Objective To investigate the relationship between-160C/A single nucleotide poly-morphism(SNP) in the CDH1 gene promoter and protein expression in hepatocellular carcinoma. Methods Samples were taken from 34 patients with hepatocellular carcinoma and -160 C/A SNP of CDH1 gene promoter was detected by blood specimens adopting direct DNA sequencing. The expres-sion of E-cadherin which encoded by CDH1 gene was determined by paraffin-embedded tissue using immunohistochemistry and the association between -160 C/A SNP and protein expression was ana-lyzed. Results The high and low expression of E-cadherin was observed in 18 cases(52.9%) and 16 cases(47.1%). In these two groups, the difference of the incidence between CC genotype and CA, AA genotype was statistically significant(P<0.05) whereas there was no marked difference between CA and AA genotype. The difference of both A and C allele frequency was significant(P<0.05). Conclusion The -160 C/A SNP of the CDH1 gene promoter may play an important role in regulating the expression of E-cadherin in hepatocellular carcinoma and the incidence of A allele is associated with down-regulation of E-cadherin expression.

Objective To investigate the feasibility, efficacy, safety and economy of secondary splenic pedicle trisection method in removing schistosoma cirrhosis caused the splenic function. Methods Thirty patients receiving spleen secondary structure amputation between July 2014 and September 2016 were analyzed. Results Laparoscopic splenectomy with secondary splenic pedicle transaction was successfully performed in 28 patients, whereas two Endo-GIAs were used in 2 patients. The average of operation time was (80 ± 20) min, and operative blood loss was (320 ± 10) ml. The drainage of the splenic fossa was removed (3- 4) days after operation.Postoperative hospital stay was (10.8 ± 1.2) days after operaions. No massive hemorrhage, pancreatic leakage, secondary infection, serious complications such as abscess under diaphragm and recent complication such as infection of incision occurred postoperatively. Platelet of all patients recovered in 4 days postoperatively, and patients with platelet>400 × 109/L was given oral aspirin enteric-coated metformin hydrochloride. All patients were followed up for 6 months postoperatively, and no intestinal obstruction, portal vein thrombosis and other long-term complications occurred in all patients. Conclusions The amputation of secondary structures of the spleen in laparoscopic splenectomy to remove schistosoma cirrhosis caused the splenic function is safe. It could shorten the length of hospital stay and reduce the medical cost. It is a valuable method for clinical promotion.

Objectives To investigate the relationship between the expression of hENT1 protein in pancreatic cancer and the efficacy,adverse reactions and prognosis of gemcitabine.Methods The tissues of 83 patients with pancreatic cancer diagnosed in Department of Hepatobiliary and Pancreatic Surgery of Jiaxing Second Hospital and Jiaxing City Hospital of Traditional Chinese Medicine from June 2013 to January 2016 were collected by endoscopic fine needle aspiration biopsy.The expression of hENT1 protein was detected by immunohistochemistry,which was divided into hENT1 low expression group and high expression group.According to the curative effect of chemotherapy,it was divided into gemcitabine effective group and drug resistance group.The clinicopathological parameters,adverse reaction rate,median survival,and progressionfree survival (PFS) were compared between the two groups.Results Of the 83 pancreatic cancer tissues,37 (44.6％) had high expression of hENT1 and 46 (55.4％) had low expression.There were no significant correlations of the efficacy of gemcitabine chemotherapy with gender,age,clinical symptoms,primary tumor location,tumor size,TNM staging,CA19-9 level,CEA level,presence or absence of liver metastasis,but gemcitabine resistance rate in high expression group was significantly higher than the low expression group (78.1％ vs 50.0％),and the difference was statistically significant (P =0.010).Both groups were able to tolerate adverse reactions of gemcitabine chemotherapy and no chemotherapy-related death was observed,but the incidence of leucopenia and thrombocytopenia in hENT1 low expression group was significantly higher than those in bENT1 protein high expression group (63.0％ vs 21.6％,47.8％ vs 16.2％),the differences was statistically significant (all P ＜ 0.05).The median survival and 1-year PFS of hENT1 protein low expression group were significantly lower than those of high expression group (11 months vs 15 months,19.4％ vs 50％),and the differences were statistically significant (P ＜0.05).Conclusions Decreased hENT1 protein expression in pancreatic cancer tissue could reduce the efficacy of gemcitabine chemotherapy,increasing the incidence of leucopenia and thrombocytopenia.

Objective To establish a novel method using a nano microfluidic chip to detect circulating tumor cells (CTCs) in peripheral blood in gallbladder carcinoma,and to study the relationship between CTCs with clinicopathology and prognosis in these patients.Methods The peripheral blood samples of 51 patients with gallbladder carcinoma were collected from June 2014 to January 2017.The CTCs from peripheral blood samples were detected by a novel nano microfluidic chip.This study aimed to study the correlation between CTCs with the clinical and pathological features.The significance of CTCs on prognosis in patients with gallbladder carcinoma was also analyzed.Results The positive rate of CTCs in the peripheral blood of gallbladder carcinoma patients was 43.1％ (22/51).There were significant correlations between CTCs with liver metastasis (P ＜ 0.05) and Nevin staging (P ＜ 0.05).The 1-and 2-year overall survival (OS) in patients with CTCs were 70.7％ and 35.3％,and the 1-and 2-year OS in patients without CTCs were 92.0％ and 56.1％.There was a significant difference in the 2-year OS (P ＜ 0.05) but no significant difference in the 1-year OS between the 2 groups of patients (P ＞ 0.05).Conclusions Peripheral blood CTCs in patients with gallbladder carcinoma were efficaciously detected by a novel nano microfluidic chip.Peripheral blood CTCs was closely related to the Nevin staging and liver metastasis.CTCs could serve as a potential prognostic indicator in patients with gallbladder carcinoma.