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Purpose@#miR-205 is a tumor suppressor and plays an important role in tumor invasiveness. However, the role of miR-205 in human gastric cancer (GC) epithelial-mesenchymal transition (EMT) remains unclear. The aim of this study was to investigate the molecular mechanism of miR-205 in the regulation of EMT in GC invasion. @*Materials and Methods@#Quantitative polymerase chain reaction (qPCR) was used to detect the expression of miR-205 in GC. Further, the correlation between the pathological parameters and prognosis of GC was statistically analyzed. A transwell model was used to evaluate the effect of miR-205-3p on the invasion and migration of GC cells. qPCR, western blotting, and luciferase assay were performed to analyze the relationship and target effects between miR-205-3p and the expression of zinc finger electron box binding homologous box 1 (ZEB1) and 2 (ZEB2). @*Results@#We found that the levels of miR-205-3p were significantly lower (P<0.05) in GC tissues than in matched normal tissues. Additionally, the expression of miR-205-3p was related to the tumor invasion depth, lymph node metastasis, lymph node invasion, and tumor, node, metastasis stage. Patients with lower miR-205-3p expression levels in the tumors had a poorer prognosis. The in vitro assays indicated that miR-205-3p could affect the invasion ability and EMT of GC cells by targeting the expression of both ZEB1 and ZEB2. @*Conclusions@#miR-205-3p promotes GC progression and affects the prognosis of patients by targeting both ZEB1 and ZEB2 to directly influence EMT.
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Objective To compare the quality of life,nutritional status and immune function of gastric cancer patients with digestive tract reconstruction using Roux-en-Y anastomosis and uncut Roux-en-Y anastomosis after radical gastrectomy.Methods 86 patients with gastric cancer were selected from May 2015 to June 2017 with radical total gastrectomy.According to the different ways of the reconstruction of the digestive tract,the patients were divided into URY group (non-severed group,41 patients) and RY group (traditional group,45 patients).The quality of life of the two groups was compared at 1 month,3 months and 6 months after operation.The nutritional status of albumin,prealbumin,transferrin,hemoglobin,retinol binding protein and weight,as well as CD4+ lymphocyte,CD8+ lymphocyte,CD4+/CD8+ ratio,IgG,IgM,IgA and other immune related indexes were observed at pre-operation and 1 month,3 months and 6 months after operation.Results As for quality of life,the score of diet limitation in group URY was significantly lower than that in group RY at 1 month after operation (P＜0.05),and no significant difference at 3 months and 6 months after operation (P＞0.05);As for anxiety,the score of group URY was higher than that in group RY (P＜ 0.05) at 1 month after operation (P＜0.05),and was lower than that in group RY at 3 months and 6 months after operation (P＜0.05).As for dry mouth,group URY was higher than that in group RY (P＜0.05) at 3 months and 6 months after operation (P＜0.05),and the other indexes were not statistically significant (P＞ 0.05).As for the nutritional indexes,prealbumin in the URY group was higher than that in the RY group at 6 months after operation (P＜0.05),and the rest were not statistically significant (P＞0.05).There was no statistical significance in immune indexes between the two groups (P ＞ 0.05).The postoperative hospitalization time of URY group was less than that of RY group (P＜0.05),and the incidence of mild reflux symptoms was lower than that of RY group (P＜0.05).There was no significant difference in the incidence of other complications between the two groups (P＞0.05).Conclusion Except for the length of hospitalization and postoperative complications in which uncut Roux-en-Y anastomosis was superior to Roux-en-Y anastomosis,there is no significant difference in quality of life and nutritional and immune indicators between the two alimentary tract reconstruction methods.
