目的:应用基因芯片技术筛选结肠癌耐药相关微小RNAs (miRNAs),探究miRNAs对化疗耐药的调控机制.方法:采用基因芯片技术分析结肠癌细胞系HCT8及其耐长春新碱细胞系HCT8/v中miRNAs的表达差异,对部分差异表达的miRNAs应用RT-qPCR进行验证,对表达差异显著的miRNAs进行靶基因预测,利用GeneOntology (GO)和京都基因与基因组百科全书(KEGG)数据库对预测到的靶基因进行生物信息学分析.结果:筛选出342个差异表达miRNAs,其中190个表达上调,152个表达下调.RT-qPCR验证结果示miR-125-5p、miR-1 81 c-5p和miR-153-3的表达情况和芯片检测结果一致;miR-130a-3p和miR-149-3p的表达与芯片检测结果不一致.GO分析结果显示,耐药相关基因主要富集的旁路是RNA聚合酶Ⅱ调控区序列特异性DNA结合旁路,主要通过正向调节发挥作用,位置主要是在细胞内有界细胞器上.KEGG分析结果显示,耐药相关基因最为富集的是轴突导向通路、胰岛素信号通路及磷脂酶D信号通路.结论:miRNAs与结肠癌化疗耐药密切相关.对这些miRNAs的研究能使我们对结肠癌的化疗耐药机制有更深入的理解,并为逆转化疗耐药提供新的思路.

Objective:To explore the clinical application of laparoscopic radical operation for rectal cancer.Method:The clinical data of 220 cases with rectal cancer treated by laparoscopic radical operation from June 2006 to December 2011 were analyzed retrospectively.Result:The operation was successfully performed in 218 cases,2 cases were transferred to open procedures and no case died during perioperative period.The average operative time was(156.32±43.46)min,the mean blood loss was(95.44±46.38)ml,and a mean of(13.62±4.83) lymphnodes were resected.The patients had no massive haemorrhage during the operation.The average recovery time of postoperative bowel function was(2.64±0.73)d,and the average postoperative hospital stay was(10.42±5.53)d.Incisional infection occurred in 4 cases,and 2 cases suffered from postoperative anastomotic leakage.Anastomotic bleeding occurred in 2 cases and 3 cases suffered from pulmonary infection.Patients were followed up for 6-60 months after operation,local recurrence were found in 11 cases(5.05%) and metastasis were found in 31 cases(14.22%).Conclusion:Laparoscopic radical resection of rectal cancer is safe,feasibility,with less trauma,more rapid recovery and less complications.It is in conformity with the surgical oncologic principles and deserves promotion and wide application.

Objective:To compare the results of laparoscopic and open radical operation in the management of rectal cancer.Methods:The clinical data of 218 cases with rectal cancer treated with laparoscopic radical operation and 127 cases treated with open radical operation from June 2006 to December 2011 were analyzed retrospectively.Results:The difference in mean bleeding volum,intestinal function recovery time,duration of hospitalization and specimen far cut end length was significant between these two groups(P<0.05),but the difference in operating time,peri-operative and postoperative complications,the number of lymph node dissection,specimen nearly cut end length,tumor local recurrence rate and distant metastasis rate was not statistically significant(P>0.05).Conclusion:Laparoscopic radical resection of rectal cancer is safe,feasibile,with less trauma and more rapid recovery.It is in conformity with the surgical oncologic principles and deserves promotion and wide application.

近年来,对于失去手术机会的中晚期肝癌患者,微波凝固治疗是主要治疗方法之一.自1999年1月至2002年12月,我们采用参芪片配合微波凝固治疗肝癌,并与单纯微波凝固治疗作对照研究,现报告如下.

80年代国外报道用自扩金属支架(SEMS)[1,4]治疗晚期食管癌,90年代中期国产支架用于临床.我院自1997～2000年底分3组共治疗晚期食管、贲门癌60例,取得较满意的姑息疗效.