Precision medicine is a medical model that proposes the individual therapy,with a joint medical method of genomics,proteomics,metabolomics and clinical big data tailored to the individual patient.The diagnosis and treatment of colorectal cancer have entered the model of precision medicine with the entering the era of precision medicine.In this article,authors summarized the recent progress of diagnosis and therapy under the guidance of precision medicine,with an aim to provide some new clues for surgeons and supports for precision prevention,diagnosis and therapy.

Digestive tract reconstruction after proctocolectomy is a critical step of colorectal surgery, proper reconstruction can promote the recovery of digestive tract function and improve the quality of life.At present, there are some candidate reconstruction methods after proctocolectomy, but standardized and proper one is not still established.Since there are differences of the reconstruction methods after proctocolectomy at the different parts of colorectum, the best reconstruction methords should be selected according to the condition and intraoperative situation of patients.

Objective To research the effect of alimentary tract reconstruction after gastrectomy on the treatment of type 2 diabetes mellitus(non-insulin-dependent diabetes mellitus, NIDDM). Methods From January 2005 to January 2008, perioperative blood glucose level and insulin therapy in 24 gastric cancer or periampullary carcinoma patients with non-obesity type 2 diabetes were retrospectively analyzed. These patients underwent different alimentary tract reconstruction, including 8 patients for Billroth I, 10 for standard Whipples operation, 6 for esophageal Roux-en-Y jejunostomy after total gastrectomy. Glucose level and insulin dosage of thease patients were compared. Results In the patients underwent Billroth I operation, change of blood glucose level before and after operation was not significant(P＞0.05). The level of blood glucose in patients underwent Whipples operation and total gastrectomy were significant changed 1 and 2 months after the operation (P<0.001). In Billroth I group, 5 patients used insulin to control hyperglycemia preoperatively. After the operation, 2 patents maintained preoperative insulin dosage, 2 had to increase the use of insulin and 1 decreased the insulin dosage. In Whipples group, 6 patients used insulin preoperatively. Interestingly, 4 patents needed less insulin to control hyperglycemia and 2 were free of insulin dependance. In total gastrectomy group, there were 4 patients using insulin to control hyperglycemia. After the operation, 2 patents needed less insulin dosage and 2 stopped using insulin. Conclusions Both Whipples operation and total gastrectomy lead to decreased blood glucose level in NIDDM patients and less need of insulin.The effect of some types of alimentary tract reconstruction after gastrectomy on treatment of type 2 diabetes mellitus is assertive.

The development of laparoscopic techniques has made surgical treatment enter into the era of minimally invasive surgery,and the application of three-dimensional (3D) high-definition laparoscopic system has brought the important innovation for laparoscopic techniques,meanwhile,it also provides stereoscopic visions and more accurate spatial orientation for surgeons.During the process of laparoscopic radical resection of lower rectal cancer,3D vision can help to identify blood vessels,nerve and tissues around the rectum,ensure accurate lymph node dissection,reduce difficulty of operation,and the learning curve of laparoscopic radical resection of lower rectal cancer for inferior surgeons might be shorten by using 3D imaging system.With the development of technology,the value on clinical application of 3D high-definition laparoscope will become more evident.

Objective To investigate the correlation between clinical features of breast cancer and microsatellite instability(MSI).Methods 60 samples of breast cancer were eollected and 5 microsatellite polymorphism loci were selected.MSI analysis Was made after DNA isolation,PCR amplification,electrophoresis and EB staining.Results The rate of MSI was 33.3%in breast cancer and 0%in normal breast tissues.MSI in breast cancer was associated with carcinoma differentiation degree.Conclusion MSI is an early event during breast carcinogenesis and it plays an important role in estimation of malignant degree.

Objective To investigate the expression of β-catenin and PCNA,and its relationship with clinical parameters and prognosis.Methods Tissue microarray technology and immunohistochemical method were used to detect the expression of β-catenin and PCNA in gastric carcinoma and normal tissue collected from January 2000 to December 2006.Data were analyzed by SPSS 19.0.Results The percentage of expression of β-catenin and PCNA in gastric carcinoma is 96.7％,99.2％,respectively,and higher than the normal gastric tissue (x2 =41.082,P =0;x2 =97.692,P =0).ROC curve was used to find that PCNA was better than β-catenin to discriminate gastric carcinoma from normal gastric tissue in sensitivity,specificity,coincidence rate(84.4％,87.5％,84.6％).The expression of β-catenin is related to lymph node metastasis in gastric cancer (x2 =6.107,P =0.04).The expression of PCNA is related to pathological type (x2 =9.71,P =0.02).The expression of β-catenin and PCNA in gastric carcinoma were positively correlated (r =0.24,P =0.005).Multivariate analysis showed that TNM staging and both positive β-catenin and PCNA were independent factors impacting on the overall survival rate of patient with gastric cancer.Conclusions The expression of β-catenin and PCNA in gastric carcinoma is signifrcandy high.PCNA is more important than β-catenin in discriminating gastric carcinoma from normal gastric tissue.Combined detection of the two kinds of protein have some clinical significance in predicting the prognosis of patients with early gastric cancer.

