China ; Humans ; Stomach Neoplasms ; diagnosis ; therapy

OBJECTIVETo analyze the relationships between smooth-muscle tumors of gastrointestinal (GI) tract and gastrointestinal stromal tumors (GISTs), and the efficacy of surgical management.

METHODSThe clinical and pathological data of 135 cases of GISTs were collected, including cases of leiomyomas/leiomyosarcoma between 1993 and 2003 and GIST between Jan. 2000 and Jul. 2005. The surgical outcomes were analyzed retrospectively.

RESULTS82.1% of former leiomyomas/leiomyosarcomas was corrected to GISTs. Overall 5-year survival rate was 79.7%. Univariate analysis revealed preoperative metastasis, tumor size, mitotic index, and postoperative metastasis or recurrence were correlated with overall survival in patients with completed resection. Multivariate analysis showed that only postoperative metastasis or recurrence were the indicators of poor prognosis, but without statistical significance (P=0.064). However, multivariate analysis for disease-free survival showed that preoperative metastasis and mitotic index were two independent predictors of poor prognosis (P=0.001 and P<0.001).

CONCLUSIONSMost former leiomyomas/leiomyosarcomas of GI tract should be corrected to the diagnosis of GISTs. Complete surgical resection is the choice of treatment for GISTs. Preoperative metastasis and mitotic index are two independent predictors of poor prognosis.

Female ; Gastrointestinal Stromal Tumors ; diagnosis ; surgery ; Humans ; Male ; Prognosis ; Survival Rate

Objective To investigate the situation of chronic diseases and the effects on quality of life among different-aged elderly in community and provide evidence for targeted improvement quality of life.Methods During March to July 2015, the elderly who was aged 60 and over as respondents from two communities in Kunming were enrolled. Cross-sectional study and cluster sampling were used based on Activities of Daily Living scale (ADL) and Balthel index.questionnaire was designed and information of chronic disease in the elderly was colected.The effects on Balthel index in different chronic diseases and age groups were analysed.Results A total of 589 subjects were investigated, chronic disease prevalence was93.70％, and the highest prevalence is hypertension that was 27.50％.The quality of life was worse in the elderly who suffered from three kinds of chronic diseases and more older. The quality of life in different age groups elderly was statistically significant (P ＜ 0.05).Conclusion The quality of life in the community elderly is relate with age and the type of chronic diseases.In order to improve their quality of life health guidance should be strengthened.

Objective To investigate the mechanism and suppression effect of human cytomegalovirus (HCMV) on proliferation of megakaryocyte progenitors(CFU-Mk)in vitro.Methods Colony forming unit-assay was applied to observe the effect of HCMV-AD 169 strain on CFU-Mk of cord blood. The technique of PCR was used to demonstrate the existence of HCMV-AD 169 DNA in the colony cells of cultured CFU-Mk.Results 1.The number of CFU-Mk colonies in HCMV-infected groups decreased significantly compared with that of control group. The CFU-Mk formation was inhibited significantly after HCMV-AD 169 strain infection.The suppression effect showed a dose-dependent fashion: 46.7 % inhibition with 10 -1of HCMV, 29.7 % with 10 -2 and 14.5 % with 10 -3 in the CFU-Mix assay. The peak of CFU-Mk colonies (d16-18) was not significantly different between control group and experimental groups, but the duration of the CFU-Mk colonies in infected groups was significantly shorter than that in control group.2. HCMV-DNA was positively detected in the colony cells of viral infected group by PCR, while negative in control group.Conclusions HCMV-AD 169 strain may inhibit the differentiation and proliferation of CFU-Mk by infecting the hematopoietic progenitors. HCMV may cause the suppression of hematopoiesis by direct infection, which may be the main reason for HCMV infection associated with thrombocytopenia.

OBJECTIVETo explore the indications of sphincter preservation operation (SPO) for rectal cancer, and factors influencing selective indications of SPO.

METHODSFrom April 1994 to April 2004, clinical data of 708 cases with rectal cancer were analyzed retrospectively. The patients received either SPO (SPO group, n=481) or abdominoperineal resection (APR group, n=227). Clinical pathologic parameters and survival rate were compared between the two groups.

