MicroRNA (miRNA) is a kind of small non-protein coding RNA and can negatively regulate the expression of target genes at the transcriptional level. In tumors miRNA can act as oncogenes and tumor suppressor genes, and its deregulation in tumors may be a possible reason for tumor progression. Several studies have established the potential usefulness of miRNA as therapeutic targets for tumor metastasis.

SiRNA comes from double-stranded RNA,which is processed into a small molecular fragment by Dicer.21-25nt siRNA,as the key effector molecules to the RNAi process,can inhibit gene expression with high specificity and high efficiency in mammalian cells.Currently,RNAi has been widely applied in a variety of cancer.RNAi has many active research explorations of the tumor development,metastasis and treatment in gastrointestinal cancer.

Objective To investigate the expression levels of Ezrin and AnnexinⅡ in gallbladder carci-noma and their association with clinicopathologic parameters and metastasis potential. Methods The tissue mi-croarray consisted of 59 gallbladder carcinoma tissues and 6 normal gallbladder tissues were examined for the ex-pression of Ezrin and AnnexinⅡusing immunohistochemistry technique. The expression of Ezrin and AnnexinⅡin 20 cases of fresh gallbladder carcinoma and 6 cases of normal gallbladder were measured with western blot. Results The expression of Ezrin and AnnexinⅡ were higher in the gallbladder cancer than those in the normal gallbladder tissue. The positive rate of Ezrin and AnnexinⅡ were 47.5% and 50.8% respectively. The expression of Ezrin was significantly correlated with live metastasis , lymph node metastasis and Nevin stages. The expression of AnnexinⅡwas significantly correlated with live metastasis , differentiation levels and Nevin stages. The expres-sion of Ezrin was correlated with AnnexinⅡ. Results of western blot suggested that Ezrin and Annexin II were highly expressed in gallbladder carcinoma tissues. The high expression of Ezrin and Annexin is closely related with liver invasion. Conclusion Measurement of the expression of Annexin and Ezrin II have important clinical significances to evaluate the malignant biological behavior of gallbladder carcinoma.

