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@#Objective To construct a radiomics model for identifying clinical high-risk carotid plaques. Methods A retrospective analysis was conducted on patients with carotid artery stenosis in China-Japan Friendship Hospital from December 2016 to June 2022. The patients were classified as a clinical high-risk carotid plaque group and a clinical low-risk carotid plaque group according to the occurrence of stroke, transient ischemic attack and other cerebrovascular clinical symptoms within six months. Six machine learning models including eXtreme Gradient Boosting, support vector machine, Gaussian Naive Bayesian, logical regression, K-nearest neighbors and artificial neural network were established. We also constructed a joint predictive model combined with logistic regression analysis of clinical risk factors. Results Finally 652 patients were collected, including 427 males and 225 females, with an average age of 68.2 years. The results showed that the prediction ability of eXtreme Gradient Boosting was the best among the six machine learning models, and the area under the curve (AUC) in validation dataset was 0.751. At the same time, the AUC of eXtreme Gradient Boosting joint prediction model established by clinical data and carotid artery imaging data validation dataset was 0.823. Conclusion Radiomics features combined with clinical feature model can effectively identify clinical high-risk carotid plaques.
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@#Objective To identify the preoperative risk factors for prolonged mechanical ventilation (PMV) after pulmonary thromboendarterectomy (PTE). Methods The clinical data of patients who underwent PTE from December 2016 to August 2021 in our hospital were retrospectively analyzed. The patients were divided into two groups according to the postoperative mechanical ventilation time, including a postoperative mechanical ventilation time≤48 h group (≤48 h group) and a postoperative mechanical ventilation time>48 h (PMV) group (>48 h group). Univariable and logistic regression analysis were used to identify the preoperative risk factors for postoperative PMV. Results Totally, 90 patients were enrolled in this study. There were 40 patients in the ≤48 h group, including 30 males and 10 females, with a mean age of 45.48±12.72 years, and there were 50 patients in the >48 h group, including 29 males and 21 females, with a mean age of 55.50±10.42 years. The results showed that in the ≤48 h group, the median postoperative ICU stay was 3.0 days, and the median postoperative hospital stay was 15.0 days; in the >48 h group, the median postoperative ICU stay was 7.0 days, and the median postoperative hospital stay was 20.0 days. The postoperative PMV was significantly correlated with tricuspid annular plane systolic excursion (TAPSE) [OR=0.839, 95%CI (0.716, 0.983), P=0.030], age [OR=1.082, 95%CI (1.034, 1.132), P=0.001] and pulmonary vascular resistance (PVR) [OR=1.001, 95%CI (1.000, 1.003), P=0.028]. Conclusion Age and PVR are the preoperative risk factors for PMV after PTE, and TAPSE is the preoperative protective factor for PMV after PTE.
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Colorectal cancer is one of the most common malignant tumors in the world, with a high mortality, but with the continuous improvement of diagnosis and treatment technology and treatment concept in recent years, many patients can get timely and effective treatment. From the aspects of distant metastasis of colorectal cancer and the progress of diagnosis and treatment under multidisciplinary diagnosis and treatment mode, focusing on the significance of multidisciplinary diagnosis and treatment mode for metastatic colorectal cancer, and exploring a more accurate and effective treatment system, so as to provide some reference for the comprehensive treatment of metastatic colorectal cancer.
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Objective:To assess the configuration and systolic function of the left ventricle in patients with chronic thromboembolic pulmonary hypertension (CTEPH) by routine ultrasound, two-dimensional speckle tracking imaging and three-dimensional echocardiography, and to observe the recovery after pulmonary endarterectomy (PEA).Methods:The patients who were diagnosed with CTEPH, underwent PEA and had no left heart disease were enrolled as the CTEPH group ( n=30) in the China-Japan Friendship Hospital from November 2016 and June 2021. The right heart catheterization data before and after surgery were recorded. In the meantime, gender- and age-matched healthy individuals who sought for physical examination during the same period were included as the control group ( n=23). Echocardiography findings before and after PEA were comparatively analyzed and compared between the two groups, including left ventricular end-diastolic diameter (LVEDd), right and left ventricular cross-section ratio (RVd/LVd), left ventricular global longitudinal strain (LVGLS), left ventricular end-diastolic/systolic volume index (LVEDVi/LVESVi), left ventricular ejection fraction (LVEF) and left ventricular stroke volume (LVSV). Associations between the mean pulmonary arterial pressure (mPAP)/pulmonary vascular resistance (PVR) and left ventricular function were discussed. Results:When compared with the control group, the LVEDd, LVEDVi, LVESVi, LVSV, LVGLS and the mitral early to late diastolic flow velocity ratio (E/A) in the CTEPH group were lower (all P<0.05). There were no significant differences between the two groups regarding LVEF, cardiac output (CO), and cardiac index (CI) (all P>0.05). There were no statistical differences of the left ventricular volume and LVSV between PEA group and the control group (both P>0.05), while the LVGLS and E/A remained lower (both P<0.05). Correlation analysis showed negative associations between mPAP and LVSV as well as E/A ( r=-0.490, -0.455; both P<0.05). Conclusions:There are changes in left ventricular configuration with abnormal filling pattern and potential systolic dysfunction in CTEPH patients. The PEA surgery could lead to recovery of the left ventricular configuration and volume, but the filling pattern and LVGLS at follow-up can not recover completely.
