Objective To investigate the expression of nucleolar spindle-associated protein 1(NuSAP1) in hepatocellular carcinoma (HCC) and in non-cancerous tissues,and to study the correlation between NuSAP1 and early recurrence and prognosis of HCC.Methods The expression of NuSAP1 in 61 cases of HCC and non-cancerous tissues were assessed by RT-PCR,quantitative PCR and immunohistochemistry.The relationship between the expression and the clinicopathological features was studied.Results The levels of mRNA and protein in HCC were higher than the non-cancerous tissues (P＜0.05).On univariate analysis,the expression levels of NuSAP1,mRNA and protein in HCC were significantly associated with TNM classification,lymphatic metastasis,early recurrence,tumor thrombosis and histological differentiation (P＜0.05).Multivariate analysis showed early recurrence was associated with the expression of NuSAP1 protein in HCC (P＜0.05).Overexpression of NuSAP1 protein was correlated with poor outcome of the patients with HCC (x2=15.846,P＜0.001).Conclusions NuSAP1 was overexpressed in hepatocellular carcinoma.Overexpression of NuSAP1 was associated with early postoperative HCC recurrence and bad prognosis.

Objective To investigate the clinical efficacy of unidirectional-loop caudal-medial approach for laparoscopic-assisted radical resection of right colon cancer.Methods The retrospective and descriptive study was performed.The clinical data of 37 patients who underwent laparoscopic-assisted radical resection of right colon cancer through unidirectional-loop caudal-medial approach at the Sixth Mfiliated Hospital of Sun Yat-sen University from January 2015 to March 2016 were collected.Tumor-free principle was followed and unidirectional-loop caudal-medial approach was conducted.Observation indicators included:(1) surgical situations:operation time,volume of intraoperative blood loss,(2) postoperative recovery:time to initial anal exsufflation,time of draining tube removal,postoperative complications,duration of postoperative hospital stay,(3) postoperative pathological examination:number of lymph node dissection,number of positive lymph node,length of specimen,incision margin,tumor pathological staging and type,(4) follow-up.All the patients were followed up using outpatient examination and telephone interview up to June 2016.Measurement data with normal distribution were presented as x ± s and measurement data with skewed distribution were presented as average (range).Results (1) Surgical situations:37 patients received successful operation,without conversion to open surgery and perioperative death.Operation time and volume of intraoperative blood loss in 37 patients were (170 ± 50)minutes and 50 mL (range,20-300 mL).(2) Postoperative recovery:time to initial anal exsufflation,time of draining tube removal and average duration of postoperative hospital stay were (3.5 ± 1.0) days,(4.3 ± 1.1) days and 10 days (range,6-21 days),respectively.Two patients with postoperative wound liquefaction were improved by symptomatic treatment,and the other patients had no complication.(3) Postoperative pathological examination:number of lymph node dissection,number of positive lymph node,number of central lymph node dissection and length of specimen in 37 patients were 22 ±8,0 (range,0-6),6 ±5 and (32 ±9)cm,respectively,with negative incision margins.Postoperative tumor pathological staging showed that stage pT1,pT2,pT3 and pT4a were detected in 0,1,33 and 3 patients,and stage pN0,pN1 and pN2 in 23,12 and 2 patients,respectively.Postoperative tumor pathological type showed that 3,7,23 and 4 patients were respectively diagnosed with mucinous adenocarcinoma,high-differentiated adenocarcinoma,moderate-differentiated adeno-carcinoma and low-differentiated adenocarcinoma.(4) Follow-up:37 patients were followed up for 3-17 months with a median time of 11 months.During the follow-up,1 patient was complicated with anastomotic recurrence and 4 with distant metastases,the other 32 patients had tumor-free survival.Conclusion Unidirectional-loop caudal-medial approach for laparoscopicassisted radical resection of right colon cancer is safe and feasible,with a good short-term outcome,and it should be widely spread.

