Anorectal malignant melanoma is a rare disease with atypical clinical symptoms and has a high misdiagnosis rate.Combined with rectal touch,endoscopy,ultrasonic inspection,CT,MRI,PET-CT,electron microscopy and the result of immunohistochemistry could help improve the diagnosis rate.This tumor tends to relapse and metastasis with poor prognosis,and there is no effective treatment.We should be on the alert for it,and the main point is early discovery,correct diagnosis,multi-disciplinary comprehensive treatment,in order to improve the survival rate of patients.

Ring finger protein 43 (RNF43) gene is closely associated with the development of various types of human tumors.The mainly mechanisms of RNF43 gene are mutation and aberrant expression.Activated RNF43 protein participates in the proliferation, apoptosis, metastasis through some signal pathways and influences the tumorigenesis and development in colorectal cancer, hepatocellular carcinoma, which plays a role of oncogene.However, it is considered as a tumor suppressor gene in mucinous ovarian tumors and intraductal papillary mucinous neoplasms of the pancreas.

Objective To precious localize DNase Ⅰ hypersensive sites exactly in the promoter region of CD133 of cell line SW480 by inverse-PCR.Methods The colonel cancer cell SW480 nuclei were suspended in digested buffer,treated with DNase Ⅰ at the concentration of 10 U/ml for 10 min.The inversePCR was performed as follows.DNA treated by DNase Ⅰ was purified,fragmented with restricted enzyme EcoRI and Xmal Ⅰ.Then the ends were blunted,ligated by T4 ligase.PCR was performed,and production was sequenced.The restricted enzymes cut sites were near DNase Ⅰ cleavage sites.Results 9 DNase Ⅰ cut sites were identified in CD133 promoter region.The DNaseI hypersensitive sites all distributed in a region -300 bp--700 bp up to transcription start site.Conclusion The DNase Ⅰ cleavage sites could identified preciously by application of inverse-PCR.These sites locate in a region of-300 bp--700 bp up to transcription start site.

Objective To evaluate the clinicophatholgic benefits and safty of antivirus therapy in patients with liver cirrhosis resulting from hepatitis B.Methods 80 patients with HBV-ralated liver cirrhosis were divided into three groups by the histopathology of liver:group of lamivudine treated with lamivudine 100 mg once daily;Adefovir group treated with Adefovir 10 mg once daily;control group treated with liver protective treatment only.Liver and renal function,PTA and HBV DNA were regularly measured.The Child push-Turotte sore and histopathology wag compared before and after treatment.All courses of treatment were 36 weeks.Results The scores of Child Pugh-Turotte sore in groups of lamivudine and Adefovir were lowered sinificantly (3.9 and 2.1 respectively),the load of HBV-DNA was decreased also[(4.1±0.9) copies/ml and(2.8±1.0) copies/ml],liver inflammmation decreased by more than 2 scores and liver fiber was improved by more than one score,with obviously significant difference(P<0.05) as compared with control group.Conclusion Patients with HBV-related cirrhosis treated with lamivudine and adefovir for antivims are improved and antivirus is important and safe to those during cirrhosis decompensation.

Objective To detect the levels of Th1 and Th2 type cytokines of peripheral CD+4 T lymphocytes in patients with colonic cancer in order to find out the significance of variance of imbalance in clinical therapy.Methods The peripheral blood lymphocytes were stimulated by stimulator in order to enhance the expression of cytokines.Then a specific fluorochrome-conjugated monoclonal antibody was added to be combined with its specific antigen.Cytokines were detected by flow cytometry.Results The levels of Th1 type cytokines such as interferon-γ/(INF-γ),interleukin-2(IL-2)were significantly lower in patients of colonic cancer than those of normal controls.The levels of Th2 type cytokines such as interleukin-4(IL-4),interleukin-6(IL-6)and interleukin-10(IL-10)were higher in patients of colonic cancer than those of normal controls.Conclusion Th1/Th2 shihs in colonic cancer.It is suggested that the levels of INF-γ/IL-4 in colonic cancer may provide clinical index for the prognosis and evaluation of immunity.

