Abstract:

Objective：To investigate the feasibility and effectiveness of laparoscopic radical gastrectomy for gastric cancer.
Methods：The follow-up data of 61 patients who underwent laparoscopic radical surgery for gastric cancer from August 2006 to December 2009 in our hospital were analyzed retrospectively.
Results： The follow-up rate was 85.2% (52/61). The follow-up period ranged from 3 to 42 months (median 22 months). Eight patients died and two patients were still alive with tumor recurrence during the follow-up perid The recurrences and deaths were all found in patients with advanced gastric cancer, and the incidence of recurrence was 0 (0/19) in stage I, 20%(2/10) in stage II, 25.0% (5/20) in stage III, and 100%(3/3) in stage IV. The 1-, 2-, 3-year overall survival rate was 97.4%, 85.6% and 71.0% respectively, and the disease-free survival rate was 92.7%, 81.2% and 67.8% respectively.
Conclusions：Laparoscopic gastrectomy for early gastric cancer has a good prognosis and can be recommended for general use. For advanced gastric cancer, the outcome of laparoscopy is not worse than that of open operation, but further study will be needed.

Abstract:

Objective：To explore the feasibility and the efficacy of radical gastrectomy plus implantation of fluorouracil sustained release for  stage Ⅲ gastric carcinorma.
Methods：Clinical materials of 188 cases of stage Ⅲ gastric cancer patieats treated in the First Affiliated Hospital, Nanchang University, from December 2008 to November 2009 were analyzed retrospectively. All cases underwent radical gastrectomy.The patients were randomly divided into two groups:Treatment (A) group, fluorouracil sustained release was implanted intraoperatively(n=96); control (B) group, fluorouracil sustained release was not used (n=92). At 4 weeks after surgery, intravenous chemotherapy was given and they were followed up.
Results：There were no obivious side-effects and complications in group A, except for more abdominal drainage,abdominal pain(78.1%) and low-grade fever(31.3%) than those in group B. The 1 year recurrence rate(6.30%) in group A was much lower than that of group B(16.30%) (P＜0.05), and the 1 year death rate(3.02%) of group A was much lower than that of group B(10.08%) (P＜0.05), respectively.
Conclusions：Implanting fluorouracil sustained release at operation is safe and feasible. It can decrease the postoperative recurrence rate and improve the postoperative survival rate of patients with stage Ⅲ gastric cancer.

Abstract:

Objective：To analyze the related factors affecting the prognosis of gastric cancer patients undergoing operation.
Methods：The clinical characteristics and follow up data of 887 patients with gastric cancer treated from January 1990 to December 2001 in our hospital were retrospectively analyzed by univariate and multivariate methods.
Results：Of the 887 cases, the overall 1-, 3- and 5-year survival rate was 79.63%, 49.29% and 43.40%, respectively. In the univariate analysis, tumor location, TNM stage, pathological type, operative method, and chemotherapy were related to the prognosis of patients with gastric cancer. Multivariate Cox model analysis showed that TNM stage, pathological type, operative method, and  chemotherapy were the related factors for patients with gastric cancer.
Conclusions：TNM stage, pathological type, operative method, and  chemotherapy are important prognostic factors for patieuts with gastric cancer undergoing operation.

Abstract:

Objective：To determine the relationship between vascular endothelial growth factor-C (VEGF-C), vascular endothelial growth factor receptor-3 (VEGFR-3, also known as Flt-4) and CNTN-1 (contactin-1) expression in human gastric cancer, as well as the correlation of them with metastatic lymph nodes and other clinicopathologic parameters.
Methods：The samples from primary foci of 37 cases with primary gastric cancer were immunohistochemically examined for VEGF-C, VEGFR-3 and CNTN-1 expressions. Assessment of lymphatic vessel density (LVD) was undertaken. Then we analyzed their relationships and correlations with clinicopathologic findings.
Results：The positivity rate of VEGF-C, VEGFR-3 and CNTN-1 in the primary tumor was 54.05%, 72.97% and 64.16% respectively. The expression of CNTN-1 significantly correlated with VEGF-C (P＜0.05) and VEGFR-3 (P＜0.05). VEFG-C was correlated to TNM stage, lymphatic vessel invasion and lymph node involvement (P＜0.05). CNTN-1 expression was associated with tumor size, TNM stage, lymphatic vessel invasion and  lymph node metastasis (P＜0.05). Higher expression of VEGFR-3 was detected in the patients with advanced TNM stage and lymphatic node metastasis (P＜0.05). Increased level of LVD was significantly associated with later TNM stage,  lymphatic vessel invasion and lymph node metastasis (P＜0.05). LVD was positively correlated with VEGF-C expression (P＜0.05).
Conclusions：High expression of VEGF-C, VEGFR-3 and CNTN-1 was observed in gastric cancer. The expression of VEGF-C correlates with LVD expression and both of them correlate with the presence of lymphatic vessel invasion and lymph node metastasis. VEGF-C-mediated CNTN-1 overexpression might promote lymphatic vessel invasion and lymph node metastasis via lymphangiogenesis pathway in patients with gastric cancer.

