Role of antibiotics in Milligan-Morgan hemorrhoidectomy for Grade III to IV Hemorrhoids: A randomized clinical trial.

PURPOSE: This study was mainly to compare the safety and long-term clinical efficacy of using intravenous antibiotics in Milligan Morgan hemorrhoidectomy for Grade III to IV Prolapsing Hemorrhoids. METHODS: This was a parallel group, 3-arm, randomized clinical trial to evaluate the efficacy of intravenous prophylactic antibiotics. A total of 150 consecutive patients undergoing Milligan Morgan hemorrhoidectomy (MMH) in a tertiary hospital for grade III/IV hemorrhoids from January 2020 to August 2022 were enrolled. Patients were randomly assigned to three groups using a computer-generated table. Group A did not receive any prophylactic antibiotic, group B received 2 g I/V Cefoxitin Sodium before the induction of anesthesia, and group C received 2 g I/V Cefoxitin Sodium before the induction of anesthesia and 6 h after operation. RESULTS: There was no significant difference in measured VAS values on the 1st day,3rd day and 7th day after surgery (p> 0.05). Compared with VAS values on the 1st day postoperatively, these values got decreased on the 3rd day and 7th day after surgery (p< 0.05). In addition, there was no significant difference among the first defecation time, wound edema, bleeding, urinary retention after surgery (p> 0.05). There was no significant difference in the outcome comparison between all 3 groups' basal and the 3rd day postoperatively no matter in WBC, NUET% or CRP (p> 0.05). However, compared with basal, the WBC, NUET%,CRP(p< 0.05) of group A and group B on the 3rd day postoperatively got rised, the rate of recurrence of hemorrhoids follow-up for 1 year was 1.4%. CONCLUSIONS: Our results suggest that there is no efficacy on intravenous prophylactic antibiotics in Milligan Morgan hemorrhoidectomy.

Rectal mature teratoma: A case report.

BACKGROUND: Rectal mature teratoma is rare and has been reported as a case report in this study. Herein, clinical presentation, magnetic resonance imaging findings, and immunohistochemistry showed a pelvic rectal mature teratoma. The case report and the surgical treatment procedure have been discussed below. CASE SUMMARY: A 29-year-old Chinese female showed up with over a 1-mo history of perianal mass that emerged after defecation. Physical examination indicated that the mass was 4 cm × 3 cm × 3 cm. The intraoperative procedure involved ligation of the sigmoid colon 10 cm above the upper edge of the tumor, followed by ligation of the rectum 3.5 cm above the upper edge of the tumor, and subsequent complete removal of the mass. The histopathology confirmed the mature teratoma. CONCLUSION: The tumor can be completely removed using surgery to prevent its recurrence.

SIRT4 functions as a tumor suppressor during prostate cancer by inducing apoptosis and inhibiting glutamine metabolism.

Localized in the mitochondria, SIRT4 is a nicotinamide adenine dinucleotide (NAD +) -dependent adenosine diphosphate (ADP) -ribosyltransferase and is one of the least characterized members of the sirtuin family. Although it is well known that it shows deacetylase activity for energy metabolism, little is understood about its function in tumorigenesis. Recent research suggests that SIRT4 may work as both a tumor suppressor gene and an oncogene. However, the clinical significance of SIRT4 in prostate cancer remains unknown. In this study, we evaluated SIRT4 protein levels in cancerous prostate tissue and corresponding non-tumor prostate tissue via immunohistochemical staining on a tissue microarray including tissues from 89 prostate cancer patients. The association between SIRT4 expression and Gleason score was also determined. Further, shSIRT4 or stable prostate cancer cell lines (22RV1) overexpressing SIRT4 were constructed via lentiviral infection. Using Cell-Counting Kit-8 (CCK-8) assay, wound healing assay, migration, and invasion and apoptosis assays, the effects of SIRT4 on the migration, invasion ability, and proliferation of prostate cancer cells were investigated. We also determined the effect of SIRT4 on glutamine metabolism in 22RV1 cells. We found the protein levels of SIRT4 in prostate cancer tissues were significantly lower than those in their non-neoplastic tissue counterparts (P < 0.01); a lower SIRT4 level was also significantly associated with a higher Gleason score (P < 0.01). SIRT4 suppressed the migration, invasion capabilities, and proliferation of prostate cancer cells and induced cellular apoptosis. Furthermore, the invasion and migration of 22RV1 cells were mechanistically inhibited by SIRT4 via glutamine metabolism inhibition. In conclusion, the present study's findings showed that SIRT4 protein levels are significantly associated with the Gleason score in patients with prostate cancer, and SIRT4 exerts a tumor-suppressive effect on prostate cancer cells by inhibiting glutamine metabolism. Thus, SIRT4 may serve as a potential novel therapeutic target for prostate cancer.

