OBJECTIVETo investigate the safety and efficacy of fast track surgery (FTS) management in gastric cancer undergoing D2 gastrectomy.

METHODSEighty gastric cancer patients undergoing D2 gastrectomy were recruited prospectively. Patients were assigned to receive FTS management (n = 40) or conventional perioperative care (n = 40). The FTS care included shorten preoperative fasting time, no nasogastric decompressing tubes and abdominal drainage placed, early postoperative oral feeding, multimodal analgesia, and early mobilisation. The length of postoperative hospital stay, medical cost, nutritional status, gut function, and postoperative complications in the two groups were recorded and compared.

RESULTSFTS group was associated with a significantly shorter postoperative hospital stay compared with conventional care group [(5.6 +/- 1.3) d vs. (9.4 +/- 1.9) d, P < 0.05]. Medical cost was less [(18 620 +/- 2360) Yuan vs. (20 370 +/- 2440) Yuan, P < 0.05] and duration of intravenous infusion [(3.5 +/- 1.4) d vs. (5.8 +/- 1.9) d, P < 0.05] was also shorter. First passage of flatus was earlier in FTS group than in conventional care group [(4.3 +/- 0.4) d vs. (5.5 +/- 0.9) d, P < 0.05]. Loss of body weight in the postoperative period was less in FTS group [(3.2 +/- 0.8) kg vs. (4.3 +/- 1.6) kg, P < 0.05]. There was no difference in morbidity or mortality between the two groups.

CONCLUSIONFTS in D2 gastrectomy is safe and efficient, and it can shorten postoperative hospital stay and hasten return of gut function.

Adult ; Aged ; Female ; Follow-Up Studies ; Gastrectomy ; methods ; Humans ; Length of Stay ; Male ; Middle Aged ; Perioperative Care ; Postoperative Complications ; prevention & control ; Prospective Studies ; Stomach Neoplasms ; surgery ; Treatment Outcome

Objective To observe the influence of targeted gene VEGF silencing of bladder cancer cell line T 24 on differentiation, maturation and function of dendritic cells .Methods A lentiviral vector named LV-VEGFA-RNAi ( experimental group ) for gene silencing targeting VEGF and a lentiviral vector named LV-CON ( negative control group ) without any valid sequences were constructed .The blank control group accepted no intervention measures . The expression of VEGF's mRNA and protein of T24 cells from each group were detected by RT-PCR and ELISA respectively .Then the immature DCs were co-cultured respectively with the supernatant of all the groups as men-tioned above.CD1a, CD83 as the maturation marker and CD86 as the immunity marker of the DCs were detected by flow cytometry.Results The expression of VEGF's mRNA and protein of T24 cells in the experimental group were obviously inhibited ( P<0.05 ) as compared with that in the negative control group and the blank control group.DCs of the experimental group had an obviously increased ( P<0.05 ) expression of CD1a, CD83 and CD86 compared with the negative control group and the blank control group .Conclusions Targeted gene VEGF silencing by RNAi has advantages to the growth and immunity of DCs , which may strengthen the anti-tumor ca-pacity of the DCs by repairing their damaged immune monitoring function .