1.Analysis of specimen quality of intersphincteric resection for rectal cancer in the Chinese Transanal Total Mesorectal Excision Registry Collaborative database: a nationwide registered study
Pengyu WEI ; Mingyang REN ; Quan WANG ; Hong ZHANG ; Chienchih CHEN ; Qing XU ; Yi XIAO ; Dan MA ; Zhicong FU ; Dehai XIONG ; Yang LI ; Hongwei YAO ; Zhongtao ZHANG
Chinese Journal of Digestive Surgery 2024;23(6):819-825
Objective:To investigate the specimen quality of intersphincteric resection with transabdominal transanal mixed approach for rectal cancer in the Chinese Transanal Total Mesorectal Excision Registry Collaborative (CTRC) database.Methods:The retrospective case-control study was conducted. Based on the concept of real-world research, the clinicopathological data of 281 pati-ents with rectal cancer in the CTRC database who underwent intersphincteric resection with trans-abdominal transanal mixed approach in 19 medical centers, including the Beijing Friendship Hospital of Capital Medical University et al, from November 15,2017 to December 31,2023 were collected. There were 196 males and 85 females, aged 61(range, 27-87)years. Observation indicators: (1) preoperative examinations; (2) neoadjuvant therapy; (3) postoperative examinations; (4) analysis of influencing factors for positive circumferential margin in surgical specimen of intersphincteric resec-tion for rectal cancer. Measurement data with normal distribution were represented as Mean±SD. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers or percentages. The chi-square test was used for univariate analysis. Logistic regression model was used for multivariate analysis. Results:(1) Preoperative examinations. Of the 281 patients, 234 cases underwent preoperative pelvic magnetic resonance imaging (MRI) examina-tion. There were 2 cases in clinical stage T0, 3 cases in clinical stage T1, 58 cases in clinical stage T2, 137 cases in clinical stage T3, 24 cases in clinical stage T4, 3 cases in clinical stage Tx, 7 cases missing clinical T staging data. There were 87 cases in clinical stage N0, 68 cases in clinical stage N1, 60 cases in clinical stage N2, 9 cases in clinical stage Nx, 10 cases missing clinical N staging data. There were 30 cases with mesorectal fascia invasion, 53 cases with extramural venous invasion. The distance from lower margin of tumor to anal margin was 41.9(range, 1.0-80.0)mm. (2) Neoadjuvant therapy. Of the 281 patients, 125 cases underwent neoadjuvant therapy, including 39 cases receiving chemo-therapy alone, 6 cases receiving short-course simultaneous chemoradiotherapy, 5 cases receiving short-course simultaneous chemoradiotherapy and delayed surgery, 48 cases receiving long-course simultaneous chemoradiotherapy, 2 cases receiving other treatments, and 25 cases missing neoadju-vant therapy data. (3) Postoperative examinations. Of the 281 patients, 249 cases achieved R 0 resection, 9 cases achieved R 1 resection, and there were 23 cases missing surgical margin data. The maximum tumor diameter, the number of lymph nodes harvested and positive rate of vessel carcinoma embolus were 30.0(range, 0.5-200.0)mm, 13(range, 0-70) and 27.55%(73/265) in 281 patients. There were 252 patients with circumferential margin records, showing positive in 15 cases, with a positive rate as 5.95%(15/252). The minimum distance from deep part of tumor to circumferential margin was 7.0(range, 0-150.0)mm in 252 patients. There were 85 cases with distal margin records, showing positive in 1 case, and the distance from lower margin of tumor to distal margin was 10.0(range, 0-202.0)mm. There were 273 patients with specimen integrity records, which showed intact specimen in 208 cases, fair specimen in 58 cases, poor specimen in 4 cases, unevaluated specimen in 3 cases. There were 7 cases with rectal perforation. Of the 281 patients, cases in pathological stage T0, Tis, T1, T2, T3, T4 were 14, 5, 22, 107, 113, 12, respectively, and there were 8 cases missing pathological T staging data. Of the 281 patients, cases in pathological stage N0, N1a, N1b, N1c, N2a, N2b were 176, 27, 27, 11,20, 12, respectively, and there were 8 cases missing pathological N staging data. Of the 281 patients, there were 4 cases with distant metastasis, 262 cases without distant metastasis, 5 cases not evaluated, and 10 cases missing tumor metastasis data. Of the 125 patients undergoing neoadjuvant