Objective To observe the efifcacy and safety of XELOX plus bevacizumab as a ifrst-ine treatment for Chinese patients with metastatic colorectal cancer. Methods In this study, we retrospectively reviewed cases in which XELOX plus bevacizumab were administered in order to evaluate its efifcacy and safety in clinical practice.In total, 40 patients with mCRC who presented at Fuchu Hospital received XELOX plus bevacizumab as a ifrst?line treatment from September, 2009 to April, 2012. Eligible patients had histologically conifrmed mCRC. XELOX consisted of a 2-h intravenous infusion of oxaliplatin 130 mg/m 2 on day 1 plus oral capecitabine 1,000 mg/m 2 twice daily for two weeks of athree?week cycle. Overall survival (OS) and survival benefit were analyzed when patients continued with XELOX plus bevacizumab beyond disease progression. Results The median progression?free survival (PFS) was 290 days [95%conif-dence interval (CI):222?409 days] and the median OS was 816 days (95%CI:490?842 days). The response rate (RR:complete plus partial response) was 67.5%, and the disease control rate (RR plus stable disease) was 90%. Conclusion XELOX plus bevacizumab may be considered a routine ifrst?line treatment option for patients with mCRC.

Objective: To observe influence of porphyromonas gingivalis (Pg, a main pathogenic bacterium of periodontal disease) on vascular intima adhesion factors and metalloproteinases. Methods: A total of 60 rats were randomly and equally divided into blank control group, Pg low dose group (Pg 2ml) and Pg high dose group (Pg 5ml) according to number table. The latter two groups respectively received intramuscular injection of corresponding dose Pg every three days without antibiotic intervention for 12 weeks. Then their venous blood was taken to measure levels of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), matrix metalloproteinase (MMP)-3 and MMP-9 in three groups. Results: Compared with blank control group, there were significant increase in contents of ICAM-1 [（175.79±14.30）ng/ml vs.（182.62±15.07）ng/ml, （189.39±14.93）ng/ml]、VCAM-1 [（256.49±37.17）ng/ml vs.（271.58±32.85）ng/ml , (286.66±30.66)ng/ml] 、 MMP-3 [（3.23±0.69）ng/ml vs.（3.61±0.82）ng/ml, (3.97±0.83)ng/ml]及 MMP-9 [（1.30±0.39）mg/L vs.（1.48±0.39）mg/L, 1.67±0.45）mg/L ]（P <0.05，or <0.01），Compared with Pg low dose group, there were significant increase in levels of above indexes in Pg high dose group (P<0.05). Conclusion: Porphyromonas gingivalis can significantly increase serum contents of vascular intima adhesion factors and metalloproteinases, aggravating pathological development of coronary heart disease.

Objective To investigate the consistency between mismatch repair proyeins expressions detected by immunohistochemistry(IHC)and microsatellite instability(MSI)identified by next-generation sequencing(NGS),and evaluate the correlation of these results with the clinical characteristics of Chinese colorectal cancer(CRC).Methods Using IHC and NGS to identify mismatch repair(MMR)and MSI status in CRC,and assessing the consistency between these different detection methods.Results The concordance rate of MSI status detected by IHC and NGS was 98.36%,indicating good agreement(Kappa=0.856).Certain pathogenic or likely pathogenic germline variants were present in the pMMR/MSI-H subtype.The co-deficiency of MLH1 and PMS2 was most common in the dMMR/MSS subtype.Patients with inconsistent typing were more likely to have early-onset right-sided colon cancer(P<0.01)and the tumor with relatively poor differentiation.Conclusions The consistency of MSI status detected by IHC and NGS is very high,98%or more.To avoid the misdiagnosis of MSI status affecting clinical decision-making for treatment plans,it is imperative to ensure the accuracy of MSI analysis,particularly in poorly differentiated early-stage right-sided colon cancers.

Colorectal cancer (CRC) is one of the most common malignant tumors recorded worldwide. This condition has high morbidity and mortality and seriously endangers people's health. Traditional diagnostic models fail to meet people's current needs for real-time monitoring of tumors. Compared with traditional detection methods, ctDNA detection is not only noninvasive but can also attain real-time detection of comprehensive genomic information of tumors. The advancement of detection technology has gradually highlighted the potential of ctDNA detection in the clinical treatment of CRC. This article reviews the advancements on the clinical application of ctDNA in early screening, minimal residual disease detection, and guidance on individualized treatment of CRC patients.

This article explores the standardized management of colorectal polyps, including classification, treatment, follow-up, and preventive control. Corresponding treatment strategies, including endoscopic resection and surgical intervention, are employed for different types of polyps. Currently, there is debate over whether to choose endoscopic resection or surgical intervention for malignant polyps at pT1 stage. Drawing on the latest literature and guidelines, the article elaborates on polyp classification, treatment modalities, follow-up, and preventive measures. Standardized management of colorectal polyps is important for reducing the incidence of colorectal cancer and improving the cure rate of early-stage colorectal cancer.