Abstract:

Objective：To determine the inhibitory effect of synthetic KLK12 short interfering RNA on the expression of KLK12 gene in human gastric cancer line MKN-45 cells, and to elucidate its effect on proliferation of MKN-45 cells in vitro.
Methods：The constructed KLK12-siRNA plasmid was stably transfected into MKN-45 cells by lipofectamine，then, MKN-45 cells were divided into negative control group，blank control group and KLK12 siRNA group. KLK12 expression was determined by real time PCR and Western blot. The proliferation，migration and invasion of transfected MKN-45 cells were evaluated by MTT assay，cell Migration and Invasion Assay Combo Kit.
Results：KLK12 siRNA significantly inhibited the expression of KLK12 in gastric cancer cells at both mRNA and protein level. The proliferation of MKN-45 cells in KLK12 siRNA group was significantly suppressed and the ability of migration was also significantly decreased in vitro.
Conclusions：The KLK12-siRNA expression vector can effectively suppress the proliferation and migration of MKN-45 cells，which may provide a novel gene therapy for gastric cancer.

Abstract:

Objective：To investigate the effect of celecoxib, a selective cyclooxygenase-2 inhibitor, to down-regulate the expression of multidrug resistance (mdrl) gene in the gastric cancer cell BGC823.
Methods：BGC823 cells were treated with celecoxib in different concentrations (0,10μmol/L and 100μmol/L) respectively.Prostaglandin E2 (PGE2) was detected by ELISA. Twenty four hs and 48 hs later，the expression of mdrl mRNA were detected by RT-PCR. P-gp protein expression in BGC823 cells was detected by immunocytochemical technique after celecoxib treatment.
Results：Celecoxib inhibited the expression of PGE2 in a dose dependent manner(P＜0.05,P＜0.01).Same effective situation between the concentration was found on the P-gp expression during the treatment with celecoxib; while the expression of mdrl mRNA  was down regulated more effectively after 48 h treatment when compared to that in 24 hs treatment group(P＜0.01).
Conclusions：Celecoxib can inhibit the expression of mdrl/P-gp in a time and dose dependent manner, which is likely to be through inhibiting COX-2 activity.The results suggest that a selective COX-2 inhibitor may play a potential role in overcoming the chemotherapeutic resistance of gastric cancer cells.

Abstract:

Objective：To stdy the differential protein expression influensed by RASSF1A gene in human gastric cancer cell line SGC7901.
Methods：The proteins of SGC7901 and RASSFIA-SGC7901 were isolated by two-dimension gel electrophoresis (2-DE). Two-DE map was established by Coomassie brilliant blue staining. The well differentially expressed protein spots were screened by Image Master imaging. The specific protein spots were identified by peptide mass fingerprints using matrix-assisted laser desorption/time of flight mass spectrometry (MALDI/TOF/MS)and through searching database using Mascot software.
Results：Eight differential protein spots were screened and identified. They included galectin-1,TRP-14,ACBP,PSMB5,PSMB4,TIM,vimentin and CD79α. Overexpression of RASSF1A up-regulated the mRNA expression of galectin-1, TRP-14 and ABCP in SGC7901.
Conclusions：Galectin-1，TRP-14 and ABCP may be involved in growth inhibition induced by RASSF1A in SGC7901.

Abstract:

Objective：To assess the efficacy and safety of D2+paraaortic lymph node dissection  (LND) (D4) for patients with advanced gastric cancer.
Methods：We searched the electronic bibliographic databases, including Cochrane library, Pubmed, EMBASE, CBM, VIP, CNKI and WABNGFANG to assemble the RCT of D2 and D4 LND for patients with advanced gastric cancer. The deadline retrieval time was October 2009. Data were extracted and evaluated by two reviewers independently.The RevMan 5.0 software was used for data analysis.
Results： Four randomized trials involving 1120 patients were included. The results indicated that compared with D4 LND, D4 LND dissection did not increase the patient′s survival rate, and there was no significant difference in the cancer recurrence rate after operation, postoperative mortality or the incidence of complications between the D2 and D4 LND.
Conclusions：Because of the limitations of the included studies,  the efficacy and safety of D2 and D4 LND for patients with advanced gastric cancer could not be  accurately assessed.

