Changes in extracellular matrix in different stages of colorectal cancer and their effects on proliferation of cancer cells

BACKGROUND The extracellular matrix is the main component of the tumor microenvironment.Extracellular matrix remodels with the oncogenesis and development of tumors.Previous studies usually focused on the changes of proteins in normal colorectal tissues and colorectal cancers.Little is known about the changes in the extracellular matrix in different stages of colorectal cancer and the effects of these changes on the development of this cancer.AIM To test the changes of type I collagen,type IV collagen,matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9),and tissue inhibitor of metalloproteinase-3(TIMP-3)in different stages of colorectal cancer and the effects of these changes on the proliferation of cancer cells.METHODS The extracellular matrix from various stages of colorectal cancer and normal colon tissue was obtained by using acellular technology.We used proteomics to detect the differential expression of proteins between normal colon tissues and colorectal cancer tissues,and then we used Western blot to observe their expression in each stage of colorectal cancer and in normal colon tissue.By coculturing the extracellular matrix and HT29 colon cancer cells in vivo and in vitro,we tested the cancer cell proliferation rate in vitro by methyl thiazolyl tetrazolium(MTT)assay and in vivo by measuring the tumor volume.RESULTS The expression of type I collagen and MMP-2 increased with increased tumor stage.The expression of MMP-9 was higher in colorectal cancer tissues and was highest in stage III cancer.The expression of type IV collagen and TIMP-3 decreased with increased tumor stage.The proliferation rate of cancer cells in the extracellular matrix of colorectal cancer was higher than that in the extracellular matrix of the normal colon.CONCLUSION These data suggest that the extracellular matrix structure and composition become disorganized during the development of tumors,which is more conducive for the growth of cancer cells.

Clinical and socioeconomic factors associated with delayed orchidopexy in cryptorchid boys in China: a retrospective study of 2423 cases

We investigated the associations of clinical and socioeconomic factors with delayed orchidopexy for cryptorchidism in China. A retrospective study was conducted on cryptorchid boys who underwent orchidopexy at Children's Hospital at Chongqing Medical University in China from January 2012 to December 2017. Of 2423 patients, 410 (16.9%) received timely repair by 18 months of age, beyond which surgery was considered delayed. Univariate analysis suggested that the laterality of cryptorchidism (P = 0.001), comorbidities including inguinal hernia/scrotal hydrocele (P < 0.001) or urinary tract disease (P = 0.016), and whether patients lived in a poverty county (P < 0.001) could influence whether orchidopexy was timely or delayed. Logistic regression analysis suggested that the following factors were associated with delayed repair: unilateral rather than bilateral cryptorchidism (odds ratio [OR]= 1.752, P < 0.001), absence of inguinal hernia or hydrocele (OR = 2.027, P = 0.019), absence of urinary tract disease (OR = 3.712, P < 0.001), and living in a poverty county (OR = 2.005, P < 0.001). The duration of postoperative hospital stay and hospital costs increased with the patient's age at the time of surgery.

Preliminary Outcome of Individualized Abdominoperineal Excision for Locally Advanced Low Rectal Cancer

Background： The introduction of individualized abdominoperineal excision （APE） may minimize operative trauma and reduce the rate of complications. The purpose of this study was to evaluate the safety and efficacy of individualized APE for low rectal cancer. Methods： Fifty-six patients who underwent individualized APE from June 2011 to June 2015 were evaluated retrospectively in Beijing Chaoyang Hospital, Capital Medical University. The main outcome measures were circumferential resection margin （CRM） involvement, intraoperative perforation, postoperative complications, and local recurrence. Statistical analysis was performed using SPSS version 16.0. Results： Fifty （89%） patients received preoperative chemoradiotherapy： 51 （91%） patients were treated with the sacrococcyx preserved; 27 （48%） patients with the levator ani muscle partially preserved bilaterally; 20 （36%） patients with the levator ani muscle partially preserved unilaterally and the muscle on the opposite side totally preserved; 7 （13%） patients with intact levator ani muscle and part of the ischioanal fat bilaterally dissected; and 2 （4%） patients with part of the ischioanal fat and intact lavator ani muscle dissected unilaterally and the muscle on the opposite side partially preserved. The most common complications included sexual dysfunction （12%）, perineal wound complications （13%）, urinary retention （7%）, and chronic perineal pain （5%）. A positive CRM was demonstrated in 3 （5%） patients, and intraoperative perforations occurred in 2 （4%） patients. On multiple logistic regression analysis, longer operative time （P = 0.032） and more intraoperative blood loss （P = 0.006） were significantly associated with perineal procedure-related complications. The local recurrence was 4% at a median follow-up of 53 months （range： 30–74 months）. Conclusion： With preoperative chemoradiotherapy, individualized APE may be a relatively safe and feasible approach for low rectal cancer with acceptable oncological outcomes.

