[Medium and long-term outcomes of laparoscopic right hemicolectomy for colon cancer].

OBJECTIVE: To evaluate factors associated with postoperative survival after laparoscopic right hemicolectomy for colon cancer. METHODS: Clinical data of patients undergoing laparoscopic right hemicolectomy in the Department of General Surgery, the Peking University Third Hospital from February 2004 to March 2011 were obtained and analyzed. Kaplan-Meier method was used to calculate survival rate and univariate analysis was performed. Proportional-hazards regression model(Cox model) was used for multivariate analysis. RESULTS: A total of 164 cases were included in this study. The conversion rate was 7.3%(12/164) and the postoperative morbidity was 18.9%(31/164). After a median follow-up period of 27 months(range from 5 to 85 months), the 5-year overall survival rate was 81.5% and the 5-year disease free survival rate was 75.7% and 5-year cancer related survival rate was 78.7%. Both univariate and multivariate analysis showed that the TNM staging and conversion were independent prognostic factors(P<0.05). CONCLUSION: The tumor stage and conversion are independent prognostic factors for patients undergoing the laparoscopic right hemicolectomy.

[Multi-slice spiral computed tomography angiography for preoperative evaluation of laparoscopic right hemicolectomy].

OBJECTIVE: To explore the application value of multi-slice spiral CT angiography (MSCTA) for the preoperative evaluation of laparoscopic right hemicolectomy. METHODS: Abdominal CT slice images of 160 patients(group A) were collected for 3-dimensional reconstruction using volume rendering technique. Interpretation and anatomical classification of the major branches and course of the superior mesenteric artery(SMA) in the reconstructed images of the arterial phase were carried out. Forty-five patients(group B) undergoing laparoscopic right hemicolectomy were evaluated with MSCT combining images obtained from the arterial phase and portal venous phase. The relationship between ileocolic artery and ileocolic vein was analyzed. The preoperative imaging findings were compared to that revealed during the procedure. RESULTS: In group A, 70(43.8%) out of 160 patents showed anatomical variations of the superior mesenteric artery, of whom 51(31.9%) had two right colic arteries, and 14(8.8%) had two middle colic arteries. Preoperative MSCTA showed that in group B ileocolic artery was running ventrally to ileocolic vein in 13(28.9%) out of 45 patients, while running dorsally in 32(71.1%). Compared to the skeletonized vessels during the procedure, the consistency rate was 100%. CONCLUSION: Anatomical variations of superior mesenteric artery are common, therefore, multi-slice spiral CT scan is vital for preoperation evaluation.

Arsenic trioxide controls the fate of the PML-RARalpha oncoprotein by directly binding PML.

Arsenic, an ancient drug used in traditional Chinese medicine, has attracted worldwide interest because it shows substantial anticancer activity in patients with acute promyelocytic leukemia (APL). Arsenic trioxide (As2O3) exerts its therapeutic effect by promoting degradation of an oncogenic protein that drives the growth of APL cells, PML-RARalpha (a fusion protein containing sequences from the PML zinc finger protein and retinoic acid receptor alpha). PML and PML-RARalpha degradation is triggered by their SUMOylation, but the mechanism by which As2O3 induces this posttranslational modification is unclear. Here we show that arsenic binds directly to cysteine residues in zinc fingers located within the RBCC domain of PML-RARalpha and PML. Arsenic binding induces PML oligomerization, which increases its interaction with the small ubiquitin-like protein modifier (SUMO)-conjugating enzyme UBC9, resulting in enhanced SUMOylation and degradation. The identification of PML as a direct target of As2O3 provides new insights into the drug's mechanism of action and its specificity for APL.