Abstract:

Objective: To investigate the feasibility, safety and short-term clinical efficacy of early hyperthermic intraperitoneal chemotherapy (HIPEC) after radical resection of T4 colorectal cancer. Methods: The clinical data of 96 patients with T4 colorectal cancer treated from January 2011 to June 2013 were retrospectively analyzed. Of the patients, 48 cases began to receive HIPEC from postoperative day 5 or 6 (once daily for a total of 3 sessions), and then underwent the first systemic infusion of mFOLFOX6 regimen within postoperative one month, for a total of 6 cycles (HIPEC group), and another 48 cases only underwent systemic chemotherapy of the same regimen (control group). The incidence of adverse effects and complications, and the 1- and 2-year recurrence and survival rate as well as the quality of life of the two groups of patients were compared. Results: HIPEC and systemic chemotherapy were all successfully performed. There were no surgical deaths or complications such as incisional wound infection, anastomotic leakage and adhesion intestinal obstruction in either group. There were no significant differences in incidence of myelosuppression, nausea, vomiting and liver dysfunction between the two groups (all P>0.05). The 1- and 2-year recurrence rate in HIPEC group were significantly lower than those in control group (2.1% vs. 20.8%; 6.3% vs. 31.3%, P<0.05). There was no difference in 1-year survival rate between the two groups (P>0.05), but the 2-year survival rate was significantly higher in HIPEC group than that in control group (81.3% vs. 58.3%, P<0.05). The ratio of patients with increased score of quality of life in HIPEC group was significantly higher than that in control group (75.0% vs. 25.0%, P<0.05). In HIPEC group, the median survival time of patients with colon cancer was significantly longer than that of patients with rectal cancer (32 months vs. 18 months, P<0.05). Conclusion: Early postoperative HIPEC for T4 colorectal cancer following radical resection is safe and feasible. It can effectively reduce peritoneal recurrence and metastasis, improve the short-term survival and quality of life of the patients, and has no obvious adverse effects.

Abstract:

Objective: To assess the clinical value of X-ray-assisted endoscopic stent placement and laparoscopic resection in treatment of obstructive colorectal cancer. Methods: Seventy-five eligible patients with cancer in the descending colon or rectum presenting with obstruction during January 2007 to December 2013 were selected. Of the patients, 37 cases underwent X-ray- assisted endoscopic stent placement and laparoscopic resection (combination group), and 38 cases were subjected to open resection plus intraoperative colonic lavage (conventional group). The main clinical variables between the two groups were compared. Results: The preoperative data between the two groups of patients were comparable. In combination group, the success rate of stent placement via colonoscopic procedure was 89.19% (33/37) and success rate of laparoscopic operation was 3.94% (31/33), and the 6 cases with operative failure were excluded. Compared with conventional group, except for increased cost of treatment (30 600 yuan vs. 25 500 yuan), the combination group showed significant advantages in intraoperative polyp detection rate (35.48% vs. 7.89%), radical resection rate (83.9% vs. 71.1%), rate of intraoperative preventive terminal ileostomy (6.45% vs. 23.68%), operative time (175.45 min vs. 202.24 min), length of incision (4.88 cm vs. 16.84 cm), number of resected lymph nodes (16.80 vs. 11.92), incidence of overall complications and infection-related complications (16.13% vs. 39.47%; 6.45% vs. 26.32%), length of postoperative hospital stay (7.36 d vs. 11.05 d), rate of second-stage surgery (6.5% vs. 28.9%), and positive rate of polyps at 3 months postoperatively (all P<0.05). There was no statistical difference in 1-, 3- and 5-year survival rate between the two groups (all P>0.05). Conclusion: X-ray-assisted colonoscopy combined with laparoscopic resection for obstructive colorectal cancer is safe and feasible, and it also has ideal radical effects and can reduce the rate of second-stage surgery.

