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| 1 | Effects of depression on parameters of cell-mediated immunity in patients with digestive tract cancers显示文摘AIM:To evaluate the effects of depression on parameters of cell-mediated immunity in patients with cancers of the digestive tract.METHODS:One hundred and eight adult patients of both sexes with cancers of the digestive tract admitted between March 2001 and February 2002 in the Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University were randomly enrolled in the study. The Zung self-rating depression scale (SDS),Zung self-rating anxiety scale(SAS),numeric rating scale (NRS) and social support rating scale (SSRS) were employed to evaluate the degree of depression and their contributing factors.In terms of their SDS index scores,the patients were categorized into depression group (SDS≥50) and non-depression group(SDS<50).Immunological parameters such as T-lymphocyte subsets and natural killer (NK) cell activities in peripheral blood were determined and compared between the two groups of patients.RESULTS:The SDS index was from 33.8 to 66.2 in the 108 cases,50% of these patients had a SDS index more than 50.Similarly,the SAS index of all the patients ranged from 35.0 to 62.0 and 46.3% of the cases had a SAS index above 50.Cubic curve estimation showed that the depression was positively correlated with anxiety and negatively with social support.Furthermore,the depression correlated with the tumor type,which manifested in a descending order as stomach,gallbladder, pancreas,intestine, esophagus,duodenum and rectum,according to their correlativity. Stepwise regression analysis suggested that hyposexuality,dispiritment,agitation,palpitation, low CD56 and anxiety were the significant factors contributing to depression.More severe anxiety (49.7±7.5 vs 45.3±6.9,P<0.05), pain (6.5±2.8 vs 4.6±3.2,P<0.05), poor social support (6.8±2.0vs 7.6±2.1,P<0.05),as well as decline of lymphocyte count (0.33±0.09vs 0.39±0.87, P<0.05) and CD56 (0.26±0.11 vs 0.29±0.11,P<0.05) were noted in the depression group compared with those of the non-depression patients. However,fewer obvious changes in CD4/CD8 ratio and other immunological parameters were found between the two groups.CONCLUSION:Depression occurs with a high incidence in patients with cancers of the digestive tract,which probably is not bhe sole factor leading to bhe impairment of immunological functions in these cases. However, comprehensive measures including psychological support should be taken in order to improve the immunological function,quality of life and clinical prognosis of these patients. | Ke-JunNan Yong-ChangWei Fu-LingZhou Chun-LiLi Chen-GuangSui Ling-YunHui Cheng-GeGao | 2004 | World Journal of Gastroenterology2004，10，2： | 48 |
| 2 | Racial differences in the anatomical distribution of colorectal cancer:a study of differences between American and Chinese patients显示文摘AIM: To compare the racial differences of anatomical distribution of colorectal cancer (CRC) and determine the association of age, gender and time with anatomical distribution between patients from America (white) and China (oriental).METHODS: Data was collected from 690 consecutive patients in Cleveland Clinic Florida, U.S.A. and 870consecutive patients in Nan Fang Hospital affiliated to the First Military Medical University, China over the past 11years from 1990 to 2000. All patients had colorectal adenocarcinoma diagnosed by histology and underwent surgery.RESULTS: The anatomical subsite distribution of tumor,age and gender were significantly different between white