Objective To detect the expression of angiotensin Ⅱ type 1 receptor (AT1R) in the different fibrotic stages of human liver. Methods The collagen Ⅰ was detected by immunohistochemical method. Indirect immunofluoresence-labelled method was used to detected AT1R. And semi-quantitative RT-PCR was used to detect AT1R mRNA. Results The type Ⅰ collagen area enlarged with the progression of hepatic fibrosis. The positive expression of AT1R was concentrated in the cytoplasm of hepatic stellate cells(HSC) around the lobes of liver or in the hepatic sinus. Eight of twelve cases of normal liver tissues were positive, and all the eighteen cases of fibrotic liver tissues were positive. The positive cell number in fibrotic liver tissues was significantly higher than that in normal ones (P

Objective:The aim of this study was to explore the applicative effects of immune-enhanced enteral nutrition(Supportan) in preoperative preparation for patients with colorectal carcinoma.Methods:56 colorectal carcinoma patients with mid-severe malnutrition were randomly divided into two groups,experiment group and control group,each of 23.Experiment group was administrated with immune-enhanced enteral nutrition(Supportan).Control group was administrated with common enteral nutrition(Nutrison Fibre).Nutritional status,immunological function,inflammatory factor and the satisfaction of colon were observed.Results:After enteral nutrition,the plasma albumin,prealbumin,IgG,IgM,CD4+ T cells and the ratio of CD4+/ CD8+ were higher in experiment group than in control group and TNF-?,IL-6 and PGE2 were lower in experiment group than in control group.Conclusions:Immune-enhanced enteral nutrition(supportan) can improve nutritional status,strengthen immunological function,and decrease inflammatory reaction in the colorectal carcinoma patients with mid-severe malnutrition.

Background and purpose:BCRP was recently discoveried as a membrane transport protein affiliated with multiple drug resistance(MDR).The aim of present study was to investigate the expression of breast cancer resistance protein(BCRP) in primary breast carcinoma and its potential significance of guiding breast carcinoma chemotherapy and to determine whether such expression can be used as a predict factor for chemosensitivity.Methods:Expression of BCRP in 31 primary breast carcinoma tissues was determined by flow cytometry.The relationship between the expression of BCRP with the clinicpathological characteristics and the prognosis of breast carcinoma patients was also analyzed.Results:The expression level of BCRP was higher in breast carcinoma tissue(0.282581?0.183686) than control group(0.03125?1.000905).There was no statistical difference befween BCRP and state of ER,PR,C-erbB_2 and EGFR in breast carcinoma tissues.In addition,it was the same situation no matter whether axillary lymph node was metastatasied or not.Conclusions:The results suggest that BCRP is expressed in primary breast carcinoma and is a cell membrane protein independent on ER,PR,c-erb-B-2,EGFR.Based chemotherapy is more effective for the patients with the overexpression of BCRP in primary breast carcinoma tissue.

Objective To assess the feasibility and short-term effect of transanal everted extraction of laparoscopic rectal excision without abdominal incision.Methods Eleven patients were operated by transanal everted extraction of laparoscopic rectal excision without abdominal incision.Results All the operations were accomplished successfully,the average operative duration was (189.5±25.2) min,the intra-operative blood loss volume was (25.4±9.4) ml,the average time to flatus was (38.9±8.6) h,the average postoperative hospital stay was (12.7±2.5) d,and the number of lymph nodes harvested was 13.5±4.1.There were no post-operative complications.Conclusion The technique of transanal everted extraction of laparoscopic rectal excision without abdominal incision is safe and feasible,but the long-term effects need more observation.

Primary malignant small bowel tumor as a rare kind of intestinal tumor is associated with a poor prognosis. The pathological types were various and complicated, such as adenocarcinoma, neuroendocrine tumor, malignant lymphoma, and malignant stromal tumor. The atypical early stage symptom resulted in difficult diagnosis at early stage, high misdiagnosis rate and lack of standard therapy schemes and means. In the past, X-ray, CT, MRI, and PET-CT were the main examination methods for primary small bowel tumor. However, with the development of radiology, a series of new diagnosis methods, including electronic enteroscopy, capsule endoscopy, multi-slice spiral CT enteroclysis and so on, promotes the diagnosis accurate rate. Surgery is still the most important method in the small bowel tumor treatment, and the alternative of the surgical method should depend on the tumor location, size and relationship with the adjacent organs. Application of the laparoscopic surgery for the small bowel tumor is still in the initial stage. Besides, some researches have confirmed that chemotherapy, radiotherapy, target therapy and endocrinotherapy have effects on the specific kind of small bowel tumor. Therefore this article will review the epidemiology, pathology, diagnosis and treatment of the primary malignant small bowel tumors.
Adenocarcinoma ; diagnosis ; epidemiology ; pathology ; therapy ; Capsule Endoscopy ; Gastrointestinal Stromal Tumors ; diagnosis ; epidemiology ; pathology ; therapy ; Humans ; Intestinal Neoplasms ; diagnosis ; epidemiology ; pathology ; therapy ; Intestine, Small ; diagnostic imaging ; pathology ; Laparoscopy ; methods ; Lymphoma ; diagnosis ; epidemiology ; pathology ; therapy ; Neuroendocrine Tumors ; diagnosis ; epidemiology ; pathology ; therapy ; Tomography, Spiral Computed