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Objective:To study the expressions of heat shock protein (HSP) 90α and HSP90β in colorectal cancer and paracancer tissues, and to investigate the relationships between HSP90α, HSP90β and clinicopathological features of colorectal cancer patients, and to analyze their correlation.Methods:The tumor tissues and paracancer tissues of 117 patients with colorectal cancer were selected from the Department of Gastrointestinal Surgery, Third Affiliated Hospital of Shandong First Medical University from January 2016 to December 2020. The expression levels of HSP90α and HSP90β were detected by immunohistochemistry, and the relationships between the two proteins and clinicopathological features and the correlation of their expressions were analyzed.Results:The positive expression rates of HSP90α in colorectal cancer tissues and paracancer tissues were 74.4% (87/117) and 12.0% (14/117) , and there was a statistically significant difference ( χ2=92.83, P<0.001) . The positive expression rate of HSP90β in colorectal cancer tissues and paracancer tissues was 61.5% (72/117) and 10.3% (12/117) , and there was a statistically significant difference ( χ2=66.86, P<0.001) . The expression of HSP90α was correlated with tumor location ( χ2=8.67, P=0.003) , vascular invasion ( χ2=8.68, P=0.003) , lymph node metastasis ( χ2=8.52, P=0.004) , T stage ( χ2=21.07, P<0.001) , N stage ( χ2=11.94, P=0.003) , M stage ( χ2=5.37, P=0.020) , pathological stage ( χ2=25.64, P<0.001) . The expression of HSP90β was correlated with lymph node metastasis ( χ2=4.03, P=0.045) , T stage ( χ2=11.09, P=0.007) , N stage ( χ2=6.56, P=0.038) , M stage ( χ2=12.43, P<0.001) , pathological stage ( χ2=17.34, P=0.001) . There was a positive correlation between the expressions of the two proteins in colorectal cancer tissues ( r=0.42, P<0.001) . Conclusion:The expressions of HSP90α and HSP90β in colorectal cancer tissues are significantly higher than those in paracancer tissues, and they are related to lymph node metastasis and pathological stage. There is a positive correlation between the two proteins, which may be involved in the occurrence and development of colorectal cancer and are expected to become new tumor markers.
