Influence of surgery on outcomes in gastric cancer

Surgery is the only possible curative treatment for gastric cancer. Although outcomes over the years have improved, there are still many controversies in the treatment of gastric cancer. One highly controversial topic is the extent of the operation. Results of recently performed large randomized studies may cause some policies to change. This article addresses the influence of surgery on outcomes of D1-D2 dissections, total versus subtotal gastrectomy, and pancreas and spleen resection and staging. Furthermore, several aspects of patient selection, the surgeon as a prognostic factor, noncurative treatment, and chemotherapy are discussed.     

Isolated hepatic perfusion with high-dose melphalan for the treatment of uveal melanoma metastases confined to the liver

Uveal melanoma is the most common primary intraocular tumour in adults. After treatment of the primary tumour, up to 50% of patients will ultimately develop metastases. Treatment options for metastases are limited. When uveal melanoma metastases are confined to the liver, isolated hepatic perfusion (IHP) could be a treatment option. Herein, we report the results of a small group of patients with uveal melanoma metastases of the liver treated with IHP. Eight patients with uveal melanoma metastases confined to the liver underwent IHP with high-dose melphalan (200 mg) for 1 h. Toxicity was graded according to the National Cancer Institute Common Toxicity Criteria and tumour response was assessed according to World Health Organization criteria. The tumour response rate (complete or partial remission) was 50%. The median time to progression was 6.7 months (range, 1.7-16.9 months). The overall median survival was 9.9 months (range, 4.7-34.6 months), with a 1 year survival of 50% and a 2 year survival of 37.5%. Three patients experienced grade 3-4 hepatotoxicity which was transient within 3 months. Although only a small group of patients has been treated and evaluated so far, IHP is a treatment option for uveal melanoma metastases confined to the liver which can result in tumour responses and may lead to survival benefits in a selective group of patients.     

进展期胃癌淋巴结转移与临床病理特征的关系

目的：探讨进展期胃癌淋巴结转移与临床病理特征的关系，为临床上进行合理的淋巴结清扫提供依据。方法：对55例进展期胃癌资料进行回顾性分析，术后常规解剖原发灶及各组淋巴结，并标记和计数，分析肿瘤部位、肿瘤大小、浸润深度、分化程度及Lauren分型与淋巴结转移率的关系。结果：进展期胃癌淋巴结转移率为74．5％；U、M、L区及全胃癌淋巴结转移率为85．7％、87．5％、67．6％和83．3％，各区和全胃癌淋巴结转移率差异无统计学意义（P〉0．05）；浆膜受侵的胃癌淋巴结转移率为82．5％，明显高于浆膜未受侵者（53．3％）（P〈0．05）；弥漫型胃癌淋巴结转移率为83．3％，明显高于肠型（64．0％）（P〈0．05）；直径〉5cm癌灶淋巴结转移率为90．0％，明显高于直径≤5cm的胃癌患者（65．7％）（P〈0．05）；浸润深度、Lauren分型和肿瘤大小是影响淋巴结转移率的主要因素，其中浸润深度为独立影响因素。结论：术中淋巴结清扫范围应结合肿瘤部位、肿瘤大小、浸润深度、分化程度及Lauren分型做出判断，并考虑患者的全身情况，合理选择淋巴结清扫范围。     

Synergism of atenoloi and nitrendipine on hemodynamic amelioration and organ protection in hypertensive rats

OBJECTIVE： This study was designed to investigate the possible synergism of atenolol and nitrendipine on blood pressure （BP） and blood pressure variability （BPV） reductions, baroreflex sensitivity （BRS） amelioration, and organ protection in hypertensive rats. METHOD： The dose was 20 mg/kg for atenolol, 10 mg/kg for nitrendipine and 20 ＋ 10 mg/kg for the combination of these two drugs. In an acute study, a single dose was given via a catheter previously inserted into the stomach in spontaneously hypertensive rats （SHR）.     

