Background and purpose:Colorectal cancer is one of the most common malignant tumors.Radical operation remains the primary treatment for the disease.Postoperative recurrence and metastases are the main cause for the patient' death.Reoperation for recurrent colorectal cancer is one of the methods to improve survival rate and quality of life for those patients.This study aimed to explore the cause,diagnosis and surgical treatment of recurrent colorectal cancer after operation.Methods:Thirty-five cases of postoperatively recurrent colorectal carcinoma who were treated from 2003 to 2006 at the Department of Surgical Oncology,2th Hospital of Jiaxing were retrospectively analyzed.Results:35 cases of colorectal cancers were re-operated and the overall rate of resection was 63 %,12 of them received radical resection with 4 recurrent rectal cancers and 8 recurrent colon cancers while others were palliatively treated.We followed up these patients from 6 to 36 months and there were 9 cases in 12 cases of radical respected group who were disease free,1 of them had lung metastases,1 liver metastases.While 23 cases in the palliative group,5 were dead,4 had liver metastases and 12 cases were alive.Of the 35 cases,26 cases(70%)tumor recurred within 3 years after first operations while others were recurrent at 1 year.Conclusions:For the patients with recurrent colorectal cancer,surgery remains one of the choices for the treatment.Multimodality treatment should be recommended for the patients at diagnosis.Completed resection of intestine with primary lesion,standard lymphadenectomy and eradicating peritoneal exfoliated cancer cells are the major steps to prevent recurrence of colorectal cancer.

Objective To study the effect of sub-chronic exposure to dehamethrin(DM) on the behavior of mice in learning and memory.Methods 60 Female SPF Kunming mice were randomly divided into 4 groups and given DM by gavaging for 60 days.Morris water maze (MWM) was used to evaluate spatial memory in mice.Results After exposure to DM,the escape latency of the solvent control group and the treatment groups were (12.20±6.5)s,(14.99±5.4) s,(15.64±8.3)s,(22.71±6.2)s on the fifth day.The escape latency of the high-dose group was higher than those of the low-dose group (P=0.0041) and the solvent control group (P=0.019) in the navigation test.The number of crossing position of the platform in the high-dose group ((2.93± 1.53)times) and the middle-dose group ((3.40± 1.12) times) were lower than that in the solvent control group ((5.87 ± 1.55) times) and the low-dose group ((4.90± 1.41)times)(P＜0.05).Conclusion Sub-chronic exposure to DM can damage the spatial learning and memory of mice.

Objective To study the effect of sub-chronic exposure to deltamethrin(DM) on the behavior of mice in learning and memory and expression of GABAA receptor α1 and γ2 subunits in the hippocampus of mice.Methods 60 female SPF Kunming mice were randomly divided into solvent control group,low-dose group,middle-dose group and high-dose group, 15 mice in each group.The latter three groups were exposured to deltamethrin for 60 days by gavage.Open field test (OFT) was applied to evaluate locomotor activity and exploratory behavior in mice.RQ-PCR was employed to measure the expression of GABAA receptor α1 and γ2 subunits in hippocampus of mice.Results After exposure to DM,the moving distance of the central area in the middle-dose group ((555.1 ± 12.8) cm) and high-dose group ((516.4± 11.88) cm) was significantly higher than that in the solvent control group ((327.3± 117.8) cm, P＜0.05).Numbers of standing in marginal area (F=4.117, P=0.010) and total movement distance (F=2.914, P=0.042) in the high-dose group ((27.9±9.9) times, (3211.3±379.8) cm) were also significantly higher than that in the solvent control group ((15.1 ±8.9)times, (3211.3±379.8)cm).The expression of GABAA receptor α1 subunit mRNA in the middle-dose group and high-dose group was significantly lower than that in the low-dose group and solvent control group(F=8.508, P=0.001) and the expression of GABAA receptor γ2 subunit mRNA in high-dose group was significantly lower than that in the other groups (F=6.738, P=0.002).Conclusion Sub-chronic exposure to DM can damage the function of locomotor activity and exploratory behavior,and inhibit the expression of GABAA receptor α1 and γ2 subunits in the hippocampus of mice.

Acute-on-chronic liver failure (ACLF) is a clinical disease significantly different from acute liver failure and acute decompensation of simple liver cirrhosis, and it may have acute progression to liver failure and failure of other organs. ACLF has a high short-term mortality rate and has become a disease burden worldwide. In recent years, several international associations for the study of the liver have proposed different diagnostic criteria for ACLF and published their respective consensus or review on the diagnosis and treatment of ACLF, and there are still great differences in the comprehension of chronic liver diseases, acute injury, and organ failure. At present, there are still limited data for the key links of ACLF management in China, such as liver transplantation, intensive care unit, and palliative care, and in the context of no consensus on the diagnosis of ACLF around the world, it is necessary to further strengthen the application of existing international criteria and evidence and the accumulation of evidence-based data in China.