Abstract:

Objective: To evaluate the clinical safety and efficacy of Ti-Ni alloy stent placement through colonoscopy combined with X-ray assistance for advanced colorectal cancer with acute bowel obstruction. Methods: Thirty-five patients with advanced colorectal cancer and acute bowel obstruction underwent palliative treatment by permanent stent placement (stent group), and 35 patients with the same conditions who were subjected to traditional colostomy served as control group. The success rate of operation and clinical effects of the two groups of patients were compared. Results: In stent group, success rate of stent placement was 100%, incidence of postoperative complications was 8.57% (postoperative intestinal perforation in one case and stent obstruction in two cases), patients began ambulation immediately after operation, without creating an artificial anus, and the survival rate was 94.2 % during 1-year followed-up. In control group, the surgical success rate was 100%, incidence of postoperative complications was 31.42% (postoperative pulmonary infection in 5 cases, wound infection in 5 cases, and abdominal infection in 1 case), and the survival rate was 97.1% during 1-year followed-up. The intestinal obstruction was completely resolved in patients of either group after operation, but in stent group compared with control group, the intestinal obstruction was quickly relieved, quality of life was improved, expense was reduced and incidence of complications was decreased and all differences had statistical significance (all P<0.05). Conclusion: Ti-Ni alloy stent placement by colonoscopy combined with X-ray assistance is a safe and effective palliative treatment for advanced colorectal cancer with acute bowel obstruction, with the advantages for patients having less suffering and better quality of life, and it also confers to patients a similar survival time as surgical treatment.

Abstract:Objective: To investigate the clinical efficacy of complete mesorectal excision (CEM) in treatment of stage III colon cancer. Methods: The clinical data of 129 patients with stage III colon cancer were retrospectively analyzed. Of the patients, 62 cases underwent CEM procedure (CEM group), and 67 cases were subjected to traditional colon cancer radical resection (traditional group). The perioperative variables and postoperative recurrence and survival between the two groups of patients were compared. Results: Compared with traditional group, in CEM group the operative time (159.4 min vs. 168.9 min), time to flatus (4.3 d vs. 4.5 d), duration of fasting (5.4 d vs. 5.7 d), retention time of drainage tube (9.4 d vs. 10.0 d), length of hospital stay (15.3 d vs. 16.0 d) and overall incidence of postoperative complications (4.84% vs. 10.45%) showed no statistical difference (all P>0.05), but the intraoperative blood loss was decreased (126.4 mL vs. 155.1 mL, P<0.05) and number of dissected lymph nodes was increased (32.6 vs. 28.3, P<0.05). There was no statistical difference between CEM group and traditional group in either 1- and 2-year recurrence rate (3.23% vs. 5.97%; 14.52% vs. 20.90%) or 1- and 2-year survival rate (98.39% vs. 95.52%; 90.32% vs. 83.58%), (all P>0.05). Conclusion: CEM has similar efficacy as traditional radical surgery in treatment of stage III colon cancer, with advantages of less bleeding and more extensive lymph node dissection.

Abstract:Objective: To investigate the impact of early postoperative chemotherapy on the clinical outcomes in patients with stage III colorectal cancer. Methods: The clinical data of 218 patients with stage III colorectal cancer treated from January 2010 to February 2014 were retrospectively analyzed. According to the time of initiation of chemotherapy, patients were divided into early chemotherapy group (started chemotherapy ≤3 weeks after surgery in 118 cases) or late chemotherapy group (started chemotherapy >3 weeks and ≤8 weeks after surgery in 100 cases). The variables that included progression-free survival, and 2-year survival and recurrence rate, as well as incidence of postchemotherapy adverse reactions and health-related quality of life score between the two groups were analyzed. Results: There was no difference in baseline data between the two groups (all P>0.05). In early chemotherapy group compared with late chemotherapy group, the progression-free survival time was significantly prolonged (876.4 d vs. 765.4 d, P=0.007), 2-year survival rate was somewhat elevated, but the difference reached no statistical significance (89.0% vs. 80.0%, P=0.091), 2-year recurrence rate was significantly reduced (17.0% vs. 34.0%, P=0.004), incidence of each postchemotherapy adverse reaction showed no statistical difference (all P>0.05), and the score for health-related quality of life at 12 months after surgery was significantly increased (71.9 vs. 64.1, P<0.001). Conclusion: For patients with stage III colorectal cancer, early postoperative chemotherapy can effectively prolong the progression-free survival, decrease recurrence and improve the health-related quality of life.

