Objective To investigate the short-term outcomes and oncological safety of laparoscopy resection for colorectal cancer. Methods Between January 2004 and March 2009, 35 patients with colorectal cancer underwent laparoscopic-assisted surgery in our hospital, among which 32 underwent radical resection, 1 underwent laparoscopic exploration, and 2 were converted to open surgery. These patients were allocated in the laparoscopic group. Same numbers of patients who underwent conventional open surgery during the same period of time were identified and allocated in the open group. Short-term data, including surgical time, intra-operative blood loss, intra-operative blood transfusion, length of incision, histopathological data, post-operative complications and post-operative functions, were collected and compared between the two groups. Results A total of 67 patients were enrolled (32 in both laparoscopy and open groups). The other 3 cases were analyzed separately (1 underwent laparoscopic exploration and 2 converted to open surgery). The two groups were well balanced as to age, gender, and TNM staging and location of tumour. Histopathologically, the laparoscopic approach was equal to conventional approach as regard to resection margin (distal margin, 5 cm vs 5 cm, P=0.664) and lymph node yield (7 vs 8, P=0.228). This study also showed a longer surgical time (250 min vs 180 min, P=0.006), but shorter length of incision (10 cm vs 20 cm, P<0.001), less demand of intra-operative blood transfusion (1 case vs 10 cases, P=0.003), reduced use of analgesics (12 cases vs 25 cases, P=0.004), shorter post-operative stay (9.5 days vs 11 days, P=0.008) and earlier recovery of bowel function of the laparoscopic group. There was no statistical difference of intra-operative blood loss (200 mL vs 200 mL, P=0.098), incidence of post-operative complications (8 cases vs 6 cases, P=0.545) and volume of post-operative negative drainage (507.5 mL vs 669.0 mL, P=0.475) between the two groups. Conclusions Though limited by a relatively small sample size, our study showed that laparoscopy approach for colorectal cancer is equal to open approach in terms of oncological safety and short-term outcome.

Gastrointestinal stromal tumor(GIST) ,a kind of rare tumor,takes 1%～3% of all tumors in digestive tract,but are the most common in mesenehymal neoplasm.At present,the primal treatment of GIST is surgical operation,standard and rationality of surgery is the significant fatter that affects its curative effect.While imatinib is the main therapeutic tool for GIST that can' t benn resected or recurrence after operation.There is no definite circumscription between optimum and malignancy,there are many factors that influence the prognosis of GIST.We commonly apply Fletcher grading to evaluate the risk of GIST.

Colorectal cancer is one of the malignant tumors that endangers human health. Nowadays the surgery is the primary therapy for colorectal cancer. Laparescopic surgery has developped for more than ten years. It consolidates its position in the field of colorectal surgery gradually. We now make a comparison of laparoscopic surgery and open surgery about the safety, the pathophysiological influence and the effective-ness, etc, in order to discuss the value of the laparoscopic surgery in the therapy of colorectal cancer.

After receiving radical resection of primary rectal cancer,about 4％ to 30％ patients would occur local recurrence.Diagnosis of local recurrence relies on postoperative follow-up,physical examination,tumor markers and imageological examination.For the local recurrent patients,conservative therapeutic regimen had been popular in the past days with poor prognosis and quality of life.Nowadays multimodality treatment with radical resurgery combined with chemoradiotherapy and IORT has been taking the main part in the management of local recurrence.The choice of surgery depends on the site of recurrence and invasion situation inside the pelvic cavity.The aim of the radical reoperation is R0 resection because it leads to an optimistic prognosis.Previously irradiated patients are relatively safe after receiving median-dose reirradiation.For the cases whose recurrence are unavailable for radical resection,palliative operation and chemoradiotherapy may be the wise choice to relieve their symptoms and improve the quality of life.

There is persuasive clinical and experimental evidence that macrophages promote cancer initiation and malignant progression. The aggregation of macrophages indicates poor prognosis of tumor associated diseases. During tumor initiation, macrophages create an inflammatory environment that is mutagenic to cells and promotes cell growth; as tumors progressing, macrophages create premetastatic niche for the arriving tumor cells at premetastatic sites ; then macrophages provide critical nutrients for these initial metastatic tumor cells.Along with these great achievements in research of macrophage, it is believed that several novel directions of tumor therapy surely occur in the future.

