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Objective:To investigate the application value of laparoscopy for stage Ⅳ gastric cancer after transformation therapy.Methods:The clinical data of 7 patients with advanced gastric cancer who underwent laparoscopic surgery after transformation therapy in the First Affiliated Hospital of Hebei North University from January 2016 to December 2020 were retrospectively analyzed. Seven patients were diagnosed as stage Ⅳ gastric cancer by computed tomography (CT), positron emission tomography (PET-CT) and laparoscopy, and underwent paclitaxel based conversion therapy. After evaluating the curative effect, they underwent surgical resection. The intraoperative and postoperative conditions and survival rate of the patients were analyzed.Results:After transformation therapy, 6 patients (85.7%) had partial remission, 1 patient (14.3%) had stable disease, and the overall effective rate was 6/7. Laparoscopic-assisted surgery was performed in 3 patients, and 4 patients were converted to laparotomy. The operation time was (297.9±35.6)min, the intraoperative blood loss was (257.0±106.0)ml, the number of dissected lymph nodes was (38.4±9.1), the gastric tube indwelling time was (72.4±9.6)h, the jejunal feeding tube indwelling time was (15.4±5.6)d, and the liquid diet time was (8.6±3.4)d, the length of hospital stay was (17.1±5.5)d. The postoperative complication rate was 3/7, and there were no unplanned secondary operations and deaths. R0 resection was performed in 6 cases, and R1 resection in 1 case. Tumor regression grade (TRG) classification: 5 cases were grade 2 and 2 cases were grade 3. The median progression free survival of the 7 patients was 15.3 months, the median overall survival was 21.6 months, and the 1-year survival rate was 6/7.Conclusions:Laparoscopy has irreplaceable value in the staging and efficacy judgment of transformation therapy for gastric cancer. However, after transformation therapy, the tissue edema increases, the tumor boundary becomes more unclear, and the surgical operation becomes more difficult. Therefore, it is not necessary to force the laparoscopic operation, and switch to laparotomy according to the situation.
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Objective:To investigate the effect of cyclin D1 (CCND1) negatively regulated by miRNA-541 (miR-541-5p) on the proliferation and migration of colon cancer cells as well as its related mechanism.Methods:Expression levels of miR-541-5p in colon cancer cell lines HT29, SW480, SW620, HCT116 and enterocyte line HIEC of the normal people as well as cancer tissues and pericarcinomatous normal tissues of 112 patients undergoing the colon cancer surgery from the First Affiliated Hospital of Hebei North University between April 2017 and March 2020 were detected by using quantitative real-time polymerase chain reaction(qRT-PCR). The potential target gene of miR-541-5p was predicted by using TargetScan, and was verified by using dual luciferase reporter gene assay, qRT-PCR and Western blot. Expression level of CCND1 was detected in colon cancer cell lines and tissues. Cells with the lowest expression level of miR-541-5p were divided into miR-NC group (the transfected control plasmid), miR-541-5p group (the transfected miR-541-5p mimics), miR-541-5p+CCND1 group (the co-transfected miR-541-5p mimics and CCND1). Effect of miR-541-5p and CCND1 on proliferation and migration ability of colon cancer cells was detected by using cell counting kit-8 (CCK8) and Transwell method. The xenograft model of colon cancer in nude mice was constructed to observe the effect of miR-541-5p on tumor growth.Results:The relative expression level of miR-541-5p in colon cancer tissues was lower than that in pericarcinomatous normal tissues (0.45±0.06 vs. 1.00±0.12, t = 43.385, P < 0.01). The relative expression level of miR-541-5p was 0.46±0.03, 0.67±0.04, 0.57±0.06, 0.17±0.02, 1.00±0.15, respectively in colon cancer cell lines HT29, SW480, SW620, HCT116 and enterocyte line HIEC of the normal people, and the difference was statistiacally significant ( F = 5.621, P < 0.01); the relative expression level of miR-541-5p in all colon cancer cell lines was lower than that in enterocyte line HIEC of the normal people. HCT116 cells were selected to make the subsequent experiments. The predicted results of TargetScan showed that 3'UTR of CCND1 might have sites complementary to those of miR-541-5p. Dual luciferase reporter gene assay showed that CCND1 was the target gene of miR-541-5p, and miR-541-5p negatively regulated the expression of CCND1. CCK-8 method showed that cell proliferation rate of HCT116 was (2.00±0.16)%, (0.89±0.08)%, (2.56±0.23)%, respectively in miR-NC group, miR-541-5p group, miR-541-5p+CCND1 group, and the difference was statistically significant ( F = 6.715, P < 0.01); among HCT116 cells with the overexpression of miR-541-5p, the transfected CCND1 chould reverse the inhibitory effect of miR-541-5p on cell proliferation. Transwell results showed that the overexpression of miR-541-5p inhibited the cell migration ability of HCT116, while the co-transfection of miR-541-5p mimics and CCND1 could reverse the inhibitory effect. In the colon cancer nude mice xenograft model, the tumor mass and size of nude mice in miR-541-5p group was decreased compared with that in the control group (all P < 0.05). Conclusions:miR-541-5p inhibits cell proliferation and migration of colon cancer cells via negatively regulating CCND1, and inhibits tumor growth in xenograft model of colon cancer in nude mice, thereby acting as a tumor suppressor in colon cancer.
