Colon cancer is one of the most common cancers in China, with an increasing incidence these years. Currently, the combined therapy based on radical surgery has dramatically improved the survival rate and life quality of patients, however, a large percentage of patients still died of recurrence and metastasis. In recent years, the treatment strategies for the recurrence of colon cancer have been greatly advanced, especially the new targeted drugs and chemotherapeutic drugs, which lead to a significantly improved therapeutic efficacy and a better life quality. Therefore, how to choose and use these new treatments synthetically and reasonably become a great challenge to all surgeons, especially to digestive surgeons.

Purpose:To find out the clinical biology value of p53 overexpression on Chinese breast cancer by Meta analysis. Methods:Reviewed all the published studies during the recent 10 years regarding p53 and breast cancer, and used standard techniques of Meta-analysis to combine the results of these studies to produce a more precise estimate of the prognostic significance of p53 mutations.Results:the mean of p53 positive express was 45%,95% confidence interval (43-47)%:, p53 positive was related with node metastasis, recurrence after surgery, over survival, tumor size and nuclear grade, but not related with age and pathology type, p53 was a special and sensitive prognostic factor for breast cancer.Conclusions:p53 can be an independent molecular marker to definitive prognostic of breast cancer, and possibly can be a reliable marker for choice of standard and individulized therapy.

Objective To compare the efficacies of laparoscopic colorectal resection and conventional open surgery by collecting and investigating related studies with Meta-analysis.Methods Randomized controlled trials(RCT) on the outcomes of laparoscopic colorectal resection and conventional open surgery that published between January 1989 and March 2008 in English were collected and analyzed.The quality of the original investigations was evaluated,and the low-level reports were excluded.Then the odds ratio(OR) for the incidence of early postoperative small bowel obstruction between the two methods were calculated.ResultsTotally 12 studies including 3032 cases were analyzed.Among which,1522 patients received laparoscopy,33 of them developed early postoperative small bowel obstruction.1510 cases underwent open surgery,and 71 of these patients showed small bower obstruction before being discharged form hospital.The pooled OR was 0.46 with a 95% confidence interval of(0.30-0.69).Conclusion Compared with open surgery,laparoscopic colorectal resection is superior in the incidence of early postoperative small bowel obstruction.

Objective To evaluate the prognostic value of microsatellite instability (MSI) in stage Ⅱ colon cancer patients.Methods 120 stage Ⅱ colon cancer patients underwent radical resection in the Department of Colorectal Surgery,Beijing Cancer Hospital from 2000 to 2007.Tissue samples were collected and DNA was extracted for MSI determination using PCR following the Pentaplex panel.Clinical parameters were also combined and analyzed statistically to explore the association between MSI status and clinical parameters.Results The incidence of high frequency of microsatellite instability (MSI-H) was 20.8％ in these 120 stage Ⅱ colon cancer patients.There was a significant correlation between the status of MSI and tumor differentiation (x2 =9.69,P =0.021);However MSI status was demonstrated to be a prognostic factor for disease free survival or overall survival (all P ＞ 0.05).Nor was MSI status associated with tumor relapse or metastasis.Age and preoperative serum CEA level were identified as independent factors for DFS by Cox regression.Conclusion In stage Ⅱ colon cancer patients,MSI status correlates with tumor differentiation,but is not a prognostic factor.

Objective To investigate the relationship between the secondary hypertension and pituitary microadenoma,and to explore the diagnostic value of magnetic resonance imaging(MRI) examination for pituitary microadenoma.Methods We analyzed the clinical information,laboratory examination results and imaging data in 21 hypertension patients complicated with pituitary microadenoma.Results The manifestations of the 21 patients were as follows:(1) The onset of hypertension was in young age,complicated with headache;(2) The results of 24-hour ambulatory blood pressure monitor(24h ABPM) showed the disappearance of circadian rhythm of blood pressure,and obvious increase of systolic/diastolic blood pressure;(3) The antihypertensive effect of antihypertensive drugs was not satisfactory;(4) Of adenohypophyseal hormones,adrenocorticotrophic hormone(ACTH) level in most patients and prolactin(PRL) level in a few patients were higher than the normal level,and the other hormones levels were normal;(5) The results of MRI examination presented adrenal cortical hyperplasia,adrenal adenoma and chromaffin tumor in some patients.(6) The results of MRI examination showed pituitary microadenoma in all of the patients.Conclusion For those middle-aged and young hypertension patients on whom antihypertensive effect of drugs is poor,MRI examination for adrenal gland and pituitary gland should be taken as the routine examination.MRI examination is the optimal imaging method for pituitary microadenoma,and supply evidence for the syndrome differentiation and treatment of pituitary microadenoma.

