Objective]To research the regulation of L-type calcium channels by Xuanfu Daizhe soup in the lower esophageal sphincter(LES) smooth muscle of rabbit reflux esophagitis model induced by mixed perfusion of hydrochloric acid and bile. [Methods]Established the rabbit model of mixed reflux esophagitis, nifedipine was used to block L-type calcium channel.The muscle tension of L-type calcium channel were compared among groups in the experiments. [Results]The calcium releasing and flowing phase of LES in the model group was higher than that in the normal group, the whole recipe group, sweet-scending group, the getting rid of bitter-reducing group and the getting rid of lifting and declining group( P<0.01). There was no significant difference between the model group and bitter-reducing group, the lifting and declining group and the getting rid of sweet-ascending group( P>0.05). There was no significant difference between the normal group and the whole recipe group in calcium releasing and flowing phase of LES( P>0.05). [Conclusion]The decreasing of reflux esophagitis model LES tension was relevant with the L-type calcium channel dysfunction;Xuanfu Daizhe soup could improve the LES tension by regulating L-type calcium channels. The sweet-ascending group had a remarkable effect among those dismantle prescription groups.

Objective To summarize the clinicopathological characteristics and effects of surgical treatment on gastric stump cancer.Methods With meta- analysis, clinical data of 902 gastric stump cancer patients who were treated in our hospital or were reported in literatures were included for analysis.Age, gender, pathological types, TNM stages, surgical treatment, prognosis were evaluated.Results Gastric stump cancer developed mostly in male patients (4.1∶1) , and the median age was 61 years.Incidence of gastric stump cancer after digestive tract reconstruction with Billroth- Ⅱ operative modality was higher than that with Billroth- Ⅰ (81.6% vs.17.1%).50.5% of the cancers were present at the anastomotic site, 21.7% at the gastric lesser curvature, 18.5% at the gastric cardia, and less than 10% at other places.Resection and radical resection rates were 81.3% and 62.7% , while operation combined organ resection was carried out (36.5% ).The 1-, 3-, 5- year survival rate of the patients with radical resection were significantly better than those with palliative resection, which was 77.8% vs.36.4% , 58.2% vs.9.8% and 28.9% vs.3.9% (P＜0.01) respectively.Conclusions Distal gastrectomy and Billroth Ⅱ GI tract reconstruction was the most common type of previous operation.Gastric stump cancer occurs more frequently at anastomotic site and the majority of histological types was well-differentiated adenocarcinoma.Most cases were at the advanced TNM-stage when diagnosed.Radical resection is an effective way to prolong the postoperative survival time in gastric stump cancer patients, especially in early stage.

Objective:To explore the feasibility of using faster regional convolutional neural network (Faster R-CNN) to evaluate the status of circumferential resection margin (CRM) of rectal cancer in the magnetic resonance imaging (MRI).Methods:This study was registered in the Chinese Clinical Trial Registry (ChiCTR-1800017410). Case inclusion criteria: (1) the positive area of CRM was located between the plane of the levator ani, anal canal and peritoneal reflection; (2) rectal malignancy was confirmed by electronic colonoscopy and histopathological examination; (3) positive CRM was confirmed by postoperative pathology or preoperative high-resolution MRI. Exclusion criteria: patients after neoadjuvant therapy, recurrent cancer after surgery, poor quality images, giant tumor with extensive necrosis and tissue degeneration, and rectal tissue construction changes in previous pelvic surgery. According to the above criteria, MRI plain scan images of 350 patients with rectal cancer and positive CRM in The Affiliated Hospital of Qingdao University from July 2016 to June 2019 were collected. The patients were classified by gender and tumor position, and randomly assigned to the training group (300 cases) and the validation group (50 cases) at a ratio of 6:1 by computer random number method. The CRM positive region was identified on the T2WI image using the LabelImg software. The identified training group images were used to iteratively train and optimize parameters of the Faster R-CNN model until the network converged to obtain the best deep learning model. The test set data were used to evaluate the recognition performance of the artificial intelligence platform. The selected indicators included accuracy, sensitivity, positive predictive value, receiver operating characteristic (ROC) curves, areas under the ROC curves (AUC), and the time taken to identify a single image.Results:The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the CRM status determined by the trained Faster R-CNN artificial intelligence approach were 0.884, 0.857, 0.898, 0.807, and 0.926, respectively; the AUC was 0.934 (95% CI: 91.3% to 95.4%). The Faster R-CNN model's automatic recognition time for a single image was 0.2 s.Conclusion:The artificial intelligence model based on Faster R-CNN for the identification and segmentation of CRM-positive MRI images of rectal cancer is established, which can complete the risk assessment of CRM-positive areas caused by in-situ tumor invasion and has the application value of preliminary screening.

