Search

Culture supernatants from GC cells inhibit neutrophil apoptosis in vitro. Neutrophils were untreated or stimulated with 20% culture supernatants from GC cells (AGS) for the indicated times. The rate of apoptosis of the cells was analyzed by staining with FITC-conjugated Annexin V and propidium iodide and determined by flow cytometry. The values represent the mean {plus minus} SE of four separate experiments: (A) representative image; (B) statistical results.

Association of CD66b+ cells in IM and TC with clinicopathological characteristics.

Univariate and Multivariate Analyses of Factors Associated with Overall Survival (OS) and Progression-free Survival (PFS).

Clinical characteristics of the 573 gastric cancer patients

Primers for real-time PCR

The accumulation of neutrophils in the invasive margin and IL-17 expression predicts reduced survival in GC patients. 245 paraffin-embedded GC samples were stained with an anti-CD66b Ab. The patients were divided into two groups according to the median CD66b+ neutrophil density. Overall survival and progression-free survival of 245 patients; High infiltration of neutrophils in the invasive margin was associated with reduced survival in different TNM stages. Cumulative overall and progression-free survival time were calculated using the Kaplan-Meier method and analyzed by the log-rank test (A). Kaplan-Meier analysis of progression-free survival and overall survival stratified by IL-17 expression in GC patients (B).

Association of CD66b+ and MMP-9+ cells in the invasive margin of GC (n = 245).

The present study investigated the role of abnormally expressed mRNA and long noncoding RNA (lncRNA) in the development of colorectal cancer (CRC). We used lncRNA sequencing to analyze the transcriptome (mRNA and lncRNA) of five pairs of CRC tissues and adjacent normal tissues. The total expression of mRNAs and lncRNAs in each sample was determined using the R package and the gene expression was calculated using normalized FPKM. The structural features and expression of all detected lncRNAs were compared with those of mRNAs. Differentially expressed mRNAs were selected to perform Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. The functional analysis of differentially expressed lncRNAs was performed by analyzing the GO and KEGG enrichment of predicted cis-regulated target genes. A total of 18.2 × 108 reads were obtained by sequencing, in which the clean reads reached ≥ 94.67%, with a total of 245.2 G bases. The number of mRNAs and lncRNAs differentially expressed in CRC tissues and normal tissues were 113 and 6, respectively. Further predictive analysis of target genes of lncRNAs revealed that six lncRNA genes had potential cis-regulatory effects on 13 differentially expressed mRNA genes and co-expressed with 53 mRNAs. Up-regulated CTD-2256P15.4 and RP11-229P13.23 were the most important lncRNAs in these CRC tissues and involved in cell proliferation and pathway in cancer. In conclusion, our study provides evidence regarding the mRNA and lncRNA transcription in CRC tissues, as well as new insights into the lncRNAs and mRNAs involved in the development of CRC.

To evaluate the effect of oral nutritional supplementation (ONS) on the postdischarge nutritional status and quality of life (QoL) of gastrointestinal cancer patients after surgery.A multi-center study was conducted on gastrointestinal cancer patients who received surgical treatment from 2013-2015. All patients were screened using the Nutrition Risk Screening 2002 (NRS 2002) to assess nutritional risk. Patients with nutritional risk were randomized into two groups: patients in the study group (n=55) were given dietary guidance and ONS, control group (n=59) received only dietary guidance. Anthropometric measurements, nutrition-related laboratory tests, and gastrointestinal function scores were also collected and analyzed using Student's t test and analysis of variance (ANOVA). In addition, the EQ-5D was used to evaluate patients' QoL.Compared with baseline measurements, the body weight of patients in the study group increased by 1.35±0.53 kg and 1.35±0.73 kg at 60 and 90 days, which were significantly higher than those in the control group (-1.01±0.54 kg, and -1.60±0.81 kg at 60 and 90 days). The results from ANOVA showed that only weight and BMI differed significantly between the study and control groups and also between different measurement times (p0.01). No differences were found for the other indicators or QoL between the study groups.ONS may improve the weight and BMI of surgically treated gastrointestinal cancer patients postdischarge. However, these effects had little impact on patients' QoL.

