Objective To investigate the safety and clinical effect of prophylactic ileostomy using right lower abdominal specimen extraction incision in laparoscopic rectal low anterior resection and its impact on ileos-tomy closure.Methods A retrospective analysis was conducted on 127 patients who underwent laparoscopic low anterior resection of rectal cancer combined with prophylactic ileostomy in Department of General Surgery in our hospital from January 2020 to December 2023.Patients were divided into observation group(n=60)and control group(n=67)based on whether with prophylactic ileostomy using the right lower abdominal specimen extraction incision or not.Relevant data and clinical data of ileostomy closure were compared between the two groups.Results(1)There was no significant difference in baseline clinical data between the two groups(P>0.05).(2)In terms of operation time,pain score within three days after surgery and postoperative first exhaust time,the observation group was better than the control group,showing statistical difference(P<0.05).In the observation group,the average length of the incision was longer than that in the control group,and it was significantly different between the two groups(P<0.05).There was no significant difference between the two groups in terms of blood loss,post-operative feeding time and postoperative hospital stay(P>0.05).(3)There was no significant difference between the two groups in postoperative and ostomy-related complication S(P>0.05).(4)The observation group was better than the control group in terms of postoperative pain score and postoperative first exhaust time,indicating statistical significance(P<0.05).There were no significant differences in surgical time,abdominal adhesion,blood loss,postoperative hospital stay and postoperative complications between the two groups(P>0.05).Conclusion The patients undergoing laparoscopic rectal low anterior resection who needs prophylactic ileostomy using right lower abdominal specimen extraction incision can improve the appearance of the incision,shorten operation time,reduce postoperative pain of the patients but does not increase postoperative complications and the difficulty of ileostomy closure.It is safe and feasible,which worthy for clinical promotion.

Objective:To investigate the value and molecular mechanism of gastric cancer stem cells in invasion and metastasis of gastric cancer.Methods:Gastric cancer stem cells were isolated by spheroid culture method, and the biological characteristics were identified. The role of gastric cancer stem cells in multidrug resistance, invasion and metastasis was analyzed. The important molecules involved in the biological behavior of gastric cancer stem cells were identified by gene chip. Screening of the signaling pathway revealed that anthrax toxin receptor 2 (ANTXR2)plays an important role in invasion, metastasis, glomerization and tumor formation.Results:Sox2 and Bmi1 expression in SGC7901 and MGC803 cells were significantly higher than monolayer culture cells (15.39±3.23). Oct4 express increased to (4.19±0.62). The expression levels of the dry-related genes Bmi1, Sox2 and Oct4 in SGC7901-SC cells were (3.29±0.52), (3.12±0.49), (2.58±0.35), respectively, which were higher than those of SGC7901-MN cells, Bmi1, Sox2 and Oct4, respectively. The differences were statistically significant ( t=5.392, 7.316, 6.449, all P<0.05) for (1.41±0.39), (2.04±0.33), (1.39±0.32); in primary cells XN0422-SC and in SGC7901-SC cells, miR-638 was in high expression (0.69±0.11), and miR-181b and miR-181a in low expression (0.12±0.05) and (0.15±0.07). ANTXR2 expression in SGC7901-SC cells was higher than that in SGC7901-MN cells ( t=6.216, P<0.05). The ANTXR2 positive cells in SGC7901-SC was 85.48%. The proportion of ANTXR2 positive cells in SGC7901 was 4.98%. Gastric cancer cells XN0422 and SGC7901 were affected by PLVT713, and ANTXR2 expression protein decreased. Conclusion:ANTXR effects a regulatory role by activating the Src/ERk signaling pathway, which can be used to predict the biological beharious of gastric cancer.

A case report of periprosthetic hip clostridium perfringens infection 13 years after total hip arthroplasty, the patient had hip pain with fever for one week. Physical examination and imaging examination confirmed the periprosthetic joint infection. The pathogenic bacterium was clostridium perfringens according to bacterial culture, and the pathogenic bacterium of clostridium perfringens was suspected relating to the gallbladder disease in this patient. Considering such periprosthetic joint infection was early stage hematogenous periprosthetic joint infection, treatment of debridement, retention of the prosthesis, irrigating, and indwelling drainage tube were conducted. By reviewing literature about periprosthetic clostridium perfringens infection, only seven reports of periprosthetic joint infection were caused by clostridium perfringens, which were all case reports. From the previous case reports and our case, we found that the infection around the prosthesis caused by clostridium perfringens was limited to the area around the joint, and prognosis of such cases may not be as severe as the natural gas gangrene which developed very rapidly, but great attention should be paid to. The hematogenous periprosthetic joint infection caused by clostridium perfringens who had gastrointestinal symptoms in the early stage should be highly suspicious of gallbladder lesions and thorough debridement, retention of the prosthesis, irrigating and indwelling drainage tube maybe a treatment method.

