Laparoscopic transabdominal ultra-low anastomosis for rectal cancer: experience of 54 cases / 中国肿瘤临床

Objectives: To evaluate the safety and feasibility of ultra-low anastomosis for anal preservation in laparoscopic rectal can-cer surgery. Methods: The clinical data of 54 patients with low rectal cancer admitted to The Affiliated Hospital of Southwest Medical University from July 2014 to June 2017 were retrospectively analyzed. The short-term effect and complications were analyzed. Results:All patients underwent successful operations; conversion to laparotomy or death was not observed in any of the patients. The mean operative time was (165 ± 31) minutes, and the intraoperative bleeding volume was (12 ± 5) mL. There was no prophylactic ileostomy in all patients. Postoperative anastomotic bleeding and anastomotic leakage occurred in 2 and 3 cases, respectively; these complica-tions were managed with conservative treatment. Postoperative urination and sexual functions of the patients remained good, and most patients were satisfied with their anal function 1 year post-operation. No local recurrences or deaths were noted after follow-up for more than 2 years. However, liver metastases were detected in 3 patients 1 year post-surgery. Conclusions: Laparoscopic transab-dominal ultra-low anastomosis for rectal cancer has a good short-term effect; however, the long-term effect remains to be evaluated.

Investigation of correlation and mechanism between moderate hypoxia and tumor malignant transformation / 重庆医学

Objective To investigate the correlation between moderate hypoxia and tumor invasiveness in colon carcinoma cell line HT‐29 and detect the expression of NF‐κB protein in nucleus and activities of MMP‐2/9 ,so as to explore its latent mecha‐nism of malignant transformation .Methods The moderate hypoxia model was established according to the pressure of O2 of tumor in vivo .After different period in moderate hypoxia ,activities of MMP‐2/9 secreted by HT‐29 cells were measured by gelatin zymog‐raphy ,NF‐κB levels in nucleus were assessed by Western blot after extraction of nucleic protein .Results MMP‐2/9 activities under moderate hypoxia gradually up‐regulated in 12 h and reached the peak at 24 h .The expression of NF‐κB protein in nucleus was simi‐lar to that of MMP‐2/9 .Conclusion Moderate hypoxia could induce malignant phenotype in HT‐29 cells through up‐regulating MMP‐2/9 activities ,in which NF‐κB may involve in this progression .

The clinical effect of compound remifentanil etomidate in gastroscopy anesthesia among 200 aged patients / 重庆医学

Objective To observe the clinical effect of compound remifentanil etomidate on gastrointestinalendoscopy and treat-ment among aged patients .Methods Divided 400 aged patients who got painless gastrointestinalendoscopy and treatment into two groups ,where one was observation group(200 aged patients) that got compound remifentanil etomidate ,while the other was control group which got fentanyl combined propofol .Compared and observed two groups on oxyhemoglobin saturation ,heart rate ,systolic-pressure ,diastolic pressure ,incidence of adverse reaction ,recovery time ,and time of leaving operating room .Results There was no obvious difference between observation group and control group on oxyhemoglobin saturation ,heart rate ,systolicpressure ,diastolic pressure before examination(P>0 .05);while there was distinct difference between examining and reviving ,which showed statisti-cal significance(P<0 .05) .The incidences of bucking ,dysphoria ,respiratory depression ,nausea and vomiting ,and dizziness in the two groups respectively were 3% 、2% 、5% 、3% 、11% and 8% 、11% 、13% 、8% 、27% ,which indicated the incidence of adverse reac-tion in observation group was obviously lower than that of control group ,where there was statistical significance (P<0 .05) .The time of recovery and the time of leaving operating room in two groups respectively were (3 .5 ± 1 .3)min、(9 .5 ± 1 .5)min and (7 .5 ± 3 .4)min、(18 .5 ± 4 .6)min ,which showed the time of observation group was lesser than that of control group ,where there was sta-tistical significance(P<0 .05) .Conclusion During the gastrointestinalendoscopy to aged patients ,compound fentanyl etomidate was safety ,less adverse reaction ,efficiency ,and strong controllability .

Effects of moderate hypoxia on invasion and metastasis of colon carcinoma cell line HT-29 in vitro / 第三军医大学学报

Objective To investigate the correlation between moderate hypoxia and maliglant transformation of colon carcinoma cell line HT-29.Methods Hypoxic conditions were produced according to p(O2)of tumor in vivo.The heterotypic adhesiveness of HT-29 cells was detected by MTT assay.Their reaction to the hypoxic environment was determined via invasion across a Matrigel-coated Transwell filter.At 0,6,12,24 and 48 h after hypoxia,MMP-2/9 activities were assessed by gelatin zymography,and osteopontin mRNA and protein levels by RT-PCR and Western blot respectively.NF-?B/p65 levels in nucleus was measured by Western blot after extraction of nucleic protein.Results After 24-hour moderate hypoxia,the heterotypic adhesiveness and invasive capacity of HT-29 cells were significantly enchanced.MMP-2,MMP-9 activities under moderate hypoxia for 6 h showed no significant change as compared with that under normoxia,then gradually up-regulated and reached the peak at 24 h.They showed no significant difference between 24 h and 48 h after hypoxia.The expression trend of osteopontin mRNA,protein and NF-?B/p65 protein in nucleus was similar to that of MMP-2,MMP-9 under moderate hypoxia.Conclusion Moderate hypoxia could induce maliglant transformation in HT-29 cells through enhancing heterotypic adhesiveness and invasive capacity and upregulating MMP-2,MMP-9 activities.OPN-NF-?B may be an important regulatory pathway besides HIF-1 under hypoxic condition,which involves maliglant phenotype induced by moderate hypoxia.