Objective The aim of this study was to analyse characteristics of CRC in a cohort under the age of 40 .Methods Using single center retrospective cohort study ,we reviewed the prospectively collected database of 2 897 colorectal cancer patients who had undergone curative CRC resections in Chongqing Medical University between 2010 and 2014 .175 patients (5 .8% ) were under 40 ,in which six patients for various reasons (including recurrent colorectal cancer hospital ,incomplete information ,etc .) were excluded .A group of 180 consecutive patients over the age of 40 undergoing surgery for colorectal cancer in the same centre was used as control .Results There had no difference in tumor classification and tumor location between the younger group (<40) and the older group(>40) ,but the lymph node positive rate in younger group was higher ,unable to accurately grasp the preopera‐tive lymph node status ,lead to lack of preoperative staging ,and that made it difficult to preoperative treatment options .Conclusion Therefore ,to young people in colorectal preoperative neoadjuvant chemoradiation indications and the assurance of intraoperative re‐section range ,we need to do more consideration.

AIM:To explore the effect of FOXQ1 gene silencing on angiogenesis and proliferation ability of co-lon cancer cells induced by Sonic hedgehog (Shh).METHODS:Lentivirus expressing different FOXQ1-shRNA or nega-tive cantrol (NC)-shRNA was used to infect the SW480 cells.The best silencing condition was screened and used in the following experiments .The SW480 cells were divided into interfered group ( FOXQ1-shRNA) and control group ( NC-shR-NA) .The MTT assay was used to observe the doubling time and cell activity .Tube formation assay was performed to detect the ability of angiogenesis.Meanwhile, the expression of vascular endothelial growth factor (VEGF)-A, matrix metallopro-teinase ( MMP) 2 and cyclin D1 at mRNA and protein levels was determined by real-time PCR and Western blot .After in-duction of the cells by recombinant Shh proteins , the changes of angiogenesis and proliferation ability in each group were detected.At the same time, the transformation of related gene was examined .RESULTS:Compared with control group , the angiogenic ability in interfered group was decreased , and no obvious difference of proliferation ability was observed .The expression of VEGF-A and MMP2 was declined significantly , and the expression of cyclin D 1 was not obviously changed . Recombinant Shh proteins improved the expression of FOXQ1 gene.Compared with NC-shRNA group, after induction, the angiogenic ability of FOXQ1-shRNA group was decreased , and the proliferation ability was not obviously changed .CON-CLUSION:FOXQ1 gene mediates the angiogenic ability but does not affect the proliferation ability of SW 480 cells.Mean-while, it may be regulated by shh pathway .

