Objective To investigate the operation timing of laparoscopic cholecystectomy (LC)after endoscopic sphincterotomy (EST).Methods A total of 240 patients with cholecystolithiasis and choledocholithiasis received EST combined with LC.They were divided into 3 groups by random digits table method with 80 cases each:3 days after EST(group A),7 days after EST(group B),and 30 days after EST (group C).Intraoperative and postoperative clinical data were compared among three groups.Results The operation time of LC in group B [(52.5 ± 6.4) min] was longer than that in group A and group C [(35.8 ± 5.7),(34.6 ± 2.6) min],and there was significant difference (P ＜ 0.01).The intraoperative conversion rate in group B [10.0 ％ (8/80)] was higher than that in group A and group C [1.3 ％ (1/80),1.3 ％ (1/80)],and there was significant difference (P ＜ 0.05).The amount of bleeding in group B [(51.7 ± 4.8) ml] was larger than that in group A and group C [(27.9 ± 6.4),(28.2 ± 3.6) ml],and there was significant difference (P ＜ 0.01).The cost of hospitalization in group C [(15 361.2 ± 1 007.8) yuan] was more than that in group A and group B [(10 085.1 ± 695.4),(10 632.4 ± 855.9) yuan],and there was significant difference (P＜ 0.01).Conclusion LC performed 3 days after EST can reduce the operation difficulty and conversion rate,and shorten the operation time,and this modality is safe and effective.

Objective To investigate the potential value of miR-141 as a diagnostic blood biomarker expression level in patients with colorectal cancer(CRC)and its change after radical CRC resection.Methods 75 CRC patients admitted to Affiliated to Medical College of Xi'an Jiaotong University 3201 Hospital from April 2019 to March 2021 were included in the experimental group,and 20 patients who received planned surgery for inguinal hernia during the same period were used as non-cancer control group.Surgical tissue and serum samples of these patients were collected.Microarray analysis was performed for miRNAs with significant expression differences in CRC tissues and serum.Real-time quantitative PCR(qRT-PCR)was used to verify the expression level of miR-141 in serum samples of the patients before surgery and at the 3rd day after surgery,and the relationship between miR-141 and clinicopathological characteristics of CRC patients was analyzed.Results By miRNA microarray analysis,we confirmed that 12 miRNAs were up-regulated simultaneously in tissue and serum samples of CRC patients,among which miR-141 was the most significantly up-regulated.Meanwhile,the relative expression level of miR-141 in serum of CRC group was significantly higher than that of non-cancer control group after qRT-PCR verification[2.50(1.06,3.12)vs.0.97(0.68,1.21),Z=-5.842,P＜0.05].According to ROC curve analysis,the AUC value of preoperative serum miR-141 for the diagnosis of CRC was 0.927(95％CI:0.862～0.992).When serum miR-141 ≥ 1.418,the accuracy of distinguishing between CRC and non-cancer control groups was 90.53％.Combined detection of serum miR-141 could increase the diagnostic AUC value of carcinoembryonic antigen and carbohydrate antigen-199 to 0.944(95％CI:0.899-0.998).For CRC patients,the relative expression level of serum miR-141 after radical resection was significantly lower than that before surgery[1.85(1.29,2.22)vs.2.55(2.07,3.18),Z=-5.416,P＜0.001].For those who did not receive radical resection,the relative expression level of serum miR-141 after surgery was slightly lower than that before surgery[2.28(1.72,2.74)vs.2.45(2.06,2.85)],but the difference was not statistically significant(Z=-1.917,P=0.055).The expression level of Mir-141 in serum of CRC patients was correlated with UICC stage and histological grade(P＜0.05).Conclusion Serum miR-141 reflects the pathological changes of CRC patients and can be used as a biomarker for non-invasive diagnosis of CRC.

[Abstract] Objective: To investigate the effect and mechanism of sevoflurane on the proliferation and invasion of colon cancer SW480 cells and the growth of transplanted tumor in nude mice by regulating the phosphorylation of PI3K. Methods: Colon cancer SW480 cells were treated with sevoflurane and randomly divided into control group, 0.5% sevoflurane group, 1.0% sevoflurane group and 2.0% sevoflurane group for subsequent experiments. The proliferation ability of SW480 cells was detected by Clone formation assay, mRNA expression levels of MDM2 and survivin in cells were detected by RT-PCR, invasion ability of cells was detected by Transwell assay, and protein expression levels of MDM2, survivin, VEGF, PI3K, p-PI3K, AKT and p-AKT were detected by Western blotting. PI3K activator 740Y-P was added for verification. SW480 cell transplanted tumor model was constructed on nude mice, and the tumor mass was weighed. The positive expression rates of MDM2 and VEGF in the transplanted tumor tissues were detected by Immunohistochemistry. Results: As compared with the control group and the low-dose group, the clone formation rate of SW480 cells and the number of invaded cells in the 1.0% and 2.0% sevoflurane groups were significantly decreased (all P<0.01), the mRNA and protein levels of MDM2 in the cells were significantly increased (all P<0.01), while the mRNA and protein levels of survivin were significantly decreased (all P<0.01); and the protein levels of VEGF, p-PI3K/PI3K and p-AKT/AKT were significantly decreased (all P<0.01). 740Y-P could reverse the effect of sevoflurane on the proliferation, invasion and expression of proteins associated with the PI3K/AKT signaling pathway in SW480 cells. The mass of transplanted tumor in 2.0% sevoflurane group was significantly decreased (P<0.01), and the positive MDM2 expression rate in tumor tissues was significantly increased (P<0.01), while the positive VEGF expression rate was significantly decreased (P<0.01). Conclusion: Sevoflurane inhibits the proliferation and invasion of colon cancer SW480 cells and the growth of xenografts in nude mice possibly by inhibiting PI3K phosphorylation.