Objective To probe into diagnosis and treatment of splenic artery aneurysms (SAA) in patients with advanced schistosomiasis and portal hypertension. Methods Clinical data on 12 cases of SAA treated in the First Hospital of Jiaxing from January 1974 to December 2000 were analyzed retrospectively. Results One case was found by color duplex flow imaging (CDFI) and one was by BUS before operation. Other 10 cases were all found during operation period. The diameters of SAA ranged from 1.8 cm to 3.5 cm. Three aneurysms were excised together with splenectomy. Ligation of proximal and distal were done in 7 cases, one case excised the aneurysm, one case had distal ligation only and was death post-operation due to rupture of the aneurysm, after splenectomy. Conclusion The incidence of SAA in patients with advanced schistosomal portal hypertension is not very rare. If found during operation, proper management of SAA and portal hypertension is important in order to get good results.

Objective To evaluate the influence of rectal washout on the prognosis of rectal cancer after anterior resection.Methods Data of 144 patients with rectal cancer undergoing anterior resection at Chinese Academy of Medical Science Cancer Hospital between May 2006 and November 2007 were reviewed.69 patients received rectal washout and 75 patients did not.The incidences of recurrence and 5-year disease-free survival rates were compared.Data were analyzed by SPSS 13.0 software packet,using x2 and t inspection.Kaplan-Meier method was used to calculate postoperative survival rate.Results Washing sample was positive for malignant cells in 55 patients (79.7％).The incidences of recurrence were 4.6％ and 6.7％ in washout group and no-washout group respectively (x2 =0.368,P =0.721).The five-year disease-free survival rate was 79.7％ in washout group and 74.7％ in no-washout group(x2 =0.517,P =0.553).Conclusions Free malignant cells were ubiquitous in rectal lumen during anterior resection,and there was a high positive rate of cytological examine for washout sample.Rectal washout may reduce local recurrence and prolong patients' survival.

Objective To investigate the effects of carboxymethytl pachymaram ( CMP ) on the methylation of SOCS-1 (suppressor of cytokine signaling-1) gene and the in vitro maturation of human mono-cyte-derived dendritic cells (DCs).Methods Human DCs were induced from the peripheral blood mono-cytes in vitro with the treatment of recombined human GM-CSF and interleukin-4 ( IL-4 ) and cultured with different concentrations of CMP (10, 50, and 100 mg/L).The methylation and expression of SOCS-1 gene were analyzed by methylation-specific polymerase chain reaction (MSP) and real-time PCR, respectively. The phenotypic markers of DCs were detected by flow cytometry .Mixed lymphocyte reaction ( MLR) and ELISA were performed to measure the lymphocyte proliferation induced by DCs and IL-12 secretion by DCs . Results CMP promoted the methylation of SOCS-1 gene, but inhibited the expression of SOCS-1 gene in dendritic cells at the concentrations of 50 mg/L and 100 mg/L.The expression of phenotypic markers (CD80, CD83, CD86 and HLA-DR), IL-12 secretion and lymphocyte proliferation induced by DCs were significantly enhanced in a dose dependent manner with the treatment of CMP .Compared with control group , the levels of methylated SOCS-1 gene and IL-12 and the lymphocyte proliferation index were increased upon the stimulation with 50 mg/L and 100 mg/L of CMP (P<0.01), but the expression of SOCS-1 gene was de-creased.The expression of CD80, CD83 and HLA-DR on DCs in the presence of 100 mg/L of CMP were higher than those of control group (P<0.05).Conclusion CMP could induce the methylation of SOCS-1 gene and the maturation of DCs derived from peripheral blood monocytes .

Objective To investigate the prognosis of local resection in patients with low rectal cancer, and assess surgical indications for this procedure. Methods One hundred and twenty-four patients with low rectal cancer from Jan 1975 to Dec 2006 were analyzed, the clinicopathologic features and surgical, outcome were examined as prognostic factors. Survival rate was estimated by Kaplan-Meier method and compared by Log-Rank test, prognostic factors were analyzed by multivariate COX proportional hazards model. Results The 5-year survival rate of 124 patients underwent local resection was 90.7 %(97/107), there were 4.8 %(6/124) patients with complications and 15.3 %(19/24) ones with local recurrence.The infiltration, vascular invasion, the size of tumor and the histological grade were significant prognostic factors of overall survival, but gender, age, the tumor site and the macroscopic type were not. Multivariate analysis indicated that the tumor infiltration were independent poor prognostic factor. Conclusion Local resection is suitable for Tis and T1 low rectal cancer, and those with high local recurrence factors should undergo radical resection. Strict follow-up and adjuvant therapy is necessary for local excision.

Objective To investigate the feasibility of laparoscopic radical resection for colorectal cancer in patients with respiratory dysfunction. Methods A total of 64 patients with colorectal cancer with respiratory dysfunction simultaneously admitted in our hospital. Following the principles of en-bloc resection, thirty-six patients underwent laparoscopic radical resection, and 28 underwent open resection. Results The time of postoperative oxygen inhalation was shorter in laparoscopic group than that in open resection group (3.5 d vs 4.6 d) (P<0.05), and independently expectorating was better in laparoscopic group than that jn open resection group (P <0.05). The time to endotracheal intubation removal (21.2 min vs 23.9 min) and oxygen saturation were no significant difference between laparoscopic group and open resection group. One case got lung infection in open resection group, both groups had no atelectasis, respiratory failure and urinary infections case. Conclusion Laparoscopic surgery is feasible for colorectal cancer in patients with respiratory dysfunction.