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Objective To explore the application value of surgical operation combined with neoadjuvant chemoradiation therapy for rectal carcinoma in phase Ⅱ and Ⅲ and to evaluate the effect of surgical resection. Methods A retrospective analysis was performed from January 2012 to January 2017, including 70 cases of middle and lower rectal carcinoma in phase ⅡandⅢin the First Affiliated Hospital of Hebei North University.Neoadjuvant concurrent chemoradiotherapy before operation was applied.Neoadjuvant radiotherapy: total dose 50 Gy, 2.0 Gy for once, 5 times per week, 5 weeks in total, the radiation field 5 wild for pelvic irradiation. Neoadjuvant chemotherapy: XELOX (oxaliplatin, capecitabine) / FOLFOX (oxaliplatin, leucovorin, 5-fluorouracil) was used for synchronous chemotherapy. After radiotherapy, the patients received surgery in 6-8 weeks. All the operations were performed according to the total mesorectum excision (TME) specification.Results A total of 70 patients underwent neoadjuvant concurrent chemoradiotherapy.The adverse effect rate was 15.71 % (11/70) of gradeⅠand 7.14 % (5/70) of gradeⅡ. No gradeⅢandⅣadverse reactions occurred. The tumor stage of 94.29 % (66/70) patients reduced. The TNM stage of the postoperation was decreased compared with that before neoadjuvant chemoradiotherapy (χ 2= 7.846, P < 0.05). Tumor resection rate was 94.29 % (66/70). Conclusion Surgical operation combined with neoadjuvant concurrent chemoradiotherapy before operation for middle and lower rectal carcinoma in phase ⅡandⅢhas a favorable efficacy and safety,which can alleviate the tumor staging and increase the eradication rate of tumors.
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Objective To investigate the risk and value of the dissection of bursectomy in T2 gastric cancer. Methods A total of 86 T2 gastric cancer patients were divided into dissection of bursectomy group (46 cases) and non-dissection of bursectomy group (40 cases) according to the random number table method. The age, Borrman type, tumor location, degree of differentiation, vascular tumor thrombus, operation type, lymph nodes metastasis, number of dissected lymph nodes, tumor size, blood loss during operation, operation time and postoperative complications were observed. The patients were followed up for 1 year, and the local recurrence, metastasis and survive were compared between 2 groups. Results There were no statistical differences in age, Borrman type, tumor location, degree of differentiation, vascular tumor thrombus, operation type, lymph nodes metastasis, number of dissected lymph nodes, tumor size, blood loss during operation and postoperative complications (P>0.05). No metastasis was found in anterior layer of transverse colon and pancreatic capsule in 2 groups. The operation time in dissection of bursectomy group was significantly longer than that in non- dissection of bursectomy group: (169.13 ± 37.94) min vs. (147.45 ± 30.27) min, and there was statistical difference (P<0.05). The patients were followed up for 1 year, and there was no local recurrence in 2 groups. There was 1 case with liver metastasis in dissection of bursectomy group, and 1 case with bony metastasis in non- dissection of bursectomy group. There was no death in 2 groups. Conclusions The dissection of bursectomy in T2 gastric cancer could be abandoned, in order to reduce the operation time, blood loss during operation, and postoperative complications.
