目的 探讨核苷酸结合寡聚化结构域1(NOD1)基因对幽门螺杆菌(Hp)感染小鼠炎性反应及免疫功能的作用.方法 将80只C57BL/6小鼠随机分为对照组和感染组,分别给予磷酸盐缓冲液(PBS)和Hp灌胃,间隔48 h灌胃1次,共5次;末次灌胃后24 h,快速尿素酶试验鉴定是否感染成功,不同时间点处死小鼠,无菌获取胃组织、脾脏组织及血液,苏木素-伊红(HE)染色法鉴定感染小鼠胃组织炎症程度的变化;PCR检测小鼠胃组织中NOD1、受体相互作用蛋白2(RIP2)mRNA的表达;酶联免疫吸附试验(ELISA)检测血清干扰素诱导蛋白10(IP-10)、干扰素β(IFN-β)水平;Western blot检测胃组织细胞核中核因子κB(NF-κB)p65表达水平;流式细胞技术分析CD4+、CD8+T淋巴细胞百分比.结果 感染组小鼠均H p感染阳性.与对照组比较,感染组小鼠胃组织腺体结构破坏、减少、萎缩,肌层间质出现炎性细胞;胃组织中NOD1、RIP2 mRNA表达水平,细胞核中NF-κB p65表达水平在Hp感染48、72、120 h后明显升高(P<0.05),NOD1 mRNA表达水平在Hp感染48 h后达到峰值,RIP2 mRNA表达水平在Hp感染120 h后达到峰值,细胞核中NF-κB p65表达水平在Hp感染72 h后达到峰值;血清IP-10、IFN-β水平在感染8、12、16周后明显升高(P<0.05),Hp感染16周后达到峰值;小鼠脾脏组织CD4+T淋巴细胞百分比在感染12、16周后明显降低(P<0.05),Hp感染12周后最低,CD8+T淋巴细胞百分比在感染8、12、16周后明显升高(P<0.05),Hp感染12周后达到峰值.结论 Hp感染可以诱导小鼠产生炎性反应,降低其免疫功能,可能与NOD1和NF-κB激活有关.

目的 探讨幽门螺杆菌(Hp)感染小鼠致胃癌模型中核因子-κB(NF-κB)的活化情况及对炎症因子的影响.方法 灌胃Hp菌液感染小鼠,并设对照组,分别于感染后18、36、54、72周采用酶联免疫吸附测定法检测血清白细胞介素-18(IL-18)、γ-干扰素(IFN-γ)、IL-10水平等;尿素酶试验及Giemsa染色观察Hp定植情况;苏木精-伊红染色观察胃黏膜病理学变化,并进行炎症评分;实时荧光定量聚合酶链反应(qRT-PCR)检测胃黏膜核苷酸结合寡聚化结构域1(NOD1)、受体相互作用蛋白2(RIP2)、NF-κB p65 mRNA表达;Western blot检测胃黏膜NOD1、RIP2、NF-κB p65、p-NF-κB p65蛋白表达.结果 模型组小鼠各时间点Hp检测均为阳性,血清IL-18水平、IFN-γ水平,炎症评分,以及NOD1、RIP2 mRNA及蛋白、p-NF-κB p65蛋白表达水平均明显高于对照组,且随时间延长而升高,IL-10明显低于对照组,且随时间延长而降低,差异均有统计学意义(P<0.05).结论 NF-κB在Hp感染小鼠致胃癌模型中活化,并可促进炎症因子分泌,损伤胃黏膜.

MicroRNAs (miRs) carried in exosomes serve an important role in the pre-metastatic microenvironment and in intercellular interactions. However, the function of exosomal-miR-10a derived from primary colorectal cancer (CRC) cells on fibroblasts in the lung metastatic microenvironment of patients with CRC remains unclear. Reverse transcription-quantitative PCR was performed using samples from patients with CRC, and demonstrated that the expression levels of miR-10a were significantly lower in serum and cancer tissue samples from patients with CRC compared with in serum from healthy individuals and paired non-cancerous tissues, respectively. In addition, the expression levels of miR-10a were inversely associated with the invasion depth of CRC. Exosomal-miR-10a derived from CRC cells reduced the proliferative and migratory activities of primary normal human lung fibroblasts (NHLFs), and the expression levels of IL-6, IL-8 and IL-1 beta in NHLFs. The present study provided insight into the phenotypic alterations of NHLFs induced by exosomal-miR-10a derived from CRC cells, which may aid understanding of the mechanism underlying the process of CRC lung metastasis.

