Objective To investigate the mechanism and clinical significance of vincristine (VCR) inhibiting gastrinproliferation effects on human colon cell line SW480. Methods Effects of VCR on the viable cell count (A value), myoinositol triphosphate (IP3, CPM value), 〔Ca2+〕i and protein kinase C (PKC) activity of human colon cell line SW480 were evaluated in vitro by MTT assay,3Hmyoinositol incorporation, fluorescence measurements and γ-32P-ATP incorporation.Results A value of VCR+PG group was lower than that of PG or control group (Ｐ＜0.01 vs control, Ｐ＜0.01 vs PG). The concentration of IP3 or 〔Ca2+〕i in VCR+PG group was lower than that in PG group (Ｐ＜0.01 vs PG); and the PKC activity of membrane was lower than that in PG group (Ｐ＜0.05 vs PG, Ｐ＞0.05 vs control). Conclusion Effects of vincristine may be through the phosphoinositide signaling pathway on gastrinstimulating cell proliferation in human colon cell line SW480. It has provided an experimental evidence for antisignaling therapy for patients with colon cancer.
In this study, the effect of neostigmine on the healing of colonic anastomoses has been investigated following onestage resection and anastomosis for complete leftsided colomic obstruction.It was found that neostingmine promoted colonic anastomotic healing either experimentally or clinically. Further, the authors discuss the pathogenesis of anastomotic leakage but suggest that neostigmine should be used in the first 5 hours after operation.
Objective To compare the effects of double stapling technique （DST） and single stapling technique （SST） in the low or ultralow anterior rectal resection and colon-anal canal anastomosis for patients with rectal cancer. Methods The clinical data of 351 patients with rectal caner， who were treated with low or ultralow anterior resection and colon-anal canal anastomosis in West China Hospital from Jan. 2009 to Dec. 2010， were collected and analyzed retrospectively. Operative and postoperative indexes of patients treated with DST （n=302） and SST （n=49） were compared. Results Compared with DST group， the distance from the dentate line to the edge of tumor， the length of the distal surgical margin 〔（1.83±0.59） cm vs. （2.07±0.56） cm〕， and hospitalization cost 〔（24 350.48±7 812.73） yuan vs.（29 455.32±7 869.33） yuan〕 of SST group were shorter or lower （P＜0.05）， but operative time was longer 〔（112.86±39.29） min vs. （100.10±36.75） min， P＜0.05〕. There were no significant differences on blood loss， duration of firstambulation， duration of first passing flatus， duration of first bowel movement， duration of pulling out nasogastric tube， duration of pulling out urinary catheter， duration of pulling out drain， postoperative hospital stay， total length of hospital stay， and the incidence of complication between the 2 groups （P＞0.05）. All patients were in functional recovery of anal control after operation. All patients were followed-up for 6-24 months （average 16 months）. During the followed-up， only 1 case suffered local tumor recurrence （SST group）， 3 cases suffered distant metastases （all in DST group）， and 15 cases （4.27％） died， of which 13 cases （4.30％） in DST group and 2 cases （4.08％） in SST group. Conclusions As in the low or ultralow anterior rectal resection and colon-anal canal anastomosis for patients with rectal cancer， SST results in shorter distal surgical margin than DST， so SST is suitable for the patients with shorter distance from the dentate line to the edge of tumor. What’s more， it saves the hospitalization cost effectively.
ObjectiveTo investigate the clinicopathological characteristics and prognosis of elderly patients with colon cancer. MethodsThe clinicopathological and followup data of patients with colon cancer were compared retrospectively between those older than 60 years (405 patients) and those younger than 40 years (146 patients). ResultsFamily history, comorbidities, preoperative intestinal obstruction, and differentiation grade were significantly different between two groups (P＜0.05). The 5-year survival rate of patients in elder group and younger group was 64.9% and 56.8% respectively, and there was significant difference （P＜0.05）. The multivariate analysis indicated that the independent predictors of survival were comorbidities, perioperative CEA level, preoperative intestinal obstruction, tumor gross type, lymph node metastasis, hepatic metastasis, and TNM stage. ConclusionPatients older than 60 years with colon cancer have unique clinicopathological characteristics and better prognosis. The independent predictors of survival are comorbidities, perioperative CEA level, preoperative intestinal obstruction, tumor gross type, lymph node metastasis, hepatic metastasis, and TNM stage.
