Objective:To investigate the predictive value of preoperative and postoperative serum tumor markers, namely, carcinoem-bryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and CA72-4, in the diagnosis of gastric cancer recurrence at different stag-es. Methods:Analysis was performed in 564 patients who underwent curative resection for gastric cancer between January 2002 and March 2007, received no chemotherapy at our hospital, and received complete follow-up according to the schedule determined pro-spectively. The values of CEA, CA19-9, and CA72-4 were evaluated before and after surgery. Results:In the pTNM-Ⅰ and pTNM-Ⅱ stage groups, patients with positive preoperative serum CEA, CA19-9, and CA72-4 levels showed recurrence rates of 50.0%, 24.1%, and 22.6%, respectively. Similarly, the recurrence rates of patients with positive postoperative serum CEA, CA72-4, and CA19-9 levels were 42.9%, 21.7%, and 14.3%, respectively. Multivariate analysis showed that the positive preoperative serum CEA level could be an inde-pendent factor of recurrence. In the pTNM-Ⅲ stage group, the recurrence rates of patients with positive preoperative serum CEA, CA19-9, and CA72-4 levels were 50.0%, 55.2%, and 47.6%, respectively. The recurrence rates of patients with positive postoperative se-rum CEA, CA19-9, and CA72-4 levels were 75.0%, 66.7%, and 66.7%, respectively. Multivariate analysis showed that high postoperative serum CA72-4 levels could be an independent factor of gastric cancer recurrence. Conclusion:Serum tumor markers exhibited differ-ent predictive values in different pTNM stages. Preoperative CEA level could be used to predict recurrence in patients with pTNM-Ⅰ and pTNM-Ⅱ stages of gastric cancer. Moreover, postoperative CA72-4 level could be used to predict recurrence in patients with pTNM-Ⅲ stage gastric cancer.

Objective: To investigate the awareness, sexual behavior characteristics and infection status of AIDS among male floating population in Anhui Province, so as to provide insights into formulating prevention and control measures for male floating population. Methods: Male floating population of three occupations including construction workers, enterprise workers, and business operators in Wuhu, Tongling, Hefei, and Fuyang cities were selected using stratified cluster random method from April to August 2021. Demographic information, knowledge of AIDS and high-risk behaviors were collected through questionnaires surveys. The results of HIV, syphilis and hepatitis C virus (HCV) antibody testing were collected through laboratory tests. Awareness rate of AIDS knowledge, sexual behavior characteristics, and positive rates of HIV, syphilis, and HCV among male floating population of different occupations were analyzed. Results: A total of 1 616 people were enrolled, including 1 016 construction workers (62.87%), 253 enterprise workers (15.66%) and 347 business operators (21.47%), and had a mean age of (40.63±12.32) years. The overall awareness rate of AIDS knowledge among male floating population was 89.54%, the awareness rates of business operators, construction workers, and enterprise workers were 98.33%, 88.29% and 82.61%, respectively, and the difference was statistically significant (P<0.05). The proportions of consistent condom use during sexual intercourse with a spouse or cohabitant, during commercial sexual encounters, and with casual partners in the past year were 7.15% (91/1 273), 64.00% (16/25) and 50.00% (8/16), respectively. The proportions of construction workers, enterprise workers, and business operators who used condoms every time they had sexual behavior with their spouses/cohabitants in the past year were 4.54%, 11.63%, and 15.60%, respectively, with statistically significant differences (P<0.05). One case of HIV, one case of syphilis, and three cases of HCV antibody were detected. Conclusion The overall awareness rate of AIDS knowledge among the male floating population in Anhui Province is relatively high, but unsafe sex behaviors exist, which may lead to the risk of HIV infection.

Objective To explore the influence of alimentary tract reconstruction after gastrectomy on the blood glucose level in patients with gastric cancers combined with type 2 diabetes mellitus. Methods From January 2004 to December 2009, the level of blood glucose and body weight before operation and 1,3,6 months after operation in 87 gastric cancer combined with type 2 diabetes mellims patients were retrospectively analyzed. These patients underwent different alimentary tract reconstructions,including 48 patients for Billroth I after distal subtotal gastrectomy (group A), 39 patients for esophageal Roux-en-Y jejunostomy after total gastrectomy (group B). Fasting blood glucose (FBG) level and body weight of these patients were compared. Results In group A, change of FBG before and after operation were not significant (P ＞ 0.05 ). The levels of FBG in group B were significantly lower in 1,3,6 months after operation [(6.7 ±0.8), (6.6 ±0.6), (6.8 ±0.7) mmol/L] than that before operation [(9.7 ± 1.4) mmol/L](P＜0.05). The lower value average difference of FBG at 1,3,6 months was significant between group A and group B (P＜0.05 ). In group B, 6 months after operation's total effective rate was 87.2% (34/39). Changes of body weight before and after operation in group A and group B were significant (P ＜ 0.05 ). But between two groups, the changes of body weight between 1,3,6 months and before operation were not significant (P ＞0.05).Conclusions Esophageal Roux-en-Y jejunostomy after total gastrectomy has obvious influence on FBG level in patients with gastric cancers combined with type 2 diabetes mellitus. It takes about 1 month to reveal the effect of operation and has nothing to do with weight loss.

