With a comprehensive elaboration of the development of the level of surgical treatment of the rectal cancer, with a preliminarily analysis of the related questions in the surgery, it is the assertion of the author that early discovery, diagnosis and treatment are the key points in raising the five-year survival rate. Constant surveillance in the region of prevalence, constant survey and close inspection of high risk groups are much more important to detect early stage cancers in time. Diagnostic rates can reach 95%-100% by fibercoloscope, barium enema, B-ultrasound and CT, etc. About 70% of rectal cancers situated at middle and desending colon can be found by anal palpation. It is important to select correct and appropriate operative modality to raise the treatment efficacy. We should follow the TME principle to select which sphincter-preserving operation should be done: Parks operation, anastomat operation, peritoneoscope operation, autonomic nerve of pelvic cavity preservation operation, or LSY operation, etc. So that not only a radical cure of the tumor is ensured, also the lymph nodes are removed, and to ensure to preserve the normal defecation function. Thus, we should individualize operation according to the site, biological character, and clinical stages. Sphincter-preserving operation accounts for above 70% of resection of rectal cancer, and its local recurrence and five-year survival rate is similar to that of Mile′s operation, but the patient′s life quality is obviously raised. Recently, phincter-preserving operation has been the first choice for resection of the rectal cancer. The author emphasizes that the combined therapy to local recurrence and metastasis is important to raise five-year survival rate. Operation only is insufficient, we should pay attention to combined therapy, such as pro-operative chemotherapy, radiotherapy and immunotherapy. We should pay more attention to detecting, diagnosing and treating the local recurrence and metastasis in early stage after operation, and resect them aggressively. When they cannot be resected, give chemotherapy and radiotherapy first, when it shrinks, it can be resected again. The five-year survival rate can reach 40%. As it is difficult to resect the liver metastasis, so when the primary cancer does not recur, liver transplantation is the first choice. Obvionsly, to raise the rate of a prolonged survival, combined therapy including chemotherapy, radiotherapy, immunotherapy and biotherapy should be instituted besides surgical excision.

Tuberous sclerosis complex (TSC) is a rare autosomal dominant neurocutaneous disease.Epilepsy is the most common manifestation.Studies show that even with a variety of antiepileptic drugs, more than 50％ of TSC related epilepsy are drug-resistant.Since cortical tubers are the main epileptogenic foci, resection surgery become an important treatment of intractable epilepsy in TSC.In recent years, with the development of electrophysiology and imaging technology, surgical treatment of epilepsy in TSC shows a great efficacy of controlling seizures and improving intelligence.Up to date, there are no standard procedures of surgical treatment for refractory epilepsy in TSC.This paper aimed to provide some instructions.

Objective To study the clinical significance of the serum level of soluble E-selectin (sE-selectin) in diagnosis and treatment of colorectal cancer. Methods The serum level of sE-selectin was measured by ELISA in 84 patients with colorectal cancer and 30 normal individuals as control. The changes in serum sE-selectin level of 54 patients with colorectal cancer were analyzed preoperatively and postoperatively, and the positive ratio of sE-selectin was compared with that of CEA, CA199 and CA242 in patients with colorectal cancer. Results The serum sE-selectin level in colorectal cancer was significantly higher than that of normal control (P0.05). There was statistically significant difference between the patients with and without hematogenous metastasis (P

Objective To evaluate the clinical significance of CEA mRNA expression in gallbladder bile for early diagnosis of liver metastasis from primary colorectal cancer. Methods [WT5”BZ] A CEA specific nest RT PCR assay was used to detect CEA mRNA expression in the gallbladder bile of 46 patients with colorectal cancer. Results The positive rate of CEA mRNA in gallbladder bile was 74%. The rate was directly proportional to that of live metastasis. Liver metastasis developed in 33% of patients with positive CEA mRNA expression. Conclusions The positive expression of CEA mRNA in gallbladder bile is a proof of prospective liver metastasis.

Objective To evaluate antitumor effect of adenovirus-mediated cytosine deaminase (CD) gene and 5-fluorocytosine (5-FC) on rectal cancer cells.MethodsCD gene was transinfected into HR-8348 rectal cacer cell lines with recombinant adenovirus mediation. The transinfection rate and expression of CD gene were detected. Plating efficiency and MTT method were used to examine inhibition of HR-8348 cell growth, and antitumor effect of CD/5-FC were evaluated on HR-8348 experimental tumor in nude mice.ResultsHigh transinfection effeciency and expression of CD gene were achieved in HR-8348 with adenovirus mediation. CD/5-FC system showed a remarkble effect of inhibition on plating efficiency and growth of the tumor cells transinfected with CD gene, but no act on tumor cells without CD gene transinfection. In a mixture of HR-8348 tumor cells with and without CD gene transinfection, CD/5-FC killed both types of tumor cells and revealed a powerful "by-stander effect". With nude mice experiment, 71.5% of inhibition of solid tumoral xenografts of HR-8348 cells was found.ConclutionCD/5-FC has significant antitumor effect on rectal cancer cells with adenovirus-mediated CD gene transinfection and has also "by-stander effect" on tumor cells.