Objective To compare the clinical efficacies of transanal total mesorectal excision(TaTME) and laparoscopic total mesorectal excision (LapTME)for rectal cancer (RC).Methods The case-control matching method and retrospective cohort study were conducted.The clinicopathological data of 100 RC patients who were admitted to the Sixth Affiliated Hospital of Sun Yat-sen University between July 2014 and January 2016 were collected.Of 100 patients,50 undergoing TaTME and 50 undergoing LapTME were respectively allocated into the TaTME and LapTME groups by case-control matching method.Observation indicators:(1) operation situations:operation time,volume of intraoperative blood loss,cases with intraoperative complications and preventive stoma;(2) postoperative recovery:time for diet intake,time for out-of-bed activity,occurrence of complications within 30 days postoperatively and duration of hospital stay;(3) postoperative pathological examinations:postoperative pathological specimen length,number of lymph node harvest,distance from lower boundary of tumor to distant margin and cases with positive circumferential margin;(4) follow-up.Follow-up using outpatient examination and network tracing was performed to detect local tumor recurrence and distant metastasis up to December 2016.Measurement data with normal distribution were represented as x±s and comparison between groups was analyzed using the paired-samples t test.Measurement data with skewed distribution were represented as M (range).Comparisons of count data were analyzed using the chi-square test.Comparisons of measurement data with skewed distribution and ranked data were done by the nonparametric test.Results (1) Operation situations:operation time,volume of intraoperative blood loss,cases with intraoperative complications and preventive stoma were (259±111)minutes,100 mL (range,20-2 000 mL),2,28 in the TaTME group and (220± 80)minutes,50 mL (range,20-1 000 mL),1,33 in the LapTME group,respectively,with no statistically significant difference (t=1.90,Z=-0.30,x2 =0.34,0.01,P＞0.05).(2) Postoperative recovery:time for diet intake and time for out-of-bed activity were (1.6±0.5) days,(2.6±0.6) days in the TaTME group and (2.4±0.5)days,(3.5 ±0.6)days in the LapTME group,respectively,with statistically significant differences (t =8.90,11.30,P＜0.05).Cases with anastomotic fistula,bleeding and stenosis,intestinal obstruction,abdominal abscess and wound infection within 30 days postoperatively were 6,1,1,0,1,0 in the TaTME group and 5,1,2,2,1,2 in the LapTME group,respectively,with no statistically significant difference (x2=0.10,0.00,0.30,2.00,0.00,2.00,P＞0.05).Cases with urinary retention within 30 days postoperatively were 3 and 0 in the TaTME and LapTME groups,respectively,with a statistically significant difference (x2 =3.00,P＜0.05).Two and 2 patients with anastomic fistula underwent reoperation in the TaTME and LapTME groups respectively,and other patients were improved by symptomatic treatment.Duration of hospital stay was 7 days (range,5-36 days)and 8 days (range,6-29 days) in the TaTME and LapTME groups,respectively,with no statistically significant difference (Z =-0.90,P ＞ 0.05).(3) Postoperative pathological examinations:postoperative pathological specimen length,number of lymph node harvest,distance from lower boundary of tumor to distant margin and cases with positive circumferential margin were (11±3)cm,13±5,(1.3±0.7)cm,0 in the TaTME group and (12±3) cm,13±5,(1.3±0.7)cm,1 in the LapTME group,respectively,with no statistically significant difference (t=0.50,0.20,0.10,x2=1.00,P＞0.05).(4) Follow-up:100 patients were followed up for 9-27 months,with an average time of 18 months.During the follow-up,distant metastasis and local tumor recurrence were detected in 2,3 patients of TaTME group and in 2,2 patients of LapTME group,respectively,with no statistically significant difference (x2 =0.00,0.20,P＞0.05).Conclusions TaTME for RC is safe and feasible.Compared with LapTME,TaTME not only achieves identical pathological quality without increasing intra-and postoperative complications,but also benefits postoperative recovery of patients.

