Objective A considerable percentage of gallbladder cancers are accompanied by su-perficial cancer spread adjacent to the main tumor. Therefore, cholecystectomy for early gallbladder cancer must be performed carefully to avoid leaving cancer cells at the surgical margins. Methods Thirty-six patients with gallbladder cancer invading no more than perimuscular connective tissue un-derwent surgical resection at our medical center. After operation, the resected specimens were investi-gated macroscopically and microscopically to clarify the clinicopathological features and the risk factors of superficial cancer spread. Results Seventy percent of all cases (25 cases) had superficial cancer spread. Comparison between the cases having superficial cancer spread and the cases without it re-vealed that the macroscopic morphology of the primary tumor and the depth of cancer invasion in the gallbladder wall were significantly different between the two groups. Furthermore, multivariate analy-sis indicated that 'superficial raised type' in macroscopic morphology was an independent predictive factor for having superficial cancer spread. Superficial cancer spread from the main tumor located in the neck of the gallbladder grew predominantly in the direction of the fundus. More advanced gallbladder cases were accompanied by more extensive superficial spread. Conclusion Superficial cancer spread is frequently observed adjacent to the gallbladder cancer, especially in the superficial raised type. A negative margin should be confirmed by intraoperative frozen section while performing cholecystectomy.

Objective To evaluate the impact of laparoscopic cholecystectomy(LC) on the prognosis of unsuspectedgallbladder cancer(GC).Methods A retrospective clinicopathologic study was performed on 21 patients with unsuapective GC,but diagnosed gallbladder cancer postoperatively by pathology.Of which,11patients underwent LC and 10 patients underwent open cholecystectomy(OC),The correlation was evaluatedbetween cumulative survival rates and the following 5 prognostic factors:histopathological grade,pathologic stage,occurrence of bile spillage,type of cholecystectomy(LC or OC),and additional surgical treatments.Results Eight patients(73%) after LC and 7 patients(70%) after OC had cancer recurrence,and the difference was of no statistical significance(P=0.86).There were no recurrences of cancer in the abdominal wall after either LC or OC.Survival rate was statistically correlated to tumor stage(P=0.006),and to the occurrence of bile spillage(P=0.003).Survival rate did not differ according to whether the operation was carried out using LC or OC(P=0.74).Conclusions LC does not worsen the prognosis of unsuspected gallbladder cancer.

To evaluate the efficacy and safety of an oxaliplatin, fluorouracil (5 FU), and folinic acid (FA) combination in treatment of patients with metastatic or advanced gastric cancer,we used oxaliplatin 130 mg/m 2 (2 hour intravenous infusion,1 d)and FA 200 mg/m 2 (2 hour intravenous infusion,1 to 5 d) followed by 5 FU 500 mg/m 2 (4 hour continuous infusion,1 to 5 d) every 3 weeks. Efficacy of treatment was evaluated after 3 cycles and the responders were confirmed 4 weeks later. In 26 case evaluated, patial release was achieved in 11 cases, stablized in 9 cases, progressed in 6 cases. The overall response rate was 42.3%. The main adverse effects were gastrointestinal tract toxicity, neurosensory toxicity and bone marrow suppression. This trail suggested that the short term curative effect of this regimen was similar to those of others and showed good efficacy and an acceptable safety profile. It is a new option for the treatment of metastatic and advanced gastric cancer.

Objective: To study retrovirus (RV)-mediated transduction of gastric carcinoma cells with the herpes simplex virus thymidine kinase (HSV-tk) gene and the subsequent treatment with ganciclovir(GCV). Methods: The TK gene was transfected into human gastric carcinoma cell line MKN28 using HSV-TK that packed with PA317 cell, the sensitivity of MKN28TK cells to GCV was examined in vitro. Results: The retroviral-mediated HSV-TK gene can be transfected to MKN28 cells. The growth rate of MKN28 cells transfected with HSV-TK gene did not change. MKN28TK cells became significantly sensitive to GCV and had bystander effect. Conclusion: Transfection of gastric carcinoma with HSV-TK has higher transfection efficiency. MKN28TK cells are significantly sensitive to GCV.