Abstract:

Objective：To investigate the antitumor mechanism and compare the antitumor effect of triptolide (TP) and triptolide loaded polymeric micelles (TP-PM) in HT29 cell, and evaluate the feasibility of polymeric micelle as triptolide nanocarrier.
Methods：HT29 cells were incubated with TP and TP-PM for 24h, 48h and 72h, then, cell viability was measured by WST-1 assay; cell membrane integrity was measured by LDH assay, and cell proliferation was measured by BrdU assay. Additionally, cell survival and apoptosis was measured by FDA-PI staining, and caspase 3/7 activity was measured by Caspase-Glo 3/7 assay kit.
Results： HT29 cell viability and proliferation was apparently inhibited by the TP and TP-PM, the inhibitions showed a time-dependent and dose-dependent manner, and the inhibitory effect of TP-PM was better than TP (P＜0.05). Both TP and TP-PM caused only slight HT 29 cell membrane damage. FDA-PI staining results indicated that FDA-positive cell showed a time-dependent and dose-dependent down trend, while PI-positive cell show a time-dependent and dose-dependent ascending trend. FDA, PI double negative cell also increased more, however, it neither showed a time-dependent nor dose-dependent effect. HT29 cell caspase 3/7 activity increased after incubated with TP and TP-PM, and TP-PM induced a higher apoptosis than TP (P＜0.05).
Conclusions：Both TP and TP-PM can potently inhibit HT29 cell growth and proliferation via induction of apoptosis,  TP-PM shows a better inhibitory effect than TP. Polymeric micelle is a promising drug carrier.

Abstract:

Objective：To investigate the inhibition of procaspase-activating compound-1(PAC-1), Oxaliplatin（L-OHP） and PAC-1 conbination with L-OHP on  human colorectal cancer cell lines （HT-29，SW116，HCT116，SW620，SW480）.
Methods：MTT assay was used to investigate the proliferation of cells before and after single and combined drug use.
Results：Both PAC-1 and L-OHP had signficant high effect of inducing apoptosis and inhibiting proliferation on five human colorectal cancer cells on a dose and time dependent manner.The IC50 of PAC-1 on different human colorectal cancer cells had no statistical significance(P＞0.05); but IC50 of L-OHP on the 5 cell lines had statistical significance(P＜0.05). PAC-1 combined with L-OHP （dosing pump at the same time）had an antagonistic effect(CI﹥1).
Conclusions：Both PAC-1 and L-OHP can inhibit human colorectal cancer cell lines, but the susceptibility of individual colorectal cancer cell lines on the two drugs are different. PAC-1 combined with L-OHP has an antagonistic effect.

Abstract:

Objective：To investigate the expression of BMI-1 mRNA and MMP-9 mRNA in colon carcinoma cells and its significance.
Methods：The expression of BMI-1 mRNA and MMP-9 mRNA in colon carcinoma cells and human colon smooth muscle cell (CSMC) was detected by RT-PCR technique, and their correlation was analyzed.
Results：The expression of BMI-1 mRNA and MMP-9 mRNA in colon carcinoma cell lines SW620 and LoVo was significantly higher(P＜0.05) than those in colon carcinoma cell line SW480 and CSMC. There was significant positive correlation between the expression of BMI-1 mRNA and MMP-9 mRNA(r=0.966，P＜0.05).
Conclusions：As an oncogene, BMI-1 may act as a biological indicator of invasion capablity of colon carcinoma cells.

Abstract:

Objective：To study  the expression of  TSPAN-1 and CORTACTIN protein in colorectal carcinoma, and investigate the relationship between the expression and clinicopathological parameters  of colorectal carcinoma.
Methods：Immunohistochemical  Elivision two-step method was used to detect the expression of TSPAN-1 and CORTACTIN protein in 80 cases of colorectal carcinoma,13 cases of  colorectal adenoma and 27 cases of normal colorectal tissues. 
Results：The positive expression rate of TSPAN-1 and CORTACTIN in colorectal carcinoma was significantly higher than that in colorectal adenoma  and normal colorectal tissues, and there was significant difference in expression of every group (P<0.01). The positive  expression rate of  TSPAN-1 and CORTACTIN was 90% and 97.5% in group colorectal carcinoma，23% and 77% in group colorectal adenoma and 7.4% and  52% in group normal colorectal tissues (P＜0.01). The expression of TSPAN-1 and CORTACTIN was positively related with lymph node metastasis,TNM stage,5-year survival rate,histopathological grading  and depth of tumor invasion  (P<0.01). The expression of TSPAN-1 was positively related with the expression of CORTACT  in colorectal carcinoma (r=0.397, P=0.013).
Conclusions：The over expression of TSPAN-1 and CORTACTIN  gene are closely related to the invasion and growth of colorectal carcinoma, and TSPAN-1 and CORTACTIN have synergistic effect on  infiltration, invasion and metastasis of malignant cells. Detecting the expression of  both TSPAN-1 and CORTACTIN may be of value in further understanding the biological behavior and predicting the prognosis of colorectal carcinoma.

