Objective：To study the regulation and mechanism of Fbxw7 on gastric cancer cell migration and invasion.Methods：SGC7901 cells were transfected with pcDNA3.1Fbxw7，then Fbxw7 mRNA level was detected by RTPCR，cell migration and invasionweremeasured by transwell assay，the expression level of mTOR wasdetected by western blot.Results：Compared with control cells，the cells transfected with pcDNA3.1Fbxw7 showed increased Fbxw7 mRNA level，decreased migration and invasion ability，downregulated level of mTOR.Conclusion：Overexpression of Fbxw7 inhibits migration and invasion ability，also promotes mTOR degradationin gastric cancer SGC7901 cells，indicating that Fbxw7 may regulate gastric cancer metastasis through mTOR signaling pathway.

Objective：To evaluate the correlation of Ki67 labeling index（LI），clinicopathological features and invasiveness of gastrointestinal stromal tumor（GIST）.Methods：This retrospective study was conducted in 155 patients with endoscopic and surgical radical resection of primary GIST.Patients were divided into groups base on Ki67 LI.The clinical and pathological data were analyzed to evaluate the significance of Ki67 LI in risk classification of GIST.Results：The statistically significant differences of Ki67 LI were observed in the following factors：tumor site，tumor size，mitotic index，risk grade，tumor with ulcer，hemorrhage，necrosis and metastasis（P<0.05）.And those factors and Ki67 LI were statistically well correlated（P<0.05）.There was no significant difference of Ki67 Li shown in the age，gender，CD117，DOG1 and CD34 positive rates（P>0.05）.The risk classification according to Ki67 LI was highly agreement with NIH classification，Kappa=0.394（P<0.05）.Conclusion：Ki67 LI is significantly associated with the progression and the invasive of GIST，it can be used as a supplement to the NIH classification and is an important indicator for GIST risk classification and predicting prognosis.

Objective：To investigate the analysis of gastroesophageal reflux、nutrition and prognosis of proximal gastrectomy combined with pyloroplasty in the treatment of upper gastric cancer patients.〖WTHZ〗Methods：To screening 150 cases of upper gastric cancer patients as research subjects，it will be divided into study group with 75 cases and control group with 75 cases，patients in control group were given proximal gastrectomy and patients in study group were given proximal gastrectomy combined with pyloroplasty，then the two groups were compared in terms of clinical efficacy and so on.Results：The gastroesophageal reflux state of the study group was better than that of the control group（P<0.05）；The nutrition state in study group was better than the control group after operation（P<0.05）；The living quality in study group was better than the control group（P<0.05）；There was no significance in prognosis in 2 groups（P＞0.05）.Conclusion：The proximal gastrectomy combined with pyloroplasty in the treatment of upper gastric cancer patients is significant，it is worthy of popularization and application.

Objective：To observe the efficacy of esophagus jejunum RouxenY anastomosis and jejunal interposition pouch on longterm effect，nutritional status and quality of life in patients undergoing gastric cancer surgery.Methods：65 patients with gastric cancer undergoing radical gastrectomy were retrospectively analyzed.According to their surgical treatment，they were divided into JIP group（29 cases）and RouxenY group（36 cases）.The operation time，postoperative hospitalization time，longterm complications，nutritional status and the quality of life were compared between the two groups.Results：There were no significant differences in the operation time [（124.36±13.47）min vs（122.09±14.28）min]，postoperative hospitalization time [（14.98±3.65）d vs（15.38±3.72）d]，the incidence of reflux esophagitis [17.24%（5/29）vs 16.67%（6/36）] and the incidence of diarrhea [6.90%（2/29）vs 8.33%（3/36）] between the two groups（P>0.05），while the incidence of dumping syndrome [10.34%（3/29）] and RSS syndrome [13.79%（4/29）] after 6 months in the JIP group was significantly lower than that in the RouxenY group [44.44%（16/36），30.56%（11/36）] （P<0.05）.The two groups showed significant differences in the hemoglobin growth [（18.56±3.08）g/L vs（12.42±2.16）g/L]，albumin growth [（13.74±2.36）g/L vs（8.01±2.17）g/L]，weigh growth [（4.69±2.87）kg vs（2.27±1.35）kg] and prognostic nutrition index growth [（15.33±4.07）vs（5.87±1.82）].The total quality of life in JIP group was better than that in RouxenY group [（87.69±11.12）vs（73.62±10.77）]（P<0.05）.〖Conclusion：Compared with esophagus jejunum RouxenY anastomosis after total gastrectomy，the patients with stomach cancer who received proximal subtotal gastrectomy plus jejunal interposition surgery show less longterm complications，better nutritional status and quality of life.

