TNF-α promotes the proliferation of colon cancer cells by activating the Wnt/β-catenin pathway / 西安交通大学学报(医学版)

Objective To investigate the effect of treatment with TNF-α on growth ability of colon cancer cells and its possible mechanism.Methods Human colon cancer HT-29 cells were treated with TNF-α(10 nmol/L). The effect of TNF-αon the proliferative ability was examined by cell growth curve assay and MTT assay,respectively. Cell cycle was detected by flow cytometry.Protein levels ofβ-catenin,c-myc and cyclinD1 were detected by Western blot.We also observed the effect of the Wnt/β-catenin pathway blockage by XAV9 3 9 on TNF-α's promoting prolif-eration of colon cancer cells and proteins related to the Wnt/β-catenin pathway.Results Upon treatment with TNF-α,the proliferative ability of HT-29 cells was enhanced (all P＜0.05),G0/G1 phase cell ratio was decreased (P＜0.05),and S phase cell ratio was increased (P＜0.05).The protein levels ofβ-catenin,c-myc and cyclinD1 were increased in TNF-α-treated HT-29 cells (all P＜0.05).XAV939 treatment resulted in a significant inhibition of cell proliferation ability (all P＜0.05)as well as the protein levels ofβ-catenin,c-myc and cyclinD1 (all P＜0.05) in the TNF-α-treated HT29 cells.Conclusion TNF-αmay be involved in the occurrence and development of colon cancer by activating the Wnt/β-catenin pathway and promoting the proliferation of colon cancer cells.

Feasibility and Safety of Enhanced Recovery after Surgery for Elderly Patients with Colorectal Cancer / 中国医学科学院学报

Objective To evaluate the feasibility and safety of enhanced recovery after surgery (ERAS) in elderly patients with colorectal cancer (CRC).Methods A retrospective analysis was conducted on 230 CRC patients undergoing ERAS from January 2017 to January 2018. These subjects included 120 young patients (<70 years) and 110 elderly patients (≥70 years).The rates of ERAS compliance,anastomotic leakage,re-operation,and re-hospitalization,the mortality,and the average hospital stay were compared between these two groups.Results The elderly group had significantly higher incidences including diabetes (20.9% vs. 10.8%,P=0.045),heart disease (24.5% vs. 11.7%,P=0.039),respiratory diseases (20.0% vs. 10.0%,P=0.041),and hypertension (26.4% vs. 15.0%,P=0.035) than the young group. However,these two groups were not statistically significant in terms of ERAS compliance rate (79% in the young group vs. 74% in the elderly group,P=0.574),incidence of anastomotic leakage (2.5% vs. 1.8%,P=1.000),re-operation rate (1.7% vs. 2.7%,P=0.672),re-hospitalization rate (2.5% vs. 4.5%,P=0.484),mortality rate within 30 days after operation (1.7% vs. 2.7%,P=0.672). The average hospital stay was 5 days in the young group and 7 days in the elderly group (P=0.000).Conclusions Although the elderly patients tend to have poor general status,their ERAS compliance rate and main treatment indicators including incidence of anastomotic leakage,re-operation rate,re-hospitalization rate,and mortality rate within 30 days after surgery are not different from young patients. Thus,the ERAS program is safe and feasible for elderly CRC patients.

Application of convolute manipulation for the treatment of femoral fractures in children / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the application of convoluted manipulation in pediatric femoral fractures.</p><p><b>METHODS</b>From March 2015 to October 2016, 12 children with femoral fractures were treated by Chinese traditional manipulation including 8 males and 4 females with an average age of 6 years old ranging from 1 to 12 years old. The causes of injury were falls in 10 cases and traffic accidents in 2 cases. Of which 1 case was transverse fractures, 4 cases were oblique fractures and 4 cases were spiral fractures, 2 cases were comminuted fracture, 1 case was greenstick fracture. All patients underwent manual reduction within 1 to 2 days, plus small splint with cedar bark, and parallel lower limb traction.</p><p><b>RESULTS</b>All the 12 patients were followed up for 1-3 months, with an average of 2 months. All the 12 patients achieved clinical union, and the average healing time was 6 weeks. There was no obvious shortening and rotational angulation. At the last follow-up, Schatzker-Lambert distal femoral fracture evaluation results were excellent in 11 cases, good in 1 case.</p><p><b>CONCLUSIONS</b>Convoluted manipulation is very important for reduction of femoral fractures in children, with the splint of cedar bark, satisfactory therapeutic effect can be achieved.</p>