Magnitude and polarization of P53-specific T-helper immunity in connection to leukocyte infiltration of colorectal tumors

The tumor antigen p53 is mutated frequently and overexpressed in colorectal cancer. As a result, patients with this type of cancer commonly display p53-specific T-helper (Th) immunity. Examination of the cytokines produced by these Th-cells showed that a majority of the proliferative p53-specific T cell cultures produced none of the key cytokines (IFNgamma, TNFalpha, IL-4, IL-5 or IL-10), indicating that these p53-specific Th-responses are not polarized. In patients who exhibited p53-specific reactivity against multiple p53-epitopes, non-polarized responses could be found side by side with polarized Th-responses that produced INFgamma or other cytokines such as IL-10. Patients who exhibited p53-specific IFNgamma-producing Th cell-immunity before surgical excision of the tumor displayed higher numbers of tumor infiltrating intraepithelial leukocytes (p = 0.04) than patients lacking such responses, suggesting that the systemic presence of p53-specific Th-cells positively affects local tumor-immunity. Our data concerning the polarization-state of p53-specific Th immunity in colorectal cancer patients support the use of vaccine formulations that induce strong Th1-polarized p53-specific immunity to ensure proper (re-)programming of the anti-tumor response.     

一阶导数光谱法测定复方红甲凝胶中乳糖酸红霉素的含量

建立测定复方红甲凝胶中乳糖酸红霉素的含量测定方法。方法：以一阶导数光谱的谷一零位值法测定乳糖酸红霉素的含量,测定波长λ谷=490±lnm。结果：回收率100.6％,RSD为3.1％,线性范围40～120μg／ml。结论：方法简便,结果准确,重现性好,适合于该制剂的含量测定。     

Altered metabolism of familial Alzheimer's disease-linked amyloid precursor protein variants in yeast artificial chromosome transgenic mice

Missense mutations in the beta-amyloid precursor protein gene (APP) co- segregate with a small subset of autosomal dominant familial Alzheimer's disease (FAD) cases wherein deposition of the 39-43 amino acid beta-amyloid (A beta) peptide and neurodegeneration are principal neuropathological hallmarks. To accurately examine the effect of missense mutations on APP metabolism and A beta production in vivo, we have introduced yeast artificial chromosomes (YACs) containing the entire approximately 400 kbp human APP gene encoding APP harboring either the asparagine for lysine and leucine for methionine FAD substitution at codons 670 and 671 (APP(K670N/M671L)), the isoleucine for valine FAD substitution at codon 717 (APP(V7171)) or a combination of both substitutions into transgenic mice. We demonstrate that, relative to YAC transgenic mice expressing wild-type APP, high levels of A beta peptides are detected in the brains of YAC transgenic mice expressing human APP(K670N/M671L) that is associated with a concomitant diminution in the levels of apha-secretase-generated soluble APP derivatives. Moreover, the levels of longer A beta peptides (species terminating at amino acids 42/43) are elevated in YAC transgenic mice expressing human APP(V7171). These mice should prove valuable for detailed analysis of the in vivo effects of the APP FAD mutations in a variety of tissues and throughout aging and for testing therapeutic agents that specifically alter APP metabolism and A beta production.      

Cloning and characterization of DXS6673E, a candidate gene for X-linked mental retardation in Xq13.1

In several families with non-specific X-linked mental retardation (XLMR) linkage analyses have assigned the underlying gene defect to the pericentromeric region of the X chromosome, but none of these genes have been isolated so far. Here, we report on the cloning and characterization of a novel gene, DXS6673E, that maps to Xq13.1, is subject to X-inactivation and is disrupted in the 5' untranslated region by a balanced X;13 translocation in a mentally retarded female. The DXS6673E gene is highly conserved among vertebrates and its expression is most abundant in brain. It encodes a hydrophilic protein of 1358 amino acids (aa) that does not show sequence homology to other known proteins. A segment of this protein consisting of neutral and hydrophobic aa with a proline residue in every second position may represent a transmembrane domain. Almost complete sequence identity was found between the 3' end of the DXS6673E gene and two expressed sequence tags (ESTs) and between the 5' end of the DXS6673E gene and a third EST. Moreover, weaker sequence similarity was observed between coding regions and two other ESTs.