Objective：Correlation analysis of Inflammationbased prognostic scores（IPS）in survival rate after rectal cancer surgery.Methods：A retrospective cohort was used to analyze the patients who underwent radical resection of rectal cancer.A total of 678 patients were enrolled.Peripheral venous blood routine and liver function on the second day after admission，the inflammation scores  NLR，DNLR，PLR，LMR，COPNLR and PNI were calculated in turn，based on widely accepted inflammatory prognosis scores.（IPS），which calculates their respective scores in turn.The 5year survival time was used as the endpoint of the inflammatory prognostic score（IPS）.The index of the index（ROC）was used as the cutoff point for predicting the 5year survival time of the preoperative inflammatory prognostic score（IPS）.According to the threshold，the patients were divided into highinflammation prognostic score（IPS）group and lowinflammation prognosis score（IPS）group.The surgical methods，tumor TNM stage，tumor size and morphology，and invasion were compared between the two groups.And the relationship between the depth，the distance of the tumor from the anal margin，and other indicators.Then，the COX proportional hazard regression model was used to analyze the factors that constitute the inflammatory prognostic score（IPS）by univariate and multivariate analysis.Results：The area under the receiver operating characteristic curve for IPS diagnosis of death risk events（ROCAUX）was 0.781 and the cutoff point was 2.5.According to the 2.5 intercept points，it is divided into low IPS group and high IPS group.The age of the two groups was（59.1±11.9）years and（59.5±9.8）years，respectively.There was a statistically significant difference in TNM staging between the two groups.The multivariate COX risk regression model showed male，NLR，DNLR and COPNLR score as risk factors，and HR were 1.489，4.027，2.208 and 2.188，respectively.The LMR score was a protective factor with an HR of 0.559.Conclusion：Preoperative inflammatory outcome score（IPS）is associated with postoperative survival in rectal cancer.High inflammatory prognostic score（IPS）suggests a poor prognosis.

