Metabolic components of human intestinal flora bind to their corresponding receptors and stimulate inflammatory cy-tokine secretion. Other changes become evident and cause inflammation, as a result, colorectal cancer (CRC) occurs. Probiotics protect intestinal mucosa and prevent CRC by functioning as an intestinal barrier and inhibiting DNA damage. Probiotics can also be used not only to prevent CRC but also to induce adjuvant treatment of CRC. Gastrointestinal tract surgery can affect gut microbiota metabolism and microecological balance. This review focuses on current research progress on the relationship between intestinal microflora and CRC.

Objective To evaluate the effciency of different embolic agents inducing the changes of the liver morphology and function in the selective portal vein embolization (PVE).Methods Forty five Spraque-Dawley rats were used in this experiment.Five were served as a control group and forty were randomly divided into 4 groups of 10 rats each.Right PVE was performed in each group by one of four different embolic agents respectively.Five rats from each group were sacrificed and dissected to inspect the morphological changes on 14th and 21st day after the procedure.The results of different groups were analyzed according to the weight ratios of the right lobe to the whole liver and the whole liver to the body,and the results were compared to each other and those of the control group using statistical Student“ t ”test. Results After the procedure,the embolized lobe was turned gray immediately with no significant differences between groups.Both on the 14th and 21st day after the procedure,the right lobe of the liver from the rats of group 1,2,3 were atrophied apparently with lots of spotty yellow scars in different sizes.There was no significant change of the embolized right lobe from group 4.By statistical analysis,the embolization using Lipiodol-ethanol 2∶1 mixture in group 2 resulted in better atrophy than group 1 ( P 0.05) and more than the gelfoam pieces ( P

Objective: To evaluate the efficacy of intraoperative hyperthermic peritoneal perfusion (CHPP) on advanced gastric carcinoma. Methods: Sixty patients with advanced gastric carcinoma were divided into the control group and the treatment group. All patients underwent radical gastrectomy and D2 node dissection. Patients in the treatment group received CHPP when surgical resection was completed. Patients in the control group underwent resection of gastric carcinoma without CHPP. Chemotherapy was administered with FOLFOX4 regimen intravenously for 12 cycles in both groups at 4 weeks after surgery. The serum Carcinoembryonic antigen (CEA) and CA19-9 were measured in patients with advanced gastric cancer before and after resection of tumor. Survival and recurrence in both groups were analyzed and compared. Results: The mean levels of the expression of CEA and CA19-9 in the peripheral blood of the 60 patients were significantly higher than the upper limits of normal (55.89±22.25μg/L vs 0～5μg/L; 125.35±61.78 U/mL vs 0～39U/mL P< 0.01). There were no significant differences in the mean levels of the expression of CEA and CA19-9 in the peripheral blood between the treatment group and the control group (54.67±22.95μg/L vs 56.09±22.15μg/L; 126.16±62.45 U/mL vs 123.35±60.88 U/mL,P>0.05). The serum CEA and CA19-9 levels were significantly decreased at 7 days after treatment in the treatment group (7.58±3.21 μg/L, 31.35±13.47 U/mL, P<0.01). The levels of these two tumor markers were decreased unremarkably at 7 days after treatment in the control group (37. 68±20.59μg/L, 98.23±36.28 U/mL, P>0.05). The serum CEA and CA19-9 levels were decreased significantly in both groups at 30 days after surgery (P<0.05). One-year survival and recurrence rates were 83.3% and 10% in the treatment group and 80% and 13.3% in the control group, with no significant differences between the two groups (P>0.05). Three-year survival and recurrence rates were 63.3% and 20% in the treatment group and 40% and 40% in the control group, with a significant difference between the two groups (P<0.05). Conclusion: Surgical resection combined with CHPP can significantly decrease the serum CEA and CA19-9 levels. Intraoperative CHPP for patients with advanced gastric carcinoma is helpful for preventing peritoneal metastasis and recurrence and can prolong survival time.

