The results of 2389 patients exmained by colonofiverscope in past nine years are reported. Polyps were found in 561 cases, including 1256 polyps in the large intestine and 82 polyps in the terminal ileum. All 1299 polyps were removed with biopsy forceps. Pathology demonstrated that there were 406 adenomas, including 89 atypical hyperplasia and 23 cases with malignant change and 932 non-canerous polyps with 102 atypical hyperplasia. Since adenoma is seen to be a precancerous change, the polypectomy by colonofiberscope , ecpecially atypical hyperplastic polyps may decrease morbidity of large intestinal cancer. Cancer associated with adenoma may be as high as 51.28%, so the recrudescence of polyps may possibly be found even afer the cancer removal. These data showed that an early discovery of small malignant adenoma is key to improve efficiency.
ObjectiveTo systematically review the effects of chewing gun on the promotion of intestinal function recovery after colorectal cancer surgery. MethodsWe searched PubMed, The Cochrane Library, CBM and CNKI databases from their inception to December 2014, to collect randomized controlled trials (RCTs) assessing chewing gun in patients after colorectal cancer surgery. References of included studies were also retrieved. Two reviewers independently screened studies according to inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsNine RCTs involved 686 patients were included. The results of meta-analysis indicated that, compared with the control group, chewing gun could significantly reduce the time to first passage of flatus (MD=-17.33, 95%CI -23.96 to -10.70, P<0.000 01), the time to the first defecation (MD=-22.25, 95%CI -36.45 to -8.05, P=0.002) and postoperative hospital stay (MD=-1.37, 95%CI -2.25 to -0.49, P=0.002) after colorectal cancer surgery, and could also reduce the intestinal obstruction caused by intestinal paralysis (OR=0.33, 95%CI 0.14 to 0.77, P=0.01). However, no significant difference in the incidence of nausea and vomiting was found. ConclusionEarly chewing gum can promote the recovery of gastrointestinal function in patients after colorectal cancer operation.
Objective To explore the expressions of caudal-related homeodomain transcription factor-2 （CDX-2）and tumor suppressor gene KAI-1 in colon carcinoma tissues and to analyze their clinical significances. Methods Immu-nohistochemical SP method was used to detect the expressions of CDX-2 and KAI-1 in 50 cases of colon carcinoma tissues and corresponding adjacent tissues （from cancer tissue ≤2cm） and 25 cases of normal colon mucosa tissues. The relation-ships of the expressions of CDX-2 and KAI-1 to the clinicopathologic features were analyzed. Results ①The positive rates of CDX-2 expression and KAI-1 expression in the colon carcinoma tissues were significantly lower than those in the normal colon mucosa tissues 〔CDX-2：34% （17/50） versus 88% （22/25）， P＜0.05；KAI-1：30% （15/50） versus 92% （23/25）， P＜0.05〕 and adjacent tissues of colon carcinoma 〔CDX-2：34% （17/50） versus 54% （27/50）， P＜0.05；KAI-1：30% （15/50） versus 58% （29/50）， P＜0.05〕， which in the adjacent tissues of colon carcinoma were significantly lower than those in the normal colon mucosa tissues （P＜0.05）. ②The positive expressions of CDX-2 and KAI-1 were related to lymph node metastasis， depth of invasion， and degree of tumor differentiation （P＜0.05）. ③Spearman rank correl-ation analysis showed that the CDX-2 expression was positively correlated with KAI-1 expression （rs=0.544， P＜0.01）. Conclusions CDX-2 and KAI-1 may be closely related to the development， invasion， metastasis， and prognosis of colon carcinoma， the combination of CDX-2 and KAI-1 in evaluation of their function has a certain guiding significance in the treatment for colon carcinoma.
Objective To evaluate the effect of visual and audiovisual distraction on anxiety and acceptance levels among patients undergoing colonoscopy. Methods A total of 180 consecutive patients undergoing colonoscopy were randomly divided into three groups: group A received visual distraction; group B received audiovisual distraction; and group C received routine care alone. Levels of anxiety and willingness to accept the same intervention if the procedure needed to be repeated were compared among the three groups. Results The reduction of anxiety score after colonoscopy in group A and group B was greater than that in group C, but the difference was not statistically significant. The rate of willingness to accept the same intervention if the procedure needed to be repeated was significantly different among the three groups: the rates for group A and group B were higher than for group C (Plt;0.05). Conclusions Both visual distraction and audiovisual distraction can significantly improve patients’ acceptance of colonoscopy. Visual distraction and audiovisual distraction have no significant effect on reducing anxiety.