Abstract:Objective: To systematically assess the clinical efficacy of hand-assisted laparoscopic surgery (HALS) and laparoscopic-assisted surgery (LAS) in treatment of colorectal cancer. Methods: The randomized controlled trials and non-randomized comparative studies comparing HALS and LAS for colorectal cancer were collected by searching several national and international databases. After screening for inclusion, quality assessment and data extraction, Meta-analysis was performed by the RevMan 5.3 software. Results: A total of 27 studies involving 3 347 patients were finally included, with 1 626 cases in HALS group and 1 721 cases in LAS group. Results of Meta-analysis showed that in HALS group compared with LAS group, the operative time (WMD=–24.18, 95% CI=–31.61––16.75) was shortened, conversion rate (OR=0.57, 95% CI=0.41–0.81) and incidence of intraoperative injuries (OR=0.48, 95% CI=0.29–0.78) were decreased, the number of trocars used was reduced, but the length of incision (WMD=1.07, 95% CI=0.64–1.50) was increased, and all differences had statistical significance (all P<0.05). There was no statistically significant difference between the two groups in terms of postoperative recovery, incidence of postoperative complications, oncological outcomes, follow-up results, postoperative pain and hospitalization costs (all P>0.05). Conclusion: HALS can be considered as an alternative for colorectal cancer, which combines the advantages of minimal invasiveness of LAS and direct view of open surgery.

Abstract:Objective: To investigate the risk factors for postoperative gastroparesis syndrome (PGS) after colorectal cancer surgery and its diagnostic and treatment strategies. Methods: Clinical data of 806 patients undergoing radical resection of colorectal cancer from January 2013 to September 2014 were collected. The influential factors for occurrence of PGS were statistically analyzed. Results: The incidence of PGS of the whole group was 1.36% (11/806), which occurred in 7 cases with right colon cancer (63.6%), 3 cases with left colon cancer (27.3%) and one case with rectal cancer (9.1%). Univariate analysis indicated that the related factors for PGS included the preoperative blood sugar level (P=0.002), presence or absence of preoperative electrolyte imbalance (P=0.023), having or not having preoperative intestinal obstruction (P=0.009), and time to first postoperative food intake (P=0.018). Multivariate Logistic regression analysis showed that the preoperative blood sugar level (P=0.002) and time to first postoperative food intake (P=0.028). were independent risk factors for PGS. Conclusion: PGS is a functional abnormality of the stomach caused by various factors, so comprehensive interventions should be implemented. Effective blood glucose control and appropriately prolonging the time to postoperative food consumption may be helpful to reduce the occurrence of PGS following radical resection of colorectal cancer.

Abstract:Objective: To investigate whether miR-124 inhibits proliferation and invasion of colon cancer cells by targeted regulation of TET protein family expressions. Methods: The effect of miR-124 on luciferase activity of TET family (TET1, TET2 and TET3) was examined respectively by using a dual-luciferase reporter gene system. The changes in mRNA and protein expressions of TET family in colon cancer HT29 cells after transfection of miR-124 mimics were tested by qRT-PCR and Western blot analysis. The changes in proliferative and invasion abilities of HT29 cells after transfection of miR-124 mimics or TET siRNAs were determined by MTS and Transwell assay, respectively. Results: The results of the dual-luciferase reporter gene assay demonstrated that the 3’UTR of each TET mRNA was specifically matched by miR-124 and their luciferase activities were significantly inhibited (all P<0.05). The mRNA and protein expressions of TET in HT29 cells were significantly down-regulated after miR-124 mimics transfection (all P<0.05). The proliferative and invasion abilities of HT29 cells were significantly reduced after either miR-124 mimics or TET siRNAs transfection (all P<0.05). Conclusion: MiR-124 inhibits proliferation and invasion of colon cancer cells probably through direct regulation of TET expression.

