Objective To generally analyze the current situations and advancement of the study on immunotherapy for colorectal cancer. Methods The pertinent published papers about the current situation and research advancement of the immunotherapy of colorectal cancer were retrospectively investigated. And also the immunogenicity and the varying principles of immunoresistance, the functional targets, the practicality, and some other characteristics of different immunotherapy for colorectal cancer were reviewed. Results The main treatments and the research focuses in the immunotherapy of colorectal cancer are initiative nonspecific immunotherapy, adoptive immunotherapy, monoclonal antibody immunotherapy, initiative specific immunotherapy, and targeted therapy. They work by fighting against the cancer itself, cutting off the tumor’s nutrition supply, activating the immune system specifically or breaking the immune tolerance and so on. Though there are still many problems unsolved, immunotherapy has a promising clinical prospect. Conclusion As a beneficial complement for surgery, chemotherapy and radiotherapy, immunotherapy plays an important auxiliary role in the combined therapy for colorectal cancer.

BACKGROUND: Polyethylene glycol-polyethyleneimine/ferroso-ferric oxide (PEG-PEI/Fe_3O_4) was selected as drug carders in tumor treatment, which can increase drug loading capacity and targeting capacity.OBJECTIVE: To test the toxicity of PEG-PEI/Fe_3O_4 nano-magnetic fluid in vitro and in vivo. METHODS: When the prepared PEG-PEI/Fe_3O_4 nano-magnetic fluid reached nano level, 7702 and HpG2 cell lines were filtrated and diluted in 5-20 multiple, and detected by in vitro MTT toxicity test assay; in vivo hemolysis test and micronucleus test was used to test the toxicity and biocompatibility.RESULTS AND CONCLUSION: MTT assay results indicated that the toxicity grade of PEG-PEI/Fe_3O_4 nano-magnetic fluid to 7702 cell line was 0-1, which was harmless to natural hepatic cells; however, PEG-PEI/Fe304 nano-magnetic fluid had slight bystander restraining effect to HpG_2 cell line. Maximum hemolysis rate of the matedel was 0.372%, which was far less than 5%. The micronucieus test result indicated that PEG-PEI/Fe_3O_4 nano-magnetic fluid had no teratogenicity or mutagenicity.

[Objective] To explore the clinical pathological characteristics and treatment of pancreatic careinoid. [Methods] Eight patients with pancreatic careinoid were recruited between January in 1997 and December in 2007 for retrospective analysis which involved tumor markers, inanunohistostaining, accompanied with other tumors, misdiagnosis, metastasis, in-hospital mortality rate, and so on. The relevant literatures were simultaneously reviewed to comprehend the clinical pathological characteristics of pancreatic carcinoid. [Results] Tumor markers CEA, CA199, CA125, and CA72-4 in pancreatic carcinoid were 0%, 25%, 12.5%, and 0%, respectively. Specimen immanohistostaining Syn, CgA, NSE, and CK in pancreatic carcinoid were 25%, 62.5%, 75%, and 75%, respectively. Two pancreatic carcinoids were accompanied by other tumors in 8 cases. The misdiagnosis rate of pancreatic carcinoid (7/8) was markedly high. Pancreatic carcinoid possessed high metastasis (50%), high in-hospital mortality rate (37.5%) and low radical operation undergone (62.5%). [Conclusions] Pancrcatic carcinoid was accompanied with high misdiagnosis rate and poor prognosis. Routine sero-markers did not help discover pancreatic carcinoid early. The final diagnosis depended on specimen immunohistostaining with Syn, CgA, NSE, and CK.

Objective To evaluate the clinical value of contrast-enhanced ultrasound (CEUS) in preoperative diagnosis of anal fistula. Methods Forty-five patients with fistula in ano were evaluated by physical examination, then CEUS were peformed by injecting SonoVue through the external opening to enhance the detection of the fistulous track and the internal opening. The results of CEUS were matched with surgical features to establish their accuracy in preoperative assessment of anal fistula. Results Simple typing fistula was found in 19 of 45 patients and 26 patients had complex fistulas. The accurate diagnostic rates by conventional ultrasound of simple typing fistula and complex fistulas were 89. 5% and 61.5%,respectively,the accurate diagnostic rates by CEUS of simple typing fistula and complex fistulas were 94. 7% and 92.3%, respectively, there was no significant difference between conventional ultrasound and CEUS about simple typing fistula( P ＞0.05), and there was significant difference about complex fistulas ( P ＜0. 05). Conclusions CEUS has a good visibility and accurate rate for diagnosis of anal fistula,It plays an important role for operation.

