Abstract:Abstract:Objective:To investigate the correlation of pathologic factors with the prognosis of colorectal cancer patients with peritoneal dissemination and/or synchronous liver metastasis, and the effect of surgical intervention on the prognosis.
Methods :Based on our 12-year database, the clinicopathologic data and the result of follow-up of colorectal cancer complicated with peritoneal dissemination(150 cases) and/or synchronous liver metastasis(166 cases) were analyzed retrospectively.
Results:Multi-variate analysis indicated that peritoneal dissemination from colorectal cancer was associated with the depth of tumor infiltration and tumor differentiation, while liver metastasis was associated with tumor differentiation, depth of tumor infiltration and the Dukes staging（P＜0.01）.Both short-term and long-term overall survival rates showed no statistical difference between unresectable colorectal cancer patients with peritoneal dissemination and unresectable colorectal cancer patients with liver metastasis（P＞0.05）. However, in the resectable colorectal cancer patients,long-term overall survival of the patients with peritoneal dissemination was significantly better than those with liver metastasis（P＜0.01）.
Conclusions:Patients with peritoneal dissemination have better long term prognosis than those with liver metastasis in colorectal cancer.Only the unresectable peritoneal dissemination or liver metastasis is indicative of end-stage colorectal cancer. Radical resection of colorectal cancer with peritoneal dissemination has a better prognosis than radical resection for patients with synchronous liver metastasis. Radical excision could be achieved in patients with local peritoneal dissemination.

Abstract:Abstract:Objective: To study the safety and feasibility of laparoscopic TME with ultra-low sphincter-saving procedure for low rectal cancer.
Methods :The clinical data of laparoscopic TME with ultra-low sphincter-saving modified procedure for low rectal cancer in the recent three and a half years in our hospital were analysed retrospectively.
Results:Eighteen cases were selected in this study and all surgery was performed successfully. The average operative time was（165.2±45.6）min, the mean volume of bleeding was（146.7±84.5）mL, the volume of abdominal drainage was（170.1±47.2）mL, postoperative time of bowel gas passage was（3.1±0.7）d, postoperative hospital stay was（8.7±1.4）d, and the number of lymphnode dissection was（12.1±3.2）. 5 cases had increased frequency of stool and all these patients recovered to near normal within one year. No other complications, such as ureteral ingury, dysuresia, fecal incontinence, or anastomotic leakage, were experience.
Conclusions:This study shows that it is safe and feasible to perform laparoscopic TME with ultra-low sphincter-saving procedure for low rectal carcinoma, and with the advantage of minimal invasion.

Abstract:〗Abstract:Objective:To evaluate the feasibility of laparoscopic resection for colorectal carcinoma in terms of economics.
Methods :Four hundred and fifty-four patients underwent radical resection for colorectal carcinoma in our hospital during recent three and a half years. Among them, 191 underwent open resection and 263 received laparoscopic resection. The total hospital charges and main subitems between the two groups were comparatively analyzed.
Results:The mean total hospital charges in the open group was thirty-one thousand yuan vs. thirty-three thousands yuan in the laparoscopic group. The difference was two thousands yuan, but there was no statistical significance (P＞0.05). Medicine fees, radiology fees, laboratory fees, test fees and operation fees were similar in both groups, and no significant difference could be seen(P＞0.05). The median therapy fees in the open group was nine thousand yuan vs. eleven thousand yuan in the laparoscopic group, and the difference was significant (P＜0.05).
Conclusions:Since the total hospital charges of laparoscopic surgery for colorectal cancer were just a little more than that of open procedure, and the former had the advantages of minimal invasion. It is worthy to perform laparoscopic surgery for patients with colorectal carcinoma.

Abstract:Abstract:Objective:To study the predictive factors of lymph node metastasis in differentiated submucosal gastric cancer (DSMGC), and to establish an objective and rational criteria of indications of endoscopic mucosal resection for DSBGC.
Methods : Clinicopathological data from 70 patients with differentiated submucosal gastric cancer were collected and the relationship between their clinicopathological characteristics and lymph node metastasis was retrospectively analyzed by univariate and multivariate analysis.
Results:Lymphatic vessel tumor emboli and presence of intermingled components of undifferentiated cancer cells (risk factors) were significantly associated with lymph node metastasis(P＜0.05). Patients with both risk factors had lymph node metastasis rate of 75%, patients with no risk factors had no lymph node metastasis.There were 26 lymph node metastases in 11 patients, and 17 of the metastasic lymph nodes were in N1, while 9 metastatic lymph nodes were beyond N1.
Conclusions:Lymphatic vessel tumor emboli and presence of intermingled components of undifferentiated cancer cells were independently related to lymph node metastasis in differentiated submucosal gastric cancer. It is rational for the paitients with one or two independent risk clinicopathological characteristics to undergo an endoscopic mucosal resection.

