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Ghrelin and gastrointestinal stromal tumors

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World Journal of Gastroenterology 2017年第10期23卷 1758-1763页

作者： Chang-Zhen Zhu Dong Liu wei-ming kang Jian-Chun Yu Zhi-Qiang Ma Xin Ye kang Li Department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China

Ghrelin, as a kind of multifunctional protein polypeptide, is mainly produced in the fundus of the stomach and can promote occurrence and development of many tumors, including gastrointestinal tumors, which has been proved by the relevant researches. Most gastrointestinal stromal tumors(GISTs, about 80%), as the most common mesenchymal tumor, also develop in the fundus. Scientific research has confirmed that ghrelin, its receptors and m RNA respectively can be found in GISTs, which demonstrated the existence of a ghrelin autocrine/paracrine loop in GIST tissues. However, no reports to date have specified the mechanism whether ghrelin can promote the occurrence and development of GISTs. Studies of pulmonary artery endothelial cells in a low-oxygen environment and cardiac muscle cells in an ischemic environment have shown that ghrelin can activate the phosphatidylinositol 3-kinase/AKT/mammalian target of rapamycin(PI3K/AKT/m TOR) signaling pathway. Moreover, some studies of GISTs have confirmed that activation of the PI3K/AKT/m TOR pathway can indeed promote the growth and progression of GISTs. Whether ghrelin is involved in the development or progression of GISTs through certain pathways remains unknown. Can we find a new target for the treatment of GISTs? This review explores and summaries the relationship among ghrelin, the PI3K/AKT/m TOR pathway and the development of GISTs.

关键词： Gastrointestinal stromal tumor PI3K/AKT/ mTOR pathway Ghrelin Occurrence Development

Eukaryotic initiation factor 5A2 and human digestive system neoplasms

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World Journal of Gastrointestinal Oncology 2019年第6期11卷 449-458页

作者： Qing-Bin Meng Jing-Jing Peng Zi-wei Qu Xiao-Min Zhu Zhang Wen wei-ming kang Department of Gastrointestinal Surgery the First Hospital of Wuhan CityWuhan 430022Hubei ProvinceChina Department of Gastroenterology General Hospital of the Yangtze River ShippingWuhan 430015Hubei ProvinceChina 不详 Department of Hepato-Biliary-Pancreatic Surgery and Liver Transplantation the First Affiliated Hospital of Guangxi Medical UniversityNanning 530021Guangxi Zhuang Autonomous RegionChina Department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

Eukaryotic initiation factor 5A2(eIF5A2),as one of the two isoforms in the family,is reported to be a novel oncogenic protein that is involved in multiple aspects of many types of human *** or gene amplification of EIF5A2 has been demonstrated in many *** evidence shows that eIF5A2 initiates tumor formation,enhances cancer cell growth,increases cancer cell metastasis,and promotes treatment resistance through multiple means,including inducing epithelial–mesenchymal transition,cytoskeletal rearrangement,angiogenesis,and metabolic *** of eIF5A2 in cancer correlates with poor survival,advanced disease stage,as well as metastasis,suggesting that eIF5A2 function is crucial for tumor development and maintenance but not for normal tissue *** these studies suggest that eIF5A2 is a useful biomarker in the prediction of cancer prognosis and serves as an anticancer molecular *** review focuses on the expression,subcellular localization,post-translational modifications,and regulatory networks of eIF5A2,as well as its biochemical functions and evolving clinical applications in cancer,especially in human digestive system neoplasms.

