Efficacy observation of paralleled clipping of rectal ligament in resection of rectal cancer in obese male patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the approach and efficacy of dealing the rectal ligament in resection of rectal cancer in obese male patients.</p><p><b>METHODS</b>A total of 92 patients (BMI>25 kg/m(2)) undergoing resection of rectal cancer from December 2008 to December 2010 in Henan Tumor hospital were assigned into 2 groups according to the surgical technique, the modified group (paralleled clipping of rectal ligament, 48 patients) and traditional group (44 patients). Operative time, intra-operational bleeding, rectal ulceration, ureteral injury, mesorectal integrity, and positive rate of lateral margin of pelvic wall were compared between two groups.</p><p><b>RESULTS</b>The operative time was (66.9±99.8) min in modified group, which was significantly shorter than that in traditional group [(125.4±12.2) min, P=0.000]. Intra-operative bleeding was (160.3±27.2) ml in modified group and (150.5±28.5) ml in traditional group (P=0.093). Rectal ulceration rated were 0 and 18.2% (8/44), mesorectal disintegrity rates were 6.2% and 22.7%, pelvic infection rates were 2.1% (1/48) and 20.4 (9/44) in modified and traditional groups respectively, whose differences were all significant (all P<0.05). No ureteral injury and positive margin were found in both two groups.</p><p><b>CONCLUSION</b>The approach of paralleled clipping of rectal ligament around the rectum meets the principle of TME, which is simple, safe and effective.</p>

Prognostic analysis of 42 patients with gastric neuroendocrine carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological characteristics and prognosis of gastric neuroendocrine carcinoma (NEC).</p><p><b>METHODS</b>Clinical data of 42 patients with gastric neuroendocrine carcinoma admitted in the Cancer Hospital of Zhengzhou University between May 2006 and July 2011 were analyzed retrospectively. The prognostic factors were determined by Log-rank test.</p><p><b>RESULTS</b>Gastric NEC was found in 42 (0.83%) of 5046 patients with gastric cancer during the same period, including 37 males and 5 females. The average age of the patients was 63 years old at the diagnosis. Forty patients underwent R0 resection and 2 patients R1 resection. Forty patients received routine adjuvant chemotherapy with fluorouracil plus oxaliplatin. The median follow-up duration was 26.0 months (range 4-70 months). The median survival was 25.0 months, and the overall 1-, 3-, 5-year survival rates were 71.4%, 26.2% and 11.9%, respectively. Univariate analysis revealed that maximum tumor diameter, tumor invasion depth, lymph node metastasis, lymphatic invasion, stage, and curability were associated with survival (all P<0.05).</p><p><b>CONCLUSIONS</b>Gastric NEC is rare. Curative operation is essential for improving the prognosis, while the choice of comprehensive treatment after surgery should be optimized.</p>

Establishment of hepatocellular carcinoma multidrug resistant monoclone cell line HepG2/mdr1 / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The multidrug resistance (MDR) associated with the expression of the mdr1 gene and its product P-glycoprotein is a major factor in the prognosis of hepatocellular carcinoma cell (HCC) patients treated with chemotherapy. Our study was to establish a stable HCC MDR cell line where a de novo acquisition of multidrug resistance specifically related to overexpression of a transgenic mdr1.</p><p><b>METHODS</b>The 4.5-kb mdr1 cDNA obtained from the plasmid pHaMDR1-1 was cloned into the PCI-neo mammalian expression vector, later was transferred by liposome to human hepatocarcinoma cell line HepG2. Then the transfected HepG2 cells resisting G418 were clustered and cultured and the specific fragment of mdr1 cDNA, mRNA and the P-glycoprotein (Pgp) in these HepG2 cells were detected by PCR, RT-PCR and flow cytometry, respectively. The accumulation of the daunorubicin was determinated by flow cytometry simultaneously. The nude mice model of grafting tumour was established by injecting subcutaneously HepG2/mdr1 cells in the right axilla. When the tumour diameter reached 5 mm, adriamycin was injected into peritoneal cavity. The size and growth inhibition of tumour were evaluated.</p><p><b>RESULTS</b>The mdr1 expression vector was constructed successfully and the MDR HCC line HepG2/mdr1 developed. The PCR analysis showed that the specific fragment of mdr1 cDNA in HepG2/mdr1 cells, but not in the control group HepG2 cells. Furthermore, the content of the specific fragment of mdr1 mRNA and Pgp expression in HepG2/mdr1 cells were (59.7 +/- 7.9)% and (12.28 +/- 2.09)%, respectively, compared with (16.9 +/- 3.2)% and (3.07 +/- 1.06)% in HepG2 cells. In the nude mice HCC model, the tumour genes of both groups were identified. After ADM therapy, the mean size of HepG2 cell tumours was significantly smaller than HepG2/mdr1 cell tumours.</p><p><b>CONCLUSION</b>The approach using the transfer of mdr1 cDNA may be applicable to the development of MDR hepatocarcinoma cell line, whose MDR mechanism is known. This would provide the experimental basis of MDR research.</p>