Objective　To explore the correlation between the expression of p33/ING1 and the clinicopathological features in patients with colorectal cancer, and to understand the possible mechanism of p33/ING1 in the oncogenesis of colorectal neoplasms. Methods　All samples of normal mucosa and cancer tissues from 52 patients with colorectal cancer were detected for their expression levels of p33/ING1 by RT-PCR. Results　A significant decrease in p33/ING1 mRNA expression was found in 30 out of 52(57.7%) colorectal cancer tissues. The results also showed that repression of p33/ING1 expression markedly related to both the Duke's stage and metastasis. Conclusion　Down-regulation of p33/ING1 may play an important role in the oncogenesis and development of colorectal carcinoma.

ObjectiveTo study the expression of ING1 mRNA and its mutation status in human colorectal cancer. MethodsSamples of normal mucosa and cancer tissues from 52 patients with colorectal cancer were detected for their expression of ING1mRNA with RT PCR, and screened for its mutation with PCR SSCP. The expression of p53 protein was detected with immunohistochemical staining.ResultsThe impaired expression of ING1mRNA in colorectal cancer was associated with an advanced Dukes′ stage and metastasis of lymph nodes ( P ≤ 0 01). The expression of ING1mRNA positively correlated to that of p53 protein ( P ≤0 01). And a infrequent mutation of ING1 was also observed. Conclusion Our results suggest that ING1 contributes to the tumorigenesis and progression of colorectal cancer through down regulating its expression rather than through mutation.

Objective To evaluate 1*"H magnetic resonance spectroscopy (1H MRS) in the differentiating recurrent brain gliomas after radiation therapy from delayed cerebral necrosis. Methods Fifteen patients who had clinical and CT, MRI changes that suggested a diagnosis of delayed cerebral necrosis or recurrent brain tumor after radiation therapy and 5 patients who had a definite clinical diagnosis of delayed cerebral necrosis underwent single voxel MR spectroscopy simultaneously both in the lesion′s region and the contralateral side. Results Of the former 15 cases who proved by surgicopathology, 14 cases were gliomas,1case was delayed cerebral necrosis, and their etiologic diagnoses of 1*"H MRS were correct. (1)1H MRS in 14 cases with gliomas exhibited specific spectral peaks including prominent choline-containing compounds (Cho), decreased or absent acetylaspartate(NAA) and total creatine (Cr),and the metabolic ratios showed significantly increased Cho/Cr, decreased NAA/Cr. Twelve cases showed abnormal lactate (Lac). (2)Among 6 cases with delayed cerebral necrosis, 5 cases exhibited decreased or absent Cho, NAA, Cr, and abnormal Lipid, 1 case showed absent Cho, NAA, and Cr with a flat curve without Lac. Conclusion 1H MRS was positively claimed for differentiating recurrent brain gliomas after radiation therapy from delayed cerebral necrosis.

BACKGROUND: Overexpression of cancer suppressor gene ING1 may cause apoptosis of many kinds of cancer cells and results in cell cycle arrest in G1 stage. ING1 is involved in p53 signaling pathway and regulates the activity of p53 as a transcription-activating factor.OBJECTIVE: To explore the association of ING1 gene expression and mutation with the clinicpathological features of colorectal cancer.DESIGN: A controlled observation of the pathological samples.SETTING: Department of General Surgery, Southwest Hospital, Third Military Medical University of Chinese PLA.PARTICIPANTS: Totally 52 fresh colorectal cancer samples were obtained from patients hospitalized in the Southwest Hospital, Third Military Medical University of Chinese PLA from October 1998 to October 1999. Normal mucosal tissues were also collected 10 cm from the margin of the tumor during the operation. The patients included 29 male and 23 female patients with an average age of 50.28 years.METHODS: ING1mRNA and protein expressions were detected in the 52 colorectal cancer tissue samples. The ING1 gene mutation was detected by analyzing single-stranded DNA polymorphism. The expression of p53 protein in the colorectal cancer tissue was detected immunohistochemically.tion-single-strand conformation polymorphism.was obviously decreased in comparison with that in the normal mucosa(0. 626 ±0. 382 vs 1. 166 ±0. 245, P ＜ 0. 001) . The expression of ING1 in the tumor tissue of patients with lymphatic metastasis was significantly lower than that in the tumor tissues from patients without lymphatic metastasis (0. 393 ±0. 243 vs 0. 960 ±0. 299, P ＜0.01). The expression of p53 protein was positively correlated with ING1 mRNA expression( P ＜ 0.01). Only one of the 52 samples was positive for ING1 gene mutation.CONCLUSION: ING1 gene may participate in the occurrence and progression of colorectal cancer and its decreased expression inhibits the action of tumor suppressor genes. The decrement in ING1 mRNA and protein expression without gene mutation indicates that ING1 participates in the pathogenesis of colorectal cancer in a manner quite different from that of the classic tumor suppressor genes.