therapy, there were 85 cases with tumor regression grade records, including 16 cases as grade 1, 27 cases as grade 2, 19 cases as grade 3, 15 cases as grade 4, 8 cases as grade 5. (4) Analysis of influencing factors for positive circumferential margin in surgical specimen of intersphincteric resection for rectal cancer. Results of univariate analysis showed that preoperative T staging on preoperative pelvic MRI, mesorectal fascia invasion, extramural venous invasion, pathological T staging, and pathological N staging were related factors for positive circumferential margin in surgical specimen of intersphincteric resection for rectal cancer ( P<0.05). Conclusions:Intersph-incteric resection with transabdominal transanal mixed approach has good specimen quality and low positive rate of surgical margin. T staging on preoperative pelvic MRI may be related to positive circumferential margin after intersphincteric resection for rectal cancer.
2.Enrichment methods and clinical application of circulating tumor cells
Dawei NING ; Yang OU ; Kai CUI ; Sheng LI ; Dehai GAO
Journal of International Oncology 2021;48(3):167-171
As an emerging tumor marker, the rarity and heterogeneity of circulating tumor cells (CTCs) increase the difficulty of detection. In recent years, CTCs enrichment technology based on biophysical, biochemical and microfluidic properties has been continuously developed, which has promoted the research and application of CTCs in malignant tumors diagnosis, clinical treatment and prognosis evaluation. Although there are still some deficiencies in the detection of CTCs, with the interdisciplinary integration, CTCs will play increasingly important roles in the diagnosis and treatment of malignant tumors.
3.Application of transesophageal ultrasound-guided minimally invasive surgical closure for congenital heart disease
Yongfeng REN ; Zhou WANG ; Dehai CHEN ; Tiangang ZHU ; Jian LI ; Jing LU ; Shanshan WANG
Chinese Journal of General Practitioners 2019;18(8):772-774
The clinical data of 31 patients with congenital heart disease(CHD)receiving minimally invasive surgical closure through chest or femoral venous catheter from June 2016 to September 2017 were analyzed retrospectively.All patients were diagnosed with esophageal echocardiography before operation.During the operation,the insert of guide wire and the sheath tube,and the placement of the sealing parasol were monitored and guided by transesophageal echocardiography (TEE).Satisfactory results were obtained in 30 patients.In 1 patients,the sealing parasol was detached,and open chest surgery was performed to remove the detached parasol and to repair the defect.TEE-guided minimally invasive surgical closure through chest or femoral vein catheter is safe and effective in the treatment of congenital heart disease and has certain clinical applicative value.
4.Cell Division Cycle Associated 8 Is a Key Regulator of Tamoxifen Resistance in Breast Cancer
Dehai YU ; Libo SHI ; Yuhui BU ; Weidong LI
Journal of Breast Cancer 2019;22(2):237-247
PURPOSE: Breast cancer (BC) is one of the most common malignancies globally, and millions of women worldwide are diagnosed with BC every year. Up to 70% of BC patients are estrogen receptor (ER)-positive. Numerous studies have shown that tamoxifen has a significant therapeutic effect on both primary and metastatic ER-positive BC patients. Although tamoxifen is currently one of the most successful therapeutic agents for BC, a significant proportion of patients will eventually become resistant to tamoxifen, leading to tumor recurrence and metastasis. Knowledge about the development of tamoxifen resistance in BC patients is still limited. METHODS: We applied a loss-and-gain method to study the biological functional role of cell division cycle associated 8 (CDCA8) in tamoxifen resistance in BC cells. RESULTS: We found that CDCA8 was significantly elevated in tamoxifen-resistant BC cells. Knockdown of CDCA8 expression significantly inhibited the proliferation of tamoxifen-resistant BC cells and reduced their resistance to tamoxifen. In contrast, overexpression of CDCA8 promoted the growth of tamoxifen-sensitive BC cells and induced their resistance to tamoxifen. CONCLUSION: In this study, we reported that CDCA8 is a key regulator of tamoxifen resistance in BC, suggesting that CDCA8 may serve as a potential therapeutic target for BC treatment.