circRNAs have been considered as a rising factor in cancers. However, the roles and mechanisms of circ-sirt1 in gastric cancer (GC) remain largely unknown. In this study, we found that the expressions of sirt1 and circ-sirt1 are decreased in tissues or serums of GC patients by real-time quantitative PCR (RT-qPCR). The expressions of miR-132-3p/miR-212-3p showed an opposite tendency in these samples. The co-transfection of miR-132-3p/miR-212-3p mimics counteracted the enhancement of sirt1 expression induced by circ-sirt1. The results of cell colony-formation assay and transwell assays demonstrated that the proliferation, migration, and invasion activities of BGC-823 cells were inhibited by circ-sirt1 overexpression or miR-132-3p/miR-212-3p knockdown, respectively. The xenograft tumor model result indicated that the circ-sirt1 overexpression suppressed the tumor growth of BGC-823 cells. The regulation of miR-132-3p/miR-212-3p between circ-sirt1 and sirt1 was verified in the mice tumor tissues. Thus, circ-sirt1 inhibited tumor growth and invasion probably by sponging miR-132-3p/miR-212-3p and upregulating sirt1 expression in GC. These findings may provide a theoretical basis for the classification of GC and a novel therapeutic target for GC patients.

目的:探讨蒲公英甾醇对Hp相关性胃炎脾胃湿热证(HAG)小鼠改善和炎症抑制作用及机制.方法:80只C57BL/6小鼠随机分为正常组17只和造模组63只,正常组小鼠给予正常饮食+常规环境+同步饲养,造模组小鼠给予肥甘饮食+湿热环境+Hp菌液,制备HAG小鼠模型.将48只造模成功的小鼠随机分为模型组、蒲公英甾醇组、iE-DAP组和蒲公英甾醇+iE-DAP组,每组12只.蒲公英甾醇组小鼠灌胃蒲公英甾醇,5mg/kg,1次/d,连续灌胃4周;iE-DAP组小鼠腹腔注射iE-DAP,100μg/只,1次/周,连续注射4周;蒲公英甾醇+iE-DAP组小鼠灌胃蒲公英甾醇,5 mg/kg,1次/d,腹腔注射iE-DAP,100 μg/只,1次/周,连续给药4周.实验过程中观察小鼠一般情况;ELISA检测小鼠血清干扰素诱导蛋白10(IP-10)和干扰素β(IFN-β)水平;快速尿素酶实验检测Hp定植;HE染色镜检小鼠胃黏膜组织病理学变化;qRT-PCR检测小鼠胃组织中核苷酸结合寡聚化结构域1(NOD1)mRNA和受体相互作用蛋白2(RIP2)mRNA表达水平;Western blotting检测小鼠胃黏膜组织p65、p-p65蛋白表达水平.结果:正常组小鼠胃黏膜组织结构完整、排列整齐、无炎症细胞浸润及充血肿胀;模型组小鼠出现脾胃湿热证症状,胃黏膜充血肿胀、结构破坏、排列无序、固有层有炎症细胞浸润;蒲公英甾醇组小鼠症状较模型组好转,胃黏膜病理损伤减轻;iE-DAP组小鼠脾胃湿热症状、胃黏膜组织病理损伤较模型组加重,蒲公英甾醇+iE-DAP组小鼠组脾胃湿热症状、胃黏膜组织病理损伤明显减轻.与模型组比较,蒲公英甾醇组小鼠血清IP-10和IFN-β水平,NOD1 mRNA和RIP2 mRNA相对表达量,以及p-p65蛋白表达降低,且HP定植减少(P＜0.05),iE-DAP组小鼠血清IP-10和IFN-β水平,NOD1 mRNA和RIP2 mRNA相对表达量,以及p-p65蛋白表达升高,且Hp定植增加(P＜0.05);与蒲公英甾醇组比较,蒲公英甾醇+iE-DAP组小鼠血清IP-10和IFN-β水平,NOD1 mRNA和RIP2mRNA相对表达量,以及p-p65蛋白表达升高,且Hp定植增加(P＜0.05);与iE-DAP组比较,蒲公英甾醇+iE-DAP组小鼠血清IP-10和IFN-β水平,NOD1 mRNA和RIP2mRNA相对表达量,以及p-p65蛋白表达降低,且Hp定植减少(P＜0.05).结论:蒲公英甾醇可改善HAG小鼠脾胃湿热证症状,抑制炎症反应,作用机制可能与调控NOD1/NF-κB通路有关.