Objective To investigate the expression and prognostic significance of Interleukin-36α (IL-36α) in colorectal cancer.Methods The expression of IL-36α was tested by immunohistochemical staining in 329 cases of colorectal cancer.According to the intensity and the proportion of positive tumor cells,all the patients were divided into IL-36α low and high expression groups.The clinicopathological factors and prognosis of patients between IL-36α low high expression groups were compared.Results Significant differences were observed in the number of patients in tumor differentiation and pM classification between patients in the IL-36α low and high expression groups (P ＜ 0.05).The 5-year overall and tumorfree survival rates of patients were 79.3％ and 77.2％ in IL-36α low expression group,and 66.3％ and 65.3％ in IL-36α high expression group (P ＜0.05).COX proportional hazard regression model revealed that high expression of IL-36α was associated with short overall survival time and tumor-free survival time of colorectal cancer patients (P ＜ 0.05).Multivariate analysis identified IL-36α expression in colorectal cancer as an independent prognosticator (P ＜ 0.05).Conclusions High expression of IL-36α was correlated with tumor differentiation and pM classification of colorectal cancers,and it is an independent predictor of poor survival for patients with colorectal cancer.

Objective To understand the dynamic of Oncomelania hupensis snail status in Duchang County at north shore of Poyang Lake so as to provide the evidence for formulating the strategy of schistosomiasis control. Methods The data about the snail status in Duchang County from 2005 to 2012 were collected and the change trend of the snail status was analyzed. Re?sults From 2005 to 2012 all the average density of living snails the occurrence rate of frames with living snails the density of infected snails and the area with infected snails showed a trend of sharp decline and stayed at a low level. Compared to 2005 the above 4 indexes in 2008 decreased by 70.06% 90.33% 79.48% and 37.88% respectively and those in 2012 decreased by 99.35% 98.98% 99.33% and 93.84% respectively. The infection rates of snails fluctuated between 0.06%and 0.53%which showed a trend of first decrease and then increase. The snail area maintained at the level of 2 052.5 hm2 since 2007. Con?clusions Most of the indexes of the snail status in Duchang County have decreased to the lowest level in history since 2012 but the snail area is stable and the infection rate of snails shows a fluctuation trend which suggests that the risks of schistosomia?sis transmission still exist and the snail control still should be strengthened.

Objective To investigate the clinical characteristics and prognosis of patients with synchronous or metachronous liver metastasis of colorectal cancer. Methods Clinical data of patients with colorectal cancer liver metastasis from 1994 to 2006 in the First Affiliated Hospital of Sun Yat-Sen University was retrospectively analyzed. The Kaplan-Meier method and long-rank test were used for bivariate comparisons. Multivariate analysis was done by the Cox regression model (Backward Wald). Results A total of 486 patients with colorectal cancer liver metastasis, including 191 synchronous and 295 metachronous liver metastasis, were analyzed. The overall 5-year cumulative survival rate was 16.2%, 9. 3% forsynchronous and 21.5% for metachronous liver metastasis respectively ( P ＜ 0. 01 ). Liver metastasis was surgically resected in 267 patients, 151 received radiofrequency ablation and 68 underwent conservative therapy with 5-year cumulative survival rates of 22. 1%, 10. 3% and 0 ( P ＜ 0. 01 ) respectively. On univariate analysis, poor prognosis was associated with older age, synchronous metastasis, higher serum CEA level, advanced N stage and poor differentiation of the primary tumor, bowel obstruction, ascites, tumor longitudinal length over 8cm, non-surgery therapy. Multivariate analysis indicated that synchronous metastasis, serum CEA level, ascites and therapy method were independent prognosis factors. Conclusions The time at which a metastasis occur, serum CEA level,ascites and curative surgical therapy determine the prognosis of patients with colorectal cancer liver metastasis. Surgical resection of metastasis in selected patients could prolong survival.

OBJECTIVETo determine the indications of colonoscopic screening for Crohn's disease in patients with fistula-in-ano.

METHODSClinical data of 302 patients with perianal fistula who received colonoscopy examination from January 2010 to December 2013 in the Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University were analyzed retrospectively. Parameters for differentiating perianal Crohn's disease from nonspecific fistulae were screened by logistic regression analysis. A regression mathematical model was established for the prediction of perianal Crohn's disease.

RESULTSA total of 302 patients received colonoscopy examination, and Crohn's disease was found in 16 patients (CD group). Results of univariate analysis on 26 parameters of clinical manifestation, laboratory and radiological examination revealed that differences in 11 clinical parameters between the CD group and non-CD group were statistically significant(all P<0.05), including age, BMI, abdominal pain, non-specific symptoms, multiple fistula, complex anal fistula, neutrophil count, platelet count, activated partial thromboplastin time, hemoglobin concentration and serum albumin concentration. Multivariate analysis revealed that age≤40 years (OR=14.464, 95% CI: 1.143-183.053, P=0.039), BMI<24.0 kg/m(OR=8.220, 95% CI:1.005-67.200, P=0.049), abdominal pain (OR=13.148, 95% CI: 1.110-155.774, P=0.041), complex anal fistula (OR=7.056, 95% CI:1.166-42.688, P=0.033) and elevated platelet count (OR=1.012, 95% CI: 1.004-1.0194, P=0.003) were independent risk factors for discovery of Crohn's disease by colonoscopy. Area under the ROC curve of the regression mathematical model based on factors mentioned above was 0.921, indicating that the model was highly predictive. The sensitivity and specificity of this model was 81.3% and 86.7% respectively when the optimal diagnostic cut-off point was established at 0.856.

