Efficacy analysis of Cheng’s GIRAFFE reconstruction after proximal gastrectomy for adenocarcinoma of esophagogastric junction

ObjectiveReconstruction of the digestive tract for adenocarcinoma of esophagogastric junction (AEG) is in dispute. This study evaluated Cheng’s gastric tube interposition esophagogastrostomy with reconstruction of His angle and fundus (Cheng’s GIRAFFE anastomosis) in laparoscopic/open proximal gastrectomy for Siewert type II AEG, which was performed at Zhejiang Cancer Hospital and the First Affiliated Hospital of Zhejiang Chinese Medical University. Here, we discuss the preliminary results of gastric emptying and anti-reflux.MethodsFrom a retrospective database, 74 patients with advanced Siewert type II AEG underwent curative proximal gastrectomy with GIRAFFE anastomosis, and their gastric emptying and anti-reflux outcomes were evaluated by the Reflux Disease Questionnaire (RDQ) score, nuclide gastric emptying, 24-h impedance-pH monitoring and gastroscopy.ResultsSeventy-four patients successfully completed proximal partial gastrectomy with Cheng’s GIRAFFE esophagogastric anastomosis. RDQ score six months after the operation was 2.2±2.5. Results of nuclide gastric emptying examinations showed that the gastric half-emptying time was 67.0±21.5 min, the 1-h residual rate was (52.2±7.7)%, the 2-h residual rate was (36.4±5.1)%, and the 3-h residual rate was (28.8±3.6)%; 24-h impedance-pH monitoring revealed that the mean DeMeester score was 5.8±2.9. Reflux esophagitis was observed by gastroscopy in 7 patients six months after surgery.ConclusionsCheng’s GIRAFFE anastomosis is safe and feasible for Siewert type II AEG.     

Survival and prognostic factors for postoperative primary appendiceal cancer: a retrospective cohort study based on the Surveillance,Epidemiology, and End Results database

BackgroundThe factors affecting the postoperative survival of patients with primary appendiceal cancer (PAC) have yet to be fully explored. And there are no clear guidelines for adjuvant treatment after appendectomy. Whether chemotherapy can prolong patient survival after appendectomy, is critical in guiding postoperative medications. The majority of studies on appendiceal cancer are single case reports, and they focused on the incidence of appendiceal cancer. The present study aimed to investigate the survival characteristics of patients with primary appendiceal cancer after surgery using the Surveillance, Epidemiology, and End Results (SEER) database.MethodsThe data of 2,891 cases of primary appendiceal cancer between 2004 to 2015 were obtained from the SEER database and subjected to survival analysis using the Kaplan-Meier method and Cox proportional-hazards model. The annual percentage change (APC) was calculated using the weighted least squares method.ResultsThe overall age-adjusted incidence rate per 100,000 population steadily increased from 0.58 in 2004 to 1.63 in 2015. For patients who received chemotherapy, the median overall survival (OS) was 65 months and the 5-year OS rate was 51.9%, and for patients who did not receive chemotherapy or whose chemotherapy status was unknown, the median OS was not reached and the 5-year OS rate was 78.9%. Age [35< age <69: hazard radio (HR) =2.147; 95% confidence interval (CI): 1.442–3.197, P<0.001; age >69: HR =5.259; 95% CI: 3.485–7.937, P<0.001], race (White race: HR =0.728; 95% CI: 0.590–0.899, P=0.003), histologic type (mucinous neoplasm: HR =0.690; 95% CI: 0.580–0.821, P<0.001; malignant carcinoid: HR =0.657; 95% CI: 0.536–0.806, P<0.001), grade (II: HR =1.794; 95% CI: 1.471–2.187, P<0.001; III: HR =2.905; 95% CI: 2.318–3.640, P<0.001; IV: HR =3.128; 95% CI: 2.159–4.533, P<0.001), and stage (localized: HR =0.236; 95% CI: 0.194–0.287, P<0.001; regional: HR =0.425; 95% CI: 0.362–0.499, P<0.001) were identified as independent predictors of survival. And after adjusting for known factors (age, sex, race, tumor size, marital status, histologic type, grade, stage), chemotherapy (HR =1.220; 95% CI: 1.050–1.417, P=0.009) was revealed to be an independent indicator of poor prognosis.ConclusionsThere was an increasing trend in the incidence of appendiceal cancer in the United States between 2004 and 2015. Chemotherapy was revealed to be an independent indicator of poor prognosis, which provide valuable insight into the therapy of primary appendiceal cancer. Large clinical trials of chemotherapy and targeted therapy for appendiceal cancer are urgently needed.     

