35例糖尿病口腔外科患者处理总结

目的总结患糖尿病口腔外科患者的处理经验。方法1997年3月～2007年6月收治35例患糖尿病口腔外科患者,其中男19例,女16例,年龄42～75岁,平均57岁。腮腺混合瘤19例;颌骨囊肿11例;下颌牙龈癌2例;口底癌3例。多为非依赖型糖尿病,入院前诊断22例,入院后诊断13例。结果35例手术患者术后伤口全部1期愈合,都康复出院。随访2个月至2年未发现其他并发症。结论控制糖尿病患者血糖在5.0-11.0 mmol/L水平是做好口腔颌面外科患者处理的关键。     

肺癌伴糖尿病50例外科治疗

目的对肺癌伴糖尿病的外科治疗进行分析、探讨。方法对2003年5月至2010年4月收治的50例肺癌合并糖尿病患者的外科治疗进行回顾、总结。结果 50例患者术后并发症发生9例,占18%。术后生存期达到1年的占90%;达2年的占74%;达3年的46%;达5年的占20%;达8年的占8%。结论患者围术期的血糖控制和并发症的预防是手术成功与否的关键,只有在围术期及时调整并采用抗生素预防,才可有效降低术后并发症和死亡率。     

妊娠期糖尿病36例临床分析

目的探讨妊娠期糖尿病对孕妇的影响,以进一步为临床治疗提供指导。方法选择我院2007年1月至2009年1月在医院住院分娩的妊娠24～34周确诊的GDM孕妇36例,同期随机选择与GDM同期分娩的产科病历资料完整的非糖尿病产妇30例,观察比较2组孕产妇并发症的发生情况。结果GDM组的并发症的发生率明显高于正常对照组,差异有显著性,P<0.05。结论妊娠期糖尿病能够增加母婴分娩时的并发症的发生率,应引起广大妇产科医生的的重视。     

救治28例糖尿病酮症酸中毒临床分析

目的探讨糖尿病酮症酸中毒的诊疗。方法回顾我科2004年￣2007年收治的28例糖尿病酮症酸中毒患者的临床资料进行分析。结果1例合并肾病患者死于肾功能衰竭外余27例血糖均降至正常痊愈出院。结论通过规范的治疗能够减低糖尿病酮症酸中毒的死亡率提高疾病的康复。     

46例大肠癌内镜检查及病理分析

目的总结分析大肠癌的临床表现、内镜及病理特点。方法回顾性分析46例大肠癌的内镜下表现与病理诊断结果等临床资料。结果本组46例患者以直肠癌为多,共22例(46.81%);病理分型中腺癌共39例(84.78%)。结论大肠癌临床表现无特异性。内镜检查对病灶和癌前病变的发现有重要的意义,大肠息肉患者应及时取活检。     

75例青年大肠癌患者病理特点分析

目的分析青年大肠癌的病理特征与老年大肠癌患者之间的差异,为青年大肠癌的预防和治疗提供理论依据。方法对本医院自2002年起收治的75例年龄小于40岁的青年大肠癌病例资料进行筛选和分析,对患者性别、临床症状,胃镜诊断材料、病理学特点和治疗情况进行统计分析,与同期老年病例进行比较。结果青年组大肠癌在患病性别、胃镜表征、肿瘤部位等方面与老年组患者并无统计学差异,而在粘液血便、排便习惯改变、肠梗阻发生率、粘液腺癌、Dukes分期相比较方面的差异有显著统计学意义(P<0.05)。结论青年人大肠癌发病晚、恶性度高,导致误诊常见以及预后较差。     