关键词： Eukaryotic translation initiation factor 5A2 Hypusine modification Acetylation modification Drug resistance Cancer therapeutics

EFFECTS OF ENTERAL AND PARENTERAL NUTRITION ON GASTROENTERIC HORMONES AND GASTRIC MOTILITY AFTER SUBTOTAL GASTRECTOMY

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Chinese Medical Sciences Journal 2008年第2期23卷 113-116页

作者： wei-ming kang Jian-chun Yu Qun Zhang Mei-yun Ke Jia-ming Qian Department of General Surgery Peking Union Medical College Hospital Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 Department of Gastroenterology Peking UnionMedical College Hospital Chinese Academy of Medical Sciences ＆Peking Union Medical College Beijing 100730

Objective To investigate the effects of enteral nutrition （EN） and parenteral nutrition （PN） on gastric motility and gastroentefic hormones after subtotal gastrectomy. Methods Forty-one patients underwent gastrectomy were randomly divided into EN group （n=20） and PN group （n=21 ）. From the first postoperative day to the seventh day, patients received either EN （EN group） or PN （PN group） with isocalofic （84.9kJ·kg^-1·d^-1） and isonitrogenous （0.11g·kg^-1·d^-1） intake. Serum gastrin （GAS）, plasma mofilin （MTL）, and plasma cholecystokinin （CCK） were measured on preoperative day, the first and seventh postoperative day. Electrogastrography （EGG） was measured on preoperative day and the seventh postoperative day. Results Compared with preoperafion, blood GAS, MTL, and CCK levels of 41 patients decreased significantly on the first day after subtotal gastrectomy （ P 〈 0. 001 ）, but returned to the preoperative levels one week later. EGG after gastrectomy showed that gastric basal electrical rhythm was significantly restrained （ P 〈 0. 001 ）. On the seventh day after subtotal gastrectomy, plasma MTL and CCK levels in EN group were higher than those in PN group （ P 〈 0.05 ）. There was no difference in GAS level between two groups. EGG in EN group was better than that in PN group postoper- atively. Conclusions The levels of gastroentefitic hormones and the gastric motility decrease significantly after subtotal gastrectomy. In contrast with PN, EN can accelerate the recovery of MTL, CCK, and gastric motility after subtotal gastrectomy.

关键词： enteral nutrition parenteral nutrition gastroenteric hormones gastric motility gastrectomy

Comparison of short-and long-term outcomes of laparoscopic vs open resection for gastric gastrointestinal stromal tumors

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World Journal of Gastroenterology 2017年第25期23卷 4595-4603页

作者： Xin Ye wei-ming kang Jian-Chun Yu Zhi-Qiang Ma Zhi-Gang Xue Department of General Surgery Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College

AIM To compare the short-and long-term outcomes of laparoscopic(LR) vs open resection(OR) for gastric gastrointestinal stromal tumors(g GISTs).METHODS In total, 301 consecutive patients undergoing LR or OR for pathologically confirmed g GISTs from 2005 to 2014 were enrolled in this retrospective study. After exclusion of 77 patients, 224 eligible patients were enrolled(122 undergoing LR and 102 undergoing OR). The demographic, clinicopathologic, and survival data of all patients were collected. The intraoperative, postoperative, and long-term oncologic outcomes were compared between the LR and OR groups following the propensity score matching to balance the measured covariates between the two *** After 1:1 propensity score matching for the set of covariates including age, sex, body mass index, American Society of Anesthesiology score, tumor location, tumor size, surgical procedures, mitotic count, and risk stratification, 80 patients in each group were included in the final analysis. The baseline parameters of the two groups were comparable after matching. TheLR group was significantly superior to the OR group with respect to the operative time, intraoperative blood loss, postoperative first flatus, time to oral intake, and postoperative hospital stay(P 0.05). No significant difference was found in postoperative adjuvant therapy(P = 0.587). The mean follow-up time was 35.30 ± 26.02(range, 4-102) mo in the LR group and 40.99 ± 25.07(range, 4-122) mo in the OR group with no significant difference(P = 0.161). Survival analysis showed no significant difference in the disease-free survival time or overall survival time between the two groups(P > 0.05).CONCLUSION Laparoscopic surgery for g GISTs is superior to open surgery with respect to intraoperative parameters and postoperative outcomes without compromising long