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Objective:To investigatethe relationship between right ventricular blood flow components and right ventricular function in patients with pulmonary hypertension (PH) by 4D-FLOW cardiovascular MR (4D-FLOW CMR).Methods:Thirty patients with PH were prospectively enrolled in this study. All patients underwent right heart catheterization to measure hemodynamics and CMR to measure right ventricular blood flow and right ventricular function within 1 week. The long-axis 4-chamber and contiguous short axis cineslices were acquired with balanced steady-state free precession sequence to calculate RV functional metrics including right ventricular end diastolic volume, end systolic volume, ejection fraction, stroke output and other functional parameters. Ventricular flow was acquired in sagittal direction, using a 3D retrospectively ECG-triggered, navigator-gated prototype sequence to analyze.RV function and flow parameters were correlated with Spearman correlation analysis.Results:Right ventricular percent of direction flow(RVPDF),percent of delayed eject flow (RVPDEF),percent of retained flow (RVPRI) and percent of residual volume(RVPRV) of PH patients measured with 4D-FLOW were 16.4%±9.2%, 16.1%±5.6%, 16.8%±6.1%, and 50.5%±12.3%, respectively. RVPDF negatively correlated with RVPRVo ( r=-0.703, P<0.001) while RVPDEF positively correlated with RVPRI( r=0.955, P<0.001). RVPDF was positively correlated with right ventricular stroke volume index (RVSVI)( r=0.38, P=0.041) and right ventricular eject fraction(RVEF)( r=0.69, P<0.001), and negatively correlated with right ventricular end systolic volume index(RVESVI)( r=-0.65, P<0.001) and right ventricular mass index(RVMI)( r=-0.45, P=0.004). RVPRVo was negatively correlated with RVEF( r=-0.58, P=0.007). The sum of RVPDF and RVPDEF (RVPDF+RVPDEF) was 35.2%±11.4%. RVEF correlated with RVPDF+RVPDEF ( r=0.825, P<0.001) and comparable to RVPDF+RVPDEF ( t=1.427, P=0.164). RVPDF was negatively correlated with pulmonary vascular resistance (PVR) ( r=-0.52, P=0.007) while RVPRVo was positively correlated with PVR ( r=0.54, P=0.004). Conclusions:4D-FLOW CMR can be used to measure right ventricular ejection fraction in PH patients without respiratory control. In PH patients, the right ventricular direct blood flow was significantly decreased, while the residual blood flow was significantly increased. The right ventricular direct blood flow and residual blood flow were related to the right ventricular function and pulmonary vascular resistance, which were important parameters to evaluate the right ventricular function and afterload in PH.
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Objective:To investigate the short term outcomes and postoperative respiratory complications of patients with chronic thromboembolic pulmonary hypertension(CTEPH) treated by pulmonary endarterectomy(PEA).Methods:45 consecutive CTEPH patients underwent PEA between December 2017 and January 2020 in our institution were enrolled, including 25 females and 20 males. The mean age of operation was 51.2(25-70) years old. 24(53.5%) patients were in New York Heart Association(NYHA) functional class Ⅲ-Ⅳ. The mean PVR before operation was 923(461-2 711) dyn·s·cm -5. All patients’ data were entered in a prospective database, divieded into patients with respiratory complications group(WRC)and without respiratory complications group(WORC). To assess risk factors for postoperative respiratory complications and its effect on short term outcomes. Results:There was a significant reduction in mPAP(from 37 mmHg to 20 mmHg) and PVR(from 923 dyn·s·cm -5 to 293 dyn·s·cm -5) in the entire group. The in-hospital mortality rate was 4.4%(2 cases), died due to postoperative cardiogenic circulatory failure, even with VA-ECMO treatment and mediastinal infection, respectively. Postoperative respiratory complications occurred in 32 patients(71.1%). The most common complications were reperfusion pulmonary edema 44.4%(20 cases) and residual pulmonary hypertension 11.1%(5 cases). The WRC group showed a tendency to have longer periods of mechanical ventilation, longer ICU stays and more ICU costs. Independent predictors of postoperative respiratory complications were time from symptom onset to PEA>36 months( OR=12.2, 95% CI: 2.1-70.7, P=0.005)and six-minute walking distance<300 m( OR=12.6, 95% CI: 1.1-138.0, P=0.0038). Conclusion:Pulmonary endarterectomy is an effective and safe treatment for CTEPH. Postoperative respiratory complications were mainly determined by symptom onset time and pre-operative status. Patients with CTEPH should consider PEA surgery early.
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Objective To evaluate diagnostic method and treatment strategy for free floating thrombus in carotid artery.Methods From Ju12016 to Oct 2017,7 patients with free floating thrombus in carotid artery was diagnosed at our department.The medical history,symptoms,diagnosis,treatment strategy and prognosis of those patients were analyzed retrospectively.Results Among 7 patients,4 were symptomatic;4 patients were concomitant with severe carotid artery stenosis and 3 with mild to moderate stenosis.3 received carotid endarterectomy and patch angioplasty.4 received carotid artery stenting with distal cerebral protection divice.There was no perioperative and 30-day stroke,myocardial infarction,death or hyperperfusion syndrome occurred.The 12-month follow up showed no restenosis,no free floating thrombus recurrence and no ischemic cerebrovascular event.Conclusion Free floating filling defect in carotid artery is a typical sign for unstable plaque.Both carotid endarterectomy and carotid artery stenting can be used for the treatment of free floating thrombus.
