肺癌是全球范围内肿瘤致死的最常见原因，其死亡率超过了结肠癌、乳腺癌和前列腺癌之和[1]。虽然肺癌已成为全球最主要的死因之一，然而在其治疗方面仍然缺乏根本有效的方法。肿瘤的化学预防（chemoprevention）是一项有效的措施[2]，其含义是：应用天然或人工合成化合物阻断、逆转或预防侵袭性肿瘤的发生，降低具有侵袭性或有临床表现的癌症的发生率。肿瘤化学预防药物研究已成为目前肿瘤学和药学的研究热点之一。
Objective To investigate the expression of calcium-dependent phospholipid binding protein 1 (CPNE1) in gastric cancer (GC) and the correlation with prognosis. MethodsThe clinicopathological data of 121 patients who underwent radical gastrectomy in the Department of General Surgery, The 940th Hospital of Joint Logistics Support Force of the People’s Liberation Army from March 2017 to December 2018 were retrospectively collected. The expression of CPNE1 in gastric cancer tissues was detected by immunohistochemical (IHC) staining, and its relationship with prognosis was analyzed. Gastric cancer tissue samples and adjacent tissue samples from 16 patients in the same time were prospectively collected, and the mRNA and protein expressions of CPNE1 were detected by real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) and western blotting (WB), respectively. Multivariate Cox proportional hazard regression model was used to analyze the prognostic factors of gastric cancer patients. ResultsIHC staining results showed that CPNE1 was mainly expressed in the cell membrane and cytoplasm of gastric epithelial cells, and the color showed different degrees of brown. Among the 121 patients, 70 (57.9%) had high CPNE1 expression and 51 (42.1%) had low CPNE1 expression. The RT-qPCR and WB results of 16 pairs of fresh tissue specimens showed that the expression levels of CPNE1 mRNA and protein in gastric cancer tissues were higher than those in adjacent tissues (gastric cancer tissue vs. adjacent tissue: CPNE1 mRNA 1.451 vs. 1.100, P=0.048; CPNE1, 0.995 vs. 0.521, P=0.001). Multivariate Cox proportional hazards regression analysis showed that high expression of CPNE1 [HR=1.923, 95%CI (1.124, 3.290), P=0.017] was risk factors affecting the prognosis of patients with gastric cancer. ConclusionCPNE1 is highly expressed in gastric cancer tissues and is associated with a poor prognosis in patients, and it may be a potential tumor biomarker.
Objective To observe the genotype distribution of Haemophilus parainfluenzae from patients with acute exacerbations of chronic obstructive pulmonary disease ( AECOPD) and their effects on A549 cells. Methods 80 hospitalized patients with AECOPD in our hospital were enrolled. Haemophilus parainfluezae were collected by sputum culture and genotyped, then inoculated with cell line A549. IL-6 and IL-8 concentrations in the supernatant were detected and cell morphology was observed at different time points. Results The patients were divided into three groups according to their symptoms. 15 Haemophilus parainfuenzae strains were collected and the positive culture rate between type 1 and type 3 COPD patients were statistically different. The concentrations of IL-6 and IL-8 were both significantly higher than control and increased as time passed. 4 genotypes were got by random amplification of polymorphic DNA ( RAPD) . In RAPD Ⅲ group, the IL-8 concentration was higher at 12h and 24h than others. No morphologic change was found in the cells inoculated with Haemophilus parainfuenzae by microscope after fixing. Conclusions Positive culture rate of Haemophilus parainfuenzae was different in different COPD groups according to symptoms. Haemophilus parainfuenzae can stimulate a cytokine response in A549 cells, maybe one of the pathogens of AECOPD, especially the RAPDⅢ type. Haemophilus parainfuenzae is not an intracellular bacteria.
