Novel miR-490-3p/hnRNPA1-b/PKM2 axis mediates the Warburg effect and proliferation of colon cancer cells via the PI3K/AKT pathway

BACKGROUND Heterogeneous ribonucleoprotein A1(hnRNPA1)has been reported to enhance the Warburg effect and promote colon cancer(CC)cell proliferation,but the role and mechanism of the miR-490-3p/hnRNPA1-b/PKM2 axis in CC have not yet been elucidated.AIM To investigate the role and mechanism of a novel miR-490-3p/hnRNPA1-b/PKM2 axis in enhancing the Warburg effect and promoting CC cell proliferation through the PI3K/AKT pathway.METHODS Paraffin-embedded pathological sections from 220 CC patients were collected and subjected to immunohistochemical analysis to determine the expression of hnRNPA1-b.The relationship between the expression values and the clinicopathological features of the patients was investigated.Differences in mRNA expression were analyzed using quantitative real-time polymerase chain reaction,while differences in protein expression were analyzed using western blot.Cell proliferation was evaluated using the cell counting kit-8 and 5-ethynyl-2’-deoxyuridine assays,and cell cycle and apoptosis were detected using flow cytometric assays.The targeted binding of miR-490-3p to hnRNPA1-b was validated using a dual luciferase reporter assay.The Warburg effect was evaluated by glucose uptake and lactic acid production assays.RESULTS The expression of hnRNPA1-b was significantly increased in CC tissues and cells compared to normal controls(P<0.05).Immunohistochemical results demonstrated significant variations in the expression of the hnRNPA1-b antigen in different stages of CC,including stage I,II-III,and IV.Furthermore,the clinicopathologic characterization revealed a significant correlation between hnRNPA1-b expression and clinical stage as well as T classification.HnRNPA1-b was found to enhance the Warburg effect through the PI3K/AKT pathway,thereby promoting proliferation of HCT116 and SW620 cells.However,the proliferation of HCT116 and SW620 cells was inhibited when miR-490-3p targeted and bound to hnRNPA1-b,effectively blocking the Warburg effect.CONCLUSION These findings suggest that the novel miR-490-3p/hnRNPA1-b/PKM2 axis could provide a new strategy for the diagnosis and treatment of CC.

Oncologic impact of colonic stents for obstructive left-sided colon cancer

Colonic stenting has had a significant positive impact on the management of obstructive left-sided colon cancer(OLCC) in terms of both palliative treatment and bridge-to-surgery(BTS). Notably, many studies have convincingly demonstrated the effectiveness of stenting as a BTS, resulting in improvements in shortterm outcomes and quality of life, safety, and efficacy in subsequent curative surgery, and increased cost-effectiveness, whereas the safety of chemotherapy after stenting and the long-term outcomes of stenting as a BTS are controversial. Several studies have suggested an increased risk of perforation in patients receiving bevacizumab chemotherapy after colonic stenting. In addition, several pathological analyses have suggested a negative oncological impact of colonic stenting. In contrast, many recent studies have demonstrated that colonic stenting for OLCC does not negatively impact the safety of chemotherapy or long-term oncological outcomes. The updated version of the European Society of Gastrointestinal Endoscopy guidelines released in 2020 included colonic stenting as a BTS for OLCC as a recommended treatment. It should be noted that the experience of endoscopists is involved in determining technical and clinical success rates and possibly oncological outcomes. This review discusses the positive and negative impacts of colonic stenting on OLCC treatment, particularly in terms of oncology.

Cost-effectiveness analysis of colon cancer treatments from MOSIAC and No.16968 trials