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Objective To study the clinical use of the ulnar-basilic arteriovenous fistula as a long-term vascular access in patients with hemodialysis.Methods The clinical data of 36 patients with 1-year follow-up who had a wrist ulnar-basilic arteriovenous fistula formed in China-Japan Friendship Hospital from January 2013 and December 2014 were retrospectively analyzed.The outcomes for this study including the surgical results,complication rate of ulnar-basilic arteriovenous fistula,immediate patency rate,average maturation time,1-year primary patency rate and true patency rate were analyzed.Results Thirty-four cases patients got successful ulnar-basilic arteriovenous fistula formed with palpable vascular thrill.There were no death cases and no severe cardio-cerebrovascular complications.No infection,heart failure,distal swelling and ischemia occurred.The immediate patency of ulnar-basilic arteriovenous fistula was 94.4%(34/36),the average maturation time was (67±4) d,1-year primary patency rate was 63.9%(23/36),and true patency rate was 67.6%(24/36).Conclusion Ulnar-basilic arteriovenous fistula with adequate 1-year primary patency and low risk of infection and complications can be a viable alternative as the hemodialysis vascular access.
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Objective:To investigate therapeutic efficacy and mechanisms of action of oncolytic agent derived from herpes simplex virus type 2 (oHSV2) in a xenograft mouse model bearing CT26 colorectal cancer. Methods:BALB/c mice were subcutaneously inoculated with CT26 cells to establish a xenograft mouse model of colorectal cancer. 1) After intratumoral administration of oHSV2, enzyme-linked im-munosorbent assay was used to determine granulocyte-macrophage colony-stimulating factor (GM-CSF) expression levels in the blood. 2) Model mice were divided into three groups:PBS group (negative control), oHSV2 group, and 5-fluorouracil (5-FU) group (positive control). After drug administration, drug effectiveness was evaluated on the basis of weight, tumor volume, general state, and survival time. 3) Cells from the draining lymph nodes (TDLN) and tumor were surgical y removed and used to quantify mature dendritic cel s (DCs) and T lym-phocytes by flow cytometry. Result:1) In the CT26 xenograft model, level of GM-CSF continuously elevated. At day 8, peak value was attained in the blood at concentration of 3150±327.1 pg/mL. Then, GM-CSF expression gradually reduced as time progressed. 2) In in vivo study, both oHSV2 and 5-FU exerted antitumor effects relative to PBS group (50 days vs. 36 days, P0.05). Skin of virus injection region did not present necrosis and ulceration. 3) In the TDLN, the frequency of DC was increased when treated with oHSV2 compared with the control group (6.49%vs. 3.73%, P<0.01). Similarly, the percentage of CD4+and CD8+T-cel s from the oHSV2-treated group was signifcantly higher than mock-treated tumors (15%vs. 8.57%, P<0.01;8.19%vs. 5.15%, P<0.01). However, number of cells in the 5-FU group were significantly reduced with respect to that of the negative group (al P<0.01). Conclusion:oHSV2 exerted potent antitumor effects in a murine colorectal cancer model. Compared with 5-FU, oHSV2 treatment caused fewer side effects. Such antitumor effect may be induced by stimulation of immune activity by GM-CSF production.
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Objective To compare the outcome of combined and staged approach on concomitant carotid and coronary severe stenosis.Methods From March 2013 to May 2015,27 patients with concomitant carotid and coronary severe stenosis were treated by carotid endarterectomy and coronary artery bypass grafting,15 cases received one-stage operation and 12 staged.The basic characteristics,details during surgery,complications,quality of life score,hospital stay and cost were compared.Results 27 patients received carotid endarterectomy and off-pump coronary artery bypass grafting under general anesthesia.Revascularization were performed on 27 carotid and 82 coronary artery.The characteristics of patients were similar between two groups,reflected with WIC,combined approach subgroup was (5.27 ± 0.88) and staged subgroup was (4.92 ± 1.24).The operation time was significantly decreased in the synchronous group [(295.33 ± 49.73)min vs (390.83 ± 73.45) min,P ＜ 0.001].Hospital stay days was also reduced [(30.20 ± 12.91) days vs(44.67 ± 6.34) days,P =0.002],the medical cost was lower in combined approach group,but no significant statistical difference.The complications including 1 case TIA,1 recurrent nerve injury in one-stage group and 1 case myocardial infarction,1 mediastinal bleeding post-operation and 1 pulmonary infection in stage group.No cerebral infarction and death.Quality of life scores(SF-36) of the two groups was 5.53 ± 1.30 and 5.75 ± 1.36 respectively,no significant difference.Conclusion The efficacy and safety of treatment for concomitant carotid and coronary severe stenosis patients with combined or staged approach was similar.But the combined approach program can reduce the hospital stay time and cost in some degree.