Objective To discuss the nursing care for patients with advanced hepatocellular carcinoma (HCC) who are receiving transcatheter arterial chemoembolization (TACE) combined with sorafenib. Methods A total of 23 consecutive patients with advanced HCC who met the inclusion criteria were enrolled in this study. TACE was carried out in all patients. Three-five days after TACE the patients started to orally take sorafenib. During the treatment course, the patients were kept under close observation for adverse reactions and complications. After leaving the hospital the patients were followed up by the extended care team members, and health education as well as appropriate nursing intervention was carried out. Results All patients with advanced HCC took sorafenib orally after TACE. The major adverse events and complications were gastrointestinal adverse reactions (n = 22) and transient liver dysfunction (n = 23). After leaving the hospital all the patients received regular follow- up examination and extended nursing care. Conclusion Usually, the incidence of adverse reactions is higher in patients with advanced HCC after TACE combined with sorafenib treatment. Careful in-hospital observation and extended out-hospital nursing can reduce the incidence of adverse reactions and thus improve the patient’s quality of life.

Objective: To understand the effect of hyperthermic intraperitoneal chemotherapy (HIPEC) on prognosis of patients with locally advanced gastric cancer, this study retrospectively analyzed the clinical and pathological data of patients undergoing surgery combined with HIPEC and those undergoing surgery alone. Methods: We retrospectively analyzed 80 stage IIIb gastric cancer patients who underwent HIPEC and 90 stage IIIb gastric cancer patients who underwent surgery alone at Tianjin Medical University Cancer Institute and Hospital between January 2009 and January 2014. These patients were divided into the HIPEC group (study group) and the surgery group (control group). The study and control groups included 24 and 26 signet ring cell carcinoma patients and 56 and 64 non-signet ring cell carcinoma patients, respectively. The study and control groups included 12 and 15 Borrmann type I cases, 28 and 30 Borrmann type Ⅱ cases, 23 and 26 Borrmann type III cases, and 17 and 19 Borrmann type cases, respectively. Four weeks after surgery, the two groups were treated with chemotherapy using the S-1 and oxaliplatin (SOX) regimen for 8 courses. This study analyzed and compared the survival of patients with gastric cancer of different pathological types and Borrmann's classifications. The surgical complications of the two groups were retrospectively analyzed. Results: The 5-year survival rates of the study group and the control group were 36.25% and 28.89%, respectively, and the difference was statistically significant (P<0.05). Among the patients with signet ring cell carcinoma, the 5-year survival rates of the study group and the control group were statistically significant (25.00% vs. 15.38%, respectively, P<0.05). There was no significant difference in the 5-year survival rate between the non-signet ring cell carcinoma patients in the study group and the control group (41.07% vs. 34.38%, respectively, P>0.05). The 5-year survival rates between Borrmann type I and typeⅡ patients in the study and control groups were not significantly different (41.67% vs. 40.00%, 35.71% vs. 33.33%, respectively, P>0.05). There was a statistically significant difference in the 5-year survival rates between Borrmann type III and type patients in the study and control groups (39.13% vs. 26.92%, 29.41% vs. 15.79%, respectively, P<0.05). There was no significant difference in surgical complications between the two groups (P>0.05). Conclusions: Surgery combined with HIPEC is safe and improves the 5-year survival rate of patients with advanced gastric cancer classified as signet ring cell carcinoma, Borrmann type III, and Borrmann type .

Objective: To investigate the corrective effect of modified Brisson technique to treat concealed penis in children. Methods: From July 2015 to July 2017, 32 patients(3-10 years old, mean 7.2 years old )with concealed penis were treated with the modified Brisson technique in the Children′s Hospital of Zhengzhou University. All the children with concealed penis were treated by the modified Brisson technique, complications, postoperative results and followed-ups were retrospectively analyzed. Results: 32 cases of concealed penile children had pain on the postoperative day, 2 cases required patient controlled analgesia device. No infection and dehiscence were noticed after discharge. All the children were followed up for 6 months to 1 year, and the results were satisfactory. Review showed that the penile body was similar to the appearance after circumcision, with obvious extension exposure, normal exposure of penile scrotal Angle and penile pubic Angle, and no obvious retraction. The internal plate of the prepuce in 5 cases was slightly edema, and edema dissolved within 2 months. Conclusions Modified Brisson is a better method to treat concealed penis in children, which can correct the pathological structure and retain the integrity of penile skin to the greatest extent.