ObjectivesTo systematically review the risk factors of carbapenem-resistant enterobacteriaceae colonization or infection in neonates.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect cohort or case-control studies on the risk factors of carbapenem-resistant enterobacteriaceae colonization or infection in neonates from inception to May 2020. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies, and meta-analysis was performed by RevMan5.3 software.ResultsA total of 9 case-control studies involving 759 patients were included. The results of meta-analysis showed that, maternal factors like placental abruption (OR=6.25, 95%CI 1.47 to 26.61, P=0.01), premature rupture of fetal membranes of parturient (OR=5.62, 95%CI 2.63 to 12.00, P<0.000 01), pregnancy-induced hypertension (OR=2.04, 95%CI 1.49 to 2.80, P<0.000 01), carbapenem antibiotics used in mothers (OR=1.77, 95%CI 1.10 to 2.81, P=0.017), neonatal factors like premature delivery (OR=1.96, 95%CI 1.06 to 3.61, P=0.03), mechanical ventilation (OR=2.14, 95%CI 1.01 to 4.55, P=0.05), surgical procedure (OR=14.17, 95%CI 2.46 to 81.70, P=0.003), umbilical vein catheter (OR=1.93, 95%CI 1.20 to 3.11, P=0.007), peripherally inserted central catheter (OR=4.30, 95%CI 1.86 to 9.93, P=0.000 6), nasogastric feeding (OR=4.37, 95%CI 1.44 to 13.29, P=0.009), use of carbapenems (OR=3.04, 95%CI 1.91 to 4.84, P<0.000 01), and admission to NICU (OR=2.78, 95%CI 1.79 to 4.33, P<0.000 01) were the risk factors of carbapenem-resistant enterobacteriaceae colonization or infection in neonates. Breastfeeding (OR=0.30, 95%CI 0.13 to 0.70, P=0.005) was the protective factor of carbapenem-resistant enterobacteriaceae colonization or infection in neonates.ConclusionsThe current evidence shows that maternal factors like placental abruption, premature rupture of fetal membranes, pregnancy-induced hypertension, carbapenem antibiotics used in mothers, and neonatal factors like premature delivery, mechanical ventilation, surgical procedure, umbilical vein catheter, peripherally inserted central catheter, nasogastric feeding, use of carbapenems, and admission to NICU are the risk factors of carbapenem-resistant enterobacteriaceae colonization or infection in neonates; while breastfeeding is the protective factor of carbapenem-resistant enterobacteriaceae colonization or infection in neonates. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the conclusions.
ObjectiveTo explore the expressions of polo-like kinase 1(PLK1) and serine/threonine kinase 15 (STK15) mRNA and protein in colon cancer cells, and to explore the inhibitive effect of SBE13 and VX-680 for PLK1 protein and STK15 protein. MethodsOne kind of cervical cancer cells(Hela cells) and 3 kinds of colon cancer cells (HCT-116 cells, HT-29 cells, and CACO-2 cells) were selected for experiment. Expression levels of PLK1 mRNA, STK15 mRNA and its protein of 4 kinds of cells were detected by reverse transcription polymerase chain reaction(RT-PCR) and Western blot method respectively. Inhibitive effect of SBE13 and VX-680 were evaluated in vitro by methylthiazolyldiphenyl-tetrazolium bromide(MTT) assay in 4 kinds of cells, which divided into 5 groups, receiving Dulbecco's modification of Eagle's medium(DMEM), dimethylsulfoxide(DMSO), SBE13, VX-680, and SBE13+VX-680 respectively. ResultsCompared with Hela cells, expression levels of PLK1 mRNA, STK15 mRNA and its protein in HCT-116 cells,HT-29 cells, and CACO-2 cells were higher(P<0.05). ① Hela cells:Compared with DMEM group, the proliferative activity were not inhibited in SBE13 group, VX-680 group, and SBE13+VX-680 group(P>0.05). ② HCT-116 cells and HT-29 cells:Compared with DMEM group, the proliferative activity were inhibited in VX-680 group and SBE13+VX-680 group(P<0.05), but was not inhibited in SBE13 group(P>0.05). ③ CACO-2 cell:Compared with DMEM group, the proliferative activity were inhibited in SBE13 group, VX-680 group, and SBE13+VX-680 group(P<0.05). ConclusionsExpression levels of PLK1 mRNA, STK15 mRNA and its protein increase in HCT-116, HT-29, and CACO-2 cells compared with Hela cells. SBE13 and VX-680 can inhibit PLK1 and STK15 protein partly in colon cancer cell lines.
Objective The survival data of patients with colon cancer who were treated by laparoscopic-assisted surgery and open surgery three years after operation were analyzed and contrasted, which provided data to support the future treatment. Methods The 217 patients who were cured by laparoscopic-assisted surgery and 193 patients who were cured by open surgery were followed up, and the rates of local recurrence, metastasis, implantative, and survival were contrasted and analyzed. Results Three years after laparoscopic-assisted surgery and open surgery, the disease-free survival rate was 86.2% （187/217） and 85.5% （165/193）, respectively, and the overall survival rate was 91.2% （198/217） and 92.7% （179/193）, respectively, the difference between the two groups was not statistic significance（P＞0.05）. The differences of the rates of local recurrence, metastasis, and implantative between the two groups were not statistic significance（P＞0.05）. Conclusions Laparoscopic-assisted surgery is similar with open surgery in the rates of local recurrence, forward metastasis, and overall survival. So laparoscopic-assisted surgery is a safe and radical curative surgery.
