Clinical efficacy of transanal specimen extraction in modified Da Vinci robot-assisted anterior resection of rectosigmoid tumor / 中华消化外科杂志

Objective To explore the clinical efficacy of transanal specimen extraction in modified Da Vinci robot-assisted anterior resection of rectosigmoid tumor.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 47 patients who underwent Da Vinci robot-assisted anterior resection of rectosigmoid tumor using transanal specimen extraction in the Second Xiangya Hospital of Central South University from March to October 2016 were collected.Excisional intestinal canal was intraoperatively taken out from the anus instead of abdominal minor incision.Observation indicators:(1) operation and postoperative recovery;(2)postoperative pathological examination situations;(3) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival of patients and tumor recurrence or metastasis up to June 2017.Measurement data with normal distribution were represented as (x)±s.Results (1) Operation and postoperative recovery:47 patients underwent successful operations,without conversion to open surgery.Of 47patients,8 underwent coloanal ultralow anastomosis,3 underwent prophylactic terminal ilenm stoma fistulization and 1 underwent intersphincteric resection after turning inside out resectable specimen.Operation time,volume of intraoperative blood loss,time for out-of-bed activity,time to anal exsufflation and time of postoperative drainagetube removal were (222±73)minutes,(21±9)mL,(1.7-±0.8)days,(2.3±l.0)days and (6±5)days,respectively.Among 3 patients with postoperative complications,2 with anastomotic fistula were cured by conservative treatment,and 1 with urinary retention removed urethra catheter at 4 weeks postoperatively.All the 47 patients had good recovery,and duration of hospital stay was (10±4)days.(2) Postoperative pathological examination situations:number of lymph node dissected was 15-± 7,with R0 resection.Tumor pathological diagnosis:rectosigmoid adenocarcinoma was detected in 38 patients (1 with high-differentiated tumor,32 with moderate-differentiated tumor and 5 with low-differentiated tumor),mixed carcinoma in 4 patients,tubulovillous adenoma in 2 patients,mucinous adenocarcinoma in 1 patient,neuroendocrine carcinoma in 1 patient and focal cacinoma in 1 patient.The maximum diameter of tumor was (3.5± 1.5) cm.Postoperative pathological T stage:4,9,18 and 14 patients were detected in stage T1,T2,T3 and T4a.Postoperative pathological N stage:30,8 and 7 patients were detected in stage N0,N1 and N2.Postoperative pathological TNM stage:stage Ⅰ,Ⅱ and Ⅲ were respectively in 11,19 and 15 patients.There was no clinical stage in 2 patients with tubulovillous adenoma.(3) Follow-up:of 47 patients,42 were followed up for 7-15 months,with a median time of 11 months.During the follow-up,38 patients had tumor-free survival,3 had tumor recurrence or metastases and 1 died.Conclusion Transanal specimen extraction is safe and feasible in modified Da Vinci robot-assisted anterior resection of rectosigmoid tumor,with minimal invasion and satisfactory short-term outcomes.

Impact of a eukaryotic translation initiation factor 3a polymorphism on susceptibility to gastric cancer

Objective: To investigate single nucleotide polymorphisms in the eukaryotic translation initiation factor 3a [eIF3a] gene and the risk for gastric cancer within the Chinese population

Subjects and Methods: A total of 322 patients with gastric cancer were selected as the patient group and 340 non-gastric cancer patients were selected as the control group using the case-control method. Polymerase chain reaction-sequence-specific primer technology was leveraged to genotype the rs77382849 single nucleotide polymorphism in the eIF3a gene. The demographic characteristics of the study population and other exposures to risk factors were collected. Unconditional logistic regression analysis was performed to determine the association between the risk factors and gastric cancer

