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Objective:To explore the clinical application value of preoperative colonoscopic marking by Nd-Fe-B magnet ring to assist laparoscopy.Methods:A total of 51 patients with colorectal tumor who underwent radical laparoscopy from January 2020 to October 2021 at the Department of Gastrointestinal Surgery, Guizhou Provincial People's Hospital were recruited. The patients were marked by Nd-Fe-B magnet ring under endoscopy one day before the operation, another magnet ring was sent into the abdominal cavity during the radical laparoscopy through cannula. The two magnet rings were attracted and clung to each other to orient the lesions. The basic information of patients, location of preoperative marks under endoscopy and laparoscopy conditions were recorded.Results:All 51 Nd-Fe-B magnet rings were successfully located to the position of colorectal tumor and fixed. According to the location of the lesions, there were 15 cases of transverse colon, 12 cases of descending colon, 19 cases of sigmoid colon, and 5 cases of upper rectal segment. According to the lesion type, there were 21 cases of colon cancer, 25 cases of polyp carcinomatosis, and 5 cases of laterally spreading tumors with partial carcinomatosis. There were 5 cases with positive margins after endoscopic mucosal resection and 1 case with positive margin after endoscopic submucosal dissection. All lesions were accurately located during the operation. The marking time was 4.1±1.2 min (3-6 min) before the operation and the localization time was 1.5±1.1 min (0.9-5.3 min) during the operation. All magnet rings were removed from the body by laparoscope. The mean distances between the tumor and the cutting edge of the proximal and distal intestinal segments were 5.5 cm and 6.3 cm, respectively. No complications such as colon mucosal injury, bleeding, intestinal perforation or local inflammatory reactions occurred.Conclusion:Nd-Fe-B magnet ring tracer technique for laparoscopic orientation is simple, fast, accurate and safe with no need for additional equipment or apparatus, which is worthy of clinical application.
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Objective To compare the effects of transcutaneous electrical acupoint stimulation ( TEAS) combined with general anesthesia and epidural block combined with general anesthesia on the re-covery of patients undergoing laparoscopic radical resection of colorectal cancer. Methods Eighty-four pa-tients of both sexes, aged 35-64 yr, with body mass index of 18-25 kg∕m2 , of American Society of Anes-thesiologists physical status Ⅱ or Ⅲ, scheduled for elective laparoscopic radical resection of colorectal cancer, were divided into 3 groups (n=28 each) using a random number table method: general anesthesia group (group G), TEAS combined with general anesthesia group (group TG), and epidural block com-bined with general anesthesia group ( group EG) . In group TG, patients received continuous TEAS of bilat-eral Neiguan, Hegu, Zusanli, Shangjuxu and Xiajuxu acupoints starting from 30 min before anesthesia in-duction until the end of surgery at a frequency of 2∕100 HZ and intensity of 3-8 mA with disperse-dense waves. In group EG, an epidural catheter was placed at L1,2 and advanced for 3 cm in the epidural space in cephalad direction, 2％ lidocaine 3 ml was given as a test dose, 0. 375％ ropivacaine 6-10 ml was injected into the epidural space, the level of anesthesia was adjusted to T6 , and then 0. 375％ ropivacaine 5 ml∕h was infused to the epidural space until the end of operation. Patients were endotracheally intubated after rou-tine induction of general anesthesia and mechanically ventilated, and combined intravenous-inhalational an-esthesia was used to maintain anesthesia. The Quality of Recovery ( QoR-15) score was recorded on 1 day before surgery and 1-3 days after surgery. The development of nausea and vomiting, cognitive decline and requirement for rescue analgesics was recorded within 3 days postoperatively. The intraoperative consump-tion of remifentanil and propofol, vasoactive drugs, extubation time, time of PACU stay, time of passing flatus and length of postoperative hospital stay were recorded. Results Compared with group G, the con-sumption of remifentanil was significantly decreased, the QoR-15 scores were increased at 1-3 days after surgery, the incidence of nausea and vomiting and cognitive decline was decreased, and the extubation time, time of passing flatus and length of postoperative hospital stay were shortened in group TG and group EG ( P<0. 05) . Compared with group TG, the intraoperative requirement for vasoactive drugs was signifi-cantly increased in group EG ( P<0. 05) . Conclusion TEAS combined with general anesthesia and epi-dural block combined with general anesthesia have the comparable effect on the recovery of patients undergo-ing laparoscopic radical resection of colorectal cancer, however, the former one provides more stable hemo-dynamics during surgery.
