Precision medicine is a new developing area of medical research and clinical practice, which is stemmed from the urgent need for high-profile medical health care and fast emergence of exquisite biological and medical technologies.Precision medicine, mainly based on the individualized molecular medicine and sophisticated medical techniques, offers multiple dimensional imaging examinations and biological molecular assays to make subsequent therapeutic strategies much more optimized to the personal disease characteristics than the traditional regimes, hence pursuing maximized efficacy and minimized side effects.The precision medicine in China is stepping into a vigorously developing stage after its first official initiation.This review summarized the development and program design of precision medicine in China to shed light on this growingly progressing area.

ObjectiveTo evaluate a new coloanal anastomosis preserving dentate line and anal sphincter. Methods After total mesorectal excision in 87 patients with low rectal carcinoma, the rectum no more than 1cm above the dentate line was preserved. The rectal mucosa was stripped and the dentate line was saved, then a sustaining anastomotic tube was fixed into the proximal colon, and the colon was pulled down and anastomosed with the remnant rectum 0.5cm above the dentate line. Results The ultralow coloanal anastomosis with anal sphincter preservation was accomplished. No perioperative death and anastomotic leakage occurred. The patients were followed up for 2 to 6 months and the follow-up rate was 89%. There was no anastomotic recurrence. Soft tissue recurrence in pelvic cavity was found in 3 cases, lymph node recurrence in obturator space recurrence in 2 cases and liver metastasis in 6 cases. Anastomotic stenosis was found in 6 cases 12 months later. The defecation function returned to normal six months after operation. Conclusions The sustaining banding method in the ultralow coloanal anastomosis with anal sphincter preservation is a safe and reliable surgical procedure.

Objective To evaluate a surgical procedure of low/ultralow colo-rectal(anal) anastomoses with sustaining bonding method after total mesorectal excision (TME) for lower rectal cancer. Methods After TME in 346 cases of lower rectal carcinoma, a sustaining anastomotic tube was inserted into the proximal colon, then the remnant was ligated and sutured. The rectal remnant no less than 1cm was preserved by colo-rectal anastomoses of modified Welch operation,while the rectal remnant no more than 1cm were preserved by colo-anal anastomoses with anal sphincter preservation. Results There was no perioperative mortality. Anastomotic leakage developed in 4 cases (1.2%), and anastomotic stenosis in 10 (2.9%). Postoperative 5 year survival and recurrence was 78.6%, 6.3% respectively. The defecation function was satisfactory in 82.6% cases. Conclusions Low/ultra-low colo-rectal(anal) anastomoses with sustaining bonding method after TME is safe and effective for lower rectal cancer.

Objective To investigate the telomerase activity and abnormality of p16 gene in liver metastatic tumors of colorectal carcinoma. Methods Telomerase activity was detected by a non isotopic PCR based TRAP assay (Telomeric repeat amplification protocol) and the homozygous deletions of p16 gene was detected by a semiquantitative multiple PCR in tissue samples from 24 liver metastases of colorectal carcinoma. Results Telomerase activity were observed in 19 (79 2%) out of the 24 colorectal carcinoma patients. There was no correlation hetween the telomerase activity, the number of metastasis, differentiation, liver fibrosis and HBsAg status of the patients. Homozygous deletions of p16 gene were found in 9 out of 24 (37 5%) patients, and homozygous deletions of p16 gene was significantly correlated with telomerase activity.Conclusion The abnormality in telomerase activity and homozygous deletions of p16 gene may be important for elucidating in liver metastases of colorectal carcinoma.

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.

e and feasible for postcolectomy patients.

Objective To investigate the outcome of induction of tumor cell apoptosis with low dosage of 131 I labelled anti carcinoembryonic antigen(CEA) monoclonal antibody C50( 131 I C50) and the therapeutic efficacy of combining radioimmunotherapy(RAIT) with chemotherapy in colorectal cancer xenografts. Methods Human colorectal cancer xenografts with positive CEA expression were established in nude mice with LoVo cell line. 5 fluorouracil(5 FU), 75 ?Ci 131 I C50, and 5 FU, combined with 131 I C50 were given to nude mice through tail vein to treat xenografts on 9th day after implantation of tumor cells. Fifteen days after implantation, each mouse was sacrificed and tumor tissues were stained with HE and terminal deoxynucleotidyl transferase mediated X DUTP nick end labeling technique(TUNEL technique). Apoptosis index(AI) of xenograft cells in each mouse was calculated. Results Under light microscope, no obvious cytolysis or necrosis of tumor cells was seen in all four groups. Apoptosis indexes in blank control group, chemotherapy group, radioimmunothera py(RAIT) group, and RAIT+chemotherapy group were (0.29?0.08)%, (18.68? 2.69 )%,(40.88 ?4.54 )% and (62.33?8.00)%, respectively. There were significant difference of apoptosis indexes between any groups( P

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.

Objective To study the effect of Yiqihuoxue Paishiyin combined with levofloxacin on renal calculus and inflammatory state. Methods 76 patients with kidney stones in our hospital from February 2015 to September 2016 were selected as the study object,and they were divided into control group 38 cases and observation group 38 cases by the method of random number table,then the control group were treated with levofloxacin, the observation group were treated with supplementing qi,promoting blood circulation and removing stones combined with levofloxacin,then the clinical effective rates,serum fever and pain related inflammatory factors before and after the treatment of two groups were analyzed .Results The total effective rates of observation group with different stone diameters and stone locations were all higher than those of control group,the serum fever and pain related inflammatory factors at different time after the treatment were all lower than those of control group , the differences were all significant ( P <0.05 ) . Conclusion Yiqihuoxue Paishiyin combined with levofloxacin treatment of kidney stones in patients with significant effect , can effectively control the body's inflammatory state, improve the level of inflammatory factors.

Objective To study the influence of clinicopathologic characteristics and surgical treatment of gastric cancer on patients' survival rate.Methods From Apr.1994 to Aug.2005, the data of 759 gastric cancer patients concerning surgical treatment, pathological diagnosis and outcome were collected. Retrospective analysis of the results was made, 3-year and 5-year survival rates were calculated by Kaplan-Meier curve method, univariate analysis was done through Log-rank and multiple factors comparison through Cox regression analysis, and follow-up duration was 4-131 months.Results Single factor analysis indicated that age,tumor location,diameter of tumor, Borrmann type, type of histology, TNM stage, depth of infiltration, lymph node metastasis, liver metastasis, peritoneal dissemination, blood of transfusion during operation, extent of the radical cure of the tumor and excision techniques were significantly influential factors for the prognosis of patients. Cox regression analysis showed that tumor location, diameter of tumor,depth of infiltration, lymph node metastasis,liver metastasis, TNM stage, peritoneal dissemination, blood transfusion during operation, extend of the radical cure of the tumor and excision techniques were independent factors influencing the postoperative survival rate.Conclusion Independent factors influencing the postoperative survival rate include tumor location, diameter of tumor, lymph node metastasis, infiltration depth of the tumor, pathological classification, liver metastasis, peritoneal dissemination, and TNM stage, extent of the radical cure of the tumor, lymphanodectomy techniques and blood transfusion during operation are also important factors.