Objective To review the relation between alpha fetoprotein(AFP) and gastric carcinoma as well as the advancement of literatures about the alpha fetoprotein-producing gastric carcinoma(AFPGC).Methods Domestic and foreign literatures on AFPGC were collected and reviewed.Results AFP is very useful to the diagnosis,pathological type and prognosis of the AFPGC as a specific tumor marker.Conclusion AFPGC is a special type of gastric cancer with high degree of malignancy and poor prognosis.

Objective To investigate the expressions of matrix metalloproteinase-26(MMP-26) and sialyl Lewis-X(SLeX) in breast carcinoma and their relation with lymphaden metastasis.Methods The expressions of MMP-26 and SLeX protein in breast carcinoma(n=120),metastatic lymph node(n=71) and normal mammary gland tissue(n=30) were studied by catalyzed signal amplification(CSA) immunohistochemical method.Results The positive rate of MMP-26 and SLeX protein expression were 16.7%(5/30) and 20.0%(6/30) in normal breast tissues,and 63.3%(76/120) and 86.7%(104/120) in breast carcinoma,resepectively.The expressions of MMP-26 and SLeX protein in breast carcinoma tissues were significantly higher than those in remote normal breast tissues(P0.05).The positive rate of MMP-26 and SLeX protein expression were 23.9%(17/71) and 88.7%(63/71) in metastatic lymph node,resepectively.The expression of SLeX protein in metastatic lymph node was correlated with that in tissues of breast carcinoma(r=0.874,P

Objective To explore the management strategy of damage control operation(DCO) for extrahepatic bile duct injury.Methods Clinical data of 15 cases with extrahepatic bile duct injury from June 2002 to September 2007 were selected as the object of this study.Results DCO was performed in all of 15 patients,then all cases were underwent reoperation after surgery intensive care unit resuscitation.All cases survived.Two cases(13.3%) occurred biliary fistula and 1 case(6.7%) occurred intestinal fistula of colon after reoperation,2 cases(13.3%)occurred infection and disruption of incisional wound,and 1 case(6.7%) occurred acute liver function failure.All complications were cured by drainage,symptomatic and supportive treatment.The cure rate of these 15 cases was 100%.There were no stricture of bile duct and correlative complications during 28 months of median follow-up.Conclusion To increase survival rate and reduce complications,severe trauma patients with extrahepatic bile duct injury should be made positively under DCO and choose eligible operations modus.

Objective To construct the recombinant of hepatocellular carcinoma-targeting adenovirus containing r-Caspase-3 gene and provide the gene therapic strategy for hepatocellular carcinoma. Methods The pAdTrack-EAFP-PALB was constructed and the r-Caspase-3 gene was subcloned into the vector. The linearized shuttle plasmid was homogenously recombined with AdEasy-1 in BJ5183 cells. The candidate clone was analyzed by restriction endonuclease digestion and sequencing, and then pAdEasy-EAFP-PALB/r-Caspase-3 vector was digested with PacⅠand transfected into AD293 cells for packaging and amplifying, recombinant virus was constructed successfully. Infection titer and efficiency of recombinant virus were monitored by green fluorescent protein (GFP) expression. The expression of r-Caspase-3 in infected HepG2 cells was detected by RT-PCR and Western blot. The apoptosis of HepG2 cells was detected by SRB dyeing method. Results Shuttle vector pAdTrack-EAFP-PALB/r-Caspase-3 was correct after identification by restriction endonuclease analysis and sequencing. By PCR and PacⅠ restriction endonuclease analysis, the homologous recombinant of pAdEasy-EAFP-PALB/r-Caspase-3 was successful. The expression of GFP was observed when linearized pAdEasy-EAFP-PALB/r-Caspase-3 was transfected into AD293 cells. AD293 cells could be infected repeatedly by recombinant adenovirus. The expression of r-Caspase-3 gene on HepG2 cells was detected by RT-PCR and Western-blot methods respectively, which confirmed that the Ad-EAFP-PALB/r-Caspase-3 was constructed successfully. The specificity of Ad-EAFP-PALB/r-caspase-3 which targeting induced hepatocellular carcinoma cells was founded by SRB dyeing test. Conclusion The Recombinant of hepatocellular carcinoma-targeting adenovirus containing r-Caspase-3 gene was constructed successfully and which established the foundation of r-Caspase-3 gene therapy in future research to hepatocellular carcinoma.

Objective To discuss the feasibility and safety of early enteral nutrition (EN) on treatment of severe acute pancreatitis (SAP) and its influence. Methods The advancement about application of early EN on treatment of SAP in recent years were reviewed. Results In patients with SAP, early EN via catheter placed in the jejunum could protect the integrity of intestinal barrier and reduce infectious complications. But no consensus had been reached about the starting time, ingredient and infusion mode yet. Conclusion Early EN may have positive effects on treatment of SAP, but further researches are still needed.

Objective To review the biologic characteristics and biologic effect of cholecystokinine (CCK) on the central nervous system. Methods The literatures of recent years on research advancement of cholecystokinine as neurotransmitters/peptides in signal transduction, neuron protection and pain management in the central nervous system are reviewed. Results CCK possesses the ability to suppress the convulsant effects of convulsants. CCK8 is able to reduce the neural damage caused and delay the neural aging. CCK antagonists play an important role in human pain transduction. Conclusion CCK has been proven to be one of the richest neurotransmitters/neuropeptides as well as an important signal factor in the brain, and its important biologic effect is being confirmed.

