ObjectiveTo investigate the clinicopathological characristics of mucinous gastric carcinoma (MUC). MethodsFrom 1994 to 2001, 438 gastric cancer patients underwent operation, among them, 36 patients (8 2%) were with MUC. The clinicopathological parameters and prognosis of MUC and non MUC were analyzed retrospectively. ResultsThere were no significant differences in age, sex, tumor site and hepatic metastasis. Patients with MUC had higher rate of serosal invasion, invasive type lymph node involvement, peritoneal dissemination. Patients with MUC were of more advanced stage (stage Ⅲ and Ⅳ:MUC 88 9%,non MUC 73 9%). The 1 year and 2 year survival rate for MUC patients was lower than that for non MUC patients (50 5%?33 1% vs. 74 9%?64 7%). Conclusions The poor prognosis of MUC was correlated with frequent serosal invasion, lymph node involvement, peritoneal dissemination, and advanced stage at the time of diagnosis.

ObjectiveTo observe the effect of eicosapentaenoic acid (EPA) on the proliferation and apoptosis of human gastric cancer cells and to explore the potential mechanism involved.MethodsHuman gastric cancer cell lines SGC-7901 and MGC-803 were treated with EPA at 10,20,40 μg/ml for 24-72 hours.The inhibition of cell proliferation was evaluated by methyl thiazolyl tetrazolium assay.The apoptosis and the distribution of cell cycle were analyzed by flow cytometry.Mitochondria membrane potential was determined with a fluorescence probe rhodamine 123.Cellular distribution of cytochrome C was quantitatively detected with enzyme-linked immunosorbent assay.Caspase-3 activity was measured with spectrofluorometry.ResultsAfter incubation with 10-40 μg/ml EPAfor 24-72 hours,the proliferation of human gastric cancer cells was markedly inhibited in a time-dependent manner.The treatment of 40 g/ml EPA for 72 hours increased the proportion of G0/G1 phase cells in both SGC-7901 and MGC-803 (P=0.006,P=0.009).In SGC-7901 and MGC-803 cells incubated with 40 μg/ml EPA for 24 hours,mitochondria membrane potential decreased significantly (P =0.001,P =0.047 ); cytochrome C level significantly declined in mitochondria (P=0.001,P=0.000) but increased in cytosol (P =0.001,P=0.000).In SGC-7901 cells,the apoptotic effector caspase-3 activity increased time-dependently along with incubation with 40 g/ml EPA.ConclusionEPA could inhibit the proliferation and promote the apoptosis of human gastric cancer cells through inducing cell cycle arrest and activating intrinsic death pathway mediated by mitochondria.

AIM: To investigate the role of CagA and the effect of small interference RNA (siRNA) on the release of IL-8 in H. pylori-infected gastric epithelial cells. METHODS: siRNA were transferred into CagA positive strain H. pylori NCTC 11637 by using electroporation. The CagA positive strain NCTC 11637 and the CagA negative strain NCTC 11639 were co-cultured with gastric epithelial cells and the level of IL-8 in the supernatant was measure by ELISA. RT-PCR and Western blotting were performed to detect CagA expression. RESULTS: The level of IL-8 induced by CagA positive strain NCTC 11637 was higher than the level induced by CagA negative strain NCTC 11639 ( 1 200.00 ?32.51) ng/L vs (100.00?8.58) ng/L, P0.05). Meanwhile, CagA mRNA decreased significantly in siRNAⅢgroup. The levels of CagA mRNA at 6, 12, and 24 h after electroporation were 31.3% (0.270/0.861), 57.6% (0.496/0.861), and 73.9% (0.637/0.861) of the control levels, respectively. Inhibition rate by siRNAⅢ was 68.7%. The Western blotting result in siRNA Ⅲ group showed that the level of CagA protein degraded to 30.7% (0.4/1.3) at 12 h after electroporation. In siRNA V group, the expression of CagA mRNA at 6 h is suppressed by 23.1% (P