Abstract:Abstract:Objective:To investigate the clinicopathologic characteristics, diagnosis and treatment of gastrointestinal stromal tumor (GIST).
Methods :Clinical data of 218 patients with GIST who underwent surgical en bloc resection were analyzed retrospectively. Light microscopy was used to study the morphologic characteristics, and the expression of CD117, CD34, S-100, Vimentin (VIM), and smooth muscle actin (SMA) was detected by S-P immunohistochemical method.
Results:The primary sites of GIST were in stomach in 69.7%(n=152), in small intestine 12.4%(n=27), in colorectum 13.8%(n=30), and in esophagus 4.1%(n=9). Among them, malignant tumors accounted for 53.2% (n=116). Most of GIST patients initially presented with an abdominal mass and alimentary tract hemorrhage. In addition, the diagnosis was confirmed by histopathology and immuno-histochemistry in all the patients. CD117 showed diffuse strong expression, CD34 and VIM often showed diffuse strong expression, and SMA and S-100 occasionally showed focal expression, and the positive rates were 100%, 76.2%, 38.1%, 4.8%, and 4.8%, respectively. There was no significant difference in the expression of CD117, CD34, S-100, VIM, and SMA protein in benign versus malignant GIST (P＞0.05). Fifty-eight GIST patients who were treated surgically were followed up from six months to three years. Nineteen patients had recurrent malignant disease, and 5 of them were managed with further surgery.
Conclusions:CD117 is a sensitive and specific marker for the diagnosis of GIST, but immunophenotype is not a predictor of the malignancy of GIST. Surgical resection, including en bloc resection of the tumors, is the only curative treatment.

Abstract:Abstract:Objective:To study the diagnosis and treatment of small intestinal stromal tumor(SIST).
Methods:We retrospectively analysed the clinical information of 32 patients with SIST.
Results:The average onset age of the patients was 52.8 years. The main clinical manifestations were dark stools, abdominal pain, abdominal mass, abdominal distention, fever, debilitation, anaemia, and loss of body weight. The tumors were located in jejunum in 26 cases, in ileum in 5 cases, and 1 patient had multiple tumors in both jejunum and ileum. The abdominal mass was discovered by B-ultrasonography in 12 patients. Among the 12 cases, 4 cases were diagnosed with the tumor located in intestinal tract, in 5 cases the origin of the tumor could not be determined, and 3 cases were misdiagnosed as tumor of the ovary. Tweenty patients who received CT scan were all discovered to have primary tumors or metastatic lesions. The CT positive detection rate was 100%, and 15 of the tumors were confirmed to be located in intestinal tract (75%). In 6 of 8 patients,the intestinal tumors were discovered by digital subtraction angiography (DSA); 5 patients were diagnosed with intestinal tumor by small intestinal endoscopy. There were no positive findings in the 4 patients who received radiographic studies of digestive tract. All patients received surgical operation. Their diagnosis was confimed as stromal tumor by pathology and immunohistochemistry. Tweenty-two patients were followed up from 6 months to 5 years, 4 patients had recurrence, 2 hepatic metastasis, and 2 died.
Conclusions:stromal tumor of jejunoileum lacks distinctive clinical manifestations, CT and DSA can be of benefit in diagnosis, and small intestinal endoscopy is an effective way for diagnosis. Operation and molecular targeted therapy are effective treatment of SIST.

Abstract:Abstract:Objective:To analyze the independent factors affecting the prognosis of gastrointestinal stromal tumor (GIST) patients undergoing radical operation.
Methods :The clinical characteristics and follow up data of the 97 patients with GIST underwent radical opsration from January, 2001 to January, 2003 in our hospital were retrospectively analyzed by univariate and multivariate methods.
Results: In the univariate analysis of the 97 cases, gender, tumor location, tumor size, tumor cell type, necrosis, mitotic count, and Gleevec administration postoperatively were found to be related to the prognosis of GIST. Multivariate Cox model analysis showed that tumor location, tumor size, tumor cell type, necrosis, mitotic count, and Gleevec administration postoperatively were independent prognostic factors for patients with GIST.
Conclusions:Tumor location, tumor size, tumor cell type, necrosis, mitotic count are important prognostic factors for patients with GIST undergoing radical operation.

