Objective　To assess the efficacy of sandostatin in preventing postoperative adhesions in rats. Methods　Fifty SD rats were randomly divided into five groups: Group 1, Control group; group 2, sandostatin 20μg/kg intraperitoneal injection (IP); group 3, sandostastin 40μg/kg IP; group 4, sandostatin 60μg/kg IP; group 5, hyaluronate sodium(HA) IP. All animal were killed on the 14th postoperative day. After adhesions were graded according to their severity, adhesive ileal segments were resected for hydroxyproline(OHP) determination. Results　The severity of adhesions in group 2.3.4 and 5 were significantly milder than that in group 1.(P<0.05). The OHP levels of adhensive intestine in group 2.3 and 4 were significantly lower than that in group 1 and 5 (P<0.05).The severity of adhesions and OHP levels in group 2.3 and 4 had no significant difference (P>0.05). Conclusions　Intraperitoneal administration of sandostatin intraoperatively might have some efficacy in preventing adhensions of intestine.

Objective To study the relationship between serum fibronectin(Fn) and hyaluronic acid(HA) in patients with hepatocellular carcinoma(HCC) and their clinical value.Methods The serum Fn and HA levels in 50 cases of HCC 14 cases of benign hepatic disease and 100 healthy persons were determined by enzyme-labelled turbidimetry and radioimmuoassay.Results The serum Fn content (125.85?29.47)mg/L of the patients with HCC was significantly lower than those of both the benign hepatic disease(210.14?18.36)mg/L and healthy controls (219.96?26.26)mg/L,P

Objective:The study aims to screen chemosensitivity-associated proteins in colorectal carcinoma tissues by using two-dimensional gel electrophoresis (2-DE) and mass spectrometry,then identify some differentially-expressed proteins. Methods:The patients with advanced colorectal carcinoma were confirmed by clinical diagnosis. Fresh carcinoma specimens were collected by biopsy and preserved in liquid N2. The tissues were classified into two groups: high sensitivity group (HS) and low sensitivity group (LS) based on drug sensitivity test. The total proteins were extracted and separated by 2-DE. The images were composed, compared, and differentially analyzed to identify the proteins with differential expression in HS and LS groups. Then the differentially-expressed protein spots were incised from the gels and digested by trypsin. The peptide mass fingerprintings (PMF) was acquired after matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) and the proteins were identified by data searching in the Mascot database. Two proteins with differential expression were detected by Western blotting.Results:The 2-DE spectrum of HS and LS groups were established. Most protein spots were distributed in the area with pH 4-8 and relative molecular weight of (20-100)×10~3. The average number of the protein spots was 842±23 in HS group and 793±19 in LS group,respectively. The mean matching rate was 90.7%. The number of differentially-expressed dots between HS and LS group was 79.00±13.56. Thirty protein dots were selected for mass spectrum and bioinformatic analysis, and 9 proteins were identified. Conclusion:Colorectal carcinoma with different chemosensitivity had differential protein expression profiles. The differentially expressed proteins may be associated with chemosensitivity and could be used for prediction of chemosensitivity of colorectal carcinoma.

Objective To investigate the expressions of claudin-5 and claudin-10 in colorectal carcinoma(CRC) and its significance.Methods Pathological verified 50 colorectal tissue (CRT),25 colorectal adenoma (CRA),25 non lymph node metastasis CRC (non-LNM CRC) and 25 lymph node metastasis CRC (LNM CRC) were detected for the expression of claudin-5 and claudin-10 by immunohistochemical SP(streptavidin perdcidase) method.Results The positive expression rate of Claudin-5 was 82%,76%,68% in CRT,CRA,CRC,respectively.The positive expression rate of claudin-5 in different groups was not significantly different(X~2 =2.638,P＞0.05).claudin-5 expression was correlated with LNM (P＜0.05),but was not correlated with gender,age,tumor,location,differentiation,tumor diameter and serous membrane invasion(P＞0.05).The positive expression rate of claudin-10 was 54%,56%,72% in CRT,CRA,CRC,respectively.The positive expression rate of claudin-10 in different groups was not significantly different(X~2 = 3.839,P＞0.05).claudin-10 expression was correlated with tumor diameter,serous membrane invasion and LNM (P＜0.05),but was not correlated with gender,age,location and differentiation (P＞0.05).There was no significant correlation between claudin-5 expression and claudin-10 expression in CRC (r = 0.050,P = 0.732).Conclusions claudin-5 and clandin-10 are expressed in CRT,CRA,and CRC.They are not involved in CRC occurrence,claudin-5 and clandin-10 abnormally expressions are significantly associated with the incidence of LNM.Meanwhile,claudin-10 expression is correlated with tumor diameter and serous membrane invasion.There was no significant correlation between claudin-5 expression and claudin-10 expression in CRC.

