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Xu X.D.,Zhejiang Provincial Peoples Hospital
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery

To investigate the effect of early enteral nutrition (EEN) supplemented with glutamine on postoperative intestinal mucosal barrier function of patients with gastric carcinoma. Eighty patients with gastric carcinoma who underwent intraoperative peritoneal hyperthermic chemotherapy(IPHC) were randomized into two groups: EEN+glutamine (EEN+Gln) group(n=40) and EEN group(n=40). Intestinal mucosal barrier function was evaluated by serum diamine oxidase (DAO), ratio of lactulose to mannitol(L/M), endotoxin lipopolysaccharides(LPS), and tumor necrosis factor-α(TNF-α) at 1 day before operation, 1 day, 7 days, 12 days after operation. Time to first flatus and tolerance to EEN were recorded as well. There were no significant differences in the two groups in demographics(all P>0.05). Two cases(5%) in the EEN+Gln group and 1 case (2.5%) in the EEN group could not tolerate well(P>0.05). On postoperative day 1, there were no differences in serum DAO, L/M ratio, LPS, TNF-α between the two groups (P>0.05). On postoperative day 7, all the parameters for mucosal barrier function were significantly lower in the EEN+Gln group. On postoperative day 12, the urinary L/M and DAO, LPS, and TNF-α were still significantly lower in the EEN+Gln group, however, urinary L/M was comparable between the two groups. There were no differences between the two groups in the time to first flatus (P>0.05). The immunologic tolerance of enteral nutrition supplemented with glutamine is favorable, which provides protective effect on intestinal mucosal barrier in patients with gastric carcinoma undergoing IPHC. Source

Li X.-Y.,Zhejiang University | Cai X.-L.,Zhejiang University | Bian P.-D.,Zhejiang Provincial Peoples Hospital | Hu L.-R.,Changan University
CNS Neuroscience and Therapeutics

Summary: Research on the potential impact of high salt intake on health has grown rapidly over the last decades. Recent studies have suggested that high salt intake could also be associated with adverse effects on cardiovascular system. The review evaluated the current level of epidemiologic evidence on the association between the level of habitual salt intake and stroke outcome. We also suggest further research direction. There were 21 independent samples from 12 studies, with 225,693 participants (follow-up, 3-19 years) and 8135 stroke events. High salt intake was associated with risk of stroke event (pooled odd ratio [OR], 1.34; 95% confidence interval [CI], 1.19-1.51), stroke death (1.40; 1.21-1.63) and stroke onset (1.11; 1.00-1.24), ischemic stroke death (2.15; 1.57-2.95), not associated with risk of ischemic stroke onset (1.07, 0.95-1.2), with no significant evidence of publication bias. High salt intake is associated with significantly increased risk of stroke event. Further research should be directed toward clarifying and quantifying these possible effects and generating testable hypotheses on plausible biologic mechanisms. © 2012 Blackwell Publishing Ltd. Source

Dai Q.Q.,Zhejiang Provincial Peoples Hospital
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery

To compare the surgical outcomes between laparoscopic and open wedge resection for gastrointestinal stromal tumors of the stomach. Clinical data of 18 cases undergoing laparoscopic wedge resection from June 2000 to August 2009 at the Zhejiang Provincial People's Hospital were compared with 30 patients treated by open surgery. The perioperative parameters and prognosis data of the two groups were compared. Compared to the open group, laparoscopic group was found with longer operative time, less blood loss, less requirement of postoperative analgesia, earlier resumption of oral intake, earlier return of first flatus, and shorter postoperative hospital stay(all P<0.05). There were no postoperative deaths in both groups. Postoperative complication rate was significantly lower in the laparoscopic group(5.5% vs. 33.3%, P<0.05). The postoperative recurrence rates were 11.8%(2/17) and 10.7%(3/28); the 5-year survival rates were 78% and 63%, respectively, and the difference was not statistically significant(P>0.05). Laparoscopic wedge resection is a feasible treatment option for GISTs of the stomach. Source

To explore the clinical significance of sphingosine kinase 1 (SPHK1) in the invasion, metastasis and prognosis of gastric cancer. Immunohistochemistry was employed to analyze the expression of SPHK1 in 206 clinicopathologically characterized gastric cancer cases from January 2001 to December 2005 at Zhejiang Provincial People's Hospital. SPHK1 protein was detected in 3 (7.5%) of 40 human non-tumor mucosa. All samples expressed the protein at a low level. SPHK1 protein was detected in 181 (87.9%) of 206 human gastric cancer cases. An elevated expression of SPHK1 protein was detected in 126 (61.2%) tumors. And SPHK1 protein was up-regulated in gastric cancer lesions compared with adjacent noncancerous tissues (P = 0.001). The expression of SPHK1 was correlated with the depth of invasion, lymph node metastasis, distant metastasis and TNM stage (P = 0.039, 0.003, 0.020, 0.003). In stages I-II and III, the 5-year survival rate of the patients with a high expression of SPHK1 was significantly lower than those with a low expression (53.6% (15/28) vs 68.6% (24/35), 7.8% (6/77) vs 30.8% (12/39), P = 0.009, 0.006). In stage IV, the expression of SPHK1 was not correlated with the 5-year survival rate (P > 0.05). Further multivariate analysis suggested that lymph node metastasis, distant metastasis, TNM stage and the up-regulation of SPHK1 were independent prognostic indicators for gastric cancer. The expression of SPHK1 in gastric cancer is significantly associated with lymph node metastasis, distant metastasis and a poor prognosis. SPHK1 may become a useful marker of predicting tumor progression and prognosis. Source

Yao H.B.,Zhejiang Provincial Peoples Hospital
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery

To investigate the association of AKR1B10 expression in gastric cancer tissues with clinicopathologic features and prognosis of gastric cancer patients. Real-time polymerase chain reaction (RT-PCR) was conducted to detect AKR1B10 mRNA expression in gastric cancer and adjacent gastric mucosa tissues (n=36). AKR1B10 protein expression was measured by immunohistochemistry in primary gastric cancer tissues (n=100) and non-tumorous gastric mucosa tissues (n=70). RT-PCR results confirmed that AKR1B10 was significantly down-regulated in gastric cancer tissues compared with that in paired adjacent mucosa [8.3% (3/36) vs. 91.7% (33/36), P=0.000]. Immunohistochemistry revealed that the percentage of AKR1B10 positive specimens in gastric carcinoma was lower than that in normal specimens [33.0% (33/100) vs. 92.9% (65/70), P=0.000]. The frequencies of positive AKR1B10 in patients was significantly correlated with tumor size (P=0.000), invasive depth (P=0.004), lymph node metastasis (P=0.028), distant metastasis (P=0.031) and TNM stages (P=0.000). The 5-year survival rate of positive AKR1B10 group was significantly higher as compared to negative group (60.6% vs. 32.8%, P<0.01). The down-regulation of AKR1B10 expression in gastric cancer may be associated with the progress of gastric cancer is suggestive of poor prognosis. Source

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