Objective: To investigate the application value of ω-3 fish oil fat emulsion in the parenteral nutritional support treatment following radical gastrectomy for gastric cancer. Methods: The retrospective cohort study was conducted. The clinical data of 60 patients who underwent radical gastrectomy for gastric cancer in Nanjing Medical University Affiliated Wuxi Second Hospital between January 2018 and December 2018 were collected. There were 37 males and 23 females, aged from 28 to 78 years, with an average age of 64 years. Thirty patients who received parenteral nutrition containing 100 mL of ω-3 fish oil fat emulsion after radical gastrectomy and 30 patients who received parenteral nutrition containing routine fat emulsion after radical gastrectomy were allocated into experimental group and control group, respectively. Observation indicators: (1) nutritional indicators in the perioperative period; (2) inflammatory indicators in the perioperative period; (3) immune indicators in the perioperative period; (4) postoperative complications. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was evaluated using the independent-sample t test. Count data were described as absolute numbers and percentages, and comparison between groups was analyzed using the chi-square test. Repeated measurement data were analyzed by the repeated measures ANOVA. Results: (1) Nutritional indicators in the perioperative period: the levels of total protein, albumin, prealbumin, and transferrin from preoperative day 1 to preoperative day 6 were respectively changed from (60.2±3.0)g/L to (57.2±3.1)g/L, from (35.3±3.1)g/L to (37.0±1.8)g/L, from (186±24)mg/L to (172±17)mg/L, from (3.0±0.7)g/L to (2.4±0.4)g/L in the experimental group and from (60.6±2.4)g/L to (55.7±4.2)g/L, from (35.0±3.8)g/L to (36.0±3.8)g/L, from (184±18)mg/L to (173±25)mg/L, from (3.1±0.6)g/L to (2.2±0.8)g/L in the control group, with no significant difference in the changing trends between the two groups (F=0.79, 2.14, 0.03, 0.36, P>0.05). (2) Inflammatory indicators in the perioperative period: the levels of white blood cells, C-reactive protein, interleukin 6, and tumor necrosis factor-α from preoperative day 1 to preoperative day 6 were respectively from (7.2±1.1)×10⁹/L to (10.2±0.9)×10⁹/L, from (7.2±2.3)mg/L to (25.5±6.3)mg/L, from (16±3)ng/L to (24±4)ng/L, from (17±4)ng/L to (22±5)ng/L in the experimental group and from (7.4±0.8)×10⁹/L to (13.0±1.3)×10⁹/L, from (6.9±2.4)mg/L to (41.6±18.9)mg/L, from (17±4)ng/L to (45±8)ng/L, from (16±4)ng/L to (43±7)ng/L in the control group, respectively, with significant differences in the changing trends between the two groups (F=63.05, 51.65, 127.82, 104.91, P<0.05). (3) Immune indicators in the perioperative period: the levels of immunoglobulin A, immunoglobulin G, immunoglobulin M, CD4⁺, CD8⁺, and ratio of CD4⁺ /CD8⁺ from preoperative day 1 to preoperative day 6 were respectively from (1.5±0.4)g/L to (2.8±0.5)g/L, from (11.1±1.7)g/L to (14.0±1.2)g/L, from (0.77±0.28)g/L to (1.61±0.31)g/L, from 42%±6% to 46%±5%, from 23%±4% to 24%±3%, from 1.82±0.42 to 2.11±0.24 in the experimental group and from (1.4±0.4)g/L to (2.3±0.6)g/L, from (10.7±1.8)g/L to (11.9±1.4)g/L, from (0.69±0.23)g/L to (1.19±0.33)g/L, from 40%±5% to 39%±4%, from 24%±3% to 23%±3%, from 1.75±0.34 to 1.81±0.35 in the control group, respectively, showing significant differences in the changing trends of the levels of immunoglobulin A, immunoglobulin G, immunoglobulin M, CD4⁺, and ratio of CD4⁺ /CD8⁺ between the two groups (F=18.39, 15.20, 38.42, 9.55, 5.50, P<0.05), showing no significant difference in the changing trend of the levels of CD8⁺ between the two groups (F=0.89, P>0.05). (4) Postoperative complications: 5 patients had postoperative complications, with a incidence rate of 16.7%(5/30), including 1 of abdominal infection, 1 of incisional infection, and 3 of pulmonary infection, and all the 5 patients were cured after symptomatic treatment. Nine patients had postoperative complications, with a incidence rate of 30.0%(9/30), including 2 of abdominal infection, 2 of incisional infection, and 5 of pulmonary infection, and all the 9 patients were cured after symptomatic treatment. There was no significant difference in the incidence of postoperative complications between the two groups (χ²=1.491, P>0.05). Conclusion For patients who receive gastric cancer surgery, ω-3 fish oil fat emulsion can reduce the inflammatory response, improve their immune function and not increase postoperative complications.

Objective To assess the efficacy and safety of morinidazole combined with appendectomy in treating purulent or gangrenous appendicitis.Methods Double-blind randomized controlled multicenter clinical trial was designed and conducted.Totally 437 patients were included,219 in the control group and 218 in the experimental group.Cases of purulent or gangrenous appendicitis were enrolled and assigned to each of the two groups.The control group received ornidazole injection for 5 to 7 days while the experimental group received morinidazole injection.Both groups underwent appendectomy.Clinical response,micrombiological outcomes,overall response were evaluated.Adverse events and side effects were recorded.Results No significant difference was observed between the two groups regarding the clinical healing rate at 5-10 days after medicine withdrawal,anaerobia clearance and overall healing rates.Adverse events occurred in 140 patients (32.1％).Incidence of adverse events in the control group and the experimental group was 34.7％ and 29.4％,respectively (P ＞ 0.05).The overall incidence of side effects was 15.1％ (66 cases).Side effects were less seen in the experimental group compared with that in the control group (11.5％ vs.18.7％,P ＜ 0.05).The most frequent side effects were aminotransferase rising,thrombocytosis,nausea,vomiting and electrocardiographic abnormality.Conclusions The effect of morinidazole plus operation was comparable with ornidazole in treating purulent or gangrenous appendicitis.The safety of morinidazole is better than ornidazole.