To study the effects of human growth hormone on protein catabolic state of gastric and colonic cancer patients after surgical intervention and whether it can improve the postoperative host immune function and reduce the postoperative fatigue syndrome (POF) by using rhGH. Thirtyeight gastric and colonic cancer patients (21 cases of gastric cancer; 17 cases of colonic cancer) were diveided into control group (n＝18) and rhGHtreated group (n＝20). All the patients were performed resection and treated by early postoperative intraperitoneal thermochemotherapy (EPIC) and total parenteral nutrition (TPN). Subcutaneous injections of 8 U rhGH at 9∶30 am was administered to the rhGHtreated group (six days) at the same time. Results: In the control group, a significant decrease in serum levels of albumin, prealbumin, transferri, IgG, IgA, IgM and CD＋３, CD＋4, CD＋8 were observed after operation (Ｐ＜0.01). In the rhGHtreated group, CD＋３, CD＋4 and CD＋8 raised significantly and the other did not change significantly. The postoperative vigour state of the patient was better than that in the control group. In the control group, pronouced weight loss of 3-5 kg, was detected on the 10th pastoperative day, while the weight loss was 1-2 kg in the rhGHtreated group (Ｐ＜0.01). Conclusion: The treatment with rhGH together with TPN and EPIC not only overcomes the protein catabolism of the cancer patient after operation by increasing protein synthesis, but also improves postoperative host immune function, reduces POF, and can raise the killing effect of chemotherapy on cancer cells, enhances the tolerance to chemotherapy.
Objective To evaluate the short-term clinical efficacy and safety of 10-Hydroxy-camptothecin （10- HCPT ） chemotherapy on gastrointestinal carcinoma. Methods We searched electronic database including CNKI （ 1995 - 2005 ）, MEDLINE （ 1995 - 2005 ） and The Cochrane Library （ Issue 1, 2005 ）. More related research data were odtained by cantacting with researchers. Randomized controlled trials of gastrointestinal carcinoma chemotherapy comparing only or including 10-HCPT chemotherapy with normal chemotherapy on efficacy rate, digestive and hematology system toxicity were included. Data related to the clinical outcome were extracted by two reviewers independently. Statistical analysis was performed by using RevMan4. 2.2. Results Twenty-five trials including 1 881 patients met the inclusion criteria. The results of meta-analysis were hsted as follows： 10-HCPT could significantly improve the short-term chemotherapy efficacy for colorectal cancer （ RR. 1.62, 95% CI 1.37 to 1.92） and gastric cancer （RR 1.48, 95% CI 1.18 to 1.85）in chemotherapy curative efficacy in short-term. 10-HCPT induced severe toxicity of lower digestive system（RR. 0.96,95% CI 0.62 to 1.50 ） without statistical significance, while severe toxicity of hematology system was significantly higher than that of control with RR 1.27,95% CI 1.02 to 1.58. Conclusions Current evidence suggests that 10-HCPT can improve hematology system short-term chemotherapy efficacy for gastrointestinal carcinoma and increase the incidence of severe toxicity. Further research is needed to value its influence on the prognosis of gastrointestinal carcinoma.