ObjectiveTo observe the efficiency of endovenous laser therapy combined with planning sucking operation in the treatment of great saphenous varicose veins. MethodsTotally 48 patients (60 limbs) were treated from May 2011 to May 2014 in general surgery department of our hospital. The main trunk of great saphenous vein was ablated by endovenous laser treatment; and the varicose veins in calf were resected by planning sucking operation. ResultsAll 48 patients (60 limbs) were cured without recurrent during 6-36 months followed-up. The operative time of each side was 18-43 min, the average operative time was 22.6 min; with 1-3 skin incisions. Hospital stay was 5-8 d, the average hospitalization time was 6.7 d. After operation, the varicose veins and the felling of swelling were disappeared, the pigmentation was reduced or disappeared. Local skin numbness showed in 6 cases and recovered in 3-7 months after operation. Felling of burns appeared in 2 cases, and was healed after treatment. Ankle swelling presented in 5 cases, and released in 6-13 d with related treatment. Different degree of subcutaneous bruising appeared without any hematoma, and recovered in 2-4 weeks. Two cases were lost during the followed-up. ConclusionsEndovenous laser therapy combined with planning sucking operation is safe and effective in the treatment of great saphenous varicose. It is worthy of promotion with minimum damage, less pain, fast recovery, no scars, shorter operative time, and shorter hospital stay.
ObjectiveTo investigate safety and feasibility of early oral feeding after laparoscopic radical distal gastrectomy. MethodsOne hundred and fifty patients with gastric cancer admitted to hospital from May 2015 to Feb-ruary 2016 were divided into early oral feeding (EOF) group and traditional feeding (TF) group by a randomized contro-lled way. The relevant postoperative indicators, including postoperative complications (wound infection, inflammatory intestinal obstruction, anastomotic leakage, pulmonary infection, gastric retention), feeding tolerance (nausea, vomiting, and reinserting of gastric tube), nutritional status (serum albumin, prealbumin), immune function (IgA, IgG, IgM), recovery of gastrointestinal function (postoperative the first anal exhaust time and defecation time), hospitalization time, and hospitalization expenses, were observed and analyzed. Results① One hundred and thirty-nine patients were included in this study, there were 72 cases in the EOF group, 67 cases in the TF group. The gender, age, boby mass index, etc. had no statistic significances between these two groups (P>0.05). ② All the patients of the two groups were cured and discharged, no patients died during perioperative period. The postoperative the first anal exhaust time, defecation time, and hospitalization time of the EOF group were significantly less than those of the TF group (P<0.05). The operative time, intraoperative blood loss, and postoperative hospitalization expenses had no significant differences between these two groups (P>0.05).③ The levels of serum albumin, prealbumin, and IgA on day 7 after operation in the EOF group were significantly higher than those in the TF group (P<0.05). The levels of IgG and IgM on day 7 after operation had no significant differences between these two groups (P>0.05). ④The tolerance rates of oral feeding of the EOF group and TF group patients was 91.7% (66/72) and 94.0% (63/67) respectively, the difference was not statistically significant (χ2=0.044, P=0.833). While 2 patients needed to be inserted gastric tube again due to nausea and abdominal distention in the EOF group, the symptoms were cured with conservative treatment about 3 d.⑤ The postoperative complications of the EOF group were 10 cases, TF group were 10 cases, the difference was not statistically significant (χ2=0.173, P=0.677). And postoperative complications were cured and discharged after active conservative treatment. Postoperative follow-up of 102 (102/139) cases were completed, follow-up time was 1-6 months, no patients admitted to hospital again for postopera-tive complications. ConclusionEarly oral feeding after laparoscopic radical distal gastrectomy is safe and feasible, which don't only increase incidence of complications, but also improve nutritional status of patients, and promote recoveries of immune function and intestinal function, and shorten postoperative hospitalization time.