OBJECTIVETo investigate the prognostic factors of colorectal cancer patients with liver metastasis in order to provide reference for clinical practice.

METHODSClinicopathological and follow-up data of 264 cases of colorectal liver metastasis in our department from January 1997 to January 2012 were analyzed retrospectively. Among these 264 patients, 217 underwent primary colorectal cancer resection, 33 underwent combined resection of primary colorectal lesion plus liver metastasis, and 14 received stoma creation alone. Besides, 197 patients received adjuvant chemotherapy, 14 received adjuvant radiotherapy, and 42 underwent interventional treatment. Clinicopathological features and treatment scheme affecting prognosis were analyzed and prognostic stratification analysis was performed according to emergence time of liver metastasis (synchronous or metachronous).

RESULTSOf 264 patients, 1-, 3-, and 5-year overall survival rates were 77.0%, 31.7%, and 14.0%; median survival time was 25 months; 1-, 3-, and 5-year survival rates of synchronous colorectal liver metastasis were 68.8%, 22.3%, and 7.7%; 1-, 3-, and 5-year survival rates of metochronous colorectal liver metastasis were 95.8%, 49.0%, and 21.3%, whose difference was statistically significant (P<0.05). Multivariate analysis showed that primary tumor differentiation, CEA level, adjuvant chemotherapy, and radical resection were independent prognostic factors of colorectal cancer patients with liver metastasis (all P<0.05), while primary tumor differentiation, CEA level, and radical resection were independent prognostic factors of synchronous liver metastasis (all P<0.05), and primary tumor location and CEA level were independent prognostic factors of metachronous liver metastasis (all P<0.05).

CONCLUSIONSRadical operation and adjuvant chemotherapy should be emphasized for colorectal liver metastasis, especially for synchronous colorectal liver metastasis. Simple resection of primary tumor can not improve the overall survival of patients with colorectal liver metastasis.

Chemotherapy, Adjuvant ; Colorectal Neoplasms ; pathology ; Hepatectomy ; Humans ; Liver Neoplasms ; diagnosis ; secondary ; therapy ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Survival Rate

With the improvement of living standard and the change of diet structure,the incidence of multiple primary carcinoma has increased significantly,which is related to the improvement of diagnosis level.In clinical work,multiple primary carcinoma was easily misdiagnosed with metastatic cancer.Many patients lost their best time to treat,because principles and prognosis of them were distinctly different.Strengthen the understanding of multiple primary carcinoma,in order to detect,diagnose and treat earlier,is beneficial to improve the survival of patients.Based on this background,this article reviewed the epidemiology,etiology,pathogenesis,diagnosis and treatment strategies of multiple primary carcinoma,aiming at improving the prognosis of patients.

Effective early screening and primary prevention is one of the major initiatives to decrease the morbidity and mortality of colorectal cancer in China. As a new non-invasive screening method for colorectal cancer in recent years, fecal DNA test detects colorectal cancer by analyzing gene mutations from intestinal tumor cells in the feces. The most widely used method among fecal DNA test is multi-target stoolDNA test (MT-sDNA). Many studies abroad on this emerging technique have been carried out to verify its high sensitivity, and it is gradually used in the clinic with continuous improvement and development of technology. Meanwhile, domestic MT-sDNA is still in the prototype stage, and more researches from Chinese population are needed. Compared with traditional screening methods, MT-sDNA technology has the advantages of non-invasiveness, painlessness and convenience. But its defects exist, such as high cost and low specificity. MT-sDNAis in accordance with precision medicine, and can largely make up for the shortcomings of traditional screening methods for colorectal cancer. It also holds a great promise for promoting the screening for colorectal cancer. This paper is aimed to discuss the application value of fecal DNA test by introducing its related researches at home and abroad,and summarizing its merits and demerits.