Peritoneal carcinoma is a kind of malignant tumor which occurs and develops on the peritoneum, including primary and secondary tumors. Hyperthermic intraperitoneal chemotherapy is a combined therapy of intraperitoneal perfusion, hyperthermia and chemotherapy on peritoneal cancer, with satisfactory curative effect. In recent years, with the continuous progress of technology and research, hyperthermic intraperitoneal chemotherapy has become the most effective method for the treatment of peritoneal cancer. In this paper, we review the current situation of hyperthermic intraperitoneal chemotherapy on peritoneal cancer.

Objective:To investigate the clinical effect of progressive transfer of penile flap combined with local scrotal flap in correction of severe concealed penis in children.Methods:The clinical data of children with severe concealed penis admitted to the Children’s Hospital Affiliated to Zhengzhou University from July 2021 to July 2023 were retrospectively analyzed. The concealed penis was corrected by progressive transfer of penile flap combined with local scrotal flap. During the operation, a small amount of excess inner prepuce was removed and the outer prepuce was cut in the middle of the dorsal side of the penis. Then the penile flap was transferred from dorsal to ventral, gradually covering the wound without tension. The local scrotal flap was lifted upwards and sutured to the frenulum for covering the ventral foreskin defect of the penis. The amount of blood loss during the operation was recorded. The pain tolerance, the duration of prepuce edema, the length of penis extension and the healing of skin flap were observed. The appearance of the penis was followed up to observe whether the penis was retracted, and the satisfaction of the children and their guardians was recorded.Results:A total of 32 male children were enrolled, ranging in age from 3 to 10 years, with an average age of 7.2 years. The penis of all the children had a conical appearance, and the penile shaft was buried under the subcutaneous anterior pubis, which was difficult to palpate in its natural state. The average intraoperative blood loss was about 5 ml. All patients had pain after the operation. Two patients needed a pump to relieve pain, and the rest could tolerate it after rectum administration of indomethacin suppositories. The edema of the prepuce was mild after the operation, and the edema basically disappeared when the patient was discharged 7-9 days later. The penis could be lengthened by 1.5-3.0 cm under static conditions, averaging about 2.0 cm. After surgery, only 1 patient had a small area (about 5 mm × 4 mm) of infection in the scrotal flap and poor incision healing, and scar healing after dressing change and intensive nursing. The other flaps healed well. After 6 to 12 months of follow-up, the penis length of 2 cases was slightly retracted from the time of discharge, and the remaining 30 cases had no significant change. The patients and their guardians were satisfied with the operation results.Conclusion:The progressive transfer of penile flap combined with local scrotal flap correction of severe concealed penis in children can fully lengthen the penile body, and the degree of postoperative retraction is low, the appearance of the penis is good, and the patient satisfaction is high.