and oriental patients. Lesions in the proximal colon (P<0.001) were found in 36.3 % of white vs 26.0 % of oriental patients and cancers located in the distal colon and rectum in 63.7 % of white and 74 % of oriental patients (P<0.001). There was a trend towards the redistribution from distal colon and rectum to proximal colon in white males over time, especially in older patients (>80 years).No significant change of anatomical distribution occurred in white women and Oriental patients. The mean age at diagnosis was 69.0 years in white patients and 48.3 years in Oriental patients (P<0.001).CONCLUSION: This is the first study comparing the anatomical distribution of colorectal cancers in whites and Chinese patients. White Americans have a higher risk of proximal CRC and this risk increased with time. The proportion of white males with CRC also increased with time.Chinese patients were more likely to have distal CRC and developed the disease at a significantly earlier age than white patients. These findings have enhanced our understanding of the disease process of colorectal cancer in these two races. | San-HuaQing Kai-YunRao Hui-YongJiang StevenD.Wexner | 2003 | World Journal of Gastroenterology2003，9，4： | 28 |
| 3 | Comparative evaluation of immune response after laparoscopical and open total mesorectal excisions with anal sphincter preservation in patients with rectal cancer显示文摘AIM: The study of immune response of open versus laparoscopical total mesorectal excision with anal sphincter preservation in patients with rectal cancer has not been reported yet. The dissected retroperitoneal area that contacts directly with carbon dioxide is extensive in laparoscopic total mesorectal excision with anal sphincter preservation surgery. Tt is important to clarify whether the immune response of laparoscopic total mesorectal excision with anal sphincter preservation (LTME with ASP) in patients with rectal cancer is suppressed more severely than that of open surgery (OTME with ASP). This study was designed to compare the immune functions after laparoscopic and open total mesorectal excision with anal sphincter preservation for rectal cancer.METHODS: This study involved 45 patients undergoing laparoscopic (n=20) and open (n=25) total mesorectal excisions with anal sphincter preservation for rectal cancer.Serum interleukin-2 (IL-2), interleukin-6 (IL-6), tumor necrosis factor α (TNFα) were assayed preoperatively and on days 1 and 5 postoperatively. CD3+ and CD56+ T lymphocyte count, CD3- and CD56+ natural killer cell (NK)count and immunoglobulin (IgG/IgM/IgA) were assayed preoperatively and on day 5 postoperatively. The numbers of CD3+ and CD56+ T lymphocytes and CD3- and CD56+ NK cells were counted using flow cytometry. An enzyme-linked immunosorbent assay (ELISA) was used for IL-2, TL-6 and TNFα determination. And IgG, IgM, and IgA were assayed using immunonephelometry.RESULTS: The demographic data of the two groups had no difference. The preoperative levels of CD3+ and CD56+ T lymphocyte count, CD3- and CD56+ NK count, serum IgG,IgM, IgA, IL-2, IL-6 and TNFα also had no significant difference in the two groups (P>0.05). The CD3+ and CD56+ T lymphocyte counts had no obvious changes after surgery in laparoscopic (d=-0.79±3.83 %) and open (d=0.42±2.09 %)groups. The CD3- and CD56+ NK counts were decreased postoperatively in both laparoscopic (d=-7.23±11.33 %) and open (d=-9.21±13.93 %) groups. The differences of the determined values of serum IgG, IgM and IgA on the fifth day after operation subtracted those before operation were -2.56±2.14 g/L, -252.35±392.94 