Objective To clarify the incidence and survival of colorectal carcinoma (CRC) patients among permanent residents in Yangpu district of Shanghai,from 2002 to 2012.Methods Data of CRC patients in permanent residents of Yangpu district were collected from the database of the registration and management system in Shanghai city.Temporal trend in the incidence of CRC was analyzed by using Annual Percent Change (APC) model.Kaplan-Meier analysis with Log-rank testing was employed to estimate the survival.Incidence and mortality rates were standardized on age composition of standard population from 2000 nationwide census.Results A total of 5 881 CRC cases were diagnosed from 2002 to 2012 with crude incidence as 50.60/105 and standardized one as 31.21/105.The crude incidence rates of colon cancer and rectal cancer were 31.09/105 and 18.27/105,respectively and the standardized rates were 14.49/105 and 8.83/105,respectively.The incidence rates of colon cancer were not significantly different between different gender.However,the incidence of rectal cancer in males was significantly higher than in females (P＜0.001).The incidence rates of CRC significantly increased in the age group older than 50 years.However,the standardized incidence rate did not change significantly (APC=0.39).A total of 3 735 cases died of CRC in this period.The annual crude mortality of CRC was 31.35/105 with the standardized rate as 13.72/105.The mortality kept increasing significantly in the population older than 60 years.Mortality of rectal cancer was significantly higher in males than in females (P＜0.001).The 5-year survival rates in both colon cancer and rectal cancer patients were 48.88％ and 54.16％,respectively.Survivals were significantly higher in those who had received surgical treatments than in those without surgical treatments (colon cancer:58.10％ vs.37.22％,P＜0.001 ; rectal cancer:66.18％ vs.39.37％,P＜0.001).Conclusion Age seemed to have contributed to an increased morbidity and mortality of CRC in Yangpu district of Shanghai.The mortality of CRC appeared higher than the incidence.Surgical treatment could significantly prolong the survival of CRC patients.

Objective To detect circulating tumor cells (CTCs) in the peripheral blood of patients with pancreatic cancer using a new nano microfluidic chip and to explore the relationship between CTCs and clinicopathological feature,postoperative recurrence and prognosis of pancreatic cancer.Methods The peripheral blood samples of 53 patients with pancreatic cancer who underwent curative resection in the second affiliated hospital of Jiaxing college of medicine were collected from January 2015 to January 2017.The CTCs from peripheral blood were detected by novel nano microfluidic chip.The cut-off value for CTCs-positive and negative groups was 1 CTC.The relationship between CTCs positive and postoperative recurrence and prognosis of pancreatic cancer were evaluated.Results The number of CTCs for 23 pancreatic cancer of 53 patients ranged from 5 to 196 per ml,and the mean number was 78.5 ± 44.7 per ml;the rate of CTCs-positive patients was 43.4％ (23/53).There were significant correlation between CTCs with vascular invasion (P =0.001),but but CTCs was not correlated with the gender,age,the presence of clinical symptoms,tumor size,pathological type,lymph metastasis and TNM stage.31 patients had tumor recurrence,and the rate of tumor recurrence was 58.5％.Among them,there were 13 cases with tumor local recurrence,10 cases with tumor distant metastasis (including liver,lung,kidney,etc.) and 8 cases with both tumor local recurrence and distant metastasis.The median recurrence free survival time of all patients was 14.0 months (13.0-17.0) and the median overall survival time was 19.0 months (15.5-24.0).The cumulative one-year and two-year recurrence free survival rate were 66.9％,12.2％ for patients with CTCs-positive and 88.3％,42.2％ for CTCs-negative patients,and the differences were statistically significant (both P ＜ 0.05).The cumulative one-year and two-year overall survival rate were 85.4％,33.6％ for patients with CTCs-positive and 96.3％,62.2％ for CTCs-negative.There was no difference in statistics in cumulative one-year overall survival rate and with a statistically significant difference in cumulative two-year overall survival rate (P =0.028).Conclusions Peripheral blood CTCs of pancreatic cancer can be effectively detected by a novel nano microfluidic chip.There were significant correlation between CTCs with vascular invasion and survival time after surgery.CTCs may be a potential prognostic indicator of the postoperative recurrence and prognosis of pancreatic cancer.

