Objective To evaluate the curative effectiveness and safety of prophylactic chemohyperthermic peritoneal perfusion (CHPP) during the radical surgery of advancing gastric cancer. Methods We searched MEDLINE (1980 to December 2002), EMBASE (1989 to December 2002), BIOSIS Previews (1980 to December 2002), Cochrane Controlled Trials Register (Issue 4, 2003) and CBMdisc (1981 to December 2002). Randomized or quasi-randomized controlled trials comparing curative gastrectomy (CG) plus CHPP with CG for advancing gastric cancer were collected. The methodological quality of included studies was assessed, and a meta-analysis was performed by RevMan 4.2 software. Results Seven RCTs involving 744 patients met the selection criteria, all trials were of lower methodological quality. ① Meta-analysis results showed that no significant difference was found comparing CG plus CDDP (cisplatin) with CG for peritoneal recurrence after operation (The pooled OR 0.69，95%CI 0.43 to 1.12). Compared with CG alone, CG plus CDDP plus MMC significantly reduced peritoneal recurrence after operation during ≥5 years follow up (OR 0.05, 95% CI 0.01 to 0.37), but this effect was not seen during lt; 5 years follow up (OR 0.35，95%CI 0.06 to 2.10). ② CG plus CDDP significantly reduced mortality after operation during ＜5 and ≥5 years follow up, compared with CG alone (OR 0.25, 95%CI 0.08 to 0.75; the pooled OR 0.62, 95%CI 0.41 to 0.95), CG plus CDDP plus MMC significantly reduced mortality after operation during ≥5 years follow up, compared with CG alone (the pooled OR 0.45, 95%CI 0.28 to 0.74), but this effect was not seen during lt; 5 years follow up (OR 0.29, 95%CI 0.08 to 1.15). ③ Side effects were reported in only one study and no significant difference was found between the two groups (P=0.96). Conclusions Because of the small number of included studies, the lower methodological quality, and the differences in diagnostic criteria of peritoneal recurrence after operation, the reviewers feel that no firm conclusion could be drawn. Some well designed RCTs of CHPP for advancing gastric cancer should be undertaken to further evaluate its effectiveness.
Objective To evaluate the possibility of detection mutations of 〖JP2〗multiple genes in stool for secondary screening for colorectal cancer. Methods Tumor specimens and stool samples from 40 patients with colorectal cancer and 40 normal persons were examined for mutations of p53, K-ras and APC gene by polymerase chain reaction single strand conformation polymorphism (PCR-SSCP) and silver nitrate staining. Results ①The mutation rate of p53, K-ras and APC gene in the tissues and stools of colorectal cancer respectively were 57.50%, 50.00%, 60.00% and 42.86%, 40.00%, 51.43%, and no mutations were found in normal mucosa and stool. ②The mutation ratioes between multiple gene and single gene had significant difference (P＜0.05). ③The sensitivities had no significant difference between faecal occult blood test (FOBT) and multiple gene mutations detection in the diagnosis of colorectal cancer, but the specificity of the latter was higher than FOBT (P＜0.05). Conclusion Detection of multiple gene mutations in stool is a vauble method in the secondary screening for colorectal cancer.