circRNAs have been considered as a rising factor in cancers. However, the roles and mechanisms of circ-sirt1 in gastric cancer (GC) remain largely unknown. In this study, we found that the expressions of sirt1 and circ-sirt1 are decreased in tissues or serums of GC patients by real-time 24 quantitative PCR (RT-qPCR). The expressions of miR-132-3p/miR-212-3p showed an opposite 25 tendency in these samples. The co-transfection of miR-132-3p/miR-212-3p mimics counteracted the 26 enhancement of sirt1 expression induced by circ-sirt1. The results of cell colony-formation assay and Transwell assays demonstrated that the proliferation, migration, and invasion activities of 28 BGC-823 cells were inhibited by circ-sirt1 overexpression or miR-132-3p/miR-212-3p knockdown, 29 respectively. The xenograft tumor model result indicated that the circ-sirt1 overexpression 30 suppressed the tumor growth of BGC-823 cells. The regulation of miR-132-3p/miR-212-3p 31 between circ-sirt1 and sirt1 was verified in the mice tumor tissues. Thus, circ-sirt1 inhibited tumor 32 growth and invasion probably by sponging miR-132-3p/miR-212-3p and upregulating sirt1 33 expression in GC. These findings may provide a theoretical basis for the classification of GC and a novel therapeutic target for GC patients. those the tissues and healthy subjects, respectively. These results demonstrated that sirt1 and circ-sirt1 are both lower expressed in GC tissues than in the noncancerous tissues, and the level of circ-sirt1 in serums from GC patients is lower than that noted from the healthy subjects. The data suggested that The data confirmed the anti-tumor function of circ-sirt1 and its downstream mechanism of miR-132-3p, miR-212-3p and sirt1 in mice model. The present work demonstrates that circ-sirt1 and sirt1 levels were decreased in tissues and serums of patients with GC, while miR-132-3p/miR-212-3p expressions show an opposite tendency in the GC patients. The miR-132-3p and miR-212-3p were downregulated in GC cells with circ-sirt1 overexpression, while sirt1 was upregulated at both mRNA and protein levels. The co-transfection of miR-132-3p/miR-212-3p mimics counteracted the enhanced expression of sirt1 induced by circ-sirt1 overexpression in BGC-823 cells. The circ-sirt1 was identified as a candidate from the sirt1 host gene in the human genome in our previous study, which expression is decreased during neointimal formation and acts as a novel biomarker of atherosclerosis. The circ-sirt1 could promote sirt1 expression mediating by miR-132/212. The present study found that circ-sirt1 acted as a suppressor in proliferation, migration and invasion in GC cells by sponging miR-132-3p/miR-212-3p to regulate the expression of sirt1. These suggested a similar function of circ-sirt1 in vascular smooth muscle cells and Glandular epithelial cells of stomach. However, if there is a positive feedback loop between circ-sirt1 and sirt1 in GC, as well as the expression and role of circ-sirt1 in other cancers, still need to be clarified in future study. to the enhancement of miR-132-3p/miR-212-3p induced by circ-sirt1. Overexpression circ-sirt1 suppressed the cell proliferation, migration and invasion in vitro and inhibited tumor growth in vivo . Our findings provide new sights into a novel molecular and the signaling of circ-sirt1/miR-132-3p/miR-212-3p/ sirt1 in GC development. in 293T cells was verified by RT-qPCR. C) The circ-sirt1 expressions in GES-1, AGS-1 and BGC-823 cells were analyzed by RT-qPCR, with GAPDH as internal control. D) The levels of circ-sirt1 in BGC-823 cells transfected with circ-sirt1 plasmid or vector were detected by RT-qPCR. GAPDH was used as the housekeeping gene. E) The protein levels of sirt1 were detected by Western blot with GAPDH as internal control. F) Clone formation, G) cell migration and invasion assays of BGC-823 cells transfected with pcDNA3/circ-sirt1 plasmid or pcDNA3.1 after 48 h. Results are representative of three independent experiments.

