Objective To explore the etiology,diagnosis and treatment of postsurgical gastroparesis syndrome(PGS)after radical gastrectomy for gastric carcinoma.Methods The data of 585 patients who had undergone radical gastrectomy for gastric carcinoma were retrospectively studied.The diagnosis was established with fiberoptic gastroscopy and biopsy before operation in all the patients,and radical subtotal gastrectomy was performed,with antero-colonic Billroth's Ⅱ anastomosis of the remnant stomach and jejunum.Results PGS occurred in 24 patients(age 46-81,mean 58.6 years)among 585 patients,the prevalence was 4.1%.In all the 24 patients,PGS occurred at the period when liquid diet was changed to semifluid diet,with the symptoms of epigastric fullness,nausea,vomiting and intractable hiccup.The vomitus contained large amount of gastric contents and a small amount of bile.The quantity of gastrointestinal decompression was 800-2000 ml/d.Upper gastrointestinal radiography using 38% meglucamine diatrizoate was performed in all the 24 patients,the contrast agent was taken orally or through gastric tube.It showed that the remnant stomach was atonic,gastric peristalsis was weak or absent,and evacuation of contrast agent was delayed.The anastomosis stoma was patent.Gastroscopy was performed in 18 patients,and a large amount of residual gastric content and anatomotic edema of anastomosis stoma were found.Howener,the gastroscope could be introenced into the duodenum or jejunal efferent loop through anastomotic stoma without difficulty,and no signs of mechanical obstruction were found.All the 18 patients were cured within10-38 days by conservative treatment.Conclusion The main causes of PGS may be the loss of gastrointestinal motility and anastomotic edema,while the risk factors may include old age,malnutrition,water-electrolyte imbalance,and peritoneal infection.Gastrointestinal radiography and gastroscopy are important diagnostic methods,and the patients can be cured by conservative treatment.

To evaluate the value of chemotherapy via portal vein pump implantation in preventing hepatic metastasis from colorectal cancer after a radical resestion. Patients after a radical resection were divided into two groups: the portal vein pump implantation chemotherapy group (Group A 32 cases), chemotherapy via peripheral vein(Grounp B 22 cases). The results showed that hepatic metastasis rate was 15 4% in group I and 36 4% in group 2. The survival rates of 1, 2, 3 years in group A were 98%, 83%, 61% respectively, while in group B they were 90%, 68%, 42%, respectively. The results suggested that portal vein pump chemotherapy was an effective treatment modality to prevent hepatic metastasis from colorectal cancer. Its clinical results were better than conventional chemotherapy via peripheral vein.

Objective To evaluate role of double stapling technique in anus-saving operations for patient with low rectal carcinoma.Method The double stapling technique was used for anus-saving in colorectal anastomosis after anterior resection in 52 patiens with rectal cancer from 1994 to 1999,and the results were evaluated.Results 2 cases were failed to close rectal.4 cases were failed to anastomose.2 cases had anastomotic fistula(3.8%).3 cases had anastomotic stenosis (5.8%).2 cases had waund infection.1 case had anastomotic bleeding.There was no operative death.Conclusion The double stapling technigue provided a safe alternative for anus-saving operation in patients with rectal cancer.

Objective Through the qualitative study of surgical field free cancer cells of patients with breast cancer,to evaluate theprevention effects of intraoperative hot hypotonic solution soaking chemotherapy on cancer recurrence after resection of breast cancer.Methods 94 cases with breast cancer divided in to study group (n=48)and control group (n=46).Before the operation wound closed,both group surgical field washing solutions were collected for examination of free cancer cell,then the wounds of study group were treated with Hyperthermic soaking chemotherapy (41℃～42℃normal saline solutions 3000 ml+5-fluorouracil 1.0 g),once five minutes,total 3～4 times.While the wound of control group were soaked with normal saline solutions only.The soaking solutions were collected for examination of free cancer cell.The rates of free cancer cell in the surgical field and local recurrence rates in the both group were compared.Result The rates of washing solutions and the rates of soaking solution and the localy recurrent rates in the study group were 29.2%,8.3%,6.3%,which in the control group were 26.1%,19.6%,15.2%.Conclusions There are free cancer cells in the surgical field of breast cancer.Hyperthermic soaking chemotherapy can kill free cancer cell and reduce localy recurrent rate.

ObjectiveTo evaluate the antitumor effects of lymphocytes from hepatic porta lymph node co cultured with staphylococcal enterotoxin A(SEA)?MethodsLymphocytes isolated from lymph node of 5 HCC patients were co cultured with SEA. The proliferation and cytotoxicity of the lymphocytes were observed. Flow cytometer was used to detect the expression of CD3?CD4 and CD8 on the surface of the lymphocytes. TNF ? and IFN ? released into the culture medium were measured by the method of ELISA. The results were compared with that yielded from TILs of the individual patients. ResultsCultured in the presence of SEA, there was a sharp rise of T cells, especially CD8 + cells. Cytotoxic activity was increased. TNF ? and IFN ? were predominantly produced in the first week.ConclusionsLymphocytes from lymph node activated by SEA were armed with an increased antitumor efficacy.

