Objective: To explore the prognostic value of nucleotide excision repair cross-complementation gene 1 (ERCC1) expression in patients receiving oxaliplatin adjuvant chemotherapy with colorectal cancer (CRC) . Methods: A total of 84 patients undergoing m FOLFOX6 chemotherapy after radical resection of CRC from Lu'an Hospital Affiliated to Anhui Medical University from January 2011 to January 2013 were selected. The expression of ERCC1 in CRC tissues was evaluated by immunohistochemistry and the correlation between ERCC1 expression and prognosis was analyzed. Results: ERCC1 was highly expressed in 30 patients (35. 7％) . Kaplan-Meier curves showed a reduction in disease-free survival (DFS) and overall survival (OS) in CRC patients with high ERCC1 expression (P < 0. 001) . Multivariate COX analysis showed that high expression of ERCC1 (DFS HR = 4. 645, 95％ CI: 2. 045 ～10. 548, P < 0. 001. OS HR = 4. 898, 95％ CI: 1. 971 ～ 12. 170, P < 0. 001) was a poor prognostic factor. Analysis of the correlation between ERCC1 expression and survival in similar subgroups was similar. Among the 16 patients with high expression and recurrence of ERCC1, liver and lung metastasis was 68. 8％ (11/16) . In 10 patients with low expression of ERCC1 and recurrence, 70. 0％ (7/10) of the patients had peritoneal metastasis. ERCC1 expression was significantly associated with the first recurrence pattern (P = 0. 006) . Conclusion: ERCC1 expression can be used as an important indicator to evaluate the prognosis of CRC patients and may help predict the first relapse pattern after adjuvant chemotherapy in CRC patients. The prognostic value of ERCC1 expression needs further study.

探讨胃蛋白酶原和4种肿瘤标志物CEA、CA50、CA199、CA242联合检测对胃癌诊断的临床意义.102例胃癌患者(胃癌组)、87例胃部良性病变患者(胃良性病变组)和71例健康体检患者(对照组).应用全自动电化学发光免疫分析仪,测定不同临床分期患者血清肿瘤标志物含量水平,分析检测结果.结果 显示,胃癌组血清胃蛋白酶原Ⅰ和CEA、CA50、CA199、CA242水平高于良性病变组和对照组患者(P＜0.05),良性病变组上述指标高于对照组(P＜0.05);胃癌Ⅲ、Ⅳ期组患者血清胃蛋白酶原Ⅰ和CEA、CA50、CA199、CA242含量明显高于胃癌Ⅰ、Ⅱ期组;指标联合检测的阳性率高于单项检测阳性率(P＜0.05).结果 表明,胃癌患者血清胃蛋白酶原Ⅰ和CEA、CA50、CA199、CA242含量较高,转移后上述指标血清含量增加,联合检测比单一检测更具诊断价值.

Objective Excision repair cross-complementing gene-1(ERCC1) are key regulatory enzymes whose expression patterns are associated with overall survival(OS) in several malignancies.Their expression patterns and prognostic value in resected gastric adenocarcinoma(GAC) are not known and need to investigate.Methods A total of 109 patients who underwent resection for GAC in Liu′an People′s Hospital from January 2010 to June 2013 had tissue available for analysis.The primary objective was to assess for the differential expression of ERCC1 using by immunohistochemistry.The secondary objective was to assess for the association between OS and the expression of ERCC1.Results The median follow-up was 21.2 months,and the median OS was 28.8 months.Resected GAC exhibited differential expression of ERCC1(high expression,n=25(23%)).ERCC1 expression was not associated with OS(18.9 months vs.27.7 months,P=0.72).In a subset analysis of patients who received chemotherapy(n=73),high ERCC1 expression was associated with decreased OS(16.7 months vs.53.8 months,P=0.03).After controlling for known adverse pathologic features,high ERCC1 expression persisted as a negative prognostic factor in multivariate Cox regression analysis(HR=2.22,95% CI1.05-4.98,P<0.05).Conversely,in patients who underwent resection only(n=35),high ERCC1 expression demonstrated a trend toward improved OS(40.4 months vs.12.7 months,P=0.10).A positive prognostic influence also was present on multivariate analysis(HR=0.20,95% CI0.05-0.84,P=0.03).Conclusion Resected GAC exhibited differential expression of ERCC1.Among all patients,ERCC1 expression levels were not associated with OS.High ERCC1 tumor expression is associated with decreased OS in the patients who received chemotherapy but is associated with increased OS in those who underwent surgery alone.ERCC1 expression have prognostic value in resected gastric cancer,and further investigation is needed.

