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Enteral nutrition can provide adequate nutrients and enhance immunity. Because it is inexpensive, no significant side effects, and convenient, enteral nutrition has been used widely. However, enteral nutrition has its limitation, therefore some details should be noticed during the management. In this paper, we discuss the details about enteral nutrition based on the data of our gastric carcinoma patients.

Recently, the incidence of carcinoma at the esophagogastric junction (CEG), especially adenocarcinoma at esophagogastric junction (AEG) is increasing. AEG has obvious difference from other parts of stomach tumor in anatomy, physiology and pathology. The scholars have not made a consensus and standard about the treatment of AEG. It is necessary to improve the knowledge and cognition about AEG and find a feasible treatment strategy.

Objective: To compare the incidence of postoperative long-term complications and quality of life between two digestive tract reconstruction techniques after total gastrectomy in order to provide evidence for clinical practice., Methods: A systematic literature search was carried out to obtain studies of randomized controlled trials (RCTs) of reconstruction techniques including jejunal interposition and Roux-en-Y. Data extracted from RCTs for meta-analysis were independently assessed by two reviewers. A meta-analysis was performed by RevMan5.0 software., Results: A total of 1628 gastric cancer cases undergoing total gastrectomy from 10 RCTs were eligible for inclusion, among whom 728 received jejunal interposition reconstruction and 954 Roux-en-Y anastomosis. As compared with Roux-en-Y anastomosis, jejunal interposition reconstruction significantly decreased the incidence of dumping syndrome (OR=0.19, 95%CI:0.11-0.34, P<0.01), increased the prognostic nutritional index (WMD=6.02, 95%CI:1.82-10.22, P<0.01), and improved the body weight postoperatively (WMD=-2.45, 95%CI:-3.81--1.71, P<0.01). Meanwhile, jejunal interposition reconstruction did not prolong operative time and hospital stay (both P>0.05)., Conclusion: Jejunal interposition has better efficacy than Roux-en-Y in dumping syndrome and quality of life, and is a reasonable and effective digestive tract reconstruction for long-term survival of gastric cancer patients.

Objective: To evaluate the effect of nasogastric decompression tube after gastric cancer operation on the postoperative recovery., Methods: A total of 174 patients with gastric cancer were prospectively enrolled from December 2009 to March 2011 and randomly divided into non-nasogastric tube control group(n=88) and nasogastric tube group(n=86). Postoperative symptoms, complications, recovery time, and quality of life during hospital stay were compared between the two groups., Results: The incidences of nausea(14.8% vs. 47.7%, P<0.01), sore throat(6.8% vs. 38.4%, P<0.01), bucking and foreign body sensation(3.4% vs. 20.9%, P<0.01), expectoration obstruction(36.4% vs. 55.8%, P<0.05) were significantly lower in nasogastric tube group than those in the control group. The intervals to ambulation and flatus were(1.46±0.58) d and(3.11±0.77) d in the non-nasogastric tube group, significantly shorter those in nasogastric tube group[(1.68±0.61) d and(3.75±1.03) d]. There was no anastomotic leak or bowel obstruction. The difference in bleeding was not statistically significant[3.4%(3/88) vs. 5.8%(5/86), P>0.05] between the two groups. The quality of life differed between the two groups(mean score, 3.36 vs. 2.78, P<0.01)., Conclusion: Early removal of nasogastric decompression tube is safe and reasonable and can improve the quality of life during hospital stay.

Objective: To provide basic information for epidemiological research of gastrointestinal (GI) malignant tumors., Methods: Data of GI cancer diagnosed in 15 hospitals of Heilongjiang province between January 1998 and December 2007 were analyzed retrospectively. The data mainly involved the age of onset, initial symptoms, pathological types, clinical staging and types of surgical procedure., Results: Gastric cancer was the most common type (45.8%) among the 33,540 GI cancer cases, then were rectal cancer (27.3%) and colon cancer (26.8%). Right colon cancer cases were more common than the left ones (1.3:1.0), particularly in people over 80 (2.1:1.0). Only 1.3% of colorectal cancer could be found in age under 30 years old. In patients aged 50 to 70, advanced gastric cancer accounted for 70.6%, advanced colon cancer 73.4% and advanced rectal cancer 72.4%. Well-moderately differentiated adenocarcinoma in early gastric cancer was 49.7%, early colon cancer 77.3% and rectal cancer 83.2%. Patients undergone radical excision in early gastric cancer accounted for 69.1%, advanced gastric cancer 79.9%, left colon cancer 91.9%, right colon cancer 83.9% and in rectal cancer for 88.3%., Conclusions: People aged 50 to 70 tend to get GI cancer in Heilongjiang province. Gastric cancer is the most common GI cancer. Radical excision is the main choice of therapy.