Abstract:

Objective：To explore the role of proline hydroxylase 2 (PHD2) in hepatocellular carcinoma angiogenesis.
Methods：(1)SP method immunohistochemical staining was used to detect PHD2 and microvessel density (MVD) was identified in 72 hepatocellular carcinoma tissues. Clinicopathological and microvessel density data were analysed. (2)Microvascular endothelial (HMEC-1) cell line was cultured in vitro, then, the cell lines were treated with different concentrations of cobalt chloride (treatment group). The expression level of  PHD2 protein was detected by Western blot. Tube formation capability of HMEC-1 cell in matrigel was examined.
Results：The expression positive rate of PHD2  in  HCC tissues was significantly lower than that in peritumor liver tissues and normal liver tissue ［22.2%（16/72）, 68.1%（49/72）, 84.6%（11/13）, respectively］(P＜0.05). MVD in PHD2 higer expression group was lower than in PHD2 low expression (52.1±4.3 vs. 69.2±5.5  respectively)(P＜0.05). Compared with the control group (normal liver tissues), the protein level of PHD2 and HIF-1α was decreased significantly,  the protein level of VEGF was increased significantly, tube formation capability of HMEC-1 cell in matrigel were decreased after CoCl2 treatment (P＜0.05).
Conclusions： In hypoxic microenvironment, the expression of PHD2 is decreased and endothelial cell proliferation is increased, but tube formation capability of endothelial cell is decreased, leading to decrease vascular maturity in HCC tumor  which are the important factors to promote invasion and metastasis of HCC.

Abstract:

Objective：To investigate the expression and significance of CD95 and JUK signal transducting system in liver cancer tissue.
Methods： Immunochemistry was employed to determine the expression of CD95, JNK1, JNK2 and c-Jun proteins in HCC tissues and adjacent normal liver tissues  in 58 cases of HCC.
Results：The staining of CD95 was located in cytoplasm, and JNK1, JNK2 and c-Jun were in nuclear. The expression of CD95,  JNK1, JNK2 and c-Jun in HCC was significantly lower than that in adjacent normal liver tissues (P<0.05).  In HCC, the negative expression of CD95 was 43(74.1%) and the positive expression was 15(25.9%). The negative expressions of JNK1, JNK2 and c-Jun were observed in 42（72.4%）, 39（67.2%）and 46（79.3 %） cases, respectively; with the positive expressions in 16（27.6%）, 19（32.8%）and 12（20.7%） cases, respectively. The CD95 expression level showed a positive correlation with the pathological grade of HCC（r=-0.516, P＜0.001); no significant relation was observed between CD95 with gender, age, number of nodules, venous infiltration or cirrhosis（P＞0.05）. The expression of JNK1, JNK2 and c-Jun respectively showed a negative correlation with the pathological grade of HCC（r=-0.364, P=0.006；r=-0.383, P=0.004；r=-0.508, P=0.002）. No significant relation was observed between CD95, JNK1, JNK2, c-Jun and gender, age, number of nodules, venous infiltration or cirrhosis（P＞0.05）.CD95 expression was positively correlated with expression JNK1（r=0.693, P＜0.001）, JNK2（r=0.357，P=0.007), and c-J un(r=0.670, P＜0.001）.
Conclusions：CD95 gene is significantly lower expressed in HCC tissue. CD95 protein may promote the initiation and development of HCC by modulating JNK signal transduction system.

Abstract:

Objective：To evaluate the indications，safety and feasibility of endoscopy combined with laparoscopy in the treatment of gastrointestinal (GI) tumors.
Methods：The clinical data of 30 patients who underwent endoscopy-directed laparoscopic resection of GI tumors from September 2007 to July 2010 were retrospectively studied. Among these tumors,2 were gastric stromal tumor，20 were colorectal adenoma,and 8 were proved to be polyp with cancerous change.
Results：Thirty patients were treated successfully and no patient was converted to laparotomy.The mean time of operation was 40～90 min,blood loss ranged from 20 mL to 50 mL, and the time of rcturn of bowel function was 1～2 days.No complication such as hemorrhage, anastomotic stomal leak, infection of incisional wound or infection of abdominal cavity occurred. postoperative hospital stay was 4 to 6 days.Follow-up of the 30 cases for 6-24 months after operation showed that no recurrence occurred.
Conclusions：Gastroenteric tumor resection by endoscopy combined with laparoscopy demonstrates its advantages such as precise tumor localization, safety,mini-trauma, few complications and quick recovery, and its widespread use is recommended.

