Analysis of functional hub genes indicates DLGAP5 is linked to lung adenocarcinoma prognosis

Introduction:The difficulty in treating lung adenocarcinoma(LUAD)is caused by a shortage of knowledge about the biological mechanisms and a lack of treatment choices.Objectives:The aim of this study was to identify a valuable molecular target for the treatment of LUAD.Methods:Using multiple databases,we screened for hub genes in LUAD using Cytoscape and explored the expression and prognosis of DLG associated protein 5(DLGAP5)in LUAD.We investigated the genetic variation,functional enrichment,and epigenetic activity of DLGAP5.Furthermore,we evaluated the relationship between the tumor microenvironment(TME)and DLGAP5.Results:Our study identified 10 hub genes in LUAD:CDC45,KIAA0101,DLGAP5,CDT1,NCAPG,CCNB1,CDCA5,CDC20,KIF11,and AURKA.We discovered that DLGAP5 was overexpressed and associated with poor prognosis in LUAD.DLGAP5 exhibited an overall genetic variation frequency of 2%,and its DNA promoter was hypomethylated in LUAD(p<0.05).The expression of DLGAP5 in LUAD showed a positive correlation with the majority of N6-methyladenosine(m6A)-methylation genes.Additionally,DLGAP5 was primarily associated with the cell cycle in LUAD.Notably,there was a significant favorable association between DLGAP5 and CD274,CTLA4,HAVCR2,and LAG3 in LUAD.Conclusion:DLGAP5 may be a therapeutic target for LUAD,as it affects cancer cells proliferation and development through the regulation of cell-cycle checkpoints and modulation of immune cell infiltration and immune checkpoints in the TME.

A novel anastomotic vacuum-assisted closure system for cervical anastomotic fistula after three-incisional esophagectomy

Introduction Surgery remains the mainstay treatment for localized esophageal squamous cell carcinoma(ESCC).In recent years,three-incision McKeown esophagectomy has been widely applied for operable ESCC considering its superiority in acquiring extensive lymphadenectomy and long-termsurvival[1].Cervical anastomotic fistula is one of the most dreaded complications in patients undergoing three-incision esophagectomy;it occurs in almost 10%–25%of patients and is responsible for almost 40%of post-operative deaths[2,3].Most surgeons prefer conservative approaches including perianastomotic drainage,total parenteral nutrition,nasogastric decompression,and the use of broad-spectrum antibiotics for cervical anastomotic fistula[4,5].However,the recovery period under this method is commonly long and unsatisfactory.Until now,the optimal treatment for cervical anastomotic fistula has not yet been established.In this study,we describe a flushingdrainage system under negative pressure conditions to treat cervical anastomotic fistula,named anastomotic vacuum-assisted closure(AVAC).