Since the concept of fast-track was raised in 2001, it has been widely used in the surgical treatment for colorectal cancer. Several studies showed that patients receiving fast-track surgery gained enhanced recovery,shorter hospital stays and less cost. The British NICE guideline also strongly recommends the use of fast-track surgery in colorectal cancer patients. The present review would discuss the concept, development, advantage, impact on the recovery of elderly patients and the cost effectiveness of fast-track surgery over the past 10 years.

With advancements in the field of cancer stem cells,the hypothesis that colon cancer originates from stem cells has not only been introduced but also receives substantial supports by separating a subpopulation of colon cancer cells through primitive cells markers.Unlike most non-tumourigenasis colon cancer cells,these tumor-initiating cells have many specific characters both in vitro and in vivo.An improved understanding of drug resistance based on cancer stem cells and molecular pathways that regulate proliferation and differentiation of gastrointestinal cancer stem cells could doubtless translate into new therapeutic strategies.

Imatinib,a small-molecule kinase inhibitor,has proven useful in the treatment of recurrent or metastatic gastrointestinal stromal tumors ,However,resistance to imatinib is a more and more serious problem.This review summarizes the existing knowledge of the imatinib resistance mechanism in gastrointestinal stromal tumors and describes the treatment directions in further.

Sunitinib malate (SU11248 ,Sutent) is an orally available small-molecule multitargeted tyrosine kinase inhibitor that has potent anti-angiogenic and antitumour activities.In 2006 sunitinib was approved by FDA for imatinib intolerant gastrointestinal stromal tumors (GIST) patients or imatinib resistant GIST patients.This article review the molecular-based mechanism,the mechanism of resistance,the biomarker,the clinical trials and the adverse effects of sunitinib in the treatment of imatinib-resistant GIST.

Primary angiosarcoma of breast is a rare malignant tumor,about 0.05%of all the malignant tumor of breast.The heteromorphism,such as endothelioeyte,blood vessel even caryocinesia,distinguishes this disease from other carcinoma of breast.Positive ratio of endothelial cell makers(Anti-FⅧR,CD3 1,CD34,UEA-1,et al)and VEGF is relatively high.Besides fine needle aspiration and biopsy,ultrasound,X-ray and MRI maybe helpful to di agnosis.Surgery is certainly the first choice to care this disease.The effect of chemotherapy,radiotherapy and tar geted therapy is still in research.

A large nunber of studies show that aspirin and other non-steroid anti-inflammatory drugs (NSAID) have chemopreventive effects on several cancer type s,and more specifically in colorectal cancer.Aspirin can help prevent colon cancer,which has a specific advantage of drug prophylaxis.Studies found that aspirin play different roles on high-risk,moderate-risk and low-risk populations in time and dose.There is limited evidence about the influence on incidence of adenoma among the general risk populations.

Background and purpose:Chemokines play an important role in breast cancer occurrence and development. However, little about the function of CCL28 in breast cancer is reported. This study was designed to observe and study the expression of chemokine CCL28 in breast cancer, and analyze their association with pathological features of breast cancer.Methods:Expressions of chemokine CCL28 in 150 breast cancer patients were determined by IHC(immunohistochemistry) technique. The corresponding normal breast tissues in paraneoplastic were also detected. The level of CCL28 expression in 150 breast cancer was analyzed whether it was associated with age, cTNM stage, tumor diameter, axillary lymph node status, ER status, PR status and HER-2 status. Results:①CCL28 was highly expressed in both breast cancer and normal breast tissues in paraneoplastic. The positive expression rate of CCL28 in breast cancer was 54.6%and the positive expression rate of CCL28 in normal paraneoplastic breast tissues was 9.3%. Expression of CCL28 in breast cancer was signiifcantly higher than that in normal paraneoplastic breast tissues, there was statistically significance between the two groups(P<0.001). ②The expression of CCL28 was not associated with age, cTNM stage, tumor size, axillary lymph node, ER, PR and HER-2 status(P>0.05). Conclusion:The level of CCL28 expression showed signiifcantly difference between breast cancer and paraneoplastic normal breast tissues. In conclusion, CCL28 may be correlated with breast cancer carcinogenesis and evolvement. The level of CCL28 expression was not signiifcantly correlated with lymph node metastasis. If CCL28 may be a factor to predict lymph node metastasis in breast cancer is worth further studying.