Objective To investigate lymphovascular invasion (LVI) in mid-low rectal cancer following neoadjuvant therapy. Methods A total of 297 consecutive patients with mid-low rectal cancer received radical surgery from August 2002 to August 2005 at Beijing Cancer Hospital. All patients were divided into the neoadjuvant therapy group and a control group according to whether they underwent preoperative radiotherapy or radiochemotherapy. Histological assessment of tumor specimens was made, and correlation of LVI and prognosis was analysed using the chi-square test. The disease-free survival rate and overall survival rate were analysed by the Kaplan-Meier survival curve. Results The overall positive rate of LVI was 23.9% (71/297). The positive rates of LVI in neoadjuvant therapy group and control group were 21.5% (31/144) and 26. 1% (40/153), respectively,with no significant difference between the groups ( x2 = 0.872, P ＞ 0.05). In the neoadjuvant therapy and control groups, LVI was significantly associated with pathologic T and N stages as well as the degree of histological differentiation (x2 =13.490, 27.401,7.323;16. 188, 21.623, 16.534, P＜0.05). In the control group, LVI was closely associated with local recurrence (x2 =4. 010, P ＜0.05 ), whereas this was not the case in the neoadjuvant therapy group (x2 =0.000, P＞0.05). LVI was significantly associated with distal metastasis in both the neoadjuvant therapy and control groups (x2 = 4.950, 14. 332, P ＜ 0.05 ). The disease-free and overall survival rates of patients with LVI were 46.4% (26/56) and 56.7% (34/60), which were significantly lower than 75.1%(148/197) and 79.4% ( 166/209 ) of those with no LVI, respectively ( x2 = 16. 720, 12.660, P ＜ 0.05 ).Conclusions Neoadjuvant therapy does not significantly reduce LVI;however, the biological behaviour of LVI has changed. Patients with LVI may benefit from neoadjuvant radiotherapy.

Objective To investigate the number, distribution and metastatic rule of lymph nodes in the mesorectum of rectal cancer specimen after processing the recta] cancer specimen with modified fat clearance technique. Methods Sixty patients with mid-low rectal cancer who had been admitted to Peking University School of Ontology from 2003 to 2008 were assigned to test group. All the 60 patients who denied neo-adjuvant therapy were treated with total mesorectal excision, and the rectums resected were processed with the modified fat clearance technique. Rectums from another 50 patients with mid-low rectal cancer in control group were fixed in formalin solution for 24 hours. The mesorectum was divided into anterior, posterior, left and right quadrants, and each quadrant was further divided into upper, middle and lower parts. The numbers of lymph nodes harvested and metastatic rate of lymph nodes between the 2 groups were analyzed by t test and chi-square test. Results (1) The numbers of lymph nodes harvested in the test and control groups were 1436 and 525, with statistical difference between the 2 groups (t =- 12. 153, P <0.05). The number of small lymph nodes(diameter≤5 mm) harvested in test group was 985. (2) The numbers of lymph nodes harvested in the anterior, posterior and bilateral mesorectum were 125,696 and 615, respectively. The numbers of lymph nodes harvested in the upper, middle and lower part of the mesorectum were 395,534 and 507, respectively. The metastatic rate of lymph nodes in the upper part of the mesorectum was 18.5% (37/200), which was significantly lower than in the middle [43.5% (87/200)] and lower [38.0% (76/200)] part of the mesoreetum (X2= 9. 414, 6.406, P < 0.05). Two hundred metastatic lymph nodes in 33 patients were harvested, 48.0% (96/200) of which with a diameter of ≤ 5 mm. Twenty percent patients had their TNM stage changed after the retrieval of metastatic small lymph nodes. Conclusions Modified fat clearance technique significandy improves the retrieval of lymph nodes, and more small lymph nodes retrieved can increase the accuracy of staging. Rectal cancer cells have strong tendency to disseminate to the distal mesorectum. Adequate excision of the distal mesorectum is key in controlling the local recurrence.