ObjectiveTo explore the clinical efficacy and application significance of continuous irrigation and drainage for intestinal fistula combined with abdominal infection.MethodsClinical data of 62 patients with intestinafistula combined with abdominal infection admitted by Department of General Surgery of The 940th Hospital of The People’s Liberation Army Joint Service Support Force from March 2012 to March 2017 were retrospectively analyzed. All patients were treated with continuous abdominal flushing and drainage after emergency surgery. The duration of peritoneal flushing, antibiotic use, blood picture recovery, fistula healing, and total hospitalization were summarized.ResultsAll 62 patients were treated successfully without death or septic shock. Among them, 49 cases of intestinal fistula were treated with continuous abdominal flushing and drainage, and 13 cases of intestinal fistula were treated by continuous flushing and drainage of the abdominal cavity. There were 6 cases of abdominal abscess, 5 cases of incision infection, 5 cases of pleural effusion, and 2 cases of pulmonary infection after surgery. The continuous abdominal cavity washing time was (45±21) d, antibiotic use time was (14±7) d, blood image recovery time was (16±8) d, the healing time of fistula was (47±24) d, total length of hospital stay was (56±27) d.ConclusionsFor intestinal fistula combined with abdominal cavity infection, peritoneal continuous flushing and drainage is related with curative effect, high cure rate, fewer complications, simple washing equipment, simple technology, lower cost, and convenient nursing, which can create a good condition for the complexity or refractory patients with intestinal fistula, and has a high clinical application significance.
ObjectiveTo explore the application value of damage control in intra-abdominal sepsis. MethodsThe related literatures were searched by searching literatures with " damage control” " damage control resuscitation” damage control surgery”, and " intra-abdominal sepsis”, to made an review. Results Despite significant advances in management and treatment, mortality from intra-abdominal sepsis remained still high. Due to its unique anatomic and microbial environment, initial operation could not completely remove the source of infection and avoid complications. Therefore, it was becoming increasingly popular to utilize a damage control strategy with abbreviated laparotomy and planned reoperations. ConclusionsDamage control is characterized by staged treatment, and is widely accepted used to manage intra-abdominal sepsis.
ObjectiveTo explore the application value of the combined detection of CA19-9, CA72-4, carcinoembryonic antigen (CEA), serum pepsinogen Ⅰ(PGⅠ), serum pepsinogen Ⅱ(PGⅡ), ratio of PGⅠ and PGⅡ (PGR), and gastrin-17 (G17) in the diagnosis of gastric cancer.MethodsOne hundred cases of gastric cancer admitted to the Joint Logistic Support Force 940 Hospital of the People’s Liberation Army from January 2016 to August 2018 were respectively collected as the observation group, 110 cases of benign gastric lesions as the control group during the same period, the levels of serum CA19-9, CA72-4, CEA, PGⅠ, PGⅡ, PGR, and G17 were tested among patients in the two groups, the diagnostic value of single and combined detection (included CA19-9, CA72-4, CEA, PGⅠ, PGⅡ, PGR, and G17) were explored.ResultsThe levels of CA19-9, CA72-4, CEA, and G17 in the observation group were higher than those of the control group (P<0.05), the levels of PGⅠ and PGR were lower than those of the control group (P<0.05). The positive detection rates of CA19-9, CA72-4, CEA, G17, PGⅠ, PGR, and combined detection in the observation group were all higher than those of the control group (P<0.05). The sensitivity and accuracy of the combined detection in the diagnosis of gastric cancer were higher than that of single serum index (P<0.05). The levels of serum CA19-9, CA72-4, CEA, and G17 in the patients of Ⅲ+Ⅳ period, low and moderate degree of differentiation, the tumor diameter was larger than five centimeters, signet-ring cell carcinoma, and distance metastasis of gastric cancer patients were on the high side compared with Ⅰ+Ⅱ period, high differentiation, the tumor diameter was less than or equal to five centimeters, glandular cancer, and no distance metastasis of gastric cancer patients, as well as the levels of serum PGⅠ and PGR on the low side (P<0.05).ConclusionThe combined detection of CA19-9, CA72-4, CEA, PGⅠ, PGⅡ, PGR, and G17 can effectively improve the diagnose rate of gastric cancer, and they are closely related to the pathological characteristics of gastriccancer patients.