AIM:To compare XELOX and FOLFOX4 as colon cancer adjuvant chemotherapy based on MOSAIC and No.16968 trails from Chinese cost-effectiveness perspective.METHODS:A decision-analytic Markov model was developed to compare the FOLFOX4 and XELOX regimens based MOSAIC and No.16968 trial.Five states were included in our Markov model:well(state 1),minor toxicity(state 2),major toxicity(state 3),quitting adjuvant chemotherapy(state 4),and death due to adjuvant chemotherapy(state 5).Transitions among the 5 states were assumed to be Markovian.Costs were calculated from the perspective of the Chinese health-care payer.The utility data were taken from published studies.Sensitivity analyses were used to explore the impact of uncertainty factors in this cost-effectiveness analysis.RESULTS:Total direct costs of FOLFOX4 and XELOX per patient were$19884.96±4280.30 and$18113.25±3122.20,respectively.The total fees related to adverse events per patient during the entire treatment were$204.75±16.80 for the XELOX group,and$873.72±27.60 for the FOLFOX4 group,and the costs for travel and absenteeism per patient were$18495.00for the XELOX group and$21,352.68 for the FOLFOX4group.The base-case analysis showed that FOLFOX4was estimated to produce an additional 0.06 in quality adjusted life years(QALYs)at an additional cost of$3950.47 when compared to the XELOX regimen over the model time horizon.The cost per QALY gained was$8047.30 in the XELOX group,which was$900.98 less than in the FOLFOX4 group($8948.28).The one way sensitivity analysis demonstrated that the utility for the well state and minor toxicity state greatly influenced the incremental cost-effectiveness ratio of FOLFOX4.CONCLUSION:In term of cost-comparison,XELOX is expected to dominate FOLFOX4 regimes;Therefore,XELOX provides a more cost-effective adjuvant chemotherapy for colon cancer patients in China.

Hexahydrocurcumin enhances inhibitory effect of 5-fluorouracil on HT-29 human colon cancer cells

AIM:To investigate the ability of hexahydrocurcumin(HHC) to enhance 5-fluorouracil(5-FU) in inhibiting the growth of HT-29 cells by focusing on cyclooxygenase(COX)-2 expression.METHODS:Antiproliferative effects of HHC and 5-FU,alone and in combination,on growth of HT-29 human colon cancer cells were assessed using 5-diphenyltetrazolium bromide(MTT) reduction assay.In combination treatment,low doses of 5-FU were used combined with various concentrations of HHC to minimize the toxicity and side effects of 5-FU.The therapeutic effects of these drugs on down-regulation of COX-2 mRNA and protein expression were examined using semi-quantitative reverse transcription-polymerase chain reaction(RT-PCR) and Western blotting analysis.RESULTS:MTT reduction assay indicated that HHC alone markedly decreased the viability of HT-29 human colon cancer cells compared to control.Semi-quantitative RT-PCR analysis indicated that HHC is a selective COX-2 inhibitor.This finding was supported by the observation that HHC significantly down-regulates COX-2 mRNA expression compared to the control(control:100.05% ± 0.03% vs HHC:61.01% ± 0.35%,P < 0.05) but does not alter COX-1 mRNA.In combined treatment,addition of HHC to a low dose of 5-FU exerts a synergistic effect against the growth of HT-29 cells by markedly reducing cell viability to a greater degree than monotherapy.Semi-quantitative RT-PCR indicated that 5-FU at the concentration of 5 μmol/L in combination with HHC at the concentration of 25 μmol/L significantly down-regulates COX-2 mRNA expression when compared with values in cells treated with 5-FU or HHC alone(HHC + 5-FU:31.93% ± 5.69%,5-FU:100.66% ± 4.52% vs HHC:61.01% ± 0.35%,P < 0.05).CONCLUSION:HHC together with 5-FU exerts a synergistic effect and may prove chemotherapeutically useful in treating human colon cancer.

Long-term efficacy of capecitabine plus oxaliplatin chemotherapy on stage Ⅲ colon cancer: A meta-analysis

BACKGROUND Many clinical studies for the long-term survival or efficacy of capecitabine plus oxaliplatin(XELOX)in colon cancer have already been studied,but its clinical benefit is controversial.AIM To evaluate the long-term efficacy of XELOX regimen in comparison with other adjuvant chemotherapy protocols in colon cancer.METHODS By searching the PubMed,EMBASE and Cochrane databases,a total of 12 randomized controlled trials involving 6698 stageⅢcolon cancer cases(XELOX protocol:n=3298 cases;other adjuvant chemotherapy protocol:n=3268 cases)were included.The parameter outcomes included the overall survival and the disease-free survival.The quality control of selected literature was based on the Jadad scale and the GRADE system.RESULTS In comparison to other adjuvant chemotherapy regimen,XELOX regimen showed a better overall survival(odds ratio=1.29,95% confidence interval:1.15-1.44,P<0.0001)and a better disease-free survival(odds ratio=1.32,95%confidence interval:1.18-1.46,P<0.0001)for colon cancer patients,suggesting the XELOX regimen can be a good option for postoperative treatment of stage III colon cancer.CONCLUSION The XELOX regimen can be a preferred option for adjuvant treatment of stageⅢcolon cancer after surgery.