CT特征对肺腺癌患者间隙转移风险模型的构建分析

目的 应用计算机断层扫描(CT)特征的预测模型以预测肺腺癌患者间隙转移(STAS)风险.方法 纳入2016年1月至2019年1月我院收治的82例肺腺癌患者为对象;所有患者均接受肺腺癌常规治疗,收集患者入院时人口学资料、临床资料特征,根据患者是否有STAS分为有转移组31例和无转移组51例;采用Cox回归方程分析肺腺癌患...     

New possible silver lining for pancreatic cancer therapy: Hydrogen sulfide and its donors

As one of the most lethal diseases, pancreatic cancer shows a dismal overall prognosis and high resistance to most treatment modalities. Furthermore, pancreatic cancer escapes early detection during the curable period because early symptoms rarely emerge and specific markers for this disease have not been found. Although combinations of new drugs, multimodal therapies, and adjuvants prolong survival, most patients still relapse after surgery and eventually die. Consequently, the search for more effective treatments for pancreatic cancer is highly relevant and justified. As a newly re-discovered mediator of gasotransmission, hydrogen sulfide (H₂S) undertakes essential functions, encompassing various signaling complexes that occupy key processes in human biology. Accumulating evidence indicates that H₂S exhibits bimodal modulation of cancer development. Thus, endogenous or low levels of exogenous H₂S are thought to promote cancer, whereas high doses of exogenous H₂S suppress tumor proliferation. Similarly, inhibition of endogenous H₂S production also suppresses tumor proliferation. Accordingly, H₂S biosynthesis inhibitors and H₂S supplementation (H₂S donors) are two distinct strategies for the treatment of cancer. Unfortunately, modulation of endogenous H₂S on pancreatic cancer has not been studied so far. However, H₂S donors and their derivatives have been extensively studied as potential therapeutic agents for pancreatic cancer therapy by inhibiting cell proliferation, inducing apoptosis, arresting cell cycle, and suppressing invasion and migration through exploiting multiple signaling pathways. As far as we know, there is no review of the effects of H₂S donors on pancreatic cancer. Based on these concerns, the therapeutic effects of some H₂S donors and NO–H₂S dual donors on pancreatic cancer were summarized in this paper. Exogenous H₂S donors may be promising compounds for pancreatic cancer treatment.KEY WORDS: Pancreatic cancer, Hydrogen sulfide donor, Sulfur-containing compound, Cell proliferation, Antitumor effect, Signaling pathway     

阿霉素联合p21CIP1基因转染对人肝母细胞瘤细胞株HepG2增殖的影响

背景与目的:阿霉素类药物是治疗肝母细胞瘤的传统化疗药,但近年来其疗效不佳是困扰临床的一大问题,目前配合基因治疗提高阿霉素的疗效,是肝母细胞瘤治疗发展的新趋势。本实验研究阿霉素与p21基因转染联合对人肝母细胞瘤HepG2细胞增殖的影响。方法:实验分为空白对照组、单独加药组、pcDNA3转染对照组、p21转染组及p21转染 药物联合组。用四甲基偶氮唑蓝(MTT)法检测转染后HepG2细胞的生长趋势,联合处理后细胞增殖抑制状况;荧光定量PCR检测转染后p21mRNA的表达情况,联合处理后survivinmRNA的水平变化。结果:转染后,p21转染组在第3d和第4d的生长速度明显慢于两对照组(P<0.01);经鉴定其有p21mRNA表达量的增高,是空白对照组的155倍(P<0.05)。以空白组为对照,在第3～5d,联合组增殖抑制率明显高于单独加药组和p21转染组(第3d:43.92%vs.32.97%、35.77%,P<0.01;第4d:59.86%vs.39.35%、40.96%,P<0.01;第5d:51.81%vs.33.91%、10.68%,P<0.01);且1～4d内随联合用药时间的延长,抑制效应增强(r=0.91,P<0.05),并在第4d时较显著(Q=1.07)。荧光定量PCR显示,联合组survivinmRNA水平显著低于p21转染组(P<0.01);与单独加药组比较,联合作用仅在48h时差异有统计学意义(P<0.01)。结论:在一定时间范围内p21可增强阿霉素对HepG2细胞的增殖抑制作用,降低胞内survivinmRNA的表达。     