Abstract:Abstract:Objective:To study the effects of exogenous RASSF1A gene on the proliferation of gastric carcinoma cell line SGC7901.
Methods :The mammal expression vector pcDNA3.0-RASSF1A and pcDNA3.0 were introduced into SGC7901 cell line by lipofectin transfection, and the SGC7901 cells stably overexpressing RASSF1A gene were established by G418 selection. The expression of RASSF1A gene was detected by Western blotting and RT-PCR. The cytobiologic characterizations of the positive clone were analyzed by MTT assay, cytometry, colony assay, and tumorigenicity experiment.
Results:SGC7901 cells with stably expression RASSF1A protein were established by lipofection mediated transfection and selected for further study. Compared with the non-transfected and vector transfected cells, the positive clone cells developed more slowly; flow cytometric data showed that more positive clone cells went into phase G0/G1 and less cells went into phase S(P＜0.05); colony formation efficiency of the positive clone cells was lower than that of non-transfected and vector transfected cells(P＜0.05). The average weight of tumor tissue in nude mice in positive clone cells was less than that of non-transfected and vector transfected cells(P＜0.05).
Conclusions:RASSF1A gene can suppress the proliferation of SGC7901 cell line.

Abstract:Abstract:Objective:To observe the effects of VEGF antisense oligonucleotide transfected to SGC-7091 cell line on expression of VEGF and survivin of the cell.
Methods :The VEGF-ASODN was synthesised artificially. There were five groups in this experiment: control group, missense group and three various concentration groups. After transfection, RNA copies were detected by real-time PT-PCR,VEGF protein in cell and culture supernate was detected by ELESA, survivin protein was measured by Western-blot, and apoptosis was detected by FCM. Growth of cells was evaluated by growth curve.
Results:VEGF-ASODN tranfection reduced the VEGF mRNA and VEGF protein expression in gastric cancer cells and supernate remarkably. It also reduced survivin protein expression and increased apoptosis in gastric cancer cells.
Conclusions:Transfection with VEGF-ASODN to gastric cancer cells SGC-7901 can reduce the expression of VEGF, and can increase apoptosis and suppress the proliferation of gastric cancer cells.

Abstract:Abstract:Objective:To investigate the effect of transforming growth factor-β1 on metastasis and invasion of gastric cancer and its mechansism.
Methods :The changes of bilogical behaver of gastric cancer SGC7901 and BGC823 cell line were tested after pretreatment by TGFβ1 at 0 or 10 ng/mL,and liver metastasis was measured 4 weeks after inoculation in Balb/c nude mice.
Results:SGC7901 and BGC823 cells treated with TGF-β1 had more hepatic metastases and the effect of penetrated reconstituted basement-membrane barriers increased significantly than that untreated control cells did. Likewise, there was an apparent increase in tumor cell migration and adhesion capacity after treating with TGFβ1.
Conclusions:These results suggest that TGF-β1 may modulate metastatic potential of gastric cancer cells by promoting their ability to break down and penetrate basement membrane barriers and by their adhesive and motile activities. TGF-β1 acts on SGC7901 and BGC823 cells as a progression-enhancing factor.

Abstract:Abstract:Objective:To investigate the protection effect of β-aescin on rat intestine ischemia /reperfusion (I/R) injury.
Methods :Eighty-eight male wistar rats were randomly divided into two groups, then they were distinguished by different time point after occurrence of reperfusion at 0 h, 1 h, and 2 h. We observed the changes of the serum tumor necrosis factor-α， interleukine-6, the apoptosis of intestine mucosal epithelial cell, intestinal microvascular permeability, and the survival rate.
Results:The group with β-aescin pretreatment was observed to have reduction of intestinal histopathological damage, and significant decrease of Haglund scores, intestinal microvascular permeability, intestinal water content and the level of TNF-α and IL-6 (P＜0.01), and inhibition of intestinal mucosa cell apoptosis (P＜0.05) and mortality rate during 36 hours (P＜0.01) compared to controlled group with I/R after reperfusion.
Conclusions:The β-aescin pretreatment could protect the intestinal mucosa from I/R injury, and it might be related to suppression of proinflammatory factors, reduction of intestinal mucosa cell apoptosis and decreased intestinal microvascular permeability.