Abstract:Objective: To investigate the effect of up-regulating miRNA-34a expression on growth of human colon cancer cells in vitro. Methods: Human colon cancer HT-29 cells were transfected with artificially synthesized miRNA-34a mimics and negative control sequences respectively. After culture for various times, the cell proliferation was measured by MTT assay, the apoptosis was detected by flow cytometry, and the expression of SIRT1 mRNA and protein was detected by qRT-PCR and Western blot analysis, respectively. Results: Compared with HT-29 cells transfected with negative control sequences, the proliferation of HT-29 cells transfected with miRNA-34a mimics was significantly decreased after 48-h culture; the apoptosis rate was significantly increased, and both expressions of SIRT1 mRNA and protein were significantly down-regulated after 72-h culture, and all differences had statistical significance (all P<0.05). Conclusion: MiRNA-34a can influence the biological behaviors of colon cancer cells probably through regulating expression of its target gene SIRT1, and up-regulating miRNA-34a expression can inhibit the growth of colon cancer cells.

Abstract:Objective: To construct recombinant lentiviral vectors expressing the shRNA against caudal-related homeobox 2 (CDX2) gene, and observe the effect of down-regulation of CDX2 gene expression on growth ability of colon cancer cells. Methods: According to CDX2 mRNA sequence, the shRNA sequences were designed and their complementary sequences were synthesized, which were then inserted into the GV248 vectors by using ligase. Positive clones were verified by DNA sequencing. Lentiviral particles were produced by cotransfection of lentiviral expression vectors with lentiviral packaging plasmids into 293T cells by lipofectamine2000, and then the viral titer was determined by serial dilution. Human colon cancer SW480 and HT29 cells were transfected with the CDX2-shRNA expressing lentiviral vectors, and then the CDX2 mRNA and protein expression were determined by qRT-PCR and Western blot analysis, and the proliferative ability was examined by CCK 8 assay and colony formation assay, respectively. Results: The results of DNA sequencing showed that CDX2-shRNA expression segments were correctly inserted into GV248 vectors, and viral titer was 1×109 TU/mL after packaging. In both SW480 and HT29 cells after transfection of CDX2-shRNA expressing lentiviral vectors, the mRNA and protein expression levels of CDX2 mRNA and protein were significantly down-regulated (all P<0.05), but no significant change was found in cell proliferation and colony forming ability (all P>0.05). Conclusion: CDX2-shRNA expressing lentiviral vectors are successfully constructed and their transfection can effectively inhibit CDX2 gene expression. Down-regulation of CDX2 gene expression exerts no obvious effect on growth of colon cancer cells.

Abstract:Objective: To investigate the effect of sodium citrate (SCT) on promoting apoptosis in gastric cancer cells and its mechanism. Methods: Gastric cancer MGC-803 cells were exposed to SCT (5, 10, 20 mmol/L) or 5-FU (0.5 mmol/L) respectively, using untreated MGC-803 cells as negative control. Then, the cell cycle distribution and apoptotic rate were analyzed by flow cytometry, the intracellular lactate content, phosphofructokinase-1 (PFK-1) activity and adenosine triphosphate (ATP) level were examined by colorimetric assay, and the expression of Bcl-2, Bax, caspase-3 and Cyt-c in MGC-803 cells were determined by Western blot analysis. Results: In SCT treated MGC-803 cells compared with negative control cells, the apoptosis and G2/M arrest were significantly increased, the intracellular lactate content, PFK-1 activity and ATP level were significantly reduced and Bcl-2 expression was significantly down-regulated, while the expressions of Bax, caspase-3 and Cyt-c were significantly up-regulated (all P<0.05). 5-FU exerted no significant effect on lactate content and PFK-1 activity in MGC-803 cells (all P>0.05), but all other effects were similar to those of SCT. Conclusion: SCT can promote apoptosis in MGC-803 cells, and the mechanism may be associated with its reducing glycolysis via inhibiting PFK-1 activity and activating mitochondria-dependent apoptotic pathway.