Time-Lag Effect of Dietary Fiber and Fat Intake Ratio on Japanese Colon Cancer Mortality

The daily intake of total dietary fiber (TDF) was evaluated from data of the National Nutrition Survey (NNS) in Japan for 41 years since 1947. An interrelationship between the nutrient intake, including TDF, and the mortality from colon cancer in Japanese people was calculated by a simple correlation coefficient and time-series correlation coeffcient.TDF intake per capita decreased rapidly from 27.4 g in 1947 to 15.8 g in 1963, and subsequently decreased by a lesser rate to 15.3 g in 1987. Fat intake increased rapidly from 18.0 g in 1950 to 56.6 g in 1987.The age-adjusted mortality from colon cancer shows a significant positive correlation with both the intakes of animal protein and of total fat, and the fat energy ratio. A time-series analysis indicates that the mortality from colon cancer was negatively correlated with TDF with a 15-27 year delay, the maximum correlation existing with a 23-year lag (r = -0.947). The TDF intake was less than 17.9 g in 1965. At the same time, the mortality from colon cancer increased rapidly. A fat/TDF ratio above 3.0 resulted in a rapid increase in colon cancer mortality.The non-adjusted mortality from colon cancer has much the same interrelationship with TDF and fat intake as the adjusted figures. It is suggested that the cause of the increased mortality from colon cancer in Japan is positively related to the increased intake of fat and protein. In addition, the decrease in TDF intake has accelerated the mortality of colon cancer after a delay of 23-24 years. The importance of fat/TDF as a nutritional criterion for the incidence of colon cancer needs to be better recognized

Metastasis-associated in colon cancer-1 in gastric cancer: Beyond metastasis

Metastasis-associated in colon cancer-1(MACC1) is an oncogene that was first identified in colon cancer. The upstream and downstream of MACC1 form a delicate regulatory network that supports its tumorigenic role in cancers. Multiple functions of MACC1 have been discovered in many cancers. In gastric cancer(GC), MACC1 has been shown to be involved in oncogenesis and t umor progression. MACC1 overexpression adversely affects the clinical outcomes of GC patients. Regarding the mechanism of action of MACC1 in GC, studies have shown that it promotes the epithelialto-mesenchymal transition and accelerates cancer metastasis. MACC1 is involved in many hallmarks of GC in addition to metastasis. MACC1 promotes vasculogenic mimicry(VM) via TWIST1/2, and VM increases the tumor blood supply, which is necessary for tumor progression. MACC1 also facilitates GC lymphangiogenesis by upregulating extracellular secretion of VEGF-C/D, indicating that MACC1 may be an important player in GC lymphatic dissemination. Additionally, MACC1 supports GC growth under metabolic stress by enhancing the Warburg effect. In conclusion, MACC1 participates in multiple biological processes inside and outside of GC cells, making it an important mediator of the tumor microenvironment.

Colorectal cancer screening:The role of CT colonography

Computed tomography colonography(CTC) in colorectal cancer(CRC) screening has two roles:one present and the other potential.The present role is,without any further discussion,the integration into established screening programs as a replacement for barium enema in the case of incomplete colonoscopy.The potential role is the use of CTC as a first-line screening method together with Fecal Occult Blood Test,sigmoidoscopy and colonoscopy.However,despite the fact that CTC has been officially endorsed for CRC screening of average-risk individuals by different scientif ic societies including the American Cancer Society,the American College of Radiology,and the US Multisociety Task Force on Colorectal Cancer,other entities,such as the US Preventive Services Task Force,have considered the evidence insuff icient to justify its use as a mass screening method.Medicare has also recently denied reimbursement for CTC as a screening test.Nevertheless,multiple advantages exist for using CTC as a CRC screening test:high accuracy,full evaluation of the colon in virtually all patients,non-invasiveness,safety,patient comfort,detection of extracolonic findings and cost-effectiveness.The main potential drawback of a CTC screening is the exposure to ionizing radiation.However,this is not a major issue,since low-dose protocols are now routinely implemented,delivering a dose comparable or slightly superior to the annual radiation exposure of any individual.Indirect evidence exists that such a radiation exposure does not induce additional cancers.

