Objective:To analyze the relationship between the expression of microRNA (miRNA, miR)-150 and epithelial-mesenchymal transition (EMT) in gallbladder cancer and its mechanism.Methods:The expression of miR-150 in 30 cases of gallbladder cancer was detected by real-time quantitative polymerase chain reaction (qPCR), and 30 cases of chronic cholecystitis tissues was used as control. Simultaneously, the expression of proliferating cell nuclear antigen (PCNA), E-cadherin, N-cadherin and matrix metalloproteinase (MMP)-9 was detected, and the relationship of miR-150 and these genes was analyzed. Human gallbladder cancer cell line GBC-SD was transfected with miR-150 mimics. Then scratch experiments and Transwell chamber experiments were used to detect changes in cell migration and invasion; qPCR and Western blotting were used to detect changes in mRNA and protein of each gene.Results:The expressions of miR-150 and E-cadherin in gallbladder cancer tissues were lower than those in chronic cholecystitis tissues ( t=-7.035, -14.146, P<0.01). The expressions of PCNA, N-cadherin and MMP-9 were significantly higher compared with chronic cholecystitis tissues ( t=3.813, 9.339, 5.616, P<0.01). The expression of miR-150 was related to the degree of tumor differentiation, clinical stage, and lymph node metastasis ( t=3.228, 2.396, -2.604, P<0.05). Pearson correlation analysis showed that miR-150 was positively correlated with E-cadherin ( r=0.630, P<0.05), and negatively correlated with PCNA, N-cadherin, and MMP-9 ( r=-0.769, -0.628, -0.616, P<0.05). After transfection, the migration and invasion ability of GBC-SD cells decreased ( F=1 965.860, 114.940, P<0.01). The expressions of PCNA, N-cadherin, and MMP-9 were decreased, while the expression of E-cadherin was increased ( P<0.05). Conclusion:Decreased miR-150 expression in gallbladder cancer plays a key role in tumor progression, and the mechanism may be that miR-150 participates in tumor EMT process by regulating some genes.

Objective:To analyze the relationship between the expression of long noncoding RNA LINC00673 and clinicopathological features of patients with colon cancer and its molecular mechanism.Methods:The expression of LINC00673 in 70 cases of colon cancer and adjacent normal intestinal mucosa was detected by real-time quantitative polymerase chain reaction (Real-time PCR). and all data was collected in Second Hospital of Hebei Medical University from April, 2017 to June, 2019. There were 45 males and 25 females were enrolled in this study, and age was (56.4±11.8) years, median age 56 year. The relationship between LINC00673 expression and clinicopathological features of patients was analyzed. RNA interference technique was used to silence the expression of LINC00673 in colon cancer cells, and the effect of the LINC00673 down-expression on cell epithelial-mesenchymal transition (EMT) and its molecular mechanism were studied.SPSS22.0 statistical software was used to analyze the data, and t-test and ANOVA were used to investigate the data. Results:The expression of LINC00673 in colon cancer tissues (1.393±0.345) was significantly higher than that in adjacent normal intestinal mucosa tissues (0.703±0.223) ( t=14.053, P<0.01). The expression of LINC00673 was correlated with the degree of differentiation (well differentiated 1.004±0.273, poorly differentiated 1.491±0.245), clinical stage (Ⅰ-Ⅱ: 1.009±0.274, Ⅲ-Ⅳ: 1.608±0.226) and lymph node metastasis (positive 1.523±0.265, negative 0.988±0.290) ( t=-6.084, P<0.01; t=-9.730, P<0.01; t=6.060, P<0.01). The level of LINC00673 in colon cancer cell lines was significantly higher than that in normal intestinal mucosa cell line HIEC ( F=21.364, P<0.01). The ability of cell migration and invasion was significantly decreased after silencing the expression of LINC00673 in LOVO ( F=1 211.220, 72.672, P<0.01). The expression of E-Cadherin in cells was increased, and the expression of N-Cadherin, Vimentin and matrix metalloproteinase (MMP)-9 was significantly decreased ( F=196.401, 147.029, 47.231, 137.190, 551.551, 35.646, 24.948, 17.593; all P<0.01), and the difference was statistically significant. Conclusion:The expression of LINC00673 was increased in colon cancer tissues. Inhibition of LINC00673 expression could suppress the EMT by regulating EMT associated genes.

