Objective: To study the influence of clinicopathologic factors on the recurrent pattern of colorectal cancer after radical treatment. Methods: There were 464 consecutive patients with colorectal cancer treated with radical surgery between January 1998 and December 2002 in our hospital. The clinicopathologic features of 90 patients with relapse of colorectal cancer after radical surgery were analyzed. According to the interval between radical surgery and recurrence, these 90 patients were divided into subgroups, the early recurrent group (within 30 months after surgery) and the late recurrent group (more than 30 months after surgery). Chi-square test was used for univariate analysis, and the Logistic regression model was performed for multivariate analysis. Result: There were 78 (86%) patients in the early recurrent group and 12 (14%) patients in the late recurrent group. The median time of recurrence was 17.4 months. The median recurrent time in stage I patients was 35.1 months, 13.6 months in stage II patients, and 12.9 months in stage III patients, respectively. Univariate analysis showed that the depth of penetration, the number of positive lymph nodes, and the gross appearance of tumor were predictors for early recurrence. Multivariate analysis revealed that the depth of penetration (T category) of the primary tumor significantly predicted for early recurrence (P= 0.049). Conclusion: A great proportion of recurrence in patients with colorectal cancer occurred within 30 months after radical treatment, but the late recurrence which occurs at more than 30 months after radical surgery should not be neglected. Patients with different patterns of recurrence had different intervals between radical surgery and recurrence. DM (distant metastasis) occurs earlier than LR (local recurrence). The depth of penetration of the primary tumor is an independent predictor for early recurrence of colorectal cancer patients after radical surgery.

Objective To study the clinical discrepancy between patients with post infectious irritable bowel syndrome(PI-IBS) and non post infectious irritable bowel syndrome(NPI-IBS),and assess the value of serum intestinal fatty acid binding protein (I-FABP) for differential diagnosis.Methods A total of 117 patients with PI-IBS,201 patients with NPI-IBS and 31 healthy controls were prospectively recruited in General Liberation Army Hospital from 2010 to 2013.Plasma samples and clinical data were collected.Serum I-FABP level was measured by an enzyme-linked immunosorbent assay.Results The median age of patients with PI-IBS was 36 years.The median time to diagnosis in PI-IBS group was significantly longer than that in NPI-IBS group [(19.7 ± 10.3) months vs (11.4 ± 5.3) months,P ＜ 0.05].Similarly,the proportion of anxiety [58.1％ (68/117) vs 28.9％ (58/201),P ＜ 0.05] and the value of I-FABP[(42.6 ± 14.8) μg/L vs (17.3 ± 11.5) μg/L,P ＜ 0.05] in PI-IBS group were significant higher than NPI-IBS patients.The level of I-FABP of healthy controls [(10.6 ± 8.2) μg/L] was also significantly lower than that of PI-IBS patients (P ＜ 0.05),yet no difference from that of NPI-IBS group.The I-FABP value of subgroup PI-IBS patients with diarrhoea (IBS-D) was significant higher than that of NPI-IBS group [(54.8 ± 9.3) μg/L vs (12.3 ± 6.2) μg/L,P ＜ 0.05].However,other parameters including gender,age,GSRS score,and I-FABP value of subgroup constipation (IBS-C) and mix (IBS-M),were not different between PI-IBS group and NPI-IBS group (all P ＞ 0.05).Conclusion PI-IBS is an occult intestinal inflammation disease with mucosa injury.I-FABP might be a potential testing marker for the diagnosis of PI-IBS.

Objective To evaluate the feasibility, therapeutic effects and normal tissue complications of three-dimensional conformal radiotherapy (3DCRT) for loco-regionally recurrent esophageal cancer after initial radiotherapy. Methods Between March 2001 and May 2007, 42 patients with loco-reigonal recurrent esophageal cancer after initial radiotherapy were treated with 3DCRT, including 27 male and 15 female with a median age of 67.5 years. Radiotherapy was delivered at 1.8 -2.0 Gy per fraction, 5 fractions per week, with a median total dose of 54 Gy. Treatment outcomes and normal tissue complications were assessed with WHO and RTOG/EORTC criteria. Results By December 31,2008, the follow-up rate was 100%. Twenty patients had follow-up time of 1 year and the remaining 22 had 2 years. The clinical symptom relief rate was 60%, and the response rate was 90.5% with a complete remission rate of 17% and partial remission rate of 74%. The overall 1- and 2-year survival (OS) rates were 60% and 24%. Grade 2 and grade 3 acute radiation esophagitis developed in 31% and 5% of the patients, respectively. Grade 2 and grade 3 acute radiation pneumonitis developed in 19% and 2% , respectively. Grade 2 and grade 3 acute radiation hematology toxicities developed in 5% and 2%, respectively. Conclusions For patients with loco-regional recurrences of esophageal cancer after initial radiotherapy, 3DCRT is feasible, with a good clinical symptom relief rate and immediate tumor response. However,the complication rate was high and the clinical indications should be strictly controlled.

