Gastric cancer and esophageal cancer are the top ranked malignant tumors of the upper gastrointestinal tract in China, and the incidence of adenocarcinoma of esophagogastric junction (AEG) has been on the rise in recent years. Currently, surgery is the main treatment strategy for AEG, but the surgical approach and the path of digestive tract reconstruction are still contro-versial. The digestive tract reconstruction after AEG surgery include traditional total gastrectomy + Roux-en-Y reconstruction or proximal gastrectomy + esophageal gastric-tube reconstruction/double-tract reconstruction/double-flap technique reconstruction. With the development of surgery, esophageal gastric-tube reconstruction has become a common digestive tract reconstruction modality after AEG compared with traditional esophagojejunal reconstruction of total gastrectomy, which can reduce the incidence of postoperative complications such as anastomotic leakage, reflux esophagitis, anasto-motic stricture, and patients' malnutrition in the long term. In order to further reduce postoperative complications, the application of new techniques and improvement of surgical methods have become the focus of research in recent years. The authors review the history of the development of esopha-geal gastric-tube reconstruction and provides an overview of the current status of esophageal gastric-tube reconstruction, reconstruction pathway, anastomotic position and modality, and research on the reduction of postoperative complications.

Gastric cancer and esophageal cancer are the top ranked malignant tumors of the upper gastrointestinal tract in China, and the incidence of adenocarcinoma of esophagogastric junction (AEG) has been on the rise in recent years. Currently, surgery is the main treatment strategy for AEG, but the surgical approach and the path of digestive tract reconstruction are still contro-versial. The digestive tract reconstruction after AEG surgery include traditional total gastrectomy + Roux-en-Y reconstruction or proximal gastrectomy + esophageal gastric-tube reconstruction/double-tract reconstruction/double-flap technique reconstruction. With the development of surgery, esophageal gastric-tube reconstruction has become a common digestive tract reconstruction modality after AEG compared with traditional esophagojejunal reconstruction of total gastrectomy, which can reduce the incidence of postoperative complications such as anastomotic leakage, reflux esophagitis, anasto-motic stricture, and patients' malnutrition in the long term. In order to further reduce postoperative complications, the application of new techniques and improvement of surgical methods have become the focus of research in recent years. The authors review the history of the development of esopha-geal gastric-tube reconstruction and provides an overview of the current status of esophageal gastric-tube reconstruction, reconstruction pathway, anastomotic position and modality, and research on the reduction of postoperative complications.

To observe the effect of high-mobility group box 1 (HMGB1) on autophagy and chemotherapy resistance in human leukemiacell line (K562) cells, and to explore the underlying mechanisms.
 Methods: The K562 cells were cultured in vitro and divided into 6 groups: a chemotherapeutic group, a chemotherapeutic control group, a HMGB1 preconditioning group, a HMGB1 preconditioning control group, a HMGB1 siRNA group and a siRNA control group. The chemotherapeutic group was further divided into a vincristine (VCR) group, an etoposide (VP-16) group, a cytosine arabinoside (Ara-C) group, a adriamycin (ADM) group and a arsenic trioxide (As2O3) group. The cell activity was evaluated by cell counting kit-8. The protein levels of HMGB1, microtubule-associate protein1light chain3 (LC3), AMP-activated protein kinase (AMPK) and mammalian target of rapamycin (m-TOR) were determined by Western blotting. The level of serum HMGB1 was evaluated by enzyme-linked immunosorbent assay (ELISA). The autophagy was examined by monodansylcadaverine staining and observed under transmission electron microscopy.
 Results: Compared with the control group, the cell activity was significantly decreased and the level of serum HMGB1 was significantly increased in the chemotherapeutic (VCR, VP-16, Ara-C, ADM and As2O3) groups (all P<0.05). Compared with the control group, the cell activity and the level of serum HMGB1 were significantly increased in the HMGB1 preconditioning group (both P<0.05). Compared with the siRNA control group, the cell activity and the level of serum HMGB1 were significantly decreased in the HMGB1 siRNA group (both P<0.05). Compared with the control group, the expression of LC3-II and the formation of autophagic bodies were increased in the HMGB1 preconditioning group (both P<0.05), the p-AMPK expression was increased and p-mTOR expression was decreased (both P<0.05).
 Conclusion: HMGB1 can increase the autophagy and promote chemotherapy resistance through the pathway of AMPK/m-TOR in K562 cells.
AMP-Activated Protein Kinases ; genetics ; physiology ; Arsenic Trioxide ; Arsenicals ; Autophagy ; genetics ; Cytarabine ; Doxorubicin ; Drug Resistance, Neoplasm ; genetics ; physiology ; Etoposide ; HMGB1 Protein ; genetics ; physiology ; Humans ; K562 Cells ; physiology ; Microtubule-Associated Proteins ; Oxides ; RNA, Small Interfering ; Signal Transduction ; TOR Serine-Threonine Kinases ; genetics ; physiology ; Vincristine

BACKGROUND: Using color Doppler ultrasonography, renal graft size, appearance, structure, and blood flow distribution can be observed. Through the use of blood flow display technique, blood flow perfusion of renal graft can be accurately observed to assist diagnosis and differential diagnosis of complications following renal transplantation. OBJECTIVE: To observe the hemodynamic characteristics during different periods of acute renal transplant rejection, summarize its specific manifestations through analyzing different reaction of two dimensional and color Doppler flow imaging (CDFI) during renal transplantation in order to get valuable index on acute rejection of renal transplantation.DESIGN, TIME AND SETTING: Comparative observation was performed at the Jinan University and First Hospital of Shenzhen University between January 2003 and January 2007.PARTICIPANTS: A total of 299 patients undergoing renal transplantation were divided into normal allograft group (n=236) and acute rejection group (n=63) according to renal allograft function.METHODS: The systolic peak flow rate, end-diastolic flow rate, mean flow rate, pulsatility index and resistance index of main renal artery and arcuate artery in patients of two groups were compared. MAIN OUTCOME MEASURES: Renal allograft arterial inner diameter and hemodynamics of two groups.RESULTS: Compared with normal allograft group, the blood flow perfusion was reduced at acute rejection, which could not reach cortex margin, blood velocity was decreased at the diastolic phase, pulsatility index and resistance index were increased (P < 0.05). CONCLUSION: Color Doppler ultrasound, as a convenient, economical and noninvasive technique, provides the reliable evidences for the renal artery pulsatility index and resistance index in clinic, and also is valuable for the acute rejection early diagnosis of renal allograft.