Apoptosis
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Breast Neoplasms
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Breast
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Cell Cycle
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Cell Division
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Estrogens
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Female
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Humans
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Methods
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Neoplasm Metastasis
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Recurrence
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Tamoxifen
5.Immunosuppressant mycophenolic acid biosynthesis employs a new globin-like enzyme for prenyl side chain cleavage.
Xiwei CHEN ; Lu WANG ; Jinmei ZHANG ; Tao JIANG ; Changhua HU ; Dehai LI ; Yi ZOU
Acta Pharmaceutica Sinica B 2019;9(6):1253-1258
Mycophenolic acid (MPA, ) and its derivatives are first-line immunosuppressants used in organ transplantation and for treating autoimmune diseases. Despite chemical synthetic achievements, the biosynthetic formation of a seven-carbon carboxylic acid pharmacophore side chain of , especially the processes involving the cleavage of the prenyl side chain between DHMP () and DMMPA (), remains unknown. In this work, we identified a membrane-bound prenyltransferase, PgMpaA, that transfers FPP to to yield FDHMP (). Compound undergoes the first cleavage step a new globin-like enzyme PgMpaB to form a cryptic intermediate . Heterologous expression of genes in demonstrates that the second cleavage step (from to ) of is a cluster-independent process . Our results, especially the discovery of the broad tolerance of substrates recognized by PgMpaB, set up a strategy for the formation of "pseudo-isopentenyl" natural products using fungal globin-like enzymes.
6.Research progress of gastric cancer circulating tumor cells
Yang OU ; Shuo WANG ; Kai CUI ; Sheng LI ; Dehai GAO
International Journal of Surgery 2018;45(4):272-276
The incidence of gastric cancer ranks the fourth in all kinds of cancers in the world,ranking the second among patients with cancer-related deaths.The 5-year survival rate of gastric cancer patients is less than 30%.About 50% of gastric cancer patients have recurred or metastasized after curative resection.Metastasis and recurrence are the major causes of death in cancer patients.CTCs play an important role in tumor metastasis.At present,there are more than 10 kinds of detection methods for CTCs in gastric cancer.The most widely used methods are RT-PCR,FCM,CelLTracks(R) AutoPrep(R) system and ISET.Recent studies have shown that CTCs in peripheral blood of patients with gastric cancer can be used to determine the clinical stage of patients,assess the prognosis and guide the individualized treatment of cancer.
7.Application of fluorescence in the identification of circulating tumor cells
Huajie YU ; Lu HAN ; Yang OU ; Sheng LI ; Dehai GAO
Journal of International Oncology 2018;45(1):35-38
There are many ways to identify circulating tumor cells in the current.Fluorescence has a wide range of applications in the identification of circulating tumor cells.The labeled cells can be observed and counted more intuitively by labeling the tumor cells with fluorescent group containing antibodies,probes and aptamers,and cytokine,CD45 and fluorescence in situ hybridization are widely used in the identification of various circulating tumor cell related tests.In recent years,people have explored the feasibility of using fluorescent probes to directly identify circulating tumor cells.With the development of biopsy probes and optical sectioning imaging technology of confocal microscopy,it is possible to directly identify circulating tumor cells with fluorescent probes in the future.
