ObjectiveTo study feasibility of sheath technique with seromuscular sleeve of pedicled colon in preventing anastomotic leakage following laparoscopic anterior resection of rectal cancer.MethodsThe clinical data of patients who underwent laparoscopic anterior resection of rectal cancer in our hospital from January 2017 to March 2020 were retrospectively collected. According to different surgical methods, they were divided into two groups: pedicled seromuscular sleeve sheath group (referred to as sleeve sheath operation group) and traditional operation group. The intraoperative and postoperative statuses were compared between these two groups.ResultsIn this study, 87 patients with rectal cancer were included, 37 in the sleeve sheath operation group and 50 in the traditional operation group. There were no significant differences in the baseline data such as the gender, age, body mass index (BMI), complicating disease, distance from lower tumor margin to anal verge, histological classification, neoadjuvant radio- chemotherapy, and TNM stage between the two groups (P>0.05). There were no significant differences in the volumes of intraoperative blood loss, the number of lymph node dissection, the first postoperative anal exhaust time and the hospitalization expense between the two groups (P>0.05). Compared with the traditional operation group, the operative time of the sleeve sheath operation group was longer (P<0.05), the postoperative hospitalization time of the sleeve sheath operation group was shorter (P<0.05). The incidence of postoperative anastomotic leakage in the sleeve sheath operation group and the traditional group were 0.0% (0/37) and 12.0% (6/50), respectively, and the difference was statistically significant (P<0.05). There were no significant differences in the anastomotic stenosis, the lymphatic fistula and the incision infection between the two groups (P>0.05). All patients were followed-up for 6 to 36 months, with a median time of 21 months. No recurrence or death occurred.ConclusionThe sheath technique with seromuscular sleeve of pedicled colon can increase the anti tension ability of anastomotic stoma and reduce the incidence of anastomotic leakage, which is a safe and effective surgical method.
Objective To investigate the surgical techniques for management of left colon carcinoma obstruction. MethodsThe techniques used in left colon carcinoma obstruction and the corresponding efficiencies reported in foreign literatures were reviewed. ResultsThe surgical techniques for management of left colon carcinoma obstruction involve palliative operation, staged operation and onestage operation. These methods had their own virtues as well as shortages. But on all accounts, onestage operation was favorable for both the patients and docters. ConclusionDifferent methods for management of left colon carcinoma obstruction have different adaptation index, first you must ensure safety, then you should try your best to do onestage operation.
ObjectiveTo investigate effect of Notch pathway regulating by inhibiting expression of forkhead box protein A1 (FOXA1) on proliferation and invasion of colon cancer SW480 cells. MethodsThe colon cancer tissues and their corresponding paracancerous tissues of 45 patients with colon cancer admitted to the First Affiliated Hospital of Henan University of Science and Technology from June 2019 to February 2021 were selected. The immunohistochemistry and real-time fluorescent quantitative PCR (qRT-PCR) methods were used to detect the expressions of FOXA1 protein and mRNA in the tissues, respectively. In addition, SW480 cells were divided into control group (untreated), shRNA-NC group (transfected with shRNA-NC), sh-FOXA1 group (transfected with sh-FOXA1), sh-FOXA1+sodium valproate group (Add 8 mmol/L Notch pathway activator sodium valproate after transfection with sh-FOXA1). Then the qRT-PCR, MTT, clone formation test, and Transwell methods were used to detect the expressions of FOXA1 mRNA, proliferation, clonogenic ability, invasion and migration of cells in each group. Western blot method was used to detect the proliferation (c-Myc, cyclinD1), invasion and migration [matrix metalloproteinase (MMP）9, MMP2], epithelial-mesenchymal transition (Vimentin, N-cadherin, E-cadherin) and Notch pathway (Notch-1, Hes-1) related protein expressions of cells in each group. Results① In the clinical cases, the expression levels of FOXA1 protein and mRNA in the colon cancer tissues were higher than those in the corresponding paracancerous tissues (protein: 0.085±0.028 vs. 0.034±0.010, t=11.036, P<0.001; mRNA: 1.62±0.34 vs. 1.00±0.09, t=11.671, P<0.001). ② In the cell experiment, compared with the control group and shRNA-NC group, the cell survival rate, and numbers of cloned cells, invasion and migrating cells were significantly reduced (P<0.05), correspondingly, the related proteins expression levels of c-Myc, cyclinD1, MMP9, MMP2, Vimentin, N-cadherin, Notch-1, Hes-1 were significantly reduced (P<0.05) and the protein expression level of E-cadherin was significantly increased (P<0.05) in the sh-FOXA1 group, which were reversed after adding the Notch pathway activator sodium valproate (P<0.05). ConclusionFOXA1 highly expresses in colon cancer tissues and colon cancer cells and it might promote the proliferation, invasion and migration of SW480 cells by activating the Notch pathway.
