Objective To investigate the surgical treatment and indications for primary lesion in patients with stage Ⅳ rectal cancer.nethods Clinical data of 118 patients with stage Ⅳ rectal cancer undergoing surgical treatment from January 1988 to December 2005 in Cancer Hospital of Chinese Academy of Medical Sciences were analyzed retrospectively using Statistical Package for the Social Sciences(Release 13.0,SPSS,Inc).Survival was estimated using the Kaplan-Meier method and compared using the log-rank test.Cox regression was used in multivariate analysis.Results One hundred and five of 118 patients received rectal primary lesion resection,including 16 cases with simultaneously metastatic tumor resection.13 of 118 patients received ostomy.The overall 5-year survival rate of the primary lesion resection group was 8.57%,the 5-year survival rate of the metastatic tumor resection group was 31.2%.The median survival in the primary lesion resection group and the ostomy group was 15 months and 13 months respectively(X2=0.736.P=0.778).Multivariate analysis showed that degree of differentiation of primary tumor,maximal diameter of liver metastasis and chemotherapy were the most important prognostic factor of the primary tumor resection group.Conclusion Simultaneous resection of primary and metastatic tumor can prolong suivival time of patients with resectable stage Ⅳ rectal cancer.

Objective To investigate the surgical treatment for patients with isolated recurrence and metastasis of colon cancer after primary curative-intent resection. Methods In this stuay,58 cases suffering from postoperative recurrence of colon cancer between the year of 1996-2005 were analyzed retrospectively.Data were analyzed using statistical package for the social sciences(Release 11.5,SPSS,Inc).x2 analysis was used to determine the related factors,survival analysis was estimated using the Kaplan-Meier method and compared using tlle log-rank test. Results In this reoperative group radical resection was achieved in 81%(47/58)cases,and palliative operation in 11 cases,with median survival time of 48 months and 12 months respectively(x2=12.30,P=0.0005). Conclusion Postoperative isolated recurrence and metastasis of colon cancer usually allows radical resection in most cases with favorable long-time survival.

Objective: To evaluate the surgical procedures and prognostic factors for colorectal carcinoma in patients aged over 70. Methods: We retrospectively reviewed 31 colorectal cancer patients aged over 70 seen in our hospital between January 1992 and December 2001.Treatment procedures and outcome of these patients were analyzed.Kaplan-Meier method was used for survival analysis and Cox regression analysis was conducted to analyze prognostic factors. Results: The median age of these patients was 74 years.The median follow-up period was 12 months.The postoperative complication rate was 22.6%.The thirty-days mortality was 6.5%.There were 28 cases of tubular adenocarcinoma (well differentiated in 5 cases,moderately differentiated in 16 cases,and poorkly differentiated in 7 cases)and 3 cases of mucinous adenocarcinoma.As to Dukes stage,there were 8 cases of B stage,9 cases of C stge,and 14 cases of D stage.The overall 5-year survival rate was 22.7%.The 5-year survival rate was 44.4%in the radical surgery group and 7.7%in the palliative surgery group.The median survival period of all patients was 12 months.The median survival period was 38 months in the radical surgery group and 9 months in the palliative surgery group.Univariate analysis showed that the predictors for survival were age,co-morbidity,preoperative serum CEA level,preoperative serum albumin concentration,duration of surgery,radical surgery,and cancer stage. Conclusion: Radical resection is a prerequisite for cure of colorectal cancer with obstruction in elderly patients.Age and preoperative serum albumin concentration are independent prognostic indicators.

Objective To evaluate the use of stapling anterior resection for rectal cancer. Methods Data of 1036 patients undergoing anterior resection for rectal cancer during 1983 to 2000 were reviewed retrospectively. Clinical results were compared statistically between patients who received stapling anastomosis (group A, n=652) and those did not (group B, n=384). Results The annual average stapler anterior resection increased from 5 cases per year (during 1983-1987) to 147 cases per year (1998-2000). The 0? Ⅰ? Ⅱ stage patients accounted for 53% in group A, and 62% in group B (P=0.004). There was higher percentage of patients in group A (66%) than in group B (39%) in which the distance from the lower edge of the tumor to anal verge was less than 8 cm (P