Objective To explore in vitro the best time window for using sinusoidal electromagnetic fields to promote the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs).Methods BMSCs were isolated and cultured from 4-week-old Sprague-Dawley rats (male and female,80-120g).The BMSCs (from passage 3) were exposed 0,1,4 or 8h/d for 7d,14,or 28d,respectively,to 15Hz sinusoidal electromagnetic fields with a maximum amplitude of lmT.Those exposed 0h/d served as the control.The relative expressions of runt related gene-2 (RUNX2),bone sialoprotein (BSP) and osteopontin (OPN) were determined using real-time,quantitative reverse transcription-polymerase chain reactions (RT-PCRs).The level of RUNX2 protein was determined by Western blotting after 14d.Alizarin red staining was used to compare calcium distribution in each group.Results Obvious promotion of differentiation to osteoblasts was observed after 7 days of exposure to the15 Hz sinusoidal electromagnetic fields,most obviously manifested by an outstanding increase of the early osteogenic index RUNX2 in those exposed 4h/d.After 14 days of intervention,the 1h/d exposure showed to be most effective,especially in inducing the changes of the late osteogenic index OPN.The trends of changes in RUNX2 protein were similar in all groups.After stimulating 1h/d for 14 and 28days,calcium deposition increased to the greatest extent.Conclusions Exposure to sinusoidal electromagnetic fields induces osteogenic differentiation to osteoblasts in rat BMSCs in vitro.There is an apparent window effect.The best results are observed with more days of exposure and shorter exposure time (1h) every day.

Objective To evaluate the clinical effects of the Masquelet technique combined with antibiotic calcium sulfate pellets in treating infected bone defects.Methods From February 2014 to February 2016,9 patients with infected bone defects were treated in our department,including 7 males and 2 females,with an average age of 37.0 years (range,24-56 years).6 cases were infected because of open fractures,3 infected after internal fixation operation.All defects were located in the lower limb diaphysis and metaphysis (3 cases in femur,6 cases in tibia).The length of the bone defects were 4-12 cm after debridement,all defects filled with PMMA loaded with Vancomycin,and fixed with exterual fixators.After 6-10 weeks,the bone cement spacers were taken out and the antibiotic calcium sulfate pellets were implanted into the membrane.A certain amount of autogenous cancellous bone granules would be mixed into the calcium sulfate pellets if the defect was larger than 6-8 cm.5 cases remained fixed with external fixators,3 cases replaced for plates,1 case replaced for plaster external fixator.Regular X-ray follow-ups were taken and complications recorded as well.Evaluate the healing of bone defect and functional recovery of adjacent joints by Samantha X score system,visual analogue scale (VAS) and Paley method,respectively.Results The 9 cases were followed up for a mean duration of 9.3 months (range,6-15 months).All bone defects healed after a mean time of 14 weeks (range,10-24 weeks).The wound poor healing occurred in only 1 case in the first stage of surgery,and cured by dressing changes.No complications of the recurrence of infection and implant failure.At the last follow-up,the average Samantha X score was 4.9,the VAS score was 0 to 3 (average 1.5) for patients standing on crutches and all the bone defect healing graded excellent evaluated by Paley method,the functional recovery of the adjacent joints graded:excellent in 6 cases,good in 2 cases,and fair in 1 case (the excellent and good rate was 89％).Conclusion Masquelet technique combined with antibiotic calcium sulfate particles is effective in the treatment of infected bone defects.

Glioma has high incidence and poor prognosis. Glioma pathogenesis is the research hotspot and difficulty in related fields. N6-methyladenin (m6A) is closely related to glioma development, and m6A related proteins play important roles in glioma, which is a potential therapeutic target for glioma. In this paper, the upstream regulatory mechanism of m6A related proteins is reviewed, and the prospect of m6A related proteins as diagnostic markers and potential therapeutic targets for glioma is discussed.