Prospective study of gracilis muscle repair of complex rectovaginal fistula and rectourethral fistula / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To assess the efficacy and experience of gracilis muscle transposition for complex rectovaginal fistula (RVF) and rectourethral fistula (RUF).</p><p><b>METHODS</b>Nineteen patients underwent gracilis muscle transposition for complex RVF and RUF from May 2009 to November 2011 in the Beijing Shijitan Hospital and the clinical data were prospectively collected. The success rate and complications were recorded. SF-36 quality of life score, Wexner fecal incontinence score, and female sexual function score before surgery and 6 months after surgery were recorded.</p><p><b>RESULTS</b>In 19 patients, there were 8 males (RUF) and 11 females (RUF). The times of failed attempt repair preoperatively ranged from 0-3 (mean, 1.0). The diameter of the fistula ranged from 0.5-3.0 cm (mean, 1.6), and all fistulas located above the sphincter. The operative time ranged from 145-400 minutes (median, 240). The postoperative hospital stay ranged from 10-39 days (median 21). Early postoperative complications included thigh pain and numbness in 2 cases, leg numbness in 2 cases. No long-term complications were noticed. The follow-up period ranged from 6-35 months (median, 18). The gracilis muscle transposition had a healing rate of 94.7% (18/19). As compared with the preoperative level, Wexner score decreased from 10.0±8.8 to 2.9±5.8, and the continence function improved significantly (P=0.002). Sexual function score of 11 female patients increased from 1.0±1.8 to 4.0±4.0, and the sexual function had a significant improvement after surgery (P=0.022). SF-36 quality of life scores improved significantly (P<0.001).</p><p><b>CONCLUSIONS</b>Gracilis muscle transposition for complex rectovaginal fistula and rectourethral fistula has high success rate with mild and rare complications.</p>

Comparison of clinical manifestation and severity between hospital-based American and Chinese patients with colorectal Crohn disease / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the differences in clinicopathological characteristics and severity between American and Chinese patients with colorectal Crohn disease(CD).</p><p><b>METHODS</b>Between March 1985 and September 2004, 68 patients with colorectal CD in Cleveland Clinic Florida (America) and 85 patients with colorectal CD in the 301 Hospital(China) were enrolled in the study. Data of two groups,including demographics, clinical characteristics, extraintestinal manifestations, presenting symptoms, location and pathological characteristics,were compared.</p><p><b>RESULTS</b>60.3% of American patients and 36.5% of Chinese patients were female(P=0.003). 11.8% of American patients and 1.2% of Chinese patients had a family history of CD(P=0.016). American patients had a significantly higher rate of extraintestinal disease (39.7% vs 20.0%), abscess(19.0% vs 0), and anorectal fistulas(51.5% vs 0). American patients had significantly more extensive disease than Chinese patients(pancolitis: 44.1% vs 4.7%, P<0.01). American patients had a significantly higher rate of disease involving the ascending colon, transverse colon, descending colon, sigmoid colon, anorectal area compared with Chinese patients(all P<0.05).</p><p><b>CONCLUSIONS</b>American patients with colorectal Crohn disease seem to have a female predominance, a higher rate of CD family history, to involve the distal intestinal tract more often, and have more severe clinical manifestation and pathological process, as compared with Chinese patients.</p>