Objective:To explore the expression of R-spondin family in colorectal cancer tissues and adjacent tissues,and to evaluate its relationship with clinic-pathological stage.Methods:A total of 64 samples of colorectal cancer tissues and adjacent tissues were collected from the patients,who received radical surgery in Xiangya Hospital,Central South University between January 2014 and August 2014.The mRNA and protein expression levels of R-spondin 1-4 and β-catenin in the colorectal cancer tissues and adjacent tissues were detected by qRT-PCR and immunohistochemistry.The relationship between the expression level of R-spondin 1-4 and the clinic-pathological factors were analyzed to explore the correlation between the expression level of R-spondin 1-4 and β-catenin in colorectal cancer.Results:Compared with the adjacent tissues,the mRNA and protein expression levels of R-spondin 1 were elevated in the colorectal cancer tissues (P＜0.05).The mRNA and protein expression levels of R-spondin 2-4 were increased in the colorectal cancer tissues than those in the normal tissues (P＜0.05),but there was no significant difference between the colorectal cancer tissues and adjacent tissues (P＞0.05).The expression level of R-spondin i was positively correlated with the nuclear expression of β-catenin in the colorectal cancer tissues (r=0.6307,P＜0.05).Conclusion:Compared with the adjacent tissues,the mRNA and protein expression levels of R-spondin 1 are significantly elevated in the colorectal cancer tissues.R-spondin 1 may play a role in promoting carcinogenesis by regulating the activity of β-catenin in the downstream of Wnt signaling pathway.

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.

The First Affiliated Hospital of Nanjing Medical University has adopted a strategy of brand development in the process of continuing medical education.Given the different recipients,the First Affiliated Hospital of Nanjing Medical University has established four types of brand-based education modes,namely Jinling high-level forum of clinical medicine,hospital management school,management salon,and clinical case discussion in English.The influence and competitiveness of the brand of hospital continuing education should be elevated through the following methods:adhering to the brand development orientation-to fulfill the public responsibility and cultivate medical talents; establishing appraisal mechanism of continuing medical education; transforming thinking of management department; relying on new media propaganda and expanding domestic and international communication.

Objective To find early diagnostic biomarkers for colorectal carcinoma by comparing differential(expressing) proteins from colorectal carcinoma and normal colorectal tissues.Methods Colorectal carcinoma tissues and paired normal tumor-adjacent colorectal tissues were collected,and tissue total protein was (extracted);differential proteome profiles were established and analysed by means of immobilized pH(gradient-based) two-dimesional polyacrylamide gel electrophoresis(2D-PAGE) and matrix-assisted laser(desorption)/ionization time of flight mass spectrometry(MALDI-TOF-MS).Results Well-resolved,(reproducible) 2-DE profiles of human colorectal carcinoma tissues and paired normal tumor adjacent colorectal tissues were obtained.For tumor tissue,a total of 1098?28 spots were detected,and for normal tissue,760?45 spots were detected.For normal tissue,The average deviation of spot position was(0.542?(0.12))mm in IEF direction and(0.933?0.098)mm in SDS-PGE direction for tumor tissue.The average deviation of spot position was(0.745?0.130)mm in IEF direction and(1.233?0.272)mm in(SDS-PGE) direction.30 differential expressing proteins were analysed by mass spectrometry and bioinformation,16 of them were well characterized including Apolipoprotein A1(apoA1),calreticulin precursor,glutathione(S-transferase),hepatic fatty acid-binding protein、heat shock protein 27 ect.Conclusions Differential expression proteins can be candidate biomarkers for early diagnosis of colorectal carcinoma;and proteomic technique is valuable for screening the diagnostic biomarkers.

Objective To provide molecular genetic basis for oncobiological difference in left sided colon cancer and right sided colon cancer. Differentially expressed proteins in left sided colon cancer and right sided colon cancer were screened by proteomic technique. Methods Tissue samples including left sided colon cancer and right sided colon cancer were collected and preserved in the -80℃ refrigerator. In the first part of our experiment, protein was separated by 2-dimensional gel electrophoresis (2-DE) and the images of the gels were acquired by the scanner and then analyzed to find the differentially expression protein-spots in different groups. The peptide mass fingerprintings (PMF) was acquired by matrix assisted laser desorptiorn/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) and the proteins were identified by data searching in the Mascotdatabase. Differentially expressed proteins were assayed by RT-PCR, Western blot, and immunohistochemical method. Results Altogether 55 differentially expressed protein spots were screened and 21 spots of them were identified. Compared with the right sided colon cancer, 14 proteins were up-regulated and 7 proteins down-regulated including HSP27 in the left sided colon cancer. HSP27 expressed higher in the right sided colon cancer than in the left sided colon cancer.Conclusion There are differentially expressed proteins in left sided colon cancer and right sided colon cancer, especially difference in HSP27 expression at mRNA and protein level, which may be molecular genetic basis for oncobiological difference in left sided colon cancer and right sided colon cancer.

Objective To study the optimal procedure of digestive tract reconstruction after total gastrectomy.Methods The clinical data of 122 patients who underwent total gastrectomy in the recent 6 years were(analyzed) retrospectively.Three types of reconstruction procedures,including Orr-type Roux-en-Y(esophagojejunostomy),P-type jejunal pouch Roux-en-Y esophagojejunostomy and distal jejunal aboral pouch Roux-en-Y esophagojejunostomy,were performed.Results There were no significant differences among the three procedures in heartburn and the amount of food intake,frequencies of meal,weight loss,dumping(syndrome),and hemoglobin and albumin levels.The operation time in P-type group was longer than the other two group(P