GNG4 Promotes Tumor Progression in Colorectal Cancer.

Colorectal cancer is a common digestive system tumor, which lacks effective therapeutic targets and biomarkers to accurately determine the prognosis. Sequencing data, immunohistochemistry, and Kaplan-Meier analysis were used to explore GNG4 clinical significance in colorectal cancer. And, through in vitro experiments, the effects of GNG4 on cell behaviors were investigated. The results showed that the mRNA and protein expression levels of GNG4 in patients with colorectal cancer were significantly higher than in normal people. The patients with high GNG4 expression had a worse prognosis than patients with low GNG4 expression. The in vitro experiments presented that after downregulating the expression of GNG4, proliferation, migration, and invasion of SW-620 colon cancer cells were all significantly reduced, apoptosis was significantly increased, and the cell cycle was blocked in the S phase. In summary, GNG4 may be of importance in the therapy of the colorectal cancer; therefore, targeting GNG4 may have certain clinical value in the treatment of colorectal cancer.

Total endoscopic thyroidectomy via bilateral breast and ipsilateral axillary approach: a clinical feasibility study.

The most commonly used minimally invasive thyroid surgery via noncervical approach is the bilateral breast approach, but there was usually a scar in the chest wall, which induced uncomfortable and bad cosmetic result. For this reason, endoscopic thyroidectomy via bilateral breast and ipsilateral axillary approach had been developed. The aims of this study are to analyze our surgical outcomes and to evaluate the effectiveness and safety. Between May 2011 and August 2012, 64 patients with thyroid diseases underwent endoscopic thyroidectomy via bilateral breast and ipsilateral axillary approach. The patients' clinical data, operative time, blood loss, drainage amounts, complications, hospital stay, area of skin flap, and postoperative visual analog pain score (VAS) were analyzed retrospectively. We describe here the details of our operative technique. All the 64 patients successfully underwent endoscopic thyroidectomy. None had to be converted, and no postoperative complications were observed. Mean operation time was 104.0 ± 25.3 minutes. Mean blood loss was 10.5 ± 3.7 mL. Mean average area of skin flap was 78.6 ± 8.6 cm2. Mean postoperative drainage amounts on day 1 were 84.5 ± 62.6 mL. Mean hospital stay was 2 to 3 days. The postoperative VAS scores on day 1 were 0 to 2. Follow-up visits range from 2 to 12 months, suggesting that no one had a relapse. Furthermore, the patients were uniformly pleased with the cosmetic results of the operation. Bilateral breast and ipsilateral axillary approach is a safe and easily popularized method that gives good surgical completeness, quick recovery, less pain, less postoperative complications, and an excellent cosmetic result. Therefore, this method is a good choice for patients with surgical thyroid diseases.

[The application of laparoscopy in biliary reconstruction and rehabilitation after transection injury of biliary duct].

OBJECTIVE: To discuss the feasibility of biliary reconstruction and rehabilitation after transection injury of biliary duct by laparoscopy. METHODS: The clinical data of 24 cases receiving biliary reconstruction after transection injury of biliary duct by laparoscopy were analyzed retrospectively from August 2002 to April 2008, including operation indications, contraindications, related operation skills and so on. In these 24 cases, the reasons of transection of biliary duct as followed: 15 cases were pancreaticoduodenectomy, 6 cases were resection of the choledochal cyst, 1 case was resection of high cholangiocarcinoma, 1 case was cholecystectomy and 1 case was resection of gastric cancer. RESULTS: Biliary reconstruction and rehabilitation was successfully completed in 24 cases by laparoscopy. There was 1 case of bile leakage and no duct stenosis complications. CONCLUSIONS: Biliary reconstruction and rehabilitation by laparoscopy was feasible and safe procedure, has a high successful rate, and deserves further clinical trials in hospitals.

[Analysis of the effect of laparoscopic hepatectomy on 61 cases of primary liver cancer].

