Objective Surgical treatment for rectal cancer has been developed for centuries. After anesthetic technics are applied， classic operation procedures for rectal cancer resection are still cited repeatedly. There are few articles regarding to the development history of surgical treatment for rectal cancer， and we summarize it chronologically. Methods We searched articles in the past 20 years， dated back to the original journal and explored the development of the operation type. Results We summarized more than 100 articles and listed more than 40 articles here. According to the articles retrieved， the surgery for rectal cancer could be dated back to 1739， spanning for more than 270 years. In the premier one hundred years， the resection area was limited and the effect of the treatment was not good. And in the recent one hundred years， the development of surgery conceptions was huge and the related knowledge and skills had been rapidly develop. The operation type for rectal cancer was gradually getting mature. Conclusions Surgery treatment for rectal cancer has been through a development of more than two hundred years， with new concepts and technics continuously fused in. Thus the meaning of surgery treatment for rectal cancer has been renewed. Introduction of total mesorectum excision， conception of 2 cm distal resective margin， development of stapling devices， preoperative chemoradiation and appplication of laparoscopic surgery have fasciliated function-preserving operations with minimal invasion， rapid recovery and high survival rate. Appearance of new drugs and improvement of local excision， preoperative chemoradiation， as well as new agents for chemotherapy and target therapy have promoted surgical resection for rectal cancer to a multidisciplinary model.
Objective To discuss the important role of preoperative chemoradiotherapy in the treatment of mid-low rectal cancer. Methods From the surgical point of view, the evidences from clinic trials in literatures of recent years and also from the results of our single institution were analyzed. Results Preoperative radiotherapy with total dosage of 50 Gy had showed more and more advantages in the past two decades. Preoperative radiotherapy with concomitant chemotherapy had definite effects in downing stage and improving local control, while its role in sphincter preserving kept in controversy. However, this combined preoperative therapies had not improved long-term survival in rectal cancer. By now, there were no proper indicators to predict the effects of therapies. Conclusion Preoperative chemoradiotherapy is still the only way to improve the rate of R0 resection and decrease the rate of local currence after surgery for patients with mid-low advanced rectal cancer.
【Abstract】Objective To analyze the clinical features of multiple primary colorectal carcinoma(MPCC). Methods Data in 21 patients with MPCC during the past 10 years in our hospital were analyzed retrospectively. Results The incidence of synchronous and metachronous carcinoma was 1.1% and 1.2% respectively. The sites and pathologic stages of tumors showed no significant difference compared with single colorectal carcinoma. 47.6% of the cases accompanied with colorectal adenoma. 77.8% of the MPCC could be found during operation. Patients with carcinoma involved rectum had relatively poor survival. Conclusion The full-course colonoscopy, careful intraoperative exploration and regular postoperative colonoscopic follow-up are essential in improving the diagnosis and prognosis of patients with MPCC.
The technique of laparoscopic radical right hemicolectomy is becoming mature, but there are still controversies on some key steps, including the extent of lymph node dissection, the scope of bowel resection, the choice of surgical access and anastomosis. The new function-preserving surgery and natural-orifice transluminal endoscopic surgery (NOTES) have further enhanced the minimally invasive nature of surgery. The author’s have reviewed the latest domestic and international literature, combined with the experience of the author’s center, and elaborated on the current focus issues of laparoscopic radical surgery for right-sided colon cancer.
ObjectiveTo explore the effect of fetal bovine serum (FBS) of different concentrations in the culture medium on osteogenic growth peptide (OGP) promoting bone marrow mesenchymal stem cells (BMSCs) proliferation and differentiation. MethodsBMSCs were separated from limb bones of 8 Sprague Dawley rats (5 weeks old) and purified by adherence method, and BMSCs at passage 3 were divided into 4 groups according to OGP concentration: OGP 1×10-10 mol/L group, OGP 1×10-9mol/L group, OGP 1×10-8 mol/L group, and control group without OGP; and 0, 2%, 5%, 8%, and 10%FBS concentration gradient was used in each group. The cell proliferation rate was detected by MTT method at 1, 3, 5, 7, 9, and 12 days after culture, and the activity of intracellular alkaline phosphatase (ALP) was determined by the method of p-nitrophenyl phosphate disodium at 9 days after culture. ResultsBMSCs showed adherent growth, rapid proliferation, long fiber vortex, and typical morphology. MTT analysis showed that cells could not sustain proliferation when FBS concentration was less than 5% in each group; when FBS concentration was above 8%, cells proliferated continually. Proliferation promoting effect of OGP 1×10-8 mol/L and 1×10-9 mol/L groups was significantly higher than that of the control group in all serum concentrations (P<0.05); when FBS concentration was lower than 10%, the proliferation promoting effect of OGP 1×10-8 mol/L group was significantly higher than that of the other 2 OGP groups (P<0.05), but when FBS concentration was 10%, OGP 1×10-8 mol/L group had no advantage of promoting proliferation. ALP test results showed that as the FBS concentration increased, ALP activity of all groups also significantly increased (P<0.05). Under the condition of 5%FBS and 8%FBS, the ALP activity of each OGP group was significantly greater than that of the control group, and it was the highest in OGP 1×10-8 mol/L group (P<0.05). Under the condition of 10%FBS, the ALP activity of each OGP group was still greater than that of the control group (P<0.05), but no significant difference was found between the OGP 1×10-8 mol/L group and OGP 1×10-9 mol/L group (P>0.05). ConclusionThe concentration of 8%FBS is the best concentration of serum for OGP promoting the proliferation and differentiation of BMSCs, and the most suitable concentration of promoting the proliferation and differentiation of BMSCs is OGP 1×10-8 mol/L.
目的 介绍1例因外伤后耻骨缺损造成反复复发腹股沟疝的治疗经验。方法 回顾性分析该患者的诊治经过，总结治疗经验。结果 该患者在外院接受左侧腹股沟疝修补术（Lichtenstein法），术后1年左侧腹股沟疝复发，再于笔者所在医院先后接受两次手术治疗。第1次行开放的双侧腹膜前间隙无张力疝修补术，术后1年再次复发，复发原因可能是补片下界固定不可靠。第2次的术式与第1次相同，术后患者恢复良好，随访16个月无复发。结论 外伤后耻骨缺损是疝修补术后复发的主要原因，坚固有效的补片支撑点是防止再次复发的关键。
To verify the role of mAbCD28 in allograft transplantation. The biological action of mAbCD28 had been tested in mixed-lymphocyte-reaction and parathyroid gland allotranplantation in rats. Results: mAbCD28 could significantly suppress the proliferation of T cells in vitro and prolong the survival time of allograft in vivo. The results showed that mAbCD28 could block the costimulatory signals transmitted by CD28 molecules, and played an immunosuppressive role in parathyroid gland transplantation in rats.
目的 探讨结直肠癌同时合并卵巢转移的临床特点和外科治疗方法。 方法 回顾性分析并总结1985～2005年间我院收治的14例结直肠癌同时合并卵巢转移的临床资料。结果 所有患者均有腹痛、或腹胀、或腹部包块、或血便、或大便习惯改变等症状。月经期患者占57.1%（8/14）。血CEA阳性者3/5例，12例行B超检查，7例行CA125、B超、纤维结肠镜及钡灌肠辅助检查者均为阳性发现。结直肠管状腺癌占71.4%，中低分化腺癌占78.6%。3例行免疫组化检查，其CK7和CK20均为阳性表达。结论 是否合并广泛的腹腔内转移、能否有条件接受广泛的手术切除以及术后的辅助放化疗是决定结直肠癌卵巢转移患者存活时间的关键。