OBJECTIVE: To investigate the effect of sericin on the proliferation of human gastric cancer MKN45 cells and explore the underlying molecular mechanism. METHODS: MKN45 cells were transfected by LC3 double fluorescent autophagic virus, and the positive cells screened by puromycin were divided into blank group, sericin group and sericin+3-MA group. After incubation with sericin for 48 h, the cells were examined for proliferation, apoptosis and cell cycle using CCK-8 assay and flow cytometry. Cell autophagy was detected by transmission electron microscopy (TEM) and fluorescent inverted microscope, and the autophagy-related markers including LC3, p62 and Beclin proteins were detected with Western blotting. Nude mice bearing gastric cancer xenograft were treated with normal saline or sericin injections (n=5) and the changes in the tumor volume and weight were measured. RESULTS: Compared with the blank group, MKN45 cells with sericin treatment showed significantly inhibited proliferation both in vitro and in nude mice. Autophagosomes were observed in sericin-treated cells under TEM and fluorescent inverted microscope. Sericin treatment of the cells significantly increased the cell apoptosis (P < 0.01), caused obvious cell cycle arrest in G(2)/M phase (P < 0.01), up-regulated the expressions of both LC3-2 and Beclin, and down-regulated the expression of p62. The autophagy inhibitor 3-MA obviously antagonized the effects of sericin on cell apoptosis, cell cycle and autophagic protein expressions. CONCLUSION: Sericin can inhibit the proliferation of human gastric cancer MKN45 cells by regulating cell autophagy to serve as potential anti-tumor agent.

In this paper, we propose and present a novel algorithm for medical image segmentation (MIS). By analyzing the current state-of-the-art related algorithms, we introduce the multi-band active contour model based limit function to make the multilayer segmentation available. With the development of image segmentation technology, the development of medical image segmentation technology also got very big, because there is no find common, accepted effect ideal is suitable for medical image segmentation method, almost existing each kind of segmentation method has application in the field of medical image segmentation. Furtherly, with the optimized aims of being robust to the noise and avoiding the bad effluence on the result, we adopt the kernel method and new initialization curve. This model suffers from low noise robustness, and model algorithm is difficult to achieve. Integrated segmentation technology refers to two or more technology is used, combined with their own advantages, so they can on the accuracy or efficiency to achieve better performance than when using a single. A new penalty term is introduced to improve numerical stability and the step length is increased to improve efficiency. As far as the robustness and effectiveness are concerned, our method is better than the existing medical image segmentation algorithms. Experimental analysis verifies the success of our method.

To construct a MYH9 gene knockout model in MGC803 cell line using transcription activator-like effector nuclease (TALEN) and observe its effect on cell cycle and apoptosis.According to FastTALE(TM) TALEN Kit, we designed TALEN pairs and constructed the plasmids targeting to MYH9 gene. After detecting their activity in MGC803 cells by plasmid transfection, DNA sequencing, RT-PCR and western blot, we selected the monoclonal cells and studied the changes in the cell cycle and apoptosis.MYH9 gene could not be knocked out but knocked down in selected MGC803 monoclonal cells, which caused cell cycle arrested at G2/M phase (P0.05) and a significant increase in the cell number with early apoptosis (P0.01).We successfully generated a MYH9 knockdown model in MGC803 cell lines by TALEN, which could be in favor of MYH9 function study in gastric cancer.

New complications are resulting from percutaneous transluminal angioplasty (PTA) and stent deployment. A 43-year-old female, admitted with weakness in the right arm, was diagnosed with right subclavian stenosis. Following PTA and a Palmaz stent deployment, her condition worsened, and symptoms spread. A corrective surgical procedure found the Palmaz stent to be almost completely compressed. The stent and plaques were carefully extracted. The etiology of compressed stent was probably due to an insufficient radial force or Hoop strength of stent. If an occlusion of the subclavian artery occurs at the segment proximal to the orifices of vertebral artery and internal mammary artery, a vertebral-subclavian steal syndrome may occur. This can be diagnosed in patients manifesting symptoms that include vertebral-basilar arterial insufficiency and a difference in brachial systolic blood pressure of at least 30 mm Hg between the two arms, with a bruit at the base of the neck or in the supraclavicular area./hea

