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.

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.

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 identify aldosterone synthase gene-CYP11B2 mRNA expression in normal and fibrotic liver in rats and evaluate the curative effect of antisterone. Methods　160 Wistar rats weighing about 250?g were divided into 4 groups. In the model group (n=40), the rats were injected with 40% CCl4 (0.25?ml/100?g) subcutaneously three times a week. In the antisterone group (n=40), the rats were injected with 40% CCl4 (0.25?ml/100?g) subcutaneously three times a week. Antisterone equivalent to 20?mg*kg-1*d-1 was given intragastrically (ig). In the malotilate group (n=40), the rats were injected with 40% CCl4 (0.25?ml/100?g) subcutaneously three times a week. Malotilate equivalent to 50?mg*kg-1*d-1 was given ig. In the control group (n=40), the rats were injected with olive oil only. After 2,4,6,8 and 10 weeks, animals were sacrificed, and morphological examination was carried out. The area of collagen was examined with an Image Analyse System. Expression of the aldosterone synthase gene, CYP11B2 mRNA, in fibrotic and normal liver was detected by means of reverse transcriptase polymerase chain reaction (RT-PCR) and in situ hybridization. Results　In situ hybridization and RT-PCR showed that the expression of CYP11B2 mRNA, which localized in the endoplasm of hepatic stellate cells (HSCs), was up regulated when fibrogenesis occurred. Histological observation indicated that the grade of fibrosis and the area of collagen in the antisterone group were less than those in model group before 6 weeks (P<0.05). There was no significant difference between the antisterone and malotilate groups (P>0.05). After that, however, the grade of fibrosis and the area of collagen in the antisterone group were higher than those in the malotilate group (P<0.05). There was no significant difference between the antisterone and model groups (P>0.05). Conclusions　The expression of CYP11B2 mRNA is up regulated in fibrotic liver. Antisterone can have a partial fibrogenesis-inhibiting effect in the early stages.

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 prognostic factors of colorectal cancer patients with liver metastasis in order to provide reference for clinical practice. Methods Clinicopathological 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). Results Of 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). Conclusions Radical 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.