Objective To study the neuropathological changes of gastrin and substance P(SP) in the intermuscular and submucous nerve plexus of the colonic walls in patients with delayed motor constipation(DMC).MethodsGastrin and rabbit SP polyclonal antibiotics were used to make an immunohistochemical staining of the samples of different segments obtained from 10 patients with DMC and 8 normal subjects(control group) for a comparative observation as well as a relative semi-quantitative analysis.Results The immune positive nerve cells of gastrin and SP in the intermuscular nerve plexus of colon with DMC were markedly reduced; no differences in the immune response of gastrin and SP in the mucous nerve plexus were found between the two groups(P＜0.01). With routine HE staining, focal inflammation occurred in the mucous membrane of DMC colon and that the neuronal vacuolus of the intermuscular nerve plexus degenerated, reduced and even disappeared. Conclusion The abnormal changes of the neural structure in the immune reponse of gastrin and SP in the intermuscular nerve plexus of colon with DMC might be related to reduction of gastrin and SP peptide neuron or dysfunctional.
Objective To investigate the difference of minichromosome maintenance protein 2 (MCM2) mRNA expression among colonic normal mucosa, colonic adenoma and carcinoma. Methods The expressions of MCM2 mRNA were determined by real-time RT-PCR in 12 colonic normal mucosa, 33 colonic adenomas and 12 colonic carcinomas. Data were evaluated by relative expression software tool (REST-XL). Results The expressions of MCM2 mRNA elevated in turn by colonic normal mucosa, adenoma and carcinoma. The expression of MCM2 mRNA in colonic carcinomas was significantly higher than that in adenomas， as well as in normal mucosa (P=0.001), while the difference of MCM2 mRNA expressions between adenoma and normal mucosa was insignificant (P=0.184). Conclusion The difference of MCM2 mRNA expressions between adenoma and carcinoma indicated the potential value on early diagnosis for colonic carcinoma.
Objective To discuss the influence of combination of 64 multi-slice spiral computer tomography (MSCT) and serum amyloid A protein (SAA) for preoperative assessment on colon cancer surgery strategy. Methods Ｔhe examination data of 110 patients diagnosed definitely as colon cancer in the West China Hospital of Sichuan University from Nov. 2007 to Nov. 2008 were studied prospectively, and randomly assigned into the MSCT+SAA group and MSCT group, respectively. Both MSCT and SAA combinative assessment were made for preoperative evaluation in MSCT+SAA group, while only MSCT was made preoperatively in MSCT group. Furthermore, the preoperative staging and prediction of operative procedures were compared with postoperative pathologic staging and practical of operative procedures, respectively. Results According to the inclusion criteria, 99 colon cancer patients were actually included into MSCT+SAA group (n=49) and MSCT group (n=50). The baseline characteristics of two groups were statistically identical. For MSCT+SAA group, The accuracies of preoperative staging T, N, M and TNM were 81.6%, 79.6%, 100% and 77.6%, respectively. For MSCT group, the corresponding rates were 82.0%, 60.0%, 98.0% and 62.0%, respectively. The difference of accuracies on staging N between two groups was observed statistically (χ2=4.498, P=0.034). There was also a statistically significant difference of the accuracy of prediction of operative procedures in MSCT+SAA group and MSCT group (95.9% vs. 82.0%, χ2=4.854, P=0.028). The preoperative staging N (P=0.008), M (P=0.010), TNM (P=0.009) and level of SAA (P=0.004) were related to the selection of operative procedures when analyzed the relationship between the operative procedures and multiple clinicopathologic factors in colon cancer. Conclusion The strategy of the combinative assessment of MSCT and SAA could advance the accuracy of preoperative staging, thus serve surgeon the more accurate prediction to surgery strategy in colon cancer.