Objective：To explore the influence of preserving left colic artery（LCA）during during laparoscopic anterior resection for rectal cancer on anastomotic leakage and recent efficacy.Methods：The clinical data of 138 patients undergoing laparoscopic anterior resection for rectal cancer r were retrospectively analyzed.The patients were divided into two groups according to the operation method：62 patients with preservation of LCA with low ligation of the inferior mesenteric artery（IMA）as the observation group，76 patients without preservation of LCA and high ligation of the IMA as control group.The general data，postoperative pathological findings，perioperative indicators，and postoperative complications were compared between the two groups.Serum antiangiogenic chemokine CXCL9，soluble E selectin（sEselectin），carcinoembryonic antigen（CEA）and carbohydrate antigen 199（CA199）were measured before and 6，12 months after surgery.All were followed up for 3 years to report recurrence and metastasis.Results：There was no significant differences in general data and postoperative pathological findings（3rd station lymph node metastasis rate，pathological type，TNM staging）between the two groups（P>0.05）.There was no significant difference in the number of lymph node diss ections [（12.44±1.92）vs（12.61±2.23）]，operation time [（130.59±17.48）h vs（128.06±16.11）h]，intraoperative blood loss [（74.85±14.69）ml vs（77.43±16.86）ml] between the observation group and the control group（P>0.05），while the difference of postoperative exhaust time [（72.53±1.79）h vs（76.11±2.82）h] and the postoperative hospital stay[（5.66±0.45）d vs（6.22±0.53）d] between the two groups was significant（P<0.05）.There was no significant differences in incision infection（0 vs 3.57%），intestinal obstruction（2.27% vs 3.57%），urinary retention（4.55% vs 7.14%），sexual dysfunction（2.27% vs 3.57%），poor stool control（2.27% vs 8.93%）between the observation group and the control group（P>0.05），while the difference of anastomotic leakage（0 vs 10.71%）between the two groups was significant（P<0.05）.At 6 and 12 months after operation，the serum levels of CXCL9，sEselectin，CEA and CA199 were significantly lower than before operation（P<0.05），but there were no significant differences between the two groups（P>0.05）.At 1 and 3 years after surgery，the recurrence and metastasis rates in the observation group were 4.55% and 20.45% respectively，which were not statistically different with 3.57% and 19.64% in the control group（P>0.05）.The overall survival rate in the observation group was 97.73% and 84.09%，which were not statistically different with 100.00% and 85.71% in the control group（P>0.05）.Conclusion：Preserving LCA during laparoscopic anterior resection of rectal cancer is beneficial to protect blood flow in the proximal anastomosis and reduce the incidence of postoperative anastomotic leakage，without increasing the difficulty of surgery and the risk of postoperative recurrence and metastasis.

Objective:To investigate the clinical effects and safety of fast track surgery（FTS）in the colon cancer patients with intestinal obstruction.Methods:The clinical data of 72 colon cancer patients with intestinal obstruction was collected and analyzed.The patients were divided into two groups：traditional group（36 cases）and FTS group （36 cases）by random number table method.The postoperative VAS score，first time out of bed，first exhaust time，first defecation time，first time，eating time and postoperative complications in hospital was collected and analyzed.Results:The VAS score of FTS group was significantly lower than that in the traditional group at the 1st and 3rd day after operation（P<0.05），but there was no significant difference between the two groups on the 7th day after operation（P>0.05）.The first time out of bed in 〖JP+1〗FTS group and traditional group was（17.66±12.10）h and（26.37±10.70）h，respectively；the first exhaust time was（47.54±15.30）h and（57.95±18.40）h，respectively；the firstdefecation time was（98.26±27.10）h and（115.63±27.50）h，respectively；the first inlet time was（48.72±13.50）h and（57.75±17.00）h，respectively；the discharging time was（5.85±2.2）d and（8.73±3.5）d，respectively.The difference between the two groups was statistically significant（P<0.05）.The incidence of postoperative pulmonary infection and incision infection in group FTS was less than that in traditional group（P<0.05）.Postoperative abdominal distention and vomiting in group FTS were significantly higher than those in traditional group（P<0.05）.There was no significant difference in postoperative complications such as intraperitoneal hemorrhage，intraperitoneal infection and anastomotic stenosis between the two groups（P>0.05）.Conclusion:FTS is a safe and effective method in colon cancer patients complicated with intestinal obstruction，and does not increase the risk of complications，which accelerates the postoperative rehabilitation and shortening hospital stays.

Objective:To explore the safety and feasibility of Enhanced Recovery After Surgery（ERAS）in laparoscopic radical gastrectomy for gastric cancer.Methods:194 gastric cancer patients who underwent laparoscopic radical gastrectomy in our hospital were enrolled in this randomized controlled trial.The subjects were randomly divided into the ERAS program group（n=98），and the conventional control group（n=96）.The clinical characteristics，recovery variables，and complications of patients were analyzed.Results:In the ERAS group，the removal time of abdominal drainage tube，the time of gastric tube removal，the time of anus recovery，exhaust defecation，oral fluid diet time，halfflow diet time and hospital stay were significantly shortened，and the hospitalization cost was significantly reduced.There was statistical difference between the two groups（P<0.05）.The incidence of intestinal obstruction，delayed gastric emptying，and incision infection was lower in the ERAS program group than in the control group，with a significant difference（P<0.05）.Conclusion:The concept of enhanced recovery after surgery is safely and effectively applied to laparoscopic radical gastrectomy for gastric cancer.

