Type Ⅰ congenital biliary dilatation is a congenital biliary duct defect disease.It is also called congenital choledochocele cyst (CCC).Endoscopic ultrasonography (EUS),magnetic resonance cholangiopacreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) are very important for the diagnosis.Operation is generally regaded as the best choose.It is recommended that cholecystectomy + choledochal cyst excision + hepatic duct jejunum Roux-Y anastomosis is the chief therapeutic method.This article reviews the pathogenesis,classifications,diagnosis and treatment of the disease.

Objective To investigate the related factors affecting prognosis of patients with colorectal cancer undergoing palliative resection.Methods The clinical data of 345 patients with colorectal cancer who underwent palliative resection at the First Affiliated Hospital of Guangxi Medical University between January 2007 and December 2011 were retrospectively analyzed.Patients selected the emergent operations or restrictive operation based on the conditions of patients,and then received chemotherapy,radiotherapy and biotherapy.Chemotherapy regimens included FOLFOX4 (5-FU/CF + oxaliplatin) regimen,XELOX (capecitabine + oxaliplatin) regimen and FOLFIRI (5-FU + CF + irinotecan) regimen.Biotherapy regimens included molecular targeted therapies using bevacizumab and cetuximab.The follow-up was applied to patients by outpatient examination,telephone interview and correspondence once every 3 months up to March 1,2014.The survival curve was drawn by the Kaplan-Meier method.The survival rate was analyzed using the Log rank test.The multivariate analysis was done using the COX regression model.Results Of the 1 930 patients,345 patients received palliative resection with a percentage rate of 17.876％.Among the 345 patients,104 patients received emergent operations and others received restrictive operations.After operation,178 patients received adjuvant treatment,FOLFOX4 regimens were done on 85 patients,XELOX regimens on 32 patients,FOLFIRI regimens on 20 patients,radiotherapy on 17 patients and molecular targeted therapies on 24 patients.Seven patients died in the perioperative period and other patients were followed up for 3.0-82.0 months with a median time of 14.0 months.The 1-,3-and 5-year survival rates and the mean survival time were 49.57％,11.88％,6.38％ and 22.6 months,respectively.The results of univariate analysis showed that the CEA levels,bowel obstruction,primary tumor resection,peritoneal implantation,distal metastasis,lymph node metastasis,tumor differentiation,postoperative adjuvant therapy were related factors affecting the prognosis of patients undergoing palliative resection (x2=3.742,18.795,37.641,13.470,4.228,5.835,4.108,6.875,P ＜0.05).The results of multivariate analysis showed that the bowel obstruction,without primary tumor resection,peritoneal implantation,low-differentiation of tumor and without postoperative adjuvant therapy were the independent risk factors affecting the prognosis of patients undergoing palliative resection (RR =1.674,2.273,1.947,1.582,1.342,95％ confidence interval:1.193-2.485,1.646-4.376,1.497-3.587,1.184-2.382,1.032-2.074,P ＜ 0.05).Conclusion The low-differentiation of tumor,peritoneal implantation,bowel obstruction,without primary tumor resection and without postoperative adjuvant therapy are the independent risk factors affecting the prognosis of patients with colorectal cancer undergoing palliative resection.

OBJECTIVETo investigate the role of transforming growth factor β1 (TGF-β1) in patients with colorectal cancer.

METHODSFresh peripheral blood were obtained from 50 patients (before surgery and at least one week after surgery) and 25 healthy donors in the morning. Fresh colorectal cancer tissues and the adjacent tissues (at least 5 cm from the tumor site) were obtained from patients undergoing tumor resection. The expression levels of TGF-β1 in the blood and tissue specimens were determined using ELISA.

RESULTSThe plasma levels of TGF-β1 in patients with colorectal cancer were significantly higher than those in the healthy donors, and decreased after the surgery (P<0.05). The tumor tissues expressed higher levels of TGF-β1 than the adjacent tissues from both CEA-negative and -positive patients. The plasma level of TGF-β1 in the patients were positively correlated with the tumor size and clinical tumor stage (P<0.05).