Apoptosis is great advancement in sphere of biology,it is characteristic death form at physiological state.Rencent researchs discover that apoptosis take important role in transplantation immunity.That graft is rejected is the major obstruction in transplantation.Allogeneic transplantation rejection is because of immune response that is mediated by T lymphocyte and aimed directly at allogenic antigen.Apoptosis of activated T lymphocyte through some pathways can induce immune tolerance.Some immune suppressant produce effect just by cell apoptosis.This review mainly presents recent advance in transplantation tolerance induced by apoptosis of T lymphocyte.

Gastrointestinal stromal tumors are rare tumors of alimentary tract and originated from the interstitial Cajal cells,with acquired mutation of KIT(CD117).Surgery is the main therapy for resectable tumors,while imatinib,a small-molecule inhibitor of receptor of tyrosine kinase,plays an important role in treating metastatic and recurrent tumors.

ObjectivesTo discuss the safety of surgical treatment and the feasibility of laparoscopic surgery for the elderly patients with gastric cancer. MethodsThe clinical and pathological materials of 104 elderly patients(65 years old or above) undergone surgical treatments retrospectively were analyzed,in order to analysis the postoperative complication incidence and the short-term outcomes in different age groups and different surgical pattern groups.ResultsThere were more preoperative comorbidities in ≥75 years old group than in ＜75 years old group(especially hypertension and diabetes),however,the incidence of postoperative complications was not significantly different.There was no difference of preoperative comorbidities, postoperative complications, surgical time or the amouts of blood loss during surgery between the laparoscopic and the traditional surgical groups,while the laparoscopic groups had short period of postoperative hospitalizing and earlier orally intake of fluid diet. There was also no difference of pathological results.ConclusionThe elderly patients with gastric cancer should have surgical treatments if the conditions are permitted, and the areas of dissection should be standard as far as possible. The old patient undergone laparoscopic surgery may have a shorter hospitalized period after operation, because their recovery of bowel function is more quickly.

Objective o explore intraperitoneal human fluorine safe release chemotherapy after radical surgery on the prognosis of patients with gastric cancer.Methods One hundred gastric cancer patients who were treated in Jinshan Hospital Affiliated to Fudan University from June 2011 to September 2012 were selected and divided into observation groups (gastrectomy + Human fluorine An chemotherapy) and control group (simple gastrectomy) according to a random number table method.Biochemical index before treatment and 7 d after treatment,complication occurrence and survival rate of two groups were compared.Results There were no statistically significant differences in terms of WBC,PLT,IBIL,Cr and other biochemical markers before and after treatment between the two groups (P＞0.05).There were statistically significant differences in terms of chemical peritonitis,intestinal obstruction,fistula,intestinal perforation and other complications between two groups (P＞0.05).The 6 months,1 year,2-year survival rates of control group were 87.50％,80.00％,62.50％,of observation group were 96.67％,90.00％,78.33％,the differences were significant (x2 =6.108,8.796,4.579;P=0.014,0.003,0.032).The 6 months,1 year,2-year free survival rates of control group were 75.00％,55.00％,35.00％,of observation group were 93.33％,86.67％,70.00％,the differences were significant (x2 =3.902,6.635,5.203;P =0.045,0.010,0.021).Conclusion Intraoperative intraperitoneal chemotherapy sustained radical surgery in patients with no adverse effects on the stomach,can effectively improve the postoperative survival rates,worthy of promotion.

The PIK3CA gene codes p100α,the catalytic subunit of phosphatidylinositol 3-kinase (PI3K) and is involved in the initiating the PI3K/AKT pathway.PIK3CA plays its biological roles through.downstream PI3K pathway. PIK3CA gene mutants can be detected in many kinds of tumors. The mutant PIK3CA gene can abnormally activate PI3K pathway,leading to the abnormal cell cycle,decreased cell adhesion,down regulated apoptosis and neovascularization,and then promotes tumor genesis and development.Recent researches have found that mutant PIK3CA gene is closely correlated with the genesis,development,differentiation,metastasis and drug resistance of colorectal cancer.Research of PIK3CA in colorectal cancer may provide significant evidence for the early diagnosis,gene screen,therapeutic regimen making,recurrence and follow up.