Objective To explore the outcome of children with mental retardation after 3 years follow-up. Methods The subjects were 237 children with mental retardation, selected from Beijing Municipal Investigation for Children with Disability in 2004. Gesell Developmental Schedule and Wechsler Intelligence Scale for Children were used to estimate the children's intelligence. Results After 3 years, the outcome showed non-mental retarded, 124 subjects (52.32%); mild mental retarded, 46; moderate mental retarded, 32; severe mental retarded, 16; profound mental retardation, 19. The related factors include urban/suburban (B=-0.622), parental knowledge about rehabilitation training (B=-0.470) and score of personal social interaction in Gesell Test(B=-0.040). Conclusion The outcomes of children with mental retardation are different. But some problems still exist even in non-mental retarded children.

Objective To investigate the suitable treatment of post operative anastomotic recurrence after anterior resection of rectal cancer and analyze the relationship between different kinds of therapy with prognosis. Methods The clinical data of 41 cases of local recurrent rectal cancer after anterior resection admitted in our hospital from 1999 to 2009 were analyzed retrospectively. The median survival time and survival rate were calculated by Life Tables method. The influence of different kinds of treatment to prognosis was evaluated by Kaplan-Meier method and the variability was analyzed by Log-rank method. P <0.01 means statistical significance. Results Thirty-three (80.5 %) of 41 patients were recurrent in the first 3 years and the median survival time was 23 months. Seventeen (41.5 %) of 41 patients underwent radical R0 resection. The median survival time of radical resection patients and non-radical resection ones were 49 months and 18 months, respectively, and the difference was significant (χ2=12.245, P=0.000). Thirty-one patients with radiotherapy and/or chemotherapy showed a statistically longer median survival time than the other 10 patients without these adjuvant treatment (39 months and 9 months, respectively) (χ2=17.533, P =0.000). Conclusion Most post operative anastomotic recurrent of rectal cancer cases occurs in the first 3 years after primary surgery. Radical resection, radiotherapy and chemotherapy can improve the prognosis.

Objective To investigate the clinical and pathologic characteristics of rectal gastrointestinal stromal tumor (GIST),and to evaluate the management of rectal GIST. Methods The clinical and pathological data of 19 cases of rectal GIST in recent 19 years were studied retrospectively. Results The diagnosis of 19 cases of rectal GIST were identified by surgery and pathology. Most rectal GISTs were spindle cell type. Immunohistochemical analysis displayed positive reactivity for CD117(100%) and CD34(73. 7% ). Graded by aggressive behavior there were 4 cases of high risk, 3 cases of intermediate risk, 5 cases of low risk and 7 cases of very low risk. Conclusions Rectal GISTs have a low prevalence and have no specific symptom in the early stage. Most tumors are low risk in aggressive behavior. It is difficult to get an accurate pathological diagnosis before operation and difficult to decide whether a sphincter preserving procedure is justified however trans-anal local resection is the therapy of choice for low risk submucosal rectal GIST(

ObjectiveTo study the outcome of 3 kinds of disabled children. Methods269 disabled children found in 2004 Beijing Disabled Children Sampling, which including 237 children with mental retarded disability, 57 with physical disability and 26 with psychological disability, were followed up in 2007. Results52.32% of mental disabled children, 8.77% of physical disabled, and 15.38% of psychological disabled children would not be seen as "disability" any longer. ConclusionThe disability before 6 years old is a kind of developmental disability, which may be recovery as development.

Objective To investigate the clinical significances of the expressions of Yes-associated protein 1 (YAP1) and collagen triple helix repeat containing 1 (CTHRC1) in triple-negative breast cancer (TNBC) and their correlations with expression of E-cadherin. Methods Immunohistochemical analysis (SABC) was performed to detect expressions of YAP1 and CTHRC1 in 73 specimens of TNBC and adjacent cancer tissues collected from patients in Dandong First Hospital from January 2006 to December 2017. The correlations between the expressions of YAP1 and CTHRC1 and clinicopathologic features and E-cadherin expression were analyzed. Results The expression rates of YAP1 and CTHRC1 in TNBC were 71.23％(52/73) and 79.45％(58/73), and 13.70％(10/73) and 27.40％(20/73) in adjacent cancer tissues, respectively, and the differences were statistically significant (χ2 values were 49.452 and 39.748, both P< 0.01). The expressions of YAP1 and CTHRC1 were related to tumor grade, clinical stage and lymphatic metastasis (YAP1:χ2 values were 10.244, 8.754, and 6.914, all P<0.05;CTHRC1:χ2 values were 12.582, 13.172, and 6.400, all P< 0.05), but they were not related to patient's age, tumor diameter and menopausal status (all P>0.05). The expressions of YAP1 and CTHRC1 were negatively correlated with expression of E-cadherin in TNBC (r=-0.371, P=0.001;r=-0.323, P=0.005). Conclusion YAP1 and CTHRC1 is closely related to the occurrence and development of TNBC and may participate in the invasion of TNBC through epithelial mesenchymal transition.

