Cardia ; Gastric Fundus ; Humans ; Stomach Neoplasms ; surgery

Anal Canal/surgery* ; Anorectal Malformations ; Constriction ; Fecal Incontinence ; Humans ; Rectal Prolapse

OBJECTIVETo investigate the association between the morphological features of biopsy-diagnosed high grade intraepithelial neoplasia in the gastric mucosa and the postoperative pathology.

METHODSFifty-one patients with biopsy-diagnosed high grade intraepithelial neoplasia in the gastric mucosa were retrospectively analyzed. Thirty-three patients underwent surgery. The morphology of lesions under endoscopy and histopathological findings of the surgical specimens were investigated.

RESULTSOf the 51 patients, 43 had superficial lesions similar to early gastric cancer under endoscopy, 8 were similar to advanced carcinoma. In the 33 surgical cases, high grade intraepithelial neoplasia of gastric mucosa was confirmed on postoperative pathological examination in 13 (39.4%) patients, adenocarcinoma was identified in the remaining 20 patients (60.6%), including 14 early gastric cancers and 6 advanced carcinomas. Thirteen cases with high grade intraepithelial neoplasia confirmed postoperatively were superficial elevated or flat lesions less than 20 mm.

CONCLUSIONSPatients with biopsy-diagnosed high grade intraepithelial neoplasia in the gastric mucosa have a high risk of cancer. Thus aggressive follow-up and appropriate surgical interventions are recommended to avoid misdiagnosis.

Adult ; Aged ; Aged, 80 and over ; Biopsy ; Female ; Gastric Mucosa ; pathology ; Gastroscopy ; Humans ; Male ; Middle Aged ; Prostatic Intraepithelial Neoplasia ; pathology ; Stomach Neoplasms ; pathology

Diabetes surgery is a new concept in recent years, which means controlling blood sugar or curing diabetes through some surgical methods. From the commencement of bariatric surgery in the 1950s to the discovery of the special function of decreasing blood sugar after these surgeries in 1970s, and then the fast developing of diabetes surgery in the past 30 years, now there seems be a different answer to the question that if we can cure diabetes. In this article, we review the historical evolution, surgical procedure, potential mechanism and outlook of diabetes surgery.
Bariatric Surgery ; methods ; Diabetes Mellitus, Type 2 ; surgery ; Humans

OBJECTIVETo study the biological behavior of cardial cancer and its influence on surgical management.

METHODSComplete clinicopathologic data of 46 cases with cardial cancer undergoing radical gastrectomy was investigated retrospectively. The relationships between tumor Borrmann type, depth of invasion, growth pattern, lymph node metastasis and 5-year survival rate postoperative were analyzed.

RESULTSOf 46 cases, Borrmann type III, Type IV and Type II was 76% (35/46), 18% (8/46) and 6% (3/46) respectively; 5-year survival rate was 40% (14/35), 0 (0/8) and 100% (3/3) respectively. In respect of the depth of invasion, pT(2) was 31% (14/46) cases with 71% (10/14) lymph node metastasis; and 5-year survival rate was 64% (9/14). pT(3) was 15% (7/46) cases with 86% (6/7) lymph node metastasis; and 5-year survival rate was 57% (4/7). And pT(4) was 54% (25/46) cases with 92% (23/25) lymph node metastasis; and 5-year survival rate was 12% (3/25). The growth pattern in 87% (40/46) cases was infiltrative; and 5-year survival rate was 28% (11/40); the growth pattern in 13% (6/46) cases was expansive; and 5-year survival rate was 100% (6/6).

CONCLUSIOND(2)(+) radical total gastrectomy should be performed on the developed cardial cancer, and if necessary, resection of body and tail of pancreas should be chosen.

Aged ; Aged, 80 and over ; Cardia ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Prognosis ; Stomach Neoplasms ; pathology ; surgery

OBJECTIVETo investigate the association of SOX9 expression and clinicopathologic factors and prognosis of gastric cancer.

METHODSA retrospective cohort study including 112 gastric cancer patients admitted to the Zhejiang Provincial People's Hospital from 2004 to 2006 was performed. Immunohistochemical analysis was used to evaluate the expression of SOX9 in the 112 specimens of gastric cancer tissues and 70 non-cancerous tissues adjacent to the tumor.