A high proportion of patients with stable angina remains symptomatic despite multiple treatment options. Di'ao Xinxuekang (XXK) capsule and Compound Danshen (CDS) tablet have been approved for treating angina pectoris for more than 20 years in China. We compare the anti-anginal effectiveness of XXK capsule and CDS tablet in patients with symptomatic chronic stable angina. A randomized, multicenter, double-blind, parallel-group, superiority trial was conducted in 4 study sites. 733 patients with symptomatic chronic stable angina were included in the full analysis set. The primary outcomes were the proportion of patients who were angina-free and the proportion of patients with normal electrocardiogram (ECG) recordings during 20 weeks treatment. Compared with CDS, XXK significantly increased the proportion of angina-free patients, but no significant difference was noted in the proportion of patients with normal ECG recordings. Weekly angina frequency and nitroglycerin use were significantly reduced with XXK versus CDS at week 20. Moreover, XXK also improved the quality of life of angina patients as measured by the SAQ score and Xueyu Zheng (a type of TCM syndrome) score. We demonstrate that XXK capsule is more effective for attenuating anginal symptoms and improving quality of life in patients with symptomatic chronic stable angina, compared with CDS tablet.

Aim: To take a deeper insight into the relationship between the root of the inferior mesenteric artery (IMA) and the autonomic nerve plexuses around it by cadaveric anatomy and explore anatomical evidence of autonomic nerve preservation in high ligation of the IMA in laparoscopic surgery for colorectal cancer. Methods: Anatomical dissection was performed on 11 formalin-fixed cadavers and 12 fresh cadavers. Anatomical evidence-based autonomic nerve preservation in high ligation of the IMA was performed in 22 laparoscopic curative resections of colorectal cancer. Results: As the upward continuation of the presacral nerves, the bilateral trunks of SHP had close but different relationships with the root of the IMA. The right trunk of SHP ran relatively far away from the root of IMA. When the apical lymph nodes were dissected close to the root of the IMA along the fascia space in front of the anterior renal fascia, the right trunk of SHP could be kept in suit under the anterior renal fascia. The left descending branches to SHP constituted a natural and constant anatomical landmark of the relationship between the root of IMA and the left autonomic nerves. Proximal to this, the left autonomic nerves surrounded the root of the IMA. Distally, the left trunk of the SHP departed from the root of IMA under the anterior renal fascia. When high ligation of the IMA was performed distal to it, the left trunk of SHP could be preserved. The distance between the left descending branches to SHP and the origin of IMA varied widely from 1.3 cm to 2.3 cm. Conclusions: The divergences of the bilateral autonomic nerve preservation around the root of the IMA may contribute to provide anatomical evidence for more precise evaluation of the optimal position of high ligation of the IMA in the future.

Although the prognostic value of nodal metastases in differentiated thyroid cancer remains controversial, it is of interest to evaluate and understand the different characteristics of predictive outcomes. A multicenter retrospective study was conducted in 215 untreated patients with differentiated thyroid cancer from July 1997 to July 2015 in 4 medical centers of Guangdong Province. A total of 107 patients with nodal metastases (group A) were compared to 108 patients without metastases (group B). The 5-year disease-free survival (DFS), overall survival (OS), and postoperative complications in both groups were calculated. Variables predictive of DFS and OS were evaluated in group A. The group A had lower 5-year DFS (69.16%, 11 months) and shorter median time of recurrence than those in group B (87.96%, 8.5 months, respectively, P 45 years and have higher pTNM stage or follicular histology tend to have poor prognosis. Selective lymph node dissection with appropriate postoperative treatment and frequent follow-up should be accorded to these vulnerable groups of patients.

