Laparoscopic total mesorectal excision versus transanal total mesorectal excision for mid and low rectal cancer: A systematic review and meta-analysis.

BACKGROUND: Laparoscopic total mesorectal excision (LaTME) and transanal total mesorectal excision (TaTME) are popular mid and low rectal cancer trends. However, there is currently no systematic comparison between LaTME and TaTME of mid and low rectal cancer. Therefore, we systematically study the perioperative and pathological outcomes of LaTME and TaTME in mid and low rectal cancer. METHODS: Articles included searching through the Embase, Cochrane Library, PubMed, Medline, and Web of science for articles on LaTME and TaTME. We calculated pooled standard mean difference (SMD), relative risk (RR), and 95% confidence intervals (CIs). The protocol for this review has been registered on PROSPERO (CRD42022380067). RESULTS: There are 8761 participants included in 33 articles. Compared with TaTME, patients who underwent LaTME had no statistical difference in operation time (OP), estimated blood loss (EBL), postoperative hospital stay, over complications, intraoperative complications, postoperative complications, anastomotic stenosis, wound infection, circumferential resection margin, distal resection margin, major low anterior resection syndrom, lymph node yield, loop ileostomy, and diverting ileostomy. There are similarities between LaTME and TaTME for 2-year DFS rate, 2-year OS rate, distant metastasis rat, and local recurrence rate. However, patients who underwent LaTME had less anastomotic leak rates (RR 0.82; 95% CI: 0.70-0.97; I2 = 10.6%, P = .019) but TaTME had less end colostomy (RR 1.96; 95% CI: 1.19-3.23; I2 = 0%, P = .008). CONCLUSION: This study comprehensively and systematically evaluated the differences in safety and effectiveness between LaTME and TaTME in the treatment of mid and low rectal cancer through meta-analysis. Patients who underwent LaTME had less anastomotic leak rate but TaTME had less end colostomy. There is no difference in other aspects. Of course, in the future, more scientific and rigorous conclusions need to be drawn from multi-center RCT research.

Clinical observation on acupuncture for treatment of male osteoporosis / 中国针灸

<p><b>OBJECTIVE</b>To compare the therapeutic effects of acupuncture combined with drug and simple drug for treatment of male osteoporosis.</p><p><b>METHODS</b>Fifty-five cases were divided into an observation group (25 cases) and a control group (30 cases) randomly. The observation group was treated with acupuncture and moxibustion at Pishu (BL 20), Shenshu (BL 23), Mingmen (GV 4), Shenque (CV 8) and so on combined with taking Alendronate, while the control group was treated with taking Alendronate simply. The improvement of both Integral of Clinical Symptoms (ICS) and Bone Mineral Density (BMD) of two groups was observed after 6 months treatment.</p><p><b>RESULTS</b>The ICS of two groups after treatment both decreased significantly (both P < 0.001), and the decreasing degree in observation group was more significant than that in control group (P < 0.001). The BMD of lumbar vertebrae and femur in observation group increased obviously than that before treatment (P < 0.01, P < 0.05). The increasing degree of BMD of lumbar vertebrae in observation group after treatment was more obvious than that in control group (P < 0.05). There were abdominal pain, diarrhea, nausea, vomiting, dyspepsia and other adverse reaction in control group, while the degree and occurrence rate of those in observation group alleviated and decreased obviously.</p><p><b>CONCLUSION</b>The effect of acupuncture combined with drug for treatment of male osteoporosis is good with little adverse reaction. This method is better than taking Alendronate.</p>

Sodium caffeate induces endothelial cell apoptosis and inhibits VEGF expression in cancer cells / 药学学报

<p><b>AIM</b>To investigate the induction of endothelial cell apoptosis and the suppression of VEGF expression in cancer cells by sodium caffeate (SCA).</p><p><b>METHODS</b>Apoptosis of transformed human umbilical vein endothelial cells (ECV304 cell line) was detected by flow cytometry, DNA electrophoresis assay and morphological assessment. Western blotting analysis was applied for determination of VEGF expression in cancer cells. Substrate degradation by type IV collagenase was measured by zymography. ELISA was used to detect the binding of type IV collagenase with relevant monoclonal antibody.</p><p><b>RESULTS</b>SCA induced ECV304 cell apoptosis in a time- and dose-dependent manner. After treatment with 100 and 250 microg X mL(-1) of SCA for 48 h, DNA laddering appeared. SCA treated cells showed strong blue fluorescence and distinct changes of nuclear morphology, such as pyknosis and the occurrence of apoptotic bodies. VEGF expression in hepatoma HepG-2 cells and prostate carcinoma DU145 cells was reduced after SCA treatment. The degradation activity of type IV collagenase including MMP-2 and MMP-9 secreted by giant cell pulmonary carcinoma PG cells was inhibited by SCA in a dose-dependent manner. SCA also reduced the binding of mAb 3D6, a relevant monoclonal antibody, to type IV collagenase.</p><p><b>CONCLUSION</b>SCA can induce endothelial cell apoptosis and inhibit VEGF expression as well as type IV collagenase activity in cancer cells. SCA might be active in modulating tumor angiogenesis and the microenvironment.</p>