Abstract Anorectal malignant melanoma (ARMM) is a subtype of malignant melanoma with low incidence and high invasion, and has a poor prognosis due to its hidden location and rapid progression. In terms of pathogenesis, the molecular landscape and potential carcinogenic driver gene characteristics of ARMM are significantly different from those of cutaneous melanoma, manifested by a lower rate of somatic mutations, no ultraviolet exposure-related mutation characteristics, a high incidence of cell structural variation, and high genomic instability. The tumor-driving genomic mutations are mainly KIT, NRAS, and NF1 mutations, and the incidence of SF3B1 mutations is significantly higher than that in other sites of mucosal melanoma. Surgery is still the main treatment for ARMM, while immunotherapy and targeted therapy need further development. This article reviews the characteristics of carcinogenic driver gene mutations and clinical diagnosis and treatment of ARMM, providing a reference for the prevention and treatment of ARMM.

Objective: To investigate the effect of Xileisan temperature-sensitive gels on endothelial nitric oxide synthase (eNOS), vascular endothelial growth factor A (VEGF-A) and tumor necrosis factor-α (TNF-α) expression in rats with bleeding internal hemorrhoids, so as to provide insights into the illustration of the pathogenesis of internal hemorrhoid hemorrhage. Methods: Thirty six-week-old SPF-graded rats of the SD strain were randomly divided into the normal group, model group and Xileisan temperature-sensitive gel group, of 10 rats in each group (half male and half female). Cotton balls were soaked with 0.16 mL of croton oil mixture and then inserted into the anus of rats in the model group and Xileisan temperature-sensitive gel group for 10 s. After 6 h when the rectal mucosa tissues presented remarkable swelling, the perianal mucosa was rubbed repeatedly with a rough glass rod until the glass rod was bloody. Following successful modeling, rats in the Xileisan temperature-sensitive gel group was given rectal administration of Xileisan temperature-sensitive gel at a dose of 0.5 mL/d, while animals in the normal group and model group were given rectal administration of the blank gel at the same dose. Following administration for 7 successive days, rats were sacrificed, and the hemorrhoids tissues were collected for pathological examinations. The eNOS, VEGF-A and TNF-α expression was determined using immunohistochemistry and compared among groups. Results: Compared with the normal group, the rat hemorrhoids mucosa showed inflammatory changes in the model group, with submucosal congestion and edema, blood vessel congestion and dilation, and visible new blood vessels, and remarkable improvements were seen in the hemorrhoid mucosal inflammation in the Xileisan temperature-sensitive gel group. There were significant differences in the integrated option density (IOD) of eNOS and VEGF-A expression in rat hemorrhoids tissues among the three groups (P<0.05), and no gender-specific differences were seen (P>0.05). The IOD values of eNOS (45.84±13.66) and VEGF-A expression (45.89±9.06) were higher in rat hemorrhoids tissues in the model group than in the normal group (23.11±5.64 and 27.91±11.65) and the Xileisan temperature-sensitive gel group (27.41±8.89 and 33.44±6.20) (P<0.05), while no significant differences were detected in the IOD of TNF-α expression in rat hemorrhoids tissues among the three groups (P>0.05). Conclusion Xileisan temperature-sensitive gel may alleviate inflammation and internal hemorrhoids hemorrhage through inhibiting eNOS and VEGF-A expression in rat hemorrhoids tissues.

Abstract Defecation disorder is one of the most common complications after orthopedic surgery, which seriously affects patients' quality of life. Based on review of national and international publications pertaining to influencing factors and interventions of postoperative defecation disorders, this review analyzes the associations of orthopedic surgery-related factors with postoperative defecation disorders, and summarizes the common interventions for postoperative defecation disorders, including medication, physical therapy and daily life management, so as to provide insights into prevention and treatment of defecation disorders after orthopedic surgery.