RESULTSLow expression of SOX9 was seen in 5(7.1%) tissues out of 70 non-cancerous tissues adjacent to the tumor. A total of 94(83.9%) patients had varying expression of SOX9, of whom 51(45.4%) had overexpression. Univariate analysis demonstrated that the expression of SOX9 was significantly associated with Lauren classification (P<0.05), tumor invasion(P<0.01), lymph node metastasis(P<0.05), distant metastasis(P<0.05) and tumor stage(P<0.05), however there was no significant association between SOX9 expression and sex, age, histological type, histology differentiation or tumor size. Kaplan-Meier analysis showed that the 5-year survival rate of patients with SOX9 over-expression was significantly lower than that of patients with low expression(29.4% vs. 49.2%, P=0.031). Multivariate Cox regression analysis showed that histology differentiation(P=0.046), tumor invasion(P=0.001), and distant metastasis(P<0.01) were independent prognostic factors for gastric cancer, however the over-expression of SOX9 was not significant(P=0.948).

CONCLUSIONSThe expression SOX9 is associated with the growth, invasion, and metastasis of gastric cancer, as well as the prognosis. However, SOX9 expression is not an independent factor for the prognosis in patients with gastric cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; SOX9 Transcription Factor ; metabolism ; Stomach Neoplasms ; metabolism ; pathology

BACKGROUNDRecent studies have revealed that the reason for the low surgical resection rate of pancreatic carcinoma partly lies in its biological behavior, which is characterized by neural infiltration. This study aimed to investigate the clinical significance of radical pancreatoduodenectomy combined with retroperitoneal nerve, lymph, and soft-tissue dissection for carcinoma of the pancreatic head.

METHODSForty-six patients with pancreatic head cancer were treated in our hospital from 1995 to 2005. The patients were divided into two groups: radical pancreatoduodenectomy combined with retroperitoneal nerve, lymph and soft-tissue dissection (group A, n = 25) and routine Whipple's operation (group B, n = 21). There were no significant differences between the two groups in relation to age, gender and preoperative risk factors, and perioperative conditions, pathological data and survival rates were studied.

RESULTSThere were no significant differences in tumor size, surgical procedure time, postoperative complications, and time of hospitalization. However, the number and positive rate of resected lymph nodes in group A were significantly higher than those in group B (P < 0.05). The 1- and 3-year survival rate in group A were 80% and 53%, respectively, which was higher than those in group B (P < 0.05). There were significant differences in the survival rates between patients with and without nerve infiltration in group A (P < 0.05).

CONCLUSIONSRadical pancreatoduodenectomy combined with retroperitoneal nerve, lymph and soft-tissue dissection, can effectively remove the lymph and nerve tissues that were infiltrated by tumor. Meanwhile, this method can reduce the local recurrence rate so as to improve the long-term survival of patients.

Cause of Death ; Humans ; Lymph Node Excision ; Pancreatic Neoplasms ; pathology ; surgery ; Pancreaticoduodenectomy ; adverse effects ; methods ; mortality ; Retroperitoneal Space ; innervation ; pathology ; surgery ; Survival Rate

OBJECTIVETo explore the effectiveness of electro-acupuncture (EA) in the treatment of childhood autism (CA) and evaluate its effectiveness using single photon emission computed tomography (SPECT).

METHODSA total of 55 CA patients (4.52±2.73 years) were enrolled in this study. All patients received EA treatments and were examined by SPECT before and after treatments.

RESULTSFollowing treatment, the intracerebral multiple focal radioactivity distribution defect areas of CA patients were observed to be partially filled. Specifically, significant differences in the ratios of regional cerebral blood flow and global cerebral blood flow before (Fb) and after (Fe) EA treatment in different lesions were observed (in the left prefrontal cortex, t=5.01, P<0.01; in the right prefrontal cortex, t=2.32, P<0.05; in the left temporal lobe, t=4.54, P<0.01; in the right temporal lobe, t=2.90, P<0.05; in the left Broca's area, t=5.82, P<0.01). After EA treatment, the patients exhibited symptomatic relief.

CONCLUSIONEA is useful to treat CA and SPECT can be used to evaluate the effectiveness of this treatment.