Objective To investigate the anti-gastric cancer effects of dendritic cells tumor vaccine loaded with heat shock protein gp96 polypeptide complex. Methods Con A sepharose affinity chromatography and mono Q ion exchange chromatography were applied to purify gp96 polypeptide complex from gastric cancer tissues and DC was loaded with gp96 polypeptide complex to prepare tumor DC vaccine. Fluorescence-activated cell sorter (FACS) was used to detect surface molecules expression of dendritic cells. Enzyme-linked immunosorbent assay ( ELISA) was used to detect IL-10 and interferon-? (IFN-?) of the supernatant secreted by activated T lymphocytes and 51Cr release test was performed to evaluate the gp96 peptide specific CTL response. Results DCs derived from patient's peripheral blood mononuclear cells loaded with gp96 polypeptide complex had high express surface molecule of GD1? (79. 3 ?4. 1)% , CD80 (84. 3 ? 2. 4) % , CD83 (85. 7 ? 3. 2) % and HLA-DR( 83.4 ? 2. 9) %. The effector T lymphocytes induced by DCs vaccine loaded with gp96 polypeptide complex had rised killing effect to primary culture gastric tumourcells(58.47?10. 71)% when compared with SGC 7901 cells(23. 98 ?4. 16)%. The level of IFN-? (2875 ? 177.66 pg/ml) significantly increased and that of IL-10 (36 ? 6.72 pg/ml) decreased. Conclusion Autologous heat shock protein gp96 polypeptide complex/DC vaccine induces strong peptide complex specific CTL response with high specificity.

Objective To investigate the possible contributing risk factors, diagnosis and treatment of gastroparesis after abdominal surgery. Methods Potential risk factors, clinical manifestations and therapeutic approaches of 22 cases of gastroparesis after abdominal operation were analyzed retrospectively. Results In this series, gastroparesis more frequently occured in those patients having a long-term preoperative gastric outlet obstruction, malignant tumor, O type blood group pancreaticoduodenectomy or simple gastrojejunostomy without gastric resection. Endoscopy, upper gastrointestinal radiography and radioisotope scintigraphy were effective methods in the diagnosis of gastroparesis, and normal gastrointestinal movement was achieved mostly in 5 weeks postoperatively by conservative treatments.Conclusions Postoperative gastroparesis can recover spontaneously after a longer period of supportive treatment combined with prokinetic drugs, and reoperation should be avoided.

Objective To investigate effects of dendritic cells (DC) vaccine on immune function in postoperative gastric cancer patients Methods DCs were extracted and pulsed with self tumor antigens in vitro Fifty patients with gastric cancer were divided into 2 groups randomly Four times of DC vaccinations were administered at 7 days intervals to the postoperative patients in treatment group after they underwent chemotherapy The control group were treated with chemotherapy only The level of IL 12 、 IFN ? and IL 4 in peripheral blood were analysed Results In DCs group, the levels of IL 12 were 37?4、 68?6、 96?12 and 59?9 pg/ml, the levels of IFN ? were 61?12、 134?19、 145?20 and 111?15 pg/ml, and levels of IL 4 were 55?7、 49?6、 46?5 and 50?8 pg/ml before and 2, 4 and 8 weeks after vaccination, respectively In control group, the levels of IL 12 were 39?7、 45?9、 44?10 and 44?6 pg/ml, the levels of IFN ? were 63?10、 61?13、 62?11、 61?7 pg/ml, and levels of IL 4 were 52?11、 55?9、 53?10、 55?8 pg/ml before and 2, 4 and 8 weeks after vaccination, respectively The levels of IL 12 and IFN ? increased significantly in DCs group No severe side effects were found during treatment Conclusion DC vaccine improves immune function of posroprative patients with gastric cancer