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Objective To look into the effect of ubiquitin (Ub) in muscles of gastric cancer patients on their nutritional status and prognosis.Methods Abdominal rectus muscles of 102 patients with gastric cancer and 53 patients with benign abdominal diseases were studied.The expressions of Ub mRNA and protein were assessed through real time-PCR and Western blot.Results The relative expression of Ub mRNA in rectus abdominis muscles of gastric cancer patients (4.10± 1.04) was significantly upregulated compared with the control group (3.17±0.32) (t =7.386,P=0.000).The expression of Ub protein in rectus abdominis muscles of patients with gastric cancer was upregulated compared with the controls (0.151 ±0.058 vs.0.084±0.046,t =7.275,P =0.000).The high expression of Ub mRNA in rectus abdominis muscles of gastric cancer patients was significantly associated with decreases in weight,body mass index,prognostic nutritional index,serum albumin and hemoglobin (x2 =11.780,6.557,11.849,15.742,8.360;P=0.001,0.010,0.001,0.000,0.004).The high expression of Ub mRNA in rectus abdominis muscles of gastric cancer patients was not correlated with the patients'sex,age,tumor size or Borrmann type (x2 =0.038,1.978,0.486,1.483;P=0.774,0.160,0.486,0.223),but it was related to the pathologic type,lymph node metastasis and TNM staging of gastric carcinoma (x2 =11.260,9.362,20.517;P=0.004,0.002,0.000).The survival rate of gastric cancer patients with high expression of Ub mRNA was lower than those with low expression (x2 =5.775,P =0.016).Conclusions Ub mRNA and protein were upregulated in rectus abdominis muscles of gastric cancer patients.The high expression of Ub mRNA in these patients was related to their nutritional status and prognosis,which might play an important role in the development of cachexia.
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Objective To systematically evaluate the efficacy and safety of enteral nutrition in preoperative bowel preparation for colorectal cancer.Methods We searched in multiple databases (i.e.CNKI,Wanfang Data,VIP,PubMed,Coehrane Library,and Web of Science) for studies up to March 2017 that compared the efficacy and safety of enteral nutrition vs.mechanical bowel preparation before surgical treatment of colorectal cancer.Meta-analysis was conducted with RevMan 5.3 to compare the two approaches in terms of postoperative lymphocyte count,complications,anal exhaust time,intestinal cleaning rate,and levels of prealbumin,albumin,hemoglobin,and transferrin.Results A total of 12 randomized controlled trials involving 617 patients were included in this study,where 308 patients received enteral nutrition and 309 had mechanical bowel preparation.The results showed that enteral nutrition was comparable to mechanical bowel preparation in bowel cleaning rate (OR =1.54,95％ CI=0.98-2.41,P=0.06) and anal exhaust time (WMD =-8.14,95％ CI=-18.25-2.07,P=0.12),and it could lead to higher levels of lymphocytes (WMD=0.19,95％ CI=0.06-0.32,P＜0.01),prealbumin (WMD=20.16,95％ CI=15.77-20.54,P＜0.01),albumin (WMD =2.60,95％ CI=1.69-3.51,P＜0.01),hemoglobin (WMD=7.18,95％ CI=3.61-10.75,P＜0.01),and transferrin (WMD=0.29,95％ CI=0.12-0.47,P＜0.01),and reduce the incidence of postoperative complications (OR=0.18,95％ CI=0.11-0.28,P＜0.01).Conclusions Current evidence showed that using enteral nutrition for bowel preparation before surgical treatment of colorectal cancer could improve postoperative profiles of lymphocyte count,prealbumin,albumin,hemoglobin,and transferrin,and reduce complications.This approach should be adopted in the clinic.
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Objective To evaluate the adjuvant analgesia effect of the addition of dexamethasone to ropiva-caine in a transversus abdominis plane(TAP)block after inguinal herniorrhaphy. Methods 100 adult male pa-tients who underwent open tension-free inguinal herniorrhaphy from August 2015 to June 2017,randomized into two groups equally. TAP block with ropivacaine with additional dexamethasone was experiment group(group D) and with ropivacaine was control group(group C). Before the operation,all the patients were performed TAP block by the same group of surgeons. Celecoxib(200mg,Q12h,po)was prescribed to all patients in 48 hours after oper-ation. VAS and clinical symptoms were recorded. The sum and time of celecoxib consumption were also recorded af-ter 72 hours postoperatively. The surveys about the Carolinas comfort scale(CCS)of all the patients one week after operation were collected. Results The averaged pain score in 48 hours after operation has no statistical signifi-cance. The occurrence of postoperative nausea and vomiting of group D is lower than group C,neither of them were statistically significant. The averaged CCS of group D was lower than group C;the difference was significant. Con-clusions Compared to single usage of ropivacaine in the single-shot TAP as a preemptive analgesia method for in-guinal herniorrhaphy,adding dexamethasone to ropivacaine didn′t show significance in analgesic intensity after in-guinal herniorrhaphy,though the adjuvant usage of dexamethasone reduced the sum and duration of other analgesic medications and enhanced the comfort of the patients after mesh-used herniorrhaphy.