Objective To explore the best ratio of platelet-rich plasma (PRP) to activator and the synergistic action of thrombin and the growth factors in PRP gel on proliferation of human marrow-derived mesenchymal stem cells (hBMSCs). Methods The activator was made up of 1000 U bovine thrombin and 1 mL 10% calcium chloride solution. PRP was mixed with the activator at the ratios of 1:1, 5:1, 10:1, 20:1, 40:1 respectively in groups A, B, C, D and E. A quantitative sandwich enzyme-linked immunosorbent assay (ELISA) was used for examining the amounts of transforming growth factor-β1 (TGF-β1) and platelet derived growth factnr-AB (PDGF-AB) in PRP gel in each group after incubation for 0,1,8,24, and 120 hours. MTT assay was used to evaluate the effect of PRP gel in each group on hBMSCs proliferation. Results When PRP was mixed with thrombin, concentrations of PDGF-AB and TGF-β1 in PRP gel increased immediately and reached the peak value in 1 hour. The PRP gel in groups B, C, and D contained the highest amounts of PDGF-AB and TGF-β1, and accelerated hBMSCs growth re-markably. The cells proliferation in group A was inhibited. Conclusions The effect of PRP on the hBMSCs proliferation depends on the concentrations of PDGF-AB and TGF-β1 in PRP. Thrombin may influ-ence the hBMSCs proliferation by regulating concentrations of growth factors in PRP to certain extent, but too high a level of thrombin may inhibit hBMSCs growth.

Objective:To explore the clinical efficacy of radical resection for lung metastasis from colorectal cancer and the prognostic factors.Methods:The retrospective cohort study was conducted. The clinicopathological data of 63 colorectal cancer patients with lung metastasis who were admitted to Peking University Cancer Hospital from January 2004 to December 2015 were collected. There were 35 males and 28 females, aged (57±12)years. Patients underwent radical resection for primary lesion and lung metastasis from colorectal cancer. Observation indicators: (1) diagnosis and treatment; (2) follow-up and survival; (3) prognostic factors analysis. Follow-up was conducte by outpatient examination and telephone interview to detect the survival of patients after operation up to December 2018. Measurement data with normal distribution were represented as Mean±SD, and measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers or percentages. The Kaplan-Meier method was used to calculate survival rates and draw survival curves. Log-rank test was used for univariate analysis and COX proportional hazard model was used for multivariate analysis. Results:(1) Diagnosis and treatment: of 63 patients with lung metastasis from colorectal cancer, 6 had synchronous lung metastasis and 57 had metachronous lung metastasis. Eighteen cases of suspected lung metastasis were initially detected by chest X-ray, and further confirmed by computed tomography (CT). Forty-five cases of suspected lung metastasis were initially detected by chest CT. All the 63 patients underwent radical resection for primary and metastatic lesions. Two of 22 cases undergoing mediastinal lymph nodes dissection were detected one positive lymph node, respectively. All patients recovered well after operation, without severe complications. There were 57 of 63 patients receiving more than 6 months of postoperative adjuvant chemotherapy and targeted therapy based on fluorouracils. (2) Follow-up and survival: 63 patients were followed up for 8-143 months, with a median follow-up time of 58 months. During the follow-up, 19 of 63 patients died, 24 patients had secondary recurrence with a 5-year recurrence rate of 38.1%(24/63) and a recurrence interval of 18 months(range, 3-58 months). Of 24 patients with secondary recurrence, 19 had lung metastasis, 3 had brain metastasis, 2 had bone metastasis, 2 had liver metastasis; some patients had multiple metastases. Of 24 patients with secondary recurrence, 5 underwent reoperation and 19 underwent chemotherapy and radiochemotherapy. The 5-year overall survival rate of 63 patients was 62.7%. (3) Prognostic factors analysis: results of univariate analysis showed that location of primary lesion, the number of lung metastases and carcinoembryonic antigen (CEA) level before resection of lung metastasis were related factors for prognosis of patients with lung metastasis from colorectal cancer ( χ2=4.162, 7.175, 6.725, P<0.05). Results of multivariate analysis showed that the number of lung metastases and CEA level before resection of lung metastasis were independent influencing factors for prognosis of patients with lung metastasis from colorectal cancer ( hazard ratio=2.725, 2.778, 95% confidence interval as 1.051-7.064, 1.072-7.021, P<0.05). Conclusions:Radical resection for lung metastasis from colorectal cancer is safe and feasible. The number of lung metastases and CEA level before resection for lung metastasis are independent influencing factors for prognosis of patients with lung metastasis from colorectal cancer.

