ObjectiveTo summarize the current research progress of serum exosome microRNAs in patients with colorectal cancer.MethodsThe domestic and foreign literatures related to serum exosome microRNAs of colorectal cancer patients, which had been reported in recent years were collected through literature search. Subsequently, those literatures were used to read and review.ResultsExosomes were extracellular vesicles, which contained lipids, proteins, DNA, RNA (mRNA, microRNA, and long non-coding RNA), and other molecules. These vesicles mediated communication between cells by transporting the above molecules. Exosomes in serum were the main carriers of microRNAs in the blood circulation system. Serum exosome microRNAs could affect the proliferation, invasion, and metastasis of colorectal cancer cells, mediate the drug resistance of colorectal cancer cells, and could be used as biomarkers to predict the prognosis of colorectal cancer.ConclusionsSerum exosome microRNAs play important role in the occurrence, development, treatment, and diagnosis of colorectal cancer. As a class of biomarker, serum exosome microRNAs have great potential in the early diagnosis and prognostic evaluation of colorectal cancer.
Objective To summarize the clinical features, diagnosis, and treatment of acute deep venous thrombosis (DVT) at lower extremity of aged patients. Method Clinical data of 98 aged patients with acute DVT at lower extremity who got treatment in our hospital from Junuary 2012 to December 2014 were analyzed retrospectively. Results Of 98 aged patients with acute DVT at lower extremity, the time from disease developed to treatment was 1 day to 10 days with an average of 4 days. The main symptom was low limb swelling progressively. All the patients were treated by the comprehensive treatment based on individual anticoagulation. A total of 96 patients (98.0%) were followed up, and the follow-up period ranged from 12 months to 24 months (average of 18 months). Of 96 patients followed-up, we found a statistically significant difference between lower extremities before treatment and those at 3 months after treatment in venous clinical severity score (VCSS) and the change of lower extremity circumference (P<0.001). Of 96 patients, 9 patients were cured, 81 patients had markedly effective results, and 6 patients had effective results. None of the patients suffered from fatal pulmonary embolismin in duration of hospital day and follow-up period, and no one suffered form DVT recurrence. Conclusions The aged patients with acute DVT at lower extremity usually see a doctor lately. The comprehensive treatment based on individual anticoagulation is safe and effective in treatment of acute DVT at lower extremity of aged patients.
Objective To investigate the effect of postoperative recovery between trans-abdominal drainage and trans-perineum drainage in patients with rectal cancer. Methods The randomized controlled trials which were related with the comparison between trans-abdominal drainage and trans-perineum drainage of rectal cancer patients were searched from January 2006 to January 2016, and then a meta-analysis was performed by using RevMan 5.2 software, basing on the data obtained from PubMed, CBM, CNKI, WanFang, and VIP database. Results The results of meta-analysis showed that, in the aspect of postoperative drainage, there was no significant difference in the postoperative drainage duration 〔MD=–0.03, 95% CI is (–1.63, 1.57), P=0.97〕 , volume of drainage liquid 〔MD=–9.53, 95% CI is (–104.95, 85.90), P=0.84〕 , and extubation time 〔MD=0.25, 95% CI is (–0.31, 0.82), P=0.38〕 between the trans-abdominal drainage group and the trans-perineum drainage group. In terms of postoperative infection, the trans-abdominal drainage could effectively reduce the incidence rate of drainage tube incision infection 〔OR=0.32, 95% CI is (0.21, 0.48), P<0.000 01〕 . However, there was no significant difference in the abdominal incision infection 〔OR=0.84, 95% CI is (0.51, 1.36), P=0.48〕 and pelvic infection 〔OR=0.77, 95% CI is (0.52, 1.15), P=0.20〕 . In addition, compared to the trans-perineum drainage, the trans-abdominal drainage could shorten the time of pain in drainage 〔MD=–5.07, 95% CI is (–6.96, –3.17), P<0.000 01〕 . But, there was no significant difference in the duration of hospitalization 〔MD=0.82, 95% CI is (–0.39, 2.03), P=0.19〕 , incidence of anastomotic bleeding 〔OR=0.95, 95% CI is (0.58, 1.54), P=0.82〕 , and incidence of anastomotic leakage 〔OR=1.33, 95% CI is (0.93, 1.92), P=0.12〕 between the two groups. Conclusion The trans-abdominal drainage could obviously decrease the incidence of drainage tube incision infection and shorten the time of pain in drainage, so it may promote the postoperative rehabilitation of rectal cancer patients.