Objective:To study the effect of B7-1 costimulatory molecule in inducing tumor immunity.Methods:The lymphocytes were examined in vitro,for both proliferation induces(PI) and specific cytotoxic activity,H22 mice were challenged subcutaneously either by the mock following which the latency,survival time and tumor mass growth were noted.Results:The H22-B7-1 cells more effectively induced the proliferation of effecter lymphocytes and the generation of specific lytic activity against H22 cells.The H22-B7-1 cells demonstrated slower rate(P

Objective To investigate the influence of transforming growth factor-?1(TGF-?1) on macrophage scavenger receptor (ScR) class A and B(ScR-B,CD36) in order to provide theoretical foundation for expounding the formation and therapy of atherosclerosis(AS).Methods THP-1 derived macrophages were divided into control group and experimental group,the cells in experimental group were treated with 3.0 mg?L-1Anti TGF-?1 Ab,the cells in control group were treated with 3.0 mg?L-1 IgG. The 125I-acetylated low density lipoprotein (125I-Ac-LDL for ScR-A) and 125I-oxidized low density lipoprotein (125I-Ox-LDL for CD36) uptaking (including 4℃ binding,37℃ association and degradation) were measured respectively.Influence of anti TGF-?1 antibody (Anti TGF-?1 Ab) on the ScR-A and CD36 mRNA expressions in THP-1 derived macrophages was measured meanwhile,respectively.Results Compared with control group ( binding: 8.23 ?g?g-1 ?1.24 ?g?g-1 protein,association:45.69 ?g?g-1 ?6.92 ?g?g-1 protein,and degradation: 112.18 ?g?g-1 ?20.15 ?g?g-1 protein),Anti TGF-?1 Ab increased 125I-Ac-LDL binding(48.67 ?g?g-1 ?6.52 ?g?g-1 protein),association (412.30 ?g?g-1?12.21 ?g?g-1 protein),and degradation (896.48 ?g?g-1 ?32.74 ?g?g-1 protein) significantly (P

Objective To evaluate pericardial devascularization with splenectomy (PCDV) for the treatment of cirrhotic portal hypertension. Methods From January 1994 to December 2004, 177 patients were treated by PCDS, among them posthepatitic cirrhosis was identified in 170 cases, and alcoholic cirrhosis in 7. One hundred and thirty two patients were operated on electively, 25 prophylactically, and 20 emergently. Results The bleeding control rate was 95% , the overall operative mortality rate was 4. 5%. The main causes of death were upper gastrointestinal bleeding, hepatic failure and intra-abdomimal hemorrhage. The mean follow-up time was 3. 6 years. The 5-year survival rate was 90%. The 5-year recurrent bleeding rate was 5. 1% , The rate of postoperative hepatic encephalopathy was 5. 1%. Conclusions This procedure has the advantage of high successful rate of bleeding control, low complication rate, and long term survival.

Objective To study the effects of angiogenesis inhibitor SU5416 on the growth and metastasis of pancreatic cancer in SD rat model. Methods Dimethylbenzanthracine (9 mg) (DMBA),was implanted into the parenchyma of Sprague Dawley rat pancreas to induce pancreatic cancer. Rats with established pancreatic carcinoma were randomly divided into 4 groups (15 rats each) to receive every the other day for consecutive 13 weeks before sacrifice peritoneal cavity injection of: Normal saline (control),5-fluorouracil 30 mg?kg -1 (5-Fu group),SU5416 16 mg?kg -1 (SU5416 group),and both 5-Fu and SU5416(combined treatment group). Tumor weight,inhibition rates,intratumoral microvessel density (MVD),apoptotic index (AI) and metastasis were evaluated. Results Tumor weight was (1.15?0.21) g,(0.68?0.42) g,(0.31?0.11) g,(0.19?0.06) g respectively;the inhibition rate was 0,48%,80%,85% respectively;the intratumoral microvessel density (MVD) was (12.3?3.2),(11.4?3.8),(2.1?1.5),(1.8?1.1) respectively;The apoptotic index (AI) was (2.64?1.86)%,(5.71?3.14)%,(13.21?4.26)%,(21.12?7.15)% respectively. Peritoneal metastasis was significantly less severe in 5-Fu group,SU5416 group and combined group than that in control group(83% versus 46%,25% and 0) ( P