To investigate the regulatory effect of microRNA-221 (MIR221) on CDKN1C/p57 expression in colon carcinoma cells in vitro.Caco2 cells were treated with or without anti-p57-siRNA prior to the addition of pre-MIR221 or anti-MIR221. The MIR221 expression pattern was detected by real-time RT-PCR, and the mRNA and protein levels of CDKN1C/p57 expression were detected using semi-quantitative RT-PCR and Western blotting. Caco2 cell proliferation following the treatment was detected with MTT assay. CDKN1C/p57 3'-UTR fragment was amplified by PCR from the genome DNA of human colon and inserted into a luciferase reporter plasmid. The luciferase reporter plasmid construct was then transfected into Caco2 cells along with pre-MIR221 or anti-MIR221, and the luciferase activity in the transfected cells was detected.MIR221-specific inhibitor significantly up-regulated CDKN1C/p57 protein expression in Caco2 cells (P0.01). Anti-MIR221 could markedly inhibit Caco2 cell proliferation, and the inhibitory effect was obviously abolished by pretreatment with anti-p57-siRNA, suggesting that the inhibition was mediated by CDKN1C/p57 (P0.01). A significant increase of luciferase activity was detected in Caco2 cells co-transfected with the luciferase reporter plasmid construct and anti-MIR221 (P0.01).MIR221 can interact with the target site on the 3'-UTR of CDKN1C/p57 mRNA to inhibit CDKN1C/p57 expression by post-transcriptional gene silencing to promote colon carcinoma cell proliferation, suggesting the value of MIR221 as a potential target for treatment of colon carcinoma.

To evaluate the effect of simulated intraperitoneal 5-fluorouracil (5-Fu) aerosol chemotherapy (AIPC) on the proliferation, apoptosis, and cell cycle of human gastric cancer cell line MKN-45 in vitro.The gastric cancer cells MKN-45 were treated with 5-Fu aerosol for 30 min under the pressure of 8 mmHg, and those treated with normal saline (NS) aerosol served as the control. The cell proliferation after the treatment was detected by MTT assay, and flow cytometry and FITC Annexin V/PI kit were used to detect the cell apoptosis and changes in the cell cycle.MTT assay showed a significantly greater inhibition rate of the cell proliferation in 5-Fu aerosol group than in NS group [(31.13∓3.51)% vs (4.65∓1.99)%, P0.001]. FCM analysis also showed a significantly higher cell apoptotic rate in 5-Fu aerosol group than in NS group [(12.00∓0.92)% vs (2.65∓0.52)%, P0.001]. Compared with saline treatment, treatment with 5-Fu aerosol resulted in a greater proportion of G1 phase cells [(51.83∓1.95)% vs (36.41∓2.33)%, P0.001] with a lowered proportion of S phase cells [(16.72∓2.36)% vs (45.20∓3.27)%, P0.001].Simulated 5-Fu AIPC can inhibit the proliferation, induce cell apoptosis and cause cell cycle arrest at G1 phase in gastric cancer cells.

To investigate miRNA-221 expression in human colorectal carcinoma (CRC) cells and the effects of miR-221-specific inhibitor on the proliferation and apoptosis of CRC cells.Four human CRC cell lines (HT-29, Lovo, SW-480, and CaCO2) were examined for miRNA-221 expression using real-time Q-PCR. The specific 2,-methoxy-modified RNA oligonucleotides of miR-221 (anti-miR-221) were synthesized and transfected into Caco2 cells via liposome, and the changes in the expression of miR-221 in the cells were detected by real-time Q-PCR. The proliferation and apoptosis of the transfected CRC cells were detected using MTT assay and flow cytometry.The 4 human CRC cells showed significantly upregulated expression of miR-221 compare with HUVECs (P0.01). The miR-221-specific inhibitor, anti-miR-221, significantly inhibited the expression of miR-221 in Caco2 cells and suppressed the cell proliferation, causing also obvious cell apoptosis (P0.01).The miR-221-specific inhibitor shows potent inhibitory effect on the growth of CRC cells, suggesting its value as a potential anti-tumor candidate for treatment of CRC.

To analyze the learning curve for an experienced laparoscopic colorectal surgeon in performing to laparoscopic D2 gastrectomy for gastric cancer.From July 2004 to July 2009, 70 patients undergoing laparoscopic D2 gastrectomy performed by a single surgical team were retrospectively evaluated. The patients were divided into groups A to G (n=10) based on the surgery date, and the operation time, estimated blood loss (EBL), conversion to open surgery, number of lymph nodes harvested, complications, and recovery indicators were compared.No statistical differences were found among the groups in age, gender, gastrectomy approach, EBL, number of lymph nodes harvested, time to flatus, or postoperative hospital stay (P0.05). No significant differences were found in the operation time between groups A and B (P=0.999) or among the other 5 groups (P0.05), but the operation time in groups A (300.00-/+104.59 min) and B (261.00-/+40.50 min) were significantly longer than that in the other 5 groups (C: 191.30-/+23.11 min, D: 188.60-/+31.38 min, E: 181.10-/+20.18 min, F: 167.50-/+32.81 min, and G: 161.30-/+29.03 min). Compared with that in group A, the time to liquid diet decreased significantly in the remaining 6 groups (P0.05). Conversion to open surgery occurred in two cases (2.86%, both in group B), 2 patients in group B and another 2 in group C developed intraoperative complications, and one in group C had postoperative complication, with the total incidence of complication of 7.14% in this series.A well-trained laparoscopic colorectal surgeon, by following the standard surgical procedures, are likely to overcome the learning curve smoothly after performing approximately 20 cases of laparoscopic D2 gastrectomy for gastric cancer.