mg/L, -506.15±912.24 mg/L in laparoscopic group, and -1.81±2.10 g/L, -282.72±356.75mg/L, -252.20±396.28 mg/L in open group, respectively. The levels of IL-2 were decreased after operation in both groups.However, the levels of IL-6 were decreased after laparoscopic surgery (d1=-23.14±263.97 ng/L and d5=-40.08±272.03 ng/L),and increased after open surgery (d1=27.38±129.14 ng/L and d5=21.67±234.31 ng/L). The TNFα levels were not elevated after surgery in both groups. There were no significant differences in the numbers of CD3+ and CD56+ T lymphocytes and CD3- and CD56+ NK cells, the levels of IgG, IgM, IgA,IL-2, IL-6 and TNFα between the two groups (P>0.05).CONCLUSION: There are no differences in immune responses between the patients having laparoscopic total mesorectal excision with anal sphincter preservation and those undergone open surgery for rectal cancer. | Jian-KunHu Zong-GuangZhou Zhi-XinChen Lan-LanWang Yong-YangYu JinLiu BoZhang LiLi YeShu Jia-PingChen | 2003 | World Journal of Gastroenterology2003，9，12： | 23 |
| 4 | 国人青年结直肠癌解剖部位分布及临床病理特点显示文摘目的:探讨中国人青年结直肠癌解剖部位分布及临床病理特点。方法:回顾性分析1974/1999年第一军医大学附属南方医院连续收治的有完整记录的CRC患者1370例,其中小于或等于40岁309例,40岁以上1061例。结果:全部病例的中位年龄为54岁,青年组(小于或等于40岁)309例,占22.3%,青年组与中老年相比:男性所占比例分别为57.0%,58.3%(P>0.05,x^2≡0.16);位于近端结肠者分别为24.1%和25.1%,位于远端结直肠者分别为72.4%和71.2%(P>0.05,x^2=0.42);腺癌皆占绝对优势,分别为71.5%和83.4%(P<0.01,x^2=18.09),黏液腺癌分别为I7.4%和12.0%(P<0.05,x^2=4.70),印戒细胞癌分别为5.5%和1.1%(P<0.01,x^2=30.20);Duke’s A期分别为18.2%和24.9%,Duke’s B期及B期以上分别为81.9%和75.1%(P<0.05,x^2=5.13);低分化所占比例分别为20.9%和11.1%(P<0.01,x^2=14.75);有淋巴结转移者分别为59.5%和34.3%(P<0.01,x^2=53.25)。结论:青年CRC性别构成及解剖部位分布同中老年CRC相比无明显差异,但具有明显不同的临床病理学特点,预后不佳,其治疗水平有赖于对这些特征的认识,力争早期诊断及治疗。 | 谢正勇 卿三华 | 2003 | 世界华人消化杂志2003，11，10： | 20 |
| 5 | 结直肠癌发病率及解剖部位变化趋势显示文摘对结直肠癌发病率及解剖部位分布变化趋势进行研究,有利于探索病因及制定合理防治策略.息肉切除术的广泛应用,使西方国家CRC发病率呈下降趋势;而西方化的生活方式和饮食习惯则使得原来低发的许多国家CRC发病率上升.CRC高发国家以结肠癌为主,低发国家则以直肠癌占优势.近年许多学者发现CRC肿瘤部位分布由远端向近端转移,并认为这与远端结直肠癌发病率下降致近端结肠癌所占比例上升有关.年龄、性别、种族、共病等多种因素可影响CRC的解剖部位:老年、女性、黑人、患有糖尿病等共病、有阳性家族史等是CRC分布于近端结肠的高危因素.近端结肠癌预后不良,尤应注意早期诊治,改善预后. | 谢正勇 卿三华 | 2003 | 世界华人消化杂志2003，11，7： | 16 |
| 6 | Trial of a novel endoscopic tattooing biopsy forceps on animal model显示文摘AIM: To tattoo gastric mucosa with a novel medical device which could be used to monitor and follow-up gastric mucosal lesions.METHODS: Combining endoscopic biopsy with sclerotherapy injection, we designed a new device that could perform biopsy and injection simultaneously. We performed endoscopies on a pig by using a novel endoscope tattoo biopsy forceps for 15 mo. At the same time, we used two-step method combining sclerotherapy injection needle with endoscopic biopsy. The acuity, inflammation and duration of endoscopy were compared between two methods.RESULTS:Compared with the old two-step method,although the inflammation induced by our new device was similar, the duration of procedure was markedly decreased and the acuity of tattooing was better than the old two-step method. All characteristics of the novel device complied with national safety guidelines. Follow-up gastroscopy after 15 mo showed the stained site with injection of 1:100 0.5 mL of India ink was still markedly visible with little inflammatory reaction.CONCLUSION: Endoscopic tattooing biopsy forceps can be widely used in monitoring precancerous lesions.Its safety and effectiveness has been established in animals. | Jian-Min Lei-MinSun Yu-JingFan Liang-JingWang | 2005 | World Journal of Gastroenterology2005，11，12： | 14 |