Objective To investigate the clinical effects of laparoscopic sleeve gastrectomy with duodenaljejunal bypass (LSG + DJB) for the treatment of type 2 diabetes mellitus.Methods The clinical data of 17 patients with type 2 diabetes mellitus who underwent LSG + DJB at the Xijing Hospital of the Fourth Military Medical University from March 2013 to February 2014 were retrospectively analyzed.The fasting blood glucose,postprandial 2-hour blood glucose,glycosylated hemoglobin (HbA1c) and body mass index (BMI) in 17 patients before operation were (9.2 ± 0.6) mmol/L,(14.4 ± 2.2) mmol/L,8.3％ ± 1.2％ and (29.4 ± 2.2) kg/m2,respectively.All the patients received LSG + DJB and were followed up by outpatient examination up to March 2015.The pre-and post-operative 12-month fasting blood glucose,postprandial 2-hour blood glucose,HbA1 c and BMI in 17 patients were compared.Measurement data with normal distribution were presented as-x ± s and analyzed by the t test.Results All the 17 patients received successful laparoscopic LSG + DJB without conversion to open surgery.The operation time,volume of intraoperative blood loss and recovery time of postoperative gastrointestinal function were (141 ±53)minutes,40 mL and 2.5 days.Of 3 patients with postoperative complications,1 patient with anastomotic leakage at postoperative day 5 received reoperation by laparoscopic Roux-en-Y gastric bypass,1 patient with digestive tract obstruction at postoperative day 10 released obstruction by reoperation and 1 patient with left subphrenic abscess and leakage at the upper of the stomach at postoperative week 2 was cured by the symptomatic treatment.The duration of hospital stay was 5.2 days.All the patients were followed up for a median time of 16 months (range,13-24 months).The postoperative 12-month fasting blood glucose,postprandial 2-hour blood glucose,HbA1c and BMI in 17 patients were (5.5 ± 0.7)mmol/L,(8.8 ± 1.7)mmol/L,5.1％ ± 0.7％ and (24.7 ± 2.3)kg/m2,which were significantly different from preoperative indicators (t =19.96,10.52,12.06,31.99,P ＜ 0.05).During the follow-up,no anastomotic ulcer and stenosis,dumping syndrome and severe malnutrition were occurred.Conclusion LSG + DJB is safe and feasible for the treatment of type 2 diabetes mellitus,with a good short-term hypoglycemic effect.

Objective To detect the expression of Id1 and HBx in HBV-related hepatocellular carcinoma (HCC) tissue samples and analyzed the correlation between Id1 expression levels and clinicopathological features of patients.Methods Tumor tissue samples obtained from a total of 113 HCC patients.The expression of Id1 proteins of these samples were detected by immunohistochemical (IHC) staining and evaluated by two independent pathologists.The corrections between the clinical pathological parameters and the IHC scores for Id1and the prognostic significance were statistical analyzed by SPSS 19.0 software.Results Ninty-six of 113 patients is HBV-related HCC.Over-expression of Id1 were found positively correlated with the HBsAg ＞ 200 s/n,histological grade,portal vein invasion.Patients with Id1 overexpression had both shorter disease-free and overall survival times.Conclusions High expression of Id1 was correlated with serum HBsAg,histological grade,portal vein invasion and poor clinical outcomes in HBV-related HCC.

Objective To study the diagnosis, pathomorphological and immunohistochemical features of gastrointestinal stromal tumor (GIST) and to explore the reference parameters for malignancy. Methods Light microscopy was used to study the morphologic characteristics in 54 cases of gastrointestinal mesenchymal tumors, and the expression of CD117,CD34 and S 100 was detected by EnVision immunohistochemical method. ResultsMost borderline and malignant tumors were found in male. CD117 showed diffuse strong expression, CD34 mostly showed diffuse strong expression, S 100 incidentally showed focal expression, and the positive rates were 100%, 59% and 16% respectively. Conclusions CD117 is a sensitive and specific marker for the diagnosis of GIST. Tumor necrosis, high tumor cellularity and intestinal tumor mitotic activity over 1/50HPF were helpful parameters for judgement of malignancy, tumors are most often seen in male.