Objective To make a better understanding of the molecular mechanisms involved in recurrence and metastasis of the hepatocellular carcinoma (HCC), some invasion related oncogenes, and growth factors have been investigated. Methods The studies were seperately carried out, the results of which were summarized in this article with relation to tumor size and invasiveness of HCC.Results The aberration rates of p53 and CDKN2 in HCC were 45.9% and 36.4% respectively, which were higher in invasive HCC compared with non-invasive HCC. H-ras expression was positive in 29.3% of HCC, which was associated with recurrence and extrahepatic metastasis of HCC. Intralesional injection of H-ras antisense gene markedly inhibited the tumor growth and metastasis of HCC in nude mice. The positive rates of transforming growth factor (TGF)-alpha, epidermal growth factor receptor (EGFR) and c-erbB-2 were 45.7%, 47.1% and 92.3% respectively. The expression of EGFR was closely related to TGF-alpha, which was related to HCC recurrence. But no obvious difference of TGF-alpha or c-erbB-2 expression was found between HCC with and without recurrence, or with and without extrahepatic metastasis. Expression of nm23 / tissue inhibitor of metalloproteinase (TIMP)-2 was positively associated with the prognosis of HCC patients (Log-rank, P<0.001). The alterative rates of above-mentioned genes and growth factors in small HCC were slightly lower than that in large ones, but no significant difference was shown except the p53 mutation.Conclusions The p53/CDKN2 mutation, overexpression of H-ras/EGFR, were associated with the invasiveness and recurrence of HCC. H-ras antisense gene might be of potential implication in the control of HCC recurrence and metastasis. Expression of nm23/TIMP-2 was closely related to the prognosis of HCC patients. Biological characteristics remained critical points to the prognosis even in small HCC.

Objective To investigate the clinical significance of nasointestinal tube placement in facilitating recovery after Roux-en-Y gastric bypass surgery.Methods The clinical data of patients with gastric neoplasms who underwent Roux-en-Y gastric bypass surgery were analyzed retrospectively.28 patients who had nasointestinal tube inserted were compared to 33 patients who didn't.Indicators for nutrition [body mass index (BMI),Nutrition Risk Screening 2002 (NRS 2002) score,serum total protein (TP),albumin (Alb) and prealbumin] and prognosis (bowel sound and anal exhaust or defecation time,anastomotic leakage rate,abdominal abscess or infection,incision infection or delayed healing,postoperative pulmonary infection rate,postoperative hospitalization time,unplanned reoperation or readmission rate) were analyzed.Results There was no statistically significant difference (all P＞0.05) between the two groups at baseline (sex,age,BMI,NRS 2002 score,operation time and blood loss during operation).The two groups had no statistically significant difference (all P＞0.05) in TP,Alb and prealbumin before the operation or at day 2 or day 6 after the operation.There were significant difference between the two groups in partial indicators for nutrition and prognosis:prealbumin at sixth days after operation (t =-2.05,P =0.045),bowel sound (t =7.71,P =0.000),anal exhaust or defecation time (t=4.52,P=0.000),postoperative hospitalization time (t=4.43,P=0.000),incision infection or delayed healing rate (x2 =4.78,P =0.029).No statistically significant difference (all P＞ 0.05) was found in anastomotic leakage rate,abdominal abscess or infection rate,postoperative pulmonary infection rate,and unplanned reoperation and readmission rate (x2=1.94,P=0.164).There was significant difference (Fisher,P =0.029) between patients aged 70 or above in the two groups in terms of postoperative pulmonary infection rate.Conclusions Enteral nutrition via nasointestinal tube after Roux-en-Y operation in patients with gastric neoplasms can promote protein synthesis,facilitate recovery of intestinal function,shorten hospitalization time and accelerate patient recovery.However,extra caution is needed in patients aged 70 or above,and early extubation should be considered based on the lung conditions of these patients.