结肠癌合并糖尿病的围手术期临床分析

目的探讨结肠癌合并糖尿病患者围手术期的治疗措施。方法在本院进行手术治疗的27例结肠癌合并糖尿病患者术前、手术中及手术后的观察,以研究结肠癌患者中糖尿病的发病情况及其与术后并发症的关系。结果术后切口感染3例,骶前间隙脓肿2例,肺部感染1例,吻合口瘘1例,并发症经有效治疗均痊愈,所有患者围手术期均安全度过。结论结肠癌并发糖尿病患者围手术期调整血糖,选择合理的手术方式,合并糖尿病的结肠癌患者可以得到较好的外科治疗效果。     

大肠癌内镜诊治临床分析

目的探讨内镜对大肠癌的诊断和治疗价值。方法对2004年1月至2009年9月行结肠镜检查2910例患者中86例病理确诊的大肠癌患者进行回顾性分析。男52例,女34例,男女之比为1.5∶1,男女之比为1.5∶1,平均年龄63岁,癌变以直肠及乙状结肠为多见,以中晚期癌为多,临床上以血便为主要表现,直肠及乙状结肠发生率最高,组织学以腺癌为主,内镜检查在诊断大肠癌是不可缺少的主要方法,对诊断和治疗大肠癌有非常重要的临床意义。     

36例脊髓型颈椎病外科治疗临床分析

目的分析不同术式外科治疗脊髓型颈椎病的临床效果。方法回顾性分析我院自2006年3月至2007年1月的36例脊髓型颈椎病患者,采用前、后路手术治疗。结果36例脊髓型颈椎病患者,经前、后路手术治疗后,优19例,良8例,优良率75.0%,有效率91.7%。结论手术是治疗脊髓型颈椎病的主要手段。     

2型糖尿病的外科治疗进展

据统计,世界范围糖尿病患者的总人数约为1.71亿,其中85%～90%为2型糖尿病[1],之中又有约90%的患者合并超重或肥胖[2],该病正严重危害人类健康。目前,该型糖尿病仍以内科治疗为主,但无法长期控制血糖水平及避免其并发症。1980年,美国北卡罗来纳大学的外科医生Pories在治疗病态肥胖症时偶然发现为3例肥胖合并严重2型糖尿病患者施行胃旁路手术后患者术后血糖水平明显下降,不再需要任何降糖措施来治疗[3]。1995年他在AnnSurg上发表文章,报道了对146例2型糖尿病患者行GBP手术后14年的随访结果,其中121例(83%)2型糖尿病治愈[4],提出了2型糖尿病外科治疗的概念,引发了医学界对各类减肥手术治疗2型糖尿病的广泛深入研究。     

Microsatellite Instability in Russian Patients with Colorectal Cancer

The aim of this study was to determine the characteristics of Russian patients with microsatellite instability (MSI) tumors. MSI in the tumor was determined in 514 patients with colon cancer using PCR and subsequent fragment analysis for five markers (NR21, NR24, BAT25, BAT26, and NR27). In the presence of microsatellite instability, the mismatch repair (MMR) system genes were examined using the NGS and MLPA methods to establish the diagnosis of Lynch syndrome. The overall frequency of MSI tumors was 15%: at stage I—19% (9/48), at stage II—21% (44/213), at stage III—16% (26/160), and at stage IV—2% (2/93). Patients with MSI tumors differed in the age of diagnosis, tumor localization, time of cancer recurrence, and stage of the disease. The overall and disease-free survival of patients whose tumors had MSI status was higher than that of patients with microsatellite-stable status, p = 0.04 and p = 0.02, respectively. Analysis of overall and disease-free survival of patients with Lynch syndrome and patients with sporadic colon cancer, but with MSI status, did not reveal significant differences, p = 0.52 and p = 0.24, respectively. The age of patients with Lynch syndrome was significantly younger than that of patients with sporadic colon cancer whose tumors had MSI status (p < 0.001).     