CONCLUSIONTGF-β1 combined with CEA can provide important information for the diagnosis, prognostic assessment and prediction of recurrence in patients with colorectal cancer, and may provide new insights for anti-TGF-β1-based tumor immune therapeutic strategies.

Biomarkers, Tumor ; metabolism ; Case-Control Studies ; Colorectal Neoplasms ; diagnosis ; metabolism ; Humans ; Neoplasm Recurrence, Local ; Prognosis ; Transforming Growth Factor beta1 ; metabolism

Objective To investigate the role of transforming growth factor β1 (TGF-β1) in patients with colorectal cancer. Methods Fresh peripheral blood were obtained from 50 patients (before surgery and at least one week after surgery) and 25 healthy donors in the morning. Fresh colorectal cancer tissues and the adjacent tissues (at least 5 cm from the tumor site) were obtained from patients undergoing tumor resection. The expression levels of TGF-β1 in the blood and tissue specimens were determined using ELISA. Results The plasma levels of TGF-β1 in patients with colorectal cancer were significantly higher than those in the healthy donors, and decreased after the surgery (P<0.05). The tumor tissues expressed higher levels of TGF-β1 than the adjacent tissues from both CEA-negative and-positive patients. The plasma level of TGF-β1 in the patients were positively correlated with the tumor size and clinical tumor stage (P<0.05). Conclusion TGF-β1 combined with CEA can provide important information for the diagnosis, prognostic assessment and prediction of recurrence in patients with colorectal cancer, and may provide new insights for anti-TGF-β1-based tumor immune therapeutic strategies.

Objective To analyze the phenotypic characteristics of LAP+CD4+ T lymphocytes and investigate their molecular mechanisms in colorectal cancer ( CRC ) microenvironment. Methods Fifty colorectal cancer patients treated in our two hospitals from January 2014 to May 2014 were included in this study. Their tumor tissues and adjacent normal tissues, peripheral blood samples, and peripheral blood samples of 25 healthy donors ( HD) were collected to isolate the lymphocytes. The different expressions of CCR7, CD45RA, Foxp3, CTLA?4, CCR4 and CCR5 in LAP+CD4+ T and LAP-CD4+ T lymphocytes were analyzed by flow cytometry ( FCM) . Results The FCM assay detected that the percentage of LAP+CD4+ T cells in peripheral blood of the CRC patients were significantly higher than that of HD [(9.44±3.18)%versus (1.49±1.00)%, P<0.001]. In addition, significantly more LAP+CD4+ T cells were also recruited into tumor tissue than those in the tumor?adjacent normal tissue [(11.76±3.74)% versus (3.87±1.64)%, P<0.001]. LAP+CD4+ T cells in the tumor?adjacent normal tissue and peripheral blood of both HDs and CRC patients mainly displayed a central memory phenotype. However, effector memory lymphocytes were predominant in the tumor tissue.In the tumor tissue, the expression of Foxp3 in the LAP+CD4+ T cells was (3.87±1.12)%, significantly lower than that in the LAP-CD4+ T cells (16.70±2.61)%, (P<0.001); the expression of CTLA?4 in the LAP+CD4+ T cells was (36.36±19.14)%, significantly higher than the (19.60± 8.91)% in the LAP-CD4+ T cells ( P<0. 001); the expression of CCR4 in the LAP+CD4+ T cells was (37.72±11.14)%, significantly higher than the (30.06±9.14)% in the LAP-CD4+ T cells (P<0.001);and the expression of CCR5 in the LAP+CD4+ T cells was (18.86±7.10)%, significantly higher than the (13.92±3.31)% in the LAP-CD4+ T cells (P<0.001). Conclusions LAP+CD4+ T cells with low expression of Foxp3 and high expressions of CTLA?4, CCR4 and CCR5 are tend to be enriched and accumulated in the tumor tissue. The unique phenotypic characteristics make these cells a distinct subset of lymphocytes, apparently different from the traditional CD4+CD25+ Treg cells.

