ObjectiveTo investigate the expressions of chemokine receptor CXCR4 and CCR7 in thyroid cancer and its clinicopathologic significance. MethodsFifty-five patients with thyroid cancer were selected in the Affiliated Hospital of North Sichuan Medical College from 2006 to 2009, and 30 patients with thyroid adenoma were selected in the same hospital during 2009. The expressions of CXCR4 and CCR7 were detected in all the selected cases samples (including thyroid cancer and thyroid adenoma) by immunohistochemical SP technique. ResultsThe positive expression rates of CXCR4 and CCR7 in the thyroid cancer were higher than those in the thyroid adenoma (Plt;0.01), which in the thyroid cancer with clinical stage Ⅲ+Ⅳ were higher than those of the clinical stage Ⅰ+Ⅱ (Plt;0.05). The positive expression rate of CCR7 in the thyroid cancer with lymph node metastasis was higher than that of the thyroid cancer without lymph node metastasis (Plt;0.05), which of CXCR4 in the patients with thyroid cancer was independent of lymph node metastasis (Pgt;0.05), and which of CXCR4 and CCR7 were also independent of the age and gender of the patients with thyroid cancer (Pgt;0.05). The positive expressions of CCR7 and CXCR4 in all the patients with thyroid cancer was positively correlated (rs=0.491, P=0.000). ConclusionsCXCR4 and CCR7 are involved in the coordination of thyroid cancer progression. They can be used as prognostic indicators of thyroid cancer. High expression of CCR7 is prone to lymph node metastasis of thyroid cancer.
Objective To explore the feasibility, safety, efficacy and mechanism of intraoperative regional chemotherapy of advanced gastric cancer.Methods The related literatures were reviewed and analyzed. Results Compared with systemic chemotherapy, intraoperative regional chemotherapy of advanced gastric cancer could increase blood drug concentration of cancerous tissue, reduce the systemic toxic side effects, increase survival rate and improve the quality of life. Conclusion Intraoperative regional chemotherapy, as an adjuvant treatment of advanced gastric cancer, has been gradually applied to clinic because of the definite curative effect, which is worth popularizing. However, it needs systemic researches and accumulation of cases.
ObjectiveTo summarize the role and mechanism of gastrokine 1 (GKN1) in the gastric mucosal relative diseases, and to explore the relationship between GKN1 and gastric mucosal relative diseases. MethodsThe literatures about GKN1 and gastric mucosal relative diseases in recent years were collected to make a review. ResultsThe expressions of GKN1 gradually declined from gastritis, gastric ulcer to gastric cancer. GKN1 had the effect of protec-ting gastric mucosa, promoting mucosal repairment, and inhibiting the progression of gastric cancer. ConclusionsGKN1 not only prevents the development of gastric benign diseases to gastric cancer, but also inhibits the progression of gastric cancer, which provides a new idea for the diagnosis and treatment of gastric cancer.
Objective To summarize and analyze the research progression of zinc deficiency in patients with type 2 diabetes mellitus or obesity after Roux-en-Y gastric bypass （RYGB） surgery. Method The domestic and international published literatures about zinc deficiency after RYGB in recent years were reviewed. Results There was a degree of zinc deficiency after RYGB surgery， its mechanisms had not been fully clarified， which were related to reduced intake and absorption of zinc， protein malnutrition， dietary factors， and specific ways of surgery and the zinc supplementation programmes after operation would also affect the postoperative zinc nutritional status. Conclusions Reasons for zinc deficiency after RYGB surgery are multifaceted and have not been clarified. Further research is needed to provide experimental and theoretical basis for management of zinc nutritional status after RYGB surgery.
ObjectiveTo explore the effect of liver metastases of intraoperative and postoperative portal vein chemotherapy and combined with folfox4 regimen chemotherapy for patients with obstrutive colorectal cancer. MethodsA total of 94 obsrutive colorectal cancer patients that could be radical resection were collected from February 2007 to May 2011 in our hospital and divided into two group. Forty-six patients in treatment group received portal vein chemotherapy after the portal vein pump were placed intraoperative, and 3-4 weeks after operation taken FOLFOX4 chemotherapy combined with portal vein infusion chemotherapy 6 courses. Forty-eight patients in the control group received only FOLFOX4 chemotherapy 6 courses 3-4 weeks after operation. Ninety-four patients were followed up for 3 years to observe the incidence of postoperative liver metastasis, at the same time comparing two groups of clinic toxicity during chemotherapy. ResultsIn three years after operation the incidence of liver metastasis were 21.7% in treatment group (10 cases had hepatic metastases), 58.3% in control group (28 cases had liver metastases), the difference in two groups was statistically significant(P < 0.01). Comparing the clinical toxicity in two group, AST in treatment group increased on first day (P < 0.01), and recovered normal on third day (P > 0.05) after operation. There were no marked difference in renal function, ALT, ALP, GGT, and LDH of liver function, medullary restraining, and reaction of gastrointestinal tract (P > 0.05). ConclusionChemotherapy via portal vein intraoperative and postoperativ combined postoperative FOLFOX4 chemotherapy can reduce the risk of postoperative liver metastasis for the patients with obstrutive colorectal cancer.
