Rectal cancer does great harm to human health which is one of the common gastrointestinal malignancies.The most effective treatment to rectal cancer is surgical resection at present.With the increasing demand on the quality of life,we minimize the surgical resection to preserve the anal function of patients while removing the tumor completely depends on the distal excision margin.But how long of the distance is safe? Lots of domestic and foreign scholars have a great controversy without a certain definition.This article reviews the progress on the distal excision margin,aiming to give help to clinical sphincter-preserving surgery.

Amplification of the human epidermal growth factor receptor 2/neu (HER2/neu) gene and overexpression of the HER2 protein (HER2) have been shown to occur in gastric and gastroesophageal junction adenocarcinoma in a number of studies.With a dismal survival rate,patients with these cancers stand to benefit from the identification of possible molecular targets such as HER2 for both prognostic and therapeutic purposes.Although these and other carcinomas that overexpress HER2 may have a poorer prognosis and exhibit resistance to conventional chemo-therapy,they have also recently been shown to respond to targeted therapy with the anti-HER2 antibody Trastuzumab.Here,the author briefly review the molecular biology,histopathology,diagnostic techniques,and interpretation,as well as the clinical implications of HER2 amplification/overexpression in gastric and gastroesophageal adenocarcinoma.

The relationship between PGE2 and sIL-2R and ca rcinoma of large intestine and the development of its immunological study is de scribed briefly.

Objective To investigate the expressions of the CD13 in gastric cancer and the relationships between it and the patients' prognosis.Methods The expressions of CD13 were detected by immunohistochemical (SP method) in 104 cases of gastric cancer and 16 cases of normal gastric mucosa.Results The expressions of CD13 in 104 cases of gastric carcinoma and 16 cases of normal gastric mucosa show positive rate were 74％ (77/104) and 0％,respectively.The expressions of CD13 in gastric cancer were higher than in normal gastric mucosa and the difference was statistically significant (P ＜ 0.01).The expressions of CD13 in gastric cancer were not relative to patients' age,gender,and lymph node metastasis (P ＞ 0.05),but to be correlative with tumor sizes,clinical stage,degree of differentiation,and patients' 5-year survival rate (P ＜ 0.05).Conclusions The abnormal expression of CD13 in the gastric cancer may be correlative with the occurrence and development of gastric cancer,which can be an important indicator to evaluate the degree of malignance,guide treatment and assess uncertain prognosis of gastric cancer.

Objective To investigate the effects of cholecystokinin (CCK) on diabetes mellitus with cholecystolithiasis. Methods Relevant literatures of recent years were reviewed. Results CCK exists widely in human body.On the one hand, CCK enhances cholecystolithiasis by causing diabetes. On the other hand, its pathological changes can also lead to cholecystolithiasis. Besides, it is possibility that the CCK-related gene abnormality is the common cause of diabetes and cholecystolithiasis. Conclusion CCK plays an important role in diabetes mellitus complicated with cholecystolithiasis. However, there is much yet to be known about CCK.

Objective To determine the expression of metastasis-associated gene 2 ( MTA2 ) and p53 in colorectal cancer and non-cancerous mucosa, analyze their relationship with clinicopathological parameters, and discuss the clinical significance. Methods 120 colorectal neoplasm patients' cancer tissues and clinical information were col-lected from the first affiliated hospital of Anhui medical university. 30 patients of them were chosen to collect non-cancerous mucosa which was 5 cm away from the tumor. Immunohistochemistry staining was used to detect the ex-pression of MTA2 and p53. According to the clinicopathological parameters, the positive and negative expression of MTA2, p53 were counted each group, discussed the relationship between positive expression and clinicopathologi-cal parameters by SPSS 19.0 . Results The immunohistochemistry showed that the positive expression rate of MTA2 was 59.16%, and the positive expression rate of p53 was 61.67%. The expression of MTA2 and p53 in colorectal cancer were significantly higher than non-cancerous mucosa ( P<0.05 ) . The MTA2 expression was positively cor-related with the depth of invasion, lymphatic metastasis, distant metastasis and TNM stages (P<0.05). The p53 protein expression was positively correlated with depth of invasion and lymphatic metastasis ( P<0.05 ) . Conclu-sion MTA2 could be used as a new clinical biomarker and therapeutic target for colorectal cancer probably, which might be more effective than p53 .

Objective To investigate the interrelationship between Golgi phosphoprotein 3 ( GOLPH3 ) expression with vasculoar endothelial growth factor( VEGF) expression in the progression of human gastric cancer by detecting the expression level of GOLPH3 and VEGF. Methods Immunohistochemistry ( IHC) was used to detect the ex-pression of GOLPH3 and VEGF in 55 cases of gastric cancerous and carcinoma-adjacent tissues. Pearson correlation analysis was used to discuss the association between GOLPH3 expression with VEGF expression. Results The im-munohistochemical detection showed that the positive expression rates of GOLPH3 and VEGF were 67. 27%, 58. 18% respectively, which were significantly higher than the positive expression rates in carcinoma-adjacent tis-sues ( P<0. 05 ) . A statistical analysis revealed that the positive expression rate of GOLPH3 and VEGF in the gas-tric cancer tissues were strongly correlated with depth of invasion ( P<0. 05 ) , distant metastasis ( P<0. 01 ) and TNM stages (P<0. 01), whereas it did not significantly correlate with age or gender or size of tumor. Compared with the negative for the GOLPH3 expression, the VEGF expression in gastric cancer tissues positive for the GOL-PH3 expression was significantly higher. The protein level of GOLPH3 expression was positively correlated with VEGF expression (r=0. 508,P<0. 01). Conclusion GOLPH3 overexpression may regulate gastric angiogenesis by upregulating the expression of VEGF, which affects the invasion and metastasis of gastric cancer.