OBJECTIVETo study the long-term clinical results of 34 chronic duodenal ulcer patients treated with high selective vagotomy plus pylorus-preserved mucosal antrectomy (HSV + PPMA).

METHODSClinical follow-up results of the patients from 8 approximately 14 years were analyzed.

RESULTSThirty-tow patients (94.1%) followed-up for 8 approximately 14 years after operation achieved Visick grades I-II. No patient died. Gastric acid secretion and infection rate of Helicobacter pylori in the antral mucosa were significantly reduced after operation. No significant difference was found in bile acids, total bacterial counts in gastric juice, and the level of serum gastrin after operation. Gastric emptying was normal. No ulcer recurrence was found by barium meal and endoscopy.

CONCLUSIONSHSV + PPMA is a better operative treatment for duodenal ulcer, which not only can decrease acid secretion and ulcer recurrence rate but also can preserve the function of antrum and pylorus and prevent post-operation bile reflux and intragastric bacterial overgrowth.

Adolescent ; Adult ; Aged ; Duodenal Ulcer ; blood ; microbiology ; surgery ; Female ; Follow-Up Studies ; Gastric Acid ; secretion ; Gastrins ; blood ; Humans ; Male ; Middle Aged ; Pyloric Antrum ; surgery ; Recurrence ; Stomach ; microbiology ; Vagotomy ; methods

OBJECTIVETo explore the therapeutic alternatives and evaluate the related clinical results of patients with primary central nervous system lymphoma (PCNSL) treated with gamma knife radiosurgery (GKS).

METHODSFrom January 1995 to December 2001, 44 patients suffering from PCNSL, who had undergone stereotactic biopsy or craniotomy, and who had received a confirmed diagnosis through pathological examination, were treated with GKS. All cases were followed up for 1 - 46 months with an average postoperative period of 27 months. The clinical materials, image features, treatment methods and results of follow-up, were retrospectively reviewed.

RESULTSThe symptoms and signs of the patients were markedly improved within 1 - 3 weeks after GKS. The Kanofsky performance status was also improved from a preoperative average of 40% to a postoperative one of 90%. Thirty-eight patients (86.36%) were in complete remission (CR), the other six (13.63%) were in partial remission (PR). The local control rate reached 100%, and the median survival time was 26.5 months. The main side effect was brain edema, which can be treated with dexamethasone and mannitol.

CONCLUSIONGKS is a safe and effective method in multimodality treatment of PCNSL. A stereotactic biopsy coupled with GKS is the first choice for diagnosis and treatment. Adjuvant chemotherapy or radiotherapy should then be given according to the patient's condition.

Adult ; Aged ; Aged, 80 and over ; Brain Neoplasms ; surgery ; Combined Modality Therapy ; Female ; Humans ; Lymphoma ; surgery ; Male ; Middle Aged ; Radiosurgery ; Retrospective Studies ; Treatment Outcome