A Liquid Biopsy-Based Approach for Monitoring Treatment Response in Post-Operative Colorectal Cancer Patients

Monitoring the therapeutic response of colorectal cancer (CRC) patients is crucial to determine treatment strategies; therefore, we constructed a liquid biopsy-based approach for tracking tumor dynamics in non-metastatic (nmCRC) and metastatic (mCRC) patients (n = 55). Serial blood collections were performed during chemotherapy for measuring the amount and the global methylation pattern of cell-free DNA (cfDNA), the promoter methylation of SFRP2 and SDC2 genes, and the plasma homocysteine level. The average cfDNA amount was higher (p < 0.05) in nmCRC patients with recurrent cancer (30.4 ± 17.6 ng) and mCRC patients with progressive disease (PD) (44.3 ± 34.5 ng) compared to individuals with remission (13.2 ± 10.0 ng) or stable disease (12.5 ± 3.4 ng). More than 10% elevation of cfDNA from first to last sample collection was detected in all recurrent cases and 92% of PD patients, while a decrease was observed in most patients with remission. Global methylation level changes indicated a decline (75.5 ± 3.4% vs. 68.2 ± 8.4%), while the promoter methylation of SFRP2 and SDC2 and homocysteine level (10.9 ± 3.4 µmol/L vs. 13.7 ± 4.3 µmol/L) presented an increase in PD patients. In contrast, we found exact opposite changes in remission cases. Our study offers a more precise blood-based approach to monitor the treatment response to different chemotherapies than the currently used markers.     

Inflammation-Related Biomarkers for the Prediction of Prognosis in Colorectal Cancer Patients

Colorectal cancer (CRC) is the leading cause of cancer deaths around the world. It is necessary to identify patients with poor prognosis or with high risk for recurrence so that we can selectively perform intensive treatments such as preoperative and/or postoperative chemotherapy and extended surgery. The clinical usefulness of inflammation-related prognostic biomarkers available from routine blood examination has been reported in many types of cancer, e.g., neutrophil–lymphocyte ratio (NLR), lymphocyte–C-reactive protein ratio (LCR), platelet–lymphocyte ratio (PLR), lymphocyte–monocyte ratio (LMR), and so on. Moreover, some scoring systems based on circulating blood cell counts and albumin concentration have been also reported to predict cancer patients’ prognosis, such as the Glasgow prognostic score (GPS), systemic inflammation score (SIS), and prognostic nutritional index (PNI). The optimal biomarker and optimal cutoff value of the markers can be different depending on the cancer type. In this review, we summarize the prognostic impact of each inflammation-related marker in CRC.     

继发性甲亢22例手术治疗分析

目的探讨22例继发性甲亢围手术期处理及手术要点,以提高治疗水平。方法 22例继发性甲亢随机分2组:改良服碘组及常规服碘组。作好相应术前准备后施行手术治疗,观察相关临床指标。结果全组22例,17例行甲状腺次全切除术,5例行真包膜内甲状腺结节摘除。术后出现轻度声嘶1例,无死亡病例。2组平均手术时间,平均术中出血量,术前T3、T4,术后24hT3、T4比较及各组术前与术后24hT3、T4比较差异无统计学意义(P>0.05)。服碘时间改良组比常规组平均缩短16.1d。结论手术是治疗继发性甲亢的主要方法,安全有效。术中要根据具体情况选择相应术式。术前碘准备以改良服碘法为佳。     

Current Status of Long Non-Coding RNAs in Human Cancer with Specific Focus on Colorectal Cancer

The latest investigations of long non-coding RNAs (lncRNAs) have revealed their important role in human cancers. LncRNAs are larger than 200 nucleotides in length and fulfill their cellular purpose without being translated into proteins. Though the molecular functions of some lncRNAs have been elucidated, there is still a high number of lncRNAs with unknown or controversial functions. In this review, we provide an overview of different lncRNAs and their role in human cancers. In particular, we emphasize their importance in tumorigenesis of colorectal cancer, the third most common cancer worldwide.     

