1.Changes and significance of serum pro-gastrin-releasing peptide, squamous cell carcinoma-related antigen and carbohydrateantigen 72-4 in patients with gastric cancer
Fei HU ; Kechang ZHANG ; Feng CHEN ; Zhengxi TONG ; Xiu TU
Journal of Clinical Medicine in Practice 2024;28(12):46-50
Objective To investigate the changes and clinical significance of serum pro-gastrin-releasing peptide (ProGRP), squamous cell carcinoma-related antigen (SCC), and carbohydrate antigen 72-4 (CA72-4) levels in patients with gastric cancer. Methods A total of 68 patients with gastric cancer (gastric cancer group), 37 patients with benign gastric lesions (benign gastric lesion group), and 30 healthy subjects (non-gastric disease group) were selected as the study participants. Serum ProGRP, SCC, and CA72-4 levels were compared among the three groups on admission. The relationships of serum ProGRP, SCC, and CA72-4 levels with pathological parameters were analyzed in the gastric cancer group. Patients in the gastric cancer group were followed up for 24-month after discharge. Multivariate Logistic regression analysis was used to identify the influencing factors of prognosis in gastric cancer patients. Receiver operating characteristic (ROC) curves were plotted and the area under the curve (AUC) was calculated to analyze the predictive value of serum ProGRP, SCC, and CA72-4 for death during follow-up in gastric cancer patients. Results The serum levels of ProGRP, SCC, and CA72-4 in the gastric cancer group were higher than those in the benign gastric lesion group and the non-gastric disease group, and the serum levels of ProGRP and CA72-4 in the benign gastric lesion group were higher than those in the non-gastric disease group (
2.Short-term clinical efficacy of Kamikawa anastomosis and jejunal interposed double channel anastomosis in laparoscopic proximal gastrectomy
Wei WEI ; Linguang FAN ; Peng CUI ; Liang ZONG ; Dongyang SONG ; Jie WANG ; Kechang ZHANG ; Jinjie ZHANG ; Wenqing HU
Chinese Journal of Digestive Surgery 2022;21(9):1218-1224
Objective:To investigate the short-term clinical efficacy of Kamikawa anasto-mosis and jejunal interposed double channel anastomosis in laparoscopic proximal gastrectomy.Methods:The retrospective cohort study was conducted. The clinicopathological data of 68 patients with esophagogastric junctional tumors and upper gastric tumors who underwent laparoscopic proximal gastrectomy in two medical centers, including 63 cases in the Changzhi People's Hospital Affiliated to Changzhi Medical College and 5 cases in the Heji Hospital Affiliated to Changzhi Medical College, from March 2018 to December 2020 were collected. There were 57 males and 11 females, aged 62(range, 39?78)years. Of 68 patients, 35 patients undergoing Kamikawa anastomosis in laparoscopic proximal gastrectomy were allocated into Kamikawa group, and 33 patients under-going jejunal interposed double channel anastomosis in laparoscopic proximal gastrectomy were allocated into double channel group. Observation indicators: (1) intraoperative situations; (2) post-operative situations; (3) follow-up. The patients were followed up by outpatient examinations and telephone interview to detect the postoperative score of chew-wun wu special symptoms, post-operative reflux anastomotic esophagitis and anastomotic stenosis up to December 2021. Measure-ment data with normal distri-bution were represented as Mean±SD, and comparison between groups was performed by the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted by Mann-Whitney U test. Comparison of ordinal data was performed by nonparametric rank sum test. Count data were expressed as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability method. Results:(1) Intraoperative situations. All the 68 patients successfully under-went laparoscopic proximal gastrectomy combined with D 1+ lymph node dissection. The operation time and volume of intraoperative blood loss of the Kamikawa group were (5.15±0.31)hours and (89±11)mL, versus (4.21±0.11)hours and (142±20)mL of the double channel group, respectively, showing significant differences between the two groups ( t=2.81, ?2.34, P<0.05). The digestive tract reconstruction time and the number of lymph node dissection were (1.95±0.13)hours and 30.4±2.4 of the Kamikawa group, versus (1.69±0.76)hours and 28.0±2.4 of the double channel group, respectively, showing no significant difference between the two groups ( t=1.79, 0.73, P>0.05). (2) Postoperative situations. The time to postoperative first flatus, duration of drainage tube placement, duration of postoperative hospital stay were (3.03±0.12)days, (5.46±0.22)days, (13.00±0.50)days of