Objective:To investigate the influences of age-adjusted Charlson comorbidity index (ACCI) on prognosis of patients undergoing laparoscopic radical gastrectomy.Methods:The retrospective cohort study was conducted. The clinicopathological data of 242 gastric cancer patients who underwent laparoscopic radical gastrectomy in 19 hospitals of the Chinese Laparoscopic Gastrointestinal Surgery Study Group-04 study, including 54 patients in Fujian Medical University Union Hospital, 32 patients in the First Hospital of Putian City, 32 patients in Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 31 patients in Zhangzhou Affiliated Hospital of Fujian Medical University, 17 patients in Nanfang Hospital of Southern Medical University, 11 patients in the First Affiliated Hospital with Nanjing Medical University, 8 patients in Qinghai University Affiliated Hospital, 8 patients in Meizhou People′s Hospital, 7 patients in Fujian Provincial Hospital, 6 patients in Zhongshan Hospital of Fudan University, 6 patients in Longyan First Hospital, 5 patients in the First Affiliated Hospital of Xinjiang Medical University, 5 patients in the First Hospital Affiliated to Army Medical University, 4 patients in the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, 4 patients in West China Hospital of Sichuan University, 4 patients in Beijing University Cancer Hospital, 3 patients in the First Affiliated Hospital of Xiamen University, 3 patients in Guangdong Provincial People′s Hospital, 2 patients in the First Affiliated Hospital of Xi′an Jiaotong University, from September 2016 to October 2017 were collected. There were 193 males and 49 females, aged 62(range, 23?74)years. Observation indicators: (1) age distribution, comorbidities and ACCI status of patients; (2) the grouping of ACCI and comparison of clinicopathological characteristics of patients in each group; (3) incidence of postoperative early complications and analysis of factors affecting postoperative early complications; (4) follow-up; (5) analysis of factors affecting the 3-year recurrence-free survival rate of patients. Follow-up was conducted using outpatient examination or telephone interview to detect postoperative survival of patients up to December 2020. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the nonparametric rank sum test. The X-Tile software (version 3.6.1) was used to analyze the best ACCI grouping threshold. The Kaplan-Meier method was used to calculate survival rates and draw survival curves. The Log-Rank test was used for survival analysis. The Logistic regression model was used to analyze the factors affecting postoperative early complications. The COX proportional hazard model was used for univariate and multivariate analyses of factors affecting the 3-year recurrence-free survival rate of patients. Multivariate analysis used stepwise regression to include variables with P<0.05 in univariate analysis and variables clinically closely related to prognosis. Results:(1) Age distribution, comor-bidities and ACCI status of patients. Of the 242 patients, there were 28 cases with age <50 years, 68 cases with age of 50 to 59 years, 113 cases with age of 60 to 69 years, 33 cases with age of 70 to 79 years. There was 1 patient combined with mild liver disease, 1 patient combined with diabetes of end-organ damage, 2 patients combined with peripheral vascular diseases, 2 patients combined with peptic ulcer, 6 patients combined with congestive heart failure, 8 patients combined with chronic pulmonary diseases, 9 patients with diabetes without end-organ damage. The ACCI of 242 patients was 2 (range, 0-4). (2) The grouping of ACCI and comparison of clinicopathological characteristics of patients in each group. Results of X-Tile software analysis showed that ACCI=3 was the best grouping threshold. Of the 242 patients, 194 cases with ACCI <3 were set as the low ACCI group and 48 cases with ACCI ≥3 were set as the high ACCI group, respectively. Age, body mass index, cases with preoperative comorbidities, cases of American Society of Anesthesiologists classification as stage Ⅰ, stage Ⅱ, stage Ⅲ, tumor diameter, cases with tumor histological type as signet ring cell or poorly differentiated adenocarcinoma and cases with tumor type as moderately or well differentiated adenocarcinoma, cases with tumor pathological T staging as stage T1, stage