Transforming growth factor-β(TGF-β), a member of the TGF-β superfamily, plays a role in multiple biological processes, including cell proliferation, differentiation, migration and tissue fibrosis, etc. Normally, TGF-βs widely express in normal tissues and most cell lines, such as macrophages and dendritic cells, But in pathological conditions, Cancer cells and cancer-associated fibroblasts also produce and secrete TGF-β. Scirrhous gastric cancer (SGC) is a special subtype of gastric cancer with rapid development, frequent peritoneal implantation, and accompanied by significant interstitial fibrosis deposition. these biological behavior characteristics all suggest that its occurrence and development are closely related to TGF-β expression, and TGF-β is considered to be associated with poor prognosis of the SGC. The use of antibodies and inhibitors of TGF-β and its signaling pathways can reduce the invasiveness of cancer cells and improve the prognosis of SGC patients. This paper reviews the expression and significance of TGF-β in SGC.

Objective:To further understand the clinical characteristics of scirrhous gastric cancer (SGC)and clear it definitions. Analyzed the clinicopathologic features and prognosis of patients with SGC and Non SGC(NSGC).Methods:The study included 342 gastric cancer patients who had undergone gastrectomy in the Second Hospital University of South China between May 2011 and May 2018. The SGC was diagnosed by endoscopic, CT, tumor stroma ratio and appearance of surgical specimen clinicopathological characteristics were summarized and compared between SGC patients and NSGC using pearson′s χ2 test or student′s t test. Survival curves were estimated with the Kaplan-Meier method. Patients were matched 1∶1 using propensity score matching, and their overall survival rates were compared. Results:A total of 342 patients with gastrectomy were collected, 49 (14.3%) were diagnosed as SGC. Patients with SGC were younger, later pathological stage lymph node metastases tend to occur than those(NSGC). SGC had a higher total gastric resection rate, easier prone to nerve/vascular invasion and omental metastasis ( P<0.01). The median survival of SGC patients and overall survival at 1, 3, and 5 years after surgery were shorter than NSGC patients, which were independent risk factors affecting the prognosis of patients. Conclusions:SGC can be well defined by endoscopy, CT, TSR and tumor appearance. It is a peculiar solid tumor with poor differentiated, advanced stage and poor prognosis. Future research should focus on how to diagnose SGC earlier and intervene in time.

Perforated peptic ulcer is a common acute abdominal disease and requires emergency surgical treatment. Laparoscopic repair PPU was started early but progressed slowly. Compared with the popularization of minimally invasive concept of laparoscopic cholecystectomy, laparoscopic repair is still under the situation of disputation, low overall application rate and extremely unbalanced development in different regions and organizations. With the embodiment of minimally invasive advantages of laparoscopy and the technology progress, as well as the updating of surgeons′ ideas and the emergence of higher quality RCT studies, the proportion of PPU in laparoscopic treatment is gradually increasing. In order to make full use of the minimally invasive value and differential diagnostic value of laparoscopy, the laparoscopy-first approach can be adopted as a routine for appropriate PPU patients. The key to case selection and the physicians experience and proficiency. Laparoscopy should be actively adopted but should not be easily expanded. If necessary, the patients should be converted to open operation. If not the advantages of laparoscopy will be drowned.

Objective To analyze set-up errors for irradiation of nasopharyngeal carcinoma by using kilo-voltage cone beam computed tomography (kV-KBCT) scanning, and to calculate the external margin from planning target volume (PTV) of nasopharyngeal carcinoma. Methods A total of 150 nasopharyngeal carcinoma patients in Meizhou People's Hospital from December 2014 to November 2016 were treated by image-guided radiation therapy (IGRT), kV-KBCT, CT image scanning matcthed by bone and grey alignment. PTV of nasopharyngeal carcinoma was also calculated. Results According to PTV formula, the external distance before radiotherapy guided by grey alignment was 0.5 mm in X-axis, 0.4 mm in Y-axis, 0.8 mm in Z-axis. While the distance was 0.1 mm in X-axis, 0.5 mm in Y-axis, 1.7 mm in Z-axis guided by bone alignment. After radiotherapy, the external distance guided by grey alignment was 0.4 mm in X-axis, 0.5 mm in Y-axis, 0.9 mm in Z-axis. While the distance was 0.1 mm in X-axis, 0.9 mm in Y-axis, 2.0 mm in Z-axis guided by bone alignment. There was no significant difference in set-up errors of 3 directions and 2 aligned ways before and after treatment.Conclusions The PTV within 3 mm is safe when IGRT is used for directing radiotherapy of nasopharyngeal carcinoma,and kV-KBCT is an effective image equipment.