Abstract:Abstract:Objective:To study the expression of galectin-3 in liver metastasis from colon cancer and its inhibition by modified citrus pectin（MCP）in mice.
Methods :Seventy-five Balb/c mice were randomly divided into 5 groups: negative control group, positive control group，low concentration MCP group, middle concentration MCP group and high concentration MCP group. CT-26 colon cancer cells were injected into the subcapsule of spleen in mice to establish a colon cancer liver metastasis model, but ont in the negative group. The concentration of MCP in drinking water was 0.0%, 1.0%, 2.5% and 5.0%(w/v) in 4 cancer model groups respectively. Liver metastasis was observed after 3 weeks. Enzyme-linked immunosorbent assay (ELISA) was used to detect the concentration of Galectin-3 in serum, and tissue microarray technique and immunohistochemistry to analyze the expression of Galectin-3 in liver metastasis.
Results:(1) Except in the negative control groups, the median volume of splenic primary lesions in each group was 1.51 cm3、0.93 cm3、0.77 cm3 and 0.70 cm3 respectively.The volume in middle and high concentration MCP groups were significantly smaller than that in positive control group (both P＜0.05).(2)Except in the negative group, the percentage of liver metastasis in each group was 100%, 80%, 73.3% and 60% respectively. The number of liver metastases in high concentration MCP groups was significantly fewer than in positive control group(P＜0.05). (3)The concentration of galectin-3 in serum in positive control group and MCP-treatment groups was significantly higher than in the negative groups (P＜0.01). But between the positive control group and MCP-treatment groups, there was no significant difference (all P＞0.05).(4) Except in the negative groups, the expression of galectin-3 in liver metastases in each group showed no significant difference (all P＞0.05).
Conclusions:The expression of galetin-3 was obviously increased in liver metastasis from colon cancer, and MCP can effectively inhibit the development of liver metastasis of colon cancer.

Abstract:Abstract:Objective:To observe the therapeutic effect of gastric bypass operation on non-obese type 2 diabetes.
Methods :Retrospective analysis the clinical data of 103 non-obese patients with type 2 diabetes underwent gastric bypass operation in our hospital during the last five years, including the body mass index,the fasting blood glucose level,the insulin resistance index,the changes in glycosylated hemoglobin before and after surgery, and the turnover of the diabetes condition six months after surgery.
Results:Postoperatively, comparing to before operation, there was no significant difference in body mass index (P＞0.05); one week after surgery,the fasting blood glucose level showed a sustained and steady downward trend (P＜0.05). With the decrease of the fasting blood glucose,the insulin resistance index and glycosylated hemoglobin also decreased significantly (P＜0.05). Diabetes cure rate was 79.6 percent overall six months later,and there was no significant difference in the control of diabetes between the different types of gastric bypass operation:esophago-jejunum Roux-en-Y surgery and Mo′s gastro-jejunum anastomosis(P＞0.05).
Conclusions:Gastric bypass operation has a good therapeutic effect on type 2 diabetes in the non-obese patients, and this therapeutic effect is not dependent on loss of body weight.

Abstract:Abstract:Objective:To explore the etiology, diagnosis and treatment of functional delayed gastric empting(FDGE) after nongastrectomy abdominal operation.
Methods :The clinical data of twenty-eight patients with FDGE in our hospital from Dec.1995 to Jan. 2007 were analyzed retrospectively.
Results:FDGE usually occurred at 4~16 days postoperatively. lt was characterized by upper abdominal distension, vomiting, loud gastric splashing sound, and large amount of gastric drainage ranging from 1 000 to 2 500mL per day. Tweenty-one cases(75.0%) were diagnosed by gastroscopy and 7(25.0%) by barium meal. All the patients recovered with conservative treatment, and gastric motility was restored at 6-38 d (average 7.6 d) after operation in all the cases.
Conclusions:The etiology of FDGE after nongastrectomy abdominal operation is related to multiple factors. Gastroscopy is valuable in the diagnosis and treatment of FDGE. FDGE can be cured by nonsurgical treatment.