Objective: To investigate the expression of transcription factor SP1, vascular endothelial growth factor(VEGF) and CD34 in serosa-infiltrating gastric cancer and their relationship with biological behavior and survival rate., Methods: Immunohistochemical technique was used to detect the expression of SP1, VEGF and CD34(described by microvessel density, MVD) in 68 specimens with serosa-infiltrating gastric cancer., Results: The positive expression rates of SP1 and VEGF in serosa-infiltrating gastric cancer were 50.0% and 52.9% respectively. In positive SP1 specimens, the positive rate of VEGF(73.5%) was significantly higher than that of negative SP1 specimens (32.4%, chi(2)=11.57, P=0.01). The mean tumor MVD was correlated with the expression levels of SP1 and VEGF(P<0.01). There was a significant correlation of the SP1 expression with tumor size and growth pattern(P =0.01). The expression levels of VEGF and MVD were correlated with Borrmann types, cell differentiation, metastatic lymph nodes and growth pattern(P<0.01). Univariate analysis revealed that SP1 and VEGF expression, MVD, Borrmann types, lymph node metastasis, tumor size and growth pattern were significant prognostic factors related to survival time. Multivariate analysis showed that SP1 expression, MVD and growth pattern were independently prognostic factors of poor survival., Conclusions: The activation of SP1 contributes to angiogenesis and metastasis in gastric cancer through the up-regulation of VEGF. SP1, VEGF and MVD may serve as valuable indicators of biological behavior of gastric cancer. SP1 protein expression is not related with the number of metastatic lymph nodes. SP1 expression and MVD may serve as valuable indicators of prognosis in gastric carcinoma.

Objective: To study the precise cause and the specific procedure about gastric mucosal lesion in rats with water immersion-restraint stress(WRS)., Methods: One hundred and forty-four Wistar rats were divided into 9 groups randomly: A, B, C, D, E, F, G, H and I group. There were 16 rats in each group. A, B and C groups underwent gastric emptying determination. Emptying rate of gastric fluid was determined with radiate nuclide (99m)Tc. D, E and F groups underwent gastric acid secretion determination after cleaning gastric contents and pylorus ligation. G, H and I groups underwent gastric acid secretion determination after pylorus ligation without cleaning gastric contents. Gastric mucosal lesion ulcer index(UI) was evaluated. The relationship between of gastric mucosal lesion and gastric emptying rate and gastric acid secretion were examined., Results: Gastric emptying rate decreased obviously when the WRS time was prolonged. There were significant differences among B (WRS 2 h), C group (WRS 4 h) and A group (controlled group) (P<0.01). There was also significant difference between B and C group (P<0.01).The rats' gastric acid secretion was inhibited significantly. The differences among E (WRS 2 h), F (WRS 4 h) and D groups (controlled group) were significant (P<0.01). There was no significant difference between F and E groups (P>0.05). The gastric mucosal lesions were aggravated with time of stress. Gastric contents cleaning could effectively prevent gastric mucosal lesions originated by stress .The operation had no influence on this test. There were significant gastric mucosal lesion UI in B and C groups compared with A group (P<0.01). The difference between B and C group was significant (P<0.01).There were no gastric mucosal lesions in A, D, E, F and G groups. However, There was significant difference between I and F group (P<0.01). No significant difference were found among A, D, E, F and G groups (P>0.05). There were significant difference between H and B group and also between I and C group (P<0.01)., Conclusions: WRS can induce gastric emptying disturbance, reduce gastric acid secretion and cause gastric mucosal lesion. As a factor inducing gastric mucosal lesion, acid can damage gastric mucosa as long as it exists without necessary peracid. The prolongation of acid with gastric mucosa contact period and the decrease of gastric mucosa resistance are perhaps the major causes of gastric mucosal lesion. Besides anti-acid, giving facilitative gastric emptying drugs and gastric lavage during stress ulcer prevention and cure should be considered. Acid evacuation in time is also a major cure for gastritis and recurrent ulcer.