Objective To compare the perioperative efficacy berween laparoscopic and open gastrectomy for the treatment of advanced gastric cancer.Methods Literatures on the comparison of the efficacy between laparoscopic and open gastrectomy were searched in the PubMed,EMBASE,the Cochrane Library,CNKI and CMCC.Articles were selected according to the inclusion criteria,and data were extracted from these trials by 2 reviewers independently and analyzed by Review Manager 5.0 software.The heterogeneity of the literatures was analyzed using the I2 test.Data were integrated by fixed or random effect model.The count data were presented by odds ratio (OR) and 95％ confidence interval (95％ CI).Results Twelve literatures were retrieved,including 1 published in Chinese and 11 in English,1 randomized controlled study and 11 retrospective non-randomized controlled studies.A total of 2 079 cases of advanced gastric cancer were included in this study,including 882 in the laparoscopic gastrectomy group and 1 197 in the open gastrectomy group.There were significant differences in the operation time,intraoperative blood loss,time to first flatus,time to first diet and duration of hospital stay between the 2 groups (WMD =41.33,-106.00,-0.55,-0.76,-2.62,95％ CI:25.44-57.21,-120.71--91.29,-0.80--0.29,-1.29--0.23,-4.05--1.18,P ＜ 0.05).There were no significant difference in the number of lymph nodes harvested and incidence of complications between the 2 groups (WMD =0.22,OR =0.82,95％CI:-1.48-1.93,0.62-1.08,P ＞ 0.05).Conclusion Laparoscopic gastrectomy can be safely performed for the treatment of advanced gastric cancer,and it brings benefits to patients in perioperative period than open gastrectomy.

Liver is the main target organ of the metastasis of colorectal cancer.More and more researches demonstrate that including micro-environment of cancer,signal transduction pathway,abnormality of chromosomes and the gene which control cell proliferation and apoptosis are the most important mechanisms in liver metastasis of colorectal cancer.The metastasis of colorectal cancer is the result of all these factors.To study the mechanism can shed some light on prevention and therapy in liver metastasis of colorectal cancer.

Objective To investigate the role of homocysteine(Hcy)and homocysteine thiolactone(HcyT)in the development of macrovascular complications in patients with type 2 DM.Methods A total of 160 subjects were recruited in this study:40 healthy controls,120 with type 2 DM.Plasma Hcy levels were measured by Polarization Immunoassay(FPIA),and HcyT concentrations were monitored using high-performance liquid chromatography(HPLC)on a reversephase C18 column with ultraviolet detection.Plasma folic acid and Vitamin B12 levels were measured with radioimmunoassay method.Results Plasma Hcy and HcyT concentrations in type 2 DM patients were significantly higher than healthy controls[Hcy:9.28(7.51～11.82)?mol/L vs 5.64(5.17～8.00)?mol/L,P

Objective To study the relationship between the polymorphism of N 5,10 methy lenetetrahydrofolate reductase (MTHFR) gene and the susceptibility to diabetic microangiopathy (DMAP) in type 2 diabetes mellitus (DM) of Han nationality in north China. Methods By PCR RFLP, MTHFR C677T mutation was detected in 229 type 2 diabetic patients, including 102 non complication diabetics (NCD group), 67 diabetic nephropathy (DN group) and 60 diabetic retinopathy (DR group), and 62 healthy persons as control (CON group). Results The frequency of homozygous BB genotype and allele B in DN and DR were significantly higher than that in NCD and CON, but NCD and COD showed similar frequency of BB genotype and allele B. Conclusion In type 2 DM of Han nationality in north China, there is a strong correlation between the polymorphism of MTHFR gene and DMAP, and the allele B may be a susceptibile gene of DMAP.