Objective To investigate the effects of chemokine like factor 1 (CKLF1) gene on the proliferative activities and osteogenic potentials of hip ligaments of ankylosing spondylitis (AS) in situ and in vitro. Methods Normal and AS hip ligament specimens were collected from 6 patients with femoral neck fracture and 4 AS patients with severe hip deformities. Ligament specimens were exposed to type Ⅱ colla-genase and obtained a single cell suspension, while phase contrast microscopy and anti-vimentin immuno- fluorescence staining (IFC) were applied to observe the cells. The specimens and fibroblasts were divided and cultured in situ and in vitro respectively, and the recombinant adeno-associated virus (rAAV)-lacZ (E. coli beta-galactosidase gene)and rAAV-hCKLF1 (human CKLF1 cDNA cloned in rAAV-lacZ in place of lacZ) were transduced for 21 days. Cell proliferation (cellularity), secretion of pro-inflammatory cytokines, expression of CKLF1 and CCR4 genes were detected by the water-soluble tetrazolium (WST-1) assay and Hoechst 33258 test (DNA content), enzyme-linked immunosorbent assay (ELISA), IFC test and fluorescent quantitative reverse transcription polymerase chain reaction (RT-PCR), respectively. Statistical analysis significance was conducted using the Student's t test and one-way analysis of variance (ANOVA) (LSD) test where appropriate. Results The second passage of normal and AS cells were positive for anti-vimentin, indicating that the cells were fibroblasts. After transducing with rAAV-hCKLF1 for 21 days, cellularity, WST-1 and Hoechst 33258 assays illustrated that CKLF1 gene transfer promoted cell proliferation (compared with the non-viral transduction and lacZ groups, F=6.98, 64.32, 115.91, P<0.05 or P<0.01). Overexpression of CKLF1 gene enhanced the secretion of pro-inflammatory cytokines (interleukin-6 and tumor necrosis factor-alpha) and the expression of bone-specific extracellular matrix proteins (osteopontin and osteocalcin) (F=34.57, 8.89, P<0.05 or P<0.01). Similar results were observed in fluorescent quantitative RT-PCR test. Conclusion Overexpression of CKLF1 promotes the proliferation of fibroblasts, the secretion of pro-inflammatory cytokines and the expression of osteogenic related target genes, suggesting that CKLF1 might be involved in the pathological ossification of AS.

Objective:To investigate the clinical and genetic features of early-onset Alzheimer's disease(EOAD)and the characteristics of pathogenic mutations in probands and their families.Methods:Clinical and genetic features of three EOAD probands and their family members China were analyzed and summarized.Peripheral blood of three probands and their relatives was collected and the genes were detected by second generation sequencing(Next Generation Sequencing, NGS). Pathogenic mutations carried by the probands were identified by whole exome sequencing and then verified by Sanger sequencing in the probands and their families.Furthermore, the clinical and genetic characteristics of EOAD were discussed.Results:The first case was familial EOAD, with the heterozygous mutation c. 851C>T(p.P284L)in exon 8 of PSEN1.The second was also a case of familial EOAD, involving the heterozygous deletion mutation c. 497_499del(p.Ile167del)in exon 6 of PSEN1.In the third proband, there was no family history and the c. 626G>A(G209E)mutation was found in exon 7 of the PSEN1 gene.All three patients had memory loss as their first symptom, accompanied by clinical manifestations of slow movement, abnormal gait, unclear speech, bladder and bowel incontinence, psychiatric and other symptoms.Conclusions:These mutations represent additional mutation types and clinical manifestations in EOAD patients.Examining the genetic characteristics of PSEN1 in EOAD may contribute to the understanding of the pathogenesis, genetic classification and clinical diagnosis of EOAD.

Objective:To investigate the current situation of general practitioners' occupational pressure in Heilongjiang Province, and explore its relationship with professional identity and perceived organizational support. It aims to provide references for the construction of general practitioners and the development of general medical education.Methods:The general situation questionnaire, perceived organizational support scale, occupational pressure scale, and professional identity scale were applied through network and site surveys for collecting data. A total of 288 questionnaires were collected with 263 valid questionnaires (91.3%). Pearson correction analysis and bootstrap analysis were performed for data analysis.Results:The average score of occupational pressure among general practitioners was (115.95±22.40), and the results of Pearson correction analysis showed that perceived organizational support was negatively correlated with occupational pressure ( r=-0.413, P<0.01) and positive correlation with professional identity ( r=0.587, P<0.01). There were also significant negative correlations between professional identity and occupational pressure ( r=-0.442, P<0.01). Moreover, the mediating effect showed that professional identity had a certain mediating effect on the relationship between perceived organizational support and occupational pressure (LLCI=-0.2039, ULCI=-0.0760, P<0.05). Conclusion:General practitioners' occupational pressure was at a high level, which can be reduced through improving the perceived organizational support and professional identity.

Liposome is an ideal drug carrier with many advantages such as excellent biocompatibility, non-immunogenicity, and easy functionalization, and has been used for the clinical treatment of many diseases including tumors. For the treatment of tumors, liposome has some passive targeting capability, but the passive targeting effect alone is very limited in improving the drug enrichment in tumor tissues, and active targeting is an effective strategy to improve the drug enrichment. Therefore, active targeting liposome drug-carriers have been extensively studied for decades. In this paper, we review the research progresses on active targeting liposome drug-carriers based on the specific binding of the carriers to the surface of tumor cells, and summarize the opportunities, challenges and future prospects in this field.
Drug Carriers/therapeutic use* ; Drug Delivery Systems ; Humans ; Liposomes/therapeutic use* ; Neoplasms/drug therapy*