In this study, the effect of neostigmine on the healing of colonic anastomoses has been investigated following onestage resection and anastomosis for complete leftsided colomic obstruction.It was found that neostingmine promoted colonic anastomotic healing either experimentally or clinically. Further, the authors discuss the pathogenesis of anastomotic leakage but suggest that neostigmine should be used in the first 5 hours after operation.
Objective To study the feasibility and curative effect of laparoscopic vs. open radical rectectomy and colectomy for colorectal cancer. Methods Sixty-two cases who underwent laparoscopic operation (17， 2， 10， 23， 9 and 1 case underwent radical right colectomy， radical transverse colectomy， radical left colectomy， Dixon， Miles and Hartmann operation respectively) and 78 cases who underwent open operation (17， 4， 11， 27， 18 and 1 case underwent radical right colectomy， radical transverse colectomy， radical left colectomy， Dixon， Miles and Hartmann operation respectively) in our department from Aug. 2001 to Jun. 2008 were included. The clinical data of patients in two groups were compared. Results There were no severe complications and death occurred in both groups and 4 cases in laparoscopic group were converted to open operation during the procedure. The mean operation time of laparoscopic group and open group were (230.6±23.5) min and (145.5±17.6) min respectively, there was a statistical difference between them (P＜0.01). The intra-operative blood loss of laparoscopic group was obviously less than that in open group 〔(135.5±22.5) ml vs. (300.6±34.5) ml， P＜0.01〕. There was no statistical difference of the number of cleared lymph nodes between two groups 〔(11.8±1.5) pieces vs. (13.3±1.7) pieces， Pgt;0.05〕. The length of distal incision margin of rectal anterior resection in laparoscopic group was obviously longer than that in open group 〔(3.1±0.4) cm vs. (2.6±0.3) cm， P＜0.01〕. The gastrointestinal and urinary function of laparoscopic group recovered more quickly than those in open group 〔(2.3±0.7) d vs. (3.6±0.9) d for intake of liquid diet， P＜0.05； (3.5±1.1) d vs. (4.7±1.2) d for intake of solid diet， P＜0.05； (2.3±0.4) d vs. (4.4±1.2) d for duration of urethral catheterization， P＜0.01， respectively〕. The length of hospital stay in laparoscopic group was shorter than that in open group 〔(8.5±0.7) d vs. (12.8±0.9) d， P＜0.01〕. But the cost of hospitalization in laparoscopic group was higher than that in open group 〔(3.14±0.25)×104 yuan vs. (2.02±0.75)×104 yuan， P＜0.05〕. There was no statistical difference of the three-year survival rate between two groups (89.5% vs. 89.1%， Pgt;0.05). Conclusion Laparoscopic radical rectectomy and colectomy for colorectal cancer is feasible and safe with minimal invasiveness.
ObjectiveTo detect 5-FU concentration and investigate the changes of pathology， and Ki-67 protein expression after intraoperative regional chemotherapy (RC) for colon cancer. MethodsAll the patients were randomized into two groups: RC group (n=20), received intraoperational RC with 100 ml physiological saline contained 5-FU (15 mg/kg) and camptothecine (0.06 mg/kg)； control group (n=20), saline alone. The samples from portal vein blood, peripheral blood, peritoneal fluid， and peri-cancerous tissues in RC group were taken to detect the 5-FU concentration by high performance liquid chromatography (HPLC), respectively at 2, 5, 10, 20, 30, and 60 minutes after treatment. The pathological changes were observed and Ki-67 protein expressions were examined by immunohistochemical staining for all the cancer tissues postoperatively in two groups. ResultsPeak concentration of 5-FU appeared at 2 min after treatment, and decreased gradually. 5-FU concentration in peritoneal fluid was the highest, and the lowest in the peripheral blood (Plt;0.01). In RC group， light karyopyknosis, nuclear swelling, and coagulative necrosis of cancer cells, and light intercellular substance hydropsia, inflammatory cells invasion were observed under light microscopic examination; light vasculitis presented also in five cases. Nuclear swelling, heterochromatin agglutination, perinuclear gap expansion, mitochondrial swelling, endoplasmic reticulum expansion, and Golgi complex expansion were observed with transmission electron microscope. Ki-67 protein expression of colon cance tissues in RC group was lower than that in control group （Plt;0.05）. Conclusions Intraoperative RC for colon cancer may sustain a high concentration of chemotherapy drugs in peritoneal fluid and portal vein blood, and alter histopathological morphology of cancer cells, and suppress Ki-67 protein expression. So, intraoperative RC may play an important role in preventing intraoperative spreading and postoperative recurrence of colon cancer.