Objectives:To determine the content of aminoacids in gastric cancer tissue and study the relationship between alterations of amino acids and cancer stages.　Methods:19 free amino acids of cancer tissue and paracancerous normal mucose were determined in 41 cases of gastric cancer.　Results:Most free amino acids were significantly increased in gastric cancer tissue as compared with those of paracancerous normal gastric tissue.The contents of proline,valine,methionine,isoleucine,leucine in advanced gastric cancer were significantly higher than those in early cases.　Conclusions:Gastric tumor tissue contains high amount of most free amino acids particularly in cases with advanced cancer..

Objective To investigate the feasibility of sigrnoid coloplasty for patients after resection of middle or low rectal carcinoma, and to evaluate the defecation function after the operation. Methods Forty-three patients with middle or low rectal cancer who had been admitted to the cancer Hospital of the Chinese Academy of Medical Sciences from January 2007 to January 2008 received sigrnoid coloplasty after rectal carcinoma resection (treatment group), and another 43 patients who had been admitted during the same period received colonic J pouch reconstruction (control group). The feasibility and safety of the 2 surgical procedures and postoperative defecation function were assessed. All data were processed by t test, chi-square test or Fisher exact probability. Results The sigmoid coloplasty was successfully performed in all patients in treatment group, while the reconstruction of the J pouch failed in 4 patients in the control group. Three patients in each group underwent temporary transverse colostomy. The incidences of postoperative complications in treatment group and control group were 7% (3/43) and 9% (4/43), respectively, with no statistical difference between the 2 groups (X2 =0. 282, P > 0.05). The median frequency of defecation in treatment group was 2.0 ± 1.5 per 24 hours, which was significantly less than 2.5 ± 1.0 in control group (X2 = 1. 242, P > 0.05). The fecal incontinence scores in treatment group and control group were 1.7 ± 0. 7 and 1.6 ± 0.8, respectively, with no statistical difference between the 2 groups (t = 0. 285, P > 0. 05). Conclusion Sigmoid coloplasty has similar benefits to colonic J pouch reconstruction, while sigmoid eoloplasty is relatively feasible, effective and safe for low colorectal or coloanal anastomosis.

Objective To investigate the distribution and severity of cerebral artery stenosis and the prognosis in elderly patients with acute cerebral infarction using digital subtraction angiography (DSA). Methods The 432 elderly patients with acute cerebral ischemia infarction underwent DSA,and they were divided into two groups: elderly group (n= 320) and non-elderly group (n= 112). The characteristics of distribution and severity of cerebral artery stenosis, the relationship between artery stenosis and relative risk factors, and the prognosis of acute cerebral infarction were analyzed.Results In elderly group, 270 cases (84.3%) had intra- and extra- cranial artery stenosis, of which 98 patients (30.6%) with pure extracranial arterial stenosis, 132 patients (41.3%) with combined extra- and intra-cranial artery stenosis. They were both significantly higher than the corresponding data in non-elderly group [23 cases (20.5%) and 28 cases (25%), P＜0.05 and 0.01]. The prevalences of moderate and severe cerebral artery stenosises were higher in elderly group than in nonelderly group [224 locations (52.1%) vs. 51 locations (40.8%), P＜0. 05]. The number of patients with previous history of cerebrovascular disease was much more and the prognosis was much worse in elderly group than in non-elderly group (both P＜0.05), Conclusions The elderly patients with cerebral infarction have severer cerebral artery stenosis, increased proportion of multivessel disease and poor prognosis. So it is very important to take aggressive treatment as soon as possible, and to make secondary prevention and effective rehabilitation so as to improve their prognosis.

Humans ; Lymphoma, B-Cell ; diagnosis ; Prognosis

Objective: To investigate the effect of comorbid cardiovascular diseases on the perioperative period of colorectal cancer pa-tients aged over 80 years. Methods: Clinicopathological data of 313 elderly patients aged over 80 years who underwent radical surgery for colorectal cancer at Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, from January 2007 to December 2018 were retrospectively collected and analyzed. Propensity score matching was used for 1 : 1 matching of 10 covari-ates. Finally, 128 patients with comorbid cardiovascular diseases were matched with 128 patients without comorbid cardiovascular dis-eases. Perioperative indicators and postoperative complications were compared between the two groups. Result: Both groups were balanced in terms of baseline variables (all P>0.05). In terms of postoperative complications, there was no statistical difference be-tween the two groups [37.5% (48/128) vs . 30.5% (39/128), P=0.235]. According to the Clavien-Dindo classification of postoperative complications, the incidence of postoperative Clavien-DindoⅣcomplications in the comorbid cardiovascular disease group was signifi-cantly higher than that in the non-cardiovascular disease group [7.0% (9/128) vs . 1.6% (2/128), P=0.031]. In terms of local surgical complications, the incidence of postoperative anastomotic leakage in patients with cardiovascular diseases was significantly higher than that in patients without cardiovascular diseases [7.8% (10/128) vs . 2.3% (3/128), P=0.046]. In terms of other local surgical compli-cations, there was no statistical difference between the two groups (all P>0.05). In terms of non-surgical local complications, the inci-dence of postoperative blood circulatory system complications in patients with cardiovascular diseases was significantly higher than that in patients without cardiovascular diseases [10.2% (13/128) vs . 3.1% (4/128), P=0.024]. There was no significant difference in the incidence of other non-surgical local complications between the two groups (all P>0.05). Conclusions: Comorbid cardiovascular diseas-es did not increase the risk of colorectal cancer surgery in patients aged over 80 years. However, it should be noted that the incidence of postoperative blood circulatory system complications and anastomotic leakage is significantly increased in elderly patients with car-diovascular diseases. For such patients, adequate preoperative evaluation, close postoperative monitoring, and the application of pro-tective stoma are key to ensure that elderly patients with colorectal cancer can successfully survive the perioperative period.