Objective To evaluate the results of surgical treatment for duodenal gastrointestinal stromal tumor (GIST).Methods Between January 2000 and January 2013,33 patients underwent surgical resection of duodenal GIST in Peking University Cancer Hospital,including local resection and pancreatoduodenectomy.Clinical data,surgical outcome and prognosis were reviewed.Results The median survival time is 94 months (range:55-132 months).The 1,3,5-year survival rates are 97％,89％ and 80％,respectively.The 5 year survival rate of patients after pancreatoduodenectomy and local resection is 78％ and 83％,respectively (P =0.091).It shows that tumor size and mitotic count and Fletcher classification influence overall survival.Conclusions When fulfiling proper safe margins,local resection is a reliable and curative option for most duodenal GISTs.

Objective To study the influence of long-term home noninvasive positive pressure ventilation (HNPPV) on respiratory muscle strength in patients with stable severe chronic obstructive pulmonary disease (COPD).Methods Sixty-four patients with stable severe COPD discharged from Huabei Oil-field Hospital,Renqiu,Hebei were divided into two groups,one (n=24) with HNPPV plus conventional therapy,and the other (n=40) with conventional therapy plus long-term oxygen therapy as controls.All parameters were followed-up for one-year and compared for the two groups,including maximal iuspiratory pressure (MIP),transdiaphragmatic pressure (Pdi),maximal transdiaphragmatic pressure (Pdimax),ratio of Pdi/Pdimax,arterial partial pressure of carbon dioxide (PaCO2),forced expiratory volume in one second (FEV1),6-min walking distance (6MWD),mortality and re-hospitalization rate.Results Age,gender,course of the disease,body mass index (BMI),arterial PaCO2,PaO2,MIP,Pdi,Pdiraax,ratio of Pdi/ Pdimax,FEV1,ratio of FEV1/FVC%,6MWD and re-hospitalization rate of the patients between the two groups were all comparable (P>0.05).In one-year follow-up,PaCO2averaged (52±8)mm Hg,MIP (64±7) cm H2O,Pdi (33±5) cm H2O,Pdimax (101±9) cm H2O,Pdi/Pdimax (0.31±0.04),FEV1 (35±4) %,FEV1/FVC% (44±4) %,6MWD (272±26) m and (2.6 ± 0.8) admissions per year in the HNPPV group,significantly different from those in the control group [ (57 ± 6) mm Hg,(59 ± 6) cm H2O,(31±4) cm H2O,(84±7) cm H2O,(0.35±0.05),(33±3)%,(41±4)%,(212±28) m,and (3.7±0.8) admissions per year] (P<0.05).One death was observed in the HNPPV group (1/24) and three in the control group (3/4 0) in one - year follow - up,with no statistically significant difference (X2=0.00,P>0.05).Conclusions Long-term use of HNPPV for patients with stable severe COPD could efficiently improve their respiratory muscle strength and endurance,thus improving their pulmonary ventilation and treatment efficcacy.

Nuclear epithelial growth factor receptor (EGFR) plays an important role in the development, metastasis, treatment, and prognosis of cancer. Radiotherapy, one of the main therapies for malignant tumor, causes EGFR transfer into the nucleus along with tumor therapy, thereby reducing radiosensitivity. Insight into the biological characteristics and functions of nuclear EGFR has an important reference value for improving radiosensitivity. Therefore, this article elaborates on EGFR transport into the nucleus,the features of nuclear EGFR,and its relationship with radiosensitivity and clinical targeted therapy.

Objective:To compare the safety and long-term survival of patients with synchronous rectal cancer liver metastasis, who received either simultaneous or staged resection to treat primary tumor and liver metastases. Methods:Clinicopathologic and peri-operative data were collected retrospectively from 54 patients with synchronous rectal cancer liver metastasis, who received both prima-ry and liver resections between January 2000 and April 2015 at Peking University Cancer Hospital. Routine follow-up was conducted. The safety and long-term survival of 19 patients who underwent simultaneous resection were compared with those of 35 patients who received staged resection. Results:The clinicopathologic data between the two groups were comparable. Postoperative Clavien-Dindo grades 1, 2, 3, and 4 complications were 10.5%(2/19), 31.6%(6/19), 5.3%(1/19), and 10.5%(2/19) for the simultaneous group, respec-tively, and 8.6%(3/35), 17.1%(6/35), 25.7%(9/35), and 0%(0/35) for the staged group correspondingly, which were not significantly different (P=0.093). However, the median postoperative hospital stay of the simultaneous group was significantly shorter than that of the staged group (14 days versus 25 days, P<0.001). The median postoperative overall survival (OS) and disease-free survival (DFS) be-tween these groups were not significantly different [not reached versus 39 months for OS, respectively (P=0.649);10 months versus 10 months for DFS, respectively (P=0.827)]. Conclusion:The postoperative complications in simultaneous resection group were not sig-nificantly increased compared with those in staged resection group for synchronous rectal cancer liver metastasis. The long-term results among the groups were similar.