Objective To summarize the clinicopathologic characters and the route of lymphatic metastasis of cancers at the gastroesophageal junction. Methods Clinicopathologic data of 86 cancer patients treated from October 2000 to December 2004 were analyzed retrospectively. Results There were 66 males and 20 females, the mean age was 60 years. Most patients were of Bormann typeⅢadenocarcinoma. The incidence of high differentiated adenocarcinoma in TypeⅠcancer was higher than that in other two types (P = 0. 002, P = 0. 004) , while the incidence of poor differentiated carcinoma in typeⅢcancer was higher than other two types(P = 0. 005 ,P = 0. 015). Metastatic rate of lymph nodes in group 1 and group 2(34. 9% ) .group 3 and group 4(36. 0% ), group 7 through to group 9(27. 9% ), group 10 and 11 (15. 1% ) was higher than in other groups, while that in group 5 and 6(11. 6% ) , and group 12(5. 8% ) was lower compared with other lymph nodes (P

0.05). Results The median survival of patients with splenectomy and without (splenectomy) was (507.4?318.6) days and (849.4?672.9) days,respectively.The patients without splenectomy survived (significantly) longer than those with splenectomy(P=0.046).The 1-year,3-year and 5-year survival rates of patients with splenectomy and without splenectomy were 61.18%, 8.23%, (0%) and (81.56%), 48.28%, 30.62%, respectively. Multivariate Cox regression analysis indicated that (only ) (splenectomy) was an independent prognostic factor (P=0.007). Conclusions The rates of postoperative complications and tumors recurrence were not influenced by splenectomy. Splenectomy did not prolong the survival time of patients with proximal gastric carcinoma who underwent radical total gastrectomy. Preservation of the spleen can prolong postoperative survival time and improve the survival rate in these patients.Splenectomy might only be (appropriate) for patients with direct invasion of the spleen.

Objective:To compare the nutritional status of inpatients after enteral nutrition (EN) and parenteral nutrition (PN). Method: A multi-center survey of 1 142 inpatients from the Department of gastrointestinal surgery, thoracic surgery, gastroenterology, respiratory disease, neurology, neurosurgery and the intensive care unit of 6 general hospitals in Beijing and Shanghai was adopted in this study. Body weight (BW), haemoglobin (Hb) and serum albumin (sALB) were compared before and after EN or PN respectively. Results: BW, Hb and sALB all decreased after the nutritional support both in EN and PN groups, but only significantly in BW and sALB (BW: -1.58?2.36 kg/m2 vs -2.09?2.66 kg/m2, P

BACKGROUND:Structural and functional changes of endothelial cels are the common pathological basis of cardiovascular disease. Severe structural and functional damage of endothelial cels are found in patients with hypertension or coronary heart diseases.
OBJECTIVE:To explore a new treatment method for hypertension from the perspective of vascular endothelial progenitor cels.
METHODS: PubMed and Wanfang databases were retrieved using the keywords “hypertension, EPCs” and approximately relevant 200 English and 100 Chinese literatures were obtained. Forty-nine eligible literatures were screened finaly.
RESULTS AND CONCLUSION:Endothelial progenitor cels have strong differentiation and proliferation capacities. This review may provide a new insight into potential sources of cels for diagnosis and treatment of hypertension.

AIM: To investigate mutations of oncogene k-ras in colorectal cancer tissues and the relationship between mutations of k - ras and biological behavior of colorectal carcinoma. METHODS:The specimens of 123 patients with colorectal cancer were collected. Real - time fluorescence quantitative PCR were performed to detect k-ras mutations at codon 12 and codon 13 of exon 1, and the results were analyzed with the corresponding clinical pathological data. RESULTS: Among 123 colorectal cancer cases, point mutations were detected in 53 cases (40.8% ) , point mutations at codon 12 were found in 42 (34.1 % ) cases, and 11(8.9% ) cases at codon 13.No closely relationship between mutations of k-ras and tumor size, location, invasive depth and differentiation extent was observed. The rate of k-ras mutation in the cases with more invaded lymph nodes was higher than that in the cases without invaded lymph nodes ( P < 0.05 ) , and the rate of k-ras gene mutation in the cases with hepatic metastases was higher than that in no hepatic metastases (P <0.05). The rate of k - ras gene mutation was higher in TNM staging Ⅲ/Ⅳ than that in Ⅰ/Ⅱ( P < 0.05 ). CONCLUSION: Mutation of oncogene k-ras plays an important role in the carcinogenesis and development of colorectal cancer, and it is closely associated with invaded lymph notes and hepatic metastases, suggesting that mutation of k- ras indicates a poor prognosis.