| 7 | Arterial chemotherapy of 5-fluorouracil and mitomycin C in the treatment of liver metastases of colorectal cancer显示文摘AIM: Regional chemotherapy using hepatic arterycatheters is a good method of treating patients withcolorectsl cancer liver metastases. We investigated thesurvival of patients with liver metastases fromcolorectal cancer using 5-fluorouracil (5-FU) andmitomycin C Cthrough implantable hepatic arterialinfusion pert. METHODS: Seventy-five patients with inoperable livermetastases from colorectal cancer were includedbetween March, 1992 and November, 2001. We placedimplantable hepatic arterial catheter (HAC) port bylaparotomy. 5-FU, 1 000 mg/m2/d continuous infusionfor five days every four weeks, was delivered in thehepatic arterial catheter through the port. MitomycinC, 30 mg/m2/d infusion in the first day every cyclethrough the port. Response to the treatment wasevaluated by serial determinations of plasma CEA andimaging techniques consisting of computerizedtomography and sonography of liver.RESULTS: Sixty-eight were performed hepatic arterychemotherapy and fifty-six were followed up amongseventy-five HAC patients. Twenty-six patients(46.4 %)have responded and 4 complete remission wereachieved. Eight patients (14.3 %) had stable livermetastases. Twenty-two patients (39.3 %) wereprogressed with increased tumor size and number.Twenty-nine patients(51.8% ) had a decreased serumCEA level, while 10 patients (17.9 %) were stable and17 patients (30.4 %) had an increased serum CEA level.There were no operative death in this series.Complications, which occurred in 18 patients (32.1%),were as followed: hepatic artery thrombosis in 11,Upper gastric and intestinal bleeding in 3, liver abscessin 1, pocket infection in 1, cholangitis in 1, and hepaticartery pseudo-aneurysm in one patient.CONCLUSION: Combined infusion of 5-FU and mitomycinC by hepatic artery catheter port is an effectivetreatment for liver metastases from colorectal cancer.The high response and lower complication rates provethe adjuvant treatment of colorectal cancer with thistreatment. | Lian-Xin Liu Wei-Hui Zhang Hong-Chi Jiang An-Long Zhu Lin-Feng Wu Da-Xun Piao Department of Surgery,the First Clinical College,Harbin Medical University,Harbin 150001,Heilongjiang Province,China Shu-Yi Qi Department of VIP,the First Clinical College,Harbin Medical University,Harbin 150001,Heilongjiang Province,China | 2002 | World Journal of Gastroenterology2002，8，4： | 7 |
| 8 | Differences in endoscopic classification of early colorectal carcinoma between China and Japan: A comparative study显示文摘AIM: To compare the differences in the endoscopic classification of early colorectal carcinoma (CRC) betweenJapan and China.METHODS: Ten cases of early CRC were included in the study. After reviewing the color pictures of these cases, 5Japanese endoscopists and 5 Chinese endoscopists made their classificatory diagnosis individually using the current Japanese classification, and indicated their findings on which the diagnosis was based.RESULTS: Some lesions diagnosed by the Japanese endoscopists as Ⅱa or Ⅱa plus Ⅱc, were classified as Is or Isp by the Chinese endoscopists. For superficial lesions consisting of elevation plus central depression, Ⅱa plus depression, Ⅱa plus Ⅱc or Ⅱc plus Ⅱa were classified according to the ratio of elevated area/depressed area.However, international as well as interobserver difference still existed in the classification of such lesions. In addition,most Chinese endoscopists overlooked slightly depressed part on the top of a protruded lesion. Laterally spreading tumor, a special type of Ⅱa, was identified as LST by some Japanese endoscopists.CONCLUSION: Discrepancies on macroscopic classification for early CRC do exist between Japanese and Chinese endoscopists, which are found not only in terminology but also in recognition of some lesions. In order to develop a universal classification, it needs for international communication and cooperation. | Ren-MinZhu Fang-YuWang IchiroHirata Ken-IchiKatsu Shu-DongXiao Zhong-LinYu Zhi-HongZhang Zhao-MinXu | 2003 | World Journal of Gastroenterology2003，9，9： | 6 |