目的 探讨微小RNA-133b(miRNA-133b)在胃癌组织中的表达情况及其对基质金属蛋白酶9(MMP-9)表达的影响.方法 选取2015年12月至2018年1月于该院胃肠外科住院行胃癌根治手术的患者78例,留取胃癌组织及癌旁组织(距肿瘤边界6 cm以上),实时荧光定量PCR(RT-qPCR)检测miRNA-133b与MMP-9 mRNA在两组标本中的表达水平,免疫组织化学(IHC)方法检测MMP-9在两组标本中的蛋白表达,应用Spearman相关性分析法对miRNA-133b和MMP-9 mRNA的表达量进行相关性分析,采用受试者工作特征(ROC)曲线分析胃癌组织中miRNA-133b表达水平对胃癌诊断的价值.结果 与癌旁组织比较,胃癌组织中miRNA-133b的相对表达量明显下调,MMP-9 mRNA及蛋白表达水平明显升高,差异均有统计学意义(1.01±0.30 vs.0.45±0.19,1.06±0.44 vs.2.03±0.55,20.51％vs.65.38％,P<0.05);且胃癌组织中miRNA-133b表达水平与MMP-9 mRNA表达量呈明显负相关性(r=-0.667,P<0.05).胃癌组织中miR-NA-133b表达水平预测胃癌的ROC曲线下面积为0.942(95％CI:0.909～0.974,P<0.05),最优截断点为0.78,预测胃癌的灵敏度和特异度分别为91.02％和80.77％.结论 胃癌组织中miRNA-133b表达降低可能通过靶向上调MMP-9的表达,促进胃癌细胞的浸润和转移,从而在胃癌发生、发展中起作用,且miRNA-133b表达水平对胃癌的诊断有重要价值.

目的 探讨microRNA-20a(miR-20a)对人结肠癌SW480细胞增殖、迁移和顺铂耐药的影响.方法 采用实时荧光定量PCR检测miR-20a在人结肠癌SW480细胞中敲低和过表达效果;利用CCK-8实验检测SW480细胞敲低和过表达miR-20a后的细胞活性;利用细胞克隆实验和Transwell迁移实验分别检测结肠癌SW480细胞的增殖能力和细胞迁移能力.结果 miR-20a在SW480细胞中能够被显著敲低或过表达(P＜0.01);敲低miR-20a降低SW480细胞的细胞活性,抑制细胞的增殖和迁移能力;过表达miR-20a则呈现相反的作用(P＜0.05);分别用20,40,80,160 μg/μl的顺铂作用于敲低miR-20a表达的SW480细胞,细胞抑制率呈现随顺铂浓度增加而增高的趋势(P＜0.05).结论 miR-20a能够增强结肠癌细胞SW480的增殖、迁移和顺铂耐药能力.

目的 探讨内镜黏膜下剥离术(ESD)与经肛门镜微创手术(TEM)对早期结直肠肿瘤的微创治疗效果.方法 选取2010年5月—2016年5月河北省唐山市人民医院收治的结直肠肿瘤(uTis-uT1)患者211例,根据手术方式分为ESD组(98例)和TEM组(113例).比较两种手术方式的手术时间、住院时间,术中出血、肿瘤完整切除、肿瘤残留及复发例数;比较两组术后出血、穿孔、梗阻、狭窄等并发症的发生情况.结果 ESD组手术时间、住院时间短于TEM组,差异有高度统计学意义(P<0.01);两组术中出血、瘤完整切除率、肿瘤残留率及复发率比较,差异无统计学意义(P>0.05).两组并发症发生率比较,差异无统计学意义(P>0.05).结论 ESD与TEM对于治疗早期直肠癌均安全有效,但ESD的手术时间及住院事件明显缩短.