Objective To assess the effect of silent mating type information regulation 2 homolog 6 (SIRT6) on migratory and proliferative activity of skin fibroblasts in the elderly,and to explore their mechanisms.Methods Circumcised foreskins were obtained from patients of different ages in Department of Urologic Surgery,Second Hospital of Shanxi Medical University,including 8 elderly patients and 8 young patients.Human skin fibroblasts were isolated from the foreskin tissues by using a collagenase digestion method.Western blot analysis was performed to determine the expression of SIRT6 and phosphorylated p65 (p-p65) in human skin fibroblasts in different age groups,scratch assay to evaluate cell migratory activity,and cell counting kit-8 (CCK8) assay to assess cellular proliferative activity.Skin fibroblasts in the elderly group were divided into 2 groups:SIRT6 group transfected with a lentiviral vector overexpressing SIRT6,and control group transfected with an empty lentiviral vector.Then,the cell migratory and proliferative activity as well as p-p65 expression were measured by the above methods,and the mRNA expression of type Ⅰ and Ⅲ collagens,and integrin subunits α3,α5 and β1 was determined by real-time PCR in the SIRT6 group and control group.Statistical analysis was carried out with GraphPad Prism 5 software by using t test for comparison between 2 groups.Results Compared with the young group,the elderly group showed significantly decreased SIRT6 expression in skin fibroblasts (0.434 ±0.179 vs.1.000 ± 0.067,t =3.040,P =0.012),migration rate (43.81％ ± 18.84％ vs.94.63％ ± 12.32％,t =5.903,P =0.003)and cellular proliferative activity at 24 and 48 hours (both P ＜ 0.05),but significantly increased p-p65 expression (1.694 ± 0.148 vs.1.000 ± 0.093,t =2.949,P =0.015).Compared with the control group,the SIRT6 group showed significantly decreased p-p65 expression (P ＜ 0.05),but significantly increased migratory and proliferative activity (both P ＜ 0.05),and elevated mRNA expression of type Ⅲ collagen and integrin subunits oα3,α5 and β1 (all P ＜ 0.05).Conclusion SIRT6 can improve the migratory and proliferative activity of human fibroblasts in the elderly,possibly by inhibiting the nuclear factor-κB pathway.

Objective:To translate 19-Item Return-To-Work Self-Efficacy (RTWSE-19) Scale into Chinese and verify reliability and validity of its application in patients after replantation of severed fingers.Methods:Brislin translation model was used to translate and back-translate RTWSE-19 Scale, and the Chinese version of RTWSE-19 Scale was adjusted through expert evaluation, group discussion and pre-survey. Using the convenient sampling method, a total of 150 patients who were treated and were willing to return to work after replantation of severed fingers in the Fourth People's Hospital of Nanhai District in Foshan, Guangdong Province from March 2019 to February 2020 were selected, and the modified Chinese version of RTWSE-19 Scale was used to investigate. The validity of the scale was evaluated by the content validity of expert evaluation and the structure validity of exploratory factor analysis. Cronbach's α coefficient, test-retest reliability and split-half reliability were used to evaluate the reliability of the scale.Results:A total of 150 questionnaires were distributed, and 141 valid questionnaires were returned. The effective recovery rate was 94.0%. The Chinese version of RTWSE-19 Scale had the same structure as the original scale. The original 19 items were retained, which were divided into three dimensions: coping with work (items 1-7) , work adjustment (items 8-14) and request to colleagues (items 15-19) . The content validity coefficient of the scale was 0.920. Through exploratory factor analysis, 3 common factors with characteristic roots greater than 1 were extracted, and the cumulative variance contribution rate was 62.4%. The Cronbach's α coefficient of the scale was 0.903, the test-retest reliability was 0.771 and the half-reliability was 0.763.Conclusions:The Chinese version of RTWSE-19 Scale in this study has good reliability and validity, which is suitable for evaluating the return-to-work self-efficacy of patients after replantation of severed fingers.

OBJECTIVETo explore the learning curve of transanal total mesorectal excision (taTME) for rectal cancer.

METHODSClinical data of 60 rectal cancer patients undergoing taTME from July 2014 to April 2016 were retrospectively analyzed. According to the sequence of operation date, 60 patients were divided into four groups (A, B, C, D) with 15 cases in each group. General information and perioperative, especially the operative indexes were compared among four groups.