ObjectiveTo investigate the effects of overexpression of alpha/beta hydrolase domain-containing protein 5 (ABHD5) on the invasion and migration of human colon cancer cell line HCT116 and the pathway of adenosine monophosphate-activated protein kinase (AMPK)/mechanistic target of rapamycin (mTOR).MethodsThe expression of ABHD5 in colon cancer tissues and its relationship with clinicopathological features was analyzed by UALCAN database. HCT116 cells were cultured in vitro and transfected with ABHD5 recombinant plasmid, then they were divided into control group, negative transfection group and ABHD5 transfection group. Real time quantitative PCR (qRT-PCR) was used to detect the expression of ABHD5 mRNA in HCT116 cells. The proliferation of HCT116 cells was detected by CCK-8 method. Transwell assay was used to detect the invasion and migration of HCT116 cells. The expression of matrix metalloprotein 9 (MMP-9), E-cadherin, Snail, and AMPK/mTOR pathway proteins p-AMPK, AMPK, p-mTOR and mTOR were detected by Western blot.ResultsThe results of the UALCAN showed that compared with normal colon tissues, the expression of ABHD5 mRNA in colon cancer tissues was decreased (P<0.05), and which in the adenocarcinoma and the N1 stage was lower than that of the mucinous adenocarcinoma (P<0.05) and N0 stage (P<0.05), respectively. Compared with the control group and the negative transfection group, the expression of ABHD5 mRNA in the ABHD5 transfection group was increased (P<0.05), the proliferation inhibition rate of HCT116 cells in the ABHD5 transfection group was increased (P<0.05), the numbers of migration and invasion cells in the ABHD5 transfection group were decreased (P<0.05), the expressions of MMP-9, Snail, p-mTOR and mTOR were reduced, and the expressions of E-cadherin, p-AMPK and AMPK were increased (P<0.05).ConclusionsThe overexpression of ABHD5 can inhibit the invasion and migration of colon cancer HCT116 cells, activate AMPK, and inhibit the expression of mTOR. It suggests that ABHD5 may play a role in inhibiting colon cancer by affecting AMPK/mTOR pathway.
Objective To determine feasibility of texture analysis of CT images for the discrimination of hepatic epithelioid hemangioendothelioma (HEHE) and liver metastases of colon cancer. Methods CT images of 9 patients with 19 pathologically proved HEHEs and 18 patients with 38 liver metastases of colon cancer who received treatment in West China Hospital of Sichuan University from July 2012 to August 2016 were retrospectively analyzed. Results Thirty best texture parameters were automatically selected by the combination of Fisher coefficient (Fisher)+classification error probability combined with average correlation coefficients (PA)+mutual information (MI). The 30 texture parameters of arterial phase (AP) CT images were distributed in co-occurrence matrix (22 parameters), run-length matrix (1 parameter), histogram (4 parameters), gradient (1 parameter), and autoregressive model (2 parameters). The distribution of parameters in portal venous phase (PVP) were co-occurrence matrix (18 parameters), run-length matrix (2 parameters), histogram (7 parameters), gradient (2 parameters), and autoregressive model (1 parameter). In AP, the misclassification rates of raw data analysis (RDA)/K nearest neighbor classification (KNN), principal component analysis (PCA)/KNN, linear discriminant analysis (LDA)/KNN, and nonlinear discriminant analysis, and nonlinear discriminant analysis (NDA)/artificial neural network (ANN) was 38.60% (22/57), 42.11% (24/57), 8.77% (5/57), and 7.02% (4/57), respectively. In PVP, the misclassification rates of RDA/KNN, PCA/KNN, LDA/KNN, and NDA/ANN was 26.32% (15/57), 28.07% (16/57), 15.79% (9/57), and 10.53% (6/57), respectively. The misclassification rates of AP and PVP images had no statistical significance on the misclassification rates of RDA/KNN, PCA/KNN, LDA/KNN, and NDA/ANN between AP and PVP (P>0.05). Conclusion The texture analysis of CT images is feasible to identify HEHE and liver metastases of colon cancer.
