Objective: To investigate the application of complete mesocolic excision (CME) in colon cancer surgery. Methods: The clinical data of 34 patients with colon cancer undergoing CME with central vascular ligation (CVL) between December 2009 and June 2012 were retrospectively analyzed. Results: The postoperative UICC pathological stages of the patients were stage I in 4 cases, stage II in 14 cases and stage III in 16 cases, respectively. The median number of lymph nodes dissected was 18 lymph nodes, and 18.8% (3/16) of the stage III patients had positive metastatic lymph nodes in the root of the mesocolon. There was no perioperative death or associated injury in the entire group. The operative time was 2.5-3.5 (median 2.75) h, intraoperative blood loss was 80-200 (median 110) mL, time to first passing of flatus and first defecation after surgery was 3-5 (median 4) d and 4-6 (median 5) d, respectively, and length of postoperative hospital stay was 11-20 (median 14) d. The postoperative complications included 3 cases of wound infection, and one case each of lung infection and chyle leakage. There was no anastomotic leak or bowel obstruction during the short postoperative period. The 34 patients were followed up for 6 months to 2 years during which no local recurrence occurred, but one case developed liver metastases 16 months after surgery and died 3 months later. Conclusion: CVL combined with CME for colon cancer is safe and feasible, and has favorable short-term efficacy. It can possibly become a standardized surgical technique for colon cancer.

Objective: To screen new tumor markers for colorectal cancer (CRC) through analyzing the differential protein expression profiles between CRC and normal mucosa by using two-dimensional fluorescence difference gel electrophoresis (2D-DIGE)-based proteomic techniques. Methods: The differentially expressed proteins were analyzed in six fresh CRC specimens and paired normal mucosa by 2D-DIGE and then identified by matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS), respectively. Thereafter, the proteins of interest were verified by immunohistochemical method in 46 cases of CRC and normal mucosal tissues. Results: 2D-DIGE analysis and MALDI-TOF-MS identification showed that the significantly up-regulated proteins in CRC tissues were ubiquinol cytochrome-c reductase core protein 1 (UQCRC1), 14-3-3 ζ and desmin etc., and the significantly down-regulated proteins were carbonic anhydrase (CA) I and CAII etc. (all P<0.05). The results of immunohistochemical staining revealed that the expression intensities of UQCRC1 and 14-3-3 ζ in CRC tissues were 2.43±0.81 and 1.41±1.07 respectively, which were significantly higher than those in normal mucosal tissues (1.80±0.96 and 0.67±0.94) (P<0.001), while the desmin expression had no significant difference between the two tissues (P>0.05); the expression intensities of CA I and CA II in CRC tissues were 1.67±0.52 and 1.18±0.84 respectively, which were significantly lower than those in normal mucosal tissues (2.93±0.25 and 2.80±0.50) (P<0.001). Conclusion: The 2D-DIGE-based proteomic techniques combined with immunohistochemical method are effective means to screen new tumor markers. UQCRC1, 14-3-3 ζ, CA I and CA II may potentially become the novel markers or therapeutic targets of CRC.

Objective: To investigate the hepatoprotective effect of hypothermic infusion of self-prepared hepatic protective solution during portal vein occlusion (PVO) in rats with obstructive jaundice. Methods: Seventy-two rats underwent common bile duct ligation, and one week later were equally randomized into control group (recanalization of bile duct and only portal vein isolation), portal vein obstruction (PVO) group (recanalization of bile duct and PVO for 1.5 h), lactated Ringer’s solution infusion group (recanalization of bile duct and portal vein infusion with 4 ℃ lactated Ringer’s solution during PVO) and self-prepared hepatic protective solution infusion group (recanalization of bile duct and portal vein infusion with 4 ℃ self-prepared hepatic protective solution during PVO). The specimens of rats’ livers from each group were harvested at 0, 6 and 24 h respectively after surgery, and then the expressions of bcl-2, Bax and caspase-3 protein in liver tissues were detected by Western blot analysis, and the liver cell apoptosis rates were measured by TUNEL assay. Results: Compared with control group, the bcl-2 expression in the liver tissues of PVO group increased slightly at each time point after surgery, but all the differences had no statistical significance (all P>0.05), while the bcl-2 expressions in the liver tissues of the two solution infusion groups were significantly increased at 6 and 24 h after surgery (all P<0.05), which were more evident in self-prepared hepatic protective solution infusion group (all P<0.05); the expressions of Bax and caspase-3 protein in the liver tissues as well as liver cell apoptosis rates of PVO group significantly increased at 6 and 24 h after surgery (all P<0.05), and the two infusion solutions significantly inhibited the elevation of Bax and caspase-3 protein expression and reduced the liver cell apoptosis rate (all P<0.05), and these effects were more pronounced in self-prepared hepatic protective solution infusion group (all P<0.05). Conclusion: Self-prepared hepatic protective solution has hepatoprotective effect during PVO in rats with obstructive jaundice, and the mechanism is related to the inhibition of liver cell apoptosis of mitochondrial pathway.

Objective: To investigate the clinicopathological diagnosis and management of gastrointestinal stromal tumors (GISTs). Methods: The clinicopathological data of 100 GISTs patients were retrospectively analyzed. Results: All patients had a single lesion on CT scan, of whom 79 cases had a benign lesion that presented as soft tissue mass with uniform density, and 21 cases had malignant tumor that showed a lobulated mass with low-density necrotic areas of variable sizes inside. The dual-phase contrast-enhanced CT scan demonstrated that there were ulcers of varying sizes in the tumor cavity, and the ulcers in 7 cases of malignant tumor were large and deep. The masses were heterogeneously enhanced under contrast-enhanced CT scan, and no enhancement was seen in the cystic necrotic area. The lesions of 56 cases were located in the stomach, 26 cases in the duodenum, 10 cases in the small bowel, 6 cases in the colon and rectum, and 2 cases in the mesentery. The pathological examination of the surgical specimens showed cell nests composed of spindle-shaped tumor cells with the typical arrangement of GISTs. All patients underwent complete resection, no lymph node metastasis was found and no intraoperative or postoperative death occurred. The average length of hospitalization was 15.2 d. The follow-up period ranged from 6 months to 24 months, during which time 5 malignant GIST patients died and all the the deaths were due to liver metastases; tumor recurrence occurred in 28 patients (28%), of whom 12 cases were borderline tumors and 16 cases were malignant tumors; 16 cases had local recurrence and 12 cases had peritoneal recurrence. All of the recurrent cases were alive during the 3-month follow-up period after a second resection. Conclusion: The diagnosis of GISTs depends on the clinical manifestations, CT scan findings and pathological examination, and GISTs may have better outcomes after early surgical resection.

Investigations reveal thymidine phosphorylase has the effects of promoting tumor angiogenesis and inhibiting cell apoptosis, and is closely related to the prognosis and outcome of the cancer patients. Meanwhile, it is also the key converting enzyme for the prodrugs of 5-fluorouracil such as 5'-deoxy-5-fluorouridine. This paper reviews the advances in the investigation of thymidine phosphorylase, including its expression and function in colorectal cancer tissue, converting effect on 5'-deoxy-5-fluorouridine and therapeutic potential.

FLJ10261 (TEME16A) is a recently defined gene that is closely related to gastrointestinal stromal tumors (GISTs). The DOG1 protein encoded by this gene is specifically expressed in GISTs, and its positive expression is more extensive and specific than the expressions of KIT and PDGFRA as proved by immunohistochemistry and in situ hybridization. Thus, it may become an alternative therapeutic target for GISTs. This paper reviews the recent advances in the relationship between DOG1 and GISTs.