To observe the effect of laparoscopy-assisted and open distal gastrectomies on the perioperative levels of C-reactive protein (CRP) and visceral proteins in patients with gastric cancer.T Fifty-three patients with gastric cancer were randomized into two groups to receive laparoscopic surgery (n=26) or open surgery (n=27). The CRP levels were measured preoperatively and at 1, 2, 3 and 7 days after the operation. The levels of the visceral proteins including albumin (ALB), prealbumin (PRE), transferrin (TRF) and retinal-binding protein (RbP) were assayed before and at 3 and 7 days after the operation.Compared with the preoperative levels, the CRP levels in both groups were significantly increased on days 1, 2, and 3 after the operation (P0.05), with the highest level occurred on day 2 postoperatively. The postoperative CRP levels were significantly lower in the laparoscopic group than in the open surgery group (P0.01). The levels of ALB, PRE, TRF, and RbP were significantly decreased after operation in both groups (P0.01) without significant differences between the two groups (P0.05).Compared with open surgeries, laparoscopy-assisted distal gastrectomy for gastric cancer causes minimal surgical trauma and mild inflammatory responses to allow the recovery of the levels of the visceral proteins.

To evaluate the effect of laparoscopic surgery in resection of suspected gastrointestinal stromal tumors.A retrospective analysis was conducted among 50 patients with suspected gastrointestinal stromal tumors. All the patients underwent laparoscopic tumor resection. Thirty-eight of the patients had a preoperative diagnosis of gastric submucosa tumor by gastroscopy, and 12 had a diagnosis of small intestinal tumor by small intestinal endoscopy. The surgical procedure, operative time, estimated blood loss, time for passage of flatus, time for eating, postoperative hospital stay, operative complications, pathology and the results of follow-up were analyzed.In these cases, the mean operative time was 90.84-/+26.69 min, with the mean estimated blood loss of 57.80-/+67.48 ml, mean time for passage of flatus of 50.90-/+18.87 h, mean time for eating of 2.94-/+0.79 days, and postoperative hospital stay of 8.62-/+3.56 days. No patient developed surgical complications, and all the lesions showed negative results on the margins of the resection.As a minimally invasive surgical approach, laparoscopic resection of suspected gastrointestinal stromal tumors reduces the intraoperative blood loss, promotes postoperative recovery of the patients and achieves R0 resection without causing serious complications.

To evaluate the safety and feasibility of laparoscopic surgery following neoadjuvant chemoradiotherapy (CRT) for mid-low rectal cancer.A retrospective analysis was conducted among 24 patients with mid-low rectal cancer who received laparoscopic total mesorectal excision (TME) after neoadjuvant CRT. Another 24 patients with mid-low rectal cancer were randomly selected form those undergoing primary laparoscopic TME to serve as the control group. The clinical data and surgical data of the two groups of patients were collected and analyzed comparatively.TME after CRT resulted in significantly lower lymph node yield compared with the control group (7.08-/+6.5 vs 12.5-/+4.1, P0.05). The two groups were comparable in the operative time, intraoperative blood loss, intestinal function recovery, positive surgical margins, rate of conversion to open surgery, and occurrence of intra- and postoperative complications.Laparoscopic surgery of mid-low rectal cancer after neoadjuvant CRT can be safe and feasible and produce surgical effects comparable to exclusive laparoscopic surgery.

