Effects of different gracilis loops in graciloplasty on congenital fecal incontinence / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the clinical effect of graciloplasty using two different gracilis encircled loops and to research the better method for the treatment of fecal incontinence after anoplasty for imperforate anus.</p><p><b>METHODS</b>Clinical data of 38 incontinence patients with congenital anal malformation undergoing graciloplasty in our hospitals from January 2009 to January 2012 were retrospectively analyzed. Twenty patients received the modified surgery in which the gracilis muscle was transposed anticlockwise into a circum-anal tunnel with a U-loop and its tendon secured to the ipsilateral pectineal ligament. Eighteen patients received the traditional surgery in which the gracilis muscle was wrapped clockwise around the anus with a γ-loop and its tendon secured to the contralateral periosteum of ischial tuberosity or pectineal ligament. All the patients were evaluated via Wexner score and anal manometry before surgery and 2 weeks, 6 months, 1 year and 2 years after surgery. In addition, it was assessed whether the patients had difficulty defecating while squatting after surgery.</p><p><b>RESULTS</b>Generalized estimating equations showed that the Wexner score in two groups gradually decreased after surgery (P=0.000), but there was no significant difference between two groups (P=0.554). At 2 weeks, 6 months, 1 year and 2 years after surgery, there were respectively 4 cases (20.0%), 3 cases (15.0%), 2 cases (10.0%), 1 case (5.0%), who showed squatting difficult defecation in the U-loop group, and 10 cases (55.6%), 12 cases (66.7%), 10 cases (55.6%), 8 cases (44.4%) in the γ-loop group. The probability of squatting difficult defecation in U-loop group was significantly lower compared to γ-loop group (P=0.002), but the probability of squatting difficult defecation in two groups did not obviously change with time (P=0.057). Repeated measures ANOVA showed that anal resting pressure, anal maximal squeeze pressure, duration of anal squeeze, and rectal maximum tolerable volume in two groups were gradually improved after surgery (all P<0.01), but there were no significant differences between two groups (all P>0.05).</p><p><b>CONCLUSIONS</b>Graciloplasty with different gracilis loops can improve anal function. However, U-loop can better improve difficult defecating while squatting, and is worthwhile for spreading in clinical practice.</p>

Expression of vasohibin-1 in colorectal cancer tissue and its correlation with vascular endothelial growth factor A and microvessei density / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the clinical significance of vasohibin-1 expression in colorectal cancer tissues and its correlation with vascular endothelial growth factor A(VEGF-A) and microvessel density (MVD).</p><p><b>METHODS</b>Tumor tissues and paired adjacent normal tissue (distance to cancer >5 cm) from 60 colorectal cancer patients undergoing resection in the Second Hospital of Tianjin Medical University from June 2013 to November 2013 were included in this study. The protein expressions of vasohibin-1, VEGF-A and MVD were detected by immunohistochemical staining. The mRNA expressions of vasohibin-1 and VEGF-A were detected by RT-PCR. The protein expressions of vasohibin-1 and VEGF-A were observed by Western blot. Correlation among parameters was examined.</p><p><b>RESULTS</b>Vasohibin-1 expression was mainly localized in the cytoplasm of tumor cells and endothelial cells. VEGF-A expression was mainly localized in the cytoplasm and membrane of tumor cells. The expressions of vasohibin-1, VEGF-A and MVD in colorectal tumor tissues were significantly higher than those in corresponding adjacent tissues [43.3% (26/60) vs. 16.7% (10/60), 51.7%(31/60) vs. 18.3% (11/60), (39.67 ± 16.80)/mm² vs. (17.85 ± 6.43)/mm², all P<0.05]. Higher vasohibin-1 expression was significantly associated with TNM stage and metastasis (P<0.05). Vasohibin-1 expression was positively correlated with VEGF-A and MVD (r=0.378, 0.628, all P<0.05). Vasohibin-1 and VEGF-A mRNA expressions and protein expressions in colorectal cancer tissues were significantly higher than those in corresponding adjacent tissues (all P<0.05).</p><p><b>CONCLUSION</b>Vasohibin-1 expression in colorectal cancer tissues is significantly higher as compared to corresponding adjacent tissues. Vasohibin-1 expression is positively correlated to VEGF-A and MVD, and associated to TNM stage and metastasis. Positive vasohibin-1 expression indicates a poor prognosis of patients with colorectal cancer.</p>

Recent Advances on Vasohibin Family Regulating Angiogenesis / 天津医药

Angiogenesis is regulated by the local balance between angiogenesis stimulators and inhibitors. Vasohibin family as a novel regulator of angiogenesis involves in the process of various pathophysiology. Vasohibin-1 is the only factor that regulates angiogenesis by means of negative feedback as the mechanism of action. It is expressed in ECs to terminate an-giogenesis. Subsequently one gene homologous to vasohibin-1 was found and designated as vasohibin-2, which is expressed in infiltrating MNCs or cancer cells to stimulate angiogenesis. Furthermore, one binding protein to vasohibin-1 and vasohib-in-2 has been discovered and renamed as small vasohibin-binding protein (SVBP). The analysis of the function of SVBP has revealed that SVBP binds to vasohibin-1 within cells, makes a heterodimer with vasohibin-1 and facilitates the secretion of vasohibin-1. This article reviews the construction features and biological activities of vasohibin family members and their ef-fects of inhibiting pathology angiogenesis.