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Objective To explore the safety and clinical effect of combined laparoscopic-colonoscopy resection of colorectal tumor.Methods A total of 26 patients with early colorectal tumor was treated by combined laparoscopic-colonoscopy resection.To observe the postoperative complications,the mean operative time,mean intraoperative blood loss,mean time of gastrointestinal function recovery,and mean postoperative hospital stay were analyzed.Results All the 26 cases were operated successfully.The mean operative time was 60 ～ 162 (93.7 ± 22.5)min.The mean intraoperative blood loss was 15 ～ 120 (35.9 ± 24.2) ml.The mean time of gastrointestinal function recovery was 48 ～ 120(73.2 ± 14.5)h.The mean postoperative hospital stay was 5 ～ 13 (7.4 ± 1.8) d.No postoperative complications occurred,such as stomach leak,enterobrosis and intestinal obstruction.Follow up 6 ～ 12 months,there were no tumor residue and recurrence.Conclusions The combined laparoscopic-colonoscopy resection was located exactly,reasonable excision scope,minimally invasive,quick recovery and other advantages.It was worth of clinical application.
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<p><b>OBJECTIVE</b>To detect the methylation status of gastric cancer tissue genome by DNA methylation chip.</p><p><b>METHODS</b>Methylation status of 6 samples of gastric cancer tissues and their matched adjacent tissues was analyzed using methylated DNA immunoprecipitation(MeDIP) combined with NibleGen chip. Significantly different methylated genes in promoter region and CpG island between two tissues were searched. Functions of these significantly different methylated genes were analyzed by Gene Ontology and Pathway assays.</p><p><b>RESULTS</b>In gene promoter regions, 113 significantly different methylated genes were identified in gastric cancer tissues, such as SHP1, FGF8 and CSF2RA, while 161 significantly different methylated genes were identified in their matched adjacent tissues, such as TNF, IGF2 and BMP7. In the CpG islands, 123 significantly different methylated genes were identified in gastric cancer tissues, such as WNT2B, JAK2 and TPT1, while 139 significantly different methylated genes were identified in their matched adjacent tissues, such as TNFRSF4, HOXC8 and NFYA. These genes located on different chromosomes. In gastric cancer tissues, the 1st and the 4th chromosomes had the most (both 11), the 18th and the 20th chromosomes had the least(both 1). In matched adjacent normal tissues, the 11th chromosome had the most (17), and no significantly different methylated gene was found on Y chromosome. These genes involved in many functions, such as protein phosphorylation, regulating cellular catabolism, ion transport, enzyme activity, transcriptional regulation, cell division, cell cycle regulation, and signal transduction.</p><p><b>CONCLUSIONS</b>There are significant differences between gastric cancer tissues and their matched adjacent tissues in DNA methylation. DNA methylation genes locate on different chromosomes, and their number and distribution vary widely. These genes may be associated with many pathways in carcinogenesis.</p>
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Objective To determine the surgical procedures and effects of ultra-distal tibial intramedullary nails combined with blocking screws in treatment of distal tibial fractures.Methods From April 2008 to September 2012,21 cases of distal tibial fractures were treated with ultra-distal tibial intramedullary nails combined blocking screws.All fractures were statically locked and closed using undreamed technique.For relatively simple fracture,blocking screws were considered when the reduction and stability was not satisfied after the insertion of intramedullary nails; for severe comminuted fractures,blocking screws were inserted directly under C-arm fluoroscopy.Partial weight-bearing was permitted 3 weeks after surgery.Quality of reduction,fracture union,and function assessment were measured at follow-up.Results No skin necrosis and soft tissue and bone infections occurred after a mean follow-up of 17.5 months (range,12-22 months).All fractures were healed with an average healing time of 12 months (range,8-26 months).X-ray findings revealed the fracture of ＜ 5° angulation on coronal and sagittal planes.There was no deformation or breakage of blocking screws and intramedullary nails.According to the criteria of Tormetta,the results were excellent in 19 cases and good in 2.Conclusion Blocking screws assists reduction and improve the fixation stability by narrowing the canal in treatment of distal tibial fractures and expands the application of intramedullary nails.