For more than a century, surgical treatment of gastric cancer is always a subject of debate, es-pecially for the extent of lymph nodes dissection for advanced gastric cancer (AGC). In this article, we re-viewed the advances on lymph node excision in AGC.

Objective:To explore the predictive factors of intestinal necrosis in acute mesenteric ischemia.Methods:This retrospective study enrolled 81 patients diagnosed as acute mesenteric vascular occlusive diseases in Zhongshan Hospital, Fudan University between Nov 2012 to May 2017. Univariate analysis and multivariate logistic regression analysis were used to identify predictive factors for intestinal necrosis.Results:In univariate analysis, the predictive factors of intestinal necrosis were peritoneal irritation sign ( P<0.001), white blood cell count ( P<0.001), serum albumin ( P=0.028), blood creatinine ( P=0.025), serum lactic acid ( P=0.008), D-dimer ( P=0.037), intestinal pneumatosis ( P=0.017), decreased or disappeared enhanced bowel wall ( P<0.001) and bowel loop dilation>2.5 cm ( P=0.01) on CT scan. According to multivariate logistic regression analysis, white blood cells ( OR=3.60, 95% CI: 1.51-5.47, P=0.007), lactic acid ( OR=4.80, 95% CI: 1.36-9.89, P=0.032), reduced or disappeared enhanced bowel wall ( OR=10.57, 95% CI: 1.82-61.10, P=0.008) were independent predictive factors of intestinal necrosis in patients with acute mesenteric ischemia. Conclusions:The predicted risk factors for intestinal necrosis in mesenteric ischemic diseases are increased white blood cells, elevated serum lactate levels, and reduced or disappeared enhanced bowel wall on CT scan.

Objective To design a new cancer vaccine by using alpha-galactosylceramide (α-Galcer,α-GC) loaded tumor cells in combination with TLR 9 ligand and to evaluate its therapeutic effects on colon canc-er in mice.Methods MC38 cells were transfected with lentivirus (GFP-CD1d) to prepare CD1d-MC38 cells. The expression of CD1d molecules in CD1d-MC38 cells was detected by fluorescence microscopy , RT-PCR and flow cytometry.The sorted CD1d-MC38 cells were loaded with α-Galcer to prepare CD1d-MC38/α-GC complex. Flow cytometry was performed to evaluate the efficiency of combination .A mouse model of colon cancer was es-tablished to investigate the therapeutic effects of α-Galcer loaded tumor cells in combination with TLR 9 ligand ( CD1d-MC38/α-GC+CpG1826) on colon cancer in mice by analyzing tumor growth and mice survival time .Im-munohistochemical staining was used to detect CD 4+T and CD8+T infiltrating lymphocytes in tumor tissues .Re-sults The MC38 cancer cells that expressed CD 1d and GFP were successfully constructed , among which 98.10%±2.53%were positive for CD1d.Moreover, the CD1d-MC38 cells could combine with α-Galcer effec-tively in a dose and time dependent manner .Compared with PBS treated group ,α-GC treated group and TLR9 ligand treated group , the experimental vaccine strategy was sufficient to inhibit the growth of established tumors and prolong survival of tumor-bearing mice (P<0.01).Immunohistochemistry analysis revealed that levels of CD4+T cells and CD8+T cells in experiment group were significantly higher than those in groups treated with PBS,α-GC and TLR9 ligand (P<0.01).Conclusion CD1d-MC38/α-GC in combination with CpG1826 could efficiently inhibit the growth of established tumors and prolong survival of tumor-bearing mice .Immunohisto-chemistry analysis revealed that CD 4+T cells and CD8+T cells played important roles in anti-tumor immunity.

Objective:To study the relation between promyelocytic leukemia protein (PML) and gastric and colorectal cancers , and explore the relation between PML and epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) .Methods:The expression situations of PML ,EGFR ,and VEGF in gastric and colorectal cancer were detected by immunohistochemistry ,and their relations with tumor invasions ,lymph node metastases ,TNM stages and patients’ survival were analyzed .Results:PML was positively expressed in normal tissue adjacent to gastrointestinal cancer .The rate of PML deficiency was 33 .8% (54/160) in gastric cancer tissue ,while it was 38 .1% (64/168) in colorectal cancer tissue .PML deficiency in gastric cancer tissue was positively correlated with gastric wall invasion (P<0 .001) ,lymph node metastases (P=0 .018) and TNM stage (P<0 .001) ,and the survival period of patients with positive PML was longer than that of patients with negative PML (52 months vs 39 months , P<0 .001) .Age ,PML deficiency and TNM stage were the independent risk factors of gastric cancer prognosis .PML deficiency in colorectal cancer tissue was positively correlated with TNM stage (P=0 .012) ,and the survival period of patients with positive PML was longer than that of patients with negative PML (53 months vs 44 months , P= 0 .001) .The positive expression of EGFR was positively correlated with colorectal wall invasion (P<0 .001) ,lymph node metastases (P<0 .001) and TNM stage (P<0 .001) .PML deficiency ,TNM stage and EGFR expression were the independent risk factors of colorectal cancer prognosis .PML expression was negatively correlated with EGFR and VEGF expression (P<0 .05) .Conclusions:PML deficiency may promote the progression of gastric and colorectal cancer by up‐regulating the expression of EGFR and VEGF .PML deficiency is correlated with prognosis of gastric and colorectal cancer patients .