目的 为进一步探讨老年急性结肠癌性肠梗阻的诊断及外科治疗方法，总结经验教训。方法 对我院1993~2005年收治的38例老年急性结肠癌性肠梗阻患者的临床资料进行回顾性分析。结果 38例老年急性结肠癌性肠梗阻患者，手术行一期切除吻合23例，肿瘤姑息性切除4例，单纯结肠双腔造口2例，Hartmann手术9例。术后发生并发症6例，其中切口感染5例，经换药愈合； 发生吻合口漏1例，最终死于腹腔感染、多器官功能衰竭。其余32例术后恢复良好。结论 提高对老年急性结肠癌性肠梗阻的认识，选择合理术式，加强围手术期处理，是减少手术并发症的发生、降低死亡率的重要措施。
Objective To investigate the feasibility and indication of synchronous resection of colonic carcinoma and its hepatic metastasis. Methods Radical sigmoidectomy and right hemi-hepatectomy plus left lateral segment resection were performed at the same time in a 71-year-old patient with sigmoid carcinoma and multiple hepatic metastasis. Results The operation lasted for 5 hours and 10 minutes with 300ml blood lost during the procedure. The patient recovered smoothly and was discharged 2 weeks after operation. Follow-up showed no reoccurrence up to the day of this presentation(4 months).Conclusion The operation could be performed safely by experienced surgeon in good-equipment hospital.
ObjectiveTo investigate effect of Notch pathway regulating by inhibiting expression of forkhead box protein A1 (FOXA1) on proliferation and invasion of colon cancer SW480 cells. MethodsThe colon cancer tissues and their corresponding paracancerous tissues of 45 patients with colon cancer admitted to the First Affiliated Hospital of Henan University of Science and Technology from June 2019 to February 2021 were selected. The immunohistochemistry and real-time fluorescent quantitative PCR (qRT-PCR) methods were used to detect the expressions of FOXA1 protein and mRNA in the tissues, respectively. In addition, SW480 cells were divided into control group (untreated), shRNA-NC group (transfected with shRNA-NC), sh-FOXA1 group (transfected with sh-FOXA1), sh-FOXA1+sodium valproate group (Add 8 mmol/L Notch pathway activator sodium valproate after transfection with sh-FOXA1). Then the qRT-PCR, MTT, clone formation test, and Transwell methods were used to detect the expressions of FOXA1 mRNA, proliferation, clonogenic ability, invasion and migration of cells in each group. Western blot method was used to detect the proliferation (c-Myc, cyclinD1), invasion and migration [matrix metalloproteinase (MMP）9, MMP2], epithelial-mesenchymal transition (Vimentin, N-cadherin, E-cadherin) and Notch pathway (Notch-1, Hes-1) related protein expressions of cells in each group. Results① In the clinical cases, the expression levels of FOXA1 protein and mRNA in the colon cancer tissues were higher than those in the corresponding paracancerous tissues (protein: 0.085±0.028 vs. 0.034±0.010, t=11.036, P<0.001; mRNA: 1.62±0.34 vs. 1.00±0.09, t=11.671, P<0.001). ② In the cell experiment, compared with the control group and shRNA-NC group, the cell survival rate, and numbers of cloned cells, invasion and migrating cells were significantly reduced (P<0.05), correspondingly, the related proteins expression levels of c-Myc, cyclinD1, MMP9, MMP2, Vimentin, N-cadherin, Notch-1, Hes-1 were significantly reduced (P<0.05) and the protein expression level of E-cadherin was significantly increased (P<0.05) in the sh-FOXA1 group, which were reversed after adding the Notch pathway activator sodium valproate (P<0.05). ConclusionFOXA1 highly expresses in colon cancer tissues and colon cancer cells and it might promote the proliferation, invasion and migration of SW480 cells by activating the Notch pathway.