鼻咽癌放疗前CT或MRI检查分期与预后关系的比较

背景与目的:影像学检查结果是鼻咽癌临床分期和确定治疗靶区的重要依据.本研究试图分析放疗前按CT或MRI检查分期与鼻咽癌患者预后的关系.方法:445例病理确诊的无转移初治鼻咽癌患者.根据治疗前影像学检查手段的不同,分为CT组230例,MRI组215例.全组患者均行常规放疗,局部晚期患者加用化疗.用Kaplan-Meier和Log-rank法计算和比较两组生存率,用Cox模型分析影响预后的凶素.结果:CT组1、2、3年生存率分别为96.9%,90.3%,85.3%,MRI组分别为98.6%,94.3%,92.3%,两组比较差异有显著性(x2=6.305,P=0.012).CT组与MRI组的l,2,3年无瘤生存率和无复发生存率比较差异均有显著性(P<0.05),MRI组优于CT组.单因素分析结果显示临床分期、N分期、分期方法和化疗是影响鼻咽癌预后的因素,多因素分析结果显示临床分期和分期方法是影响鼻咽癌患者预后的独立因素.结论:鼻咽癌放疗前行MRI检查分期较CT检查分期来确定放疗靶区可提高鼻咽癌患者的生存率和局控率,临床分期和分期方法是影响鼻咽癌患者预后的独立因素.     

MIPPO技术结合锁定加压钢板对A型闭合性胫骨远端骨折患者踝关节功能及活动范围的影响

目的 探讨微创经皮钢板接骨术(MIPPO)结合锁定加压钢板对A型闭合性胫骨远端骨折患者踝关节功能及活动范围的影响.方法 选取2017年2月至2020年2月收治的A型闭合性胫骨远端骨折患者48例作为研究对象,以数字法将其随机分为对照组和观察组,各24例.对照组采用普通接骨板治疗,观察组采用MIPPO技术结合锁定加压钢板治...     

拉米夫定对慢性乙肝患者HBV-DNA及HBeAg的阴转作用

目的：探讨拉米夫定治疗前后慢性乙肝患者血清及周围血单个核细胞（PBMCs）内HBV-DNA及HBeAg的变化。方法：用ELISA检测患者血清标志物;用荧光定量PCR检测患者血清及PBMCs内HBV-DNA的含量。拉米夫定对病人进行治疗,12周为一疗程,共4个疗程。结果：拉米夫定治疗48周后HBeAg及血清、PBMCs内HBV-DNA阴转率分别为52.31、46.15、41.82,较常规治疗组差异具有显著性（P〈0.05）。结论：拉米夫定对慢性乙肝患者HBV-DNA、HBeAg有较好的转阴率,且PBMCs内HBV-DNA的检测是鉴定拉米夫定疗效的一个重要指标,对抗病毒治疗具有明显的指导意义。     

原发性肺癌血中检测sFas的临床价值

目的：探讨sFas在原发性肺癌中的表达及其临床价值。方法：应用ELISA检测40例原发性肺癌标本及30例良性病变中sFas的表达情况。结果：在不同病理类型中sFas表达差异显著（P〈0．05）;在不同TNM分期中：Ⅰ期与Ⅱ期、Ⅰ期与Ⅲ期,sFas表达差异显著（P〈0．05）。在Ⅱ期与Ⅲ期表达差异不显著（P〉0．05）。结论：sFas升高有利于肺癌逃避免疫攻击,有利于其浸润与转移。