To evaluate the clinical effect of intraoperative and early postoperative continuous hyperthermic pertioneal perfusion chemotherapy (CHPPC) for gastric cancer.Eight-five patients with gastric cancer were randomized into therapeutic group with perioperative CHPPC combined with intravenous chemotherapy (n=44) and control group with intravenous chemotherapy only (n=41). The postoperative complications, adverse effects, local recurrence rates, distant metastasis rates, and 1- and 3-year survival rates were compared between two groups.No significant differences were found in the postoperative complications and adverse effects between the two groups. The recurrence rate and distant metastasis rates in the therapeutic group were significantly lower than those in the control group (20.45% vs 43.90%, and 15.90% vs 39.02%, P0.05). The 1- and 3-year survival rates in the therapeutic group were significantly higher than those in the control group (90.90% vs 78.05%, and 59.09% vs 34.15%, P0.05).Perioperative CHPPC for gastric cancer is safe and feasible, and can reduce the recurrence rate, distant metastasis rate and improve the survival for gastric cancer patient after operation.

To evaluate the frequency of microsatellite instability (MSI) and absence of hMLH1/hMSH2 expression in young patients with colorectal cancer, and investigate their role in screening hereditary nonpolyposis colorectal cancer (HNPCC).Seventy-three young patients (below 40 years old) with colorectal cancer were examined for DNA mismatch repair deficiency by microsatellite testing and immunohistochemical detection of hMLH1/hMSH2 gene products.The frequency of MSI and absence rate of hMLH1/hMSH2 expression are 56.16% and 49.32% in these patients, respectively, which increased significantly with younger age for cancer diagnosis.Defects in the DNA mismatch repair system are frequent in Chinese young patients with colorectal cancer. Microsatellite analysis and immunohistochemical detection are useful for efficient identification of HNPCC in these young patients.

AIM: To investigate the causes of small intestinal bleeding as well as its diagnosis and therapeutic approaches. METHODS: A retrospective analysis was conducted according to the clinical records of 76 patients with small intestinal bleeding admitted to our hospital in the past 5 years. RESULTS: In these patients, tumor was the most frequent cause of small intestinal bleeding (37/76), followed by Meckel’s diverticulum (21/76), angiopathy (15/76) and ectopic pancreas (3/76). Of the 76 patients, 21 were diagnosed by digital subtraction angiography, 13 by barium and air double contrast X-ray examination of the small intestine, 11 by 99mTc-sestamibi scintigraphy of the abdominal cavity, 6 by enteroscopy of the small intestine, 21 by laparoscopic laparotomy, and 4 by exploratory laparotomy. Although all the patients received surgical treatment, most of them (68/76) received part enterectomy covering the diseased segment and enteroanastomosis. The follow-up time ranged from 1 year to 5 years. No case had recurrent alimentary tract bleeding or other complications. CONCLUSION: Tumor is the major cause of small intestinal bleeding followed by Meckel’s diverticulum and angiopathy. The main approaches to definite diagnosis of small intestinal bleeding include digital subtraction angiography, 99mTc-sestamibi scintigraphy of the abdominal cavity, barium and air double contrast X-ray examination of the small intestine, laparoscopic laparotomy or exploratory laparotomy. Part enterectomy covering the diseased segment and enteroanastomosis are the most effective treatment modalities for small intestinal bleeding.

To investigate the diagnostic and therapeutic value of laparoscopy in patients with massive small intestinal bleeding.Twenty-two patients with massive small intestinal bleeding and hemodynamic alteration underwent laparoscopic laparotomy in our unit from December 2002 to April 2005. Post pathologic sites were found, laparoscopy- or laparoscopy-assisted part small intestinal resection including pathologic intestinal site and enteroanastomosis was performed in all these patients.The bleeding sites were successfully detected by laparoscopy in all these 22 patients. Massive small intestinal bleeding was caused by jejunum benign stromal tumor in 8 cases, by jejunum potential malignant stromal tumor in 5 cases, by jejunum malignant stromal tumor in 1 case, by Mechel's diverticulum in 5 cases, by small intestinal vascular deformity in 2 cases, and by ectopic pancreas in 1 case. A total of 16 patients underwent laparoscopy-assisted enterectomy and enteroanastomosis of small intestine covering the diseased segment and 6 patients received enterectomy of the diseased segment under laparoscope. No surgical complications occurred and the outcome was satisfactory.Laparoscopy in diagnosis and treatment of massive small intestinal bleeding is noninvasive with less pain, short recovery time and definite therapeutic efficacy.