Objective To evaluate the clinical application of interventional therapy in all kinds of pelvic trauma emergency.Methods There were tolally 16 cases in this paper(13 male and 3 female, 17～45 years old with average 31 years old). All patients had blood loose shock ( different blood pressure drop, limb pulse weakness and so on ). The blood pressure was(50～100)mmHg/(20～60) mmHg before interventional therapy,emergency selective external iliac artery, internal iliac artery and/or bleeding artery embolization and artery occlusion broken operation were performed. After operation pay attention to observe the life physical sign.Results Bleeding of internal iliac artery trunk,internal pudendum artery and obturator artery was in 8,3 and 4 cases respectively;1 case had thrombosis in external iliac artery.After emergency interventional treatment, blood pressure rose again progressively and became stability(90～120) mmHg/(60～90) mmHg,no serious complication presented.Conclusion The interventional treatment is the rapid and reasonable selection to cure the pelvic closed vessal injury and to save life.

0.05). Conclusions Gansulin 50R and Novolin 50R have similar efficacy and safty profiles in the treatment of diabetic patients.

Operating methods for XCY2002-1/200 field battle X-ray diagnosis vehicle are expounded. Performance of every function is evaluated. The problems and corresponding improvement are put forward.

Objective To explore the correlation between axon guidance factor Semaphorin 5A and clinicopathological features and its role in the invasion and metastasis of gastric cancer.Methods The expression of Semaphorin 5A in gastric cancer tissues of 171 patients with different gender,age,histological type and TNM stage was detected with immunohistochemistry assay.The expression of Semaphorin 5A was determined by Western blotting assay in gastric cancer cell lines SGC7901 and MKN-45 with metastatic ability and gastric cancer cell lines SNU-1 and AGS without metastatic ability.With RNA interfere technique(RNAi),Semaphorin 5A siRNA expression vector was constructed and transfected into gastric cancer cell line SGC7901.The stable gastric cancer cell line down-expressing Semaphorin 5A was established.The effect of Semaphorin 5A gene silencing on the adhesion,migration and invasion of gastric cancer cell was examined by cell adhesion test,wound healing test and transwell chamber assays.Results The expression level of Semaphorin 5A was correlated with the differentiation degree of gastric cancer(x2 =6.32,P =0.01),lymphnode metastasis(x2 =7.68,P=0.01)and distant metastasis of gastric cancer(x2 =13.67,P =0.00),not correlated with age(x2 =0.21,P=0.79),gender(x2=1.79,P=0.15)and the depth of gastric cancer invasion(x2=1.34,P=0.55).The expression of Semaphorin 5A in cell lines SGC7901 and MKN-45 was significantly higher than that of cell lines SNU-1 and AGS(P＜0.01).Semaphorin 5A gene silencing significantly suppressed the adhesion,migration and invasion abilities of gastric cancer cells.Conclusion Semaphorin 5A may play a catalytic role in the invasion and metastasis of gastric cancer through increasing the adhesion,migration and invasion abilities of gastric cancer cell.

Objective To evaluate the indication,operation pattern and therapeutic effect of ano-saving surgery for lower rectal carcinoma. Methods Retrospective analysis on the clinical feature of 320 patients with lower rectal carcinoma (postoperative time ≥5 years)treated by ano-saving surgery, the 5-year survival rate, local recurrence rate, and mortality were compared in the various operations. Results The success performed rate of ano-saving operation for lower rectal cancer was 58.5%(320/547).Among them, anastomotic leakage after surgery occurred in 4 cases (1.25%), and 26 cases had anastomostic narrowness (8.13%) within 1 year after surgery.The defecation function after surgery, in patients received colonic J pouch or transverse coloplasty pouch was much better than that in patients received coloanal or colorectal anastomosis. 5-year survival rates, and anastomostic recurrence rates were as follows:In ultra-low anastomosis were 63.24% and 10.27%. Park′s operation 66.67% and 5.13%, local resection 89.46% and 10.71%, respectively. 5-year recurrence rate in the pelvic soft tissue was 3.44%(11/320).Two cases died after operation. Conclusions Lower or ultra-low colon-rectum anastomosis becomes the main operative pattern in preserving anal sphincter in lower rectal cancer.Local resection of lower rectal tumor might be considered if the indecation is selected strictly. Colonic-J-pouch or transverse coloplasty pouch is good for improving the defecation function after ano-saving surgery for lower rectal cancer.