Objective To evaluate the value of hand assisted laparoscopic radical resection for distal gastric cancer. Methods The clinical data of 80 patients with advanced gastric cancer from August 2015 to December 2017 were retrospectively analyzed. Among them, 30 patients underwent hand-assisted laparoscopic surgery, 25 patients underwent open surgery, and 25 patients underwent laparoscopic assisted surgery. The operative time, bleeding volume, number of recected lymph nodes, time to postoperative exhaust, postoperative complications, length of hospitalization, hospitalization expenses, length of incision and so on were compared among the three groups. The data were analyzed with SPSS 21.0 software. Measurement data are expressed as mean±standard deviation. ANOVA was used to compare measurement data, and the chi square test or Fisher exact test was used to compare count data. P<0.05 indicated that the difference was statistically significant. Results There was no significant difference in the number of recected lymph nodes, postoperative hospitalization expenses, or postoperative complications among the three groups (P>0.05). The hand-assisted laparoscopic surgery group, laparoscopy assisted surgery group, and open surgery group had significantly different operative time [(186.30±15.27) min vs (230.80±17.06) min vs (183.36±16.03) min] , intraoperative bleeding volume [(93.33±46.86) mL vs (98.80±55.10) mL vs (246.80±92.90) mL] , time to postoperative exhaust [(2.3±0.6) d vs (2.42±0.44) d vs (3.04±0.56) d] , length of stay [(8.90±1.19) d vs (9.40±1.44) d vs (10.92±1.73) d] , and incision length [(7.97±0.49) cm vs (8.04±0.61) cm vs (24.04±2.11) cm] (P<0.001 for all). The length of incision, blood loss, time to postoperative exhaust, and hospital stay were significantly lower in the hand-assisted laparoscopic operation group and laparoscopically assisted operation group than in the open operation group (P<0.001). The operative time was significantly shorter in the hand-assisted laparoscopic surgery group and laparotomy group than in the laparoscopically assisted operation group (P<0.001). Conclusion Hand assisted laparoscopic distal gastrectomy is safe and feasible, can achieve the radical effect of open surgery for tumor resection and lymph node dissection, and does not increase the economic burden of patients. Hand assisted laparoscopic surgery has the advantages of less intraoperative bleeding, faster postoperative recovery, and shorter operative time than laparoscopic assisted surgery. Key words: Hand assisted laparoscopy; Laparoscopy assisted; Traditional laparotomy; Advanced gastric cancer

目前胆管癌仍是胆道系统最常见的恶性肿瘤[1?2] ,其起病隐匿,患者就诊的首要症状多为渐进性黄疸,发现时往往已属晚期,失去了手术切除机会,根治性手术五年生存率仅10%,预后极差[3] .对于无法行根治性手术或者不愿意行根治性手术的患者,内镜下胆道引流术可以有效解除阻塞性胆汁淤积,减轻黄疸?皮肤瘙痒?腹痛等相关并发症,预防胆管炎并避免渐进性胆道梗阻引起的肝衰竭等,是解除恶性胆道梗阻的一种有效的姑息性治疗手段.

目的 探讨声辐射力脉冲成像(ARFI)包括声触诊组织成像(VTI)和声触诊组织量化(VTQ)技术在评价肝细胞肝癌射频消融(RFA)范围及残留病灶中的应用价值.方法 选择2015年6月至2017年8月收治的确诊肝细胞肝癌患者108例,病灶110个.所有患者在射频消融术前24 h之内和术后1个月分别接受二维超声、ARFI、超声造影(CEUS)检查.比较消融后二维超声、VTI和超声造影所测消融区大小.以超声造影为"金标准"判断VTI、VTQ技术评估RFA后残留病灶的敏感性、特异性、阳性预测值、阴性预测值、诊断效率.结果 二维超声所测消融区大小与超声造影所显示大小差异有统计学意义(P<0.05),VTI所测消融区大小与超声造影所显示大小差异无统计学意义(P>0.05).行RFA的110个病灶中经CEUS发现残留病灶20个,VTI检出14个,VTQ检出17个.VTI诊断残留病灶的敏感性70％,特异性93.3％,阳性预测值70％,阴性预测值93.3％,诊断效率89.1％;VTQ诊断残留病灶的敏感性85％、特异性95.6％、阳性预测值为81％,阴性预测值为96.6％,诊断效率为93.6％.结论 VTI技术可准确反映消融区的大小,ARFI识别RFA后残留病灶具有重要价值.

