Objective To investigate the relationship between CD40,Ki-67,and CD34 expressions and clinical significance of gastric cancer.Methods The expressions of CD40,Ki-67,and CD34 were detected by immunohistochemistry in 80 cases of gastric carcinomas and adjacent mucosas.Results The high expression of CD40 was detected in 36.3％ (29/80) cases of gastric cancer tissues,and Ki-67 was 53.8％ (43/80).The high expression of CD40 was related to lymph node metastasis,depth of invasion,and the patient's prognosis.The high expression of Ki-67 was related to histological differentiation,depth of invasion,vascular invasion,and lymph node metastasis (P ＜ 0.05).Expression of CD40 was positively related to Ki-67 and CD34 in gastric carcinomas (P ＜ 0.05).Conclusions The high expressions of CD40,Ki-67,and CD34 in gastric cancers are related to the tumor proliferation,tumor angiogenesis,and the prognosis of patients.

Objective To research the expressions of Sirtuin 1 (SIRT1) in colorectal cancer and normal tissue and the relationship with clinicopathologic features.Methods The expression levels of SIRT1 mRNA and protein were detected respectively by quantitative real-time reverse transcriptase PCR (RT-QPCR) and immunohistochemistry (IHC) in 45 cases of colorectal carcinoma and 30 cases of normal mucous membrane tissue,and the relationships between the expression status and clinicopathologic features were analyzed.Results In colorectal carcinoma,the expression of SIRT1 mRNA were higher than that in control group [M(QR):2.488(3.447) vs.1.563(2.867),Z =-2.304,P ＜0.05],so was the protein level (71.1％ vs.43.3％,x2 =5.787,P =0.029).The expression of SIRTI was associated with lymph node metastasis (RT-QPCR:Z =-2.160,P =0.031;IHC:P =0.043),neoplasm stages (RT-QPCR:Z =-2.411,P =0.016;IHC:P =0.008),and might associated with the tissue differentiation (RT-QPCR:x2 =10.864,P =0.004;IHC:P =0.322).On the other hand,no significant differences were observed regarding age,sex,tumor size,gross type,depth of invasion,tumor site and distant metastasis.Conclusion The expression of SIRT1 in colorectal cancer is higher than that in control group,the high level of SIRT1 is related to the tumorigenesis and progression of colorectal cancer as well as correlated with prognosis in colorectal cancer.

Objective: To analyze the related factors of postoperative complications after laparoscopic assisted D2 radical resection for advanced gastric cancer. Methods: From August 2015 to July 2017, 80 patients with advanced gastric cancer admitted to the First Hospital of Jiaxing were selected.All the patients were treated with laparoscopic-assisted D2 radical resection, and the risk factors related to postoperative complications were analyzed by logistic regression analysis model. Results: There were 33 cases (41.25%) with postoperative system complications, 19 cases (23.75%) with complications of level Ⅱ and above; 15 cases (18.75%) with postoperative local complications, among them 12 cases (15.00%) appeared level Ⅱ and above local complications.The number of concomitant diseases and age were related risk factors for systemic complications in patients with advanced gastric cancer after laparoscopic D2 radical resection (OR=1.982, 95%CI: 2.183-34.405, OR=6.587, 95%CI: 1.738-23.495, all P<0.05). The preoperative neoadjuvant chemotherapy, reconstruction method and age were the risk factors for local complications in patients with advanced gastric cancer after laparoscopic D2 radical resection (OR=8.273, 95%CI: 4.982-35.394, OR=12.304, 95%CI: 2.384-88.921, OR=6.365, 95%CI: 2.183-21.384, all P<0.05). Conclusion Treatment of advanced gastric cancer patients with laparoscopic D2 radical mastectomy, attention should be paid to control the patients' age, preoperative neoadjuvant chemotherapy, reconstruction mode, associated disease and other related risk factors.In order to ensure the safety of patients and to avoid postoperative complications.

Objective:To explore the application effect of adjustable body position protection belt in patients undergoing not painless colonoscopy.Methods:A randomized and controlled trial was used, a total of 180 patients who planned to undergo not painless colonoscopy in the Endoscopy center, the First Hospital of Jiaxing from January to October 2022 were selected as the research objects. They were divided into the experimental group and the control group by the random number table method, with 90 cases in each group. The control group adopted the traditional method of colonoscopy body position placement, and on this basis, the experimental group used the adjustable body position protection belt to assist the patient body position placement. The maintenance rate of body position in colonoscopy, the cecal intubation time, the degree of intraoperative pain and the acceptance rate of re-examinationunder the same operating doctor and nurse were compared between the two groups.Results:The maintenance rate of body position in colonoscopy was 97.78%(88/90) in the experimental group and 58.89%(53/90) in the control group, the difference was statistically significant ( χ2 = 37.84, P<0.05). The cecal intubation time was (7.84 ± 4.39) min in the experimental group and (10.13 ± 5.85) min in the control group, the difference was statistically significant ( t = 2.98, P<0.05). The intraoperative pain score was 2.96 ± 1.39 in the experimental group and 4.28 ± 1.42 in the control group, the difference was statistically significant ( t = 6.31, P<0.05). The acceptance rate for re-colonoscopy was 88.89%(80/90) in the experimental group and 72.22%(65/90) in the control group, the difference was statistically significant ( χ2 = 7.98, P<0.05). Conclusions:Use of adjustable body position protection belt to assist body position placement before the patients undergoing not painless colonoscopy, it can improve the maintenance rate of body position during not painless colonoscopy, shorten the time of cecal intubation, reduce the intraoperative pain degree, and patients also have a higher willingness to undergo colonoscopy again.