醫院感染是指住院患者在醫院內獲得的感染,包括在住院期間發生的感染和在醫院內獲得出院后發生的感染。重癥加強治療病房( ICU) 是醫院感染的高發科室, 其中又以肺部感染最為常見, 導致患者死亡率增加及治療成本上升。隨著醫療技術的發展, 器官移植、有創檢查及治療手段的不斷推廣, 以及廣譜抗生素、糖皮質激素和免疫抑制劑在臨床治療中的廣泛應用, 下呼吸道感染病原菌的種類不斷發生變遷, 由多重耐藥菌( MDR) 及真菌引起的感染不斷增多, 成為下呼吸道感染的主要病原菌之一。在大多數情況下, 這類條件致病菌在合適的部位定植而不引起感染, 當機體因各種因素造成的抵抗力下降、菌群失調或天然屏障結構破壞時可引起感染發生。 由于定植菌的致病性是相對的, 臨床上無法通過患者的臨床表現經驗診斷至屬或種, 實驗室亦無法單純依賴培養鑒定技術確定其是感染病原菌還是定植菌。在呼吸機相關性肺炎( VAP) 患者中, 下呼吸道的真菌定植率較高, 但真正出現真菌性肺炎的患者比例并不高, 以致對患者的結局無顯著影響。如果僅僅根據真菌定植結果制定治療方案就容易造成抗真菌藥物的過度使用。因此, 判斷肺部感染的病原學是定植還是感染成為目前醫院感染治療中的難點問題之一。
【Abstract】Objective To investigate the effects of human growth hormone (GH) on colonic cancer cells to provide experimental evidence about the GH safety in colonic cancer therapy. Methods The nude mouse model of colonic carcinoma induced with SW480 cell line was established to observe the effects of GH on the transplanted carcinoma. GH and 5-FU were administered to SW480 cells cultured in vitro to observe the cell growth with MTT method. Results The volume, average diameter and weight of the transplanted carcinoma in GH group were significantly higher than those in control group（P＜0.05）. In vitro, the value of A in GH group was significantly higher than control group （P＜0.01), but the value of A in 5-FU+GH group was lower than control group（P＜0.01）. Conclusion GH can promote colonic cancer cell growth; GH combined with cell cycle specific chemotherapeutic drugs is safe in colonic cancer therapy and may be used as a promoter of chemotherapy.
Objective To study the relationship between blood metastasis of colorectal cancer and cancer metastasis related factors.MethodsCK20 mRNA in peripheral blood was investigated by reverse transcription polymerase chain reaction (RTPCR) and proteins of CD44v6 and p53 in cancer tissues were examined by immunohistochemical in 50 cases of colorectal neoplasm. ResultsThe results showed that the positive rates of peripheral blood micrometastasis of colorectal cancer were 68%. It escalated along with the rising of the Dukes stage, the rates in Dukes C and D stage were significantly higher than that in Dukes A and B stage. The positive rates of CD44v6,p53 expression in colorectal cancer were 74% and 62% respectively. The positive rates of CD44v6 and p53 in Dukes A and B stage were significantly lower than those in Dukes C and D stage,in peripheral blood and colorectal cancer micrometastasispositive group were significantly higher than that in the micrometastasisnegative group. CK20 mRNA was significantly correlated with expressions of CD44v6 and p53 in cancer tissues. Conclusion The detection of CK20 mRNA in blood before operation and after operation examination of CD44v6 and p53 in cancer tissues are helpful for prediction of blood metastasis of colorectal neoplasm and postoperative treatment.