Objective To explore the feasibility,safety,efficacy and mechanism of intraoperative regional chemotherapy of advanced gastric cancer. Methods The related literatures were reviewed and analyzed. Results Compared with systemic chemotherapy,intraoperative regional chemotherapy of advanced gastric cancer could increase blood drug concentration of cancerous tissue,reduce the systemic toxic side effects,increase survival rate and improve the quality of life. Conclusion Intraoperative regional chemotherapy,as an adjuvant treatment of advanced gastric cancer,has been gradually applied to clinic because of the definite curative effect,which is worth popularizing. However,it needs systemic researches and accumulation of cases.

Purpose: To discuss the feasibility and effect of reserving fertility treatments for young patients with ovarian malignant tumors. Methods: Retrospective analysis of clinical data of 40 patients receiving conservative treatments. Results: Among the 40 cases, there were 25 cases of malignant ovarian germ cell tumors, 13 cases of epithelium carcinomas, 2 cases of sexual cord mesenchymal tumors. 34 patients have survived till now, among which there are 20 cases of malignant ovarian germ cell tumors, 12 cases of epithelium carcinomas, 2 cases of sexual cord mesenchymal tumors. 8 patients relapsed after the first operation, six of which had hysterectomy as second operation. Among the 32 surving patients who have preserved their uterus, 31 patients have normal menstruations. 11 patients married and 6 patients had successful pregnancies. Conclusions: We should try our best to preserve the fertility of young patients with ovarian malignant tumors.

BACKGROUND: Heme oxygenase-1 (HO-1) plays an important role on preventing tissues and organs from oxidant stress injury, which remains currently one of the most active areas of investigation. OBJECTIVE: To study HO-1 over-expression on the survival and fiver function of rats after reduced-size liver transplantation by constructing recombinant adenovims Ad5-HO-1.DESIGN, TIME AND SETTING: Randomized controlled animal study was performed in the Institute of Pediatrics, Children Hospital Affiliated to Chongqing Medical University from September 2003 to March 2005. MATERIALS: Seventy-four SD rats were used to establish in situ reduced-sized liver transplantation models. METHODS: Recombinant adenoviral vector encoding Ha-1 gene (AdS-HO-1) was generatred by molecular biology method, wluch was administered to donors via voln at 48 hours before transplantation. All rats were randomly divided into control group(n=12),saline group(n=12), cobalt protoporphyrin (CoPP)group(n=13),Ad5-HO-1 group(n=13),Ad5-green fluorescent protein(GFP)group(n=12),and Ad5-HO-1+zinc protoporphyrin (ZnPP)group (n=12).Livers of donor wefe harvested and stored for 24 hours at 4℃ in HTK solution. Before it is implantedinto recipient. MA IN OUTCOME MEASURES: Survival rate and liver function; portal vein blood flow monitored 2 hours after transplantation by Color Doppler How Imaging; pathological changes of transplanted liver tissue observed by HE staining;HO-1 activity, tumor necrosis factor-alpha(TNF-α),Bcl-2 and Bax expression detected by immunohistoehemical staining; changes of HO-1,TNF-α,bcl-2 and bax mRNA detected by molecular viewpoint. RESULTS: Survival rate in the Ad5-HO-1 group was significantly higher than that in the saline group at al,7,and 21 days after liver transplantation(P＜0.05).Glutamic pyruvic transaminase decreased in the Ad5-HO-1 group as compared to that in the saline,Ad5-GFP,and Ad5-HO-1+ZnPP groups(P＜0.05);portal venous blood flow significantly increased 2 hours after transplantation(P＜0.05);HO-1 activity also significantly increased(P＜0.05).RT-PCR and immunohistochemical staining showed that HO-1 and bcl-2 expressions increased(P＜0.05),but bax and TNF-αexpressions decreased(P＜0.05).CONCLUSION:Ad5-HO-1 significantly induces high expression of HO-1 increases portal venous blood flow within 2 hours alter liver transplantation, and promotes liver functional recovery so as to prolong survival time of rats after liver transplantion.

0.05);but statistical significance was found between the ?-hGH group with rhGH+GPT group and CPT group (P 0.05).Conclusions The results demonstrate that ?-hGH had no influence on the level of CEA,cAMP and cGMP of the transplanted colonic COLO-320 cell line carcinoma in nude mice.

BACKGROUND: Chemotherapy has been the very important adjunctive treatment for the patients with large intestine cancer. However, obvious individual difference exists in the sensitivity of the patients to the chemotherapeutic drugs, and the difference is related with the age and sex of the patients or not?OBJECTIVE: To make an exploratory discussion of that whether the difference of the sensitivity of chemotherapeutic drugs exists in different ages and different sexes of the patients with epidemiological investigation of the tumor cell survival rate.DESIGN: Controlled experimental study based on pathological samples.SETTING: General surgery department of an affiliated hospital of a medical college.PARTICIPANTS: Tumor cell samples of 169 cases of colorectal cancer tissue obtained from patients with colorectal cancer at the Department of General Surgery of the affiliated hospital of North Sichuan Medical College during the period from January 2001 to January 2003 were involved as subjects. The patients, 97 males and 72 females, were made a definite diagnosis of the large intestine cancer by operation and pathological examination and have not been treated with chemotherapy before operation.METHODS: The sensitivity of chemotherapy drugs were measured on the survival tumor specimens of 169 patients with colorectal carcinoma with Methyl thiazolyl tetrazolium(MTT) test method in vitro. The differences of different ages and different sexes were analyzed in patients.MAIN OUTCOME MEASURES: The absorbance values of tumor cell 72hours after treatment with chemotherapeutic drugs.RESULTS: There was no obvious significance of the tumor' s sensitivity to chemotherapeutic agents in different ages and sexes in patients with colorectal cancer( P ＞ 0.05).ONCLUSION: The individual difference of sensitivity for chemotherapeutic agents in patients with colorectal cancer is not related with the age and gender, needless to consider age and gender in selecting chemotherapeutic agents for different individuls.