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Objective To investigate the expressions of myostatin (MSTN) in the gastric cancer patients' rectus abdominis and serum,and to discuss its relation with the nutritional status and outcome of the gastric cancer patients.Methods We recruited 102 patients with gastric cancer and another 53 patients with benign abdominal disease who were admitted to Zhejiang Province People's Hospital and Tongde Hospital of Zhejiang Province from February 2008 to February 2011.We tested MSTN expression in the malignant patients' rectus abdominis and serum using reverse transcription polymerase chain reaction,Western blot,and enzymelinked immunosorbent assay.Relationship between MSTN expression and nutrition status of gastric cancer patients was explored.Results The relative expression of MSTN mRNA of rectus abdominis muscle in gastric cancer group and control group was 3.43 ± 1.11 and 1.07 ± 0.31 (t =19.406,P ＜ 0.01),the relative expression level of MSTN protein in gastric cancer group and control group was 0.115±0.696 and 0.085±0.499 (t=2.856,P＜0.05) and its serum expression 8.79±4.32 and 1.21±0.55 in these two group (t =16.701,P＜0.05),showing significant difference.The high (defined as higher than median) expression of MSTN in rectus abdominis muscle of gastric cancer patients was significantly correlated with age (x2 =22.039,P =0.000),percentage of more than 10％ decline in body weight in half a year (x2 =14.365,P=0.000),body mass index (BMI) ＜22 kg/m2 (x2 =6.800,P=0.009),serum albumin (x2 =31.018,P=0.000),hemoglobin (x2=10.079,P =0.001),prognostic nutritional index (x2 =10.074,P =0.002),higher Nutritional Risk Screening 2002 Score (Z=2.628,P=-0.009),tumor stage of TNM (Z=2.550,P=0.011).The expression of the rectus abdominis muscle in patients with gastric cancer was significantly correlated with the survival rate of the patients (x2 =12.200,P＜0.01).Conclusions The expression of MSTN increases in the rectus abdominis and serum of gastric cancer patients with cachexia.The increased MSTN expression is closely related with malnutrition and TNM stage in these patients,suggesting MSTN may also play an important role in the muscle consumption of the gastric cancer patients.
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Proton pump inhibitors as a kind of acid drug are widely used in clinical.However,it is overused all over the world although generally safe and effective.Studies have shown the uncertainty of potential long-term adverse effects,especially the contact with the mechanism of gastric cancer.Clinicians should pay more attention to the potential carcinogenic risk of long-term proton pump inhibitors in treatment.The mechanism of pathophysiology and the clinical researches of proton pump inhibitor-induced gastric neuroendocrine tumors,gastric carcinoma,and gastric cardia cancers are summarized as follows.