Objective: To study the association between the AKAP12 promoter methylation and recurrence of hepatocellular carcinoma. Methods: A total of 142 primary liver cancer patients underwent surgery in department of Hepatobiliary surgery in Peking University Cancer Hospital from 2003 to 2009 were selected as subjects in the survey; with the inclusion criteria as hepatocellular carcinoma, no cancer cells were observed in the surgical margin(SM) samples. All patients had neither lymph nor distant metastasis at the time of surgery, and receiving complete follow-up data for at least 3 years. By the end of May 2014, a total of 75 patients had relapsed of whom 71 died and there were no lost. All samples were acquired from the frozen surgical tissues. Genomic DNA was extracted using phenol/chloroform method and performed bisulfite modification following with polymerase chain reaction (PCR). AKAP12 methylation in hepatoma and the corresponding SM samples from 142 patients was determined by denature high-performance liquid chromatography (DHPLC) and bisulfite clone sequencing. Kaplan-Meier and Cox proportion hazard regression model were used to identify the factors related to the survival time. Results: In 142 cases, 125 patients (88.0%) were male and 17 (12.0%) cases were female. The median age was 52.5 years, ranging from 34 years to 76 years. AKAP12 methylation-positive rate was significantly higher in hepatomas than SMs (54.9% vs. 10.2%, P<0.001). Patients with AKAP12 methylation-positive had less risk of the recurrence (HR=0.62, 95%CI: 0.39-0.99); with tumor diameter more than 5 cm (HR=1.53, 95%CI: 1.00-2.50),portal vein invasion(HR=4.53, 95% CI:2.69-7.64) increased the recurrence risk. Moreover, portal vein invasion had a higher risk of death (HR=2.98, 95% CI: 1.73-4.98). Conclusion There was significant association between AKAP12 DNA methylation and low risk of recurrence and long progression-free survival of hepatocellular carcinoma patients.

OBJECTIVETo detect the influence of compatibility of rhubarb with different traditional Chinese medicines (TCM) on extracted quantities of AQs, and to provide scientific basis for the clinical code for rhubarb preparation.

METHODThe influence of compatibility of rhubarb with different traditional Chinese medicines (saponin, alkaloids, flavonoids TCMs, animal medicines and mineral medicines) on decocting volume of anthraquinone substance was detected using ultra performance liquid chromatography.

RESULTIn comparable conditions, more AQs were extracted from mixed decoction of rhubarb and saponin medicinal materials (Astragali Radix, Notoginseng Radix et Rhizoma, Glycyrrhizae Radix et Rhizoma, Polygalae Radix, Ginseng Radix et Rhizoma) than single decocting of rhubarb. The mixed decoction of rhubarb and alkaloid medicinal materials (Coptidis Rhizoma, Sophorae Flavescentis Radix, Prepared Aconiti Lateralis Radix Praeparata, Phellodendri Chinensis Cortex, Aconiti Lateralis Radix) caused a remarkable decrease in extracted quantities of AQs. And the mixed decoction of rhubarb and mineral medicines (Natrii Sulfas, Gypsum Fibrosum, Ostreae Concha, Alumen) also resulted in less extracted quantities of AQs to varying degrees. Besides, more rhubarb AQs were extracted from mixed decoction with Curcuma than single decoction. But less rhubarb AQs were observed in mixed decoction with Lonicerae Flos, Rehmanniae, Artemisiae Herb and Forsythiae Fructus than single decoction to varying degrees. In the study, the maximum extracted quantities of AQs is 2. 3-fold higher than the minimum, the largest difference existed in the extracted quantity of physcion which was 13.5 times.

CONCLUSIONIn compatibility between rhubarb and different TMCs, mixed decoction and single decoction show different influences on extracted quantity of rhubarb AQs. It is proved that more AQs may be extracted from mixed decoction between rhubarb and saponin medicinal materials, whereas less AQs may be observed in mixed decoction between rhubarb and alkaloid medicinal materials.

Alkaloids ; chemistry ; Animals ; Anthraquinones ; analysis ; isolation & purification ; Chromatography, High Pressure Liquid ; methods ; Drug Compounding ; methods ; standards ; Flavonoids ; chemistry ; Humans ; Medicine, Chinese Traditional ; methods ; standards ; Plants, Medicinal ; chemistry ; Reference Standards ; Reproducibility of Results ; Rheum ; chemistry ; Saponins ; chemistry

Objective To observe the effect of hypoxia on the expression of epithelial growth factor receptor (EGFR) and cell apoptosis of breast and cervical cancer xenografts in nude mouse models.Methods The nude mouse models with MCF-7 and HeLa xenografts were established.The degree of hypoxia and EGFR expression were observed by confocal microscopy.The influence of EGFR expression on cell apoptosis under hypoxia was observed by TUNEL assay.Results EGFR expression was either up-regulated or down-regulated in the MCF-7 and HeLa cells with high degree of hypoxia.Furthermore,the degree of apoptosis was reduced in tumor tissues with high EGFR expression compared with that in those with low expression of EGFR.Conclusion The hypoxia in MCF-7 and HeLa cells exerts heterogeneous effect on EGFR expression.Under hypoxic conditions,EGFR exoression is negatively correlated with cell apoptosis.