CONCLUSIONSParameters that predict Crohn's disease in patients with perianal fistula include age, BMI, abdominal pain, classification of fistula and platelet count. Colonoscopy is recommended for patients at high risk.

Abdominal Pain ; Adult ; Age Factors ; Body Mass Index ; Colonoscopy ; Crohn Disease ; blood ; complications ; diagnosis ; epidemiology ; Female ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Multivariate Analysis ; Neutrophils ; Partial Thromboplastin Time ; Platelet Count ; ROC Curve ; Rectal Fistula ; blood ; complications ; Retrospective Studies ; Risk Factors ; Sensitivity and Specificity

OBJECTIVETo investigate the expression and clinical significance of G protein-coupled receptor 31 (GPR31) in colorectal cancer tissue.

METHODSCancer tissues and adjacent normal tissues of 321 cases with colorectal cancer confirmed by pathology and undergoing resection in the First Affiliated Hospital of Sun Yat-sen University from January 1996 to December 2008 were collected. The expression of GPR31 was examined by immunohistochemical staining. According to the expression level of GPR31 (A value=0.051), all the patients were divided into low GPR31 expression group and high GPR31 expression group. Clinicopathology and prognosis between the two groups were compared. Risk factors affecting prognosis were investigated.

RESULTSGPR31 expression was significantly higher in colorectal cancer tissues compared to adjacent normal tissues (mean A, 0.063±0.014 vs. 0.045±0.020, P<0.001). A total of 197 cancer tissue samples were defined as low expression and 124 as high expression. Significant difference was observed in the number of patient in pM classification between the two groups (P=0.007). High expression group had obviously higher distant metastasis rate than low expression group [12.1% (15/124) vs. 4.1% (8/197), P=0.007]. The 5-year survival rate and tumor-free survival rate were 84.3% and 82.2% in the low expression group, and both 59.7% in high expression group (all P<0.05). Multivariate analysis revealed elderly, abnormal CEA, lymphatic metastasis, distant metastasis and up-regulated GPR31 expression were independent risk factors of overall survival and disease-free survival in colorectal cancer patients (all P<0.05).

CONCLUSIONSGPR31 expression is significantly up-regulated in colorectal cancer tissues. High GPR31expression indicates poor prognosis of colorectal cancer, and may be used as a predictive marker.

Aged ; Biomarkers, Tumor ; metabolism ; Colorectal Neoplasms ; diagnosis ; metabolism ; Disease-Free Survival ; Humans ; Lymphatic Metastasis ; Prognosis ; Receptors, G-Protein-Coupled ; metabolism ; Risk Factors ; Survival Rate ; Up-Regulation

Objective To investigate the clinical efficacy and therapeutic progress of orthotopic liver transplantation for the treatment of hepatic epithelioid hemangioendotheliom(a EHE). Methods Clinical data of 2 patients diagnosed with hepatic EHE were retrospectively analyzed. One patien(t case 1) was diagnosed with multiple hepatic EHE complicated with multiple infarction lesions of the spleen, and underwent orthotopic liver transplantation combined with splenectomy. The other cas(e case 2) was diagnosed with multiple hepatic EHE and received orthotopci liver transplantation alone. Literature review was performed. Pathological characteristics, clinical efficacy of liver transplantation and clinical prognosis of hepatic EHE patients were analyzed. Results Two patients successfully underwent surgery and were discharged postoperatively. The diagnosis of hepatic EHE was confirmed by pathological examinaiton and case 1 was complicated with EHE of the spleen . For case 1, tacrolimus was replaced by sirolimus at postoperavtie 1 month. At postoperative 4 months, capecitabine was orall y administered( chemotherapy) for EHE recurrence. At 6 months after surgery, the patient wa sdiagnosed with recurrent hepatic EHE complicated with multiple bone metastases, and waso rally administered with sorafenib. At postoperative 7 months, the patient died from cachexia and liver failure. Case 2 was followed up until the submission date( 8 months after surgery). No postoperative complications and tumor recurrence were observed. Previous studies had demonstrated that surgical resection was the primary therapy of hepatic EHE. Liver transplantation was highly recommended for patients with multiple unresectable hepatic EHE and extra-hepatic lesions. Moreover, chemotherapy, percutaneous puncture combined with transcatheter arterial chemoembolization and anti-angiogenesis treatment exerted certain clinical efficacy.C onclusions Surgical resection remains the primary therapy of hepatic EHE. For patients with multiple intrahepatic EHE, liver transplantation is considered as the optimal treatment. Much attention should be diverted to the prevention and treatment o f recurrent hepatic EHE following liver transplantation, aiming to improve the clinical efficacy.