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<p><b>OBJECTIVE</b>To investigate the expression of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) in the serum and the rectus abdominis muscle in patients with gastric cancer and its relationship with the nutritional status. Method Clinical data of 102 patients with gastric cancer (gastric cancer group) and 53 patients with benign abdominal disease (control group) who were admitted to Zhejiang Province People's Hospital from January 2008 to October 2013 were analyzed retrospectively. Enzyme-linked immunosorbent assay(ELISA) was used to detect the serum expression of TWEAK. Reverse transcription polymerase chain reaction (RT-PCR) and Western blot were used to detect the mRNA and protein expression of TWEAK in the rectus abdominis muscle. Relationship between TWEAK expression and nutritional status of gastric cancer patients was examined.</p><p><b>RESULTS</b>The relative expression level of TWEAK protein in serum of gastric cancer group and control group was 0.403±0.065 and 0.148±0.036 respectively. The relative expression of TWEAK mRNA in the rectus abdominis muscle tissue was 0.313±0.089 (gastric cancer group) and 0.118±0.005 (control group). The relative expression of TWEAK protein in the rectus abdominis muscle tissue was 0.197±0.064 (gastric cancer group) and 0.066±0.014 (control group), and the differences were statistically significant (both P=0.000). The high expression of TWEAK (high than median) in rectus abdominis muscle of gastric cancer patients was related to the percentage of more than 10% decline in body weight (P=0.000), the small percentage of ideal body weight at the time of admission (P=0.000), BMI<20 kg/m(P=0.023), higher NRS2002 nutritional risk screening score (P=0.000), lower prognostic nutrition index (P=0.000) and serum albumin <35 g/L (P=0.000).</p><p><b>CONCLUSIONS</b>The expression of TWEAK in serum and rectus abdominis muscle of gastric cancer patients up-regulates compared to non-tumor patients. The expression level of TWEAK in the rectus abdominis muscle of gastric cancer patients is closely related to poor nutritional status, suggesting that TWEAK may play a key role in the process of cachexia of gastric cancer patients.</p>
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Humans , Apoptosis , Blotting, Western , Cachexia , Cytokine TWEAK , Metabolism , Enzyme-Linked Immunosorbent Assay , Gene Expression , Nutritional Status , RNA, Messenger , Stomach Neoplasms , Metabolism , Tumor Necrosis Factor-alphaABSTRACT
Objective To study the safety and efficacy of laparoscopic splenectomy and portoazygous devascularization for portal hyperteation.Methods The data of 58 patients who underwent laparoscopic splenectomy and portoazygous devascularization were retrospectively collected and analyzed.Results The operative time for laparoscopic splenectomy and portoazygous devascularization was (2.6 ±0.6) hours.The intraoperative bleeding was (149.5 ± 32.7) ml.The time taken for the bowel to return function was 3.5 ±1.3 days.The hospitalization time was (5.1 ± 1.2) days.When the splenic volume was greater than or equal to 1.5 liters, the conversion to open surgery rate significantly increased [36.0％ (5/14);P ＜ 0.05].The 1, 2, 3, and 4 years cumulative recurrent gastrointestinal bleeding rates were 0, 5.2％, 10.0％, and 15.8％, respectively.Conclusions Laparoscopic splenectomy and pericardial devascularization was safe, efficacious and feasible.When the splenic volume was greater than 1.5 L, whether laparoscopic surgery should be attempted requires further research.
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Objective To investigate the prognostic significance of proteolysis-inducing factor (PIF) in gastric cancer patients.Methods Biopsies of the rectus abdominis muscle were obtained intra operatively from 53 gastric cancer patients and 53 subjects undergoing surgery for benign abdominal diseases,muscle and serum PIF,ubiquitin expression,and proteasome proteolytic activities were assessed through reverse-transcription polymerase chain reaction (RT-PCR),Western blot,and enzyme-linked immunosorbent assay (ELISA).Results PIF was significantly upregulated in muscle of gastric cancer compared to control muscles.PIF was upregulated in 60％ (32/53) muscle of gastric cancer.Over expression of PIF in muscles of gastric cancer were associated with level of serum albumin,tumor node metastasis (TNM) stage,and percent of weight loss.The survival rate of patients with a high expression of PIF was significantly lower than those in patients with low expression (P ＜ 0.05).Conclusions PIF was significantly upregulated in muscle of gastric cancer,over expression of PIF in muscles of gastric cancer was associated with level of serum albumin,TNM stage,percent of weight loss,and prognosis.PIF might play an important role in progression and prognosis of gastric cancer.