Objective:To investigate the clinical effect and prognosis with ultrasoundguided percutaneous retroperitoneal catheterization and preperitoneal drainage for the treatment of severe acute pancreatitis.Methods:98 cases of surgical treatment of severe acute pancreatitis patients，using random numbers table patients were divided into control group （after ultrasoundguided percutaneous peritoneal drainage tube） and the experimental group （first abdominal puncture drainage treatment，and then after ultrasoundguided percutaneous peritoneal drainage tube），49 cases in each group.Compared two groups of patients with postoperative peripheral blood leukocyte levels back to normal time，organ failure rate，the length of time needed for the statistical differences，compared two groups of patients before and after the treatment （7 d） postoperative bladder pressure，APACHEⅡ score，content of TXA2 and PGI2 levels of statistical significance，compared two groups of patients after treatment clinical curative effect of statistical significance.Result:The recovery time of WBC in the experimental group [（22.31±1.96）d] was lower than that in the control group [（26.84±2.07）d]，and the organ failure rate in the experimental group （34.69%） was lower than that in the control group （57.14%），the differences were statistically significant（P<0.05）.After treatment，treatment group patients with APACHEⅡ score（6.94±3.22） was significantly lower than the control group patients（11.91±3.86）（P<0.05）；After treatment，TXA2[（146.53±20.61）ng/ml] in the experimental group was significantly lower than that in the control group [（218.21±17.94）ng/ml]（P<0.05），and PGI2[（173.54±15.38）ng/ml] in the experimental group was significantly higher than that in the control group[（146.47±16.12）ng/ml].The recovery rate in the experimental group was significantly higher than that in the control group（P<0.05）.Conclusion:Ultrasoundguided percutaneous retroperitoneal catheterization and preperitoneal drainage for the treatment of severe acute pancreatitis can significantly improve the prognosis of patients，reduce organ system failure，and improve clinical efficacy.

Objective:To review the shortterm result of surgical treatment of child patients with anomalous left coronary artery from the pulmonary artery（ALCAPA）.Methods:A retrospective，single institution review was conducted on 86 child patients with ALCAPA underwent coronary reimplantation.All the patients underwent coronary reimplantation procedure with cardiopulmonary bypass.Patients with moderate or severe MR underwent mitral valve repair simutanously.To evaluate the short outcome of coronary reimplantation and MVP surgery，we analyze the related factors during the surgery and perioperative recovery.Results:There were two inhospital deaths.The median cardiopulmonary bypass time and crossclamp time were 112.0min（95.0～141.0min）and 73.0min（57.0～91.5min）,respectively.The median mechanical ventilation time and intensive care unit time were 22.0h（8.0～93.0h） and 69.0h（24.0～168.0h），respectively.Three patients underwent ECMO support and weaned off successfully.The median postoperative LVEF 55.0%（34.3～65.0%）did not improved compared with the preoperative LVEF.The LVEDD 34.5mm（27.0～38.0mm）decreased significantly compared with preoperative LVEDD（P<0.05）.in the patients with LVEF<50%，the postoperative LVEF increased significantly[（35.5%（26.0～42.0%） vs 25.0%（19.0～35.0%）]，P<0.05）.No patient with severe MR and ten patients with moderate MR when were discharged.Conclusion:The coronary reimplantation has a satisfactory shortterm result for child patients with ALCAPA.