Abstract:Objective: To investigate the role of glycogen synthase kinase 3β (GSK-3β) in cadherin 17 (CDH17)-mediated of gastric cancer cell invasion and the mechanism. Methods: Gastric cancer MKN-45 cells were transfected with CDH17 siRNA or exposed to GSK-3β inhibitor SB216763 respectively, with untreated and empty vector transfected MKN-45 cells as blank control and negative control, respectively. The changes in GSK-3β, β-cantenin and NF-κB (p50/p65) expressions and invasion ability of each group of cells were determined. Results: Compared with blank control cells, in MKN-45 cells transfected with CDH17 siRNA, the CDH17, phosphorylated GSK-3β, β-cantenin and p50/p65 expressions were significantly decreased, and the number of invaded cells was significantly reduced (all P<0.05). In MKN-45 cells exposed to SB216763, the CDH17 and β-cantenin expressions showed no significant difference (both P>0.05), while the phosphorylated GSK-3β and p50/p65 expressions were significantly decreased, and number of invaded cells was significantly reduced (all P<0.05). In MKN-45 cells transfected with empty vectors, all parameters showed no significant change (all P>0.05). Conclusion: In the signaling pathway of CDH17-medated gastric cancer cell invasion, GSK-3β may be an important molecule downstream to β-cantenin for regulating NF-κB activity through its phosphorylation level.

Abstract:Objective: To investigate expressions of Notch1, Notch3 and Hes1in gastrointestinal stromal tumors(GIST) and their clinical significance. Methods: The tissue specimens of 48 cases of resected GIST and tissue specimens of gastrointestinal tissue adjacent to 48 cases of GIST were collected. The protein expressions of Notch1 and Notch3 along with the down-steam target gene Hes1 were determined by immunohistochemical staining, and the relations of each protein expression with the clinicopathologic factors of GIST patients were also analyzed. Results: IIn GIST tissue compared with its adjacent gastrointestinal tissue, the positive expression rate of either Notch1 (58.33% vs. 29.17%), Notch3 (97.97% vs. 35.47%) or Hes1 (35.47% vs. 10.42%) protein was significantly increased (all P<0.05). After comparison of the positive expression rate of each protein between or among groups of GIST patients stratified by gender, age, tumor site, tumor size and NIH risk classification, the results showed that Notch1 expression was significantly associated with NIHrisk classification (χ2=16.53, P=0.001), Notch3 expression was irrelevant to any of the above factors (all P>0.05) and Hes1 expression was significantly related to tumor size (χ2=7.78, P=0.02). Conclusion: The expressions of Notch signaling pathway related proteins are increased in GIST tissue, which may play an important role in the occurrence and development of GIST.

Abstract:Objective: To investigate the therapeutic effect of duodenal-jejunal bypass (DJB) surgery on type 2 diabetes mellitus (T2DM) in rats and the mechanism. Methods: Rats with T2DM induced by high-fat diet and low-dose streptozotocin injection were randomly divided into DJB group or sham operation group, with 15 rats in each group. The changes in body weight, fasting blood glucose and lipid profiles before and after operation in both groups were examined. At 8 weeks after operation, the specimens of intestinal Roux loop in rats of DJB group and corresponding intestinal segment in rats of sham operation group were harvested and weighed, and then the mRNA and protein expressions of the key enzymes involved in glucose and lipid metabolism were determined by RT-PCR and Western blot analysis. Results: There was no significant difference in fasting blood glucose and lipid levels and body weight between the two groups before operation (all P>0.05). In DJB group compared with sham operation group after operation, the fasting blood glucose level and each lipid index were significantly decreased (all P<0.05), but body weight showed no significant change (2.025 g vs. 0.702 g), the weight of intestinal Roux loop was significantly increased and both mRNA and protein levels of the key enzymes for glucose and lipid metabolism were significantly increased (all P<0.05). Conclusion: DJB can effectively reduce glucose and lipid levels in T2DM rats, and this effect may probably contribute to the alteration in metabolic patterns of the small intestine itself after operation.

