Objective To investigate the relationship between the expression of Pin1 and Ki67 and the clinicopathologic features of gastrointestinal stromal tumors (GIST).Methods 40 paraffin-embeded specimens of surgical resected GIST from Jan.2013 to May.2015 in Pathology Department of Yuhuangding Hospital Affiliated to Qingdao University were retrieved and expressions of Pin1 and Ki67 were detected by immunohistochemical methods.Results The positivity rate of Pin1 and Ki67 in GIST was 80％ and 32.5％ respectively.The expression of Pin1 was associated with malignancy of GIST,tumor location,tumor size and mitotic counts.The expression of Ki67 is associated with malignancy of GIST,tumor location,tumor size,mitotic counts and tumour necrosis.Pin1 expression was positively related with Ki67 expression.Conclusion Pin1 and Ki67 is closely related with malignancy of GIST,which may be potential factors in predicting prognosis of GIST.

Objective To summarize the experience of intraoperative neuromonitoring (IONM) system for monitoring and protection of recurrent laryngeal nerve (RLN) during thyroid surgery.Methods A total of 220 cases were enrolled in this study (53 males and 167 females),with the median age of 38.2 years old.There were 85 cases of thyroid cancer,19 cases of thyroid benign tumor,90 cases of thyroid goiter,3 cases of Hashimoto's diseases,and 23 cases of hyperthyroidism.113 cases had tumors larger than 5 cm in diameter.During the procedure,2 recording needle electrodes were put in cricothyroid muscle and 1 stimulator electrode was explored in tracheoasophageal groove.If any RLN was fight there or nearby,doctors can see the electromyogram and hear the toothonk.With careful dissection,RLN can be found out till exploring into the larynx site.Results Electromyogram showed in 207 cases (278 nerves),and it didn't show in 13 cases,among whom 9 cases were false-negative because of system or annesthesia problems,4 cases didn't manage to have needle electrodes put in properly due to cricothyroid muscle being invaded.No permanent RLN paralysis occoured.Transient nerve paralysis occurred in 2 cases,who recovered in 1 month after operation.Conclusion IONM system is an effective way to avoid damage to RLN in thyroidectomy.

ObjectiveTo evaluate the safety and effectiveness of fast track surgery (FTS) in l aparoscopy-assisted radical distal gastrectomy (LADG) for gastric cancer.MethodsSixty-one patientswith distal gastric cancer were randomly divided into three groups:FTS + LADG group (n =19) undergoing LADG and FTS treatments,LADG group (n =22) undergoing LADG and traditional perioperative cares,and FTS + ODG ( open distal gastrectomy) group ( n =21 ) undergoing ODG and FTS treatments.FTS treatments included avoidance of mechanical bowel cleansing,restrictive perioperative intravenous infusion,early ambulation,early enteral nutrition.The age,sex,body weight,anastomotic mode,number of lymph node dissected,and tumor stage,serum albumin (ALB),blood urea nitrogen (BUN),C-reaction protein (CRP),flatus time,postoperative hospital stay,medical cost,and postoperative complications were compared between three groups. ResultsThe level of ALB in FTS + LADG group were higher than in LADG group at the 4th and 7th day after surgery ( P ＜ 0.05,P ＜ 0.01 ).Compared to LADG group,the variation of ALB from preoperation to 4th day after surgery in FTS + LADG group and FTS + ODG group was significant( P ＜ 0.01,P ＜ 0.05 ).CRP level between FTS + LADG group and FTS + ODG group were different significantly at 4th and 7th day after surgery ( P ＜ 0.05,P ＜ 0.05).FTS + LADG group has earlier recovery of gastrointestinal peristalsis than other two groups ( P ＜ 0.05,P ＜ 0.05 ).The medical cost in FTS + LADG group was less than in LADG group ( P =0.003 ),but higher than in FTS + ODG group (P ＜0.01 ).ConclusionsThe practice of FTS in LADG was safe,effective,improves nutritional status,eases stress reaction,accelerates gastrointestinal peristalsis and postoperative rehabilitation.

Objective To explore the efficiency of transcervical video-assisted mini-incision thyroidectomy for thyroid tumor. Methods 53 patients with thyroid tumors who underwent the video-assisted mini-incision thyroidectomy from Jan. 2006 to Dec. 2009 in the Department of Thyroid Surgery, Yantai Yuhuangding Hospital,were retrospectively studied. Results All of the patients, except 5 cases converting to open thyroidectomy, underwent the video-assisted mini-incision thyroidectomy successfully. The temporary recurrent laryngeal nerve injury occurred in 1 patients. The subcutaneous fluid accumulation occurred in 3 patients. The skin burns around the incisions occurred in 3 patients. There was no complication of hematoma, hypocalcemia, or superior laryngeal nerve injuries. The follow-up period was from 3 months to 35 months. There was no evidence of recurrence and metastasis by postoperative ultrasonic and CT scan and radioiodine scintigraphy. Conclusions The video-assisted mini-incision thyroidectomy is feasible, safe, and with the advantage of cosmetic results. For thyroid tumor,especially thyroid cancer, longer follow-up is necessary to draw definitive conclusion on recurrence and survival rate.