RESULTSThere were 66 patients with tumor located in sigmoid-rectum borderline, 138 in upper rectum, 195 in middle rectum, 309 in lower rectum. Dixon operation was performed in 449 patients, Bacon operation in 12, and "J" Poch anastomosis in 20 and Hartman operation in 13. There was no differences in sex, ages, liver metastasis, size, depth of invasion and Dukes stages between APR and SPO groups, but there was significant difference in lower bowel obstruction, tumor location, differentiation degree, infiltrated circumference of intestine, lymph node metastasis and radical approaches between the two groups. Radical excision was performed in 660 rectal cancer cases with radical excision rate of 91.5% . SPO was performed in 481 cases with preservation rate of 66.7%, including 135 lower rectal cancer with preservation rate of 43.7%. The operative mortality was 0.4% (3/708), regional recurrence rate was 5.51% (39/708) after operation. The median survival time was (65.0+/- 6.9) months in SPO group and (42.2+/- 5.6) months in APR group (P< 0.01), the 5-year survival rate was 59.3% and 42.3% in SPO and APR group (P< 0.001).

CONCLUSIONSSPO should be considered as primary choice for rectal cancer patients, but it must be ensured that complete radical resection be performed. Indications for SPO in lower rectal cancer depend on tumor location,differentiation degree,and infiltrated circumference of intestine,lymph node metastasis.

Anal Canal ; surgery ; Colorectal Surgery ; trends ; Humans ; Rectal Neoplasms ; surgery ; Retrospective Studies

OBJECTIVETo improve the accuracy of preoperative evaluation of cervical lymph node metastasis in thoracic esophageal squamous carcinoma.

METHODSForty-two patients with thoracic esophageal squamous carcinoma underwent neck ultrasonography. Enlarged lymph nodes with their long axis greater than 10 mm and a short-to-long axis ratio greater than 0.5 were considered as metastatic.

RESULTSPreoperative neck ultrasonography revealed the enlarged lymph nodes in 16 patients, but only in 5 (31%) cases the nodes were palpable. Among them 9 were classified as metastatic (cM(1-LN)), including 4 patients with palpable nodes. In 5 cM(1-LN) patients surgical intervention was canceled and the remaining 37 patients underwent trans-thoracic esophagectomy. Cervical node metastasis (pM(1-LN)) was confirmed pathologically in 6 surgical patients, 4 with tumors invading the adventitia (pT3) and the other 2 into the surrounding structure (pT(4)) (pT(1), pT(2) vs. pT(3), pT(4), P = 0.020). All 6 pM(1-LN) patients had concomitant mediastinal node metastasis and 4 of them had upper abdominal node metastasis. Statistically significant relationship was detected between cervical and abdominal nodal status (r = 0.536, P = 0.007). In comparison with the results of pathological examination and treatment response, the accuracy and sensitivity were 81% and 95% (P = 0.043), 36% and 82% (P = 0.081), respectively, for palpation and ultrasonography. Five out of 39 (13%) patients had their therapy changed due to ultrasonographic findings.

CONCLUSIONSNeck ultrasonography for cervical lymphadenopathy is of high sensitivity and accuracy, which plays an important role in the preoperative evaluation and therapeutic decision-making.

Adult ; Aged ; Carcinoma, Squamous Cell ; diagnostic imaging ; secondary ; surgery ; Esophageal Neoplasms ; pathology ; surgery ; Female ; Head and Neck Neoplasms ; diagnostic imaging ; secondary ; surgery ; Humans ; Lymph Node Excision ; methods ; Lymph Nodes ; diagnostic imaging ; Lymphatic Metastasis ; diagnosis ; Male ; Middle Aged ; Neck ; diagnostic imaging ; Sensitivity and Specificity ; Ultrasonography

OBJECTIVETo evaluate and compare the results of vagina vasorum lymph node dissection (VLND) and non-vagina vasorum lymph node dissection (NVLND) in patients with gastric cancer after radical operation.

METHODSA total of 759 cases of evaluable patients with gastric cancer, operated from June 1994 to April 2005, were retrospectively analyzed. Of which, 627 cases underwent radical gastrectomy: 215 patients received VLND and 412 cases received NVLND. The operation time, intraoperative blood loss, operative complications and survival rate were recorded and compared between the two groups.

RESULTSThe 5- and 10-year overall accumulative survival rates of VLND group and NVLND group were 55.4% and 51.2%, 39.1%and 36.8%, respectively (all P < 0.05). No significant differences in intraoperative blood transfusion (loss), operation time, operative complication rate was found between the two groups. The 5- and 10-year accumulative survival in patients with a tumor of phase N0-N2, T2-T4, Ib-IV in VLND groups were all significant higher than those in NVLND group.

CONCLUSIONSVLND is a safe technique in advanced gastric cancer, it dose not prolong operation time or increase operative complications but improves survival.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Lymph Node Excision ; methods ; Lymphatic Metastasis ; Male ; Middle Aged ; Retrospective Studies ; Stomach Neoplasms ; pathology ; surgery ; Survival Analysis ; Treatment Outcome ; Young Adult

OBJECTIVETo compare the clinicopathological characters and operative prognosis of gastric cancer complicated with Krukenberg tumor and with pelvic peritoneal dissemination.