the Kamikawa group, versus (4.42±0.21)days, (9.97±0.76)days, (16.46±0.92)days of the double channel group, showing significant differences in the above indicators between the two groups ( t=?5.80,?5.58, 3.40, P<0.05). Cases with or without drainage tube placement were 32 and 3 of the Kamikawa group, versus 33 and 0 of the double channel group, respectively, showing no significant difference between the two groups ( P>0.05). Cases with grade 1, grade 2, grade 3, grade 4 complica-tions of Clavien-Dindo classification were 31, 0, 4, 0 of the Kamikawa group, versus 27, 3, 1, 2 of the double channel group, respectively, showing a significant difference between the two groups ( Z=?6.28, P<0.05). Postoperative anastomotic stenous, reflux symptoms, anastomotic fistula, pancreatic fistula, pulmonary infection were found in 4, 2, 0, 0, 0 case of the Kamikawa group and 0, 1, 3, 1, 2 cases of the double channel group, respectively. There was no significant difference in the above indicators between the two groups ( P>0.05). There was no complication of incisional infection, abdominal hemorrhage, lymphatic fistula or gastroparesis in either group. Of the 4 patients with perioperative anastomotic stenosis in the Kamikawa group, 2 cases were improved after once gastroscopic balloon dilatation, 2 cases were improved after 4 times of gastro-scopic balloon dilatation. (3) Follow-up. All the 68 patients were followed up at postoperative 3, 6, 12 months. The scores of chew-wun wu special symptoms scale at postopertaive 12 months of the Kamikawa group and double channel group were 16.8±0.7 and 14.6±0.7, respectively, showing a significant difference between the two groups ( t=2.20, P<0.05). There were 2 cases of grade B reflux esophagitis and 1 case of grade B reflux esophagitis, respectively, showing no significant difference between the two groups ( P>0.05). There was no anastomotic stenosis occurred in either group. Conclusions:Laparos-copic proximal gastrectomy with Kamikawa anastomosis or jejunal interposed double channel anastomosis is safe and feasible for esophagogastric junction tumors and upper gastric tumors. The Kamikawa anastomosis has less volume of intraoperative blood loss, shorter time to postoperative first flatus, duration of drainage tube placement and postoperative hospital stay, higher quality of postoperative lfe.
3.Analysis of influencing factors and regularity of inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction
Kechang ZHANG ; Linguang FAN ; Jie WANG ; Yinhao YANG ; Maojie ZHANG ; Yong LIU ; Qisheng CHENG ; Jinjie ZHANG ; Peng CUI ; Liang ZONG ; Wei WEI ; Wenqing HU
Chinese Journal of Digestive Surgery 2022;21(10):1370-1375
Objective:To investigate the influencing factors and regularity of inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction (AEG).Methods:The retrospective case-control study was conducted. The clinicopatho-logical data of 185 Siewert type Ⅱ and Ⅲ AEG patients in two medical centers (113 cases in Changzhi People's Hospital Affiliated to Changzhi Medical College and 72 cases in Heji Hospital Affiliated to Changzhi Medical College) from January 2017 to January 2022 were collected. There were 143 males and 42 females, aged (64±8)years. Patients underwent radical resection of AEG combined with inferior mediastinal lymph node dissection. Observation indicators: (1) clinicopathological charac-teristics of Siewert type Ⅱ and Ⅲ AEG patients; (2) analysis of influencing factors for inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG; (3) regularity of inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were represented as absolute numbers or percentages, and comparsion between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the rank sum test. Univariate and multivariate analyses were conducted using the Logistic regression model. Results:(1) Clinicopathological characteristics of Siewert type Ⅱ and Ⅲ AEG patients. Pathologic staging as stage Ⅰ, Ⅱ, Ⅲ and Ⅳ, degree of tumor invasion as stage T1, T2, T3 and T4, length of esophageal invasion ≤1 cm, >1 cm and ≤2 cm, >2 cm and ≤3 cm, >3 cm and ≤4 cm were found in 30, 61, 75, 7, 3, 41, 79, 50, 101, 46, 18, 8 cases of the Siewert type Ⅱ and Ⅲ AEG patients without inferior mediastinal lymph node metastasis, respectively, versus 0, 2, 10, 0, 0, 0, 5, 7, 4, 3, 2, 3 cases of the Siewert type Ⅱ and Ⅲ AEG patients with inferior mediastinal lymph node metastasis, showing a significant differences between them ( Z=?2.21, ?2.49, ?2.22, P<0.05). (2) Analysis of influencing factors for inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG. Results of univariate analysis showed that pathological staging, depth of tumor