Objective To approach the inhibitory effect of Iodine-125 (125I) on moderately differentiated adenocarcinoma of colon by establishing the nude mice model bearing subcutaneous tumor of SW480 cell. Methods The moderately differentiated adenocarcinoma of colon cells (SW480) were implanted subcutaneously to the nude mice. The bearing tumor nude mice were randomly divided into study group (n=24) and control group (n=24) by using method of random sampling. One blank particle was implanted into the mouse of the control group, a 1.48×107 Bq dosage 125I particle was implanted into the mouse of the study group, then the growth of tumor was observed after implantation. Six bearing tumor nude mice were sacrificed and the tumors were obtained on day 7, 14, 21, and 28 after implantation, respectively. The expression of proliferating cell nuclear antigen (PCNA) was detected by immunohistochemistry SP method. The cell apoptosis was determined by TUNEL method. Results As the accumulation of radiation time, the volume of tumor in the study group was smaller than that in the control group on day 10 after implantation (Plt;0.05). The PCNA labeling index in the study group was lower than that in the control group on day 14 after implantation (Plt;0.05). The apoptotic index in the study group was higher than that in the control group on day 21 after implantation (Plt;0.05). Conclusion Persistent low dose 125I radiation could down-regulate the expression of PCNA, and induce the apoptosis of moderately differentiated adenocarcinoma of colon cell, which might be a mechanism of inhibiting the proliferation of moderately differentiated adenocarcinoma of colon.
摘要:目的：回顾性分析比较左半结肠癌急性梗阻一期手术与同期左半结肠癌根治术患者的手术临床资料,探讨左半结肠癌急性梗阻一期手术的可行性。方法： 回顾性将我中心2004年1月至2007年3月收治的59例左半结肠癌急性梗阻一期手术病例分为A组,将同期226例左半结肠癌根治术病例分为B组,比较两组之间清除淋巴结数、术后进食时间、吻合口漏发生率、肺部感染率、切口感染率、住院时间、复发和转移率。结果： 在上述观察指标中,在A组分别为（133±18）枚,（36±09）d,1/59（169%）,4/59（678%）,2/59（339%）,(124±09)d,6/59（1017%）；B组分别为128±15,32±08,1/226（044%）,8/226（354%）,6/226（265%）,117±15,23/226（1062%）；经统计学处理,两组间没有显著性差异。结论：术中合理应用结肠灌洗,良好的手术技巧,术后积极辅助治疗,左半结肠癌急性梗阻一期手术是安全可行的,可避免二次手术带给患者的痛苦,术后并发症也无明显增加。Abstract: Objective: Retrospective analysis and comparison of acute obstruction of left colon cancer onestage surgery and the same period a radical mastectomy in patients with left colon cancer surgery clinical data,To study the possibility of acute obstruction of left colon cancer onestage surgery. Methods:A retrospective of my center from January 2004 to March 2007 were treated 59 cases of acute obstruction of left colon cancer onestage surgery patients were divided into A group, will be left over the same period 226 cases of radical resection of colon cancer patients were divided into group B, compare the number of lymph nodes removed between the two groups, after the consumption of time, the incidence of anastomotic leakage, pulmonary infection, incision infection, length of stay, recurrence and metastasis rate. Results: Observed in the above indicators, in the A group were 133±18,36±09,1/59 (169%),4/59 (678%), 2/59 (339%),124±09,6/59 (1017%); B group were 128±15,32±08,1/226 (044%), 8/226 (354%), 6/226 (265%), 117±15,23/226 (1062%); Statistical analysis between the two groups there was no significant difference. Conclusion: Rational application of intraoperative colonic irrigation, good surgical technique, postoperative adjuvant treatment of active, acute obstruction of left colon cancer onestage surgery is a safe and feasible, it may avoid the second operation to bring the patient’s pain, postoperative complications and no increased significantly.
