After lower rectal anterior resection, patients often experience defecation disorders such as increased stool frequency and fecal incontinence. Researches have shown that these disorders may be resulted from pathophysiological consequences such as impaired neorectal compliance, decreased internal anal sphincter function, direct damage or injury of the nervous supply and the loss of rectal sensation.

Virus-based anti-tumor therapies are novel biological treatments. Viral vectors can infect tumors to kill cancers directly (on-colysis), act as cancer vaccines to activate the immune system, and deliver genes with anti-tumor activity to the cancer cells. Genetic engineering has been applied to viruses to achieve more specific and efficient cancer treatment. Simultaneously, a reasonable combi-nation of viral vectors and existing anti-tumor therapy can improve the therapeutic effect. Consequently, virus-based therapy is expect-ed to serve as an effective anti-tumor strategy. We reviewed recent studies on the anti-tumor viral therapy of colorectal carcinoma.

At present,the main treatment methods of the patients with advanced colorectal cancer include surgery,chemotherapy,radiotherapy,targeted therapy,physical ablation and immunotherapy,but the chemotherapy is still the main treatment.The emergence of new chemotherapy drugs and the combination of radiotherapy,chemotherapy and targeted therapy in clinical have improved curative effect for the patients with advanced colorectal cancer.In order to better improve the quality of life,reduce side effects and obtain the best effect,now the individual multidisciplinary treatment has become an inevitable trend in the treatment of advanced colorectal cancer in clinical.

Objective To explore the clinical efficacy of image-guided 125I radioactive seed interstitial implantation therapy for unresectable pancreatic cancer.Methods 25 patients with unresectable pancreatic cancer evaluated by retrospective follow-up were enrolled in this study,13 patients received radioactive seeds implantation while 12 patients were given non-surgical treatment.We observe and compare the clinical benefits,objective curative effect,complications,adverse reaction,survival between the two groups of patients.Results Compared with the non-surgical treatment group,the clinical benefit rate in the radiotherapy seed implantation group was 92％ (12/13) while that of the non-surgical group was 42％ (5/12),the difference was of statistically significance.The numbers of cases evaluated as effective were 6 (46％) and 4 (33 ％) respectively,the difference was not statistical significant (x2 =0.427,P ＞ 0.05);The radioactive seed implantation group had no serious postoperative complications;3 cases who received subsequent chemotherapy in radioactive seed implantation group(23％,3/13) and 3 cases in non-surgical treatment group(25％,3/12)suffered from serious adverse reactions,the difference was of no statistical significance(x2 =0.013,P ＞0.05);Comparing the survival rate between the two groups,x2 =0.001,P =0.969,the difference was of no statistical significance.Conclusions The therapy of 125I radioactive seed implantation for unresectable pancreatic cancer significantly relieves cancer caused pain and improves quality of life.

Objective:To explore the clinical and pathological features of familial gastric cancer, and to get the early discovery and early treatment of it.Methods:Two kindreds of familial gastric cancer were followed up and their clinical and pathological features were analyzed.Results:Six patients with gastric cancer were found in the 2 kindreds.Autosomal dominant inheritance was observed in these cases.clinical and pathological features of familial gastric cancer were showed according to the document analysis:early onset;poor prognosis;patients suffer simultaneous or metachronous carcinoma;CDH1 germline mutation carriers had higher penetrance;pathologically, tumors are mostly diffuse infiltrative type with lower differentiated degree and earlier metastasis to lymphnodes;in one kindred,the sites of the lesions were relatively consistent.Conclusion:Familial gastric cancer has particular clinical and pathological features:early onset;poor prognosis;patients suffer simultaneous or metachronous carcinoma;CDH1 germline mutation carriers have higher penetrance; pathologically,tumors are mostly diffuse infiltrative type with lower differentiated degree and earlier metastasis to lymphnodes.