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Objective@#To investigate the expression and clinicopathological significance of hypoxia-inducible factor 1 alpha (HIF-1α), glucose transporter 1(GLUT-1) and lactate dehydrogenase(LDH)-5 in colorectal cancer.@*Methods@#The expression levels of HIF-1α, GLUT-1 and LDH-5 were detected by immunohistochemical staining in 142 specimens of human carcinoma in comparison with adjacent normal tissues.@*Results@#The expression levels of HIF-1α(78.2%, 111/142), GLUT-1(75.4%, 107/142) and LDH-5(68.3%, 97/142) were higher in tumor tissues than in adjacent normal tissues(14.8%, 21/142; 11.3%, 16/142; 7.0%, 10/142; P<0.01 for all three proteins), and such over-expression was significantly associated with lymphovascular invasion, tumor grade and pathological stages(all P<0.01). Additional studies showed that HIF-1α, GLUT-1 and LDH-5 were positively associated with each other(r<0.3, P<0.05 for all three proteins).@*Conclusion@#The data suggest that HIF-1α, GLUT-1 and LDH-5 expression may serve as prognostic indicators for colorectal cancer patients.
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Objective To investigate the relationship between HGF/c-Met and biological behavior and prognosis of gastric carcinoma.Methods The expression of HGF.c-Met.microvessel density and microlymphatic densitv in 58 cases of gastric carcinoma and 27 cases of gastric ulcer were evaluated by immunohistochemistry，using monoclonal antibodies for HGF，c-Met，CD34 and Lyve-1 respectively.Results HGF and c-Met protein were overexpressed in gastric carcinoma，and were significantly higher than those in the mucosa of gastric ulcer(P＜0.01).The microvessel density and microlymphatic density of gastric carcinoma were significantlv different between those with and those without lymphatic metastasis and distant metastasis(all P＜0.05)：The positive expression of HGF and c-Met in those with lymph node metastasis(86％，80％)was significantly higher than those without lymph node metastasis(57％，36％)，P＜0.05.That with distant metastasis(100％.94％)was higher than that without(71％，60％)，P＜0.01.The 5 year survival rate in patients with positive HGF and c-Met expression was much lower than that with negative expression(P=0.019，P＜0.01)，Multivariate analysis indicated HGF and c-Met expression，depth of invasion.lymph node metastasis.distant metastasis，microvessel density and microlymphatic density were all independent prognostic factors of gastric carcinoma.ConclusionsExpression of HGF and c-Met closely correlated with carcinogenesis，development and prognosis of gastric carcinoma.
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Objective To investigate the expression of hypoxia-inducible 1 alpha(HIF-lα)and glucose transporter 1(Glut1)in human breast cancer and its relationship to proliferating cell nuclear antigen (PCNA)protein and clinical pathologic factors.Methods Immunohistochemical staining was used to measure the expression of HIF-lα.Glut1 and PCNA in human breast fibroadenoma,usual hyperplasia and breast carcinoma.Results HIF-1α expression was not found in breast fibroadenoma and hyperplastic Iesions.In contrast.the positive rate of HIF-1α was found in the ductal carcinoma in situ 55%(DCIS,11/20)and the invasive breast carcinoma 85%(51/60).Glut1 positivity in breast carcinoma was 58.8%(47/80).The totsl positive rate of PCNA in breast carcinoma was 75%(60/80),that in DCIS was 65%(13/20)and that in invasive carcinoma was 78.3%(47/60).There was a positive correlation between HIF-lα and Glut 1 level (r=0.653,P＜0.01),a positive correlation between HIF-1α and PCNA level(r=0.693,P＜0.01);and also a positive correlation between Glutl and PCNA level(t=0.742.P＜0.01).conclusion The overexpression of HIF-lα and its target gene Glut1 played important roles in carcinogenesis and progression of breast carcinoma and closely correlated with cell proliferation of breast carcinoma and may become a new target for treatment of breast carcinoma.