Analysis of the social and clinical factors affecting the age of children when receiving surgery for hypospadias:a retrospective study of 1611 cases in a single center

We aimed to explore the associations between the age at which children undergo surgery for hypospadias and a range of social and clinical factors in a single center.Our aim was to promote the early surgical treatment of children with hypospadias.For a 6-year period,social and clinical data were collected from all children undergoing surgery to repair hypospadias in Children’s Hospital of Chongqing Medical University(Chongqing,China),located in southwest of China.We analyzed the correlations between age at surgery and a range of social and clinical factors.A total of 1611 eligible cases were recruited,with a mean age of 54.3 months and a median age of 42 months:234 cases(14.5%)were classified into a“timely operation”group,419(26.0%)cases into a“subtimely operation”group,and 958(59.5%)cases into a“delayed operation”group.According to multivariate regression analyses,the higher the regional economic level,the closer the urethral opening to the perineum,and the higher the educational level of the guardians was,the younger the children were when they underwent the initial surgery for hypospadias;this was also the case for families without other children.Our subgroup analysis showed that the primary educational level of the guardians was a risk factor for subtimely surgery in their children(odds ratio[OR]=1.52,95%confidence interval[CI]:1.08-2.15,P<0.05).A lower regional economic level(OR=1.87,95%CI:1.26-2.78,P<0.01),a lower educational level of the guardians(OR=3.84,95%CI:2.31-6.41,P<0.01),and an anterior-segment urethral opening(OR_(1)[vs middle hypospadias]=2.07,95%CI:1.42-3.03;0R_(2)[vs posterior hypospadias]=2.63,95%CI:1.75-3.95;P<0.01)were all risk factors for delayed surgery in children.

Incidence characteristics of testicular microlithiasis and its association with risk of primary testicular tumors in children: a systematic review and meta-analysis

Background To systematically evaluate the incidence characteristics of testicular microlithiasis(TM)in children and its association with primary testicular tumors(PTT).Methods A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis(PRISMA)statement.A priori protocol was registered in the PROSPERO database(CRD42018111119),and a literature search of all relevant studies published until February 2019 was performed.Prospective,retrospective cohort,or cross-sectional studies containing ultrasonography(US)data on the incidence of TM or the association between TM and PTT were eligible for inclusion.Results Of the 102 identified articles,18 studies involving 58,195 children were included in the final analysis.The overall incidence of TM in children with additional risk factors for FTT was 2.1%.In children,the proportion of left TM in unilateral cases was 55.7%,the frequency of bilateral TM was 69.0%,and proportion of classic TM was 71.8%[95%confidence interval(Cl)62.4-81.1%,P=0.0,72=0.0%].About 93.5%of TM remained unchanged,and newly detected PTT rate was very low(4/296)during follow-up.The overall risk ratio of TM in children with a concurrent diagnosis of PTT was 15.46(95%Cl 6.93-34.47,P<0.00001).Conclusions The incidence of TM in children is highly variable.Nonetheless,TM is usually bilateral,of the classic type,and remains stable or unchanged at follow-up.Pediatric patients with TM and contributing factors for PTT have an increased risk for PTT;however,there is no evidence to support mandatory US surveillance of children with TM.

Diagnosis,treatment,outcome,and reasons for delayed treatment of cryptorchidism with torsion in children:a 16-year retrospective study in a large pediatric medical center

We describe and summarize the diagnosis,treatment,and reasons for delayed treatment of children with cryptorchidism torsion in Children's Hospital of Chongqing Medical University.The study included 19 cases of cryptorchidism torsion.The age of the children ranged from 16 days to 12 years(median:6 years).The interval from diagnosis to surgery varied from 4 h to 16 days(median:3 days).Ultrasound was performed in all cases.Fifteen cases had cryptorchidism torsion,2 cases had a soft tissue mass in the inguinal region,and 2 cases had an inguinal/abdominal teratoma.Five cases were treated with an orchidopexy,12 cases were treated with orchiectomy,and 2 cases received resection of a testicular tumor.The 5 children with an orchidopexy were followed up from 1 month to 7 years(median:3 years),with 1 child having a testis retraction and no blood supply.Of the 12 children who had an orchiectomy,three had delayed diagnosis due to family unawareness of the condition,while other delays were due to delayed referral from primary care facilities.The relative rarity and insufficient awareness of cryptorchidism torsion resulted in a low rate of testicular salvage.Therefore,hospitals of all levels should be fully aware of cryptorchidism with torsion and ensure a male child's genital system and inguinal region are examined to improve the success rate of testicular salvage.

Long-term follow-up results of testicular torsion in children

December 2020 to investigate the long-term follow-up results after testicular torsion(TT)in children.Boys with TT were divided into the salvage orchiopexy group and the orchiectomy group,and the baseline characteristics,ultrasonographic indications,intraoperative findings,testicular volumes,and adverse events during follow-up were compared.A total of 145 cases were included in this study.Approximately 56.6%of patients who underwent salvage orchiopexy had testicular atrophy(TA),and the median testicular volume loss of the testes was 57.4%.Age less than 6 years,delayed surgery,and intraoperative poor blood supply were associated with TA in pediatric TT after orchiopexy.Most atrophied testes appeared within 3-6 months after surgery.Compared with the corresponding age-matched healthy controls,the contralateral testicular volumes were larger in the orchiopexy(P=0.o01 without TA,and P=0.042 with TA)and orchiectomy groups(P=0.033).The adverse events were comparable in patients with orchiectomy or orchiopexy.In summary,follow-up before 3 months after surgery may not offer sufficient clinical value,while that 3 months after surgery should be regarded as the first follow-up time for testicular monitoring.The contralateral testes of patients with TT showed compensatory hypertrophy.We suggest performing orchiectomy when torsed testes are surgically assessed as Arda gradeⅢor inviable.

Xanthogranulomatous Cholecystitis and Misdiagnosis Analysis

INTRODUCTION Gastric sub-epithelial masses （SEMs） are relatively common findings when receiving gastric endoscopy. It is a mass, bulge, or impression visible. Computed tomography （CT） and magnetic resonance imaging can assist in making a diagnosis,