Gastrointestinal malignant tumors are common worldwide,particularly gastric cancer(GC)and colorectal cancer(CRC),with complex and not fully understood molecular mechanisms behind their occurrence and progression.Treatment typically involves a comprehensive approach centered on surgery,which,despite achieving good outcomes,still faces challenges due to high recurrence rates and low survival rates impacting patient health.N6-methyladenosine(m6A)is the most abundant internal modification in mRNAs and plays a crucial role in regulating RNA post-transcriptional modifications and downstream functions.Fat mass and obesity-associated protein(FTO)was the first identified m6A demethylase capable of removing dynamic,reversible m6A modifications.During the development of gastrointestinal malignancies,FTO regulates the expression of specific genes,affecting tumor cell proliferation and metastasis;modulates the expression of tumor-related cytokines and immune-related molecules,influencing the tumor microenvironment;and plays a significant role in sensitivity and resistance to chemotherapy.FTO is upregulated in most types of GC,indicating poor prognosis.High FTO expression enhances GC cell migration and invasion,increases chemoresistance,promotes tumor stem cell proliferation and differentiation,and inhibits apoptosis,thus facilitating GC progression.In CRC,many studies show that FTO is upregulated in tissues and cells,promoting CRC progression by enhancing cell proliferation,migration,invasion,and resistance to chemotherapy.Low FTO expression can also elevate m6Am levels in CRC cell cytoplasmic mRNA,promoting tumor stem cell proliferation,differentiation,tumor formation,and increasing resistance.In contrast,high FTO expression inhibits tumor stem cell proliferation and differentiation.FTO is also upregulated in other gastrointestinal tumors like pancreatic and esophageal cancers,where high expression promotes progression and indicates poor prognosis.FTO has both promoting and inhibitory effects on liver and biliary malignancies.As research confirms FTO's widespread oncogenic role in the gastrointestinal tract,developing FTO inhibitors and related drugs offers new avenues for treating gastrointestinal malignancies.Currently identified agents like CS1,omeprazole,and mupirocin significantly inhibit CRC and GC progression by directly or indirectly suppressing FTO.Tumors can evade immune surveillance through FTO-mediated mechanisms,suggesting that blocking FTO-mediated immune escape and enhancing the antitumor effects of immune cells could provide treatment options for gastrointestinal malignancies.Targeting FTO in combination with immunotherapy to inhibit GC and CRC growth and metastasis and reduce resistance presents broad therapeutic prospects.

Objective:To explore the practice of comprehensive teaching based on multiple evaluation in general surgery practice teaching.Methods:A total of 83 students were selected from the General Surgery Department, The Second Affiliated Hospital of Harbin Medical University. Among them, 40 interns used traditional teaching (control group) and 43 interns used comprehensive teaching based on multiple evaluation (experimental group). After the teaching, the assessment results of the theoretical knowledge and skill operation of the two groups of interns were evaluated, and the instructor evaluated the comprehensive ability of the interns, and evaluated the teaching satisfaction and teaching feedback results. SPSS 24.0 was used for t-test and Chi-square test. Results:After the teaching, the examination scores of interns' theoretical knowledge and skill operation in the experimental group [(94.24±2.28) points and (92.33±2.58) points] were higher than those in the control group [(90.56±2.37) points and (88.75±2.41) points]. The scores of independent learning ability, independent thinking ability, logical thinking ability, group cooperation ability, and humanistic care ability of interns in the two groups after teaching were significantly higher than those before teaching, and the scores of each ability in the experimental group were higher than those in the control group ( P<0.05). The total satisfaction rate of interns in the experimental group [95.35% (41/43)] was higher than that in the control group [75.00% (30/40)], and the difference was statistically significant ( P<0.05). The experimental group in improving the participation and learning efficiency of interns in teaching activities [97.67% (42/43), 90.70% (39/43)] was significantly higher than the control group [75.00% (30/40), 70.00% (28/40)] ( P<0.05). Conclusion:The application of comprehensive teaching based on multiple evaluation in general surgery practice teaching can help improve the interns' theoretical knowledge and skill operation performance, improve their comprehensive ability and teaching satisfaction, and improve their learning enthusiasm and efficiency, which deserves promotion and application.

