Perineural invasion(PNl) is regarded as a factor associated with local recurrence and an important prognostic factor in pancreatic cancer.Little is known about the mechanism of PNI in Pancreatic cancer.This review summarizes the role of innervation, clinicopathologic factors, lymhatic vessels, vascularity, cytokines, adhesion molecules, some immunoglobulin superfamily members and mucin in PNI.Because PNI is often followed by poor survival.An ear-lier diagnosis can improve pancreatic cancer prognosis.IPEUS,CT scan and immunostaining CK-19, K-ras gene a-nalysis can be used to diagnose perineural invasion pre-, in-tra-or postoperatively.A wide surgical exeresis with an enough lymph nodes clearance together with surrounding connective and nervous tissue can get a better long term survival rate.

Adult ; Carcinoma, Small Cell ; pathology ; Female ; Humans ; Male ; Melanosis ; pathology ; Uterine Cervical Neoplasms ; pathology

objective To evaluate the clinical application value of ileum to the S-type of suture pro- duced orthotopic neobladder.Methods Radical cystectomy and ileal neobladder with"S"shape were per- formed in 3patients with transitional cell carcinoma.Ureter implant into neobladder with embedding nipple techniques,bottom of neobladder coincide with urethra stump.Results The average operative time to form a neobladder was 5 hours,average bleeding volume was 366 ml during operation,3 cases can control urine dur- ing daytime,nycturia 1-3 times every night.Neobladder has a large capacity,low pressure,and electrolytes of blood was normal.Conclusion The construction of an ileal neobladder using a smaller part of ileum that has been completely detubularized and fashioned by S shape is easy and agreeable to perform.This mode of oper- ation has low complication rates,achieves adequate capacity at low pressure,and provides satisfactory conti- nence rates.It is a fine scheme to treat invasion and multiple carcinoma of bladder.

Objective:To search for a method for radical resection of pancreatic and duodenal malignancy involving the mesentery root and for the long post-operation survival of patients.Methods:From Jan.2004 to Aug.2006,a total of 26(16 male and 10 female. aged 27-70)patients with pancreatic and duodenal malignancy involving the mesentery root were treated in our department.The patients included 3 with duodenal malignancy and 23 with pancreatic malignancy.Curative resection was performed by the extended pancreaticoduodenetomy(Whipple procedure)combined with mesentery root resection(MRR)for all patients.The outcomes,safety and the post-operation survival rate were analyzed retrospectively.Results:Thirteen patients were treated with Whipple procedures combined with MRR,9 were treated with partial portal vein/superior mesenteric vein(PV/SMV)and reconstruction of the vessel,and 4 patients received pre-shunt between PV and SMV with artificial vessel graft before the extended Whipple and MRR procedures.The operation time was 2.5 to 7(4.4?1.1)hour,and blood loss was 300 to 5 000(1892?1414)ml with the blood transfusion of 0 to 5 600(2 100?1 586)ml.There was no death in our group and 7(27%)had post-operation complication.The post-operation hospital stay was 10 to 30 days.The pathologic examination showed negative surgical margins for all specimens.The tumor size was 4 to 10 (6.17?2.03)cm.After a follow-up of 9 to 38 months,the pain was relieved in all patients.One of the 3 patients with duodenal adenocarcinoma had liver metastasis at 10 months after operation,and the other 2 survived 10 months and 27 months without evidence of tumor reccurence.The patient with pancreatic micro-adenocarcinoma died of local reccurence 9 months after operation.The patient with neuroendocrine carcinoma died of organ failure 24 months after operation.The patient with lymphoma have survived for 24 months after operation.The 1-year and 2-year accumulated survival rates in the 20 cases with pancreatic ductal cancer were 86.6% and 45.6%. respectively.Conclusion:The extended Whipple procedure with MRR is safe and effective.It can obtain R0 resection in patients with malignant tumors(over 5 cm in diameter)in the head,neck and uncinate process of the pancreas and duodenal.