Objective To explore the role of acoustic radiation force impulse imaging ( ARFI) including virtual touch tissue imagine ( VTI) and virtual touch tissue quantification ( VTQ) as well as real-time shear wave elastography ( SWE) in evaluating radiofrequency ablation range in liver of experimental pig and the difference between the two techniques. Methods Twenty fresh hepatic lobes of the pigs ( thickness:6～8 cm; length and width:more than 8 cm) were used in ultrasound-guided radiofrequency ablation ( RFA) . The changes of the acoustic image in ablation area were observed. The maximum long diameter, anteroposterior diameter, area of ablation place and VTQ were measured under ARFI imaging conditions, and the maximum long diameter, anteroposterior diameter, area of ablation place and Young 's modulus value were measured under SWE imaging conditions. Then the differences between the measured values by the two methods and the real measured value in ablation area after dissection and the differences between the hardness value in ablation area and non ablation area were observed and compared, respectively. Results Twenty RFA experiments were performed successfully. There was no significant difference in the area of lesions measured by the ARFI technique and the actual values (P>0. 05). Also there was no statistically significant difference in the area of lesions measured by the SWE technique and the actual values (P>0. 05). The maps of SWE color hardness were more delicate and clear than those of VTI hardness. Conclusion Both ARFI and SWE can accurately evaluate the shape, size and hardness in radiofrequency ablation area, while two dimensional ultrasound imaging can not do it. Moreover the map of SWE color hardness is more delicate than that of ARFI.

目的 探讨斑蝥酸钠维生素B6注射液联合参芪扶正注射液对晚期恶性肿瘤患者生活质量的影响.方法 60例晚期恶性肿瘤患者随机分为两组,对照组30例,给予参芪扶正注射液,同时给予对症及营养支持治疗;治疗组30例,给予参芪扶正注射液+斑鳌酸钠维生素B6注射液连用21 d,间隔1周后重复使用,28 d为1个疗程.两组患者共完成3个疗程后进行评估.结果 治疗组与对照组患者在Karnofsky体力状况评分、体质量、生活质量评分变化等指标的差异有统计学意义(P＜0.05),且治疗组患者1年生存率略高于对照组,不良反应发生较少.结论 斑蝥酸钠维生素B6和参芪扶正注射液联合使用能明显改善晚期肿瘤患者的生活质量,效果优于参芪扶正注射液单药,不良反应少,值得临床推广.

目的：探讨改良入路腹腔镜手术或三联合外科手术在胃贲门癌根治术中的可行性。方法河北医科大学第二医院胃肠外科设计了一种能够将开腹手术、手辅助或腹腔镜手术结合在同一台手术的专利装置（腹腔镜手助器），并将这3种手术结合在一起的方式称为TULS。回顾性分析2014年6—8月行TULS贲门癌根治术治疗的8例患者临床资料。结果本组8例患者均顺利完成手术，无中转开腹患者，平均手术时间为186（155～218） min，术中出血量为110（80～200） ml，清扫淋巴结数目为27（19～38）枚／例，无术中及术后严重并发症的发生，于术后9～14（中位数11） d痊愈出院。术后随访5（4～6）月，均无明显不适。结论 TULS应用于贲门癌根治术，安全可行，短期疗效满意。

Objective To assess the clinical effect of the combined application of thymopentin and Shenqifuzheng injection on advanced lung cancer,explore the effect of the combined application of the both on T lymphocyte subpopulation,natural killer cell and living quality of patients with advanced lung cancer,and to give basis for the clinical treatment of malignancies.Methods Sixty eight patients with lung cancer,who missed or refused operation,radiotherapy and chemotherapy,were selected.The objects of study were randomly divided into general common supportive treatment group,thymopentin treatment group,Shenqifuzheng injection treatment group,and thymopentin-Shenqifuzheng injection treatment group,with the adoption of 2 × 2 factorial design.Venous blood 3 ml from each patient was respectively collected before and after treatment,so as to test T lymphocytes population (CD4+,CD8+,CD4+/ CD8+),NK cells and other immunological indicators,and to assess the change in immune function of the patient.Karnofsky scale was used to evaluate the living quality of the patient.Results For thymopentin,Shenqifuzheng injection and the combined application of the both,it was statistically significant (P ＜ 0.05) in assessment of immunological indicators and living quality.Conclusions The combined application of thymopentin and Shenqifuzheng injection,the both of which are positively interactive,will achieve a better curative effect,with a bright future in application.