Objective To explore the feasibility and efficiency of minimally invasive video-assisted thy-roidectomy on thyroid microcarcinoma, and sum up the experiences. Methods 9 patients with thyroid microcarci-noma who underwent the minimally invasive video-assisted thyroidectomy from Jan 2006 to Feb 2009, were retro-spectively studied. Results All of the patients, except 1 case converting to open thyroidectomy, underwent the minimally invasive video-assisted thyroidectomy successfully. The subcutaneous hydrops occurred in 1 patient. The skin burns around the incisions occurred in 1 patient. There were no complications of recurrent laryngeal nerve injuries, neck hematoma, hypocalcemia, or superior laryngeal nerve injuries. The follow-up period of 15 cases were from 3 months to 37 months. There were no evidences of recurrence and metastasis by both postopera-five ultrasonic/CT examination and radioiodine scintigraphy. Conclusions The minimally invasive video-assisted thyroidectomy is safe and feasible (similar to the traditional thyroidectomy), of gratifying cosmetic results, for low-risk differentiated thyroid microcarcinoma without lymph node metastasis. For the median-risk or high-risk, more patients, comparative studies and long follow-ups are necessary to draw definitive conclusions in terms of its recurrence and survival rate.

OBJECTIVETo investigate the methylation in promtor region of RASSF2 and sFRP1 in sporadic colorectal cancer patients in order to provide screening method for early colorectal cancer.

METHODSThe methylation in promoter region of RASSF2 and sFRP1 in serum samples of 59 sporadic colorectal cancer patients and 59 healthy volunteers was detected by methylation specific PCR. The association between clinicopathological features of sporadic colorectal cancer patients and methylation in promoter region of RASSF2 and sFRP1 was analyzed.

RESULTSThe methylation rates of RASSF2 and sFRP1 gene in serum of 59 sporadic colorectal cancer patients were 27.1% and 30.5%, significantly higher than those in healthy volunteers(0%, both P<0.01). The methylation of RASSF2 or sFRP1 occurred in 29(49.2%) patients, which was significantly higer than the methylation rate of single gene(P<0.05). No association was found between methylation ratio of RASSF2 and sFRP1 and clinicopathological features in sporadic colorectal cancer patients.

CONCLUSIONSMethylation in promoter region of RASSF2 and sFRP1 is often detected in serum of colorectal cancer patients. The combination detection of methylation for the two genes may provide information for early screening of colorectal cancer.

Colorectal Neoplasms ; diagnosis ; genetics ; DNA Methylation ; Female ; Humans ; Intercellular Signaling Peptides and Proteins ; blood ; genetics ; Male ; Membrane Proteins ; blood ; genetics ; Middle Aged ; Promoter Regions, Genetic ; Tumor Suppressor Proteins ; blood ; genetics

Objective:To summarize the relevant evidence for prevention and management of stoma prolapse in patients with enterostomy, so as to provide reference for the clinical prevention and management of stoma prolapse measures.Methods:According to the evidence-based resource "6S" evidence pyramid model, systematically searched about the evidence of enterostomy patients prolapse prevention and management in UpToDate, BMJ best practice, Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, CNKI, Wanfang database,VIP Database, SinoMed,etc. The search time limit was from 30 January 2017 to 30 May 2023, 2 researchers independently evaluated the quality of the literature, selected and extracted the evidence.Results:A total of ten articles were included, including one clinical decision, five guidelines, one expert consensus, one evidence, one systematic review, one position statement. Through analysis, 20 best evidences were identified, including perioperative evaluation, preoperative colostomy site marking, reducing abdominal pressure, enterostomy prolapse nursing, health education and the follow-up.Conclusions:Best evidence summary for the prevention and care of stoma prolapse in enterostomy patients provides evidence-based reference for clinical application. Nurses should carefully select and apply evidence in combination with clinical situations and patients′ wishes, so as to develop a personalised stoma prolapse prevention and management programme for patients with enterostomy.