Avidin chase reduces side effects of radioimmunotherapy in nude mice bearing human colon carcinoma

AIM: To evaluate the influence of avidin chase on the side effects of radioimmunotherapy (RIT) in nude mice bearing human colon carcinoma and therapeutic outcome.METHODS: Purified anti-CEA monoclonal antibody (McAb)was biotinylated with NHS-biotin, and then radiolabeled with 188Re by the direct method. 188Re-labeledbiotinylated anti-CEA McAb (188Re-CEA McAb-Bt) was intravenously injected followed by intravenous injection of avidin after 24 h. SPECT imaging and biodistribution study were performed at 28-48 h after the injection of 188Re-CEA McAb-Bt. Three groups of nude mice subcutaneously grafted with human colon carcinoma were treated 7 d after the graft. Mice in the avidin chase group received intravenous injection of 188Re-CEA McAb-Bt (11.1 MBq/20 μg) followed by intravenous injection of cold avidin (80 μg) after 24 h. Mice in the control group (treated group without avidin chase) only received the injection of 188Re-CEA McAb-Bt (11.1 MBq/20 μg), another control group (non-treated group) only received 0.1 mL normal saline solution. Toxicity was evaluated on the basis of change of body weight and peripheral WBC counts, and therapy effects were determined by variation in tumor volume. Histological analysis of tumors was also performed.RESULTS: Avidin chase markedly accelerated the clearance of 188Re-CEA McAb-Bt from the blood and normal tissues. The tumor uptakes of 188Re-CEA Mc Ab-Bt at 28 h were 5.90 and 6.42% ID/g, respectively, in chase group and in non-chase group, while the tumor-to-background (T/NT) ratios were 3.19 and 0.56, respectively. The tumor uptake was slightly decreased by avidin chase, but the T/NT ratios were increased. In treated groups the growth rate of body weight and the number of WBC decreased after injection of 188Re-CEA McAb-Bt, and the WBC counts recovered earlier in the group with avidin chase than in the group without avidin chase. Compared to the nontreated group, treated groups with and without avidin chase showed significant anti-tumor effects.CONCLUSION: Avidin chase can effectively reduce the side effects of RIT, and improve therapeutic efficacy.

中药有效成分防治结肠癌机制研究进展

结肠癌是世界范围内最常见的恶性肿瘤之一,其常规治疗手段在为患者提供生存益处的同时,副作用和局限性也不容忽视。中药因其多靶点、多途径、毒副作用较小的抗肿瘤优势备受国内外学者关注。不少中药及从中提取的以黄酮类、酚类、生物碱为代表的中药有效成分在抗肿瘤方面发挥了有效作用,其机制与抑制肿瘤细胞增殖、诱导细胞凋亡、调控自噬、抑制肿瘤细胞侵袭和转移、抑制肿瘤血管生成等有关。本文就近年来中药有效成分抑制结肠癌机制研究进行梳理,以期为中药应用于结肠癌的临床治疗提供参考。

全腹腔镜下肠吻合与辅助切口肠吻合在右半结肠癌根治术中的临床疗效对比

目的:对比分析全腹腔镜下肠吻合与辅助切口肠吻合在腹腔镜右半结肠癌根治术中的临床疗效。方法:回顾分析2017年1月至2022年10月收治的拟手术治疗的右半结肠癌患者的临床资料,根据消化道重建方式分为观察组(全腹腔镜下肠吻合)与对照组(辅助切口肠吻合)。收集两组患者临床资料(年龄、性别、体质指数)、手术时间、术中出血量、手术切口长度、淋巴结清扫数量、术后疼痛评分、术后首次排气时间与排便时间、术后下床活动时间、切口愈合时间、住院时间及术后并发症发生率。结果:共纳入152例患者,其中观察组74例,对照组78例。与对照组相比,观察组术后疼痛评分低,手术切口、术后首次排气时间、术后首次排便时间、术后下床行走时间、切口愈合时间短,差异有统计学意义(P<0.05);两组手术时间、淋巴结清扫数量、术中出血量及术后并发症发生率差异无统计学意义(P>0.05)。结论:与腹腔镜辅助切口肠吻合术相比,全腹腔镜肠吻合的临床疗效更佳,值得临床推广。