Abstract:

Objective：To investigate the effectiveness of sero-muscular flap-covering anstomosis for acute obstructive left-colon carcinoma.
Methods：Clincal data of 57 patients with acute obstructive left-colon carcinoma treated in our department from 2000—2009 were retrospectively analyzed. All of them were treated with one-stage  resection and anastomosis with sero-muscular flap-covering.
Results：Among the 57 cases, no postoperative intestinal fistula,abdominal infection or death occurred,5 were complicanted with wound infection only.
Conclusions：One-stage  resection and anastomosis with sero-muscular flap-covering in patients with acute obstructive left-colon carcinoma is safe and feasible,and can avoid the problems of secondary operation  and colostomy. This anastomotic procedure has proved effective in preventing anastomotic fistula after primary resection of acute obstructive carcinoma of left colon.

Abstract:

Objective：To compare the safety and effectiveness of routine drainage and no-drainage regimes after selective colorectal cancer radical resection. 
Methods：All patients received selective colorectal cancer radical resection were randomly divided into two groups: group I (no-drains,n=59), group II (with drains,n=61).The incidence of anastomotic leak and complications specific to the drain, as well as other complications were compared in the 2 groups.
Results：The mean length of postoperative stay was (12.8±2.7)d in group I and (13.1±2.8)d in group II (P＞0.05),and postoperative days for oral intake were  (5.2±1.8)d in group I and (5.5±1.6)d in group II(P＞0.05).No significant difference was noted in the incidence of postoperative complications between the no-drain group and the drain group(11.9% vs. 13.1%,P＞0.05); however, the pain index in group 1 was significantly lower that in group II (P<0.05).
Conclusions：No routine abdominal drainage after colorectal cancer radical resection is safe and reliable, and routine abdominal drinage to prevent anastomotic leak and other complications is unnecessary.

Abstract:

Objective：To study the clinical characteristics, diagnosis and treatment of femoral hernia  in males.
Methods：The clinical data of 37 cases of femoral hernia in males admitted to our department in the last nine years were analyzed retrospectively.
Results：The clinical manifestations of femoral hernia  in males included a reducible mass below the inguinal ligament in all 37 cases, on the right side in 24 cases, and the left side in 13 cases; inguinal pain in 29 cases, incarceration or strangulation in 19 cases, and gut incarceraion with bowel obstruction in 7 cases. Herniorrhaphy was performed in 35 of the patients, including. McVay repair performed in 19 cases, tension-free hernioplasty performed in 13 cases, and femoral herniorrhaphy through an incision below the inguinal ligament performed in 3 cases. All the cases were followed up for 6 months to 5 years, no recurrence was found.
Conclusions：The diagnosis of  in males femoral hernia can be made according to clinical symptoms and signs. Doppler ultrasound examination is helpful for diagnosis of femoral hernia. Herniorrhaphy is the only effective means of treatment of femoral hernia.

Abstract:

Objective：To explore the plan of minimally invasive operation methods for managing the common bile duct stones (CBDS) according to different conditions.
Methods：The clinical data of 203 patients with CBDS treated in our department during last 9 years were analyzed retrospectively. According to the different type of operation, the patients were devided into: Endoscopic papillary balloon dilatation (EPBD) group, including 22 cases, endoscopic sphincterotomy  (EST) group, including 105 cases; and laparoscopic common bile duct exploration (LCBDE) group, including 76 cases.
Results：Statistically significant difference was not found among the three groups in success rate of surgery, recent complications rate or residual stone  rate (P＞0.05).The operation time was significantly different statistically (P=0.000), and the shortest was LCBDE group. Hospital stay was statistically significantly different (P=0.000), and the shortest was EPBD group. Stone recurrence, reflux cholangitis and papillary stricture rate were statistically different(P＜0.05), they were equivalent in LCBDE group and EPBD group, and worst in EST group.
Conclusions：EPBD should be carried out as the first choice for patients with CBDS. If EPBD fails or there is no indication for EPBD, LCBDE can be selected, while EST should be applied only to suitable candidates with strict indications.