Objective: To investigate the expression of carcinoembryonic antigen-related cell adhesion molecule 19 (CEACAM19) in colorectal cancer tissues, and evaluate the clinical pathological characters and prognostic significance. Methods: Ninety-eight patients with colorectal cancer in Beijing Huairou Hospital from July 2015 to July 2018 were selected. The expression level of CEACAM19 protein in primary colorectal cancer and corresponding non-tumor tissues (>2 cm) was detected by immunohistochemistry. The correlation between clinical pathological characters and CEACAM19 expression level was analyzed. The prognostic influencing factors were analyze by univariate and multivariate Cox regression methods. Survival curve was drawn by Kaplan-Meier method. Results: The high expression rate of CEACAM19 in colorectal cancer tissues was significantly higher than that in adjacent non-tumor tissues: 69.4% (68/98) vs. 16.3% (16/98), and there was statistical difference (χ² = 45.060; P<0.01). Expression of CEACAM19 in colorectal cancer tissues was significantly associated with TNM stage (P<0.05), and was not associated with age, gender, tumor diameter, histological differentiation, tumor location, lymph node stage and invasion depth (P>0.05). Univariate Cox regression analysis result showed that lymph node stage, TNM stage and CEACAM19 expression were influencing factors of overall survival in patients with colorectal cancer (P<0.05 or <0.01), and the TNM stage and CEACAM19 expression were influencing factors of disease-free survival in patients with colorectal cancer (P<0.01). Multivariate Cox regression analysis result showed that TNM stage increased and CEACAM19 high expression were independent risk factors of overall survival (HR = 2.628 and 0.199, 95% CI 1.147 to 6.021 and 0.045 to 0.868, P = 0.022 and 0.032) and disease-free survival (HR = 2.009 and 0.303, 95% CI 0.965 to 4.185 and 0.101 to 0.911, P = 0.048 and 0.034) in patients with colorectal cancer. Survival curve analysis result showed that the median overall survival and disease-free survival in CEACAM19 low expression patients were significantly longer than CEACAM19 high expression patients (47.9 months vs. 27.8 months and 43.2 months vs. 26.3 months, P<0.01); the median overall survival and disease-free survival in TNM Ⅰ to Ⅱ stage were significantly longer than TNM Ⅲ stage patients (43.9 months vs. 24.2 months and 39.3 months vs. 23.7 months, P<0.01). Conclusions The CEACAM19 in colorectal cancer tissues is high expression, and the CEACAM19 expression level can be used as biomarker for prediction the prognosis of colorectal cancer.

Objective Pancreatic neuroendocrine carcinoma ( pNEC) is a highly malignant tumor. This study aimed to evaluate the role of surgery and the prognosis for patients with pancreatic neuroendocrine carcinoma ( pNEC ) . Methods We collected and reviewed all clinical data of patients who underwent radical surgery for pNEC from Jan 2000 through Jan 2016 in our hospital. Cox?regression analysis wasused to evaluate the factors potentially influencing survival. Results Twenty patients including 11 males and 9 females ( median age, 62.5 years) were included in this study. All patients underwent radical surgery and 17 cases received postoperative platinum?based chemotherapy. The median follow?up time was 41 months (range, 1 to 127 months).The 1?,3?, and 5?year survival rates of the patients were 66.7%, 51.5% and 28.1%, with a median survival time of 75.3 months.The multivariate analysis indicated that tumor size and Ki?67 index were of prognostic significance. Conclusions Pancreatic neuroendocrine carcinomas are rare but increasing in incidence. Patients with localized nonmetastatic primary tumors seem to benefit from surgery. Early diagnosis and multimodality therapy are key points of an improved survival.

Objective Pancreatic neuroendocrine carcinoma ( pNEC) is a highly malignant tumor. This study aimed to evaluate the role of surgery and the prognosis for patients with pancreatic neuroendocrine carcinoma ( pNEC ) . Methods We collected and reviewed all clinical data of patients who underwent radical surgery for pNEC from Jan 2000 through Jan 2016 in our hospital. Cox?regression analysis wasused to evaluate the factors potentially influencing survival. Results Twenty patients including 11 males and 9 females ( median age, 62.5 years) were included in this study. All patients underwent radical surgery and 17 cases received postoperative platinum?based chemotherapy. The median follow?up time was 41 months (range, 1 to 127 months).The 1?,3?, and 5?year survival rates of the patients were 66.7%, 51.5% and 28.1%, with a median survival time of 75.3 months.The multivariate analysis indicated that tumor size and Ki?67 index were of prognostic significance. Conclusions Pancreatic neuroendocrine carcinomas are rare but increasing in incidence. Patients with localized nonmetastatic primary tumors seem to benefit from surgery. Early diagnosis and multimodality therapy are key points of an improved survival.

Chronic constipation is a common gastrointestinal disease severely affecting the patient׳s quality of life. The traditional treatment of constipation is the use of laxatives. Recently, several new drugs including lubiprostone, linaclotide and prucalopride have been approved for treatment of chronic constipation. However, a significant unmet medical need still remains, particularly among those patients achieving poor results by current therapies. The 5-HT4 receptor modulators velusetrag and naronapride, the guanylate cyclase C agonist plecanatide and the ileal bile acid transporter inhibitor elobixibat are recognized as the most promising drugs under investigation. Herein, we give a comprehensive review on the pharmacological therapeutics for the treatment of chronic constipation, with the purpose of reflecting the drug development trends in this field.