ObjectiveTo investigate the most appropriate culture time with the action of EGF in colon cancer stem cells enrichment by suspension culture.MethodsDLD-1 cells were cultured in serum-free medium containing 20 ng/mL EGF to generate spheroid cells. The time gradient was set to 10 d, 20 d, 30 d and 40 d, the cell proportion of CD133+, CD44+ and CD133+CD44+ were confirmed by flow cytometery. The ability of self-renewal was detected by the sphere forming assay and the limited dilution assay, and the in vitro tumorigenicity of the cells was detected by the colony formation assay.ResultsIn the 30 d group, the proportion of CD133+ and CD133+ CD44+ cells were significantly higher than those in the other groups (allP<0.05), the CD44+ cell was higher than that in the 20 d group (P<0.05), but there was no significant difference with the other two groups (P>0.05). The results of the limited dilution assay and the colony formation assay, the number of spheres in the 30 d or 40 d group was the highest among the 4 groups, and there was no statistical difference between the 30 d group and 40 d group (P>0.05), with statistically significant difference between the 30 d, 10 d and 20 d groups (all P<0.05). The results of the sphere forming assay and the self-renewal ability of 30 d group was significantly higher compared with other groups (all P< 0.05).ConclusionThe cancer stem cells could be enriched more efficiently by suspension culture using 20 ng/mL EGF for 30 days.
Objective To investigate the features of extracolonic carcinoma spectrum in Northeast Chinese with hereditary nonpolyposis colorectal cancer. Methods The extracolonic carcinoma spectrum’s characteristics of 85 families registered in strict conformity with the HNPCC Amsterdam criteriaⅡwere analyzed retrospectively. Results In the 85 HNPCC families， the tumorous patients were 509 cases，the primary tumors were 589 cases， among the total consisted of 219 cases of colon cancer， 91 cases of rectal cancer，and 279 cases of extracolonic cancer， the most common extracolonic carcinoma was lung cancer. Conclusions Extracolonic carcinoma is an important part of cancer spectrum in HNPCC family， and the common extracolonic carcinoma in Northeast of Chinese are lung cancer， gastric cancer， endometrial cancer， liver cancer， and esophagus carcinoma.
Objective To investigate the effectiveness and mechanism of recombinant human granulocyte-macrophage colony-stimulating factor (rhGMCSF) gel on wound debridement and healing of deep II thickness burn. Methods Between December 2008 and December 2010, 58 patients with deep II thickness burn, accorded with the inclusive criteria, were collected. There were 36 males and 22 females with an average age of 32.4 years (range, 12-67 years). The causes were hot liquid in 38 cases and fire in 20 cases. The time from injury to treatment was 1-3 days (mean, 2.1 days). In this randomized, double-blind, and self-control study, all patients were randomly divided into 2 groups, wounds were treated with rhGMCSF gel (test group) or gel matrix (control group). There was no significant difference in wound area between 2 groups (P gt; 0.05). The time of completed removal eschar and the percentage of removal-area of eschar were recorded at 2, 6, 10, 14, and 18 days during healing process. The time of wound healing was also recorded. Results Compared with control group, the necrotic tissues on the burn wound got soft in test group at 4 days after treatment. At 6 days, they loosened and eventually sloughed off. The wound bed presented in red and white, followed by rapidly growing granulation tissues. Except 18 days after treatment, there were significant differences in the percentage of removal-area of eschar between 2 groups (P lt; 0.05). The time of completed removal eschar in test group [(7.71 ± 2.76) days] was significantly shorter than that in control group [(14.71 ± 3.63) days] (t=13.726, P=0.000). The time of wound healing in test group was (18.41 ± 2.47) days, which was significantly shorter than that in control group [(23.58 ± 3.35) days] (t=15.763, P=0.000). Conclusion Compared with the gel matrix, the rhGMCSF gel may promote wound debridement and healing in deep II thickness burn.