Abstract:Objective: To compare the efficacy and impact on immune system of total laparoscopic and open distal radical gastrectomy with D2 dissection. Methods: The clinical data of patients with distal gastric carcinoma treated from 2009 to 2013 were retrospectively analyzed, and finally 78 cases were selected according to the inclusion and exclusion criteria. Of the patients, 38 cases underwent totally laparoscopic D2 radical gastrectomy (TLDG group), and 40 cases were operated with open distal D2 radical gastrectomy (ODG group). The parameters for efficacy and immune function between the two groups after the operation were compared. Results: In TLDG group compared with ODG group, the overall operative time (229.3 min vs. 197.7 min) and time for digestive tract reconstruction (27.6 min vs. 18.5 min) were significantly prolonged, but the intraoperative blood loss (99.5 mL vs. 175.3 mL), time to first postoperative flatus (3.6 d vs. 4.7 d), and theoretical postoperative discharge time (10.7 d vs. 14.7 d) were all significantly reduced (all P<0.05), while there was no statistical significance in the number of dissected lymph nodes, the distance of proximal margin, incidence of postoperative complications, follow-up rate, recurrence and metastasis rate, and 2-year survival rate between the two groups (all P>0.05); the white blood cell count, and IL-6 and CRP levels determined at postoperative day 1 and 7 were all significantly decreased (all P<0.05). Conclusion: Totally laparoscopic distal gastrectomy has the advantages of minimal invasiveness, less influence on immune function, and faster recovery. So it is a safe, feasible and effective procedure.

Abstract:

Objective: To assess the safety and efficacy of performing laparoscopic-assisted radical gastrectomy in patients with a history of prior abdominal surgery. Methods: The literature of studies comparing laparoscopy-assisted gastrectomy for patients with and without previous abdominal surgery was searched in several databases since their inception. After literature screening based on the inclusion criteria and exclusion criteria, data extraction and quality assessment, Meta-analysis was performed by Revman 5.3 software. Results: Five articles with 6 studies were finally included, involving a total of 982 patients, of whom 286 cases had a history of abdominal surgery and 696 cases did not. Results of this Meta-analysis indicated that in patients with previous history of abdominal surgery compared with those without history of abdominal surgery, the operative time was prolonged (WMD=15.51, 95% CI=12.74–18.28, P<0.05), but all other variables that included intraoperative blood loss (WMD=–0.36, 95% CI=–9.65–8.92), status of intraoperative lymph node dissection (WMD=1.78, 95% CI=–2.36–5.92), length of hospitalization (WMD=0.65, 95% CI=–0.33–1.62), and incidence of postoperative complications (OR=1.63, 95% CI=0.97–2.75) had no statistical difference (all P>0.05). Conclusion: History of abdominal surgery exerts no significant influence on performing laparoscopic-assisted gastrectomy, so this procedure is safe and feasible.