OBJECTIVE: To explore the feasibility and the effect of laparoscopic hepatectomy for primary liver cancer(PLC). METHODS: A retrospective study on 61 cases of laparoscopic hepatectomy for PLC was made between November 2002 and June 2007, among which there were 49 male and 12 female, aged from 14 to 71 years. All patients were diagnosed as PLC by type-B ultrasonic, CT or MRI, and APF. RESULTS: Fifty-six patients were completed laparoscopically successfully. Five cases underwent conversion to open operation because of hemorrhage. The mean operative time was 60 min (30-150 min). The mean blood loss was 450 ml (100-2000 ml). The mean hepatic portal block time was 20 min (15-30 min). All the patients had excellent recovery without any postoperative surgical complications. The patients were mobilized out of the bed in 24 hours. Oral intake of food started in 1 to 3 days. The average postoperative hospital stay was 6.6 d (5-10 d). CONCLUSION: Laparoscopic hepatectomy for PLC is safe and feasible by using hepatic portal block instrument.

[Laparoscope hepatectomy for hepatic hemangioma: a report of 18 cases].

OBJECTIVE: To evaluate the feasibility and practicality of laparoscopic hepatectomy for hepatic hemangioma. METHODS: Candidate for laparoscopic liver resection were 18 cases of hepatic hemangioma from January 2002 to October 2006. The portal bloods stream was blocked by the laparoscope portal blood blocker. The Electric-cautery and ultracision were used for liver transection. Operative procedures included anatomical left hepatectomy in 2 cases, non-anatomical left hepatectomy 1 case, left lobectomy 5 cases, local liver resection 10 cases. Two cases of hepatic hemangioma associated with gallbladder stone were performed cholecystectomy synchronously, 1 case associated with chronic appendicitis were performed appendectomy synchronously. RESULTS: Laparoscopic left liver resection was successfully performed in all 18 cases. The operative duration was (185.4 +/- 55.7) min. The quantity of blood lost during the operation was (416.2 +/- 128.8) ml. The postoperative recovery was smooth and good. No critical complications occurred. The duration for hospitalization was (6.2 +/- 1.0) d. CONCLUSION: Laparoscope hepatectomy for hepatic hemangioma is safe and feasible.

Laparoscopic pancreaticoduodenectomy to treat cancer of the ampulla of Vater.

OBJECTIVES: We explored the feasibility, difficulty, and indications for laparoscopic pancreaticoduodenectomy. METHODS: Since November 11, 2002, we have successfully completed 5 laparoscopic pancreaticoduodenectomies. Patients included 4 males and 1 female, average age 43 years. Three patients had duodenal papillary cancer, one had cancer of the head of the pancreas, and one had pancreatic mixed cancer (duodenal papillary cancer, hepatobiliary ductal adenocarcinoma). The average mass size was 1.5/1.8 cm to 2.6/2.5 cm. RESULTS: The pathology diagnosis was well-differentiated duodenum papillary adenocarcinoma in 3 patients, head of pancreas endocrine small cell carcinoma in 1, and duodenum papillary adenoma with malignancy ductal intermediate differentiation adenocarcinoma in 1. During surgery, average blood loss was 770 mL. Operation time averaged 528 minutes. The main difficulties during surgery were estimation and identification of pancreatoduodenal tumor resection and hepatoduodenal ligament venation changes. After surgery, 1 patient had a small amount of pancreatic leakage, another developed stress ulcer bleeding; both patients became normal after appropriate treatment. The fourth patient developed severe recurrence of pancreatitis with pneumonia and on the 39th day after surgery developed stress ulcer bleeding. This patient died during the second operation. CONCLUSION: Laparoscopic pancreaticoduodenectomy is a very difficult and risky operation. It requires ample clinical experience in traditional pancreaticoduodenectomy, perfect laparoscopic surgery technique, consultation and cooperate with the surgical team, updated laparoscopy equipment, and very strict surgical indications. For hospitals that meet the above conditions and requirements, laparoscopic pancreaticoduodenectomy is very safe and feasible.