| 9 | Detection of K-ras gene mutation in fecal samples from elderly large intestinal cancer patients and its diagnostic significance显示文摘AIM:To study the diagnostic significance of K-ras gene mutations in fecal samples from elderly patients with large intestinal cancer.METHODS: DNA was extracted in the fecal and tissue samples from 23 large intestinal cancer patients, 20 colonic adenomatoid polypus patients and 20 healthy subjects. The K-ras gene mutations at the first and second bases of codon 12 were detected by the allele specific mismatch method.RESULTS: The K-ras gene mutation was 56.52%(13/23) in the large intestinal cancer patients, which was notably higher than that in the normal subjects whose K-ras gene mutation was 5%(1/20) (x^2=12.93, P<0.001). There was no significant difference in comparison with that of colonic adenomatoid polypus patients whose K-ras gene mutation was 30%(6/12)(x^2=3.05, P>0.05). The K-ras gene mutation at the second base of codon 12 was 92.13%(12/13) in the large intestinal cancer patients. There was no significant difference between the detection rate of K-ras gene mutation in the fecal and tissue samples (X^2=9.35, P<0.01).CONCLUSION:Our results indicate that detection of the K-ras gene mutations in fecal samples provides a non-invasive diagnostic method for the elderly large intestinal cancer patients. Its significance in the early diagnosis of large intestinal cancer awaits further studies. | JunWan Zi-QiZhang Wei-DiYou Hua-KuiSun Jian-PingZhang Ya-HongWang Yong-HeFu | 2004 | World Journal of Gastroenterology2004，10，5： | 5 |
| 10 | CT结肠造影的优势及关键技术显示文摘目的:评价CT结肠造影(CTC)对结肠病变检出的优势,总结结肠CTC检查的技术关键.方法:对46例患者行结肠充气CTC检查,部分病例采用了仰及俯卧位双体位扫描,综合应用了包括多平面重建、仿真内窥镜、表面和透明重建、管腔展开等多种后处理技术来评价结肠黏膜面及肠外表现.结果:11例CTC未见异常,11例为结肠息肉(其中1例为家族性息肉病患者),16例结肠恶性病变(2例表现为结肠壁局限性增厚、14例表现为肠壁肿块),5例结肠炎性病变,3例其他结肠病变.结论:CTC可真实地评价结肠病变的部位、大小以及周围侵犯;充分的肠道准备、充入足够量的气体并充分利用多种后处理技术是CTC的技术关键. | 叶玉芳 张淑倩 李东辉 王连庆 周汝明 刘蓉辉 孙吉林 | 2010 | 世界华人消化杂志2010，18，7： | 4 |
| 11 | Problems in screening colorectal cancer in the elderly显示文摘AIM: To explore the problems in the screening of colorectal carcinoma in the elderly.METHODS: Three models of colorectal cancer prevention were examined: standard screening, active check-up of suspected cases and summons to have endoscopic checkup for previously diagnosed colorectal polyps. The study was performed among three groups of elderly individuals:Group 1 (167 cases), hospitalized asymptomatic individuals without symptoms in large intestines. Group 2 (612 cases):old individuals at home for the aged, out of which 32 showed symptoms of colon disorders; Group 3 (44 cases): elderly people with diagnosed polyps. As a result of 1788rectosigmoidoscopies, we identified 61 individuals with polyps, out of which 44 patients were over 65 years old.However, only 9 of these 44 individuals agreed to have the endoscopy performed again.RESULTS: One cancer and 13 polyps were detected in Group 1, and two polyps in Group 2. However, it should be noted that only eleven individuals from Group 2 agreed to have the endoscopy. In Group 3, there were no relapses of the polyps among the nine individuals who came back for the endoscopy.CONCLUSION: Poor understanding of the screening procedures is one of the greatest problems in early detection of the cancer in the aged. Paradoxically, the cooperation is better with hospitalized patients, than with 'successfully old'persons. | DavidoviM.Mladen Milosevic P.Dragoslav Zdravkovic Sanja Bojic Bozidar Djurica Snezana | 2003 | World Journal of Gastroenterology2003，9，10： | 4 |