Autistic Disorder ; diagnostic imaging ; physiopathology ; therapy ; Brain ; blood supply ; diagnostic imaging ; pathology ; physiopathology ; Cerebrovascular Circulation ; Child ; Electroacupuncture ; Humans ; Imaging, Three-Dimensional ; Tomography, Emission-Computed, Single-Photon ; methods ; Treatment Outcome

OBJECTIVETo investigate the efficacy of uncutted Roux-en-Y esophagojejunostomy with jejunal pouch (URYJP) after total gastrectomy.

METHODSTotal gastrectomy was performed on 168 patients of gastric cancer, and 3 methods were used for reconstruction: the uncutted Roux-en-Y esophagojejunostomy with a jejunal pouch was performed on 69 patients(group A),Roux-en-Y esophagojejunostomy with the P-type jejunal pouch on 50 patients(group B),and Roux-en-Y esophagojejunostomy with the Orr-type jejunal pouch on 49 patients (group C). The alimentary tract reconstruction time, morbidity and mortality were compared. The 121 cases that survived for more than 1 year were analyzed for quality of life(QOL),including body weight, intake quantity, prognosis nutritional index (PNI), and Visick scores 6 and 12 months after the operations.

RESULTSAll the patients recovered quickly and no anastomosis leakage or duodenal fistulas were found. It took (30+/-7) minutes to finish the reconstruction in group A, which was significantly shorter than that in group B [(57+/-6) minutes] or in group C [(48+/-6) minutes]. There were no significant differences among 3 groups in the incidence of alkaline reflux gastritis. The incidence of Roux stasis syndrome was 2.2% in group A, which was significantly lower than 17.9% and 19.4% in group B and C. Weight loss and food intake gain in group A was superior to those in group B and C 6 months and 12 months postoperatively. As compared with prognosis nutritional index(PNI) postoperatively, those of 3 groups decreased significantly 6 months postoperatively. At 12 months after operation, the PNI of group A returned to the level before operation, while PNI of both group B and C remained significantly lower than those before operation (both P < 0.05). The Visick score of group A was superior to those of group B and C 6 months and 12 months postoperatively.

CONCLUSIONSThe new uncutted Roux operation with jejunal pouch can prevent alkaline reflux gastritis and Roux-en-Y stasis syndrome. It may be a standard procedure for reconstruction after total gastrectomy.

Adult ; Aged ; Aged, 80 and over ; Anastomosis, Roux-en-Y ; methods ; Female ; Gastrectomy ; Humans ; Jejunum ; surgery ; Male ; Middle Aged ; Postoperative Period ; Stomach Neoplasms ; surgery

OBJECTIVETo evaluate the effect and toxicity of oxaliplatin combined with capecitabine (Xeloda) as a second-line chemotherapy regimen for patients with advanced gastric cancer.

METHODSTwenty-four patients with advanced gastric cancer who had been treated by multiple chemotherapy regimens presenting poor responses were allotted. LX regimen (oxaliplatin 85 mg/m(2) in 2-hour infusion on D1 and D15, capecitabine 1250 mg/m(2)/d divided in two daily doses given from D1 to D14) was adopted. The cycles were repeated every 28 days. All patients received two or more cycles.

RESULTSAll 24 patients were evaluated after having received 2 to 6 cycles of chemotherapy, totally 92 cycles. The overall response rate was 29.2% (including 2 CR, 5 PR, 10 NC and 7 PD). The time to tumor progression (TTP) was 2 to 18 months (median 5 months), and duration of remission was 4 to 14 months (median 8 months). The major toxicities were bone marrow suppression and nausea/vomiting.

CONCLUSIONOxaliplatin combined with capitabine is effective as a secondary line regimen for patients with advanced gastric cancer. This protocol is active and well tolerated. Further clinical studies are warranted.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Capecitabine ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Drug Administration Schedule ; Female ; Fluorouracil ; analogs & derivatives ; Humans ; Liver Neoplasms ; drug therapy ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Nausea ; chemically induced ; Neoplasm Staging ; Neutropenia ; chemically induced ; Organoplatinum Compounds ; administration & dosage ; Remission Induction ; Stomach Neoplasms ; drug therapy ; pathology