Objective To analyze the phenotypic characteristics of LAP+CD4+ T lymphocytes and investigate their molecular mechanisms in colorectal cancer ( CRC ) microenvironment. Methods Fifty colorectal cancer patients treated in our two hospitals from January 2014 to May 2014 were included in this study. Their tumor tissues and adjacent normal tissues, peripheral blood samples, and peripheral blood samples of 25 healthy donors ( HD) were collected to isolate the lymphocytes. The different expressions of CCR7, CD45RA, Foxp3, CTLA?4, CCR4 and CCR5 in LAP+CD4+ T and LAP-CD4+ T lymphocytes were analyzed by flow cytometry ( FCM) . Results The FCM assay detected that the percentage of LAP+CD4+ T cells in peripheral blood of the CRC patients were significantly higher than that of HD [(9.44±3.18)%versus (1.49±1.00)%, P<0.001]. In addition, significantly more LAP+CD4+ T cells were also recruited into tumor tissue than those in the tumor?adjacent normal tissue [(11.76±3.74)% versus (3.87±1.64)%, P<0.001]. LAP+CD4+ T cells in the tumor?adjacent normal tissue and peripheral blood of both HDs and CRC patients mainly displayed a central memory phenotype. However, effector memory lymphocytes were predominant in the tumor tissue.In the tumor tissue, the expression of Foxp3 in the LAP+CD4+ T cells was (3.87±1.12)%, significantly lower than that in the LAP-CD4+ T cells (16.70±2.61)%, (P<0.001); the expression of CTLA?4 in the LAP+CD4+ T cells was (36.36±19.14)%, significantly higher than the (19.60± 8.91)% in the LAP-CD4+ T cells ( P<0. 001); the expression of CCR4 in the LAP+CD4+ T cells was (37.72±11.14)%, significantly higher than the (30.06±9.14)% in the LAP-CD4+ T cells (P<0.001);and the expression of CCR5 in the LAP+CD4+ T cells was (18.86±7.10)%, significantly higher than the (13.92±3.31)% in the LAP-CD4+ T cells (P<0.001). Conclusions LAP+CD4+ T cells with low expression of Foxp3 and high expressions of CTLA?4, CCR4 and CCR5 are tend to be enriched and accumulated in the tumor tissue. The unique phenotypic characteristics make these cells a distinct subset of lymphocytes, apparently different from the traditional CD4+CD25+ Treg cells.

Objective To investigate the role of transforming growth factor β1 (TGF-β1) in patients with colorectal cancer. Methods Fresh peripheral blood were obtained from 50 patients (before surgery and at least one week after surgery) and 25 healthy donors in the morning. Fresh colorectal cancer tissues and the adjacent tissues (at least 5 cm from the tumor site) were obtained from patients undergoing tumor resection. The expression levels of TGF-β1 in the blood and tissue specimens were determined using ELISA. Results The plasma levels of TGF-β1 in patients with colorectal cancer were significantly higher than those in the healthy donors, and decreased after the surgery (P<0.05). The tumor tissues expressed higher levels of TGF-β1 than the adjacent tissues from both CEA-negative and-positive patients. The plasma level of TGF-β1 in the patients were positively correlated with the tumor size and clinical tumor stage (P<0.05). Conclusion TGF-β1 combined with CEA can provide important information for the diagnosis, prognostic assessment and prediction of recurrence in patients with colorectal cancer, and may provide new insights for anti-TGF-β1-based tumor immune therapeutic strategies.