Objective To explore the research status and development tendency of relation between indoleamine 2，3-dioxygenase （IDO） and immune escape of gastric cancer. Methods The related literatures about IDO， immune escape of gastric cancer， and their the relationship at domestic and international in recent ten years were collected and reviewed. Results Gastric cancers induced that dendritic cells expressed IDO by the CD4＋ CD8＋ regulatory T cells， which made the microenviroment tryptophan starvation， thus inhibited T cell proliferation. While tryptophan metabolites existed T cell cytotoxicity that inhibited T cell proliferation. IDO-specific inhibitor 1-MT combinated with chemotherapy drugs in the treatment for gastric cancer was a synergistic effect. Conclusions IDO as an immune modulating enzymes may play a key role in the process of immune tolerance that induced by gastric body. IDO may become a new target for inhibition of gastric malignancy formation and enhance the effectiveness of tumor immune treatment.
ObjectiveTo summarize the pathogenesis and epidemiology features of gastrointestinal stromal tumor(GIST), explore its diagnosis and therapy, and analyze its prognosis. MethodThe pertinent literatures about the pathogenesis, epidemiology features, diagnosis, therapy, and prognosis of GIST in recent years were reviewed. ResultsGIST was non-epithelial tumor which derived from interstitial cells of Cajal, was the most common mesenchymal tumor about accounting for 1%-3% in the digestive tract tumor. The median onset age of patients with GIST was 40-60 years. The gastric stromal tumor was about 60% in all the digestive tract tumor. The current consensus statement was that there was a relation between the pathogenesis of the GIST and proto-oncogene c-kit or platelet-derived growth factor receptor alpha(PDGFRα)gene mutation. But the mutations of PDGFRαand c-kit gene did not emerge at the same time in the same patient. The clinical manifestations of GIST were not specific, and the diagnosis mainly depended on endoscope and image technology, the correct diagnosis depended on pathological examination. The treatment of GIST was given priority of surgery and molecular targeted drug therapy, and the prognosis was closely related to risk assessment stratify of GIST. ConclusionsGISTs are mesenchymal tumors that has a potential of malignant transformation, the risk classification criteria for aggressive clinical course of primary GIST is an important indication for guiding the clinical therapy and prognostic evaluation. Further research would be needed in prevention, diagnosis, treatment, and relapse prevention of GIST.
Objective To investigate the clinical features, diagnosis, and surgical methods of left-sided appendicitis (LSA). Methods We retrieved LSA-related literatures through Pubmed, Google Scholar English databases, Wanfang, CNKI, VIP, and SinoMed databases (published from January 1981 to June 2017), as well as 2 cases of LSA who treated in Beibei Traditional Chinese Medical Hospital, to analyze the clinical characteristics of LSA and its diagnosis and treatment methods. Results There were 92 articles in a total of 212 LSA patients were retrieved, and 2 cases treated in Beibei Traditional Chinese Medical Hospital, a total of 214 LSA patients were included in the analysis. Pain fixed position of LSA: 139 cases (65.0%) located in left-lower quadrant, 30 cases (14.0%) located in right-lower quadrant, 8 cases (3.7%) located in peri-umbilical, 15 cases (7.0%) located in mid-lower abdomen, 15 cases (7.0%) located in left-upper quadrant, 3 cases (1.4%) located in right-upper abdomen, 2 cases (0.9%) located in mid-upper abdomen, 2 cases (0.9%) located in pelvic cavity, respectively. LSA had occurred in association with several types of abnormal anomalies: 131 cases (61.2%) suffered from situs inversus totalis (SIT), 53 cases (24.8%) suffered from midgut malrotation (MM), 21 cases (9.8%) suffered from cecal malrotation, 4 cases (1.9%) suffered from long appendix, 2 cases (0.9%) suffered from free ascending colon, and 3 cases (1.4%) were unclear. The diagnosis of 114 LSA cases (53.3%) before operation was correct, in which the correct diagnosis rates of SIT-LSA and MM-LSA were 74.8% (98/131) and 22.6% (12/53), respectively. Three patients (1.4%) underwent conservative treatment, and 211 patients (98.6%) underwent surgical treatment, including 25 cases (11.7%) of laparoscopic surgery, 145 cases (67.8%) of open abdominal surgery, and unknown of 41 cases (19.1%). Laparotomy incision: abdominal incision in 74 cases (51.0%), ventral midline incision in 16 cases (11.0%), the left side of the anti McBurney incision in 43 cases (29.7%), right McBurney incision in 12 cases (8.3%). Conclusions LSA mainly occurs in association with 2 types of congenital anomalies: SIT and MM. There is some difficult to make diagnosis for abnormal anatomy and inaccurate pain location of LSA, so it is easy to cause the delay in diagnosis or misdiagnosis. For LSA, the choices of laparoscopy or laparotomy operation methods are applicable.