Objective To investigate the application value of diameter change of superior rectal vein (SRV) and inferior mesenteric vein (IMV) by CT examination in the efficacy evaluation of neoadjuvant therapy for locally advanced rectal cancer.Methods The retrospective descriptive study was conducted.The clinicopathological data of 40 patients with locally advanced rectal carcer who underwent neoadjuvant therapy in the First Affiliated Hospital of Chongqing Medical University were collected.There were 28 males and 12 females,aged from 12 to 75 years,with the age of (55± 12)years.All patients underwent radical resection of rectal cancer according to the principle of total mesorectal resection after neoadjuvant therapy.Observation indicators:(1) MRI examination;(2) CT examination;(3) surgical situations;(4) follow-up.Follow-up was performed using outpatient examination to detect postoperative complications up to June 2019.The measurement data with normal distribution were represented as Mean±SD,and paired sample t test was used for intra-group comparison.Count data were described as absolute numbers or percentages.Results (1) MRI examination:there were 22 patients with positive extramural vascular invasion (EMVI) and 18 with negative EMVI.(2) CT examination:the diameter of SRV was (3.9 ± 0.9) mm and (3.0 ± 0.6) mm before and after neoadjuvant therapy,showing a significant difference (t=5.75,P＜0.05).Subgroup analysis:for the 30 patients with response to neoadjuvant therapy,the diameter of SRV changed significantly after neoadjuvant therapy [(4.1 ± 1.0) mm vs.(3.4±0.7) mm,t =6.20,P＜0.05];for the 10 patients without response to neoadjuvant therapy,the diameter of SRV showed no significant difference after neoadjuvant treatment [(3.6±0.6)mm vs.(3.5±0.8)mm,t=1.13,P＞0.05].The diameter of SRV was (4.2±0.8)mm in 22 patients with EMVI and (3.7±0.8)mm in 18 patients with negative EMVI,showing a significant difference between the two groups (t =2.45,P＜0.05).The diameter of IMV was (5.1 ± 0.9)mm and (4.2±0.9)mm before and after neoadjuvant therapy,showing a significant difference (t=4.16,P＜ 0.05).Subgroup analysis:for the 30 patients with response to neoadjuvant therapy,the diameter of IMV changed significantly after neoadjuvant treatment [(5.1 ± 0.9) mm vs (4.6± 0.8) mm,t =0.76,P＜ 0.05];for the 10 patients without response to neoadjuvant therapy,the diameter of SRV showed no significant difference after neoadjuvant treatment [(5.0±0.9)mm vs (4.8±1.0)mm,t=0.76,P＞0.05].The diameter of IMV was (4.8± 0.9) mm in 22 patients with EMVI and (4.6±0.8) mm in 18 patients with negative EMVI,showing no significant difference between the two groups (t =2.45,P＞ 0.05).(3) Surgical situations:40 patients underwent radical resection of rectal cancer,including 4 with synchronous liver metastases undergoing resection of metastases.(4) Follow-up:40 patients were followed up for 3.0-6.0 months,with a median follow-up time of 4.5 months.One of 40 patients with perineal incision infection was improved and discharged after dressing change,1 with anastomotic leakage on the 5th day after operation was improved and discharged after conservative treatment,1 of 2 with adhesive intestinal obstruction was improved after surgery and 1 was improved after conservative treatment,other 36 patients were discharged and no obvious abnormality occured during the follow-up.Conclusions The diameters of SRV and IMV in patients with locally advanced rectal cancer can be significantly decreased significantly after neoadjuvant therapy.The diameters of SRV and IMV can be used as potential indices to evaluate the effects of neoadjuvant therapy for rectal cancer,and the SRV had a higher evaluation value.

Objective: To investigate the influence of trached extubation time on the emergent agitation during the recovery of sevoflurane combined anesthesia in infants. Methods: Sevoflurane, propofol and remifentanil were combined to maintain general anesthesia after intubation. The propofol infusion was stopped 10 minutes before the operation, and the remifentanil infusion was stopped 5 minutes before the end of the operation. The sevoflurane concentration was reduced to 1%, and the oxygen flow was adjusted to 6 L/min when the sevoflurane inhalation was stopped. Ninety infant patients with cleft palate were randomized into 3 groups (n=30): 30 patients in group A were extubated within 5 minutes, 30 patients in group B were extubated between 5 and 10 minutes, and 30 patients in group C were extubated after 10 minutes. A postoperative agitation score was given after extubation and recorded away from the operating room. Propofol was administered when agitation occurred. The recovery time after the operation and time away from the operating room were recorded. Results: The recovery times of group A, group B, and group C were 21.8 ± 2.5 minutes, 21.4 ± 2.1 minutes and 20.9 ± 1.3 minutes, respectively, although the differences were not significant (P > 0.05). The times away from the operating room of group A, group B, and group C were 8.1 ± 1.6 minutes, 5.2 ± 2.0 minutes and 2.1 ± 0.7 minutes, respectively, and the differences were statistically significant (P < 0.05). When endotracheal intubation was removed, the incidence of agitation in group A (26/30) was higher than that in group B (16/30) and group C (5/30), and the differences were statistically significant (P < 0.05). The incidence of agitation in group B was also significantly different from that in group C (P < 0.05). Conclusion Propofol, which is used to control coughing and prolong the extubation time, can effectively prevent emergent agitation during the recovery period from sevoflurane-based anesthesia in infants. The optimum time of extubation was 15 minutes.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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