Objective:To evaluate the influence of fasttrack surgery in perioperative period on the clinical outcomes of patients with esophageal cancer.Methods:Clinical data of 139 patients with esophageal cancer were retrospeetively analyzed.70 cases（study group）were treated with fast track surgery and 69 cases（control group）were treated according to routine protocol in the perioperative period.Results:The postoperative exhaust time，time to drainage tube removal，and length of hospital stay were significantly shorter in the study group than those in the control group（all P<0.05）.There was no significant difference between the two groups in the operative time and hospitalization costs（P>0.05）.The overall postoperative uncomfortable symptom rate was 64.3% in the study group and 91.3% in the control group（P<0.05）.But the complication rate as no significant difference between the two groups（P>0.05）.Conclusion:Fasttrack surgery in the perioperative period for patients with esophageal cancer can promote bowel function recovery and improve the clinical outcome.

Objective:To investigate the clinical effect of enhanced recovery after surgery（ERAS）combined with acupoint application on gastrointestinal function recovery after laparoscopic radical cystectomy.Methods:100 patients with bladder cancer who were randomly divided into the ERAS group and the ERAS+acupoint application group, 50 patients in each group.The ERAS related treatments were performed in the ERAS group during perioperative period，The ERAS+acupoint application group was based on the ERAS and implemented acupoint application therapy.The recovery time of bowel sounds，the time of first anal exhaust，the time of first defecation，the time of first meal，the time of abdominal distension after surgery and the degree of abdominal distension were observed.Results:The recovery time of bowel sounds，the time of first anal exhaust，the time of first defecation，the time of first meal and the time of abdominal distension after surgery in the ERAS+acupoint application group were（1.56±0.36）d，（3.02±0.38）d，（4.80±0.56）d，（5.40±0.48）d，（3.23±0.52）d，respectively.In the above statistical time，the ERAS group were（2.25±0.52）d，（3.77±0.42）d，（5.58±0.64）d，（6.70±0.36）d，and（5.00±0.66）d，respectively.In the above statistics，ERAS+acupoint application group was significantly shorter than ERAS group（P<0.05）.In ERAS group，there was a significant statistical difference in the number of patients with abdominal distension degree between the first day after surgery and the fifth day after surgery（P<0.05）.〖JP3〗In ERAS+ acupoint application group，there was no statistical difference in the number of patients with abdom〖JP〗inal distension 〖LM〗degree between the first day after surgery and the fifth day after surgery（P>0.05）.However，on the 5th day after the operation，the ERAS+ acupoint application group had a significantly lower degree of abdominal distension than the simple ERAS group，and the difference was statistically significant（P<0.05）.Conclusion:Based on the ERAS，acupoint application was applied to the patients after radical cystectomy，which can effectively promote the recovery of gastrointestinal peristalsis function and is worthy of clinical promotion.

Objective:To investigate the clinical efficacy of laparoscopic ureteral reconstruction to treat ureteral injury caused by uterectomy.Methods:20 patients with ureteral injury caused by uterectomy were treated laparoscopically by transperitoneal approach.The ureter was first found supine or above the external iliac artery.Distal ureter was completely dissociated.The ureter was cut off 1cm above the injury site，then ureter was anastomosed to the bladder.〖WTHZ〗Results:The average operation time was 96 minutes.All cases were done by laparoscopic，no blood transfusion and no other serious complications occurred.Follow up was done for 4 to 26 months and 5 of them had mild hydronephrosis and 1 of them had left ureteral orifice stenosis which was been cured after balloon dilation.Conclusion:Laparoscopic ureteral reconstruction is a mini invasive，safe and effective method to treat ureteral injury after hysterectomy andshowed a good clinical value.