This article explores the standardized management of colorectal polyps, including classification, treatment, follow-up, and preventive control. Corresponding treatment strategies, including endoscopic resection and surgical intervention, are employed for different types of polyps. Currently, there is debate over whether to choose endoscopic resection or surgical intervention for malignant polyps at pT1 stage. Drawing on the latest literature and guidelines, the article elaborates on polyp classification, treatment modalities, follow-up, and preventive measures. Standardized management of colorectal polyps is important for reducing the incidence of colorectal cancer and improving the cure rate of early-stage colorectal cancer.

Objective:To investigate the safety and risk factors of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic lesions.Methods:Five thousand one hundred and sixty patients who underwent EUS-FNA in the Department of Endoscopy, Fudan University Shanghai Cancer Center from January 2012 to December 2022 were retrospectively reviewed. The incidence of adverse events was calculated, and independent risk factors were analyzed by univariate and logistic regression.Results:The incidences of postoperative pancreatitis, intraoperative bleeding and postoperative bleeding were 1.38% (68/4 930), 0.82% (42/5 143) and 0.78% (40/5 143) respectively. No perforation or death occurred. Age >60 years ( OR=0.581, 95% CI: 0.356-0.946, P=0.029), tumor located in the neck, body and tail ( OR=0.355, 95% CI: 0.194-0.652, P=0.001), lesion diameter of >20-40 mm ( OR=0.450, 95% CI: 0.227-0.893, P=0.023), and lesion diameter >40 mm ( OR=0.382, 95% CI: 0.168-0.869, P=0.022) were independent protective factors for postoperative pancreatitis. Transduodenal puncture ( OR=2.435, 95% CI: 1.319-4.496, P=0.005) was an independent risk factor for postoperative pancreatitis. Puncture for 3-4 pass ( OR=0.439,95% CI: 0.235-0.821, P=0.010), lesion diameter of >20-40 mm ( OR=0.154, 95% CI: 0.069-0.341, P<0.001), and lesion diameter >40 mm ( OR=0.326, 95% CI: 0.143-0.743, P=0.008) were independent protective factors for intraoperative bleeding. Fine-needle biopsy (FNB) needle ( OR=2.314, 95% CI: 1.189-4.502, P=0.014) was an independent risk factor for postoperative bleeding. Conclusion:EUS-FNA is a safe procedure with low incidence of adverse events. The occurrence of postoperative pancreatitis and intraoperative bleeding is mainly related to clinical characteristics of the lesion, while postoperative bleeding is related to the type of puncture needle.

[Objective] To compare the clinical efficacy of super pulse thulium laser enucleation of the prostate (SPThuLEP) with "open tunnel" and transurethral holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH), in order to provide reference for the treatment options of BPH. [Methods] The clinical data of 112 BPH patients treated in our hospital during Jan.2023 and Jul.2023 were retrospectively analyzed, including 65 treated with SPThuLEP with "open tunnel" and 57 with HoLEP.The operation time, postoperative hemoglobin decrease, postoperative bladder irrigation, catheter indwelling time, hospitalization time and complications were compared between the two groups.The changes of maximum urine flow rate (Qmax), international prostate symptom score (IPSS), quality of life score (QoL), postvoid residual (PVR) and prostate-specific antigen (PSA) were compared between the two groups before operation and one month after operation. [Results] All operations were successful without conversion to open or transurethral plasmakinetic resection.The postoperative decrease of hemoglobin in SPThuLEP group was lower than that in HoLEP group [(13.12±6.72) g/L vs. (21.02±6.51) g/L], with statistical difference (P<0.05). There were no significant differences in the operation time [(63.35±15.73) min vs.(61.02±17.55) min], postoperative bladder irrigation time [(1.07±0.45) d vs. (1.06±0.36) d], catheter indwelling time [(2.98±0.56) d vs. (3.01±0.63) d] and hospitalization time [(3.63±0.61) d vs.(3.79±0.76) d] between the two groups (P>0.05). No blood transfusion, secondary bleeding or unplanned hospitalization occurred, and there were no serious complications such as transurethral electroresection syndrome (TURS), urethral stricture and urinary incontinence.One month after operation, the Qmax, IPSS, QoL, PVR and PSA of the two groups were significantly improved compared with those before operation (P<0.05), but with no statistical difference between the two groups (P>0.05). [Conclusion] SPThuLEP with "open tunnel" has comparable efficacy as HoLEP in the treatment of BPH.With advantages of small amount of bleeding and high safety, this minimally invasive technique can be widely popularized in clinical practice.