RESULTSThere were no significant differences in age, sex, preoperative staging, BMI, tumor size among four groups (all P>0.05). The distance from tumor to anal verge in A group was(6.7±2.5) cm, which was significantly different with B group (4.6±1.2) cm, C group (4.5±1.0) cm and D group (4.0±1.0) cm (P=0.000, P=0.000, P=0.001). Ratio of receiving neoadjuvant therapy was 0, 60.0%(9 cases), 26.7%(4 cases) and 26.7%(4 cases) in A, B, C, D groups respectively with significant difference (P=0.004). Ratio of receiving complete taTME was 73.3%(11/15) in A group, 26.7%(4/15) in B group, 13.3%(2/15) in C group and 26.7%(4/15) in D group, while other patients underwent laparoscopy-assisted procedures. This ratio of A group was significantly higher as compared to B, C, D groups (P=0.003). The operation time was significantly different among four groups [A group (223.0±105.2) minutes, B group (299.0±131.0) minutes, C group(278.0±44.8) minutes, D group (246.0±34.0) min, P=0.035]. Fluctuation of operation time was more common in A and B groups, which became stable in C and D groups. Though intra-operative blood loss was not significantly different among four groups [A group (249.0±559.6) ml, B group (288.0±568.1) ml, C group (87.0±43.3) ml, D group (69.0±64.5) ml, P=0.225], but it presented a decline trend in C and D groups. Number of harvested lymph node from postoperative pathological specimen was 10.9±5.9 in A group, 9.6±2.7 in B group, 15.8±4.8 in C group, and 14.2±5.1 in D group, with significant difference among groups (P=0.008; A group vs. C group, P=0.010; B group vs. C group, P=0.002; B group vs. D group, P=0.021). There were no significant differences in specimen length, postoperative complication rate, distal margin distance and hospital stay.

CONCLUSIONA well-skilled laparoscopic colorectal surgeon, by following the standard surgical procedures, are likely to overcome the learning curve smoothly after performing approximately 30 cases of taTME for rectal cancer.

Abdomen ; Aged ; Anal Canal ; Blood Loss, Surgical ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Laparoscopy ; Learning Curve ; Length of Stay ; Lymph Nodes ; Male ; Middle Aged ; Neoadjuvant Therapy ; Operative Time ; Postoperative Complications ; Rectal Neoplasms ; surgery ; Retrospective Studies

Purpose: Drug resistance is one of the main causes of chemotherapy failure in patients with small cell lung cancer (SCLC), and extensive biological studies into chemotherapy drug resistance are required. Materials and Methods: In this study, we performed lncRNA microarray, in vitro functional assays, in vivo models and cDNA microarray to evaluate the impact of lncRNA in SCLC chemoresistance. Results: The results showed that KCNQ1OT1 expression was upregulated in SCLC tissues and was a poor prognostic factor for patients with SCLC. Knockdown of KCNQ1OT1 inhibited cell proliferation, migration, chemoresistance and promoted apoptosis of SCLC cells. Mechanistic investigation showed that KCNQ1OT1 can activate transforming growth factor-β1 mediated epithelial-to-mesenchymal transition in SCLC cells. Conclusion Taken together, our study revealed the role of KCNQ1OT1 in the progression and chemoresistance of SCLC, and suggested KCNQ1OT1 as a potential diagnostic and prognostic biomarker in SCLC clinical management.

AIM: To explore the promoting effect of 2-APB on skin wound healing in mice and its potential mechanism. METHODS: KM mice were divided into 5 groups: control group, DMSO group, low (50 mg/L), medium (100 mg/L) and high (200 mg/L) concentration 2-APB group. On the back of each mouse's skin use a circular punch about 1 cm on both sides of the midline of the spine to make a skin wound with a diameter of 10 mm and as deep as the fascia. The control group was only wrapped with gauze and no drugs were applied; the DMSO group was applied 1 g DMSO/Vaseline ointment per day; in the 2-APB group, apply 1 g of 2-APB/Vaseline ointment at a corresponding concentration every day. Pictures were taken the next day to observe the healing, and the material was taken on the 21st day, HE staining was used to observe the pathological morphology of the wound and western blot to detect TRPM7, TGF-β, collagen-I and IL-1β expression. RESULTS: Compared with the control group and the DMSO group, different concentrations of 2-APB could significantly promote skin wound healing in mice (P<0.01), but there was no significant difference in wound healing rate between the DMSO group and the control group group. The results of HE staining showed that, compared with the control group group and the DMSO group, 2-APB could increase the collagen content of the wound and the thickness of the dermis (P<0.01), but there was no significant difference between the DMSO group and the control group group. At the same time, 2-APB could also significantly increase the expression of TGF-β and Col-I on the wound, and inhibit the expression of TRPM7 and IL-1β. CONCLUSION: Different concentrations of 2-APB (50, 100 and 200 mg/L) can promote skin wound healing, and its mechanism may be related to the inhibition of TRPM7.