Calpains are the family of Ca2+-activated cysteine pro-teases. Although calpains are considered to be cytoplasmic en-zymes, recent research has demonstrated that μ-calpain, m-cal-pain, calpain 10 and their endogenous inhibitor calpastatin are present in the mitochondria and play important roles both in caspase -dependent and-independent pathways in cell death phe-nomena. Calpains exert direct and indirect effects on the caspases
and regulators of apoptosis pathway such as Bcl-2, Bax, Bid, promoting the release of Cyt-C, AIF, then result in cellular ap-optosis. To allow pharmacological targeting of these enzymes, thorough knowledge of their patterns of activation and further in-teractions with already known apoptotic pathways is necessary.

Objective To evaluate the clinical effect of chemotherapy via both hepatic artery and portal vein on liver metastasis of colorectal cancer. Methods Forty-eight patients with colorectal cancer (admitted to our hospital from Jan, 1994 to Dec, 2000)were divided into group Ⅰ, in which 17 patients received chemotherapy via both hepatic artery and portal vein, group Ⅱ in which 16 patients received simple hepatic artery chemotherapy, and group Ⅲ in which 15 patients received simple portal vein chemotherapy. Chemotherapy was begun 2 weeks after operation. The drugs used in chemotherapy regime were 5-fluorouracil(5-FU) 500mg/m 2 + Mitomycin(MMC) 4mg/m 2 + Epirubicin(EPI) 60mg/m 2, once per week, 2-3 times as a course. The chemotherapy regime was the same for the 3 groups. Results The respective effective rate for liver metastasis was 76.5%, 62.5%, 46.7% in group Ⅰ, group Ⅱ, and group Ⅲ. The 0.5, 1 and 2 year survival rates were 100%, 82.4% and 52.9% respectively in group Ⅰ, 87.5%, 62.5% and 43.7% respectively in group Ⅱ, and 93.3%, 60% and 33.3% respectively in group Ⅲ. There were statistically significant differences between group Ⅰ and groups Ⅱ and Ⅲ (P

0.05) except that IFN-? secretion of L-SEA group was lower than that of SEA group at 4th day (P

Objective To assess the efficiency and safety of alendronate for the prevention and treatment of glucocorticoid-induced osteoporosis (GIOP).Methods The electronic databases of PubMed,EMBASE,Cochrane Library,Web of Science,Chinese BioMedical Literature Database (CBM) and Wanfang Data were searched for all randomized controlled trials (RCT) of alendronate vs.placebo.Two reviewers independently selected trials for inclusion,assessed trial quality using Jadad's scale and extracted the data.RevMan 5.1 software was used for data synthesis and Meta-analysis.Results Seven studies with 1111 patients were included.Compared with placebo,alendronate significantly increased bone mineral density (BMD) at the lumbar spine[MD ＝3.35,95％CI (2.67-4.02),P =0.000] and the femoral neck[MD =1.90,95％ CI (0.89-2.92),P =0.000] after 12 months of therapy.After 24 months of therapy,alendronate significantly increascd BMD at the lumbar spine [MD =3.91,95％ CI (2.37-5.45),P =0.000],but not at the femoral neck [MD =1.91,95％ CI (-1.15-5.02),P =0.22].Compared with placebo,no significant reduction was found by the use of alendronate in the incidence of vertebral fractures [RR =1.00,95％ CI (0.49-2.07),P =0.99] or nonvertebral fractures[RR ＝ 1.02,95％ CI (0.49-2.14),P =0.95].No difference was shown with the adverse event between the two groups[RR =0.97,95％ CI (0.90-1.05),P =0.47].Conclusions Alendronate is effective for the prevention and treatment of glucocorticoid-induced bone loss at the lumbar spine and the femoral neck with relatively good safety profile.Yet,there is no significant difference between the two groups in reducing the incidence of vertebral fractures and non-vertebral fractures.Large-scale RCT designed to observe whether different lengths of alendronate therapy will influence the efficiency should be conducted in the future and to further explore whether it can reduce the incidence of fractures.

AIM To investigate the effects of honokiol on ischemic neurological deficiency and on the scavenging ability of ischemia reperfusion (I-R) brain tissue for reactive oxygen species (ROS). METHODSCerebral ischemia was induced by middle cerebral artery occlusion (MCAO) in rats. I-R in mice were induced by blood stream pause in bilateral common carotid arteries for 30 min and reperfusion for 30 min. The activities of ROS scavenging enzymes were determined with colorimetric methods. RESULTS Intravenous honokiol in 5-50 μg·kg-1 significantly decreased the neurological deficiency score, and diminished cerebral infarction volume in rats. In I-R brain tissue of mice, intravenous honokiol in 7-70 μg·kg-1 evidently enhanced the activities of superoxide dismutase, catalase, glutathione peroxidase and peroxidase, and markedly lowered lipid peroxidative product malondialdehyde content. Moreover honokiol significantly increased Na+-K+-ATPase activity in I-R brain tissue. CONCLUSION Honokiol ameliorates the neurological deficiency behavior and diminishes infarction volume in MCAO rats; and enhances cerebral scavenging ability for ROS and Na+-K+-ATPase activity in cerebral I-R mice. It is indicated that honokiol is a protective agent for cerebral ischemia and I-R.