To evaluate the effect of pirarubicin (THP) in combination with hyperthermia on gastric cancer tissues in vitro and explore the underlying mechanisms.In vitro three-dimensional culture models were established with tissue biopsies from 36 patients with pathologically confirmed gastric cancer. The tumor cell viability was measured by MTS-PMS assay, and HE staining was used to study the histomorphological changes of the tissues following chemotherapy and hyperthermia.Synergistic tumor cell-killing effects of cisplatin, THP, and mitomycin with hyperthermia was observed in the tumor tissues (P=0.000), and THP exhibited stronger cytotoxic effects than the other drugs. Histomorphological study suggested strong killing effects of THP on the tumor tissues, which displayed disrupted tissue structure, cellular degradation and necrosis, karyopyknosis and karyolysis, with cytoplasm loss. The anti-tumor effects of THP were associated with clinical staging and pathological grading of the tumors (P=0.000), but not with the patients' gender, age, tumor size and preoperative CEA levels (P0.05).Pirarubicin shows good synergistic effects with hyperthermia, and the cytotoxicity of pirarubicin against gastric cancer tissue is enhanced considerably by mild hyperthermia. THP can be a potential therapeutic drug for intraperitoneal chemohyperthermia.

To evaluate the surgical outcomes of laparoscopic resection for rectal cancer and to investigate how surgeons without previous training of laparoscopic cholecystectomy(LC) can quickly learn laparoscopic resection for rectal cancer.Clinical data of 105 cases of laparoscopic rectal resection performed by a group of surgeons without previous training of LC were reviewed. The cases were divided equally into 3 groups (groups A, B and C) according to the sequence of the operations. The operating time, blood loss, lymph node harvest, length of specimen, conversion rate to open surgery, intra- and postoperative complications and hospital stay were compared between the 3 groups.There were no significant differences between the 3 groups with respect to age, gender, Dukes'stage or surgical approach (P0.05). The operating time in group A was 196.1+/-30.3 min, significantly longer than that in group B (164.8+/-22.7 min) and group C (158.7+/-20.9 min) (P0.001), but the operating time did not vary significantly between groups B and C (P0.05). The blood loss was significantly greater in group A than in groups B and C (72.4+/-21.5, 48.2+/-16.3, and 46.6+/-15.4 ml, respectively, P0.001), but showed no significant difference between the latter two groups (P0.05). The rate of conversion to open surgery decreased from 11.4% in group A to 2.9% in group B and group C, but the difference was not statistically significant (P0.05). The rate of intraoperative complications declined from 17.1% in group A to 5.7% in group B and group C, showing no significant difference either. The lymph node harvest, length of specimen, and postoperative complications showed no significant variation between the 3 groups (P0.05), but group C had significantly shorter mean hospital stay in comparison with groups A and B (P0.001). The 35 patients in group A received the operation within a time period of 17 months (2.1 cases per month), and operations in groups B and C were done in 7 months (5 cases per month).The learning curve of laparoscopic rectal resections is approximately 35 cases, and the surgeons without previous experience of laparoscopic cholecystectomy can learn the surgical skills after performing 35 laparoscopic resections for rectal cancer at the monthly frequency of 2.1 cases.

To evaluate the regional anatomy between the abdominal autonomic nerves including the abdominal aortic plexus (AAP) and the inferior mesenteric artery (IMA), and explore the safe ligation point on the IMA and the optimal dissection method to avoid autonomic nerve injuries.Dissections and observation were carried out on 16 fixed male cadavers. The AAP located in the thin fascia layer covering the surface of the aorta and its branches. No autonomic nerves were found in the area around the root of the IMA, and the point where the IMA and the left trunk of the AAP intersected was highly variable. The left trunk of the AAP adhered more closely to the IMA than to the aorta.In view of autonomic nerve preservation, the only safe site for ligation of the IMA is at its origin, and no other such sites are available along the IMA trunk and its branches. The IMA and the posterior fascia layer containing the autonomic nerves constitute the optimal surgical plane for IMA ligation, which should be performed following skeletonization of the IMA with careful preservation of the integrity of the posterior fascia layer.