Objective:To investigate the expression of glutathione peroxidases 4 (GPX4) in colon adenocarcinoma and its relationship with clinicopathological features and prognosis of patients.Methods:The data set of colon adenocarcinoma was obtained from The Cancer Genome Atlas (TCGA) database to analyze the expression of GPX4 in colon adenocarcinoma tissues and its predictive value for overall survival (OS). A total of 93 colon adenocarcinoma tissues and 87 adjacent mucosa tissues after operation from November 2009 to May 2010 provided by the National Human Genetic Resources Sharing Service Platform were selected. The expression of GPX4 protein was detected by using tissue chip immunohistochemistry. The relations between the expression of GPX4 protein and the clinicopathological features and OS of colon adenocarcinoma patients were analyzed. Cox proportional hazards regression model was used to analyze the factors affecting the prognosis. The nomogram for predicting OS rate was established and drawn.Results:The analysis of data from TCGA database showed that in 380 cases of colon adenocarcinoma, the expression of GPX4 in colon adenocarcinoma tissues were higher than that in the normal colonic mucosa tissues [the value of fragments per kilobase of exon per million fragments mapped (FPKM): 85.654 (20.351-356.237) vs. 56.230 (48.783-63.931)], and the difference was statistically significant ( Z = -6.150, P<0.05). The OS in GPX4 high-expression group (FPKM ≥83.614) were poorer than that in GPX4 low-expression group (FPKM < 83.614) (median OS time: 84.40 months vs. 94.03 months, 5-year OS rate: 58.6% vs. 72.7%), and the difference was statistically significant ( P<0.05). Tissue chip immunohistochemical staining results show that the high-expression rate of GPX4 protein in colon adenocarcinoma tissues was higher than that in adjacent normal tissues [38.0% (35/92) vs. 7.3% (6/82)], and the difference was statistically significant ( χ2 = 22.727, P<0.01); the high-expression rate of GPX4 protein in left colon adenocarcinoma tissues was higher than that in right colon adenocarcinoma tissues [47.2% (25/53) vs. 25.6% (10/39), and the difference was statistically significant ( χ2 = 4.42, P = 0.036); the 5-year OS rate of patients in GPX4 high-expression group was lower than that in GPX4 low-expression group (25.7% vs. 57.9%), and the difference was statistically significant ( χ2 = 9.051, P<0.05). Multivariate Cox proportional hazards regression model analysis showed that lymph node metastasis (stage N 1-N 3) ( HR = 2.241, 95% CI 1.242-4.046, P = 0.007) and high expression of GPX4 ( HR = 2.783, 95% CI 1.598-4.848, P<0.01) were independent factors affecting the poor prognosis of colon adenocarcinoma patients. The above factors were used to establish a nomogram for predicting the prognosis of patients with colon adenocarcinoma, the C index was 0.739, indicating that the nomogram had good predictive performance. Conclusion:The expression of GPX4 is up-regulated in colon adenocarcinoma tissues, and its high expression is related to the malignant biological behavior of the tumor and poor prognosis.

Objective To investigate the safety and efficacy of enhanced recovery after surgery (ERAS) used in laparoscopic colorectal cancer surgery.Methods We conducted a retrospective analysis of the medical records of 99 cases treated with ERAS programed laparoscopic colorectal cancer surgery (ERAS group) and 103 cases treated with traditional perioperative care and laparoscopic colorectal cancer surgery (controlled group) from Mar 2017 to Sep 2017 in our center.Results There was no significant difference in age,gender,BMI,ASA classification,tumor location,operation time,pathological stage and the incidence of postoperative complications between ERAS group and controlled group (all P ＞ 0.05).Compared to control group,ERAS had less blood loss,shorter time to pass first flatus,stool and start diet and shorter hospitalization day,with all the difference statistically significant [(60 ± 63)ml vs.(112 ± 245)ml,(3.0±0.8)dvs.(4.3 ±1.2)d,(3.5 ±1.0)dvs.(4.6±1.3)d,(4.1 ±1.2)dvs.(5.4± 2.0)d,(5.8±2.1)dvs.(7.8±2.5)d,t=-2.021、-9.216、-6.887、-5.252、-6.163,allP＜ 0.05].No patients in both groups suffered from readmission or death within 30 days after surgery.Conclusion Patients treated with ERAS programed laparoscopic colorectal cancer surgery is safe and effective,with rapid recovery and reduced hospital stay.