ObjectiveTo evaluate the rationale of combined evisceration for the treatment of advanced gastric cancer.MethodsThe clinical data of 137 cases with advanced gastric cancer treated with combined evisceration from 1994 to 2001 were analyzed retrospectively.ResultsEleven cases underwent combined hepatectomy, 25 cases with splenectomy, 13 with transverse colectomy, 15 with cholecystectomy, 4 with auxiliary adrenalectomy, 38 with splenectomy plus distal pancreectomy, 13 with pancreatoduodenectomy, 18 with other adjecent evisceration. The operative mortality rate was nil. The 1-,3-,5-year survival rate were 60.2%,26.3% and 16.6% respectively.Conclusions Combined evisceration for treating advanced gastric cancer was feasible and yielded a longer survival.

Objective To investigate the efficacy of sunitinib in the treatment of patients with imatinibresistant advanced gastrointestinal stromal tumor (GIST).Methods The clinical data of 45 patients with imatinib-resistant advanced GIST who received the treatment of sunitinib (37.5 mg/d) at the First Affiliated Hospital of Sun Yat-Sen University from March 2008 to June 2012 were retrospectively analyzed.The mutation of c-kit and platelet-derived growth factor receptor α (PDGFRα) was detected,and the efficacy of imatinib was assessed after the treatment for 3 months,and factors influencing the survival were analysed.The survival rate was calculated using the Kaplan-Meier method,survival analysis was done using the one-way analysis of variance,and multivariate analysis was done using the COX regression model.Results The median time of treatment with sunitinib for the 45 patients was 11.0 months (range,4-37 months).The complete remission rate,partial response rate,rate of stabilized condition and disease progression rate were 15.6％ (7/45),8.9％ (4/45),46.7％ (21/45) and 28.9％ (13/45) after the treatment with sunitinib for 3 months.All the patients with clinical (imaging) complete remission received surgery for metastatic lesions or B-ultrasound guided ablation for single liver metastasis before the treatment with sunitinib.The most common grade 3 or 4 adverse reactions of sunitinib were hand-foot syndrome and anemia.C-kit and PDGFRα mutational analysis were carried out.C-kit exon 9 mutation was detected in 9 patients,c-kit exon 11 mutation in 21 patients,and no mutation was detected in 12 patients.The median progression-free survival time was 8.0 months (range,4.1-11.9 months),and the median overall survival time was 25.0 months (range,13.4-36.6 months).The results of univariate analysis showed that the primary lesion sites and mutational status of primary lesions were factors influencing the progression-free survival and overall survival (x2=5.967,6.622 ; 7.965,8.765,P ＜ 0.05).The results of multivariate analysis showed that only the mutational status of c-kit of primary lesions was the independent factor influencing the progression-free survival and overall survival (Wald =6.540,7.205,P ＜ 0.05).The progression-free survival and overall survival of patients with c-kit exon 9 mutation and patients with no gene mutation were significantly longer than patients with c-kit exon 11 mutation (x2 =7.965,8.765,P ＜ 0.05).Conclusion Sunitinib with a dosage of 37.5 mg/d could effectively treat patients with imatinib-resistant advanced GIST.A better survival is observed in patients with c-kit exon 9 mutation or with no gene mutation when compared with patients with c-kit exon 11 mutation.