METHODSThirty-nine female cases of gastric carcinoma with pelvic metastasis were treated operated on between August 1994 and March 2006. Among them, 18 cases were complicated with Krukenberg tumor and 21 cases with pelvic peritoneal dissemination. The clinicopathological characters in the two groups were recorded and compared and the operative prognosis were analyzed.

RESULTSThere was no significant difference in age, tumor location and size, hepatic metastasis, organic encroachment, infiltration degree, positive lymph nodes, differentiated degree, tissue typing, Borrmann typing, value of carcinoembryonic antigen between the two groups (P > 0.05). The rate of P3 (peritoneal dissemination) in the cases of Krukenberg tumor (44.4%) was significantly lower than that in pelvic peritoneal dissemination group (85.7%) (P < 0.01), whereas the focal resection rate (77.8%) and multi-organ dissection rate (55.6%) were significantly higher than in pelvic peritoneal dissemination (38.0%, 23.8%) (P < 0.05). The mean survival of all cases was 12.6 months. The mean survival in the patients with Krukenberg tumor and pelvic peritoneal dissemination was 20.5, 15.0 months, respectively (P < 0.05). The mean survival of total focal resection, palliative focal resection, non-focal resection was 19.9, 12.5 and 5.7 months, respectively (P < 0.01). Non-focal resection, pelvic peritoneal dissemination, P3 of peritoneal implantation, hepatic metastasis, organic encroachment, total gastric cancer were unfavorable prognosis factors for all cases.

CONCLUSIONSCompared with pelvic peritoneal dissemination, the gastric cancer with Krukenberg tumor is associated with more limited peritoneal dissemination, higher resection rate and better prognosis. Focal resection can improve the prognosis.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Krukenberg Tumor ; pathology ; surgery ; Middle Aged ; Neoplasm Seeding ; Pelvic Neoplasms ; pathology ; secretion ; surgery ; Peritoneal Neoplasms ; pathology ; secondary ; surgery ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; pathology ; surgery

OBJECTIVETo evaluate the relationship between clinicopathologic features and prognosis of colorectal cancer after surgical treatment.

METHODSThe clinical characteristics, pathologic features and survival rate of 761 patients with colorectal cancer after surgical treatment were univariately and multivariately analyzed.

RESULTSThe overall 3- and 5-year survival rates of patients with colorectal cancer after surgical treatment were 62.9% and 60.7% with a median survival of 1,825 days. The factors of gross findings, degree of differentiation, infiltration, nodal and distant metastasis and neoplastic intestinal obstruction influenced the survival rate by univariate analysis. The factors of Dukes stage, gross tumor configuration, intramural spread and differentiation degree were available independent prognostic factors through multivariate analysis.

CONCLUSIONDukes stage, as the most important available independent prognostic factor (P < 0.0005), is able to assess the postoperative survival.

Adult ; Aged ; Colorectal Neoplasms ; diagnosis ; mortality ; pathology ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Regression Analysis ; Survival Rate

OBJECTIVETo summarize the experience and short-term clinical outcomes of hand-assisted laparoscopic surgery (HALS) in sphincter-preserving surgery for low and ultralow rectal cancer.

METHODSData of 49 patients with rectal cancer who underwent HALS for low or ultralow anterior resection between January 2010 and January 2011 were analyzed retrospectively.

RESULTSThe proximal resection margin was (14.3±6.9) cm and the distal margin was(4.3±1.9) cm. The mean operative time was(128.3±70.9) min. On postoperative macroscopic evaluation, the mesorectum was intact in 42 cases, nearly intact in 7 cases. The circumferential resection margin was more than 2 mm in 42 cases, and less than 2 mm in 7 cases. Forty-six patients underwent R0 resection, and 3 cases underwent R1 resection. The median retrieved lymph node (LN) was 16.20±9.23, and the median positive LN was 1.12±2.19. Postoperative pathological examination showed TNM stage was I( in 12 patients, II(A in 18, II(B in 1, III(A in 2, III(B in 8, III(C in 5, IIII( in 3. The median postoperative hospital stay was (6.25±3.87) d. There were no anastomotic leakage, ileus, intra-abdominal or anastomotic bleeding. There were two wound infections.

CONCLUSIONLow and ultralow anterior resection for rectal cancer using HALS approach is safe and feasible with favorable short-term outcome.

Adult ; Aged ; Aged, 80 and over ; Anal Canal ; surgery ; Female ; Hand-Assisted Laparoscopy ; methods ; Humans ; Male ; Middle Aged ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Treatment Outcome