Results: A higher frequency of the eIF3a rs77382849 GG homozygote genotype was observed in the gastric cancer patients compared with the controls [63.98 vs. 54.41%, p < 0.05]. After adjustment of exposure risks, such as age, gender, smoking, and drinking, the rs77382849 single nucleotide polymorphism was still associated with susceptibility to gastric cancer. When the eIF3a rs77382849 GG homozygote genotype was used as the reference group, the GA genotype [GA vs. GG: OR = 0.545, 95% CI: 0.386-0.769, p = 0.001] and AA genotype [AA vs. GG: OR = 0.245, 95% CI: 0.072-0.836, p = 0.025] were both correlated with a significantly decreased risk for gastric cancer development

Conclusion: An association between eIF3a rs77382849 polymorphism and susceptibility to gastric cancer was observed in these Chinese patients

Inhibitory effect of jianpi-jiedu prescription-contained serum on colorectal cancer SW48 cell proliferation by mTOR-P53-P21 signalling pathway / 中南大学学报(医学版)

To investigate the effect of jianpi-jiedu (JPJD) prescription-contained serum on colorectal cancer SW48 cell proliferation and the underlying mechanisms.
 Methods: Crude extract from JPJD was made by water extract method and the main components of crude extract from JPJD were analyzed by ultra-performance liquid phase high resolution time of flight mass spectrometry (UPLC-Q-TOF/MS). The low, medium, and high-concentration of JPJD-contained serum were prepared by the serum pharmacological method. The effect of serum containing JPJD on SW48 cell proliferation was determined by MTT assay. The cell cycle was detected by flow cytometric method. The protein levels of mammalian target of rapamycin (mTOR), phospho-mTOR, P-P53, and -P21, and the mRNA level of mTOR were examined by Western blot and RT-PCR, respectively.
 Results: Seven compounds including calycosin-7-glucoside, astragaloside, ginsenoside-Re, ginsenoside-Rb1, glycyrrhizinic acid, apigenin, atractylenolide-II were identified. MTT assays demonstrated that the SW48 cell proliferation was inhibited by medium and high concentration of JPJD-contained serum and the percentages of cells at G1 phase in SW48 cell cultured in the medium and high concentration of JPJD serum group were significantly higher than those in the control group (P<0.05). Meanwhile, the levels of mTOR mRNA and phospho-mTOR protein in the medium and high concentration of JPJD serum groups were substantially lower than those in the control group (P<0.05). Conversely, the expressions of phospho-P53 and P21 protein were significantly increased in the medium and high concentration of JPJD serum group compared with those in the control group.
 Conclusion: JPJD prescription-contained serum can inhibit SW48 cell proliferation, which may be related to mTOR-P53-P21 signaling pathways.

Effect of jianpi-jiedu formula on tumor angiogenesis-relevant genes expression in colorectal cancer / 中南大学学报(医学版)

To investigate the effect of the jianpi-jiedu formula (JPJD) on the expression of angiogenesis-relevant genes in colon cancer.
 Methods: Crude extract was obtained from JPJD by water extract method. The effect of JPJD crude extract on colon cancer cell proliferation capacity was determined by MTT assays. The IC50 value was calculated by GraphPad Prism5 software. Affymetrix gene expression profiling chip was used to detect significant differences in expressions of genes after JPJD intervention, and pathway enrichment analysis was performed to analyze the differentially expressed genes. Ingenuity Pathway Analysis software was applied to analyze differentially expressed genes relevant to tumor angiogenesis based on mammalian target of rapamycin (mTOR) signaling pathway and then the network diagram was built. Western blot was used to verify the protein levels of key genes related to tumor angiogenesis.
 Results: JPJD crud extract inhibited the proliferation capacity in colon cancer cells. The IC50 values in 24, 48, and 72 hours after treatment were 13.060, 9.646 and 8.448 mg/mL, respectively. The results of chip showed that 218 genes significantly upgraded, and 252 genes significantly downgraded after JPJD treatment. Most of the genes were related to the function of biosynthesis, metabolism, cell apoptosis, antigen extraction, angiogenesis and so on. There were 12 differentially expressed angiogenesis genes. IPA software analysis showed that the JPJD downregulated expression of sphingomyelin phosphodiesterase 3 (SMPD3), VEGF, vascular endothelial growth factor A (VEGFA), integrin subunit alpha 1 (ITGA1), cathepsin B (CTSB), and cathepsin S (CTSS) genes, while upregulated expressions of GAB2 and plasminogen activator, urokinase receptor (PLAUR) genes in the colorectal cancer cell. Western blot results demonstrated that JPJD obviously downregulated expressions of phospho-mTOR (P-mTOR), signal transducer and activator of transcription 3 (STAT3), hypoxia inducible factor-1α (HIF-1α), and VEGF proteins, while obviously upregulated the level of phospho-P53 (P-P53) protein.
 Conclusion: JPJD may inhibit colorectal tumor angiogenesis through regulation of the mTOR-HIF-1α-VEGF signal pathway.

