Clinically curable adrenal metastasis is rare. We report a case of synchronous solitary adrenal metastasis from rectal cancer in a 51-year-old man who underwent curative resection. A right adrenal mass was found by ultrasonography during his routine physical examination and this was confirmed by computed tomography (CT). His serum carcinoembryonic antigen (CEA) level was found elevated, and colonoscopy revealed a rectal tumor located 10cm from anal verge. A simultaneous laparoscopic right adrenalectomy and anterior resection for rectal carcinoma was performed. Histopathological examination revealed well-differentiated rectal adenocarcinoma with adrenal metastasis. The patient is still alive and free from disease 6 years after the surgery. A review in the literature showed that synchronous solitary adrenal metastasis from colorectal carcinoma is very rare. Surgical resection and for selected patients, laparoscopic procedure may provide survival benefit and potential surgical cure for a solitary metastasis.

Objective To investigate the value of interleukin-6 (IL-6) level as a prognostic indicator in diabetic ketoacidosis (DKA) patients.Methods Data of 88 cases of DKA in Sir Run Run Shaw Hospital collected from June 1,2010 to December 31,2012 were analyzed prospectively.They were divided into two groups according to the survival of patients followed up for 28 days:non-survival group (n =12) and survival group (n =76).Serum levels of IL-6,lactate,base excess and APACHE Ⅱ score in 24 hours after admission were compared between two groups by independent t test.The receiver operating characteristic (ROC) curve was plotted to analyze the performance of IL-6 as a prognostic indicator in the early stage of DKA.Correlations between IL-6 value and lactate,base excess,APACHE Ⅱ score were analyzed.Results The IL-6 values were elevated obviously in non-survival group.The ROC of IL-6 had an area under curve (AUC) of 0.783,and the cut-off value of IL-6 for the death followed up for 28 days was 448.9 ng/L.In all patients,IL-6 values and APACHE Ⅱ score showed a positive correlation between them (r =0.919,P =0.005),and also positive correlations existed between IL-6 and lactate as well as base excess (r=0.922,P=0.003; r=0.887,P=0.015)in24 hours.Conclusions IL-6 value is a reliable prognostic indicator in the early stage of DKA.

Recently we found that ATP5J was over-expressed in tissue samples from patients with colorectal cancer. However, the clinical significance and function of the over-expression of ATP5J in these patients remains unclear. We investigated these issues in the current study. Our results indicated that expression of ATP5J was significantly higher in colorectal cancer tissue than in adjacent tissue, and it was also significantly higher in metastatic lymph nodes than in primary cancer tissue (P<0.05). A correlation between ATP5J expression and tumor differentiation was detected, but no correlation with gender, age, T stage, lymph node metastasis, or survival status was observed. Down-regulation of ATP5J expression attenuated the ability of cell migration and increased the sensitivity to 5-fluorouracil (5-Fu) in cells of the DLD1 cell line. Inversely, up-regulation of ATP5J expression enhanced cell migration and decreased 5-Fu sensitivity, suggesting that the function of ATP5J in colorectal cancer might involve cell migration and 5-Fu sensitivity.

Metastatic carcinoma of the spermatic cord from colon cancer is extremely uncommon. The prognosis of metastatic spermatic cord cancer is poor. Resection of the metastasis and systematic chemotherapy may improve the prognosis. We report two cases and review of the literature. A 81-year-old man presented with painless left scrotum mass 60 months after left hemicolectomy for a descending colon cancer. Biopsy of the mass confirmed a metastatic adenocarcinoma. He refused any further treatment. Following 16 months, he was in a poor quality of life with the mass enlarged and ulceration. Another 66-year-old man presented with painless left scrotum mass 25 months after left hemicolectomy for a descending colon cancer. Radical orchidoepididymectomy followed by 7 cycles of FOLFOX4 chemotherapy was performed. Histological examination showed both mucinous adenocarcinoma in primary and secondary tumor. He was free from disease 20 months after diagnosis.

OBJECTIVE:To investigate the reversing effect of Bcl-XL small interfering RNA (siRNA) on the acquired resistance to tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) in human colon cancer.METHODS:Human colon cancer cells DLD1-TRAIL/R, with acquired resistance to TRAIL, were firstly transfected with Bcl-XL siRNA for 24 h followed by the treatment of TRAIL protein. The survival rate of DLD1-TRAIL/R cells was assessed by FACS analysis and cell number counting, respectively, and activation of its apoptotic signaling was evaluated by Western blot.RESULTS:Bcl-XL siRNA effectively downregulated the expression of Bcl-XL protein and reversed the acquired resistance to TRAIL in DLD1-TRAIL/R cells. After combination treatment of Bcl-XL siRNA and TRAIL protein, the apoptotic rate of DLD1-TRAIL/R cells was more than 50% and survival rate was less than 40%, whereas there was no effect on the survival of DLD1-TRAIL/R cells after treatment with control treatment or TRAIL protein treatment alone (P < 0.05). Western blot analysis demonstrated that caspase-8, caspase-9, Bid, caspase-3, and poly (ADP-ribose) polymerase (PARP) were obviously activated after combination treatment with Bcl-XL siRNA and TRAIL protein, and the release of cytochrome C was also significantly increased.CONCLUSION:Bcl-XL siRNA can effectively reverse the acquired resistance to TRAIL in human colon cancer cells, suggesting that it might be a new strategy for overcoming the resistance in cancer therapy.

目的观察氨甲环酸用于结直肠癌根治术中的止血效果。方法将结直肠癌患者100例随机分为氨甲环酸组和对照组,每组50例。氨甲环酸组术前20min静脉滴注氨甲环酸10mg/kg,术后继续静脉滴注1.6g/d,连用3d。对照组仅用0.9%氯化钠溶液。记录两组手术时间、术中出血量、术后3d引流量和围手术期输血量,并观察术后凝血功能指标(PT、APTT、Fib)变化情况和患者用药后的不良反应。结果氨甲环酸组与对照组相比,术中出血量、术后3d每天引流量和总引流量、围手术期输血量均显著减少,差异均有显著性(P<0.05);两组手术前后凝血功能指标无显著变化(P>0.05);患者用药后不良反应轻微且能自行缓解。结论氨甲环酸能减少结直肠癌根治术术中、术后出血量和围手术期输血量,止血效果显著。同时对机体凝血功能无明显影响,安全性好。

孤立性髓外浆细胞瘤(solitary extramedullary plasmacytoma,SEP)由Schridde在1905年首先报道,临床上非常少见.多发生于淋巴组织较丰富的头颈部.而在直肠的SEP极为罕见.我院1995年2月至2005年10月共收治4例直肠SEP,结合文献回顾,探讨直肠SEP的临床特点、诊断和治疗.

<正>肿瘤坏死因子相关凋亡诱导配体(TRAIL)能杀灭众多肿瘤细胞而不损伤多数正常细胞,它的发现为肿瘤基因治疗带来了新的曙光,但深入研究发现,TRAIL基因治疗的进一步发展受到了耐药问题的困扰。了解TRAIL基因耐药机制,尤其是治疗过程中形成的获得性耐药机制,对于预防并逆转耐药具有重要意义。本实验将重组腺病毒Ad／gTRAIL 反复处理DLD1细胞来建立获得性TRAIL基因耐药细胞株并进一步分析耐药的可能机制。