Circulating tumor cells(CTCs)are a special type of biomarker that can be used as a diagnostic tool to predict the prognosis of multiple tumors.At present,although circulating tumor cells have not been full clinically application,studies on circulating tumor cells have shown high clinical efficacy,especially in the fields of breast cancer,lung cancer,prostate cancer and colorectal canc-er.This article reviews the research progress of circulating tumor cells in metastatic cancer and non-metastatic cancer,analyzes the clinical efficacy and practicability of circulating tumor cells.

OBJECTIVETo assess the association of single nucleotide polymorphisms of hsa-miR-196a2, hsa-miR-149, hsa-miR-146a, hsa-miR-499 with susceptibility to ischemic stroke.

METHODSTaqman-PCR and DNA sequencing assays were employed to determine the genotypes of the 4 loci among 510 patients and 523 controls. And their association with the disease was assessed.

RESULTSAnalysis showed that smoking, diabetes, hypertension, BMI index and abnormal serum lipid metabolism were significantly associated with ischemic stroke, and that rs2910164 was significantly associated with the disease in codominant (CG vs. CC: P=0.002, OR=1.878, 95%CI=1.269-2.789), dominant (P=0.012, OR=1.325, 95%CI=1.110-1.580), recessive (P=0.008, OR=1.630, 95%CI=1.130-2.342) and allele (P=0.002, OR=1.449, 95%CI=1.210-1.731) genetic models. Stratified analysis further showed that the significant association only existed in population with smoking and hypertension. By contrast, no association was found between hsa-miR-196a2 rs11614913, hsa-miR-149 rs2292832 and hsa-miR-499 rs3746444 with the disease.

CONCLUSIONOur study indicated that smoking, diabetes, hypertension, fat and hyperlipidemia are risk factors for ischemic stroke. Hsa-miR-146a rs2910164 is significantly associated with the disease in those with smoking and hypertension in Dongyang region and may be involved in the process of the disease. The G allele G, GG and CG+GG genotypes of the locus may underlie the susceptibility to the disease in Dongyang region.

Aged ; Alleles ; Case-Control Studies ; China ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; MicroRNAs ; genetics ; Middle Aged ; Polymorphism, Single Nucleotide ; Stroke ; genetics

Colon cancer is a common malignant tumor. Early diagnosis and treatment is one of the most important clinical challenges. Since MicroRNA is discovered to closely relate to cancer, it has been suggested to be used in the diagnosis and treatment of cancer. This review focuses on recent advances in the diagnosis and treatment of MicroRNA in colon cancer and the role of MicroRNA in Wnt signaling pathways and epidermal growth factor receptor (EGFR) signaling pathways.

Objective To summarize surgical experience for the treatment of substernal goiter.Methods 102 cases of substernal goiter underwent surgical resection,in 74 by low collar incision,12 cases by larger low collar incision and pillowing the shoulder pad about 20 degrees for neck hyperextension,8 cases by unilateral or bilateral infrahyoid muscles transection,8 cases by low collar and up-mid-sternal incision plus horizontal sawing in 2 and 3 ribs.Results Resection was performed successfully in all cases.Hoarseness occurred in 7 cases,4 cases recovered after one month,3 cases did not improve because of tumor invasion of laryngeal recurrent nerve.Postoperative transient hypocalcemia in 9 cases recovered after 2 to 3 months.102 patients were followed up for 1 to 3 years without recurrence.Conclusions Substernal goiter can be resected successfully through a transcervical approach or mid-sternal incision.CT scanning and chest X radiograph are decisive for the surgical approach.

Objective To explore the diagnosis and treatment of cystic dilatation of the cystic duct in adults.Method Clinical data of 25 cases of the cystic dilatation of cystic duct in adults in 3 hospitals in Songhuajiang river drainage area from 1991 to 2012 confirmed by surgery were analyzed retrospectively.Results The 25 cases were with manifestations of chronic cholecystitis,and 14 patients with right upper quadrant recurrent biliary colic and nausea,vomiting and other gastrointestinal symptoms,9 patients with yellowish discoloration of sclera and skin,and fever.Ultrasonography was done in 25 cases,ERCP in 16 cases and MRCP in 9 cases,displaying liquid dark area of diameter from 1.6 cm × 1.6 cm to 2.5 cm ×2.5 cm in the gallbladder tube suspective of calculi,and characteristic dumbbell shape image.Preoperative diagnosis was cystic duct cyst with stones or gallstones which was confirmed by surgery.Gallbladder and cyst resection was performed in all 25 cases,and bile duct jejunum Roux-en-Y anastomosis was done in 2 of these cases because of introgenic bile duct injury.Conclusions Cysts of the cystic duct is the special type (Ⅵ type) of choledochocele,and its prognosis is good after surgical treatment.