目的 探讨平滑肌蛋白22α(SM22α)基因启动子区甲基化状态及mRNA表达在胃癌发生中的作用,为胃癌早期诊断和治疗寻找新的靶点.方法 甲基化特异性聚合酶链反应检测56例胃癌及其对应的正常癌旁组织中SM22α基因启动子区甲基化状态;荧光实时定量PCR技术检测胃癌组织及正常癌旁组织中SM22α基因mRNA的表达.比较胃癌组织和正常癌旁组织中SM22α基因启动子区甲基化状态及mRNA表达的差异情况,并分析它们与胃癌患者临床病理特征之间的关系.结果 胃癌组织中SM22α 基因启动子区甲基化率显著低于正常癌旁组织(P<0.05),其mRNA表达水平显著高于正常癌旁组织(P<0.05),且甲基化阳性的胃癌组织中SM22α基因mRNA表达量显著低于甲基化阴性的胃癌组织(P<0.05).胃癌组织中SM22α基因启动子区甲基化状态及、mRNA表达水平与胃癌患者的淋巴结转移呈显著相关(P<0.05).结论 SM22α 基因启动子区的低甲基化导致其表达升高可能在胃癌发生、发展中起重要作用,SM22α有可能成为胃癌分子诊断和治疗的重要靶点.

目的:观察快速康复对老年患者腹腔镜胃癌根治术后炎症反应及恢复的影响.方法:将94例胃癌患者随机分为实验组与对照组,每组47例.两组患者均择期行腹腔镜胃癌根治术治疗.对照组给予常规护理措施,实验组患者给予快速康复措施护理.观察两组患者围术期的炎性反应指标变化情况、术后恢复情况及并发症发生情况.结果:两组患者术前CRP及PCT水平比较差异均无统计学意义(P>0.05),两组患者术后1d上述指标较治疗前均增高,对照组患者增幅更加显著,组间比差异具统计学意义(P<0.05).实验组患者术后排气时间及下床时间均早于对照组患者,组间比差异具统计学意义(P<0.05).实验组患者术后并发症发生率低于对照组患者,组间比差异具统计学意义(P<0.05).结论:老年胃癌患者在腹腔镜根治术后采用快速康复护理措施,显著降低患者炎性反应指标水平,术后下床早,排气早,并发症发生率低,临床应用前景广泛.

目的 探讨二甲双胍对进展期胃癌合并2型糖尿病患者行胃癌根治术后生存期的影响.方法 选取2011年1月至2015年10月胃肠外科收治的进展期胃癌且合并2型糖尿病患者87例,其中42例应用二甲双胍控制血糖(试验组),45例应用其他降糖药物控制血糖(对照组),术后进行随访观察,比较2组的无病生存率(PFS)及总生存率(OS).结果 二甲双胍组进展期胃癌患者3年-DFS和OS分别为52.4％和69.0％,显著高于对照组进展期胃癌患者的31.1％和46.7％(P<0.05).多因素COX分析显示二甲双胍是进展期胃癌合并2型糖尿病术后患者3年-DFS和3年-OS的独立保护因素(P<0.05).结论 二甲双胍可显著提高进展期胃癌合并2型糖尿病术后患者的无病生存率及总生存率,延长患者的生存时间.

