Overall management strategies for colorectal cancer patients during the COVID-19 outbreak / 中华消化外科杂志

The Corona Virus Disease 2019 (COVID-19) since December, 2019 has a wide range of infection due to the strong infectious characteristics. Both medical staff and patients are at increased risk of infection. It is an urgent clinical problem for specialist doctors to work with diagnosis and treatment of cancer patients during the epidemic situation. Based on the colorectal cancer diagnosis and treatment guidelines (2019 CSCO guideline), combined with their own experience, the authors propose the overall management strategies for colorectal cancer patients. This strategies cover the key diagnosis and treatment of colorectal cancer, and provide targeted clinical practice. These work will be helpful for colorectal cancer specialists to carry out the diagnosis and treatment of colorectal cancer effectively under the epidemic of COVID-19.

New progression and direction of translational medicine on colorectal cancer / 中华消化外科杂志

Translational medicine is characterized by its close association with precision medicine in the field of colorectal cancer.In particular,the studies of life histology promote the prevention and treatment of colorectal cancer entered the stage of precision medicine.Accurate molecular typing of colorectal cancer has been used to guide clinical practice is an important breakthrough in the field of colorectal cancer translational medicine in recent years,and its clinical value has been verified.As an important tool for the effective integration of clinical data and life histology data,the biomedical big data platform is expected to contribute to the continued breakthrough of translational medicine in precision molecular typing.New treatment methods,such as liquid biopsy technology with non-invasive,flexible features can be dynamically detected as soon as possible to find the state of somatic mutations.Among them,circulating tumor DNA has a good detection sensitivity and specificity,highlighting the value of early recurrence monitoring.In addition,new therapeutic strategies,such as immunological checkpoints and chimeric antigen receptor genetically modified T-cell therapy,are under intense study in the field of colorectal cancer.Based on the biomedical big data analysis in the context of the precise molecular typing,dynamic liquid biopsy monitoring technology,new immunotherapy and other fields will be the future of colorectal cancer translational medicine research hot and breakthrough direction.

Clinical bottlenecks of individual diagnosis and treatment of colorectal cancer and breakthrough strategies / 中华消化外科杂志

The incidence and mortality of colorectal cancer (CRC) increased rapidly in recent decades and become enormous challenges in China.Lack of effective early warning of molecular markers and dynamic monitoring technology in term of early diagnosis,treatment evaluation,dynamic recurrence and metastasis monitoring are the clinical diagnosis and treatment bottlenecks of CRC.Traditional diagnosis and treatment of CRC rely on a single level of patient information with low accuracy.Based on the system of biology medical model,to carry out a joint diagnostic model,will overcome the traditional problems through a number of multi-level information integration of the joint diagnosis model,will significantly improve the sensitivity and specificity of diagnosis of CRC.The major challenge in patients with advanced and metastatic CRC is the instability of the tumor genome and the treatment-induced resistance during chemotherapy and targeted therapy.It is necessary to carry out continuous dynamic biopsy in order to accurately guide the development of treatment decisions.Compared with the pathological examination of traditional surgical specimen,liquid biopsy,such as circulating tumor cells,circulating tumor DNA detection technology,with noninvasive,real-time dynamic monitoring,could evaluate the efficacy of treatment,and guide the precise individual diagnosis and treatment.Today,the new strategy and new technology need to undergo clinical trials urgency,through technology optimization,reduction of costs and improvement of detection accuracy,would quickly extended to clinical applications in future.

Toll-like receptor 4 on islet beta cells senses expression changes in high-mobility group box 1 and contributes to the initiation of type 1 diabetes

Type 1 diabetes mellitus is caused by the autoimmune destruction of beta cells within the islets. In recent years, innate immunity has been proposed to play a key role in this process. High-mobility group box 1 (HMGB1), an inflammatory trigger in a number of autoimmune diseases, activates proinflammatory responses following its release from necrotic cells. Our aim was to determine the significance of HMGB1 in the natural history of diabetes in non-obese diabetic (NOD) mice. We observed that the rate of HMGB1 expression in the cytoplasm of islets was much greater in diabetic mice compared with non-diabetic mice. The majority of cells positively stained for toll-like receptor 4 (TLR4) were beta cells; few alpha cells were stained for TLR4. Thus, we examined the effects of anti-TLR4 antibodies on HMGB1 cell surface binding, which confirmed that HMGB1 interacts with TLR4 in isolated islets. Expression changes in HMGB1 and TLR4 were detected throughout the course of diabetes. Our findings indicate that TLR4 is the main receptor on beta cells and that HMGB1 may signal via TLR4 to selectively damage beta cells rather than alpha cells during the development of type 1 diabetes mellitus.

Nutrition and metabolism changes after total gastrectomy / 国际外科学杂志

Obviously pathophysiologic changes will appear with patients undergoing total gastrectomy.The changes will influence the long-term prognosis and quality of life of the patient.Regulation of food intake,enterokinesia and metabolism of nutritions will alter after the operation.These will lead to many postoperative complications,such as early dumpling syndrome(EDS),reflux of esophagitis,dyspepsia and malabsorption of the nutrients.