Objective To evaluate the tolerance and safety of sorafenib for elderly patients with advanced renal cell carcinoma.Methods Forty cases with advanced renal cell carcinoma were enrolled,26 were males and 14 were females,the average age was 70 years.Recurrence or metastasis was found in 32 patients who had received nephrectomy,22 of the 32 cases had received cytokine therapy before recurrence or metastasis.Primary renal lesions of 8 cases could not be resected,so patients get renal tumor biopsy.Pathological type of all patients was clear cell carcinoma.KPS of all the patients were ≥70 points.Sorafenib was used as first-line treatment,with 400 mg twice per day,until intolerance or disease progression occurred.Results The average treatment time was 7.5 months (3-18 months),CR 0 case,PR 6 cases,SD 29 cases,PD 5 cases.The overall objective response rate and disease control rate were 15.0% (6/40)and 87.5%(35/40),respectively.The median follow-up period was 11 months.The adverse reaction included hand-foot skin reaction(70.0%),alopecia (62.5%),rash(52.5%),diarrhea(37.5%),loss of appetite(32.5%),fatigue(27.5%).Most adverse reactions occurred around the second week after drug therapy initiation,their duration did not equal.And most of these adverse reactions could be released by symptomatic treatment,they did not affect the treatment.Conclusions The types of adverse reactions of sorafenib for elderly patients with advanced renal cell carcinoma are similar to those reported in the literature.Generally the degree of adverse reactions is minor,with good tolerance and safety.

Objectives To investigate the role of lymphangiogenesis in the perineural micrometastasis of pancreatic adenocarcinoma. Methods The clinical data of 30 pancreatic adenocarcinoma patients who were admitted from Sep. 2005 to Oct. 2006 for extended radical surgery were collected. The samples including pancreatic cancer, adjacent tissue, lower bile duct, pancreatic tail, the structure surrounding the SMA (peripancreatic nerve plexus) and lymph nodes were collected during operation. They were subjected to conventional pathological examination. The lymphatic capillaries weredetected by double immunohistochemical staining and the lymphatic vessel density ( LVD) was measured. Results Intra-pancreatic and/or peripancreatic neural invasion was observed in 25 patients (83. 3% ) , of which 20 were found to have both the peri-pancreatic and intra-pancreatic neural invasion. The other 5 only had the intrapancreatic neural fiber invasion and there was no single patient with peri-pancreatic neural fiber invasion only. Peri-neural invasion was not significantly associated with patients' age, gender, lymph node metastasis, tumor size and the location (P > 0.05) , but was obviously associated with JPS clinical staging ( P < 0. 05 ). The mean intratumoral LVD was (4.2 ±3.4) per field, which was significantly lower than (11.3 ±6.9) per field of adjacent tissue and (10.8 ±4.4)per field of normal pancreatic tissue(P<0.01). The mean intratumoral LVD between adjacent tissue and normal pancreatic tissue was not statistically different. Lymphatic vessel invasion was observed in non-malignant tissues in 18 patients, and there was a distribution correlation between lymphatic vessel invasion and extra-pancreatic neural plexus invasion (P<0.05). Conclusions The incidence of peri-neural invasion was high, peri-neural invasion was associated with JPS clinical staging and lymphatic vessel invasion, which suggested the possibility of the cancer spreading by peritumoral lymphangiogenesis route into the peri-SMA neural plexuses.