目的 改善左半结肠癌性梗阻一期切除吻合术中结肠灌洗的方法。方法 利用市售塑料自来水三通管及大口径(直径3 cm)螺纹管制成结肠灌洗器，于梗阻近端结肠置入形成术中封密式结肠灌洗。结果 24例患者采用自制结肠灌洗器行术中结肠灌洗，无腹腔污染，术后无一例发生吻合口漏，均一期愈合，顺利出院。结论 掌握好一期手术适应证，自制结肠灌洗器可运用于左半结肠癌性梗阻一期切除吻合，术中肠腔灌洗彻底，方便，无污染，无溢漏，且制作简单，成本低。
Objective To evaluate the potential roles of celecoxib on proliferation and cell cycle progression of colon adenocarcinoma cells and on the hepatic metastasis of nude mice. Methods The human colon cancer cells HT-29 and HCT-116 were employed in the study. After treatment with celecoxib, the inhibitory effects of celecoxib on the proliferation of cancer cells were quantified by MTT assay, and the cell cycle progression was detected by flow cytometry, tumor cells were inoculated in nude mice, and the hepatic metastasis was detected. Results ①Celecoxib inhibited the proliferation of the tumor cells in time and dose-dependent manners （P＜0.05，P＜0.01）. The inhibitory effect on HT-29 cells was ber than that on HCT-116 cells （P＜0.05）. ②Celecoxib changed cell cycle progression of both kinds of cells, and decreased the proliferation index of both kinds of cells too. ③Celecoxib could inhibit the growth of the hepatic metastatic tumor obviously. Conclusion Celecoxib may inhibit the activity of cyclooxygenase-2, and resulting in the inhibition of division and proliferation, apoptosis of tumor cells and interfering in metastasis and relapse of colon cancer.
Objective To investigate the difference of minichromosome maintenance protein 2 (MCM2) mRNA expression among colonic normal mucosa, colonic adenoma and carcinoma. Methods The expressions of MCM2 mRNA were determined by real-time RT-PCR in 12 colonic normal mucosa, 33 colonic adenomas and 12 colonic carcinomas. Data were evaluated by relative expression software tool (REST-XL). Results The expressions of MCM2 mRNA elevated in turn by colonic normal mucosa, adenoma and carcinoma. The expression of MCM2 mRNA in colonic carcinomas was significantly higher than that in adenomas， as well as in normal mucosa (P=0.001), while the difference of MCM2 mRNA expressions between adenoma and normal mucosa was insignificant (P=0.184). Conclusion The difference of MCM2 mRNA expressions between adenoma and carcinoma indicated the potential value on early diagnosis for colonic carcinoma.
ObjectiveTo explore the risk factors influenced postoperative complications of colon cancer. MethodsIn this study, 114 patients diagnosed definitely as colon cancer were enrolled from January 2009 to April 2010 in this hospital. The patients were divided into the complication group and non-complication group according to the occurrence of postoperative complications during hospital day. Furthermore, clinicopathological features and operative parameters of patients were compared in two groups, and independent factors for postoperative complications were identified by multiple regression analysis. ResultsThere were statistical differences between two groups in operation time (t=2.034, P=0.032), diabetes mellitus (χ2=5.920, P=0.015), differentiation degree of tumor (χ2=7.163, P=0.028), hospital stay (χ2=0.411, P=0.026), and ASA grades (χ2=11.585, P=0.009). The morbidity of patients with operative time gt;200 min was significant higher than that ≤100 min (χ2=8.884, P=0.003) and 100-200 min (χ2=7.318, P=0.007). The morbidity of patients with ASA Ⅳ grade was higher than that with ASA Ⅰ grade (χ2=13.426, P=0.000). For tumor differentiation, the morbidity of patients with well-differentiated tumor was higher than that with moderately differentiated tumor (χ2=4.950, P=0.026) and poorly differentiated tumor (χ2=7.476, P=0.006). The hospital stay (P=0.009), age (P=0.024), diabetes mellitus (P=0.018), and ASA grade (P=0.001) were the independent factors for postoperative complications by multivariate regression analysis. ConclusionThe physical quality indexes are the mostly common risk factors of postoperative complications for colon cancer, emphasizing on the high-risk factors and making a targeted and individual treatment plan for each patient are of great important to improve the prognosis.