Objective:To investigate the efficacy, safety, and overall survival of advanced upper gastric cancer patients who received preoperative chemoradiation therapy. Methods:A total of 62 patients who received preoperative chemotherapy or chemoradiation therapy in the Department of Gastrointestinal Surgery of Beijing Cancer Hospital&Institute were retrospectively observed to determine the efficacy and safety and to perform survival analysis of preoperative chemoradiation therapy. Results:Results of the postoperative pathology showed that the number of patients with T4 and N3 stages was significantly lower in the preoperative chemoradiation therapy group than in the preoperative chemotherapy group (P<0.05). In addition, the differences between the two groups in terms of safety and toxicity were not significant (P≥0.05). Analysis also showed that the differences between the two groups in terms of survival were not significant (P≥0.05). Conclusion:Patients with advanced upper gastric cancer can gain a potential survival advantage from preoperative chemoradiation therapy. Compared with preoperative chemotherapy, preoperative chemoradiation therapy was performed without increased risk of toxicity and insecurity. Preoperative chemoradiation therapy can also improve the local control ratio, especial y the control ratio of lymphatic metastasis. However, the final results of survival analysis depend on long-term follow-up of patients.

Objective To prepare compound ketoconazole ointment and perform the stability study .Methods Ketocon-azole ,mupirocin and mometasone furoate were used as active pharmaceutical ingredients (API) .PEG mixture was used as ma-trix to prepare the ointment .Stability of the API in the ointment was evaluated by the stress tests .Results The optimal ratio of PEG400 to PEG3350 for the ointment matrix was 2:1 .Mometasone furoate and mupirocin in the ointment were stable to the high temperature(40 ℃)while ketoconazole had some degradation .The stability of the API was improved by addition of 0 .5％ of L-A .During the accelerate test ,the ointment had no color change and the API percentages were above 98％ .Conclu-sion The novel compound ketoconazole ointment was successfully prepared and the formulation stability was excellent .

Neoadjuvant chemoradiation has been accepted as a standard of care for local advanced middle to low rectal cancer. Patients with clinical complete response (cCR) or near cCR following neoadjuvant chemoradiation may benefit from watch and wait strategy or organ-preserving surgery with good short- and long-term outcome and quality of life (QOL). Yet the criteria of cCR varies and cCR is not consistent with pCR. Therefore, the obstacle to the strategy lies on whether its failure can be salvaged and the complexity of follow-up. Available studies demonstrated that local recurrence or regrowth can be salvaged by surgery without compromising the survival. So, the key is appropriate follow-up schedule and timely salvage. The strategy has not drawn much attention until recently, and relevant studies go slowly because of low data availability, patient awareness, and peer acceptance. We still believe that more and more patients might benefit from this strategy, along with the increasing attention of QOL from the patients. That may be obtained through screening of the right patients and optimizing treatment modality, evaluation methods, and protocol of follow-up.

In the era of evidence-based medicine, the diagnosis and treatment of gastric cancer are based on the evidence from important clinical trials. International and Chinese trials are performed on early, locally advanced, and late stage gastric cancer and the key points of trials of each aspect are different. Clinical trials of early gastric cancer mainly focus on the minimally invasive treatments like endoscopic resection and laparoscopic surgery. Clinical trials of locally advanced gastric cancer aim to raise the extent of radical treatment and multimodality treatment patterns. As to late stage gastric cancer, the trials aiming to prolong survival of the patients, conversion treatment, target therapy, immune therapy and new drug development are mostly interested.
Clinical Trials as Topic ; Combined Modality Therapy ; Humans ; Laparoscopy ; Stomach Neoplasms ; surgery

Laparoscopic surgery has been increasingly used in rectal cancer surgery. Though there are still some controversies, most of the research results support that the outcome is similar for rectal cancer patients with either laparoscopic or open surgery, in term of short-term such as safety and efficacy and long-term such as oncologic outcome. Standardization of laparoscopic training together with the comprehensive management concept are the prerequisites of laparoscopic rectal cancer surgery. Those doctors who do minimally invasive surgery should follow the rationale that smaller incision and sphincter preservation are secondary to safety and oncological result of the patients. It is the comprehensive management and personalized treatment that bring opportunities for the continuous development and innovation of innovative technologies and concepts, for example, non-operative treatment, endoscopic therapy, natural orifice transluminal endoscopic surgery, single incision laparoscopic surgery, and robotic surgery. And they may finally lead to better outcome and quality of life for the patients.