Objective:To investigate effects of neoadjuvant chemotherapy in patients with gastric cancer,and to analyze its influence on disease related indexes.Methods:A total of 42patients with gastric cancer who were treated with neoadjuvant chemotherapy in our hospital from July 2011to March 2013 were selected as observation group,and 42cases who were treated with routine operation were enrolled as control group,then the total effective rates and serum disease related indexes before and after the treatment of two groups were compared.Results:For stageⅢand stageⅣpatients in the two groups,the total effective rates of observation group were significant higher than those of control group;while for stageⅢ and stageⅣ patients,serum disease related indexes at forth and twelfth week after the operation were all significantly lower than those of control group,and those indexes were all lower than those before undergoing the treatment(Pall0.05).After treatment,evaluated indexes of two groups were all significant different from each other.Conclusion:The application effect of neoadjuvant chemotherapy in patients with gastric cancer is better,and it has greater influence on the disease related indexes.

Objective Study of preservation of the intercostobrachial nerveradical effect of clinical application in the treatment of breast cancer modified. Methods 48 cases of breastcancer were randomly divided into experime-tal group and control group,each group of 24 cases. Two groups of patients were performed radical resection of the corresponding improvement, compared two groups of patients the operation time; complications; feeling to theipsilateral arm and armpit skin after operation. Results Operation time of two groups of patients, no significant difference(P >0.05); patients in the experimental grouponly 4 cases in the ipsilateral medial upper arm and axillary skin sensory abnormalities, and 13 patients in control group had postoperative paresthesia,significant difference was statistically significant(P <0.01); 5 patients in control group had subcutaneous effusion in patients after the operation, the experimental group was 3cases, puncture and its compression bandage were all cured. Conclusion In preserving intercostobrachial nerve in radical resection of breast cancer modiied, can be significantly reduced in patients with postoperative ipsilateral medial upper arm andaxillary sensory disability and pain, improve the quality of life of patients.

目的比较小切口胆囊切除术(MC)与传统开腹胆囊切除术(OC)治疗急性胆囊炎的临床疗效。方法将符合手术条件的80例急性胆囊炎患者,按照就诊先后顺序,随机分为A组和B组,每组40例,A组采用MC治疗,B组采用OC治疗,治疗过程中观察两组患者的平均手术时间、术中平均出血量、平均切口长度、平均住院时间及并发症等情况。结果两组患者在平均手术时间、术中平均出血量、平均切口长度、平均住院时间及并发症等方面比较差异均有统计学意义(P<0.05),A组患者的各项指标均低于B组患者。结论两种手术方法治疗急性胆囊炎均有效,小切口胆囊切除术(MC)的疗效优于传统开腹胆囊切除术(OC),具有手术时间短、术中出血量少、住院时间短、手术切口小、并发症低等优点,可在广大基层医院作为急性胆囊炎手术治疗的首选术式推广应用。

腺样囊性癌是生长缓慢但恶性度高的上皮性肿瘤,好发于腮腺、颌下腺、舌下腺、腭腺等小涎腺及皮肤等组织,其具有局部侵袭性强、远处转移率高、长期预后较差等典型生物学特征.目前,治疗腺样囊性癌主要是采用以手术为主,辅以术后化学治疗、放射治疗和基因分子治疗等综合治疗手段,能显著提高患者疗效及改善患者预后.我们近期诊断皮肤腺样囊性癌1例,现报道如下.