Clinical analysis of 20 cases of primary colorectal lymphoma / 中国普通外科杂志

Objective To investigate the diagnosis and the relationship between its clinicopathological characteristics,treatment and the prognosis of primary colorectal lymphoma.Methods The clinical data of 20 primary colorectal lymphoma patients who received operative treatment in the past 34 years in our hospital were retrospectively summarized,and the influence of treatment and each clinicopathological factor on prognosis was assessed.Results Tumor size,lymph node metastasis,invasion of neighboring organs and distant metastasis,and type of operative treatment were significantly related to the survival(P0.05).Conclusions Diagnosis of primary colorectal lymphoma before operation is difficult,and misdiagnosis is common.Operative treatment is the main therapeutic means for colorectal lymphoma.Radical operation combined with chemotherapy can gain a good prognosis.

The Relationship of Expression of CD_(44)V_6, PCNA to Lymph Node Metastasis in Colorectal Carcinoma / 中国医师杂志

To explore the relationship of expression of metastasis associated protein-CD 44 V 6 and proliferating cell nuclear antigen(PCNA) to lymph node metastasis in colorectal carcinoma,randomly selected patients with colorectal carcinoma who underwent coloproctectomy plus D 2～D 3 lymph node dissection were studied.The 104 patients were divided into:A group (n=48) without lymph node metastasis and B group(n=56) with metastasis.The expressions of CD 44 V 6 and PCNA were assayed by immunohistochemical technique.The results indicated that the 56 cases(75%) of B group were positive for expressions of CD 44 V 6 and PCNA,there was obvious correlation between both the expressions and lymph node metastasis(P

The prevention and treatment of parastomal hernia: report of 44 cases / 中国普通外科杂志

Objective To investigate prevention and treatment of parastomal hernia. Methods Clinical data of parastomal hernia of 44 cases were analyzed respectively with special respect to clinical features and repair methods. Result Simple sutures were used in 23 cases, mesh repair in 16 cases, stoma relocation plus mesh repair in 5 cases. Postoperative recovery was satisfactory in 39 cases. Incisional infection occurred in 5 cases, and hernia recurrence developed in 3 cases (6.8%) during a follow-up of 6 to 108 months (average 49 months) in 41 patients. Conclusion The causes of parastomal hernia are miscellaneous especially incisional infection; Perioperative malnutrition must be corrected companying diseases properly controlled, and operative technique improved to prevent the incidence of parastomal hernia; Surgery is the only cure for parastomal hernia. Mesh repair and/or stoma relocation is sometimes necessary.

Surgical treatment of rectal carcinoid:a report of 36 cases / 中国普通外科杂志

Objective To investigate the rational method of treatment of rectal carcinoid and its outcome.Methods The clinical data of 36 cases of rectal carcinoid were retrospectively analysed.Results During a follow-up of 82.6+/-63.4 months,there were no cases with recurrence among the 20 patients with tumor size2cm.Conclusions Tumor diametar can be used to estimate the degree of malignancy of rectal carcinoid.TNM staging is simpler and practical for deciding the method of surgical treatment.