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The relative long-term efficacy and safety of sirolimus-eluting stents [SES] compared with paclitaxel-eluting stents [PES] in multiple comparative studies remains controversial. This report evaluates 29 randomized trials with 18,379 patients in whom long-term [more than 1 year] outcomes were evaluated. The primary outcomes were target lesion revascularization [TLR] and the secondary end points were death, cardiac death, myocardial infarction [MI], major adverse cardiac events [MACEs], target vessel revascularization [TVR] and stent thrombosis [ST]. In comparison with PES, SES significantly reduced the long-term risk of TLR [RR=0.68; 95% CI=0.57 to 0.80, p<0.001], TVR [RR=0.69; 95% CI= 0.60 to 0.79, p<0.001] and MACE [RR=0.82; 95% CI= 0.77 to 0.88, p<0.001], while there were no significant difference with respect to death, cardiac death, MI and ST between the two groups. SES performance was significantly better for reducing the former three outcomes and comparable for the majority of the secondary end points when compared against PES
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<p><b>OBJECTIVE</b>To compare the short-term efficacy of laparoscope-assisted transanal total mesorectal excision (LA-taTME) and conventional laparoscopic TME (LTME) for rectal cancer by meta-analysis.</p><p><b>METHODS</b>Clinical studies that compared clinical outcomes of LA-taTME and LTME were searched from form PubMed, Embase, Ovid, CNKI and Wanfang database before January 2016. Two reviewers independently screened the articles and assessed the quality of the included studies by using the MINORS standard which involves 12 items. The score is 0-2 for each item and the maximum score is 24, and the ideal global score should be above16. RevMan 5.3 software was used for meta-analysis and outcome measures included operation time, hospital stay, number of harvested lymph node, rate of conversion, positive rate of circumferential resection margin and the rate of incomplete mesorectum.</p><p><b>RESULTS</b>Seven studies were included in the analysis, and the score of all the studies was more than 16 points. A total of 479 patients (208 in LA-taTME, 271 in LTME) were enrolled. There were no significant differences in terms of age, sex, tumor location and clinical stage between two groups (all P>0.05). Results of meta-analysis showed that LA-taTME had lower rate of incomplete mesorectum (OR=0.29, 95% CI:0.10 to 0.84, P=0.02), lower rate of complications (OR=0.59, 95% CI:0.35 to 0.97, P=0.04) and shorter hospital stay (MD=-1.66, 95% CI:-3.22 to -0.11, P=0.04) than those of LTME, with significant differences. In terms of operation time (MD=-14.49, 95% CI:-37.87 to 8.90, P=0.22), number of harvested lymph node (MD=-0.45, 95% CI:-1.98 to 1.08, P=0.56), the rate of conversion (OR=0.31, 95% CI:0.08 to 1.24, P=0.10) and positive rate of circumferential resection margin (OR=0.43, 95% CI:0.17 to 1.04, P=0.06), there were no significant differences between two groups.</p><p><b>CONCLUSION</b>Compared to LTME, LA-taTME has similar short-term efficacy for rectal cancer, but it can reduce the rate of complications and rate of incomplete mesorectum.</p>
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Humans , Abdomen , Digestive System Surgical Procedures , Methods , Laparoscopes , Laparoscopy , Length of Stay , Operative Time , Rectal Neoplasms , General SurgeryABSTRACT
Objective To compare the outcome and early patency rate of revascularization treatment for patients with iliac artery occlusion or stenosis.Methods Retrospective analysis was made on 105 cases of iliac artery occlusion or stenosis from January 2009 to April 2014.49 were with iliac artery occlusion and 56 with iliac artery stenosis.Results The demographics,and comorbidities were not statistically different between the 2 groups.The occlusion group had more critical limb ischemia and the ankle-brachial index was lower than the stenosis group.The occlusion group underwent more hybrid surgery and used more covered stents in the operation.The peri-operative complication was higher in the occlusion group,but the difference was not statistically different.The ABI improved significantly for all patients after surgery.The early patency rate was similar in the 2 groups.Conclusions Revascularization treatment for patients with iliac artery occlusion and stenosis was safe and effective,with similar early patency rate and peri-operative complications between the two groups.