Objective:To explore the therapeutic effect of microexternal fixation combined with forearm interosseous dorsal skin flap for the repair of severe tiger contracture.Methods:Fortytwo patients with severe tiger mouth contracture were divided into two groups by random number expression.The control group was treated with miniature external fixator combined with retrograde radial artery snuff socket perforator flap.The study group was treated with miniature external fixator.Repair of forearm interosseous dorsal skin flap.The clinical efficacy and complications were observed and compared between the two groups.The changes of the width of the tiger mouth and the width of the tiger mouth before and after operation were compared with the visual analogue scale（VAS）pain score and the skin quality of the operation site.Results:There was no difference in VAS pain score between the two groups before operation.The average VAS pain score of study group after surgery was（1.3±0.8），while the score of control group was（2.5±0.8）（P<0.05）.The effective rate of the study group was 85.7%，the control group was 76.2%；the concurrent rate of the study group was 28.6%，the control group was 66.7%；the quality of life of the study group was higher than that of the control group（all P<0.05）.Conclusion:Mini external fixator combined forearm interosseous dorsal skin flap to repair severe contracture has good treatment effect，not only can reduce the postoperative complications，can effectively repair in escaping angle and tucks width and reduce postoperative pain of patients，has wide application prospect，is worth further promotion and application in clinic.

Objective:To investigate the efficacy of antiosteoporosis treatment on elderly patients with intertrochanteric fractureMethods:Elderly patients with intertrochanteric fracture treated with PFNA were randomly divided into antiosteoporosis treatment group（group A）and nonantiosteoporosis treatment group（group B）.The patient's general information was recorded.Patients in group A were given antiosteoporosis treatment after the operation.Patients in group B receive no antiosteoporosis drugs.One year followup was carried out and several indicators were recorded，such as the fracture healing time，the occurrence of fractures in other parts of the body，the complications of deep infection，hip varus，internal fixation incision，internal fixation fracture and internal fixation failure.The hip function was evaluated by the Harris score system at 6 months and 1 year after surgery，while the bone density was tested by the United States Lunar DPXNP dualenergy xray absorptiometry.Results:All cases were followed up.The fracture healing time in group A was（12.1±2.9）weeks and in group B was（12.8±3.3）weeks.There was no significant difference between the two groups（P>0.05）.Neither deep infection nor hip varus，incision of internal fixation，fracture around internal fixation，internal fixation failure or other complications occurred in both groups.During the followup period，there was none refracture of limbs and other parts in group A，2 distal fractures of radius and 1 thoracolumbar fracture happened in group B（P>0.05）.The Harris score of hip joint in group A[87.3±14.6，95.8±15.4] at 6 months and 1 year after operation were significantly higher than in group B[78.6±15.9，86.1±16.8]（P<0.05）.Compared with the control group，the bone mineral density in group B[0.66±0.08，0.71±0.10] was significantly increased than group A[0.74±0.05，0.81±0.09]at 6 months and one year after surgery，the difference was statistically significant（P<0.05）.Conclusion:In elderly patients with intertrochantericfracture，the postoperative  antiosteoporosis treatment didn’t promote the fracture healing significantly，but it made good sense in increasing bone mineral density and improving hip joint function.

Peritoneal carcinomatosis（PC）is a type of localized tumor that spreads on the peritoneal surface is mostly a peritoneal metastasis of gastrointestinal tumors.PC is considered to be an end-stage disease，and palliative treatment is often used.The combination of cytoreductive surgery（CRS），intraoperative or postoperative early hyperthermic intraperitoneal chemotherapy（HIPEC）and perioperative systemic chemotherapy is the current standard treatment for PC.The clinical effect of CRS and HIPEC can reduce the recurrence rate of peritoneal tumors and prolong the survival of patients.This article summarizes the application of peritoneal hyperthermic perfusion chemotherapy in peritoneal metastasis of gastrointestinal tumors.

Nowadays，the incidence of esophagogastric junction tumor is increasing year by year，and the prognosis of the patients is poor.Surgery is still the most feasible treatment，but surgery alone is not effective.Preoperative chemoradiotherapy is the standard treatment regimen for patients with esophagogastric junction tumor in western countries，while eastern countries prefer perioperative chemotherapy regimen.The emergence of targeted therapy will bring new hope to patients with esophagogastric junction tumor.We will discuss the treatment of the esophagogastric junction tumor，combining with multiple clinical trials and the latest research.