Objective To compare Th1/Th2 drift situation in patients with lymphoma with that in patients with solid tumors, and establish the effective immune function detectable criterion of lymphoma in biological treatment process. Methods The whole blood samples of 10 patients with lymphoma, 202 patients with solid tumors including 36 patients with upper digestive tract cancer, 64 colorectal cancer, 43 lung cancer and 20 the other malignancies, and 30 healthy persons as controls were collected. Stimulation agent was used to stimulate the cells in order to increase cell factor expression and fluorescent labeled specific anti-cytokine monoclonal antibody was used to bind with specific antigen. The expression of specific cytokines was detected by flow cytometry. Results Positive percentages of IFN- γ and IL-4 and ratio of IFN- γ /IL-4 in CD+4 T cells of human peripheral blood had statistically differences between in patients with lymphoma and controls (P < 0.05). The ratio of Thl/Th2 (CD+4 intracellular cytokine INF-α/IL-4) in patients with lymphoma was lower than that in patients with upper digestive tract cancers (esophagus and stomach cancers) (P = 0.023), however, had no statistical differences with that in patients with other solid tumors (colorectal, lung, kidney, breast and other tumors), but had a downward trend. Conclusion Immune functions in patients with lymphoma are lower than those in patients with solid tumors and immune treatment is a necessary to adjuvant chemotherapy. The ratio of Th1/Th2 (INF- α/IL-4) is expected to become effective detection criterion.

10.3969/j.issn.1000-8179.2013.12.009

Objective To observe the levels of Th1 and Th2 type cytokines of peripheral blood CD+4 T lymphocytes at different stage of treatment of colonic cancer,in order to find out the laboratory evidence of tumor immunotherapy.Methods The peripheral blood lymphocytes were stimulated by stimulator in order to enhance the expression of cytokines.Then specific fluorescent-conjugated monoclonal antibodies were added to combine with its specific antigens.Cytokines were detected by flow cytometry.Results At different stage of treatment of colonic cancer,the levels of Th1 type cytokines of each stage was significant.The levels of Th2 type cytokines at each stage were not significant.The IFN-γ//IL-4 ratio were significantly different during tumor immunothempy.Conclusion At different stage of treatment of colonic cancer,the levels of Th,type cytokines were obviously associated with treatment.The levels of Th2 type cytokines had no association with treatment.Among them,the changes of Th1/Th2 ratio (IFN-γ/IL-4) had more correlation with tumor immunotherapy.So the reasonable immunotherapy can reverse Th1/Th2 ratio and immune inhibition.

Objective To investigate the clinical application of early postoperative enteral nutrition in patients undergoing colon cancer operation.Methods 90 patients suffering from colon cancer were randomly divided into the enteral nutrition group,indwelling stomach tube group and the control group.The control group was given conventional treatment and the indwelling gastric tube group was received postoperative intermittent clamping of stomach tube and enteral nutrition.Moreover,patients in the enteral nutrition group were pulled out the tube on the first postoperative day while giving enteral nutrition.All patients were observed for exhaust defecation time,length of hospital stay postoperative and nutrition indicators.Results Exhaust defecation time,length of hospital stay postoperative had significant difference among three groups.Indwelling stomach tube group set minimum length of stay and first passage of flatus and defecation in the three groups [the enteral nutrition group:(50.07±11.59) h,(76.75±27.37) h,(10.1 1±1.57) d,the control group:(62.03±12.31) h,(90.67±25.64) h,(11.80±1.83) d,indwelling stomach tube group:(43.53±11.94) h,(61.17± 22.67) h,(8.70±1.53) d (P ＜ 0.05)].The levels of hemoglobin and plasma albumin one week after operation were statistically lower than pre-operation,while that the level of these nutrition indicators were higher in indwelling stomach tube group compare to control group (all P ＜ 0.05).The same result was observed between enteral nutrition group and control group.Whereas,the change of nutrition indicators between the enteral nutrition group and the control group was not statistical significant (P ＞ 0.05).Conclusion Indwelling stomach tube combined with enteral nutrition is a reasonable choice for patients after colonic cancer surgery.

Objective To investigate the diagnosis,the treatment methods and the prognosis of rectal cancer patients after renal transplantation.Methods Four patients with rectal cancer were found in 1035 renal transplantation recipients.Three of four patients were treated with anterior resection (AR) or abdomenoperineal resection (APR) with total mesorectal excision (TME).The two patients accepted regular adjuvant chemotherapy for six months period after surgery,but one patient rejected to accept any chemotherapy after surgery.Otherwise,one patient was only treated with chemotherapy and best support therapy for diagnosed as rectal cancer with multiple liver metastases.Results Two patients were fine to be followed up,8 months and 21 months after rectal resection respectively.Two other patients eventually died of metastasized cancer 5 months and 31 months respectively after therapy had been initiated.Conclusion Transplantation patients should receive standard oncology treatment,including operation and adjuvant treatment,so long as their general condition and organ graft functions allow to do so,although a higher degree of morbidity might be encountered,and periodical colorectal screening should be performed before and after renal transplantation.