OBJECTIVE:To determine 5-Fu concentration in serum,peritoneal fluid and tissue by HPLC in patients undergoing rectal cancer operation and receiving regional chemotherapy.METHODS:20 patients who undergoing rectal cancer operation and receiving regional chemotherapy were administered with drugs,whose blood samples were taken from portal veins,peripheral veins,peritoneal fluid and tissues around tumor at 2,5,10,20,30 and 60min,respectively after administration for the determination of 5-FU by HPLC.RESULTS:Peak concentrations in all samples appeared 2 minutes after administration,but lowered gradually thereafter.The drug level in peritoneal fluid was the highest,but was the lowest in the tissue,and that in the portal vein was higher than in peripheral veins.CONCLUSION:For patients who undergoing rectal cancer operation,regional chemotherapy could maintain 5-FU concentration at a higher level in portal vein,peritoneal fluid and tissue around cancer,which has significance in the prevention of metastasis to the local sites and liver after rectal cancer operation.

Objective Recent studies have found that Roux-en-Y gastric bypass( RYGB) can inhibit the levels of blood glucose in type 2 diabetes,but its mechanism still remains unknown. In present study,we observed the effect of RYGB on insulin and GLP-1of type 2 diabetes mice. Methods The 12-week-old male SD rats were divided into four groups:group A ( no surgery,normal diet) ,Group B ( no surgery,DM diet+STZ injection) ,group C ( gastric bypass surgery+normal diet) ,group D ( gastric bypass surgery+DM diet+STZ injection) . One week after surgery rehabilitation,the diabetes model was built by STZ ( revulsant of the classical diabetes model) and high-fat-control diet. After four months,the changes of blood glucose,OGTT,body weight,food intake,water intake in each group were examined. Furthermore,the patho-logical changes of insulin and pancreatic were detected by HE staining. Meanwhile,the liver PEPCK gene and protein expression were detec-ted by using RT-PCR and Western blot. Results Four groups of rats all have significant changes in diet and weight. HE staining suggests the disseminated hyperemia and edema in pancreas and showed that islet has been severe damaged. Compared with no treatment normal diet,nor-mal rat+DM diet+STZ injection,has a markedly elevated blood glucose level 3 days later,insulin,OGTT,GLP,and ITT all have remarkable changes in different time periods,with a statistically significance (P<0. 05). Compared with the normal rat+DM diet+STZ injection group, RYGB + DM diet+ STZ injection group showed that these indicators of pancreas pathological changes significantly,glucose,insulin,OGTT, GLP,ITT all have significantly drop,as well as the gene and protein expression of PEPCK (P<0. 05). Conclusion RYGB can exert influ-ence on the change of insulin,OGTT,GLP,ITT and PEPCK in islets of type 2 diabetes rats,which may play a positive role in the further clini-cal applications.

Objective To measure 5Fu concentration after intraoperative regional arterial perfusion chemotherapy in gastric antrum cancer patients.Method In this study,32 gastric antrum cancer patients intraoperatively received through right gastroepiploic artery intraarterial perfusion of 5-Fu (1000 mg/m2),and drug conentrations were measured in portal venous blood,peripheral venous blood,peritoneal fluid and in removed cancer tissues 2,5,10,20,30,60 minutes after infusion started by high performance liquid chromatography method.Result 5-Fu in portal vein blood and peritoneal fluid reached peak concentration after 2 minutes at (48.8 ±6.8) μg1/ml and (75.3 ±30.7) μg/ml,respectively.The drug concentration in portal venous blood was (19.2 ± 2.0) μg/ml at 30 minutes and that in peritoneal fluid was (17.3 ±7.4) μg/ml at 60 minutes,both were higher than that of the effective experimental tumor suppressing concentration (15 μg/ml).Peripheral venous blood concentration reached peak concentration of (5.4 ± 2.0) μg/ml at 5 minute.The drug concentration in removed cancer tissues was (80.5 ± 20.1) μg,/ml.Conclusions Regional intraarterial perfusion chemotherapeutics in gastric antrum cancer patients during operation immediately makes the concentration of chemotherapy rise in the portal vein blood and peritoneal fluid and in cancer tissues to a much higher level than that in peripheral blood.This helps kill cancer cells that fell out during the surgery.

Objective To investigate the factors associated with postoperative complications after laparoscopic-assisted radical surgery in rectal cancer.Methods The clinical data of 310 patients with rectal cancer performed by laparoscopic-assisted radical resection from November 2010 to August 2013 were analyzed retrospectively.The differences between patients with and without postoperative complications were compared.All the data were analyzed by the t test,chi-square test or Logistic regression analysis.Results Among the 310 patients,postoperative complication occurred in 80 patients.On univariate analysis,postoperative complication was associate with gender,age,body mass index,preoperative comorbidity,diameter and location of tumor,TNM staging,operative time and surgeon experience (all P ＜ 0.05).Logistic regression analysis revealed that gender,body mass index,preoperative comorbidity,location of tumor,TNM staging and surgeon experience were independent risk factors for postoperative complications (all P ＜ 0.05).Follow-up was available in 260 patients,with a median follow-up of 18 months (3-30 months).Differences in survival rates between patients with and without postoperative complications were no statistical significance (x2 =1.201,P =0.273).Conclusions Gender,body mass index,preoperative comorbidity,location of tumor,TNM staging and surgeon experience are independent risk factors for postoperative complications in laparoscopic-assisted radical surgery for rectal cancer.The short and medium-term survival time between patients with and without postoperative complications are similar.