Objective:To explore the feasibility of using faster regional convolutional neural network (Faster R-CNN) to evaluate the status of circumferential resection margin (CRM) of rectal cancer in the magnetic resonance imaging (MRI).Methods:This study was registered in the Chinese Clinical Trial Registry (ChiCTR-1800017410). Case inclusion criteria: (1) the positive area of CRM was located between the plane of the levator ani, anal canal and peritoneal reflection; (2) rectal malignancy was confirmed by electronic colonoscopy and histopathological examination; (3) positive CRM was confirmed by postoperative pathology or preoperative high-resolution MRI. Exclusion criteria: patients after neoadjuvant therapy, recurrent cancer after surgery, poor quality images, giant tumor with extensive necrosis and tissue degeneration, and rectal tissue construction changes in previous pelvic surgery. According to the above criteria, MRI plain scan images of 350 patients with rectal cancer and positive CRM in The Affiliated Hospital of Qingdao University from July 2016 to June 2019 were collected. The patients were classified by gender and tumor position, and randomly assigned to the training group (300 cases) and the validation group (50 cases) at a ratio of 6:1 by computer random number method. The CRM positive region was identified on the T2WI image using the LabelImg software. The identified training group images were used to iteratively train and optimize parameters of the Faster R-CNN model until the network converged to obtain the best deep learning model. The test set data were used to evaluate the recognition performance of the artificial intelligence platform. The selected indicators included accuracy, sensitivity, positive predictive value, receiver operating characteristic (ROC) curves, areas under the ROC curves (AUC), and the time taken to identify a single image.Results:The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the CRM status determined by the trained Faster R-CNN artificial intelligence approach were 0.884, 0.857, 0.898, 0.807, and 0.926, respectively; the AUC was 0.934 (95% CI: 91.3% to 95.4%). The Faster R-CNN model's automatic recognition time for a single image was 0.2 s.Conclusion:The artificial intelligence model based on Faster R-CNN for the identification and segmentation of CRM-positive MRI images of rectal cancer is established, which can complete the risk assessment of CRM-positive areas caused by in-situ tumor invasion and has the application value of preliminary screening.

OBJECTIVETo investigate the relationship between extranodal tumor deposits and prognosis in patients with colorectal cancer.

METHODSThe literatures on extranodal tumor deposits and postoperative survival rate in patients with colorectal cancer published at home and abroad from 1990 to 2014 were retrieved in 15 English literature databases such as MEDLINE/PubMed, Web of Science, Directory of Open Access Journals(DOAJ), SpringerLink and Chinese literature databases such as Chinese Biomedical Literature Database CD-ROM, China National Knowledge Infrastructure (CNKI) Database with the internet platform of Yonsei University Library. After screening for inclusion, data extraction and quality assessment, meta-analysis was conducted by the Review Manager 5.3 software.

RESULTSThere were 10 studies meeting the inclusion criteria for meta-analysis. The total sample size of the studies was 4 068 cases with ENTD(+) 727 cases, while ENTD(-) 3 341 cases. Meta analysis showed that 5-year overall survival rate and 5-year relapse-free survival rate were significantly lower in ENTD(+) group than those in ENTD(-) group (OR 0.27, 0.23; 95% CI:0.18 to 0.43, 0.16 to 0.34 respectively, both P=0.000); the 5-year overall survival rates were both significantly lower in ENTD(+) group as compared to ENTD(-) group for patients with N0 and N(+) colorectal cancer (both P<0.05).

CONCLUSIONExtranodal tumor deposits is a poor prognostic factor of patients with colorectal cancer.

Colorectal Neoplasms ; diagnosis ; pathology ; Disease-Free Survival ; Humans ; Neoplasm Recurrence, Local ; Prognosis ; Survival Rate