OBJECTIVE: To determine the incidence of surgical site infection (SSI) after abdominal surgery and to further evaluate the related risk factors of SSI in China. METHODS: The multicenter cross-sectional study collected clinical data of all adult patients who underwent abdominal surgery from May 1, 2018 to May 31, 2018 in 30 domestic hospitals, including basic information, perioperative parameters, and incisional microbial culture results. The primary outcome was the incidence of SSI within postoperative 30 days. SSI was classified into superficial incision infection, deep incision infection, and organ/gap infection according to the US Centers for Disease Control and Prevention (CDC) criteria. The secondary outcome variables were ICU stay, postoperative hospital stay, total hospital stay, 30-day mortality and treatment costs. Multivariate logistic regression was used to analyze the risk factors of SSI. RESULTS: A total of 1666 patients were enrolled in the study, including 263 cases of East War Zone Hospital of PLA, 140 cases of Affiliated Hospital of Qingdao University, 108 cases of The First Affiliated Hospital of Nanchang University, 87 cases of Central War Zone Hospital of PLA, 77 cases of West China Hospital, 74 cases of Guangdong General Hospital, 71 cases of Chenzhou First People's Hospital, 71 cases of Zigong First People's Hospital, 64 cases of Zhangjiagang First People's Hospital, 56 cases of Nanyang City Central Hospital, 56 cases of Lanzhou General Hospital of Lanzhou Military Command, 56 cases of Shandong Provincial Hospital, 52 cases of Shangqiu First People's Hospital, 52 cases of People's Hospital of Xinjiang Uygur Autonomous Region, 48 cases of The Second Xiangya Hospital of Central South University, 48 cases of Chinese PLA General Hospital, 44 cases of Affiliated Hospital of Xuzhou Medical University, 38 cases of Hunan Province People's Hospital, 36 cases of Dongguan Kanghua Hospital, 30 cases of Shaoxing Central Hospital, 30 cases of Northern Jiangsu People's Hospital, 29 vases of The First Affiliated Hospital of Zhengzhou University, 27 cases of General Hospital of Tianjin Medical University, 22 cases of Zigong Fourth People's Hospital, 21 cases of The Second Hospital of University of South China, 18 cases of Tongji Hospital, 15 cases of Nanchong Central Hospital, 12 cases of The 901th Hospital of PLA, 11 cases of Hunan Cancer Hospital, 10 cases of Lanzhou University Second Hospital. There were 1019 males and 647 females with mean age of (56.5±15.3) years old. SSI occurred in 80 patients (4.8%) after operation, including 39 cases of superficial incision infection, 16 cases of deep incision infection, and 25 cases of organ/interstitial infection. Escherichia coli was the main pathogen of SSI, and the positive rate was 32.5% (26/80). Compared with patients without SSI, those with SSI had significantly higher ICU occupancy rate [38.8%(31/80) vs. 13.9%(220/1586), P<0.001], postoperative hospital stay (median 17 days vs. 7 days, P<0.001) and total hospital stay (median 22 days vs. 13 days, P<0.001), and significantly higher cost of treatment (median 75 000 yuan vs. 44 000 yuan, P<0.001). Multivariate analysis showed that male rise(OR=2.110, 95%CI:1.175-3.791, P=0.012), preoperative blood glucose level rise(OR=1.100, 95%CI: 1.012-1.197, P=0.026), operative time (OR=1.006, 95%CI:1.003-1.009, P<0.001) and surgical incision grade (clean-contaminated incision:OR=10.207, 95%CI:1.369-76.120, P=0.023; contaminated incision: OR=10.617, 95%CI:1.298-86.865, P=0.028; infection incision: OR=20.173, 95%CI:1.768-230.121, P=0.016) were risk factors for SSI; and laparoscopic surgery (OR=0.348, 95%CI:0.192-0.631, P=0.001) and mechanical bowel preparation(OR=0.441,95%CI:0.221-0.879, P=0.020) were protective factors for SSI. CONCLUSIONS The incidence of postoperative SSI in patients with abdominal surgery in China is 4.8%. SSI can significantly increase the medical burden of patients. Preoperative control of blood glucose and mechanical bowel preparation are important measures to prevent SSI.
Abdomen ; surgery ; Adult ; Aged ; China ; Cross-Sectional Studies ; Female ; General Surgery ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Operative Time ; Postoperative Complications ; prevention & control ; Preoperative Period ; Retrospective Studies ; Risk Factors ; Surgical Wound Infection ; prevention & control