ObjectiveTo compare the clinical efficacies between bloodletting cupping plus acupuncture and acupuncture alone in treating hypertension.MethodSixty patients with primary hypertension were randomized into a treatment group and acontrol group, 30 cases in each group. The treatment group was intervened by bloodletting cupping plus acupuncture, while the controlgroup was by acupuncture. The clinical symptoms, blood pressure, and hemorheological parameters were observed before and after intervention.ResultThe clinical symptoms were improved in both groups after intervention, and the total effective rate was 76.7%in the treatment group versus 63.3% in the control group; the blood pressure dropped in both groups, and the differences were statistically significant between the two groups (P<0.05); the treatment group was superior to the control group in improving the whole blood viscosity and erythrocyte sedimentation rate(P<0.01).ConclusionBloodletting cupping is effective in treating primary hypertension; regarding the short-term therapeutic efficacy, bloodletting cupping plus acupuncture can produce a more significant effect than acupuncture alone in improving the blood pressure, whole blood viscosity, and erythrocyte sedimentation rate in primary hypertension patients.

Objective Serum miRNA has been regarded as a potential biomarker for diagnosis, therapeutic evaluation and prognostic prediction in cancer patients. This study aims to explore the clinical significance of the expression level of metastasis- related microRNA (miR- 18b) in the serum in AFP- negative (≤ 20 ng/ml) hepatocellular carcinoma(HCC) patients receiving radiofrequency ablation (RFA). Methods A total of 131 HCC patients with negative serum AFP, who were encountered during the period from January 2007 to January 2011 at authors’ hospital, were enrolled in this study. Radiofrequency ablation (RFA) of the lesions was carried out in all patients. Serum samples were collected before RFA. Forty - three healthy individuals were selected for control. The expression level of serum miR - 18b was deternmined by using quantitative real- time PCR method in all the patients and the healthy individuals. The correlations of the expression level of serum miR - 18b with clinico - pathological factors, postoperative recurrence, overall cirrhosis (P = 0.035), tumor diameter (P < 0.01) and tumor differentiation (P = 0.020). During the follow-up period, 79 patients (60.3%) developed recurrent tumors, and the expression level of serum miR- 18b in them was dramatically higher than that in the patients showing no recurrence (3.26 ± 1.28 vs. 2.42 ± 0.86, P <0.01). The incidence of recurrence after RFA, especially distant intrahepatic metastasis, in patients with higher expression level of serum miR- 18b was strikingly higher than that in patients with lower expression level of serum miR- 18b (72.3% vs. 48.5%, P = 0.005). Kaplan- Meier survival analysis indicated that both overall survival rate and recurrence- free survival rate of patients with higher expression level of serum miR-18b were significantly lower than those of patients with lower expression level of serum miR- 18b. Conclusion The expression level of serum miR - 18b is significantly elevated in AFP - negative HCC patients. The expression level of serum miR- 18b might be used as an ideal biomarker for monitoring tumor recurrence as well as for predicting prognosis after RFA.

OBJECTIVE: To explore the significance of hMSH2 aberrant expression in patients with sporadic colorectal cancer in Xinjiang Uygur Autonomous Region. METHODS: Clinicopathological parameters and postoperative samples of 327 patients with sporadic colorectal cancer were collected in Xinjiang Uygur Autonomous Region. Immunohistochemistry PV-9000 two-step method was performed to measure hMSH2 expression in the postoperative pathologic specimens. Prognostic value of hMSH2 expression was evaluated. RESULTS: Thirty-five (10.7%) patients showed aberrant nuclear staining of hMSH2 expression. The patients with aberrant expression of hMSH2 showed better prognosis than the normal expression group, with significant difference (P<0.05). CONCLUSION In Xinjiang, aberrant hMSH2 expression can be regarded as an independent prognostic factor in patients with sporadic colorectal cancer.
Colorectal Neoplasms ; genetics ; metabolism ; Humans ; Immunohistochemistry ; MutS Homolog 2 Protein ; genetics ; metabolism ; Prognosis