Objective To observe apoptosis of renal development in mouse. Methods Light,electron microscopy and TUNEL method were used. Results The apoptosis could be easily found in cells between S like body in nephrogenic zone and in renal corpuscles before birth, especially at 14 18 days prenatally. The apoptotic cells in epithelia of renal tubule or collecting duct could be observed in postnatal renal medulla. In medullary papilla the cell death peaked around postnatal day 7. Electron microscopy revealed that apoptotic cells were ingested by neighboring cells. Some apoptotic cells detached from epithelia into the lumen of tubule or duct. Conclusion This study provides morphologically some evidences of apoptosis in the mouse kidney embryonically and postnatally. The apoptosis in cortex was apparently related to the development of nephrogenic zone and renal corpuscles; and the apoptosis in medulla might play an important role in the development of renal tubular epithelia. [

ObjectiveTo explore the clinic symptom and the characteristics of video,tightly close,intracranial electroencephalogram (EEG) of patients with central region diastematia epilepsy. Methods Retrospective analysis of 9 patients with central region diastematia epilepsy admitted from June,2007 to August,2009.The characteristics of all patients' seizure symptom and EEG manifestation were analyzed using patients' medical history,video and EEG records.ResultsPatients with central region diastematia epilepsy had relatively long sezure history.The duration of seizure was commonly short,with frequent episode and no obvious intelligence impairment.The seizure was often accompanied with the hyperkinesia in the lower limbs.Scalp EEG showed discharges with low amplitude waves in the mean line area.The superhigh amplitude and regular rhythm slow sharp wave could be found in the diastematia cortex EEG.All patients had an Engel Class Ⅰ outcome after surgery.ConclusionThe seizure symptoms are characteristic in the patients with central region diastematia epilepsy,and some special manifestations can be found in different phase,wave amplitude,rhythm,lead array.

Objective: To assess the effect of balloon angiopl asty on circulating endothelin (ET) and TNF-α levels and tissue endothelin in experimental atherosclerosis in rabbits. Methods: After 20 New Z ealand rabbits had a high cholesterol diet for at least 8 weeks, successful ball oon angioplasty was performed in rihgt iliac arteries in 18 rabbits. Circulatin g levels of ET and TNF-α were measured before as well as immediately and 24 h after balloon angioplasty. Tissue endothelin immunoreactivity in atherosclerotic iliac artery wall after balloon angioplasty was assessed by immunohistochemica l technique. Results: Plasma levels of ET and TNF-α were signi ficantly increased immediately after ballon angioplasty (76.40±13.58)pg/ml vs (92.67±11.38) pg/ml and (31.35±6.23) U/ml vs (56.26±7.37) U/ml, resp ectively (P<0.05) .There was no change in plasma ET and TNF-α levels 24 h after balloon angioplasty (77.13±12.87) pg/ml vs (76.40±13.58) pg/ml and (33.41±6.79) U/ml vs (31.35±6.23) U/ml， respectively (P>0.05). T issue endothelin immunoreactiuvity was markedly increased in right iliac artery wall after balloon angioplasty than that in opposite iliac artery wall. Conclusion: The increase of plasma ET, TNF-α levels and tissue ET-IR in iliac artery wall after balloon angioplasty may be associated with the injury of l ocal vascular intima, suggesting that ET and TNF-α may take part in the corona ry constriction and the development of coronary restenosis after percutaneous tr ansluminal coronary angioplasty.