invasion and length of esophageal invasion were related factors affecting inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG ( odds ratio=2.48, 3.26, 2.03, 95% confidence intervals as 1.02?6.01, 1.21?8.80, 1.18?3.51, P<0.05). Results of multivariate analysis showed that depth of tumor invasion and length of esophageal invasion were independent influening factors affecting inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG ( odds ratio=4.01, 2.26, 95% confidence interval as 1.35?11.96, 1.26?4.06, P<0.05). The inferior mediastinal lymph node metastasis probability of AEG patients with the length of esophageal invasion >3 cm and ≤4 cm was 9.47 times that of AEG patients with the length of esophageal invasion ≤1 cm. (3) Regularity of inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG. The number of inferior mediastinal lymph nodes including No.110, No.111 and No.112 dissected in 185 patients of Siewert type Ⅱ and Ⅲ AEG were 127, 50 and 27. The number of lymph nodes dissected and the number of metastatic lymph nodes in No.110 and No.111 of patients with length of esophageal invasion ≤1 cm, >1 cm and ≤2 cm, >2 cm and ≤3 cm, >3 cm and ≤4 cm were 69, 4, 42, 4, 4, 1, 12, 4 and 23, 0, 17, 0, 7, 2, 3, 0, respectively. There were significant differences in metastatic lymph nodes in No.110 and No.111 of patients with length of esophageal invasion ≤1 cm, >1 cm and ≤2 cm, >2 cm and ≤3 cm, >3 cm and ≤4 cm ( χ2=8.45, 7.30, P<0.05). Of the 185 patients of Siewert type Ⅱ and Ⅲ AEG, the ratio of cases with inferior mediastinal lymph nodes metastasis was 6.49%(12/185). The ratio of inferior mediastinal lymph nodes metastasis in cases with length of esophageal invasion ≤1 cm, >1 cm and ≤2 cm, >2 cm and ≤3 cm, >3 cm and ≤4 cm were 3.81%(4/105), 6.12%(3/49), 10.00%(2/20), 27.27%(3/11), respectively. The ratio of No.110 lymph nodes metastasis in cases with length of esophageal invasion ≤1 cm, >1 cm and ≤2 cm, >2 cm and ≤3 cm, >3 cm and ≤4 cm were 2.86%(3/105), 6.12%(3/49), 5.00%(1/20), 27.27%(3/11), respectively, showing a significant difference among them ( χ2=8.26, P<0.05). Conclusions:Depth of tumor invasion and length of esophageal invasion are independent influening factors affecting inferior mediastinal lymph node metastasis in Siewert type Ⅱ and Ⅲ AEG. The rate of inferior mediastinal lymph node metastasis increases with the increase of the length of esophageal invasion.
4.Effect of dexmedetomidine on cell apoptosis during spinal cord ischemia-reperfusion in rats
Chengdong ZHANG ; Jingjing CAO ; Qun LIU ; Kechang HUANG
Chinese Journal of Anesthesiology 2017;37(10):1222-1225
Objective To evaluate the effect of dexmedetomidine on cell apoptosis during spinal cord ischemia-reperfusion(I∕R)in rats. Methods Forty-eight adult male Wister rats, weighing 200-260 g, were divided into 4 groups(n=12 each)using a random number table: sham operation group (Sham group), I∕R group, prophylactic dexmedetomidine use group(DPro group)and dexmedetomidine postconditioning group(DPost group). The model of spinal cord I∕R was established by temporary occlu-sion of the abdominal aorta using the modified Zivin′s method. Dexmedetomidine 5 μg·kg-1·h-1was in-travenously infused at 1 h before occlusion of the abdominal aorta in group DPro. Dexmedetomidine 5 μg·kg-1·h-1was intravenously infused for 1 h starting from the time point immediately after beginning of reperfusion in group DPost. The equal volume of normal saline was given instead in Sham and I∕R groups. The motor nerve function of the hindlimb was assessed and scored at 4, 12 and 24 h of reperfusion. The rats were sacrificed at 24 h of reperfusion, and L2-5segments of the spinal cords were removed for microscopic examination and for determination of Bcl-2 and Bax positive cells(by immuno-histochemistry)and cell ap-optosis(by flow cytometry). The apoptosis rate was calculated. Results Compared with group Sham, motor nerve function scores were significantly decreased at 4-12 h of reperfusion, and the apoptosis rate of nerve cells and Bcl-2 and Bax positive cells were increased in group I∕R, and motor nerve function scores were significantly decreased at 4 h of reperfusion, and the apoptosis rate of nerve cells and Bcl-2 and Bax positive cells were increased in DPro and DPost groups(P<005 or 001). Motor nerve function scores were significantly higher, and the apoptosis rate of nerve cells was lower, Bcl-2 positive cells were higher, and Bcl-2 and Bax positive cells were lower in DPro and DPost groups than in group I∕R(P<005 or 001). Conclusion The mechanism by which dexmedetomidine reduces spinal cord I∕R injury is related to inhibiting cell apoptosis in rats.