Objective To determine the influence of abiraterone acetate (AA) on neuroendocrine differentiation (NED) in metastatic castration-resistant prostate cancer (mCRPC) and the prognostic predicting value of the serum NED markers in mCRPC patients treated with AA.Methods We conducted an analysis in 115 chemotherapy-naive mCRPC patients who were treated with chemotherapy in Renji hospital from 2013 to 2017.The median age was 70,ranged from 65 to 76 years old.The median CgA,NSE and PSA levels were 101.1 ng/ml (78.5-150.0 ng/ml),13.4 ng/ml (10.5-17.6 ng/ml) and 38.8 ng/ml (11.2-123.2 ng/ml),respectively.Among them,48 cases were classified as the group without AA treatment.The other 67 cases were classified as group after AA failure.In group without AA treatment,the median CgA,NSE and PSA levels were 109.1 ng/ml(80-151.5 ng/ml);13.8 ng/ml(10.8-18.2 ng/ml) and 39.2 ng/ml (8.6-200 ng/ml),respectively.In group after AA failure,the median CgA,NSE and PSA levels were 105.4 ng/ml(78.8-175.5 ng/ml),13.8 ng/ml(10.8-17.6 ng/ml) and 39.0 ng/ml(8.4-219.8 ng/ml),respectively.In the group with serial evaluation of NED markers during AA treatment,the median serum CgA,NSE levels at baseline were 115.9 ng/ml(90.1-201.5 ng/ml),13.3 ng/ml (10.4-18.1 ng/ml),respectively.The endpoints were PSA PFS(progression-free survival) and radiographic PFS (rPFS).Results In 34 patients with serial evaluation,serum NED markers level in 19 patients increased after the failure of AA treatment.Median serum CgA and NSE levels were 115.9 ng/ml(90.1-201.5 ng/ml)and 13.25 ng/ml (10.37-18.14 ng/ml) at baseline.Median serum CgA and NSE levels were 129.6ng/ml (75.5-230.5 ng/ml) and 14.7 ng/ml (11.8-19.1 ng/ml) after 6 months treatment,respectively.The median serum CgA and NSE levels were 130.4 ng/ml (95.7-205.7 ng/ml) and 15.2 ng/ml(12.4-18.7 ng/ml) at the time of failure of AA treatment,respectively.There was no significant difference of NED markers between baseline and failure of AA treatment (P =0.243).In logistic univariate analysis,AA treatment and its duration were not independent factors influencing NED(P =0.30;P =0.52).Compared with the NED markers elevation group in the first 6 months of AA treatment and baseline supranormal NED markers group,the NED markers decline group(PSA PFS(17.1 vs.10.4 months,P ＜ 0.001) and rPFS (17.0 vs.10.4 months,P =0.003)) and baseline normal NED markers group(PSA PFS(14.1 vs.9.5 months,P =0.001) and rPFS(16.4 vs.10.5 months,P ＜ 0.001)) has a longer median PSA PFS and rPFS respectively.In multivariate Cox analysis,baseline NED markers level and NED markers variation during the first 6 months of AA treatment remained significant predictors of rPFS(P ＜ 0.05),and PSA-PFS (P ＜ 0.05).Conclusions We found there was heterogeneity in changes of NED markers in different mCRPC patients during AA treatment,and AA might not significantly lead to progression of NED of mCRPC in general.Serial CgA and NSE evaluation might help clinicians guide clinical treatment of mCRPC patients.Serum NED markers elevation during the first 6 months of AA treatment and elevated baseline NED markers levels indicated poor prognosis in mCRPC treated with AA.