Objective To evaluate the treatment effect and security of transcatheter arterial chemoembolization(TACE)combined with sorafinib for intermediate-advanced hepatocellular carcinoma.Methods From July 2008 to November 2010,the treatment effects of two groups of patients with advanced hepatocellular carcinoma were retrospectively analyzed and compared,including 44 patients treated by sorafenib combined with TACE(test group)and the other 44 patients treated only with TACE(control group).To assess the treatment effect based on mRECIST,the time for patients' tumor progression(TTP),overall survival(OS)time and adverse events were recorded.Survival rate were analyzed using KaplanMeier method and Log-rank analysis in SPSS 18.0.Results Till January 2011,24 patients(54.5％)survived and 20 patients(include patients lost to visit)died(45.5％)among the test group,13 patients survived(29.5 ％)and 31 patients(include patients lost to visit)died(70.5 ％)among the control group.No complete remission condition was observed in all patients.Among the test group,1 patient got partial remission,24 ones remain stable and 19 patients got progression.While among the control group,conditions remained stable in 21 patients and progressed in rest 23 ones.The disease control rate(DCR)in the test group and control group were 56.8％(25/44)and 47.7％(21/44)respectively,with no statistical significance(x2 =0.729,P =0.393).The median overall survival time(mOS)of test group and control group were 21.0(95 ％ CI:14.9-27.1)months and 10.0(95 ％ CI:6.4-13.6)months respectively,and the difference reached statistical significance(x2 =7.436,P =0.006).The median time to tumor progression(mTTP)of test group and control group was 1 1.0(95％ CI:8.7-13.3)and 6.0(95％ CI:3.9-8.1)months respectively,and the difference had statistical significance(x2 =10.437,P =0.001).The adverse events of test group mainly included hand-foot skin reaction,loss of appetite,fever,fatigue and diarrhea.The adverse events of control group mainly included fever,loss of appetite,nausea,vomiting and fatigue.The incidences of hand-foot skin reaction,baldness,diarrhea were significantly higher in test group than those in the control group(P ＜0.05).In most patients,these side effects were mild-to-moderate,and alleviated remarkablely after symptomatic treatment.Conclusions Compared with TACE alone,TACE combined with sorafenib can prolong the OS and TTP significantly for the patients with intermediate-advanced hepatocellular carcinoma.However,the DCR of the two groups has no statistical significance.

300?10~(9)/L. Results:One hundred and six patients were enrolled into this study. Of the 106 patients, 100 patients completed the study and were evaluable for efficacy. The median nadir of platelet was 49(5-76)?10~(9)/L in the control cycle and 69(6-221)?10~(9)/L in the study cycle. Median durations of PLT≤75?10~(9)/L, ≤50?10~(9)/L, and ≤20?10~(9)/L were 7 (0-26), 2 (0-20), and 0 (0-9) days in control cycle versus 3.5 (0-28) (P0.05) days in study cycle, respectively. The median duration of platelet recovery to 80?10~(9)/L was 5 (1-18) days in control cycle versus 2(0-28) days in study cycle (P

OBJECTIVE:To summarize the clinical effect of compound glycyrrhizin(CG)on SARS.METHODS:The clin?ical data of73patients with clinically diagnosed SARS(37cases were treated by CG)were prospectively analysed.RESULTS:After CG treatment,the symptoms of dry cough,chest distress and dyspnea improved quickly and the elevated serum level of aminotransferase decreased.The maximal dosages of corticosteroids used in CG group and control group were(354.3?219.8)mg/d and(430?262.6)mg/d,respectively.The average time to occurrence of antibody,duration for reduction of corticosteroid dosage and duration of hospital stay were shorter in CG group than those in control group.There was no significant difference in titer value of antibody between two groups.CG had little effects on WBC,blood sugar and electrolytes.CONCLUSION:CG may be a promising drug against SARS with less side effect.

Multidrug resistance (MDR) is the most common cause in the failure of cancer chemotherapy. Drug transporters play an important role in multidrug resistance in cancer. Activation of drug pumps which belong to ATP-binding cassette (ABC) transporters leads to the efflux of drug via cell membrane.Three subgroups of ABC transporters are involved in the transport of cytotoxic drugs.These transporters include ABCB subgroup,ABCC subgroup and ABCG subgroup. In this review,the author discussed the recent research advances in the ABC transporters associated with MDR.