Objective To compare the short-term efficacies of laparoscopic intersphincteric resection (ISR) and laparotomy for ultra-low rectal cancers by Meta-analysis.Methods We searched case-control trials that compared clinical outcomes of laparoscopic ISR and laparotomy from PubMed, EMBase, Ovid, CNKI and Wanfang database.Relevant published and unpublished data and conference papers were also retrieved.Two reviewers independently assessed the qualities of the included studies.Meta-analysis was performed by using of RevMan5.2 software.Results A total of 5 trials with 552 cases were included.The results of Meta-analysis showed that in terms of blood loss of the operation [mean difference (MD) =-65.42, 95％ CI:-93.45--37.38, Z=4.57, P＜0.000 01], flatus passage time (MD=-0.96, 95％CI:-1.45--0.47, Z=3.83, P=0.000 1) and hospital stays (MD=-1.69,95％CI:-2.19--1.19, Z=6.63, P＜0.00001),laparoscopic ISR were significantly superior than those of laparotomy, with significant differences.In terms of operation time (MD =6.61,95 ％ CI:-21.29-34.51, Z =0.46, P =0.64), the positive rate of circumferential resection margin (OR =1.01, 95％ CI: 0.37-2.80, Z =0.02, P =0.98) and postoperative morbidity (0R=0.73, 95％ CI: 0.45-1.20, Z =1.23, P =0.22), there were no significant differences in the two groups.However, laparotomy may clean more numbers of lymph nodes than those of laparoscopic ISR (MD =-1.16, 95％CI:-2.14--0.18, Z =2.31, P =0.02), with significant difference.Conclusion The shortterm efficacy of laparoscopic ISR is superior than that of laparotomy in the treatment of ultra-low rectal cancer.

Objective To investigate the characteristic,diagnosis,clinical staging, treatment and clinical prognosis of occult breast carcinoma (OBC). Method Forty-six cases of OBC were analyzed retrospectively with the clinical and follow-up information that were confirmed by postoperative pathologic diagnosis from November 1981 to November 2005. Results All patients showed axillary node enlargement as the first sign and were operated.The operation included axillary node excision in 2 patients,radical mastec-tomy or modified radical mastectomy in 44 patients. Forty-five cases got follow-up for 1-22 years,33 cases had existed 3 years,18 cases had existed 5 years,8 cases had existed 10 years. Conclusions For axillary mass which causes are uncertain ,the possibility of OBC should be considered .Meanwhile excision and pathological examination is necessary.The metastatic histological structure and immunohistochemical index of the axillary nodes usually provide important clue for the source of this tumor.Radical or modified mastectomy is the best method, and pest-operative chemotherapy and/or radiotherapy should be done. It has been showed that targeted therapy is very important to breast cancer with C-erbB-2 positive recently.To the cases that neck lymphatic metastasis is M4G3 positive by immunohistochemical examination and no primary focus clinically, the diagnosis of OBC should be considered. The cases without primary focus have better prognosis than those with primary focus.

Objective:To investigate therapeutic efficacy and mechanisms of action of oncolytic agent derived from herpes simplex virus type 2 (oHSV2) in a xenograft mouse model bearing CT26 colorectal cancer. Methods:BALB/c mice were subcutaneously inoculated with CT26 cells to establish a xenograft mouse model of colorectal cancer. 1) After intratumoral administration of oHSV2, enzyme-linked im-munosorbent assay was used to determine granulocyte-macrophage colony-stimulating factor (GM-CSF) expression levels in the blood. 2) Model mice were divided into three groups:PBS group (negative control), oHSV2 group, and 5-fluorouracil (5-FU) group (positive control). After drug administration, drug effectiveness was evaluated on the basis of weight, tumor volume, general state, and survival time. 3) Cells from the draining lymph nodes (TDLN) and tumor were surgical y removed and used to quantify mature dendritic cel s (DCs) and T lym-phocytes by flow cytometry. Result:1) In the CT26 xenograft model, level of GM-CSF continuously elevated. At day 8, peak value was attained in the blood at concentration of 3150±327.1 pg/mL. Then, GM-CSF expression gradually reduced as time progressed. 2) In in vivo study, both oHSV2 and 5-FU exerted antitumor effects relative to PBS group (50 days vs. 36 days, P<0.01;51 days vs. 36 days, P<0.01), and oHSV2 proved to be less toxic and safer. At day 28, the 5-FU group presented highly significant difference in mouse body weight compared with that of PBS group (16.61 g vs. 22.07 g, P<0.01). However, oHSV2 group did not show statistical y significant change (al P>0.05). Skin of virus injection region did not present necrosis and ulceration. 3) In the TDLN, the frequency of DC was increased when treated with oHSV2 compared with the control group (6.49%vs. 3.73%, P<0.01). Similarly, the percentage of CD4+and CD8+T-cel s from the oHSV2-treated group was signifcantly higher than mock-treated tumors (15%vs. 8.57%, P<0.01;8.19%vs. 5.15%, P<0.01). However, number of cells in the 5-FU group were significantly reduced with respect to that of the negative group (al P<0.01). Conclusion:oHSV2 exerted potent antitumor effects in a murine colorectal cancer model. Compared with 5-FU, oHSV2 treatment caused fewer side effects. Such antitumor effect may be induced by stimulation of immune activity by GM-CSF production.