OBJECTIVETo evaluate the effect of hepatitis on surgical treatment and prognosis of colorectal liver metastasis(CRLM).

METHODSA retrospective study of medical records of all the patients undergoing operation with colorectal liver metastasis in Peking University Hepatobiliary pancreatic Surgery Ward I from November 2007 to January 2013 was conducted. A total of 175 patients were eligible and divided into two groups: with hepatitis (n=16) or without hepatitis (n=159).

RESULTSPreoperative liver function was similar in these two groups. There were no significant differences in preoperative serum albumin, total bilirubin and prothrombin time between two groups (all P>0.05), except for lower blood platelet in hepatitis group after operation. Major hepatectomy was performed in 37.5% (6/16) and 22.0% (15/159) of two groups respectively (P>0.05). There were also no significant differences in operation time, blood loss, surgical complications and drainage volume (all P>0.05). The median overall survival time was 46 months in hepatitis group and 33 months in non-hepatitis group, and the median disease free time was 8 months in hepatitis group and 10 months in non-hepatitis group (all P>0.05).

CONCLUSIONCRLM patients concomitant with hepatitis have adequate liver reserve function for major hepatic resection and have similar prognosis of patients without hepatitis.

Colorectal Neoplasms ; Drainage ; Hepatectomy ; Hepatitis ; Humans ; Liver Neoplasms ; Operative Time ; Prognosis ; Retrospective Studies

OBJECTIVEIn order to understand the glycyrrhizin content range in the wild and cultivated Glycyrrhiza uralensis in China and to find the related influencing factors of glycyrrhizin content.

METHODThe glycyrrhizin content of 165 wild and 1 013 cultivated G. uralensis samples from 37 countries in 9 provinces was determined by HPLC, and the effects of the producing region, medicinal parts, cultivation years, soil type and texture on the glycyrrhizin content were analyzed.

RESULT AND CONCLUSIONThe average glycyrrhizin content was (4.43 +/- 1.32)% in the wild G. uralensis population, and (1.51 +/- 0.49)% in the cultivated and the glycyrrhizin content in the cultivated was less than the minimum sandards in the Chinese Pharmacopoeia. The glycyrrhizin content was significant different in the wild and cultivated G. uralensis in different producing regions, respectively. The glycyrrhizin content in roots and rhizome of the wild G. uralensis had no significant difference, it had no significant difference in the cultivated G. uralensis from 1 to 4 years and it increased rapidly after 5 years, and the effects of the soil types and texture on it were significant.

China ; Glycyrrhiza uralensis ; chemistry ; growth & development ; Glycyrrhizic Acid ; analysis

OBJECTIVETo explore the role of repeat liver resection in colorectal liver metastasis (CRLM) with early recurrence and to analyze the risk factors of early recurrence.

METHODSClinicopathological and follow-up data of 303 CRLM patients undergoing liver resection in our department between January 2000 and August 2014 were analyzed retrospectively. The 5-year overall survivals between early recurrence(within postoperative 1 year) and non-early recurrence were compared. The impact of repeat liver resection on 5-year survival of early recurrence was analyzed. Clinicopathological features which might be associated with early recurrence were investigated using univariate and multivariate analyses.

RESULTSAmong 303 patients, 192(63.4%) patients had recurrence, including 145 patients of early recurrence and 47 of non-early recurrence. The 5-year overall survival of early recurrence patients was significantly lower compared with non-early recurrence ones(16.0% vs. 63.9%, P=0.000). Among 145 early recurrence patients, 80 were evaluated as resectable, of whom 22 received repeat liver resection. Compared with other 58 patients receiving conservative treatment, above 22 patients receiving repeat liver resection had a significantly higher 5-year overall survival(27.1% vs. 0%, P=0.033). Multivariate analysis revealed T-stage of primary tumor, lymph node metastasis, and larger size(> 5 cm) of metastatic liver focus were independent risk factors of early recurrence, and good efficacy of neo-adjuvant chemotherapy was independent protective factor of early recurrence(all P<0.05). Repeat liver resection was associated with better long-term survival.

CONCLUSIONSThe prognosis of early recurrence after liver resection in CRLM patients is poor, while repeat resection for resectable lesions in recurrence patients can obviously prolong the survival. For those with late T-stage, lymph node metastasis, and larger metastatic liver focus, actively preoperative neo-adjuvant chemotherapy should be considered.