【摘要】 目的 研究过氧化酶增殖因子活化受体γ（peroxisome proliferator-activated receptor gamma， PPARγ）和血管内皮生长因子C（vascular endothelial growth factor C， VEGF-C）在胃癌组织中表达的相关性，分析其表达与临床病理因素之间的关系。 方法 2005年3月-2009年3月间采用逆转录-聚合酶链反应方法检测36例胃癌手术标本中PPARγ和VEGF-C mRNA的表达，同时选取相同患者的胃正常组织作为对照。 结果 PPARγ mRNA在胃癌中的表达量高于癌旁正常组织，两者的差异有统计学意义（P=0.007）；VEGF-C在胃癌中的表达量高于癌旁正常组织，两者的差异有统计学意义（P=0.004）；PPARγ的表达与VEGF-C表达无关联性（r=0.135，P=0.414）；PPARγ表达与胃癌组织中浸润程度有关（χ2=4.620，P=0.032）、淋巴结转移有关（χ2=15.753，P=0.000）和临床病理分期有关（χ2=4.610，P=0.032）；VEGF-C表达与胃癌组织中淋巴结转移有关（χ2=4.729，P=0.030）、远处转移有关（χ2=4.064，P=0.044）和临床病理分期有关（χ2=6.300，P=0.012）。 结论 PPARγ和VEGF-C可能在胃癌新生淋巴管形成中起重要作用，两者的表达水平与胃癌患者的病情判断及预后评价密切相关。【Abstract】 Objective To investigate the significance of expressions of peroxisome proliferator-activated receptor gamma (PPARγ) and vascular endothelial growth factor C (VEGF-C) in gastric carcinoma as well as their correlation, and to study the relationship between the expressions and clinicopathologic characteristics of gastric carcinoma. Methods Thirty-six pairs of normal mucosa and cancer specimens were obtained from patients who had undergone gastric operation for primary gastric carcinoma and subjected to reverse transcription-ploymerase chain reaction (RT-PCR) for PPARγ and VEGF-C mRNA detection. Results The positive rate and level of PPARγ mRNA expression were higher in gastric cancer tissues than those in normal gastric mucosa (P=0.007). The positive rate and level of VEGF-C mRNA expression were also higher in gastric cancer tissues than those in normal gastric mucosa (P=0.004). Simultaneously, the expression of PPARγ was not correlated with that of VEGF-C (r=0.135, P=0.414), while the highly productions of PPARγ and VEGF-C in gastric carcinomas were both associated with the lymph node metastasis and the clinical stage (Plt;0.05). Conclusion PPARγ and VEGF-C may play an important role in the lymphangio-genesis of gastric cancer, and united detection of PPARγ and VEGF-C expressions may be correlated with making diagnosis, evaluating prognosis in patients with gastric cancer at the same time.
Objective To investigate effect of hepatocyte growth factor (HGF) after lentivirus-mediated RNA interference (RNAi) targeting c-Met on invasion of colonic carcinoma cell line SW480. Methods The experiment was assigned into 3 groups: NC group, the normal cells were infected by the shRNA negative control virus (the NC-20 andNC-40 represented the negative group which were added 20 ng/mL and 40 ng/mL respectively HGF after being infected); KD group, the normal cells were infected by the shRNA-c-Met target virus (the KD-20 and KD-40 represented the interfered group which were added 20 ng/mL and 40 ng/mL HGF respectively after being infected; KD1, KD2, KD3, and KD4 represented the different RNAi targets for the purpose gene); CON group, the normal cells were not infected by any virus. The lentiviral vector shRNA-c-Met was constructed and verified by polymerase chain reaction (PCR) and DNA sequencing. The SW480 cells were infected with the shRNA-c-Met after packed with lentivirus plasmid. Fourty-eight hours transfection later, the c-Met mRNA of the transfected SW480 cell was detected by real time PCR and the c-Met protein was examined by Western blot. Seventy-two hours after transfection, the cell apoptosis was detected by flow cytometry and the invasions in the different cells with stable transfection were detected by Transwell test. Results The RNAi sequence targeting c-Met gene was successfully inserted into the lentiviral vector. The shRNA-c-Met transfection resulted in an obviously reduced expression of c-Met mRNA in the SW480 cells. The efficency of gene knock down of the KD4 (the cells with No.4 target spot knocked down) was 81.4%. The shRNA-c-Met tansfection resulted in an obviously reduced expression of c-Met protein in the SW480 cells. After transfection, the apoptosis rate of the KD group was significantly higher than that in the NC group (P<0.001) or the CON group (P<0.001). The invasion ratios in the NC group, NC-20 group, and NC-40 group were significantly higher than those in the KD group (P<0.001), KD-20 group (P=0.015), and KD-40 group (P=0.017), respectively; which in the NC-20 group and NC-40 group were increased as compared with the NC group (P<0.001,P<0.001), and in the NC-40 group was increased as compared with the NC-20 group (P=0.005). The invasion ratios in the KD-20 group and KD-40 group were increased as compared with the KD group (P<0.001,P<0.001), and in the KD-40 group was increased as compared with the KD-20 group (P=0.014). Conclusion Lentivirus-mediated RNAi targeting c-Met could effectively suppress expression of c-Met in SW480 cells and could reduce invasion of HGF on SW480 cells with knocked down c-Met.