Objective To evaluate the surgical treatments of refractory sclerosing peritonitis related peritoneal dialysis.Methods Clinical data of 15 patients with refractory sclerosing peritonitis related to peritoneal dialysis treated in the General Surgery Department of the 900th Hospital of the Joint Logistics Support Force of the People's Liberation Army from June 30,2014 to May 30,2018.Among them,5 cases underwent"open abdomen peritoneal catheter removal+intestinal adhesiolysis+abdominal infection flushing and drainage with catheter",4 cases underwent"laparoscopic peritoneal catheter removal+intestinal adhesiolysis+abdominal infection flushing and drainage with catheter",3 cases underwent"laparoscopic peritoneal dialysis catheter removal+abdominal infection flushing and drainage with catheter",2 cases underwent"open abdomen peritoneal dialysis catheter removal+abdominal infection flushing and drainage with catheter",and 1 case underwent"laparoscopic examination combined with laparotomy exploration and removal of lower abdominal catheter+intestinal adhesiolysis+abdominal infection flushing and drainage with catheter".Age,gender,clinical symptoms,abdominal CT examination,peripheral blood routine,blood biochemistry,blood C-reactive protein(CRP),white blood cells,biochemistry,and aetiology of peritoneal dialysis fluid were collected and followed up,and the therapeutic effect was evaluated.Results 15 patients were transferred to the Department of Surgery after ineffective treatment in the Department of Internal Medicine.Preoperatively(after 5 days of antibiotic treatment)compared to before antibiotic treatment,there were no significant changes in blood WBC,blood NEUT％,CRP,and peritoneal fluid WBC(P＞0.05).Laparoscopic exploration or laparotomy exploration was performed,during which the peritoneal dialysis catheter was removed and the abdominal infection focus was cleared.A pelvic cavity washout drainage tube was left in place postoperatively.Fourteen patients had a good recovery after surgery,with effective control of peritonitis symptoms and no complications such as intestinal obstruction or enterocutaneous fistula.After the removal of the peritoneal dialysis catheter,all patients switched to hemodialysis.A comparison of inflammatory markers before and after surgery showed a significant decrease after surgery.Three days postoperatively compared to before surgery(after 5 days of antibiotic treatment),there were no significant changes in blood WBC,blood NEUT％,CRP,and peritoneal fluid WBC(P＞0.05).Seven days postoperatively compared to before surgery(after 5 days of antibiotic treatment),there was a significant decrease in blood WBC[(7.43±2.65)× 109/L VS(10.17±5.24)× 109/L],blood NEUT％[(88.23±9.02)％VS(85.07±11.57)％],and CRP[(152.88±113.01)mg/L VS(114.49±92.97)mg/L](P＜0.05);the peritoneal fluid WBC at 7 days postoperatively showed no significant change compared to before surgery(after 5 days of antibiotic treatment)(P＞0.05).The cases were followed up for at least 22 months,and 13 patients did not experience peritonitis or intestinal obstruction again.One patient died 39 days after surgery due to multiple organ failure,and one patient died from other causes after a 2-year follow-up.Conclusion For refractory sclerosing peritonitis related peritoneal dialysis that is ineffective in medical conservative treatment,On the basis of reasonable and effective antibiotics to control infection,surgical intervention should be actively carried out and surgical methods such as surgery should be used to control the progress of peritonitis,reduce mortality and improve the cure rate.

OBJECTIVETo identify risk factors associated with overall survival (OS) for patients undergoing primary hepatic resection for metastatic colorectal cancer.

METHODSThe clinical and pathological data were prospectively collected from 191 consecutive patients undergoing primary hepatic resection for colorectal liver metastases from January 2000 to August 2012. The survival curve was drawn by Kaplan-Meier method, and the survival rates were analyzed by Log-rank test. Parametric survival analysis was used to identify predictors of cancer-specific survival.

RESULTSThe 5-year overall survival were 38.4% and median survival time was 33 months; 5-year disease-free survival were 23.6%, and the median disease-free survival time was 10.0 months. 5-years survival rate was significantly lower in patients with synchronal metastasis than in patients with heterochronia metastasis (27.4% vs. 51.8%, χ(2) = 6.527, P < 0.05). In overall survival, univariate analysis found 7 risk factors: gender (χ(2) = 5.219), N stage of the primary tumor (χ(2) = 5.591), bilobar metastases (χ(2) = 4.269), number of metastases ≥ 2 (χ(2) = 5.051), disease-free interval ≥ 6 months (χ(2) = 6.527), carcinoembyonic antigen level ≥ 30 µg/L (χ(2) = 4.454), and extrahepatic disease (χ(2) = 5.158). On multivariate analysis, 3 risk factors were found to be independent predictors of poor survival: N stage of the primary tumor (RR = 2.198, 95%CI: 1.146-4.216), disease-free interval ≥ 6 months (RR = 1.840, 95%CI: 1.139-2.973), carcinoembyonic antigen level ≥ 30 µg/L(RR = 1.854, 95%CI: 1.056-3.255).

CONCLUSIONSResection of liver metastases provides good long-term cancer-specific survival benefit. N stage of the primary tumor, disease-free interval, carcinoembyonic antigen level are important prognostic factors for colorectal liver metastasis.

Adult ; Aged ; Aged, 80 and over ; Carcinoembryonic Antigen ; blood ; Colorectal Neoplasms ; pathology ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Liver ; surgery ; Liver Neoplasms ; secondary ; surgery ; Male ; Middle Aged ; Prognosis ; Risk Factors ; Survival Rate ; Young Adult