The incidence of complications after radical resection of esophageal carcinoma is high up to about 20%-50%. The incidence of pneumonia, pleural effusion, tracheal intubation, anastomotic fistula and cardiac events is relatively high. Among them, pulmonary complications are the most common complications after esophageal cancer operation and cause the most perioperative deaths. Among the factors that influence the occurrence of postoperative complications of esophageal cancer, the amount of fluid infusion during and after the operation is closely related to the occurrence of postoperative complications. Moreover, in the environment of enhanced recovery after surgery (ERAS), it is more important to optimize the postoperative fluid management of esophageal cancer. Restricted fluid therapy plays a more and more important role in patients undergoing esophagectomy. This review integrated the relevant research results and discussed the advantages of the restricted fluid therapy compared with other fluid therapy, how to control the restricted infusion volume and infusion speed and how to monitor and evaluate the infusion process and the selection of infusion types, so as to provide reference for clinical practice test.
The esophageal disease is a major clinical disease. The esophageal stent has extensive clinical applications in the treatment of esophageal diseases. However, the clinical application of esophageal stent is limited, because there are lots of complications after implantation of esophageal stent. Biodegradable esophageal stent has two advantages: biodegradability and good histocompatibility. It is expected to solve a variety of complications of esophageal stent and provide a new choice for the treatment of esophageal diseases. Standardized esophageal stents are not fully applicable to all patients. The application of 3D printing technology in the manufacture of biodegradable esophageal stent can realize the individualized treatment of esophageal stent. And meanwhile, the 3D printing technology can reduce the manufacturing cost of the stent. This review aimed to summarize and discuss the application of esophageal stent, the current research status and prospect of biodegradable esophageal stent and the prospect of 3D printing technology in degradable esophageal stent, hoping to provide evidence and perspectives for the research of biodegradable esophageal stent.
ObjectiveTo investigate expression levels of thymidylate synthase (TS), excision repair cross-comple-menting gene 1 (ERCC1), β-tubulin 3 (TUBB3), ribonucleotide reductase subunit 1 (RRM1)in different pathological types of non-small cell lung cancer (NSCLC), and evaluate detection strategies of above genes for individualized chemotherapy of NSCLC. MethodsWe retrospectively analyzed clinical data of 94 NSCLC patients who underwent radical resection in Department of Thoracic Surgery of Beijing Friendship Hospital from February 2010 to October 2012. Messenger ribonu-cleic acid (mRNA)expression levels of TS, ERCC1, TUBB3 and RRM1 were examined by immunohistochemistry. ResultsThere were 91 patients (96.81%)with low mRNA expression of TS, 90 patients (95.74%)with low mRNA expression of ERCC1, 59 patients (62.77%)with low mRNA expression of TUBB3, and 48 patients (51.06%)with low mRNA expression of RRM1. There was no statistical difference in mRNA expression levels of TS, ERCC1, TUBB3 or RRM1 between adenocarcinoma and non-adenocarcinomas (P > 0.05). The percentage of low mRNA expression of TUBB3 in adenocarcinoma was significantly lower than that in non-adenocarcinomas (58.21% vs. 74.07%). Among patients with same pathological types of NSCLC, mRNA expression levels of TS, ERCC1 and TUBB3 were all positively correlated with mRNA expression of RRM1 (correlation coefficient all greater than 0.80). ConclusionFor individualized chemotherapy of NSCLC, when selecting gene detection, mRNA expression levels of ERCC1 and TS need not be detected and can be considered as low expression by experience, mRNA expression levels of TUBB3 in adenocarcinoma and RRM1 in all pathological types of NSCLC should be routinely examined. For non-adenocarcinoma patients, whether or not to examine mRNA expression level of TUBB3 can be decided in a comprehensive manner.
Objective To observe the growth of orthotopic transplanted tumor in nude mice after stomatin-like protein 2 (SLP-2) expression decreased, and to further study the role of SLP-2 in the development and progression of esophageal squamous cell carcinoma. Methods Using RNA interference technique, esophageal squamous cell carcinoma cell lines with specific expression of SLP-2 and stable expression of luciferase were established. The healthy female nude mice with weight ranging from 19 to 22 g were randomly divided into 3 groups (n=12), 6 mice were used to establish subcutaneous xenografts, and the other 6 mice were used to establish the orthotopic transplanted tumor model (Group 1: cell infected with SLP-2-1 plasmid; group 2: cell infected with SLP-2-2 plasmid; group 3: cell infected with SHGFP plasmid). Index of the experiment end was weight loss and poor general situation in any mouse. Before the nude mice were sacrificed, the luciferase value of the tumor was detected by using in vivo imaging technique. After the nude mice were sacrificed, the primary tumor was removed for pathology examination. Results There was no significant difference in region of interest (ROI) value between the group 1 and group 2 (P=0.943). The ROI value for both groups 1 and 2 was significantly lower than that in the group 3 (P=0.002, P=0.000). The primary tumor infiltrated into the muscularis propria of esophageal was observed in all groups. Conclusion SLP-2 is involved in the development and progression of esophageal squamous cell carcinoma, and the decrease of SLP-2 expression can inhibit the growth of esophageal squamous cell carcinoma.