5.Multi-slice CT Enterography with Double-iflling Method in Diagnosis of Inlfammatory Bowel Diseases
Kechang LIU ; Weiwei XIANG ; Shenglan ZHANG ; Guangzhang XIANG ; Yan YIN ; Guoping YANG
Chinese Journal of Medical Imaging 2015;(1):14-18
Purpose To summarize the imaging features of inflammatory bowel diseases (IBD) with double-filling method using multi-slice CT enterography (MSCTE), and to evaluate the clinical significance of MSCTE in diagnosis of IBD. Materials and Methods MSCTE data with double-filling method of 52 patients with IBD were retrospectively analyzed. 52 IBD patients included 42 cases of Crohn's disease (CD) and 10 cases of ulcerative colitis (UC). Bowel dilatation and lesions display were evaluated. Results Among 52 patients, ileum dilated optimal in 10 cases (19.23%) and good in 42 cases (80.77%); jejunum dilated good in 21 cases (40.38%) and poor in 31cases (59.62%). Exhaustive evaluation for large bowel diseases were good in 50 cases (96.15%). The ileocecal junction displayed well in 52 cases (100.00%). Among the 42 cases of CD, 20 cases (47.62%) had lesions limited in the small intestine, 22 cases (52.38%) had lesions involved both small intestine and colon. Among 10 cases of UC, 9 cases had lesions limited in the colon, and 1 case with the terminal ileum and the colon involved simultaneously. The MSCTE findings of 52 patients included bowel wall thickening and abnormal enhancement in 52 cases, stenosis in 28 cases, increased mesenteric vascularity in 46 cases, enlarged mesenteric lymph nodes in 27 cases, phlegmon in 10 cases, incomplete intestinal obstruction in 4 cases, abscess or inflammatory masses in 7 cases, fistulas in 3 cases, perianal lesion in 12 cases, serous cavity effusion in 15 cases, sacroiliitis in 13 cases, the urinary and biliary stones in 18 cases, and hepatosplenomegaly in 9 cases. Conclusion MSCTE with double-filling method can delineate the wall lesions of small bowels and colons very well, and can also display extraintestinal lesions and complications. It obviously improves the accuracy of localization and qualitative diagnosis on IBD.
6.Relationship between mycelium morphology and laccase production of Pleurotus ferulae in submerged cultivation.
Youzhi CHEN ; Lu WANG ; Lin PENG ; Zhongyang DING ; Liang ZHANG ; Zhenghua GU ; Guiyang SHI ; Kechang ZHANG
Chinese Journal of Biotechnology 2013;29(11):1701-1705
In this study, the relationship between mycelium morphology and laccase production was studied. The results indicated that the morphology of P. ferulae pellets was changed when glass beads were added. Laccase production showed higher with spherical mycelium than with filamentous or flocculent mycelium. In addition, the spherical mycelium with a diameter of 0.2-0.4 mm highly affected laccase production. Effect of the composition of culture medium on pellets was investigated and results indicated that various concentrations of glucose, corn meal and wheat bran were important to the formation of pellets in diameter of 0.2-0.4 mm. Besides nutrients, the addition of non-nutritional substrates influenced the distribution of P. ferulae pellets. However, the production of laccase was not promoted by non-nutritional substrates.
Culture Media
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Fermentation
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Glass
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chemistry
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Industrial Microbiology
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Laccase
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biosynthesis
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Mycelium
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cytology
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growth & development
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Pleurotus
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cytology
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enzymology
7.Effects of medicinal insect, Catharsius molossus on biosynthesis of polysaccharides from Ganoderma lucidum in submerged culture.