ObjectiveTo investigate factors associated with postoperative complications after laparoscopic radical surgery in rectal cancer.MethodsThe clinical data of patients with rectal cancer performed by the laparoscopic radical resection from February 2013 to December 2016 were analyzed retrospectively. All the data were analyzed by the t test, chi-square test or logistic regression analysis.ResultsThere were 343 patients with rectal cancer performed by the laparoscopic radical resection. The postoperative complications occurred in the 97 (28.3%) patients. The result of univariate analysis showed that the postoperative complications rate was associated with the gender, age, body mass index, preoperative anemia, preoperative comorbidity, location and diameter of tumor, operative time, and surgeon experience (all P<0.050). The results of logistic regression analysis revealed that the gender, age, body mass index, preoperative anemia, preoperative comorbidity, location of tumor, operative time, and surgeon experience were the independent risk factors for the postoperative complications (all P<0.050).ConclusionGender, age, body mass index, preoperative anemia, preoperative comorbidity, location of tumor, operative time, and surgeon experience are independent risk factors for postoperative complications in laparoscopic radical rectal surgery for rectal cancer.
Objective To explore the tumorigenicity and expressions of dishevelled 3 (DVL3) in HCT116 cells and HCT116 spherical cells. Methods Human colorectal tumor HCT116 cells were cultured in the serum-free culture medium for HCT116 spherical cells. Through the subcutaneous tumor experiment in nude mice and clone formation assay, we observed the tumor growth and colony formation ability of the two kinds of cells in vivo and in vitro. The Western blotting experiment was utilized to detect the expressions of DVL3 in these two kinds of cells. Results ① Colonyformation: the mean value of colony formation rate in the HCT116 cells group was 3.78%, and the mean value of fcolony formation rate in the HCT116 spherical cells group was 28.67%, which was higher in the HCT116 spherical cells group (t=21.16, P<0.05). ② Tumorigenicity in nude mice: 11 nude mice with tumor formation were observed in the HCT116 cells group, and the tumor formation rate was 55.0%; 18 nude mice with tumor formation were observed in the HCT116 spherical cells group, and the tumor formation rate was 90.0%, the tumor formation rate of the HCT116 spherical cells group was higher (P=0.039). The tumor volume of the HCT116 cells group was (92±31) mm3, and the tumor volume of HCT116 spherical cells group was (298±85) mm3, the tumor volume of the HCT116 spherical cells group was larger (t=9.27, P<0.05). ③ The expression of DVL3: the expression level of DVL3 in HCT116 cells was 0.12±0.05, and expression level of DVL3 in HCT116 spherical cells was 0.35±0.10, the expression level of DVL3 in HCT116 spherical cells was higher (t=4.31, P<0.05). Conclusions The HCT116 spherical cells have stronger colonization and tumorigenicity than the HCT116 cells. It has been speculatd that the high expression of DVL3 may be closely related with the stronger tumorigenicity.