ObjectiveTo investigate the effect of repeated transfer of liposome mediated CD gene plus radiation on the growth of human rectal cancer cells xenograft in nude mouse Methods HR 8348 cells transfered with liposome mediated CD gene repeatedly (at day 0,4,8,12 ) and treated with fractionated radiation at a dosage of 2 Gy/day to a total dose of 30 Gy. At the same time, mice were injected i.p.with 800 mg/kg/day of 5 FC for 12 days. Results Compared with controls tumors in treatment group grew with an inhibition rate of 78 7% in weight, and 81 5% in volume. ConclusionRepeated transfer of liposome mediated CD gene working together with radiation effect a significant inhibition on the growth of xenografted human rectal carcinoma HR 8348 cells in nude mouse.

Objective To study the effects of the expression of hypoxia inducible factor-1 alpha (HIF-1?) induced by FasL on the invasiveness of rectal cancer cells. Methods With molecular cloning method, eukaryotic expression vectors of pcDNA3.1 FasL containing total length of FasL cDNA sequence were transfected into human rectal cancer cells HR-8348. The cell invasiveness was examined. A hypoxia model of HR-8348 was reproduced, and its invasiveness was assessed with transwell methodology. Expression of HIF-1? was assayed by Western bloting. Results The number of HR-8348 cells transfected with FasL penetrated transwell filter membrane was larger (12.930?2.434) than that of empty vector transfected cells (7.670?2.093) and control cells (8.133?1.959) with statistically significant differences (P0.05), but it was significantly higher in FasL positive HR-8348 cells than in FasL negative cells at 12h and 24h after hypoxia (P0.05). Conclusions FasL is an effective factor inducing HIF-1? expression, and FasL expression correlates positively with HIF-1? expression. Enhanced FasL expression in rectal cancer cells could induce higher expression of HIF-1?, enable the tumor cells to adapt to hypoxia environment, and enhance the invasiveness of tumor cells.

Objective To study the expression of cathepsin B (CatB) and metallothionein (MT) in colorectal cancer tissue, and explore their association with lymphatic and hepatic metastasis. Methods Immunohistochemistry technique was used to assay the expression of CatB and MT in 82 cases of primary colorectal cancer, normal colon mucosa, and lymph node and hepatic metastasis. The relationship between the expressions of CatB and MT and the clinical stage or pathological grading of the colorectal cancer were analyzed. Results The rate of CatB expression in primary tumor, normal colon mucosa, and lymph node with metastasis and hepatic metastasis was 48.8%, 20.7%, 66.7%, and 59.1%, respectively, and that of MT expression was 53.7%, 26.8%, 71.4% and 72.7%, respectively. The rates of CatB and MT expression in primary tumor, and lymph node and hepatic metastasis were higher than that in normal mucosa tissue. The rate of coexpression of CatB and MT in lymph node and hepatic metastasis was higher than that in primary tumor and lymph node without metastasis. As regard to clinical stages, the positive rates of CatB and MT in Dukes C and D were higher than that in Dukes A and B (?2=11.024 4, 10.933 8, P

Objective To develop a new method for detecting colorectal cancer cells in peripheral blood using a hybrid technology referred to as fluorescent amplification catalyzed with T7 polymerase technique (FACTT). Method A model of colorectal cancer circulating tumor cells in peripheral blood was reproduced by mixing serial dilutions of HT29 cells with 1?107 peripheral blood monocytes from healthy subjects. After all nucleated cells were isolated from the model, biotinylated monoclonal antibody CEA against the Gold epitopes Ⅳ, which was expressed on the cell surface of human colorectal cancer cells but not on the normal cells, was added followed by the adding of avidin-biotinylated-DNA. Then T7 RNA polymerase and nucleoside triphosphates (NTPs) were added to perform RNA amplification at room temperature for 3h. Finally, RNA products were quantified by adding the RNA intercalating dye RiboGreen. RT-PCR was used to detect the expression of CEA mRNA as a control to assess the sensitivity of fluorescent amplification catalyzed with T7 polymerase technique. Results A method of detecting circulating colorectal cancer cells in peripheral blood by fluorescent amplification catalyzed with T7 polymerase technique was established. It was shown that the technique had a detection level of 5 HT29 cells among 1?107 monocytes, and it was more sensitive than RT-PCR technique, by which the level of detection was 1?102 cells among 1? 107 monocytes. Conclusion Fluorsescent amplification catalyzed with T7 polymerase technique is a new and sensitive technology for detecting circulating colorectal cancer cells in peripheral blood.

Objective To explore the influence of cathepsin B (CatB) expression on the ability of adhesion and invasiveness of colorectal cancer cells. Methods Human colon cancer cell line LoVo and rectal cancer cell line HR-8348 were used in the present study. The total length of CatB mRNA was cloned and transfected into the cells, and the CatB expression was detected by RT-PCR. Cell adhesion was detected with Matrigel and invasiveness was assessed with transwell method. Results CatB mRNA expression was detected and enhanced expression was found in LoVo and HR8348 cells tranfected with pcDNA3CatB. Cell adhesion rates to Matrigel stromatin in control LoVo cells, empty vector transfected cells and CatB transfeted cells were 0.461 6?0.148 7, 0.412 1?0.215 8 and 0.691 6?0.150 8, respectively. The adhesive rate of CatB transfected LoVo cells was higher than that of the control cells and the empty vector transfected cells with significant differences (F=5.839 0, P