关键词： Gastric gastrointestinal stromal tumor Laparoscopic surgery Open surgery Clinical outcome Prognosis

Effects of Glutamine Supplementation on Patients Undergoing Abdominal Surgery

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Chinese Medical Sciences Journal 2009年第1期24卷 55-59页

作者： Yue-Dina Fan Jian-chun Yu wei-ming kang Qun Zhang Department of Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 China

Objective To evaluate the effects of supplementation of glutamine （GLN） on maintaining glu- tathione （GSH） level, immune system function, liver function, and clinical outcome of patients receiving abdominal operation. Methods Forty patients undergoing elective abdominal surgical treatment were randomly divided into 2 groups： study group （n=20） and control group （n=20）. All patients received total parenteral nutrition （TPN） for up to 7 days during perioperative period. The study group received TPN supplemented with GLN dipeptide while the control group received TPN without GLN dipeptide. Patients in both groups received equivalent nitrogen and caloric intake. Blood sample was taken on preoperative day, and the 1st, 3rd, 6th postoperative day to measure GSH level, immune indexes, and liver function indexes. Results The decrease of GSH level in plasma and red blood cell （RBC） in study group was less than that in control group during postoperative period. Ratio of GSH/glutathione disulfide （GSSG） in plasma in study grouP was higher than that in control group on the 3rd postoperative day （52.53±11.46 vs. 31.43±7.27, P = 0.001）. Albumin level in study group was higher than that in control group on the 3rd postoperative day （37.7±3.8 g/L vs. 33.8±4.2 g/L, P = 0.02）. There was no significant difference in the levels of immunoglobin （IgG, IgM, IgA） or T lymphocyte subgroup （CD4, CD8, CD4/CD8） in both groups during postoperative period. There was one case with infectious complication in control group, while none in study group. A trend of shortened hospital stay was observed in study group compared with control group （22.3±2.1 d vs. 24.9±1.7 d,P= 0.32）. Conclusions Supplementation of GLN-enriched TPN has beneficial effects on maintaining GSH levels in plasma and RBC, sustaining GSH/GSSG ratio and albumin level, and keeping antioxidant abilities during postoperative period in patients with abdominal operation, with the trends of decreasing incidence of infectious complicati

关键词： glutamine dipepfide glutathione total parenteral nutrition abdominal operation

Laparoscopic Partial Splenectomy for Giant Hemangioma Misdiagnosed as Splenic Cyst:a Case Report

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Chinese Medical Sciences Journal 2010年第3期25卷 189-192页

作者： Jin Wang Jian-chun Yu wei-ming kang Zhi-qiang Ma Department of General Surgery Peking Union Medical College Hospital ChineseAcademy of Medical Sciences ＆ Peking Union Medical College Beijing 100730 China

ALTHOUGH unusual, hemangioma is the most common type of primary splenic neoplasm.1 Usually, splenic hemangioma appears as solid mass, but sometimes it presents cystic corn-ponent as well, which is difficult to discriminate from some other lesions, such as abscess, simple cyst, parasitic cyst, and lymphangioma.2 Preoperative diagnosis of splenic hemangioma mainly depends on imaging study （e.g. ultrasonography, CT, MRI）.

关键词： splenic hemangioma splenic cyst laparoscopic partial splenectomy misdiagnosis

Factors associated with early recurrence after curative surgery for gastric cancer

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World Journal of Gastroenterology 2015年第19期21卷 5934-5940页

作者： wei-ming kang Qing-Bin Meng Jian-Chun Yu Zhi-Qiang Ma Zhi-Tian Li Department of General Surgery Peking Union Medical College Hospital Chinese Academy of Medical Science and Peking Union Medical College Department of Gastrointestinal Surgery First Hospital of Wuhan City