T2, stage T3, stage T4, chemotherapy cycles were (58±9)years, (22.6±2.9)kg/m 2, 31, 106, 85, 3, (4.0±1.9)cm, 104, 90, 16, 29, 72, 77, 6(4,6) in the low ACCI group, versus (70±4) years, (21.7±2.7)kg/m 2, 23, 14, 33, 1, (5.4±3.1)cm, 36, 12, 3, 4, 13, 28, 4(2,5) in the high ACCI group, showing significant differences in the above indicators between the two groups ( t=-14.37, 1.98, χ2=22.64, Z=-3.11, t=-2.91, χ2=7.22, Z=-2.21, -3.61, P<0.05). (3) Incidence of postoperative early complications and analysis of factors affecting postoperative early complications. Of the 242 patients, 33 cases had postoperative early complications, including 20 cases with local complications and 16 cases with systemic complica-tions. Some patients had multiple complications at the same time. Of the 20 patients with local complications, 12 cases had abdominal infection, 7 cases had anastomotic leakage, 2 cases had incision infection, 2 cases had abdominal hemorrhage, 2 cases had anastomotic hemorrhage and 1 case had lymphatic leakage. Of the 16 patients with systemic complications, 11 cases had pulmonary infection, 2 cases had arrhythmias, 2 cases had sepsis, 1 case had liver failure, 1 case had renal failure, 1 case had pulmonary embolism, 1 case had deep vein thrombosis, 1 case had urinary infection and 1 case had urine retention. Of the 33 cases with postoperative early complications, there were 3 cases with grade Ⅰ complications, 22 cases with grade Ⅱ complications, 5 cases with grade Ⅲa complications, 2 cases with grade Ⅲb complications and 1 case with grade Ⅳ complica-tions of Clavien-Dindo classification. Cases with postoperative early complications, cases with local complications, cases with systemic complications were 22, 13, 9 in the low ACCI group, versus 11, 7, 7 in the high ACCI group, respectively. There were significant differences in cases with postoperative early complications and cases with systemic complications between the two groups ( χ2=4.38, 4.66, P<0.05), and there was no significant difference in cases with local complications between the two groups ( χ2=2.20, P>0.05). Results of Logistic regression analysis showed that ACCI was a related factor for postoperative early complications of gastric cancer patients undergoing laparoscopic radical gastrectomy [ odds ratio=2.32, 95% confidence interval ( CI) as 1.04-5.21, P<0.05]. (4) Follow-up. All the 242 patients were followed up for 36(range,1?46)months. During the follow-up, 53 patients died and 13 patients survived with tumor. The 3-year recurrence-free survival rate of the 242 patients was 73.5%. The follow-up time, cases died and cases survived with tumor during follow-up, the 3-year recurrence-free survival rate were 36(range, 2-46)months, 29, 10, 80.0% for the low ACCI group, versus 35(range, 1-42)months, 24, 3, 47.4% for the high ACCI group. There was a significant difference in the 3-year recurrence-free survival rate between the two groups ( χ2=30.49, P<0.05). (5) Analysis of factors affecting the 3-year recurrence-free survival rate of patients. Results of univariate analysis showed that preoperative comorbidities, ACCI, tumor diameter, histological type, vascular invasion, lymphatic invasion, neural invasion, tumor pathological TNM staging, postoperative early complications were related factors for postoperative 3-year recurrence-free survival rate of gastric cancer patients undergoing laparoscopic radical gastrectomy [ hazard ratio ( HR)=2.52, 3.64, 2.62, 0.47, 2.87, 1.90, 1.86, 21.77, 1.97, 95% CI as 1.52-4.17, 2.22-5.95, 1.54-4.46, 0.27-0.80, 1.76-4.70, 1.15-3.12, 1.10-3.14, 3.01-157.52, 1.11-3.50, P<0.05]. Results of multivariate analysis showed that ACCI, tumor pathological TNM staging, adjuvant chemotherapy were indepen-dent influencing factors for postoperative 3-year recurrence-free survival rate of gastric cancer patients undergoing laparoscopic radical gastrectomy ( HR=3.65, 11.00, 40.66, 0.39, 95% CI as 2.21-6.02, 1.40-86.73, 5.41-305.69, 0.22-0.68, P<0.05). Conclusions:ACCI is a related factor for post-operative early complications of gastric cancer patients undergoing laparos-copic radical gastrectomy. ACCI, tumor pathological TNM staging, adjuvant chemotherapy are indepen-dent influencing factors for postoperative 3-year recurrence-free survival rate of gastric cancer patients undergoing laparoscopic radical gastrectomy.