Granulin: An Invasive and Survival-Determining Marker in Colorectal Cancer Patients

Background: Granulin is a secreted, glycosylated peptide—originated by cleavage from a precursor protein—which is involved in cell growth, tumor invasion and angiogenesis. However, the specific prognostic impact of granulin in human colorectal cancer has only been studied to a limited extent. Thus, we wanted to assess the expression of granulin in colorectal cancer patients to evaluate its potential as a prognostic biomarker. Methods: Expressional differences of granulin in colorectal carcinoma tissue (n = 94) and corresponding healthy colon mucosa were assessed using qRT-PCR. Immunohistochemistry was performed in colorectal cancer specimens (n = 97), corresponding healthy mucosa (n = 47) and colorectal adenomas (n = 19). Subsequently, the results were correlated with histopathological and clinical patients’ data. HCT-116 cells were transfected with siRNA for invasion and migration assays. Results: Immunohistochemistry and qRT-PCR revealed tumoral over expression of granulin in colorectal cancer specimens compared to corresponding healthy colon mucosa and adenomas. Tumoral overexpression of granulin was associated with a significantly impaired overall survival. Moreover, downregulation of granulin by siRNA significantly diminished the invasive capacities of HCT-116 cells in vitro. Conclusion: Expression of granulin differs in colorectal cancer tissue, adenomas and healthy colon mucosa. Furthermore, granulin features invasive and migrative capabilities and overexpression of granulin correlates with a dismal prognosis. This reveals its potential as a prognostic biomarker and granulin could be a worthwhile molecular target for individualized anticancer therapy.     

Fish Oil Decreases C-Reactive Protein/Albumin Ratio Improving Nutritional Prognosis and Plasma Fatty Acid Profile in Colorectal Cancer Patients

Previous studies have shown that n‐3 polyunsaturated fatty acids n‐3 (n‐3 PUFA) have several anticancer effects, especially attributed to their ability to modulate a variety of genomic and immune responses. In this context, this randomized, prospective, controlled clinical trial was conducted in order to check whether supplementation of 2 g/day of fish oil for 9 weeks alters the production of inflammatory markers, the plasma fatty acid profile and the nutritional status in patients with colorectal cancer (CRC). Eleven adults with CRC in chemotherapy were randomized into two groups: (a) supplemented (SG) daily with 2 g/day of encapsulated fish oil [providing 600 mg/day of eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA)] for 9 weeks (n = 6), and (b) control (CG) (n = 5). All outcomes were evaluated on the day before the first chemotherapy session and 9 weeks later. Plasma TNF‐α, IL‐1β, IL‐10 and IL‐17A, the pro/anti‐inflammatory balance (ratio TNF‐α/IL‐10 and IL‐1β/IL10) and serum albumin, showed no significant changes between times and study groups (p > 0.05). C‐reactive protein (CRP) and the CRP/albumin ratio showed opposite behavior in groups, significantly reducing their values in SG (p < 0.05). Plasma proportions of EPA and DHA increased 1.8 and 1.4 times, respectively, while the ARA reduced approximately 0.6 times with the supplementation (9 weeks vs baseline, p < 0.05). Patients from SG gained 1.2 kg (median) while the CG lost ?0.5 kg (median) during the 9 weeks of chemotherapy (p = 0.72). These results demonstrate that 2 g/day of fish oil for 9 weeks of chemotherapy improves CRP values, CRP/albumin status, plasma fatty acid profile and potentially prevents weight loss during treatment.     