单中心腹腔镜与开腹手术治疗T_(3)~T_(4a)期结肠癌的近远期疗效比较

目的:比较腹腔镜与开腹手术治疗T_(3)~T_(4a)期结肠癌围术期疗效及远期生存情况。方法:选取2018年1月1日至2019年12月31日采用腹腔镜与开腹手术治疗的T_(3)~T_(4a)期结肠癌患者,分为腹腔镜组(n=102)与开腹组(n=43),分析两组围手术期资料、术后并发症、总生存期、无瘤生存期、1年与3年生存率及无瘤生存率、总生存率、总无瘤生存率、肿瘤复发转移情况。结果:两组患者基线资料差异无统计学意义(P>0.05)。腹腔镜组术中出血量少于开腹组[50.00(20.00,50.00)mL vs. 50.00(50.00,100.00)mL,P<0.001],获取淋巴结数量多于开腹组[17.00(14.00,22.00)枚vs. 14.00(11.00,20.00)枚,P=0.018],术后恢复进食时间[3.00(3.00,4.00)d vs. 4.00(3.00,6.00)d,P<0.001]、排气时间[3.00(3.00,3.00)d vs. 4.00(3.00,5.00)d,P<0.001]短于开腹组,术后总体并发症与不完全肠梗阻发生率低于开腹组(32.35%vs. 51.16%,3.92%vs. 16.28%,P<0.05)。两组术后1年、3年生存率及无瘤生存率、总生存率、总无瘤生存率、肿瘤复发转移率差异无统计学意义(P>0.05)。在T_(4a)亚组中,腹腔镜组与开腹组的各项生存指标差异均无统计学意义(P>0.05)。结论:腹腔镜手术治疗T_(3)~T_(4a)期结肠癌是安全、可行的,更利于术后恢复,可取得与开腹手术相当的肿瘤治疗效果。

罗森塔尔效应干预结合个性化饮食指导在结肠癌术后患者中的应用效果观察

目的:探讨罗森塔尔效应干预结合个性化饮食指导在结肠癌术后患者中的应用效果。方法:选择2021年6月—2023年1月收治的行腹腔镜结肠癌根治术患者118例,根据随机数表法分为观察组和对照组,每组59例。对照组采用术后常规护理干预措施,观察组在对照组基础上给予罗森塔尔效应干预结合个性化饮食指导。比较两组患者临床相关指标、干预前后营养状况和胃肠激素水平,观察两组并发症发生情况。结果:观察组患者肠鸣音恢复时间、首次排气时间、首次排便时间和住院时间明显短(少)于对照组,差异有统计学意义(P<0.05)。干预后两组患者血红蛋白、白蛋白和总蛋白水平均高于干预前,且观察组高于对照组,差异均有统计学意义(P<0.05)。干预后两组胃动素和胃泌素水平均低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:罗森塔尔效应干预结合个性化饮食指导可促进结肠癌术后患者恢复,提高患者营养状况,改善胃肠激素水平,减少并发症发生。

香砂六君子汤联合XELOX化疗及贝伐珠单抗靶向治疗对晚期结肠癌患者近期疗效及肿瘤标志物的影响

目的:探讨香砂六君子汤联合XELOX化疗及贝伐珠单抗靶向治疗对晚期结肠癌患者近期疗效及肿瘤标志物的影响。方法:选取2020年1月—2023年10月南平市人民医院收治的105例晚期结肠癌患者作为研究对象,随机分为观察组(n=54)和对照组(n=51)。对照组采用XELOX化疗及贝伐珠单抗靶向治疗,观察组在对照组基础上联合香砂六君子汤治疗。比较两组近期疗效、免疫功能、肿瘤标志物[糖类抗原242(CA242)、糖类抗原199(CA199)、癌胚抗原(CEA)]水平及不良反应发生情况。结果:观察组客观缓解率(ORR)、疾病控制率(DCR)分别为51.85%、68.52%,均高于对照组的31.37%、49.02%,差异有统计学意义(P<0.05)。治疗后,两组CD3^(+)、CD4^(+)水平低于治疗前,CD8^(+)水平高于治疗前,但观察组CD3^(+)、CD4^(+)水平高于对照组,CD8^(+)水平低于对照组,差异有统计学意义(P<0.05)。治疗后,两组CA242、CA199、CEA水平均低于治疗前,且观察组CA242、CA199、CEA水平均低于对照组,差异有统计学意义(P<0.05)。观察组胃肠道反应发生率为37.04%,低于对照组的56.86%,差异有统计学意义(P<0.05);两组脱发、贫血、周围神经毒性及肝肾功能损伤发生率比较,差异无统计学意义(P>0.05)。结论:香砂六君子汤联合XELOX化疗及贝伐珠单抗靶向治疗可提高晚期结肠癌近期效果,减轻机体免疫功能损伤,降低肿瘤标志物表达水平,且安全性良好。