Objective To investigate the difference of effect between laparoscopic and open surgery in patients with traumatic rupture of spleen. Methods The literatures on comparison of laparoscopic and open surgery in patients with traumatic rupture of spleen were retrieved in PubMed, Web of Science, CNKI, Wanfang, and VIP databases from Jan. 2007 to Jan. 2017, and then Stata 12.0 software was applied to present meta-analysis. Results ① The condition during operation: compared with the OS group, operative time of the LS group was shorter [SMD=–0.71, 95% CI was (–1.12, –0.30), P=0.001] and intraoperative blood loss of the LS group was less [SMD=–1.53, 95% CI was (–2.28, –0.78), P<0.001]. ② The postoperative condition: compared with the OS group, the postoperative anal exhaust time [SMD=–2.47, 95% CI was (–3.24, –1.70), P<0.001], postoperative ambulation time [SMD=–2.97, 95% CI was (–4.32, –1.62), P<0.001], and hospital stay [SMD=–1.68, 95% CI was (–2.15, –1.21), P<0.001] of the LS group were all shorter. ③ The overall incidence of complications and the incidence of complications: on the one hand, compared with the OS group, patients in the LS group had a lower overall incidence of postoperative complications [OR=0.29, 95% CI was (0.19, 0.43), P<0.001]. On the other hand, compared with the OS group, patients in the LS group had lower incidences of infection [OR=0.27, 95% CI was (0.13, 0.55), P<0.001], ascites [OR=0.36, 95% CI was (0.13, 1.00), P=0.049], bleeding [OR=0.29, 95% CI was (0.10, 0.90), P=0.032], ileus [OR=0.34, 95% CI was (0.13, 0.90), P=0.030], incision fat liquefaction [OR=0.27, 95% CI was (0.08, 0.94), P=0.040], and incision rupture [OR=0.17, 95% CI was (0.03, 0.96), P=0.045]. However, there was no statistical difference on splenectomy fever [OR=0.41, 95% CI was (0.13, 1.27), P=0.123], pancreatic fistula [OR=0.40, 95% CI was (0.06, 2.63), P=0.343], liver function lesion [OR=0.36, 95% CI was (0.10, 1.34), P=0.127], and thrombosis [OR=0.33, 95% CI was (0.09, 1.22), P=0.097] between the 2 groups. Conclusions Laparoscopic surgery can not only significantly reduce the incidence of multiple complications of traumatic rupture of spleen, but also can speed up the recovery rate of postoperative recovery. Therefore, it is safe and beneficial in treatment of patients with traumatic rupture of spleen.
Objective To compare efficacy of laparoscopic surgery and open surgery in treatment of rectal cancer after neoadjuvant chemoradiotherapy. Methods The relevant literatures were retrieved from databases including CNKI, CBM, Wanfang, VIP, PubMed, Cochrane Library, and Embase from 2007 to 2017, all the relevant randomized controlled trial (RCT) or non-randomized controlled trial (NRCT) of laparoscopic surgery versus open surgery in patients with rectal cancer were collected according to the inclusion and exclusion criterial. Two reviewers independently screened the literatures, extracted the data, and assessed the bias risk of the included studies. Then, the meta-analysis was performed using RevMan 5.3 software. Results A total of 11 RCTs and 9 NRCTs involving 2 036 patients with rectal cancer were included, of these, including 1 021 cases of laparoscopic surgery and 1 015 cases of open surgery. The results of the meta-analysis showed that the operation time was increased ［WMD=14.21, 95% CI (1.92, 26.51)］, the intraoperative blood loss ［WMD=–38.96, 95% CI (–60.29, –7.63)］, first postoperative exhaust time ［WMD=–0.86, 95% CI (–1.14, –0.57)］, first postoperative intake food time ［WMD=–0.89, 95% CI (–1.15, –0.62)］, and postoperative hospitalization time ［WMD=–2.38, 95% CI (–3.44, –1.32)］ were reduced in the laparoscopic surgery as compared with the open surgery; the rate of the sphincter-saving was increased ［OR=2.35, 95% CI (1.67, 3.30)］, the rates of the local recurrence ［OR=0.25, 95% CI (0.13, 0.47)］, postoperative overall complications ［OR=0.34, 95% CI (0.26, 0.43)］, infection of incision ［OR=0.39, 95% CI (0.25, 0.62)］, intestinal obstruction ［OR=0.30, 95% CI (0.17, 0.53)］, lung infection ［OR=0.32, 95% CI (0.18, 0.57)］, and anastomotic fistula ［OR=0.40, 95% CI (0.22, 0.73)］ were decreased in the laparoscopic surgery as compared with the open surgery; the intraoperative lymph node resection ［WMD=–0.99, 95% CI (–2.11, 0.12)］, the rates of the 3-year disease-free survival ［OR=0.91, 95% CI (0.54, 1.54)］, pelvic infection ［OR=0.64, 95% CI (0.17, 2.45)］, anastomotic bleeding ［OR=0.54, 95% CI (0.22, 1.34)］, urinary retention ［OR=0.71, 95% CI (0.34, 1.48)］, and urinary tract infection ［OR=1.22, 95% CI (0.45, 3.30)］ had no significant differences between these two surgeries. Conclusion Laparoscopy surgery is still safer, more effective, and more reliable than conventional open surgery after neoadjuvant chemoradiotherapy in rectal cancer, but it needs more clinical RCTs to further provide accurate and reliable results.