Objective To explore the clinical comprehensive therapy of Peutz-Jeghers syndrome. Methods From January 2000 to December 2010，71 cases of Peutz-Jeghers syndrome underwent endoscopic polyp resection firstly，and those with unresectable lesions or with severe complications underwent rescue laparotomy. After endoscopic or surgical treatment，the patients took Celecoxib capsules voluntarily for 6 to 9 months under informed consents. All cases were followed up from 6 months to 8 years. Results Twenty-nine patients had familial history of Peutz-Jeghers syndrome among the 71 patients （41 males and 30 females）. Sixty-two cases underwent 94 surgeries and intussusception was the most common cause of laparotomy. Sixty-five patients underwent 169 double-balloon endoscopy （DBE） therapies，and a total of 1 714 polyps were resected by DBE polypectomy. The largest major axis of small-bowel polyp was 8 cm. No severe complications occurred after DBE polypectomy except for 3 cases of intestinal perforation. Eight patients took Celecoxib capsule，3 of them were treated more than 6 months，and DBE examination showed the gastrointestinal polyps reduced in number and size. Conclusion The comprehensive treatment （including of endoscopic therapy，operation，and drug intervention） is a safe and effective clinical model to treat Peutz-Jeghers syndrome．
Objective To investigate the medication advancement of gastrointestinal polyposis in patients with Peutz-Jeghers syndrome (PJS). Methods Literatures about the medication advancement on gastrointestinal polyposis of PJS were reviewed and analyzed. The recent development of targeting drugs, especially the data of cyclooxygenase-2 selective inhibitors and rapamycin, were emphatically summarized. Results With the deep investigation of PJS and application of selective drugs, the medication of gastrointestinal polyposis in cases of PJS has got more advancement. The extensive use of synthetic cyclooxygenase-2 inhibitors and rapamycin in clinic developed a new way to treat gastrointestinal polyposis of PJS. Conclusion The cyclooxygenase-2 selective inhibitors and rapamycin have the following features: noninvasive, high selectivity and good curative effects. They have splendid prospects in the clinical treatment of gastrointestinal polyposis in patients with PJS and are bring the treatment of gastrointestinal polyposis in cases of PJS into a targeting therapy phase.
Objective To investigate the safety and efficiency of a blood glucose control method in diabetic patients with gastrointestinal neoplasm who were subjected to postoperative early enteral nutrition (EEN). Methods Thirty-seven diabetic patients with gastrointestinal neoplasm received enteral nutriment——Glucerna SR through nasojejunal tubes 24 hours after operation. The blood glucose level was safely controlled through injecting insulin intravenously and subcutaneously. Meanwhile, any change of blood and urine glucose level was monitored and the indexes representing the levels of nutrition, biochemistry and immunity were measured before the implementation of EN, 5 d and 8 d of EN after operation, respectively. Results All the patients were able to bear EEN and there was no severe complications occurred. Significant increase of serum levels of albumin, prealbumin and transferrin were observed after EEN support （P＜0.05）, as well as the serum levels of IgG， IgA and IgM （P＜0.01）. However, body weight， HGB and the serum levels of ALT and TBIL showed no significant changes （Pgt;0.05）. There were 81.1%（30/37） of patients whose blood glucose levels were controlled steadily within the range of (7.8±1.1) mmol/L. Conclusion Injecting insulin intravenously and subcutaneously after operation may be a safe and effective method to control blood glucose level. And the postoperative implementation of EEN can be considered as the first choice of nutrition support for diabetic patients with gastrointestinal neoplasm.
Objective To compare the clinical effects of early enteral and parenteral nutrition, and to study their effects on cytokine release, cellular immune function and protein metabolism in early postoperative patients with gastrointestinal cancer. Methods Thirty-six patients with gastrointestinal cancer were randomly divided into early postoperative enteral nutrition (EN) group (19 cases) and parenteral nutrition (PN) group (17 cases), and they were supported with EN or PN during postoperative period of 1-7 days, respectively. The levels of serum tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), and interleukin-10 (IL-10) were measured by ELISA. The total lymphocyte count (TLC) and subgroups of lymphocyte (CD3, CD4, CD8, CD4/CD8 and NK cell) were determined with flow cytometer. The urea and creatinine of the 24 h excretory urine were examined at four different phases: preoperative (pre), 1st d, 3rd d and 5th d after operation (pod). The clinical recovery indicators and the complication incidence were also observed. Results All the patients followed the project of nutritional support and relevant examinations, and there was no severe complication and no patient died during the research. The IL-1β, IL-6 and IL-10, the 24 h urea and creatinine increased, while the serum TNF-α and TLC (except 3, 5 pod of EN group) decreased. There was no marked change of the proportion of lymphocyte subgroups after operation and there was no significant difference of the changes of IL-1β, IL-10 and TNF-α between the two groups as well. The levels of IL-6 (3, 5 pod), the 24 h urea (3, 5 pod) and creatinine (3, 5 pod) were significantly lower in EN group than those in PN group （P＜0.05）, whereas TLC (3, 5 pod) were significantly higher than that in EN group （P＜0.05）. In addition, the postoperative infection incidence （10.5% vs 35.3%）, fever duaration, rehabilitation time and medical cost were significantly lower in EN group than those in PN group （P＜0.05）.Conclusion The early postoperative EN has an advantage over PN in the patients with gastrointestinal cancer, which could decrease the release of cytokine and suppress protein metabolism resulting from operational stress, and could reduce the incidence of postoperative infection and inflammatory reaction time. They could also improve the cellular immune function and decrease the rebilitation duration and medical cost.
