Clinical efficacy of transanal endoscopic microsurgery for the rectal tumor / 中华消化外科杂志

Objective To explore the clinical efficacy of transanal endoscopic microsurgery (TEM) for the rectal tumor.Methods The clinical data of 35 patients with rectal tumors who were admitted to the Second Affiliated Hospital of Nanchang University between November 2012 and March 2014 were retrospectively analyzed.The preoperative endorectal ultrasonography (ERUS) was applied to patients for evaluating local invasion and lymph node metastasis,and confirming the pathological types of tumors,size and location of tumors,depth of invasion and with or without lymph node enlargement around the rectal wall,and then patients underwent TEMs.Patients were followed up by outpatient examination,telephone interview and instant messenger (WeChat) till August 2014.Results The tumors of 6 patients were located in the anterior wall of rectum,11 were in the posterior wall of rectum,9 were in the left and 9 in the right side walls of rectum.The diameter of tumor,distances between distal margin of tumor and anal verge,volume of intraoperative blood loss and operation time were (2.3 ± 0.9) cm (range,0.7-4.8 cm),(8 ±4)cm(range,4-17 cm),(32 ±19)mL (range,5-60 mL) and (79 ±35)minutes (range,31-150 minutes),respectively.Tumors with positive margin showed the negative margin after supplementary resection.All the patients didn't receive the specific analgesic therapy with the intake of liquid diets at postoperative day 1-3,and they were discharged after anal exsufflation.The duration of hospital stay was (4.2 ±1.2)days (range,2.0-9.0 days).The results of pathological examination showed that rectal adenoma were detected in 12 patients,rectal carcinoma in situ in 2 patients (Tis stage),rectal carcinoid in 2 patients,low-risk T1 stage of rectal cancer in 9 patients,high-risk T1 stage in 7 patients and T2 stage in 3 patients who received chemotherapy.Seventeen patients had postoperative complications,including 9 with perineum swelling and frequent defecation,4 with functional impairment of anal sphincter,2 with acute urinary retention and 2 with mild errhysis with the eased symptoms after symptomatic treatment.A total of 35 patients were followed up for 5-22 months with a median time of 11 months.The recurrence rate of rectal cancer was 2/19,including in the low-and high-risk T1 stage of 1/16 and in T2 stage of 1/3.Two of 12 patients without adjuvant therapy had recurrence of tumors,and other patients had no recurrence of tumors after adjuvant therapy.Conclusion TEM is safe and feasible in the treatment of rectal adenoma,carcinoma in situ,rectal carcinoid as well as rectal cancer in the low-and high-risk T1 stage.

Effect of antisense miR-224 on gastric cancer cell proliferation and apoptosis / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To observe the effects of miR-224 antisense oligonucleotide (ASO) on the proliferation and apoptosis of gastric cancer cells in vitro and vivo.</p><p><b>METHODS</b>The expression of miR-224 in the cancer tissues and their adjacent tissues in 120 gastric cancer patients were detected by real-time quantitative PCR. The biological effects of miR-224 ASO on human gastric cancer SGC7901 cells was assessed by MTT assay, clone formation assay, flow cytometry and in vivo experiment in nude mice.</p><p><b>RESULTS</b>Compared with the control group (0.50 ± 0.07), miR-224 ASO significantly reduced the miR-224 mRNA expression in the cancer patients (0.09 ± 0.01, P < 0.05). MTT assay results showed that the survival rate of gastric cells at 24 h, 48 h and 72 h was 53.6%, 59.1% and 70.1% in the miR-224 ASO group, and 12.3%, 17.4% and 24.7%, respectively, in the control group (P < 0.05 for all). Clone formation assay revealed that clone formation rate in the miR-224 ASO group was (5.33 ± 0.74)%, significantly lower than the (33.33 ± 8.38)% in the control group (P < 0.05). Flow cytometry indicated that the apoptotic index was (15.68 ± 1.46)% in the miR-224 ASO group and (3.36 ± 0.88)% in the control group (P < 0.01). In addition, the expressions of Bcl2 mRNA and protein were 1.05 ± 0.04 and 0.21 ± 0.03 in the miR-224 ASO group, significantly lower than that in the control group (4.87 ± 0.96 and 0.88 ± 0.09, P < 0.01). The in vivo study further showed that the tumor volume in the experimental group is significantly smaller than that in the control group (P = 0.01).</p><p><b>CONCLUSIONS</b>MiR-224 is overexpressed in human gastric cancer. Reducing the expression of miR-224 can effectively inhibit the growth and promote apoptosis of gastric cancer cells. miR-224 may become a new target for the regulation of gene expression in gastric cancer.</p>

Detection of Pathogens and Antimicrobial Resistance of Surgical Incision Infection / 中华医院感染学杂志

OBJECTIVE To investigate the resistance status of pathogens from surgical incision infection.METHODS The secretion of infected wounds was cultured to detect pathogens by routine methods from Jan 2001 to Dec 2006.The identifications and antimicrobial-susceptible tests of pathogens causing incision infection were determined by Full Automated Analyzer.All data were analyzed retrospectively.RESULTS A total of 246 pathogen strains were cultured from the secretion of surgical incision infection in 6 years,of which Gram-negative bacilli,Gram-positive cocci and fungi accounted for 57.7%,34.1% and 8.2%,respectively.The first place of isolates was Escherichia coli,followed by Staphylococcus aureus,Pseudomonas aeruginosa,Klebsiella pneumoniae,Acinetobacter baumannii,etc.74.5% of S.aureus isolates and 83.3% of S.epidermidis isolates were resistant to oxacillin.45.1% of E.coli of the isolates and 35.0% of isolates of K.pneumoniae were extended-spectrum ?-lactamases producing.Almost all of the detected resistant strains showed serious multiple resistance.Vancomycin and imipenem still had better activity for antimicrobial multiple resistant bacteria.CONCLUSIONS Surgical incision infection is serious.Infection surveillance should be taken to control surgical infection.Pathogens infected surgical incision are multi-resistant to antibiotics.

Comparison of different methods of choledochal cyst excision for treatment of congenital choledochal cyst / 中国普通外科杂志

Objective To evaluate the effects of laparoscopic choledochal cyst excision for treatment of congenital choledochal cyst.Methods Forty patients with congenital choledochal cyst were randomly divided into control group and observation group: the control group underwent open abdominal excision of choledochal cyst,while the observation group had laparoscopic resection of choledochal cyst.Results The operations of all the 40 cases in the 2 groups were successfully completed.The operative time was longer in the observation group(P