9.Medical TH adhesive embolism for establishing a rabbit model of ischemic necrosis of lunate bone
Yunxiang LU ; Yuxian CHEN ; Ze ZHUANG ; Jianhua REN ; You PENG ; Dehai SHI ; Kun WANG ; Zhiyong LI
Chinese Journal of Tissue Engineering Research 2014;(5):663-668
BACKGROUND:Kienb?ck disease lacks of suitable animal models, which are similar to the pathological process of avascular necrosis of human lunate bone.
OBJECTIVE:To establish a new animal model of Kienb?ck disease using medical TH adhesive embolism and to explore the rationality of model establishment.
METHODS:A total of 30 healthy adult New Zealand rabbits, male or female, were selected. Using self-control method, the rabbits were randomly assigned to experimental sides and control sides. By dril ing in the center of the lunate bone, 0.2 mL of medical TH glue was injected three times. An equal volume of physiological saline was injected into the center of the lunate bone on the control side. X-ray examination, general observation, Micro-CT measurement of bone, and tissue pathology detection were conducted at 4, 8 and 12 weeks.
RESULTS AND CONCLUSION:Gross specimen, X-ray and histological results showed that ischemic necrosis of the lunate bone on the experimental side was visible at 8 weeks after model induction. The ischemic necrosis of the lunate bone became more typical at 12 weeks. Among the Micro-CT microscopic parameters of trabecular bone, trabecular bone density parameters bone volume fraction and the number of trabecular bone were significantly lower on the experimental side than those on the control side (P<0.05). Spatial parameters of trabecular bone significantly increased. Trabecular separation and structure model index on the experimental side were significantly greater than those on the control side. Results suggested that ischemic necrosis of the lunate bone appeared on the experimental side at 8 weeks after injection of medical TH glue. Rabbit models of ischemic necrosis of the lunate bone can be established at 12 weeks. Thus, alterations, which were similar to ischemic necrosis of human lunate bone, appeared, such as blood transportation damage in the lunate bone, trabecular bone fracture, and empty lacuna, when surrounding tissues were not obviously injured.
10.A clinical study of preventive effect of entecavir on HBV reactivation in lung cancer with HBV carriers after chemotherapy
Dehai CHE ; Zhen LI ; Gang XU ; Yan YU ; Hua ZHANG ; Yan LIU
Practical Oncology Journal 2014;(1):7-11
Objective The present study aims to determine the correlation between liver function dam-age and hepatitis B virus ( HBV ) reactivation caused by chemotherapy , and the preventive effect of entecavir on HBV reactivation in lung cancer with HBV carriers .Methods A total of 160 lung cancer patients with HBV car-riers in the affiliated tumor hospital of Harbin Medical University from January 2011 to December 2012 was inves-tigated and the clinical data were studied retrospectively .The patients were divided into prophylactic group ( n=80)and control group(n=80).In prophylactic group,0.5 mg of daily oral entecavir was administered before the chemotherapy until 6 months after the completion of chemotherapy .Control group received no entecavir .The inci-dence of HBV reactivation ,functional damage of liver ,toxicities and disruption of chemotherapy were measured . Results The comparison between the control group (25%) and prevent group (5%) showed a statistically signifi-cant difference in the incidence of HBV reactivation (P<0.01).Moreover,HBV-DNA level(HBV-DNA≥104 copies/mL)was risk factors of HBV reactivation (P<0.05).Histology and stage of lung cancer,the chemother-aphy scheme containing platinum , positive HBeAg were not significantly correlated with HBV reactivation ( P>0.05).There were significant differences in grade III and IV hepatic toxicity (P<0.05)between control group (30%)and prevent group(5%),but was not in grade I and II hepatic toxicity (P>0.05).Disruption of chemo-therapy showed significant difference between control group (20%)and prevent group(5%)(P<0.05).The ma-jor grade 1 ~2 toxicities were myelosuppression,nausea,vomiting,skin rash,diarrhoea,neurotoxicity,fatigue, headache,insomnia,etc.All adverse reactions were cured after treatment .Conclusion The prophylactic adminis-tration of oral entecavir could reduce the risk of HBV reactivation in lung cancer with HBV carriers .

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