AIM: To characterize patterns of gastric cancer recurrence and patient survival and to identify predictors of early recurrence after ***: Clinicopathological data for 417 consecutive patients who underwent curative resection for gastric cancer were retrospectively analyzed. Tumor and node status was reclassified according to the 7th edition of the American Joint Committee on Cancer tumor-node-metastasis classification for carcinoma of the stomach. Survival data came from both the patients' follow-up records and telephone *** gastric cancer was diagnosed based on clinical imaging, gastroscopy with biopsy, and/or cytological examination of ascites, or intraoperative findings in patients who underwent *** of early recurrence were compared in patients with pT1 and pT2-4a stage tumors. Pearson's χ 2 test and Fisher's exact test were used to compare differences between categorical variables. Survival curves were constructed using the Kaplan-Meier method and compared via the log-rank test. Variables identified as potentially important for early recurrence using univariate analysis were determined by multivariate logistic regression ***: Of 417 gastric cancer patients, 80(19.2%)were diagnosed with early gastric cancer and the remaining 337(80.8%) were diagnosed with locally advanced gastric cancer. After a median follow-up period of 56 mo, 194 patients(46.5%) experiencedrecurrence. The mean time from curative surgery to recurrence in these 194 patients was 24 ± 18 mo(range, 1-84 mo). Additionally, of these 194 patients,129(66.5%) experienced recurrence within 2 years after surgery. There was no significant difference in recurrence patterns between early and late recurrence(P < 0.05 each). For pT1 stage gastric cancer, tumor size(P = 0.011) and pN stage(P = 0.048) were associated with early recurrence of gastric *** age, pT stage, pN stage, Lauren histotype,lymphovascular invasion, intraoperative chemothe

关键词： Stomach neoplasms Gastrectomy D2lymphadenectomy Recurrence Chemotherapy

Postoperative Early Standard and Sequential Nutritional Support in the Treatment of Gastroesophageal Anastomotic Fistula:a Case Report

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Chinese Medical Sciences Journal 2015年第2期30卷 131-134页

作者： Chang-zhen Zhu kang Li Jian-chun Yu wei-ming kang Zhi-qiang Ma Xin Ye Department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical College

GASTROESOPHAGEAL anastomotic fistula is aserious and potentially life-threatening complicationafter the resection of esophagus, gastricand cardia tumor.1 Before 1987, the incidenceof gastroesophageal anastomotic fistula is about 2%-4% inChina, and the mortality rate is as high as 50% or more.2 Inthe last 30 years, with the rapid development of clinicalnutrition support method, nutritional support.

关键词： enteral nutrition parenteral nutrition gastroesophageal anastomotic fistula

Interpretation of the development of neoadjuvant therapy for gastric cancer based on the vicissitudes of the NCCN guidelines

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World Journal of Gastrointestinal Oncology 2020年第1期12卷 37-53页

作者： Xian-Ze Wang Zi-Yang Zeng Xin Ye Juan Sun Zi-Mu Zhang wei-ming kang Department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical College

Gastric cancer is one of the most common digestive system tumors in China,and locally advanced gastric cancer(LAGC)accounts for a high proportion of newly diagnosed *** surgery is the main treatment for gastric cancer,surgical excision alone cannot achieve satisfactory outcomes in LAGC *** therapy(NAT)has gradually become the standard treatment for patients with LAGC,and this treatment can not only achieve tumor downstaging and improve surgical rate and the R0 resection rate,but it also significantly improves the long-term prognosis of ***/preoperative neoadjuvant chemotherapy and preoperative chemoradiotherapy are both recommended according to a large number of studies,and the regimens have also been evolved in the past *** the NCCN guidelines for gastric cancer are one of the most authoritative evidence-based guidelines worldwide,here,we demonstrate the development course and major breakthroughs of NAT for gastric cancer based on the vicissitudes of the NCCN guidelines from 2007 to 2019,and also discuss the future of NAT.

关键词： Gastric cancer Locally advanced gastric cancer Neoadjuvant therapy Neoadjuvant chemotherapy Neoadjuvant chemoradiotherapy NCCN guidelines