Purpose: This study aimed to evaluate the long-term efficacy of the ligation of the intersphincteric fistula tract (LIFT) procedure in treating high transsphincteric fistulas. Methods: We conducted a retrospective study to evaluate the success rate of LIFT treatment in 82 patients with high transsphincteric fistulas involving at least one-third of the external sphincter. This study was carried out across 2 centers from November 2009 to February 2023. Results: All patients underwent successful surgery with a median operative time of 48.9 minutes (range, 20–80 minutes), and no intraoperative or postoperative complications were reported. The median follow-up duration was 85.5 months (range, 4–120 months), with 5 patients (6.1%) lost to follow-up. Treatment was successful in 62 patients, whose symptoms disappeared and both the external opening and the intersphincteric incision completely healed, yielding an overall efficiency rate of 80.5%. There were 15 cases (19.5%) of treatment failure, including 6 (7.8%) that converted to intersphincteric anal fistula and 9 (11.7%) that experienced persistent or recurrent fistulas. Only 1 patient reported minor overflow during the postoperative follow-up, but no other patients reported any significant discomfort. There were no statistically significant differences between patients with surgical success and those with treatment failure in terms of fistula length, history of previous abscess or anal fistula surgery, number of external orifices or fistulas, and location of fistulas (all P>0.05). Conclusion LIFT is a safe and effective sphincter-preserving procedure that yields satisfactory healing outcomes and has minimal impact on anal function.

Purpose: This study aimed to evaluate the long-term efficacy of the ligation of the intersphincteric fistula tract (LIFT) procedure in treating high transsphincteric fistulas. Methods: We conducted a retrospective study to evaluate the success rate of LIFT treatment in 82 patients with high transsphincteric fistulas involving at least one-third of the external sphincter. This study was carried out across 2 centers from November 2009 to February 2023. Results: All patients underwent successful surgery with a median operative time of 48.9 minutes (range, 20–80 minutes), and no intraoperative or postoperative complications were reported. The median follow-up duration was 85.5 months (range, 4–120 months), with 5 patients (6.1%) lost to follow-up. Treatment was successful in 62 patients, whose symptoms disappeared and both the external opening and the intersphincteric incision completely healed, yielding an overall efficiency rate of 80.5%. There were 15 cases (19.5%) of treatment failure, including 6 (7.8%) that converted to intersphincteric anal fistula and 9 (11.7%) that experienced persistent or recurrent fistulas. Only 1 patient reported minor overflow during the postoperative follow-up, but no other patients reported any significant discomfort. There were no statistically significant differences between patients with surgical success and those with treatment failure in terms of fistula length, history of previous abscess or anal fistula surgery, number of external orifices or fistulas, and location of fistulas (all P>0.05). Conclusion LIFT is a safe and effective sphincter-preserving procedure that yields satisfactory healing outcomes and has minimal impact on anal function.

Purpose: This study aimed to evaluate the long-term efficacy of the ligation of the intersphincteric fistula tract (LIFT) procedure in treating high transsphincteric fistulas. Methods: We conducted a retrospective study to evaluate the success rate of LIFT treatment in 82 patients with high transsphincteric fistulas involving at least one-third of the external sphincter. This study was carried out across 2 centers from November 2009 to February 2023. Results: All patients underwent successful surgery with a median operative time of 48.9 minutes (range, 20–80 minutes), and no intraoperative or postoperative complications were reported. The median follow-up duration was 85.5 months (range, 4–120 months), with 5 patients (6.1%) lost to follow-up. Treatment was successful in 62 patients, whose symptoms disappeared and both the external opening and the intersphincteric incision completely healed, yielding an overall efficiency rate of 80.5%. There were 15 cases (19.5%) of treatment failure, including 6 (7.8%) that converted to intersphincteric anal fistula and 9 (11.7%) that experienced persistent or recurrent fistulas. Only 1 patient reported minor overflow during the postoperative follow-up, but no other patients reported any significant discomfort. There were no statistically significant differences between patients with surgical success and those with treatment failure in terms of fistula length, history of previous abscess or anal fistula surgery, number of external orifices or fistulas, and location of fistulas (all P>0.05). Conclusion LIFT is a safe and effective sphincter-preserving procedure that yields satisfactory healing outcomes and has minimal impact on anal function.