Objective To further explore the relationship of CEA in gastric cancer tissue expression and serum levels,and seek after the prediction effect of serum CEA in the peritoneal metastasis.Methods Retrospective analysis of 38 gastric cancer patients with peritoneal metastasis (group A) and 60 gastric cancer patients without peritoneal mnetastasis (group B),and analyze the first time in two groups of patients with preoperative serum CEA levels.The expression levels of CEA was examined by Immunohistochemistry method in primary tumors、negative margin and peritoneal metastases foci from group A and in primary tumors from group A,and the detection result of the statistical was analyzed.Results The expression of the first preoperative CEA serum levels in group A and group B was 73.68％ and 41.67％ respectively (x2 =9.604,P =0.002),and the two groups of patients with the first preoperative CEA serum levels was (74.00 + 6.00) ng/mL,(46.06 + 9.03) ng/mL,The two groups was statistically significant (t =4.715,P ＜0.01).In group A,the expression of CEA of primary tumors was higher than that of negative margins (x2 =29.587,P =0.000);the difference expression of CEA positive degree in gastric cancer primary tumors and negative margins was statistically significant(Z =-5.348,P =0.000).In peritoneal metastases foci the expression of CEA was 92.11％,that was 64.82％ in primary tumor(x2 =6.728,P =0.009);the difference expression of CEA positive degree in peritoneal metastases foci and primary tumors was statistically significant (Z =-5.397,P =0.017).In primary tumors,the expression of CEA in group A and group B was 68.42％ and 42.67％ respectively (x2 =4.450,P =0.035),the two groups of patients with the difference expression of CEA positive degree was statistically significant,the two groups was statistically significant(Z =-2.227,P =0.026).Conclusion Over expression of CEA might have a critical role in peritoneal metastases of gastric carcinoma.The differences of the expression of CEA in gastric cancer in different tissues may indicate the risk of gastric cancer peritoneal metastasis.

Gastrin is mainly secreted by the G cells in antrum and the upper part of small intestine.Gastrin receptor distributes in various tissues.Gastrin and its receptor have several functions including regulating cell growth and differentiation,inhibiting apoptosis,promoting cell proliferation,invasion and metastasis.Studies have shown that gastrin and its receptor involve with various cancers occurrence and development.Gastrin and its receptor can be used to diagnosis early gastric cancer,and be used as a potential targets in gastric carcinoma treatment.The relationship of gastrin and its receptor with gastric carcinoma were reviewed in this paper.