ObjectiveTo explore the clinical electrophysiology, seizure symptomatology, multimodal imaging characteristics and epileptogenic zone location of the temporal -parietal -occipital junction (TPOJ) epilepsy.MethodsThe seizure symptomatology, head MRI, PET-CT and their fusion manifestations, long-range scalp video EEG monitoring results of 6 cases of TPOJ epilepsy patients from March 2015 to August 2018 were analyzed retrospectively in the Second Hospital of Lanzhou University, and the value of localization of epileptogenic zone was analyzed, and the role of multi-modal evaluation based on SEEG in localization of epileptogenic zone was discussed.ResultsThe first symptoms: 2 of 6 patients were complicated visual hallucination; 3 were head eye deflection (2 were opposite to epileptogenic focus, 1 was ipsilateral); 1 was excessive movement. EEG of scalp: the epileptogenic potentials in intermittent period were all multi -brain regions, but could be lateralized; in seizure period, the electroencephalogram was diffuse in 4 cases, without lateralization, and could be lateralized in 2 cases (1 case was the beginning of one hemisphere, 1 case was the beginning of one posterior head). Imaging findings: MRI was negative in 2 cases, post-traumatic soft focus in 2 cases, and FCD in 2 cases; after fusion of MRI and PET-CT, low metabolic areas in a large area including TPOJ could be found. Six patients were implanted with stereotactic electrodes, and the epileptogenic focus could be identified by EEG monitoring after implantation.ConclusionFor TPOJ epilepsy, the manifestations of premonitory and multimodal images at the onset of seizure can provide important clues for the lateralition of epileptogenic zone; scalp EEG and the first symptoms except premonitory can only provide reference clues; multimodal evaluation based on stereoelectroencephalogram can accurately locate the onset of seizure.
ObjectiveTo preliminarily explore the damage effect of stereo electroencephalogram-guided radiofrequency thermocoagulation after increasing the number of electrodes in the epileptic foci.MethodsEight cases were included from 42 patients requiring SEEG from the Department of Neurosurgery of the Second Hospital of Lanzhou University during June 2017 to Jan. 2019, of which 6 cases were hypothetical epileptogenic foci located in the functional area or deep in the epileptogenic foci that could not be surgically removed, 2 patients who were unwilling to undergo craniotomy; added hypothetical epileptic foci Electrodes, the number of implanted electrodes exceeds the number of electrodes needed to locate the epileptic foci. After radiofrequency thermocoagulation damages the epileptogenic foci, the therapeutic effect is analyzed.ResultsIn 8 patients, the number of implanted electrodes increased from 1 ~ 6, with an average of (4±2.2), and the number of thermosetting points increased by 2 ~ 10, with an average of (7±3.1); follow-up (9±3.2) months, Epilepsy control status: 3 cases of Engel Ⅰ, 3 cases of Engel Ⅱ, 2 cases of Engel Ⅲ; 8 cases of epileptic seizure frequency decreased≥50%. There was a statistically significant difference in the frequency of attacks before and after thermocoagulation (P<0.05).ConclusionsIncreasing the lesion volume of the epileptic foci can obviously improve the efficacy of epilepsy. SEEG-guided radiofrequency thermocoagulation is an effective supplementary method for classical resection.
ObjectiveTo explore the long-term seizure outcome and prognostic factors of patients with frontal lobe epilepsy after surgery, so as to guide the evaluation of treatment and provide clinical reference.Methods This study retrospectively analyzed the clinical data of patients with frontal lobe epilepsy undergoing surgical treatment by multimodal epilepsy surgical evaluation system in the functional neurosurgery of the Second Hospital of Lanzhou University from January 2016 to February 2020, there were 17 males and 13 females, the age of onset of epileptic seizures was (16.30±10.65) years, the age at the time of surgical treatment was (23.98±11.04) years, and the duration of seizures was (7.68±6.37) years. The multimodal epilepsy surgical evaluation system includes phase I non-invasive evaluation and phase II invasive evaluation. The collected research variables were analyzed by descriptive statistics and multivariate logistic regression analysis to evaluate the importance of each research variable to the prognosis of epilepsy surgery, and to determine the potential prognostic factors, so as to explore the epilepsy control situation of patients with frontal lobe epilepsy after surgery and the influence of each variable that may affect the prognosis of epilepsy on the prognosis.ResultsThe analysis of the clinical data of 30 patients with frontal lobe epilepsy showed that the good prognosis rate after FLE surgery (Engel I) was 70%, and the average follow-up was (29.9±14.1) months. The results of multivariate logistic regression analysis showed that the duration of epilepsy, the frequency of seizures, the presence or absence of stereotactic EEG (SEEG) monitoring, whether the lesion was completely removed, and whether acute postoperative seizures occurred were independent predictors of prognosis (P<0.05).ConclusionThis study found that the long duration of epilepsy, frequent seizures, and postoperative acute seizures are significantly related to poor prognosis. The application of SEEG and complete resection of epileptic lesions can significantly improve the prognosis of FLE surgery.