Oxidative Damage in Sporadic Colorectal Cancer: Molecular Mapping of Base Excision Repair Glycosylases MUTYH and hOGG1 in Colorectal Cancer Patients

Oxidative stress, oxidative DNA damage and resulting mutations play a role in colorectal carcinogenesis. Impaired equilibrium between DNA damage formation, antioxidant status, and DNA repair capacity is responsible for the accumulation of genetic mutations and genomic instability. The lesion-specific DNA glycosylases, e.g., hOGG1 and MUTYH, initiate the repair of oxidative DNA damage. Hereditary syndromes (MUTYH-associated polyposis, NTHL1-associated tumor syndrome) with germline mutations causing a loss-of-function in base excision repair glycosylases, serve as straight forward evidence on the role of oxidative DNA damage and its repair. Altered or inhibited function of above glycosylases result in an accumulation of oxidative DNA damage and contribute to the adenoma-adenocarcinoma transition. Oxidative DNA damage, unless repaired, often gives rise G:C > T:A mutations in tumor suppressor genes and proto-oncogenes with subsequent occurrence of chromosomal copy-neutral loss of heterozygosity. For instance, G>T transversions in position c.34 of a KRAS gene serves as a pre-screening tool for MUTYH-associated polyposis diagnosis. Since sporadic colorectal cancer represents more complex and heterogenous disease, the situation is more complicated. In the present study we focused on the roles of base excision repair glycosylases (hOGG1, MUTYH) in colorectal cancer patients by investigating tumor and adjacent mucosa tissues. Although we found downregulation of both glycosylases and significantly lower expression of hOGG1 in tumor tissues, accompanied with G>T mutations in KRAS gene, oxidative DNA damage and its repair cannot solely explain the onset of sporadic colorectal cancer. In this respect, other factors (especially microenvironment) per se or in combination with oxidative DNA damage warrant further attention. Base excision repair characteristics determined in colorectal cancer tissues and their association with disease prognosis have been discussed as well.     

老年糖尿病合并肺结核52例临床分析

目的了解糖尿病合并肺结核的临床特点,提高对老年糖尿病肺结核的认识,争取早发现、早治疗。方法对2年间52例老年糖尿病肺结核病例进行临床分析。结果治疗3个月后,血糖控制在正常范围者32例,结核病变吸收和好转者39例,痰菌阴转者25例,空洞闭合或缩小者7例,空洞无变化者3例,死亡2例。结论积极控制血糖,使血糖控制在正常水平,合理的抗结核治疗对控制老年糖尿病肺结核亦起积极作用。     

Significant Overexpression of DVL1 in Taiwanese Colorectal Cancer Patients with Liver Metastasis

Undetected micrometastasis plays a key role in the metastasis of cancer in colorectal cancer (CRC) patients. The aim of this study is to identify a biomarker of CRC patients with liver metastasis through the detection of circulating tumor cells (CTCs). Microarray and bioinformatics analysis of 10 CRC cancer tissue specimens compared with normal adjacent tissues revealed that 31 genes were up-regulated (gene expression ratio of cancer tissue to paired normal tissue > 2) in the cancer patients. We used a weighted enzymatic chip array (WEnCA) including 31 prognosis-related genes to investigate CTCs in 214 postoperative stage I–III CRC patients and to analyze the correlation between gene expression and clinico-pathological parameters. We employed the immunohistochemistry (IHC) method with polyclonal mouse antibody against DVL1 to detect DVL1 expression in 60 CRC patients. CRC liver metastasis occurred in 19.16% (41/214) of the patients. Using univariate analysis and multivariate proportional hazards regression analysis, we found that DVL1 mRNA overexpression had a significant, independent predictive value for liver metastasis in CRC patients (OR: 5.764; 95% CI: 2.588–12.837; p < 0.0001 on univariate analysis; OR: 3.768; 95% CI: 1.469–9.665; p = 0.006 on multivariate analysis). IHC staining of the immunoreactivity of DVL1 showed that DVL1 was localized in the cytoplasm of CRC cells. High expression of DVL1 was observed in 55% (33/60) of CRC tumor specimens and was associated significantly with tumor depth, perineural invasion and liver metastasis status (all p < 0.05). Our experimental results demonstrated that DVL1 is significantly overexpressed in CRC patients with liver metastasis, leading us to conclude that DVL1 could be a potential prognostic and predictive marker for CRC patients.