Objective To investigate success rate and influential factors of laparoscopic colorectal resections (LCRs) followed by natural orifice specimen extraction (NOSE) in patients with rectal cancer. Methods From April 2016 to April 2018, retrospective analysis were performed in 76 patients with rectal cancer who received LCRs+ NOSE. We prefer to anal approach firstly, however if it fails, vaginal approach would be tried. If both approaches fail, the patient would be judged to be unsuitable for NOSE, then specimen would be removed through abdominal incision. Surgical indications, location of excision, procedure, incision site, method of aspiration, specimen size, and NOSE failure were recorded. Statistical analysis were performed by using SPSS18.0 software was used for statistical analysis of the data, and the chi-square test of the success and failure cases of NOSE was used to analyze the data. The size of specimens was examined by t-test. P<0.05 was statistically significant. Results 7 cases of conversions to open abdominal incision occurred during operation. 51 (73.9%) patients, including 48(94.1%) cases of anal approach and 3 (5.9%) cases of vagina approach, received successful NOSE after LCRs, while 18 (26.1%) cases failed A lower success rate of NOSE occurred mainly in male patients with severe colon lesions and large tumor size. The mean size of removed specimens was (3.6±3.2) and (5.6±1.5) cm by using anal approach and vaginal approach respectively, and the mean tumor size of the failed cases was (6.6±4.4) cm (P<0.05). Conclusion Better prognosis could be achieved in patients with rectal cancer underwent laparoscopic resection + NOSE, while higher success rate could be achieved when milder lesions or in female patients. Key words: Rectal neoplasms; Laparoscopy; Natural orifice endoscopic surgery

Objective To observe and compare the efficacy and safety of the endoscopic submucosal dissection(ESD)and transanal endoscopic microsurgery(TEM)in the treatment of lower rectal neuroendocrine tumors.Methods Eighty-nine patients(grades G1 and G2)with low-grade rectal neuroendocrine tumors(≤7 cm from the anus)were included in this study.Thirty-five patients were treated with ESD and fifty-four patients were treated with TEM.The operative time,intraoperative blood loss,average hospital stay were compared,And complete resection rate,perforation,and postoperative recurrence rate were followed up for 5 years after operation. Results The intraoperative blood loss of the patients in the TEM group was less than that in ESD group(P<0.05).The operative time and the hospital stay of the patients in the TEM group were shorter than those in ESD group(P<0.05).There was no difference in complete resection rate,perforation,and postoperative recurrence rate between the two groups (P> 0.05). Conclusion Compared with TEM has the advantages of less intraoperative blood loss,shorter operative time,and shorter hospital stay,and is worthy of clinical promotion.

目的 探讨各临床因素与胃癌肝转移患者外科治疗效果的相关性.方法 统计82例胃癌肝转移患者的临床资料.患者均采用胃部全切或胃大部切除,部分患者辅助D2淋巴结清扫,肝脏转移病灶切除保证切缘在1 cm以上.所有患者术后根据实际情况选择电话或门诊随访,随访日期截止至患者死亡或2017年5月31日,随访有效率100％,采用Cox风险比例分析模型进行多因素分析.结果 所有患者存活时间为1～45个月,其中1年生存率为52.44％,2年生存率为28.05％,3年存活率为12.20％,中位生存时间为18.83个月;单因素分析结果显示,性别、年龄、肝内病灶分布、肝内病灶直径、肝脏切除方法、术后化疗等因素与患者外科治疗效果无关(P＞0.05);组织学分级、淋巴结转移、肿瘤数目、术前化疗为影响患者的术后预后的影响因素(P＜0.05);多因素分析结果显示,淋巴结转移、肿瘤多发、低分化肿瘤是影响外科治疗结果的危险因素(P＜0.05).结论 胃癌肝转移患者中肝内肿瘤数目为单发、组织学分级为中、高分化、未出现淋巴转移的患者采取外科治疗,治疗效果更加显著.

目的 探讨经肛门内镜显微手术(transanal endoscopic microsurgery,TEM)联合术后放疗治疗早期直肠癌的的临床效果.方法 89例早期直肠癌患者术前经电子肠镜、CT、MRI、腔内超声等检查证实为单发性病灶,无远处转移灶,无淋巴结转移.肠壁浸润深度为黏膜层或黏膜下层;术前病理取活组织检查组织类型为中、高分化腺癌;术前均未行新辅助放化疗.根据患者及家属意愿分为TEM组42例和腹腔镜下直肠癌根治术(腔镜)组47例,分别采用TEM和腹腔镜下直肠癌根治术;TEM组联合术后放疗.结果 TEM组手术时间、住院时间、术中出血量、术后并发症种类和例数均少于腔镜组,差异有统计学意义(P<0.05).结论 TEM具有术中出血量少、手术时间短、术后并发症少、术后恢复快、住院时间短的优点,联合术后放疗治疗早期直肠癌是安全可靠的,具有与腹腔镜下直肠癌根治术相同的临床疗效.