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<p><b>OBJECTIVE</b>To investigate the application of home enteral nutrition (HEN) in patients with advanced gastric cancer and its impact on the quality of life.</p><p><b>METHODS</b>Data of 60 consecutive patients with advanced gastric cancer, who could not underwent operation and had relapse metastasis, from June 2010 to June 2012 were retrospectively analyzed. According to familial nutritional pattern, these 60 patients were divided into HEN group (25 cases) receiving home enteral nutritional support and control group (35 cases). HEN patients were supported through jejunostomy tube or nasal gastric tube. Control patients were supported through total parental nutrition or purely eating respectively. All the patients received intravenous chemotherapy and evaluated by Karnofsky index and Spitzer system in the first, third, sixth and twelfth month. In the sixth month, patients were also examined by EORTC QLQ-C30.</p><p><b>RESULTS</b>No significant differences were found between the two groups according to 8 elements containing age, sex, BMI, etc. A total of 53 patients died within one year, including 21 in HEN group and 32 in control group. The Karnofsky scales showed that HEN group scored meanly 57.4, 39.6 and 28.2 in the third, sixth and twelfth month respectively, which were significantly higher than those of control group (45.3, 29.2 and 20.1, P=0.041, P=0.012 and P=0.015 respectively). The Spitzer scales showed that HEN group scored meanly 5.12, 4.04 and 2.54 on average in the third, sixth and twelfth month respectively, which were significantly higher than those of control group (4.32, 3.01 and 1.97, P=0.048, 0.035 and P=0.024 respectively). The EROTC QLQ-C30 scales showed that HEN group scored higher than control group in functional scales (P<0.05), and lower in the symptom scales of short breathing, pain and tired (P=0.025, P=0.044, P=0.036 respectively), while higher in diarrhea (P=0.047).</p><p><b>CONCLUSIONS</b>The quality of life of patients with advanced gastric cancer declines gradually with the nutritional status deteriorating. HEN can be applied to improve the nutritional status and quality of life.</p>
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Humans , Enteral Nutrition , Home Care Services , Jejunostomy , Quality of Life , Retrospective Studies , Stomach Neoplasms , TherapeuticsABSTRACT
Objective To investigate the impact of enteral nutrition (EN) through jejunal feeding tube on the nutritional status and immunologic function of patients during chemotherapy after total gastrectomy.Methods Totally 86 patients with gastric cancer who had undergone total gastrectomy with radical resection and jejunostomy received adjuvant venous chemotherapy in our department from January 2009 to June 2010.They were divided into EN group ( n =43 ) and control group ( n =43 ) according to the hospitalization number.The EN group maintained the jejunostomy tube until the end of 6 courses of chemotherapy,and was given EN support for 7 days through jejunal tube during each course of chemotherapy; the control group removed the tube before chemotherapy without further dietary restriction or nutrition support.The nutritional and immunologic indicators on the 1 st day before chemotherapy and the 1st day after 6 chemotherapy courses were measured.ResultsThree patients in the EN group withdrew from the study because of catheter blockage or catheter loss and 2 patients in the control group failed to complete the trial because of chemotherapy side effects or economic reasons; 81 patients entered the final analysis.After 6 courses of chemotherapy,both groups experienced body weight loss,but the percentage is significantly lower in EN group than in control group (6.9％ ± 0.95％ vs.11.2％ ± 1.32％,P =0.0000).Compared with the nutritional status before the first chemotherapy,the prognosis nutritional index (PNI) in both groups declined after the 6th chemotherapy.Such decline was not statistically significant in EN group ( P =0.1534) but was significant in control group (P =0.0000).The PNI in EN group after chemotherapy was significantly higher than that in control group (P =0.0040).The levels of IgG,NK,CD4 +,and CD4 +/CD8 + were significantly higher in EN group than in control group ( P =0.0083,0.0143,0.0000,and 0.0000,respectively) after chemotherapy.ConclusionEN during postoperative chemotherapy may improve the nutritional status and immunologic function in gastric cancer patients after total gastrectomy.
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Objective To improve the quality of life in gastric cancer patients after total gastrectomy by exogenous trypsin supplement.Method In this study 106 patients were divided into two groups,with 53 patients in each group,oral pancreatic enzyme capsule was given in comparison without in control group.Patients were asked to fill in EORTC QLQ-C30 questionnaire and Korenaga questionnaire at half a year postoperation,stool sample was collected at the same time for fecal fat assay.Results A total of 86 patients completed this test at postoperation half a year.With a comprehensive assessment of quality of life in patients by the scoring system of EORTC QLQ-C30 and Korenaga and the fecal fat contents measurement.Exogenous trypsin plays a positive role in preventing weight loss,improving emotional function,alleviating loss of appetite,insomnia,fatigue,postprandial fullness,nausea,vomiting and diarrhea,and improving intestinal tolerance to fat and the overall health status of patients.Conclusions Total gastrectomy causes exocrine pancreatic dysfunction,exogenous supplement of the enzyme improves postoperative quality of life in these patients.