Objective To investigate the expression of miR-126 in human colon cancer cells and its effect on drug resistance. Methods Forty five cases of colon cancer tissues, para-carcinoma tissues and 30 cases of normal colon tissues were collected from July 2010 to August 2013 in Department of Oncology of our hospital. By detecting miR-126 expression levels using fluorescent PCR, culturing HCT116 cells in vitro, suppressing the expression of miR-126 by transfecting the suppressing sequence, we studied the drug resistance effect of miR-126 in HCT116 cells. Results The positive rate of miR-126 expression in colon cancer tissues was significantly lower than that in para-carcinoma tissues and normal tissues(P 0.05); moreover, this rate in para-carcinoma tissues was also lower than that in normal tissues, but the difference was not significant(P 0.05). No significant differences of miR-126 expression in age, gender, differentiation,and, tumor size were observed(P 0.05), but miR-126 expression was found to be associated with lymph node metastasis, Dukes′staging and clinical staging; the differences among miR-126 expression levels was also significant(P 0.05).In 0, 5, 10,20 mg/L oxaliplatin medium, cancer cell activity(absorbance) in miR-126 positive group was significantly lower than in miR-126 negative group(P 0.05). Conclusion The positive expression of miR-126 in colon cancer tissues is relatively low, whereas this positive expression can reduce drug resistance of cancer cells and is beneficial to the treatment of colon cancer.

Objective:To compare the long-term outcomes of laparoscopic surgery and open surgery for colonic cancer.Methods:The randomized controlled trials between Jan.1995 and Jul.2011,reported on the long-term outcomes of laparoscopic versus open surgery for colon cancer,were collected by searches of CHKD,VIP,PUBMED,EMCC and the Ovid database.The standard of literature enrollment and exclusion was made,according to which the literatures were selected.Jadad scale was used to evaluate the chosen study.Data were extracted from these trials and data analysis was performed by RevMan 4.2.8.Results:According to the same screening criteria,a total of 2 689 patients from 6 trials were included(1 347 patients in the laparoscopic surgery group and 1 342 patients in the open surgery group).Except body mass index,the age,gender,tumor stage and ASA class were similar between the two groups.There was no statistically significant difference in the long-term outcomes between the two groups,including recurrence rate,local recurrence rate,distant metastasis rate,port site or incision implantation metastasis rate,survival rate in 3 years and 5 years,no-tumor survival rate in 3 years and 5 years.Conclusions:The long-term outcomes are similar between laparoscopic and open surgery for colon cancer.Laparoscopic surgery for colon cancer is an acceptable alternative.

Objective To explore risk factors of occurrence of carcinoma of esophagus in Xingtang county and to provide scientific basis for direct prevention of carcinoma of esophagus.Methods 45 dead cases and 180 healthy people were investigated for risk factors of carcinoma of esophagus.Results One-way ANOVA revealed that OR value of tumor family history,carcinoma of esophagus,alcohol drinking and absorbing of onion were 5.3,9.0,4.33,3.22 respectively,(all P0.01).Conditional logistic regression showed that OR value of history of upper digestive tract diseases,family history of tumor,alcohol drinking were 5.07,5.54,1.98 respectively,(all P0.01).Conclusion History of upper digestive tract diseases,family history of tumor,alcohol drinking may be risk factors of occurrence of carcinoma of esophagus.

患儿,男性,3岁,无意中发现腹部肿块,于2005年5月入院,4天前患儿腹胀,腹膨隆,不伴恶心、呕吐,无发热、寒战.超声检查发现:肝左外叶内探及大小约11.6 cm×10.0 cm囊实混合性包块回声,内可见不规则液性暗区及多个强回声斑点,轮廓清;腹腔内可探及片状腹水暗区.超声诊断:①肝左外叶囊实混合性占位病变(错构瘤?)(图1);②腹水.CT检查发现:左侧腹腔巨大囊实性占位;大量腹水及右侧胸腔积液.考虑恶性肿瘤可能性大.术中见:肿物来自左肝外叶,约12.0 cm×10.0 cm×8.0 cm,呈扁圆形,边清,有包膜,张力较高,瘤体断面呈鱼肉状,水肿.腹内中等量浑浊积液.病理诊断:肝间叶性错构瘤.