Gaoqiang LIU ; Chongyang DING ; Kechang ZHANG ; Xiaoling WANG ; Wenjun HAN
Chinese Journal of Biotechnology 2009;25(6):914-919
We studied the effects of several medicinal insects on biosynthesis of polysaccharides from Ganoderma lucidum in submerged culture. The results showed that the medicinal insect, Catharsius molossus at 5 g/L significantly promoted the biosynthesis of intracellular polysaccharides (IPS) and extracellular polysaccharides (EPS) of G. lucidum, and compared with control, IPS and EPS yields markedly enhanced from (1.93 +/- 0.09) g/L to (2.41 +/- 0.12) g/L and (520.3 +/- 20.2) mg/L to (608.9 +/- 20.2) mg/L, respectively (P < 0.05). Both IPS and EPS consisted of five kinds of components, and IPS-1 and EPS-1 were the major components of IPS and EPS, respectively. Further separation studies showed that IPS-1 was made up of three single compounds, while EPS-1 was made up of two single compounds. There were no new components in both IPS and EPS obtained from G lucidum in submerged culture by the addition of the insect, C. molossus, suggesting the biosynthetic pathways of the major components of IPS and EPS had not been changed.
Animals
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Cockroaches
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chemistry
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Culture Media
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chemistry
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Fermentation
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Materia Medica
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pharmacology
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Polysaccharides
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biosynthesis
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chemistry
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Reishi
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growth & development
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metabolism
8.Effects of medicinal insect Catharsius molossus on submerged fermentation and in vivo anti-hepatoma activity of Ganoderma lucidum.
Gaoqiang LIU ; Chongyang DING ; Kechang ZHANG ; Xiaoling WANG
Chinese Journal of Biotechnology 2009;25(6):880-886
We studied the effects of Catharsius molossus (a Chinese medicinal insect) on the cell growth, fermentation kinetics of key bioactive substances and anti-cancer activity of Ganoderma lucidum in submerged fermentation. The results showed that C. molossus at all the tested concentrations had no stimulatory effect on the cell growth. However, addition of C. molossus at 5 g/L lead to significant effects on the fermentation kinetics of polysaccharides and triterpenoids of G lucidum, and at 7th day in fermentation process, the yields of polysaccharides and triterpenoids reached 2.81 g/L and 539.0 mg/L, respectively, while they were 2.25 g/L and 428.2 mg/L in control. In vivo anti-cancer studies showed that the inhibitory rates of control fermented G lucidum (CFG) and a combination of water extract from C. molossus and CFG on the developed tumor (Heps) in mice were 41.61% and 42.24%, respectively. Moreover, the inhibitory rate of the G lucidum fermented with C. molossus (GFC) reached 57.21%, which was enhanced 37.49%, compared to the inhibitory rate of the control fermented G lucidum. These results suggest that supplementation of C. molossus in submerged fermentation of G lucidum lead to a significant enhancement of the anti-cancer activity of cultured G lucidum.
Animals
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Antineoplastic Agents, Phytogenic
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biosynthesis
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therapeutic use
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Cockroaches
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chemistry
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Culture Media
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chemistry
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Female
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Fermentation
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Liver Neoplasms
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drug therapy
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Male
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Materia Medica
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pharmacology
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Mice
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Polysaccharides
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biosynthesis
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pharmacology
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Reishi
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growth & development
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metabolism
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Triterpenes
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metabolism
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pharmacology
9.The effects of human hepatocarcinoma HepG2 cell culture supernatant on T lymphocyte activity
Kechang ZHANG ; Junying WU ; Baiqing LI
Journal of Clinical Hepatology 2009;25(3):204-206
Objective To observe the role of human hepatocarcinoma HepG2 cell culture supernatant on T lymphocyte of the activation, proliferation, IL-2 secretion and inducing apoptosis in vitro. To explore the mechanism of immune escape in tumor.Methods Peripheral blood mononuclear cells (PBMC) were cultured with different concentration of tumor cell culture supernatant. Cell proliferation was examined with standard cytometry and MTT. The apoptotic rate and immune phenotype were analyzed by FACS. The level of IL-2 was determined with ELISA.Results Adding HepG2 supernatant, there was no significant influence in activation of lymphocyte, but the proliferation rat and the secretion of IL-2 were obviously decreased. The lymphocyte apoptosis rate was raised.Conclusion The tumor cell may produce a certain soluble protein, thus escape from the immune surveillance of tumor-bearing host.
10.Study on the relationship between high expression of co-stimulatory molecule 4-1BBL on tumor cell lines and immune escape
Kechang ZHANG ; Junying WU ; Baiqing LI
Chinese Journal of Immunology 2001;0(10):-
0.05),but the proliferation rate(P


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