Objective To study the expressions of P53,vascular endothelial growth factor (VEGF) and proliferating cell nuclear antigen (PCNA) in astrocytomas and their relationships with prognosis of these patients.Methods Immunohistochemical SP method was employed to detect the P53,VEGF and PCNA expression in 126 cases of human brain astrocytomas of different grades,collected in our hospital from May 2002 to May 2010; their correlations and their significance in the prognosis in these patients were analyzed.Results P53,VEGF,and PCNA expressed differently in astrocytomas of different grades,enjoying a positive relation with grades (P＜0.05); positive correlations of between P53 expression and both VEGF and PCNA expressions (r=0.608,P=0.000; r=0.432,P=0.001).In patients with the same grade of astrocytoma,those having positive P53 expression enjoyed poorer prognosis and lower survival rate with significant difference (P＜0.05); while VEGF and PCNA expressions had no correlation with the progonosis.Conclusion The expressions of PCNA,VEGF and P53 are closely associated with grade of the astrocytomas,and only P53 expression is an indicator of poor prognosis.

Objectives To investigate the expression and differential diagnosis value of Galectin-3 and Cyclin D1 in benign and malignant thyroid mass.Methods The expression of Galectin-3 and Cyclin D1 protein in 31 cases of nodular goiter(group A),65 cases of papillary thyroid carcinoma(PTC,group B) and 10 cases of normal thyroid tissues(group C,the control group)was detected by SP immunohistochemical method.The clinical data were analyzed.Results The expression level of Galectin-3 in group B was 83.03％ (54/65),significantly higher than that in group A(19.35％,6/31) and group C(0％).The difference of group A and group B in terms of the expression level of Galectin-3 protein had statistical significance(x2 =36.360,P ＜0.05).The expression level of Cyclin D1 protein in group B was 72.30％ (47/65),significantly higher than that in group A(12.90％,4/31)and group C(0％).The difference of group A and group B in terms of the expression level of Cyclin D1 protein had statistical significance(x2 =29.740,P ＜ 0.05).The combination detection of the positive expression of Galectin-3 and Cyclin D1 in benign and malignant thyroid mass showed that the difference between group A and group B had statistical significance(P ＜ 0.01).The expression of Galectin-3 and Cyclin D1 was positively correlated in group B(R =0.509,P ＜0.05).The positive expression rate of Cyclin D1 protein was 90％ (18/20) and 64.44％ (29/45)respectively in PTC patients with lymph node metastasis and without lymph node metastasis.The difference had statistical significance (P ＜ 0.05).Conclusions The expression of Galectin-3 and Cyclin D1 is positively correlated in PTC and the expression of the 2 proteins in PTC is higher than that in nodular goiter and normal thyroid tissues,indicating that the 2 proteins can be used as valuable markers for patients with thyroid carcinoma.Combined detection of Cyclin D1 and Galectin-3 protein in thyroid tissues is useful for the diagnosis of thyroid cancer.

ObjectiveTo explore the clinical and pathological features of Hainan patients with thyroid carcinoma treated in Hainan Provincial People' s Hospital.Methods A total of 239 clinical cases of Hainan patients with thyroid carcinoma treated in Hainan Provincial People' s Hospital from 2006 to 2010 were retrospectively analyzed.Results The number of thyroid carcinoma cases between 2006 to 2008 was stable.But the cases in 2009 were 72.97％ higher than that in 2008.Female' s peak of onset age was 25 to 55 years and male was 20 to 55 years.The cases of Hant were 231 (96.65％) and the national minority were 8(3.35％ ).So ethnic composition ratio between cases and local population has a very significant difference (x2 =21.376,P ＜0.01 ).The eastern and western regions had 175 cases and 64 cases respectively,138 (78.86％) and 34(46.88％ ) cases from city respectively.Urban and rural ratio between eastern and western areas had a significant difference (x2 =4.420,P ＜ 0.05 ).The 239 cases were composed of 228 cases (95.4％) of papilarry thyroid carcinoma,7 cases (2.92％) of medullary thyroid carcinoma,both 2 cases (0.84％) of follicular thyroid carcinoma and anaplastic thyroid carcinoma.Conclusions The incidence of Hainan nationality patients with thyroid carcinoma treated in Hainan Provincial People' s Hospital has increased from 2006 to 2010,with younger trend and regional difference.Thyroid carcinoma has a difference in race and region.The rank of the rate of pathological type is papillary thyroid carcinoma,medullary thyroid carcinoma,follicular thyroid carcinoma,undifferentated thyroid carcinoma in order.