目的 总结经肛门显微外科手术治疗直肠肿瘤疗效的影响因素.方法 回顾性分析60例经肛门显微外科手术治疗直肠肿瘤患者,对其中术后复发者进行影响因素进总结,并进行logistic多因素分析.结果 本研究有无效9例,发生率为15%,疗效单影响因素有肿瘤浸润深度(T2分期)、病灶距离肛缘距离(≥10 cm)、切除深度、存在并发症(P<0.05),而与性别、年龄、肿瘤大小、CEA含量、CA199含量无关(P>0.05);logistic多危险因素分析,浸润深度、病灶距离肛缘距离、切除深度、并发症是经肛门显微外科手术治疗直肠肿瘤疗效独立影响因素(P<0.05).结论 经肛门显微外科手术治疗直肠肿瘤疗效影响因素有浸润深度、病灶距离肛缘距离、切除深度、并发症,而与其他因素无关.

Objective To investigate the safety,cancer radical and early efficacy after laparoscopic gastric cancer resection D2.Methods Seventy-two cases of gastric cancer patients were randomly divided into two groups according to the admission order,each group 36 cases.The control group was given traditional open gastric resection,while the observation group took laparoscopic gastric D2 resection.The early efficacy,tumor radical and surgical safety of two groups were compared.Results The operation time of observation group was significantly longer than that of control group.The incision length,blood loss,recovery time of gastrointestinal function,ambulation,and the average hospital stay time of observation group were significantly less than those of control group(P <0.05 or <0.01).The number of lymphadenectomy,the length of near and far cutting edge showed no significant difference between two groups(P >0.05).The postoperative complication rate of observation group 11.11%(4/36)was significantly lower than that of control group 27.78%(10/36)(P <0.05).Conclusion Laparoscopic gastric D2 resection has good early effect,safe and small surgical trauma,which are conducive to the recovery of patients,the method has good clinical application value.

Objective:To evaluate the clinical ef icacy of transanal endoscopic microsurgery (TEM)for rectal tumors.Methods:Data from the twenty patients who received TEMoperation between February 2014 and August2014 in Tangshan People's Hospital,which were analyzed and summarized to evaluate clinical ef icacy in complications including bleed loss,postoperative bleed-ing,postoperative infection ,fecal incontinence and the average time of hospitalization.Results:Al the patients’tumor were removed completely by TEM,during the tewnty cases,fourteen cases were vil ousa -tubular adenomas,three cases were high grade intraepithelial neoplasia ,four cases were high dif erentiated adenocarcinoma and two cases were rectal carcinoid.According to the pathological,al margins were negative.The bleeding was less than 10ml.Postoperative bleeding,fecal incontinence,infections and other complications did not appear on.There were five patients appeared mild pain and discomfort for their anal after operating.Given symptomatic treatment ,the patients have relieved after the second day.The postoperative average hospital stay was 4.5 days.Conclusion:TEMis a safe and ef ective surgical approach,which is provided with bet er clinical results for the treatment of rectal tumors.

OBJECTIVE:The present study was conducted to elucidate the prognostic prediction value of the expression of the protein inhibitor of activated signal transducer and activators of transcription 3 (PIAS3) in gastric cancer (GC).METHODS:We detected the expression of PIAS3 in GC tissue, adjacent non-tumor tissue, GC cell lines, and GES-1 cell line. Besides, both clinicopathological data and follow-up records were obtained for patients' survival analyses.RESULTS:We showed that both protein and mRNA expression of PIAS3 in GC tissue were significantly lower than those in adjacent non-tumor tissue, respectively. Besides, the relative mRNA expression value of PIAS3 in each of GC cell lines was also much lower than that in GES-1 cell line. With multivariate survival analyses, PIAS3 protein expression in GC tissues, and status of lymph node metastasis were identified to be the independently prognostic predictors of GC by using the Cox regression with bootstrapping method.CONCLUSIONS:Lower expression of PIAS3 protein, indicating the poor survival of GC, is a potential marker for prediction the prognosis of patients.