Objective To investigate the diagnostic value of CT scanning and MR imaging on acute cholecystitis.Methods The CT or MR imaging data of 21 patients with proved acute cholecystitis were retrospectively reviewed.Eleven patients were examined with contrast-enhanced multi-detector-row spiral CT scanning and other 10 cases underwent contrast-enhanced MR imaging.Results Nineteen patients showed obscure gallbladder outlines(90.5%).The gallbladder wall demonstrated even thickening in 15 patients(71.4%) and irregular thickening in 6 cases(28.6%).All patients showed inhomogeneous enhancement of the gallbladder wall(100%).The bile was hyper-dense or hyper-intense on T1W image in 11 cases(52.4%).Ten cases had free peri-cholecystic effusion(47.6%),and 16 cases had peri-cholecystic adhesive changes or fat swelling(76.2%).Patchy or linear-like transient enhancement of the adjacent hepatic bed in the arterial phase was seen in 16 cases(76.2%).Twelve patients developed pleural effusion,or ascites,or both(57.1%).Gallbladder perforation complicated with peritonitis was seen in one case,micro-abscess formation and pneumocholecystitis was observed in another case,and one case had gallbladder diverticulum.Conclusion Wall blurring,pericholecystic adhesion or fat edema,and transient enhancement of adjacent hepatic bed in the arterial phase are the imaging findings specifically associated with acute cholecystitis,which are readily appreciated on contrast-enhanced multi-phasic CT and MR scanning.

Objective To evaluate the efficacy of transcatheter arterial chemoembolization(TACE) combined with radiofrequency ablation(RFA) in treating primary hepatocellular carcinoma(HCC).Methods From March 2004 to March 2006,137 patients with primary HCC underwent TACE alone(n=87) and TACE+RFA(n=50),respectively,after the interventional treatment,all patients periodically received CT reexaminations and alpha fetoprotein(AFP) measurement.The therapeutic efficacy,AFP level and survival rate between two groups were compared with each other.Results In TACE group the effective rate(CR+PR) was 34.5%,AFP decreasing amplitude was 54.2%,and 2 years survival rate was 43.7%.While in TACE+RFA group,the effective rate(CR+PR) was 70.0%,AFP decreasing amplitude was 78.0%,and 2 years survival rate was 62.0%,there were significant differences between two groups(P

Objective To investigate the correlation among lymph node metastasis and clinical features,postoperative survival rate in rectal cancer.Methods Seventy-nine patients who had accepted total mesorectal excision(TME) were collected,and the correlation among their clinical features(including gender,age,tumor size,gross type,depth of infiltration,histology type,differentiated degree and the level of blood serum CEA),lymph node metastasis,and postoperative survival rate were analyzed.Results There was significant correlation between six factors(namely the tumor size,gross type,depth of infiltration,histology type,differentiated degree and the level of blood serum CEA) and lymph node metastasis in single factor analysis.However,multivariate analysis showed that only gross type of tumor and depth of tumor infiltration were related to lymph node metastasis.The postoperative survival time of 43 non-metastasis cases was remarkably longer than that of 33 cases with lymph node metastasis(?2=18.806,P=0.000),and it was longer in 22 cases with

Objective To validate the accuracy of the colorectal cancer model of the Association of Coloproctology of Great Britain and Ireland(ACPGBI-CCM),and to find out the relationship between clinical risk factors and the predictive value produced by ACPGBI-CCM.Methods The patients diagnosed definitely as colorectal cancer in the department of anal-colorectal surgery,West China hospital from April 2007 to July 2007 were analyzed retrospectively.And the predictive value of mortality for each patient was calculated by ACPGBI-CCM,then the difference of risk factors was compared by classifying the patients into lower risk group and higher risk group by making the median predictive mortality as a cut point.Results From April 2007 to July 2007,a total of 99 patients diagnosed definitely as colorectal cancer accepted treatment,and among which 67 patients included in this study were admitted whose average age was 60.09 years.And there were 34 male and 33 female patients;15 right hemicolon cancer,9 left hemicolon cancer,43 rectal cancer;Dukes staging:A 0 case,B 37 cases,C 24 cases,D 6 cases.The observed mortality 30 days after operation was 0,whereas the predictive mortality was 0.77%-25.75% with a median value of 3.36%.Then the patients whose predictive mortality were ≤3.36% were grouped as lower risk group(34 cases),the others higher risk group(33 cases),and there was strikingly different predictive mortality between two groups 〔(8.86?4.51)% vs(1.76?0.68)%,P0.05).Furthermore,stratification analysis was made for risk factors,and it came out that there were great differences of predictive mortality for different age groups and ASA grading,having internal medicine complications or not,having chemotherapy or not,and for cancer resected or not,and the differences were statistically significant(P0.05).Conclusion The clinical applicability of the ACPGBI-CCM is ascertained in such a large volume single medical centre,but the ACPGBI-CCM overpredicts the mortality in this study which may be attributed to the different areas,nations,or the different cultures.The complications and the neo-adjuvant or adjuvant therapy are further found out that they may be independent predictive factors of survival,and more research will be needed to prove this.