Objective To study the role of Cysteine-rich 61 ( Cyr61/CNN1) in repair of combined injury by observing whether exogenous CCN1 promotes the proliferation and migration of radiation-injured L929 cells. Methods A radiation model of L929 cells was induced by ? ray at a dose of 4 Gy. The irradiated L929 cells were cultured in a medium containing 2 ml adenovirus plasmids of CCN1 or RFP at 37 ℃ in an atmosphere containing 5% CO2,which served as a CCN1 group and a RFP group,respectively. Irradiated L929 cells cultured in a blank control medium served as a blank control group. Effects of CCN1 on proliferation and migration of radiation-injured L929 cells were detected by MTT assay,plate colony formation assay,cell cycle analysis,and scratch test of wound healing. Results The proliferation and colony formation rates of L929 cells cultured in a medium containing CCN1 were significantly higher than in RFP and control groups [colony formation rate:( 34. 4 ?3. 6) % vs ( 24. 5 ?2. 9) % and ( 29. 5 ?3. 5) %,P

To compare the clinical features and prognosis in patients with cytomegalovirus pneumonia from other pneumonia after allogeneic hematopoietic stem cell transplantation (allo-HSCT). A total of 118 patients with pulmonary complications after allo-HSCT from March 2016 to June 2019 were analyzed retrospectively, who were divided into cytomegalovirus (CMV) pneumonia group ( n=34) and the non-CMV pneumonia group ( n=84). Compared with non-CMV pneumonia group, CMV pneumonia group presented earlier median onset time (1.8 vs.6.0 months, P=0.015) after allo-HSCT, more dyspnea (41.2% vs. 19.0%, P=0.012), hypoxemia (38.2% vs. 13.1%, P=0.006), and interstitial pneumonia (82.4% vs. 23.8%, P<0.01).The incidence of CMV-viremia and serum viral load in CMV pneumonia group were significantly higher than those in non-CMV pneumonia group. Consistently, and the development of mixed infection in CMV pneumonia group was higher than that of non-CMV pneumonia group (41.2% vs. 16.7%, P=0.013). The median follow-up time was 12.8 (0.4-46.5) months. The 1-year attributable mortality in CMV pneumonia group was significantly higher than that in non-CMV pneumonia group (26.5% vs. 10.7%, P=0.004), while the 1-year overall survival rate was significantly lower than that in non-CMV pneumonia group (61.8% vs. 85.7%, P=0.001). Reduced-intensity conditioning (RIC)( P=0.036), high flow ventilation ( P=0.033) and negative CMV-viremia ( P=0.009) were unfavorable prognostic factors of patients with CMV pneumonia. Compared with those with non-CMV pneumonia, patients with CMV pneumonia had more characteristic clinical manifestations and imaging features. However, due to the higher incidence of mixed infections, the causes of pneumonia need to be identified by bronchoscopic alveolar lavage. In conclusion, patients with CMV pneumonia have worse clinical outcome. RIC, high flow ventilation and negative CMV-viremia are adverse prognostic factors for CMV pneumonia.

Objective To study the effect of heat stress on the permeability,cytoskeleton and cell cycle of human skeletal muscle cell (HSKMC).Methods The HSKMC membrane permeability was detected by calcium ion inflow with flow cytometer,the cytoskeleton was stained by CBB 250,and the cell cycle was determined by flow cytometer.Results After 1 h of heat stress on human HSKMC cells under different temperature gradient,the median level of calcium ion was 91.63 in 43 ℃ heat stress group compared with 22.98 in 37 ℃ control group.As temperature increased,thicker and shorter cytoskeleton and stress fiber were shown under the high power lens of microscope.The DNA expression of skeleton cells at G0/G1 stage was 44.13-62.98 in groups under heat stress.Compared with normal control group,DNA expression was much higher in heat stress group,when HSKMC was cultured under 37 ℃ temperature for another 18 h,it kept decreasing DNA expression to a similar level as control group.Conclusions Heat stress can cause calcium iron inflow resulting in intracellular calcium overload,and affect the cytoskeleton leading to loss of normal web ordered arrangement and increased gap in HSKMC cells,which give rise to blocking cell cycle into G0/G1 stage.

Objective To observe the effects of radiation on the growth and expression of cysteine-rich 61(Cyr61/CCN1) of L929 cells and investigate the relationship between CCN1 expression and radiation injury.Methods L929 cells were cultured and divided into 2 groups,cells irradiated with 4 Gy ?-irradiation as radio-group and untreated cells as control group.The cell proliferation was measured by MTT assay and plate colony formation testing.Flow cytometry was utilized to quantify the cell cycle distribution.CCN1 expression at protein and mRNA levels were determined by immunocytochemistry(ICC) and RT-PCR respectively.Results Significant inhibition of proliferation(P

OBJECTIVETo investigate the effects, side-effects and security of bupivacaine, ropivacaine combined with fentanyl in postoperative continuous epidural analgesia.