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Objective To evaluate effects of alimentary reconstruction procedures (integral continual jejunal interposition, Billroth Ⅱ and isolated jejunal interposition) after subtotal gastrectomy on postoperative plasma gastrin, motilin and cholecystokinin. Methods Twenty-four dogs were divided into 3 groups undergoing distal subtotal gastrectomy and three different digestive tract reconstruction (integral continual jejunal interposition, Billroth Ⅱ and isolated jejunal interposition). The concentration of plasma gastrin, motilin and cholecystokinin were detected by enzyme-linked immunosorbent assay before and after operation. Results Two months after operation, plasma gastrin level of the integral continual jejunal interposition group (2. 2 ±0. 7 ) ng/L, ( 3.9 ± 0. 8 ) ng/L was significantly lower than that of preoperative both in fasting and postprandial state (3.8 ± 1.0) ng/L, (5.3 ± 1.6) ng/L, all P ＜0.05, but was significantly higher than other two groups in postprandial state (2. 7 ± 1.0) ng/L, (3.6 ±0. 6) ng/L, P ＜0. 05. Two months after operation, plasma motilin concentration of integral continual jejunal interposition group (577 ±204) ng/L, (1003 ± 209) ng/L were significantly higher than that of preoperative both in fasting and postprandial (429 ± 128) ng/L, (854 ± 218 ) ng/L, P ＜ 0. 05. The postoperative plasma motilin of integral continual jejunal interposition group ( 1003 ± 209 ) ng/L was significantly higher than other two groups in postprandial state (840 ±205) ng/L, (986 ± 189) ng/L, P ＜0. 05. Two months after operation,plasma cholecystokinin concentration of integral continual jejunal interposition group ( 19.6 ± 2.0 ) ng/Lwere significantly higher than that of preoperative both in postprandial ( 19.0 ± 2. 0) ng/L, P ＜ 0. 05. The postoperative plasma cholecystokinin of integral continual jejunal interposition group ( 19. 6 ± 2. 0) ng/L was significantly lower than other two groups (22.2 ± 2. 1 ) ng/L, (20. 1 ± 2. 5 ) ng/L, P ＜ 0. 05. Conclusion Integral continual jejunal interposition after distal gastrectomy maintains the postoperative plasma motilin and gastrin in a relatively higher level and decreases the concentration of plasma cholecystokinin.
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Objective To investigate the expression of heparanase and vascular endothelial growth factor-C (VEGF-C) protein in human gastric carcinoma, and to evaluate its clinical implications during the progress of gastric carcinoma. Methods The expression of heparanase and VEGF-C protein in 97 cases of gastric cancer, adjacent tissues and normal tissues in 20 subjects was determined by immuno- histochemistry. Results The positive rate of heparanase and VEGF-C protein in tumor tissues (61.9% and 66.0%) were significantly higher than those in adjacent tissues of cancer (7.2% and 5.0%) and normal tissues (8.3% and 5.0%, P 0.05) . The positive expression of VEGF-C protein in the tumor tissues was significantly related with serosal infiltration, lymphatic invasion, lymph node metastasis and TNM stage Ⅲ-Ⅳ (P0.05). The 1, 3 and 5-year survival rates of patients with expression of heparanase or VEGF-C protein were significantly less than that of patients without expression of heparanase or VEGF-C (P
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Objective To evaluate the advantage of transabdominal modified Sugiura procedure Methods We retrospectively analyzed 45 cases undergoing transabdominal modified Sugiura procedure from May 1997 to May 2003 The procedure included devascularization of near half gastric and inferior part of esophagus after splenotomy The left and right vagus nerves, the anterior and posterior Latarjet nerves and paraesophageal collateral veins were left intact The gastric submucous vasculature was sutured on the plane 3～5 cm distal to cardia (suture group); or the esophagus 3 cm above cardia was cut and reanastomosed with pipe anastomat Results There was no inhospital mortality Free portal veinous pressure and portal vein flow speed did not change significantly The flow volume of portal vein decreased ( P