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Objective To detect the expression of SSX and to correlate it with clinical indicators of primary hepatocellular carcinoma (HCC).Methods The expression of SSX1-5 mRNA and SSX1 protein were respectively detected by RT-PCR and Western blot and immunohistochemistry staining.The relation between the expression of SSX mRNA and SSX1 protein with clinical indicators were analysed.Results SSX1,SSX2,and SSX3 mRNA were expressed in hepatocellular carcinoma cell lines BEL-7404,Hep G2,and SMMC-7721.In 26 HCC samples,SSX1-SSX5 mRNA was detectable in 53.8％,42.3％,50.0％,46.2％ and 26.9％.The expression of SSX1 mRNA was not related to serum AFP levels (P ＞0.05).Specific expression was both found in the normal group and the high value group.The expression rate of SSX1 mRNA was 85.7％ in the older group,which was higher than in the younger group (16.7％,P ＜ 0.05).The expression rate of SSX1 protein was 50％ in HCC tissues,which was not seen in the caner-adjacent or cirrhosis tissues.In 49 HCC paraffin tissue section samples,the expression rate of SSX1 protein was higher than that in caner-adjacent tissues (46.9％ vs 18.4％,P ＜ 0.05).The expression rate of SSX1 protein was 68.3％ in the large hepatocellular carcinoma group,which was higher than in the small hepatocellular carcinoma group (29.6％),(P ＜ 0.05).Conclusions SSX1 mRNA is expressed with a high percentage and specificity in HCC and their products are new potential promising targets for antigen-specific immunotherapy of HCC.The detection of SSX1 expression has the potential value for auxiliary diagnosis of HCC.
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Objective To study the clinical outcome of endoscopic vessel harvesting system (EVH) for the treatment of lower limbs varicose veins.Methods Patients (n =41) with varicose veins admitted from Jan 2011 to May 2013 were randomly divided into EVH group (n =20) and stripping group (n =21).Indexes as postoperative VAPS (48 hours and 1 week),subcutaneous ecchymosis (1 week),hematoma(1 week),skin numbness (1 week),CEAP classification (3 months),surgery effect and satisfaction scores(3 months) were compared between the two groups.Results 48 hours and 1 week VAPS was lower in EVH group(P ＜0.01).After EVH there was less subcutaneous ecchymosis (1 week),hematoma(1 week) and skin numbness (1 week) (all P ＜ 0.01).Postoperative CEAP classification improved significantly in both groups (P ＜ 0.01),while surgery effect and satisfaction scores (3 months) were better in EVH group (P ＜ 0.05).Conclusions EVH is a safe and minimally invasive technique in treatment of varicose veins of the lower limbs.
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Objective To evaluate selective retention of the great saphenous vein (GSV) belowknee in the prevention of saphenous nerve injury during varicose veins surgery.Methods From January 2009 to January 2012,280 consecutive patients with incompetence of the GSV resulting in varicose veins were prospectively randomized into 2 groups.Patients in the experimental group underwent stripping restricted to the below knee level,patients in control group underwent GSV stripping to the ankle level Patients in the two groups were treated with transilluminated powered phlebectomy,and foam sclerotherapy.Primary end points were postoperative pain,saphenous nerve injury,quality of life and recurrence rate.Results After one month follow-up:5.71％ patients had symptoms of nervous system in the observation group,14.29％ patients had symptoms of nervous system in the control group (P =0.02).After 1 year follow-up,1.47％ patients had symptoms of nervous system in the observation group,7.14％ patients had symptoms of nervous system in the control group (P =0.02).Conclusions Selective retention of great saphenous vein below-knee decreases saphenous nerve injury.
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After lower rectal anterior resection, patients often experience defecation disorders such as increased stool frequency and fecal incontinence. Researches have shown that these disorders may be resulted from pathophysiological consequences such as impaired neorectal compliance, decreased internal anal sphincter function, direct damage or injury of the nervous supply and the loss of rectal sensation.
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Caveolin-1 is an important surface structural marker of Caveolae. It is closely involved in the proliferation, apoptosis, invasion, metastasis, angiogenesis, signal transduction and multi-drug resistance of various tumor cells. Recent studies have found that altered Caveolin-1 expression has dual roles, as a tumor suppressor and promoter, in different stages of gastrointestinal cancer development and progression. The exact mechanisms of Caveolin-1s' involvement in the development of gastrointestinal cancer remain to be clarified and have attracted the attention of a lot of researchers.