OBJECTIVETo investigate the association between expression of hepatocyte growth factor(HGF) and its receptor c-Met and primary colorectal cancers with synchronous liver metastases.

METHODSA total of 30 colorectal cancer patients with synchronous liver metastasis underwent radical resection of primary cancer and liver cancer in our hospital from June 2001 to June 2010. According to lymphatic metastasis, patients were divided into group A(T1~T4N1~N2M1, n=21) and group B(T1~T4N0M1, n=9). Twenty-one matched T1~T4N1~N2M0 and 21 T1~T4N0M0 patients were used as the controls of group A. Nine matched T1~T4N0M0 patients were used as the controls of group B. Expressions of HGF and c-Met in tissues of primary loci, liver loci and metastatic loci were detected by immunohistochemistry.

RESULTSIn primary loci of group A, the positive rate of HGF was significantly higher than that of T1~T4N1~N2M0 and T1~T4N0M0 controls [71%(15/21) vs. 43%(9/21), 19%(4/21), all P<0.05]. The positive rate of c-MET[90%(19/21)] was significantly higher compared to T1~T4N0M0 control[43%(9/21), P<0.05], while not significantly different compared to T1~T4N1~N2M0 control[86%(18/21)]. In primary loci of group B, positive rates of HGF and c-MET were not significantly different as compared to T1~T4N0M0 control[6/9 vs. 5/9, P>0.05; 8/9 vs. 6/9, P>0.05]. Concordance of HGF and c-MET expression in group A among primary loci, lymphatic metastatic loci and hepatic metastatic loci was 81%(17/21) and 76%(16/21).

CONCLUSIONHGF-c-Met may play a role in colorectal cancer patients with synchronous liver metastasis who have regional lymphatic metastasis, and may have few effect on colorectal cancer with synchronous liver metastasis without corresponding lymphatic metastasis.

Adult ; Aged ; Colorectal Neoplasms ; metabolism ; pathology ; Female ; Hepatocyte Growth Factor ; metabolism ; Humans ; Liver Neoplasms ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Proto-Oncogene Proteins c-met ; metabolism

OBJECTIVETo compare the clinical short-term safety and efficacy between robotic right colectomy (RRC) and laparoscopic right colectomy(LRC) with meta-analysis.

METHODSA search of the Medline, Embase, Ovid, CNKI and WANFANG databases was performed for studies comparing clinical or oncologic outcomes of RRC with LRC before July 2014. The RevMan 5.2 software was used for meta-analysis. The operative time, estimated blood loss, length of hospital stay, conversion rate to open surgery, postoperative complications and related outcomes were evaluated.

RESULTSSix studies including 217 RRC cases and 400 conventional LRC cases were enrolled and analyzed. The meta-analysis showed that RRC had longer operative time (MD=48.05, 95% CI: 26.52 to 69.57, P<0.01), less estimated blood loss (MD=-17.74, 95% CI: -28.32 to -7.16, P=0.01), faster postoperative intestinal peristalsis recovery (MD=-0.79, 95% CI: -1.10 to -0.48, P<0.01), lower postoperative overall complications (OR=0.63, 95% CI: 0.42 to 0.93, P=0.02). Conversion rate and postoperative hospital stay between the two groups were not significantly different (all P>0.05).

CONCLUSIONCompared to LRC, RRC is associated with less estimated blood loss, faster postoperative intestinal peristalsis recovery, lower postoperative overall complications, and longer operative time.

Colectomy ; Humans ; Laparoscopy ; Length of Stay ; Operative Time ; Postoperative Complications ; Postoperative Period ; Robotic Surgical Procedures