Abstract:Objective: To assess the clinical value of double contrast-enhanced ultrasonography (DCEUS) of the stomach combined with determination of serum macrophage inflammatory protein 1 (MIP-1) and vascular cell adhesion molecule 1 (VCAM-1) in preoperative staging for gastric cancer. Methods: Six-hundred and eighty-five patients with gastric cancer underwent gastroscopy and DCEUS examination for preoperative staging, and meanwhile, their preoperative MIP-1 and VCAM-1 levels were measured by ELISA assay. According to the results of postoperative pathological tumor staging, the accuracy in preoperative stage estimation of gastric carcinoma between DCEUS and DCEUS plus MIP-1 and VCAM-1 measurement was compared. Results: The sensitivity (specificity) of DCEUS in estimating T stage of gastric cancer was 93.10% (92.05%) for T1, 67.47% (65.50%) for T2, 78.62% (80.47%) for T3 and 91.41% (90.70%) T4 respectively, with an overall accuracy rate of 80.15%, in estimating N stage was 90.55% (80.99%) for N0, 63.57 % (73.87%) for N1, 88.40% (92.50%) for N2 and 82.35% (73.68%) for N3 respectively, with an overall accuracy rate of 82.92%, and in estimating M stage was 99.29% (84.82%) for M0 and 71.48% (98.43%) for M1 respectively, with an overall accuracy rate of 88.61%. Both serum levels of MIP-1 and VCAM-1 were significantly related to the degree of invasion, lymphatic metastasis, distant metastasis and pathological stage of gastric carcinoma (all P<0.05). The sensitivity (specificity) of DCEUS plus MIP-1 and VCAM-1 measurement in estimating T stage of gastric cancer was 93.10% (92.05%) for T1, 87.95% (94.19%) for T2, 95.07% (92.33%) for T3 and 91.41% (90.70%) for T4 respectively, with an overall accuracy rate of 92.41%, in estimating N stage was 98.43% (96.90%) for N0, 89.15% (94.26%) for N1, 95.22 % (95.22%) for N2 and 92.65% (89.36%) for N3 respectively, with an overall accuracy rate of 94.16%, and in estimating M stage was 99.76% (97.68%) for M0 and 96.20%(99.61%) for M1 respectively, with an overall accuracy rate of 98.39%. The overall accuracy rates of DCEUS plus MIP-1 and VCAM-1 measurement in estimating either T, N or M stage of gastric cancer was significantly higher than that of DCEUS alone (all P<0.05). Conclusion: Serum levels of MIP-1 and VCAM-1 are closely related to pathological stage of gastric cancer, and DCEUS in combination with MIP-1 and VCAM-1 detection may help increase the accuracy rate of preoperative staging of gastric cancer.

Abstract:Objective: To evaluate the feasibility and safety of laparoscopic resection for gastric stromal tumors. Methods: The data of patients who underwent surgical resection for gastric stromal tumors and met the study requirements from January 2010 to January 2016 were collected. Patients undergoing laparoscopic and open surgery were matched in a 1:1 ratio according to the tumor location, with 36 cases each in laparoscopic group and open surgery group finally enrolled. The main clinical variables between the two groups of patients were compared. Results: The general data of the two groups of patients were comparable. The tumor in 5 cases was located near the cardia of the stomach, in 12 cases located at the lesser curvature of the stomach and in 13 cases located in the body or fundus of the stomach. The type of gastric resection performed in the laparoscopic and open surgery group (gastric wedge resection: 26 cases vs. 23 cases; gastric partial resection: 8 cases vs. 10 cases) had no statistical difference (P<0.05). In laparoscopic group compared with open surgery group, the average operative time and intraoperative blood loss were reduced (114 min vs. 140 min; 90 mL vs. 138 mL), the average time to flatus and oral liquid food intake as well as length of postoperative hospital stay were shortened (2.6 d vs. 3.1 d; 4.1 d vs. 5.3 d; 6.0 d vs. 8.3 d), and incidence of overall perioperative complications was decreased (0.0% vs. 16.7%), and all differences had statistical significance (all P<0.05). There was no statistical difference in postoperative pathological variables, recurrence rate, and overall survival and disease free survival rate between the two groups (all P>0.05). Conclusion: For primary gastric stromal tumor, laparoscopic surgery is safe and feasible, and compared with open surgery, it has the advantages of less trauma, few complications and quicker recovery of the patients under the condition of same tumor location.