METHODSA total of 1 600 postoperative continuous epidural analgesia patients receiving different agents in SICU were divided into two groups: 0.1% bupivacaine +5 microg/ml fentanyl group (group B, n = 920) and 0.2% ropivacaine +2 microg/ml fentanyl group (group R, n = 680). The effects (visual analog-scale score and content to analgesia), side effects were analyzed retrospectively in the two groups.

RESULTSCompared with group B, patients in group R had higher analgesia contentment (P < 0.05), but no difference in visual analog-scale score was found in the two groups. The incidences of urinary retention, nausea and vomiting, skin itching in group B were significantly higher than those in group R (P < 0.05). In each group, patients over sixty had higher ratio of hypotension than those under sixty (P < 0.05); The female patients had a higher incidence of nausea and vomiting than male patients (P < 0.05); The incidence of debility and numbness of lower limbs in patients with lumbar segments epidural analgesia was higher than those with thoracic analgesia (P < 0.05).

CONCLUSIONS0.1% bupivacaine +5 microg/ml fentanyl and 0.2% ropivacaine +2 microg/ml fentanyl can provide adequate pain relief in postoperative continuous epidural analgesia, and 0.2% ropivacaine +2 microg/ml fentanyl comes with less side effects. The incidence of complication is related with analgesics, age, gender and the position of epidural puncture.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Amides ; administration & dosage ; adverse effects ; Analgesia, Epidural ; adverse effects ; methods ; Analgesia, Obstetrical ; adverse effects ; methods ; Analgesics, Opioid ; administration & dosage ; adverse effects ; Anesthetics, Local ; administration & dosage ; adverse effects ; Bupivacaine ; administration & dosage ; adverse effects ; Female ; Fentanyl ; administration & dosage ; adverse effects ; Humans ; Male ; Middle Aged ; Pain, Postoperative ; prevention & control ; Retrospective Studies

OBJECTIVETo explore the molecular mechanism of pain associated with chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS) in the rat model of prostatic inflammation.

METHODSThirty-six male SD rats were equally randomized to an experimental and a control group, the former injected with 50 μl of 3% λ-carrageenan into the ventral prostate to make the model of non-bacterial prostatic inflammation, while the latter with the same volume of sterile saline solution. At 1, 2 and 4 weeks after modeling, the prostate, L6-S1 dorsal root ganglion (DRG) and spinal cord were harvested for examination of the expressions of the nerve growth factor (NGF), transient receptor potential ankyrin 1 (TRPA1), and calcitonin-gene-related peptide (CGRP) by immunohistochemistry and Western blot.

RESULTSThe expressions of NGF, TRPA1 and CGRP in the prostatic tissue were all significantly increased in the experimental group as compared with the control (P <0.05), with a gradual decrease with the prolonging of time (P <0.05). In the L6-S1 DRG and spinal cord, the expressions of NGF, TRPA1 and CGRP exhibited no significant differences between the experimental and control groups at 1 week after modeling (P >0.05) and kept at high levels in the experimental group at 2 and 4 weeks, though not significantly different from those at 1 week (P >0.05). Statistically significant differences were observed in the expressions of the three proteins in the experimental rats among different time points (P <0.05), but not between the two groups at any time point (P >0.05).

CONCLUSIONThe molecular mechanism of CP/CPPS can be evaluated in the rat model of prostatic inflammation established by injecting λ-carrageenan into the prostate. TRPA1 may play an important role in connecting the upstream and down-stream pathways of CP/CPPS-associated pain.

Animals ; Calcitonin Gene-Related Peptide ; metabolism ; Carrageenan ; Chronic Disease ; Chronic Pain ; metabolism ; Ganglia, Spinal ; metabolism ; Humans ; Male ; Nerve Growth Factor ; metabolism ; Pelvic Pain ; metabolism ; Prostatitis ; chemically induced ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; metabolism ; TRPA1 Cation Channel ; TRPC Cation Channels ; metabolism

Melanosis coli is the brownish black discoloration of the colon due to accumulation of pigment containing macrophages in lamina propria. The nature and source of this pigment is controversial but many studies have suggested that the pigment is related to lipofuscin. Melanosis coli has been reported to be closely associated with prolonged administration of anthraquinone purgatives. But this condition is sometimes associated with colonic polyp colon cancer, rediation therapy or non-anthraquinone purgatives administration. Moreover the fact that melanosis coli could be found in subjects who never used purgatives suggested that, even though chronic consumption of anthraquinone purgatives seems to play a major role, other factors may be involved in the pathogenesis of melanosis coli. We presented a case of melanosis Coli in a 47-year-old female with history of rectal instillation of petroleum for control of hemorrhoids.
Administration, Rectal* ; Cathartics ; Colon ; Colonic Neoplasms ; Colonic Polyps ; Female ; Hemorrhoids ; Humans ; Lipofuscin ; Macrophages ; Melanosis* ; Middle Aged ; Mucous Membrane ; Petroleum*