Objective To evaluate the curative effect of laparoscopic radical gastrectomy combined with Roux-en-Y reconstruction of the digestive tract in treatment of advanced gastric cancer complicated with type 2 diabetes mellitus.Methods 73 advanced gastric cancer complicated with type 2 diabetes mellitus patients between May 2014 to May 2016 underwent distal partial gastrectomy or total gastrectomy with Rouxen-Y GI reconstruction.Results Compared with preoperative data,postoperative level at after 1 month and 3 months were respectively for FPG (14.9 ± 1.9 vs.8.7 ± 0.9,8.8 ± 0.9) mmol/L,OGTT 2 h PG (15.4±1.8 vs.8.68±0.9,8.7 ±0.9) mmol/L,HbA1 (10.4％ ±0.8％ vs.7.4％ ±0.6％,7.4± 0.6),BMI (29.9±1.2vs.25.4±0.7,25.2±0.6) kg/m2,TC (8.4±0.6 vs.6.7±0.6,6.7±0.4) mmol/LandTG (2.53±0.53 vs.1.86±0.27,1.91±0.33) mmol/L(withallP＜0.05).Conclusion Laparoscopic radical gastrectomy combined with Roux-en-Y reconstruction of the digestive tract for advanced gastric cancer significantly improves patients' co-occurring.

Objective To investigate the expression and sensitivity of 6 muhidmg resistance gene products(MDR) : GST-π、LRP、MRP、Topo Ⅱ、P-gp、TS in gastric cancer during neoadjuvant chemotherapy. Methods Expression of the 6 muhidrug resistance gene was detected by immunohistoehemistry in 35 cases of stomach cancer tissues before and after neoadjuvant chemotherapy. The relationship between muhidrug resistance gene and neoadjuvant chemotherapy was analyzed. All patients were given FOLFOX4, and the effects were evaluated according to World Health Organization criteria. Results The overall response rates to chemotherapy was 46%, expression of the 6 mtdtidrug resistance gene in 35 cases of stomach cancer tissues were as follows:GST-π was 40% ,LRP was 69% ,MRP was 34% ,Topo Ⅱ was 37% ,P-gp was 86%, TS was 40%, expression of the 6 muhidrug resistance gene did not change during neoadjuvant chemotherapy; GST-π、LRP、MRP、Topo Ⅱ、P-gp were not correlated with chemotherapy sensitivity(P > 0.05), while TS was significantly correlated with chemotherapy sensitivity (P = 0.0048). Conclusion FOLFOX4 does not effect a change in the expression of the 6 muhidrug resistance gene: GST-π、LRP、MRP、Topo Ⅱ、P-gp and TS, while TS is significantly correlated with gastric cancer chemotherapy sensitivity.

ObjectiveTo investigate theeffectof expression of excision repair cross complementing 1(ERCC1) on adjuvant chemotherapy and prognnsis in advanced gastric cancer.MethodsIn this study 88 advanced gastric cancer cases were divided into initial neoadjuvant chemotherapy group (45 patients) and upfront surgical group (43 cases).In neoadjuvant chemotherapy group two courses neoadjuvant chemotherapy with XELOX were given before an interval standard radical gastrectomy.Postoperatively another four cycles of chemotherapy with XELOX were given; In upfront surgical group standard radical gastrectomy was done followed by 6 cycles of postoperative chemotherapy with XELOX;Patients in the two groups were followed up for 3 years.ResultsERCC1positive expression were 49％ and 44％ in neoadjuvant group and surgical patients; Response rate in neoadjuvant chemotherapy group was 49％.Patients with ERCClnegative expression were more sensitive to chemotherapy (P ＜0.05 ); 3-year recurrence-free survival rate in patients with ERCC1negative expression was 64％,which was significantly higher than 30％ in patients with positive expression,the difference was statistically significant (P ＜ 0.05 ) ;3-year recurrence-free survival rate in initial surgical group patients with ERCCl-negative expression was 79％,significantly higher than in patients with positive expression (38％),the difference was statistically significant (P ＜0.05) ; Cox regression analysis revealed that ERCC1expression is closely related to 3-year disease-free survival ( P ＜ 0.05 ). ConclusionsERCC1expression in patients with advanced gastric cancer is related to chemosensitivity and prognosis,it can forecast the prognosis and chemotherapy sensitivity.