Adolescent ; Adult ; Child ; Child, Preschool ; Choristoma ; metabolism ; pathology ; surgery ; Encephalocele ; metabolism ; pathology ; surgery ; Female ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Infant ; Male ; Meningocele ; metabolism ; pathology ; surgery ; Middle Aged ; Mucin-1 ; metabolism ; Neuroglia ; metabolism ; pathology ; Nose Diseases ; metabolism ; pathology ; surgery ; S100 Proteins ; metabolism ; Vimentin ; metabolism ; Young Adult

To explore the feasibility of chemical and biological method in evaluation of the in vitro dissolution rate of Liuwei Wuling tablet (LWT), this experiment investigated the inhibitory effect of LWT dissolving solutions on LX-2 hepatic stellate cells in 0.1% SDS dissolution medium in different dissolving periods. From these results, the cumulative dissolution rate of LWT was obtained based on the cell inhibitory rate. The dissolution rates of deoxyschizandrin, phillyrin, and Specnuezhenide were determined by HPLC method. A novel approach of self-defined weighting coefficient had been created to establish the integrated dissolution rate model. Then f2 similar factor method was used to evaluate the relevance of these two methods. The results showed that f2 values for deoxyschizandrin, phillyrin, Specnuezhenide, and the integrated dissolution were 61, 43, 61 and 75 respectively, indicating that the dissolution of multi-component integration could fully reflect the biological potency of the whole recipe. The dissolution evaluation method for multicomponent integration based on biological activity is expected to be one of the effective means for in vitro dissolution test of LWT.
Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Kinetics ; Quality Control ; Solubility ; Tablets ; chemistry

To study the influence of stir-baked with sand on active ingredients, diarrhea and hepatoprotection of Herpetospermum caudigerum, the contents of herperione and herpetin in H. caudigerum before and after stir-baking with sand were analyzed by HPLC. The effect of stir-baked with sand on diarrhea of H. caudigerum TL was evaluated using the mean stool rate (MSR) and mean diarrheal index ( MDI) and the influence of stir-baked with sand on hepatoprotective effect of H. caudigerum TL was examined using a mouse model of CCl4-induced liver injury based on the analysis of serum ALT and AST activities. The results of HPLC analysis showed the content of herperione in H. caudigerum after stir-baking with sand decreased by 40.9% (P < 0.01) and the content of herpetin had no change. Pharmacodynamic results showed that the MSR and MDI of high-dose and middle-dose group of H. caudigerum TL after stir-baking with sand were significantly lower than that of high-dose and middle-dose group of H. caudigerum TL without stir-baking with sand; The high-dose and middle-dose of H. caudigerum TL with/without stir-baking with sand significantly alleviated liver injury as indicated by the decreased levels of serum ALT and AST, but the ALT and AST levels of high-dose and middle-dose group of H. caudigerum TL after stir-baking with sand were higher than that of H. caudigerum TL without stir-baking with sand. The results revealed that the stir-baking with sand could effectively relieve diarrhea effect of H. caudigerum TL, while it also reduces the hepatoprotection of H. caudigerum TL.
Animals ; Chromatography, High Pressure Liquid ; Cooking ; Cucurbitaceae ; chemistry ; Diarrhea ; chemically induced ; Female ; Liver ; drug effects ; Male ; Mice ; Protective Agents ; pharmacology

OBJECTIVETo evaluate the efficacy and progression-free survival of erlotinib after progression of disease to gefitinib in patients with advanced pulmonary adenocarcinoma who previously obtained a disease control with gefitinib.

METHODIn this retrospective study, 12 patients with advanced or metastatic pulmonary adenocarcinoma,who were previously obtained a partial response or a stable disease with gefitinib,were treated with erlotinib after gefitinib failure. Erlotinib efficiency, progression-free survival and overall survival were analyzed.

RESULTSNice (75%)achieved stable disease and three (25%) achieved progression disease with erlotinib treatment after gefitinib failure. No complete response or partial response was observed. The disease control rate was 75%. The median progression-free survival and overall survival of erlotinib were 180 days and 831 days.

CONCLUSIONErlotinib seems to be an optional treatment after gefitinib failure for advanced pulmonary adenocarcinoma patients,who previously responded to gefitinib.

Adenocarcinoma ; drug therapy ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; therapeutic use ; Drug Tolerance ; Erlotinib Hydrochloride ; Feasibility Studies ; Female ; Humans ; Kaplan-Meier Estimate ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Quinazolines ; therapeutic use ; Retrospective Studies ; Treatment Outcome