Objective To explore the changes of the pressure of sphincter of Oddi(SO)in postoperative patients with cholangiolithiasis.Methods Sixty cases with multiple biliary calculi operation (recurrent cholangiolithiasis group),80 cases with biliary calculi operation at first time(cholangiolithiasis group)and 9 cases with external injuries of pancreas or liver(control group),who were examined in order to identify common bile duct pressure(CBDP),SO basal pressure(SOBP),amplitude of SO contractions (SOCA),frequency of SO contractions(SOF),then comparing the difference of statistics among the three groups.Results CBDP,SOBP,SOCA,SOF in recurrent cholangiolithiasis group and cholangiolithiasis group were significantly higher than those in control group[(13.78 ±9.91),(12.65 ±7.64)mm Hg(1mm Hg =0.133 kPa)vs.(12.54 ± 2.35)mm Hg,(15.27 ± 9.15),(14.89 ± 7.87)mm Hg vs.(13.63 ± 3.27)mm Hg,(106.30 ± 54.70),(98.39 ±38.29)mm Hg vs.(87.65 ±56.38)mm Hg,(6.91 ± 1.92),(6.25 ±2.17)times/min vs.(5.26 ± 2.11)times/min](P ＜ 0.05),but there was no significant difference between recurrent cholangiolithiasis group and cholangiolithiasis group(P ＞ 0.05).Conclusion SO dysfunction resides in the postoperative patients with cholangiolithiasis,and it is possible related with the formation and/or recurrence of cholangiolithiasis.

ObjectiveTo survey the status of Helicobacter pylori (HP)infection in cholangiocarcinoma,and its relation to clinical and pathological parameters and prognosis. MethodsHP infection in 80 cholangiocarcinoma samples and 30 controls was detected by PCR,in those with positive results the expression of Cag A and its subtypes of Vac A sla,m1 and m2 was further tested by PCR.ResultsChi-square test showed that the detection rate of in HP ( + ) in cholangiocarcinoma group is 71％,higher than 20％ in control group.The positive cases of CagA and VacA sla,m1,m2 in cholangiocarcinoma group was respectively 30,40,5 and 43 cases.HP infection in cholangiocarcinoma was correlated with the location of the tumor(x2 =27.580,P ＜ 0.05 ). MultivariateLogisticanalysisshowedthat cholangiocarcinoma is over 10 times more likely in HP ( + ) patients than HP ( - ) ( OR =10.531 ).Cox regression analyses showed that the infection of HP(HR =8.105,P =0.032),the staging of TNM( Ⅱ/ⅢHR=9.141,P=0.040,Ⅳ HR =29.071,P=0.040) and surgery (HR=9.531,P =0.015) are all independent prognostic factors of cholangiocarcinoma. Life table analyses showed HP infection negatively affects the survival time of cholangiocarcinoma after a surgery ( u =10.074,P =0.002),and the median survival time is 7.25 months shorter than HP( - ) patients. ConclusionsIt is common that HP infection complicating cholangiocarcinoma,usually with the genotype of VacA sla/m2,HP infection is a risk factor for cholangiocarcinoma,and negatively affects oatients survival after surgery.

Objective To explore the relationship between cholelithiasis and the function of sphincter of Oddi (SO). Methods To identify the existence of calculi, choledochoscopy was performed in patients 6 weeks after exploration of the common bile duct (CBD) and T tube drainage, in which 71 were patients with stones in gall bladder, CBD or intra-hepatic bile duct, and 9 with trauma of pancreas or liver.Biliary manometry was performed after choledochoscopy, and an additional manometry was applied after calculus removal if calculi were detected. The indices measured included SO basal pressure ( SOBP), amplitude of SO contractions (SOCA), frequency of SO contractions (SOF) and CBD pressure (CBDP). The patients with cholelithiasis were classified into cholecystolithiasis group, choledocholithiasis group, and hepatolithiasis group according to the position of calculi. Patients with trauma were assigned as the control group.Results All variables in 50 patients with choledocholithiasis were similar before and after the procedure.The variables in patients with cholecystolithiasis and choledocholithiasis had no difference from those of the control (P ＞ 0. 05 ). The SOBP and SOCA of patients in hepatolithiasis group were lower than those of the control group ( P ＜ 0. 05 ), while no difference in SOF was detected (P ＞ 0. 05 ). Conclusion The function of SO in patients with hepatolithiasis is abnormal ( decrease in SOBP and SOCA). Biliary manometry cannot be the reliable evidence for the existence of calculi in bile duct.