Abstract:Objective: To compare the clinical efficacy of laparoscopic transabdominal preperitoneal (TAPP) herniorrhaphy and Lichtenstein onlay patch repair for inguinal hernia. Methods: The clinical data of 120 patients with inguinal hernia undergoing surgical treatment from December 2013 to December 2015 were retrospectively collected. Of the patients, 53 cases received laparoscopic TAPP repair (TAPP group) and 67 cases underwent Lichtenstein procedure (Lichtenstein group). The main clinical variables between the two groups of patients were analyzed and compared. Results: In TAPP group compared with Lichtenstein group, the operative time (52.2 min vs. 79.6 min), time to postoperative food intake (12.2 h vs. 20.5 h) and ambulation (9.6 h vs. 21.8 h) as well as length of hospital stay (3.9 d vs. 6.1 d) were all reduced (all P<0.05). The cost of treatment (6 632.7 yuan vs. 3 853.7 yuan) was increased (P<0.05). No statistical difference was noted in intraoperative blood loss, incidence of postoperative complications and recurrence rate between the two groups (all P>0.05). Conclusion: For inguinal hernia, laparoscopic TAPP repair is less invasive compared with Lichtenstein technique, and is also safe and reliable. So it is a favorable treatment option in clinical practice.

Abstract:

Colorectal cancer (CRC) results from multistep and multifactorial processes and is associated with the influences of multiple genes. Recent studies demonstrated that microRNAs (miRNAs) have close relation with the regulation of gene expressions in oncogenesis of CRC. MiRNAs can regulate proteins through their target genes, and these proteins controlled by miRNAs can also in turn modulate the expression of miRNAs, which establishes a complex regulatory network that plays an important role in occurrence and development of tumors. MiR-101 has been found down-regulated in CRC, and regulating the proliferation, invasion and metastasis of CRC cells through multiple target sites and pathways. In this article, the authors address the role of miR-101 in formation and progress of CRC.

Abstract:Abdominoperineal resection (APR) is a standard procedure for low rectal cancer. However, avoiding a permanent colostomy thereby improving the quality of life has long been a desire of patients as well as a great challenge to surgeons. Total anorectal reconstruction (TAR) after APR is to prevent those changes in physical appearance and defecation function resulting from permanent colostomy by various reconstructive procedures to reconstruct rectum and the function of internal and external sphincters. Here, the author presents the current status and progress in this field.

Abstract:In recent years, hyperthermia as a treatment method for malignant tumors, has been widely used in clinical settings. Hyperthermia can effectively prevent the recurrence and metastasis of malignant tumors, and improve the quality of life and prolong the survival period of the patients, but the anticancer mechanism of hyperthermia is not clear. For gaining insight into the mechanism of action of hyperthermia against malignant tumors, the authors, in this paper, summarize the recent researches about hyperthermia and eukaryotic translation initiation factor 5A (eIF5A), which demonstrate that eIF5A has a relative high expression in colorectal cancer, gastric cancer and other malignant tumors, and plays an important role in promoting the proliferation, invasion and metastasis of tumor cells, and eIF5A expression level declines in different degrees in gastric cancer and colon cancer cells after hyperthermia, indicating that eIF5A may play an important role in the action of hyperthermia on malignant tumors.

Abstract:Tumor protein D52 (TPD52), which is involved in tumor cell proliferation, invasion, metastasis, inhibition of DNA repair and induction of protective immunity against tumor, is overexpressed in various cancers, such as breast cancer, prostate cancer, lung cancer, ovarian cancer and blood system malignant lesions. TPD52 is one of the most promising candidate proteins relating to tumor diagnosis and targeted therapy. This paper intends to review the roles of TPD52 in tumor occurrence, development and its potential application value in tumor diagnosis and molecular targeted therapy, with the purpose of specifying the further study direction of TPD52 and achieving its better clinical application value.