MiR-3653 inhibits the metastasis and epithelial-mesenchymal transition of colon cancer by targeting Zeb2.

Aberrant expression of microRNAs (miRNAs) has been widely recognized to play critical roles in the pathogenic processes of colon cancer. However, the expression and functions of miR-3653 in colon cancer remain uncovered. This study revealed for the first time that miR-3653 expression was significantly decreased in colon cancer tissues and cell lines. MiR-3653 overexpression led to decreased migration and invasion of HCT116 cells while miR-3653 knockdown resulted in opposite influence of the metastatic behaviors of HT29 cells. qRT-PCR and western blot demonstrated that miR-3653 suppressed the epithelial-mesenchymal transition (EMT) of colon cancer cells using both gain- and loss- of function assay. Mechanically, miR-3653 was found to interact with the 3'-UTR of Zeb2 through the complementary sequences and inhibited the expression of Zeb2 in colon cancer cells. Rescue experiments demonstrated that the inhibitory effect of miR-3653 overexpression on cell metastasis and EMT was abrogated by forced expression of Zeb2. This study demonstrates that miR-3653 suppresses the metastasis and EMT of colon cells by targeting Zeb2, and serves as a promising biomarker and therapeutic target in colon cancer.

Perianal atypical leiomyoma: A case report.

RATIONALE: Reports on perianal atypical leiomyoma, a perianal tumor, are rare. We confirmed a perianal atypical leiomyoma by its clinical presentation, magnetic resonance imaging findings, and immunohistochemistry. PATIENT CONCERNS: A 28-year-old female with a perianal mass found more than 4 years ago. The 5cm_4cm_4cm sized mass was located on the left side of the anus and vagina; The magnetic resonance imaging (MRI) scan revealed: A 4.1cm × 5.2cm × 4.9cm sized round mass was observed on the left side of the circumference. DIAGNOSES: Perianal atypical leiomyoma. INTERVENTIONS: anal peripheral mass resection was performed under lumbar anesthesia. OUTCOMES: The postoperative course was uneventful, healing, the patient was discharged. LESSONS: Perianal atypical leiomyomas are benign tumors, but with the clinically atypical leiomyoma, it is sometimes difficult to distinguish between potential malignant smooth muscle tumors,and there may be malignant changes. Surgery should ensure complete resection, and to avoid postoperative recurrence, there should be a regular follow-up.

[Effect of electroacupuncture at Chengshan (BL 57) on postoperative pain of mixed hemorrhoids].

OBJECTIVE: To discuss the effect of electroacupuncture at Chengshan (BL 57) on postoperative pain of mixed hemorrhoids. METHODS: One hundred and twenty cases with postoperative pain of mixed hemorrhoids were divided into an electroacupuncture group (60 cases) and a medication group (60 cases) randomly. The disperse-dense wave in frequency of 2Hz/100Hz at Chengshan (BL 57) were used in the electroacupuncture group. Its first treatment was in 30 min after the operation, and then it was given once a day after hip bath in the morning. 2 tablets of Naproxen Sunstained Release Capsule were taken in 30 min after operation in the medication group, and then it was taken 2 tablets a day before dressing change. After 4 times of treatment, evaluate the changing condition of Visual Analogue Scale (VAS) at 5 h, 24 h, 48 h and 72 h after operation. RESULTS: The VAS at 5 h, 24 h, 48 h and 72 h after operation in the electroacupuncture group (6.78 +/- 2.12, 5.56 +/- 1.87, 4.34 +/- 2.23 and 3.15 +/- 2.11) were all lower than those in the medication group (7.56 +/- 2.01, 6.23 +/- 1.15, 5.57 +/- 2.21 and 4.34 +/- 2.12), and the difference was statistically significant (all P < 0.05). CONCLUSION: Electroacupuncture at Chengshan (BL 57) can reduce the postoperative pain of mixed hemorrhoids.