PURPOSE: The importance of long noncoding RNAs (lncRNAs) in tumorigenesis has recently been demonstrated. However, the role of lncRNAs in development of thyroid cancer remains largely unknown. MATERIALS AND METHODS: Using quantitative reverse transcription polymerase chain reaction, expression of three lncRNAs, including BRAF-activated long noncoding RNA (BANCR), papillary thyroid cancer susceptibility candidate 3 (PTCSC3), and noncoding RNA associated with mitogen-activated protein kinase pathway and growth arrest (NAMA), was investigated in the current study. RESULTS: Of the three lncRNAs (BANCR, PTCSC3, and NAMA), expression of BANCR was significantly up-regulated while PTCSC3 and NAMA were significantly down-regulated in papillary thyroid carcinoma (PTC) compared to that in normal tissue. BANCR-knockdown in a PTC-derived cell line (IHH-4) resulted in significant suppression of thyroid stimulating hormone receptor (TSHR). BANCR-knockdown also led to inhibition of cell growth and cell cycle arrest at G0/G1 phase through down-regulation of cyclin D1. In addition, BANCR was enriched by polycomb enhancer of zeste homolog 2 (EZH2), and silencing BANCR led to decreased chromatin recruitment of EZH2, which resulted significantly reduced expression of TSHR. CONCLUSION: These findings indicate that BANCR may contribute to the tumorigenesis of PTC through regulation of cyclin D1 and TSHR.
Carcinogenesis ; Cell Cycle Checkpoints ; Cell Line ; Cell Proliferation* ; Chromatin ; Cyclin D1 ; Down-Regulation ; Polymerase Chain Reaction ; Protein Kinases ; Receptors, Thyrotropin* ; Reverse Transcription ; RNA, Long Noncoding* ; RNA, Untranslated ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyrotropin*

Objective:To detect the expression of fibroblast-specific protein 1 (FSP1/S100A4) , ɑ-smooth-muscle actin (ɑ-SMA) and fibroblast-activated protein (FAP-ɑ) in tumor-associated fibroblasts (TAFs) in papillary thyroid carcinoma (PTC) , and to investigate its relationship with the origination and development of PTC.Methods:The expression of FSP1/S100A4, ɑ-SMA and FAP-ɑ in normal thyroid and PTC was determined by SP method of immunohistochemistry, and the relationship between these indicators and important clinicopathological parameters were analyzed.Results:The positive expression of FSP1/S100A4, ɑ-SMA and FAP-ɑ was observed in PTC, but not detected in the follicular epithelium or stromal cells of normal thyroid. In addition, the expression of FAP-ɑ was significantly related to tumor size, lymph node metastasis and TNM classification ( χ2=6.833, P<0.05; χ2=10.296, P<0.05; χ2=4.910, P<0.05) . The expression of ɑ-SMA was positively related to the invasion of capsule and lymph node metastasis ( χ2=6.008, P<0.05; χ2=11.766, P<0.05) . The expression of FSP1/S100A4 was negatively related to the clinicopathological parameters above ( P>0.05) in PTC. Conclusion:TAFs in PTC may indicate the infiltration and metastasis, which provideds new thinking for the treatment strategies of papillary thyroid carcinoma.

Objective:To study the effect of enhanced recovery after surgery (ERAS) on intestinal function and gut microbiota changes in patients who underwent laparoscopic gastrectomy.Methods:From Aug. 2018 to Dec. 2019, 80 patients who underwent laparoscopic radical D2 gastrectomy for gastric cancer in the first Department of Gastrointestinal Surgery of Yantai Yuhuangding Hospital were selected. According to whether it adopts ERAS treatment or not, patients were divided into 2 groups (n=40) : ERAS group and traditional perioperative treatment group. The time of postoperative bowel sounds, the time of first exhaust and defecation, the proportion of antibiotic-related diarrhea and surgical site infection (SSI) were recorded. Stools were collected before operation, first time after operation, 1, 2 weeks and 1 month after operation. 16S rRNA sequencing method was used to identify the diversity and species of gut microbiota. The diversity index of intestinal flora in the perioperative period and changes in the proportion of probiotics (bifidobacterium and lactobacillus) were compared.Results:The appearance time of bowel sounds, the first exhaust and defecation time [ (16.25±6.41) h, (23.95±6.02) h, (34.95±9.34) h] in ERAS group were significantly earlier than those in the traditional treatment group [ (22.3±6.49) h, (28.45±7.12) h, (48.1±15.64) h], and the difference was statistically significant ( P<0.05) . The incidence of antibiotic-related diarrhea was higher in the traditional treatment group (3/40) than in ERAS group (1/40) , but the difference was not statistically significant ( P>0.05) . The ratio of postoperative SSI was slightly higher in ERAS group, but the difference was not statistically significant ( P>0.05) . In the perioperative period, the intestinal flora diversity index (Chao1 and Shannon index) and the proportion of probiotics (lactobacillus acidophilus and bifidobacterium) were not significantly different between the two groups before surgery ( P>0.05) ; while at the first time, one week, 2 weeks after the operation, and 1 month after the operation, ERAS group was higher than the traditional group ( P<0.05) ; and at each postoperative time point, the traditional group decreased significantly than the ERAS group. The first time decrease was the largest, ( P<0.05) ; With the passage of time after operation, the diversity of intestinal flora and the proportion of probiotics gradually recovered. By 1 month after operation, the two groups did not return to the preoperative gut microbiota diversity state or proportion. Conclusion:The concept of enhanced recovery after surgery (ERAS) promotes the recovery of intestinal function in patients with gastric cancer, does not reduce the proportion of antibiotic-associated diarrhea (AAD) or surgical site infections (SSI) , and maintains the diversity of gut microbiota balance and stability.