Objective:To summarize the clinical effect of laparoscopic medial umbilical ligament dissection in two-stage Fowler-Stephens orchiopexy (FSO).Methods:A case-series study was conducted.Clinical data of children who underwent two-stage FSO from March 2020 to July 2022 in the Department of Urology, Children′s Hospital Affiliated to Zhengzhou University were retrospectively analyzed.Indexes such as operation time, amount of blood loss, degree of postoperative pain in the operative area, testicular position, size, texture and parental satisfaction at the operative side 1 month, 6 months and 1 year after surgery were collected.Measurement data of normal distribution were expressed as Mean± SD and compared using the independent sample and paired sample t-tests. Results:A total of 18 children with complete clinical data were included in this study.Their age ranged from 7 months to 10 years, with an average of 2 years.There were 10 cases of FSO on the left side and 8 cases on the right side.Twelve cases (group A) had the testis directly descending to the scrotum without amputation of the umbilical medial ligament during the operation, including 7 cases on the left side and 5 cases on the right side; 6 cases (group B) with testis not descending to the scrotum received amputation of the umbilical medial ligament, and the testicle was pulled into the scrotum without tension, including 3 cases on the left side and 3 cases on the right side.The age of patients in group A [(0.88±0.26) years] was lower than that in group B [(4.32±2.96) years] ( t=-4.11, P<0.05).The operation time of patients in group B was (47.50±1.87) min, slightly longer than that in group A [(46.17±1.47) min] ( t=-1.66, P>0.05).The intraoperative bleeding volume in group B was (5.18±0.42) mL, slightly higher than that in group A [(4.96±0.20) mL] ( t=-1.56, P>0.05).Patients in both groups had mild pain in the operative area, which could be tolerated by the children.There were no significant differences in testicular position, size, texture and satisfaction between the two groups 1 month after surgery.Reexamination at 6 months after operation showed that 1 case in group A had mild testicular retraction, located above the scrotum; no significant testicular retraction was observed in group B; the size and texture of testis in both groups had no significant change compared with those before operation, and the blood supply was normal according to the color ultrasound findings; parental satisfaction was high.Reexamination at 1 year after operation showed that 1 case of testis in group A was located above the scrotum, 2 cases had no obvious development, and the rest cases had increased testis size [(0.51±0.03) mL] compared with before operation [(0.31±0.02) mL] ( t=-22.97, P<0.05); all cases of testis in group B returned to normal position, 1 case had no obvious development, and the rest cases had increased testis size [(0.45±0.02) mL] compared with before operation [(0.24±0.01) mL] ( t=-32.87, P<0.05).There was no significant difference in testicular size increase between group A [(0.20±0.03) mL] and group B [(0.20±0.01) mL] ( t=-1.19, P>0.05). Conclusions:In the case that the medial umbilical ligament obviously affects the testicular descent, it can be dissected, which significantly shortens the distance of testis descending to the scrotum.The testicular position after surgery is normal, and the two-stage FSO does not affect the testicular development.

Objective:To investigate the clinical effect of progressive transfer of penile flap combined with local scrotal flap in correction of severe concealed penis in children.Methods:The clinical data of children with severe concealed penis admitted to the Children’s Hospital Affiliated to Zhengzhou University from July 2021 to July 2023 were retrospectively analyzed. The concealed penis was corrected by progressive transfer of penile flap combined with local scrotal flap. During the operation, a small amount of excess inner prepuce was removed and the outer prepuce was cut in the middle of the dorsal side of the penis. Then the penile flap was transferred from dorsal to ventral, gradually covering the wound without tension. The local scrotal flap was lifted upwards and sutured to the frenulum for covering the ventral foreskin defect of the penis. The amount of blood loss during the operation was recorded. The pain tolerance, the duration of prepuce edema, the length of penis extension and the healing of skin flap were observed. The appearance of the penis was followed up to observe whether the penis was retracted, and the satisfaction of the children and their guardians was recorded.Results:A total of 32 male children were enrolled, ranging in age from 3 to 10 years, with an average age of 7.2 years. The penis of all the children had a conical appearance, and the penile shaft was buried under the subcutaneous anterior pubis, which was difficult to palpate in its natural state. The average intraoperative blood loss was about 5 ml. All patients had pain after the operation. Two patients needed a pump to relieve pain, and the rest could tolerate it after rectum administration of indomethacin suppositories. The edema of the prepuce was mild after the operation, and the edema basically disappeared when the patient was discharged 7-9 days later. The penis could be lengthened by 1.5-3.0 cm under static conditions, averaging about 2.0 cm. After surgery, only 1 patient had a small area (about 5 mm × 4 mm) of infection in the scrotal flap and poor incision healing, and scar healing after dressing change and intensive nursing. The other flaps healed well. After 6 to 12 months of follow-up, the penis length of 2 cases was slightly retracted from the time of discharge, and the remaining 30 cases had no significant change. The patients and their guardians were satisfied with the operation results.Conclusion:The progressive transfer of penile flap combined with local scrotal flap correction of severe concealed penis in children can fully lengthen the penile body, and the degree of postoperative retraction is low, the appearance of the penis is good, and the patient satisfaction is high.