b>RESULTS</b>HC-9204 cells treated with adriamycin (20 micro mol/L) showed extensive cell death with nucleus fragmentation detected by TUNEL assay. FACS analysis showed a significant sub-G(1) peak and apoptosis in 31% cells 24 hr after treatment. Bax was able to significantly decrease clonogenic survival rate in adriamycin treatment group, showing time dependence. Bax could selectively sensitize HCC-9204 cells to cell death induced by DNA damaging agent-adriamycin.</p><p><b>CONCLUSION</b>Overexpression of Bax is able to sensitize HCC-9204 cell apoptosis induced by a driamycin.</p>

CONSTRUCTION OF AN INDUCIBLE VECTOR CARRYING GREEN FLUORESCENT PROTEIN / 解放军医学杂志

Objective To construct the inducible vector carrying green fluorescence protein(GFP). Methods We constructed an inducible vector pMD-GFP, including GFP cDNA, which allowed controlled expression of protein upon addition of 100 ?mol/L Zinc as an external inducer. The whole length of GFP cDNA were transfected into human hepatocellular cancer cells HCC-9204 by the method of lipofectin transfection. The expression of GFP was observed under fluorescence microscopy. Results The inducible vector carrying green fluorescence protein was successfully constructed. The observation under fluorescence microscopy showed that green fluorescence was spread in entire HCC-9204 cells transfected with GFP gene. Conclusion This new kind of the inducible vector could serve as a new tool and method for observing the growth and metastasis of neoplasm.

A study on the mechanism of adriamycin-induced apoptosis of human hepatic carcinoma cells / 中国普通外科杂志

0.05). ConclusionsAdriamycin can induce apoptosis of cancer cells, and this is an important mechanism for its anticancer effect. This effect may be related to the down regulation of Bel-2 (expression).

Overexpression of transfected p27~(KIP1) induces cell cycle arrest in G_1 phase and subsequent apoptosis of HCC-9204 cell line / 中国普通外科杂志

ObjectiveTo investigate the effect of p27 KIP1 transfection on cell cycle and apoptosis of hepatocellular carcinoma cells(HCC). MethodsWe used an inducible expression system pMD neo, which allowed controlled expression of protein upon addition of zinc as an external inducer. p27 KIP1 cDNA was transfected into human HCC 9204 cell line. Expression of p27 KIP1 was analyzed and cell growth was observed. ResultsExpression of p27 KIP1 in protein and mRNA increased significantly in HCC 9204 cell line transfected with p27 KIP1 . The cell growth reduced by 35%, p27 KIP1 over expression caused cell growth arrest at G 1 by 35% ( P =0 000). Apoptotic cell index significantly increased ( P =0 000).Conclusionp27 KIP1 may cause cell cycle arrest in G 1 phase and subsequently lead to apoptosis.

OVEREXPRESSION OF p27~(KIP1) INHIBITS GROWTH OF SGC7901 CELLS / 解放军医学杂志

To elucidate the effect of p27 KIP1 on cell cycle and proliferation of gastric carcinoma cells, we transfected the full e length cDNA of p27 KIP1 into human SGC7910 gastric cancer cells by the method of lipofectin transfection. Expression of p27 KIP1 at protein or mRNA level was analyzed by Western blotting, and RNA dot blotting, respectively. Effect of p27 KIP1 on cell growth was observed by trpan blue exclusion assay and anchorage independent growth in soft agar. Flow cytometry was applied to assess the effect of p27 KIP1 on cell cycle. The results showed that the expression of p27 KIP1 at protein or mRNA level increased evidently in SGC7901 cells transfected with p27 KIP1 . The cell growth was reduced by 42% 48h post induction with zinc as determined by cell viability assay. The rate of anchorage independent growth in soft agar decreased significantly. p27 KIP1 over expression caused cell arrest at G 1 by 36%(from 33 68% to 69 29%, P

Biological effect of p27~(KIP1) on gastric carcinoma cells SGC7901 in nude mice / 中国普通外科杂志

Objective To determine the biological effect of p27 KIP1 on gastric carcinoma cells SGC7901. Methods The total length of p27 KIP1 cDNA was transfected into human gastric cancer cells SGC7901 by lipofectin transfection. Expression of p27 KIP1 in protein or mRNA level was examined by Western blotting and RNA dot blotting respectively. Effect of p27 KIP1 on cell growth was observed by trpan blue exclusion assay. Tumorigenicity test in nude mice was applied to assess the biological effect of p27 KIP1 in vitro. Results Expression of p27 KIP1 in protein or mRNA increased evidently in SGC7901 cells transfected with p27 KIP1 . The cell growth was reduced by 42% about 48h after the induction with Zn 2+ ,which was determined by cell viability assay. The tumorigenicity of nude mice was reduced evidently(P