OBJECTIVETo investigate the association between two polymorphisms of the APOC3 gene (T-455C and C-482T) and hereditary risk of non-alcoholic fatty liver disease (NAFLD).

METHODSA total of 287 patients with NAFLD and 310 control subjects were genotyped by PCR and direct sequencing. Serum lipid profiles were also detected by standard biochemical

METHODSOne-hundred-and-eighty of the study participants were used to measure the APOC3 content by enzyme-linked immunosorbent assay. Inter-group differences and associations were assessed statistically using Chi square and t tests and logistic and linear regression analyses.

RESULTSThe frequencies of neither the genotypes or alleles were significantly different between the NAFLD cases and the controls. Compared with the most common genotypes-455TT or-482CC, none of the variants showed a significant increase in risk of NAFLD or for the clinical and biochemical parameters. The adjusted odds ratios (with 95% confidence intervals) of NAFLD were 1.25 (0.79-1.96) and 1.20 (0.76-1.89) for carriers of the APOC3-455C and-482 T variants respectively (P more than 0.05).

CONCLUSIONThe T-455C and C-482T polymorphisms of the APOC3 gene are not associated with risk of NAFLD, pathogenic changes in lipid profiles, or insulin resistance in Han Chinese.

Adult ; Aged ; Alleles ; Apolipoprotein C-III ; genetics ; Case-Control Studies ; Female ; Gene Frequency ; Genotype ; Humans ; Insulin Resistance ; Lipids ; blood ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; genetics ; metabolism ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; Young Adult

ObjectiveTo study the effects of small-dose glucocorticoid (GC) on glucocorticoid receptor (GR) and cellular immune function in critical patients.MethodsForty ICU critical patients admitted in Shanghai Changzheng Hospital from March 2007 to March 2009 were enrolled in the study and were divided into GC group and non-GC group according to the use or absence of GC.Blood samples were collected at days 1,7 and 10 after GC treatment to detect GR binding affinity of mononuclear leukocytes (MNLs) and polymorphonuclear leukocytes (PMLs) in the peripheral blood and the CD4/CD8 ratio in the T lymphocytes.The method of GC use was that the hydrocortisone was given intravenously at a dose of 100 mg every eight hours.ResultsGR binding capacity of MNLs at day 1 and 7 showed no statistical difference between the GC and non-GC groups.GR binding capacity of MNLs in the GC group was lower at day 1 and was much lower at day 7 (P ＜ 0.05 ).However,in the non-GC group,it was lower at day 1,but showed significant improvement at day 7 ( P ＜ 0.05 ).The change of GR binding capacity of PMLs was similar to that of MNLs.There was no significant difference of CD4/CD8 ratio between the GC and non-GC group at day 1.The ratio of CD4/CD8 in the non-GC group was significantly higher than that in the GC group at day 10 (P ＜0.05).CD4/CD8 ratio in the GC group showed a slight reduction at day 10,with no significant difference from that at day 1.While,the non-GC group showed a significant increase of CD4/CD8 ratio at day 10 as compared with that at day 1 (P ＜ 0.05 ).ConclusionLow-dose GC plays some role in the negative feedback regulation of GR binding capacity of peripheral blood leukocytes and in the inhibition of cellular immune function.

Objective To explore the etiology,diagnosis and treatment of omohyoid muscle syndrome(OMS).Method Clinical data of 34 OMS cases was analyzed retrospectively from 1980 to 2008.In the autopsy of 19 bodies we studied omohyoid muscle,especially the intermediate tendons,sheaths of tendon and projection of omohyoid muscles.Result The symptom of omohyoid muscle syndrome lies in a mass that can be seen on the neek while swallowing,and the patient feels discomfort and dysphagia.The mass disappears immediately after swallowing and cann't be found by palpation.Congenital fascia weakness,intermediate tendon sheath relaxation,atrophy,degeneration and contracture of omohuoid muscle causes OMS.OMS was diagnosed on clinical manifestation.All 34 patients were treated surgically including cutting off the cross part of omohyoid muscle and sternocleidomastoid muscle,separating adhesion of muscle and fascia.Postoperatively symptoms disappeared in all these 34 patients.Conclusions Omohyoid muscle syndrome is a disease that can be easily diagnosed basing on characteristic clinical symptom and sign,the prognosis is good if treated properly by an operation.