| 12 | CT结肠造影二维和三维图像评价结肠病变的优势与不足显示文摘背景:随着多层探测器螺旋CT的广泛应用,已使胃肠道等空腔脏器的CT检查成为可能。目的:通过结肠充气CT结肠造影扫描,评价二维和三维图像对结肠病变检出的有效性以及各自的优势和不足。方法:38例患者导泻后经肛门注入适量空气,行多层螺旋CT扫描,再经工作站对扫描获得的容积数据进行后处理,获得多平面重组的冠、矢状面图像、表面重建、透明重建、仿真内窥镜和管腔展开图像,由2位有经验的影像科医师对上述图像进行分析,评价结肠病变的性质、位置、大小和肠外表现,并与电子结肠镜或手术病理结果对照。结果和结论:除1例为家族性息肉病外,其余37例患者共检出17枚息肉、20个结肠肿块和5例结肠炎性病变。对3种类型病变的检出率,多平面重组分别为82%、100%和100%;仿真内窥镜分别为100%、100%和80%;表面重建分别为41%,90%和40%;透明重建分别为47%、90%和40%。管腔展开技术对所检病变的显示率达100%。二维图像可对结肠病变准确定位并精确测量大小,在显示结肠病变肠外表现方面的优势明显,仿真内窥镜的敏感性较高,管腔展开技术又进一步避免了检查盲区,表面重建和透明重建在显示结肠全景方面价值较高。 | 张淑倩 叶玉芳 李东辉 周汝明 王连庆 刘蓉辉 孙吉林 | 2011 | 中国组织工程研究与临床康复2011，15，4： | 3 |
| 13 | Colorectal cancer in geriatric patients: Endoscopic diagnosis and surgical treatment显示文摘AIM: To investigate the prevalence of colorectal cancer in geriatric patients undergoing endoscopy and to analyze their outcome.METHODS: All consecutive patients older than 80 years who underwent lower gastrointestinal endoscopy between January 1995 and December 2002 at our institution were included.Patients with endoscopic diagnosis of colorectal cancer were evaluated with respect to indication, localization and stage of cancer, therapeutic consequences, and survival.RESULTS: Colorectal cancer was diagnosed in 88 patients (6% of all endoscopies, 55 women and 33 men, mean age 85.2 years). Frequent indications were lower gastrointestinal bleeding (25%), anemia (24%) or sonographic suspicion of tumor (10%). Localization of cancer was predominantly the sigmoid colon (27%), the rectum (26%), and the ascending colon (20%). Stage Dukes A was rare (1%), but Dukes D was diagnosed in 22% of cases. Curative surgery was performed in 54 patients (61.4%), in the remaining 34 patients (38.6%)surgical treatment was not feasible due to malnutrition and asthenia or cardiopulmonary comorbidity (15 patients), distant metastases (11 patients) or refusal of operation (8 patients).Patients undergoing surgery had a very low in-hospital mortality rate (2%). Operated patients had a one-year and three-year survival rate of 88% and 49%, and the survival rates for nonoperated patients amounted to 46% and 13% respectively.CONCLUSION: Nearly two-thirds of 88 geriatric patients with endoscopic diagnosis of colorectal cancer underwent successful surgery at a very low perioperative mortality rate, resulting in significantly higher survival rates. Hence,the clinical relevance of lower gastrointestinal endoscopy and oncologic surgery in geriatric patients is demonstrated. | Andreas Kirchgatterer Pius Steiner Dietmar Hubner Eva Fritz Gerhard Aschl Josef Preisinger Maximilian Hinterreiter Bernhard Stadler Peter Knoflach | 2005 | World Journal of Gastroenterology2005，11，3： | 1 |
| 14 | 结肠充气CT对检测大肠肿瘤的敏感性和特异性显示文摘目的:评价结肠充气CT对检测大肠肿瘤的敏感性和特异性.方法:对100例临床怀疑大肠肿瘤的患者进行结肠充气CT和结肠镜检查.结果:结肠镜检测出大肠癌13例,大肠息肉23例,共46个息肉(11个直径大于或等于1cm,14个直径在6-9mm,21个直径≤5mm).结肠充气CT检测出大肠癌15例(其中假阳性1例),大肠息肉16个(9个直径大于或等于1cm).结肠充气CT对检测大肠癌的敏感性100%(95%可信区间(confidenceinterval,CI)(75-100%),特异性93%(95%C166-100%);对检测大肠癌+直径大于或等于1cm息肉的敏感性92%(95%C173-99%),特异性96%(95%C178-100%).结肠充气CT还检测出结肠镜未发现的大肠癌Ⅰ例,2例大肠癌患者的远处转移和1例其他肿瘤.结论:结肠充气CT对检测大肠癌和直径1cm以上息肉有很高的敏感性和特异性,但对直径1cm以下息肉检出率低.对于临床可疑的大肠癌患者,结肠充气CT可作为检测结肠癌的初步检查手段. | 王毅 龚水根 张伟国 陈金华 张连阳 陈金萍 | 2004 | 世界华人消化杂志2004，12，2： | 1 |
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