ObjectiveTo review cancer associated fibroblasts(CAFs) and its role in the evolution of gastrointestinal neoplasms. MethodDomestic and international publications in relation to CAFs and its role in the evolution of gastrointestinal neoplasms were collected and reviewed. ResultsIn the gastrointestinal cancers, as the largest number and the most important stromal cells of the tumor microenvironment, CAFs induce the homeostasis of cell microenviron-ment out of balance, promote the remodeling of the tumor metabolism and extracellular matrix(ECM), and thus impulse the generation, proliferation, invasion and metastasis of the tumor by secreting different kinds of cytokines. ConclusionsThe key role CAFs playing in the tumor generation and evolution makes themselves and the multiple relatively specific molecules they secrete a new target for prognosis and targeted therapy, and this gives us a new idea for the combined treatment of gastrointestinal tumor or any other tumors.
ObjectiveTo investigate the diagnosis, treatment, and prognosis of the postoperative intestinal obstruction of gastrointestinal cancer. MethodThe clinical data of 58 patients with postoperative intestinal obstruction of gastrointestinal cancer from January 2011 to January 2013 were analyzed retrospectively. ResultsIn 58 patients with postoperative intestinal obstruction, there were 46 cases of incomplete intestinal obstruction, 12 cases of complete obstruction. Seventeen cases were treated conservatively and 41 cases were accepted laparotomy. The surgical exploration found that there were 4 cases of strangulated abdominal internal hernia, 4 cases of volvulus, 1 case of stercoral obstruction, 2 cases of intussusception, 9 cases of adhesive intestinal obstruction, and 21 cases of tumor recurrence. There were 32 patients with high tumor markers before laparotomy, including 19 cases of tumor recurrence. Fourteen cases had no obvious tumor lesions detected by PET-CT, but recurrence and metastasis were found by surgical exploration. ConclusionsThe recurrent postoperative intestinal obstruction of gastrointestinal cancer mostly means recurrence and metastasis, with poor prognosis. Early laparotomy may improve the prognosis and the quality of life, elevated tumor markers have some links with tumor recurrence and PET-CT is not sensitive for multiple nodular metastases.
O6-carboxymethyl guanine(O6-CMG) is a highly mutagenic alkylation product of DNA that causes gastrointestinal cancer in organisms. Existing studies used mutant Mycobacterium smegmatis porin A (MspA) nanopore assisted by Phi29 DNA polymerase to localize it. Recently, machine learning technology has been widely used in the analysis of nanopore sequencing data. But the machine learning always need a large number of data labels that have brought extra work burden to researchers, which greatly affects its practicability. Accordingly, this paper proposes a nano-Unsupervised-Deep-Learning method (nano-UDL) based on an unsupervised clustering algorithm to identify methylation events in nanopore data automatically. Specially, nano-UDL first uses the deep AutoEncoder to extract features from the nanopore dataset and then applies the MeanShift clustering algorithm to classify data. Besides, nano-UDL can extract the optimal features for clustering by joint optimizing the clustering loss and reconstruction loss. Experimental results demonstrate that nano-UDL has relatively accurate recognition accuracy on the O6-CMG dataset and can accurately identify all sequence segments containing O6-CMG. In order to further verify the robustness of nano-UDL, hyperparameter sensitivity verification and ablation experiments were carried out in this paper. Using machine learning to analyze nanopore data can effectively reduce the additional cost of manual data analysis, which is significant for many biological studies, including genome sequencing.