替吉奥联合伊立替康治疗晚期结肠癌的临床疗效

目的观察替吉奥联合伊立替康治疗晚期结肠癌的临床疗效。方法采用回顾性分析,收集2021年5月—2022年4月福建医科大学附属龙岩第一医院接诊的102例晚期结肠癌患者的临床资料,按治疗方案不同分为替吉奥组和卡培他滨组,每组51例。替吉奥组采用替吉奥联合伊立替康治疗,卡培他滨组采用卡培他滨联合伊立替康治疗,21 d为1个治疗周期,2组均治疗2~8个周期。比较2组临床疗效,治疗前后血清基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)水平,不良反应及1年生存率。结果替吉奥组客观缓解率高于卡培他滨组(54.90%vs.33.33%,χ^(2)=4.812,P=0.028);治疗后,2组血清MMP-9及VEGF水平均低于治疗前,且替吉奥组低于卡培他滨组(P<0.01);替吉奥组与卡培他滨组不良反应总发生率无显著差异(25.49%vs.33.33%,χ^(2)=0.756,P=0.385);替吉奥组1年生存率高于卡培他滨组(74.51%vs.54.90%,χ^(2)=4.293,P=0.038)。结论替吉奥联合伊立替康治疗晚期结肠癌患者可提高临床疗效,降低血清MMP-9及VEGF水平,用药安全性高,且可提高患者1年生存率。

快速康复护理路径在结肠癌手术护理中对患者康复效果的影响分析

目的 分析快速康复护理路径应用在结肠癌手术护理中对患者康复效果的影响。方法 选取2021年1月—2023年3月本院收治的80例接受结肠癌手术治疗的患者进行研究,将其随机分为参照组与实验组,每组40例。参照组在围手术期进行常规护理,实验组在围手术期实施快速康复护理路径,对比两组患者术后康复效果。结果 术后两组患者首次排气、首次排便、肠鸣音恢复以及下床活动等时间指标相比,实验组均比参照组用时更少,组间差异有统计学意义(P<0.05);术后实验组患者躯体功能、心理功能、社交功能、物质生活状态及总生活质量等评分均比参照组高,组间差异有统计学意义(P<0.05);术后1d和术后3d两组VAS评分相比,实验组均低于参照组,组间差异有统计学意义(P<0.05);术后并发症总发生率,实验组低于参照组,组间差异有统计学意义(P<0.05)。结论 对结肠癌手术患者在围手术期采用快速康复护理路径模式,对于促进患者的胃肠功能恢复和提高生活质量等均可发挥显著作用,推广价值高。

Impact of dexmedetomidine-assisted anesthesia in elderly patients undergoing radical resection of colon cancer

BACKGROUND Radical resection of colon cancer under general anesthesia is one of the main treatment methods for this malignancy.However,due to the physiological charac-teristics of elderly patients,the safety of perioperative anesthesia needs special attention.As anα2-adrenergic receptor agonist,dexmedetomidine(Dex)has attracted much attention from anesthesiologists due to its stabilizing effect on heart rate and blood pressure,inhibitory effect on inflammation,and sedative and analgesic effects.Its application in general anesthesia may have a positive impact on the quality of anesthesia and postoperative recovery in elderly patients undergoing radical resection of colon cancer.METHODS A total of 165 colon cancer patients who underwent radical surgery for colon cancer under general anesthesia at Qingdao University Affiliated Haici Hospital,Qingdao,China were recruited and divided into two groups:A and B.In group A,Dex was administered 30 min before surgery,while group B received an equivalent amount of normal saline.The hemodynamic changes,pulmonary compliance,airway pressure,inflammatory factors,confusion assessment method scores,Ramsay Sedation-Agitation Scale scores,and cellular immune function indicators were compared between the two groups.RESULTS Group A showed less intraoperative hemodynamic fluctuations,better pulmonary compliance,and lower airway resistance compared with group B.Twelve hours after the surgery,the serum levels of TLR-2,TLR-4,IL-6,and TNF-αin group A were significantly lower than those of group B(P<0.05).After extubation,the Ramsay Sedation-Agitation Scale score of group A patients was significantly higher than that of group B patients,indicating a higher level of sedation.The incidence of delirium was significantly lower in group A than in group B(P<0.05).CONCLUSION The use of Dex as an adjunct to general anesthesia for radical surgery in elderly patients with colon cancer results in better effectiveness of anesthesia.

Biological effect of expression of exogenous human nuclear receptor hLRH-1 in SW480 cells and its molecular mechanism

Objective: To explore the possible biological function of human nuclear receptor hLRH-1 in tumorigenesis and progress of colon cancer. Methods: Plasmids pcDNA3-hLRH-1 were introduced into SW480 cells via lipofectamine. The expression of mRNA and protein of exogenous hLRH-1 were detected by RT-PCR and western blotting, respectively. MTT assay was carried out to survey the proliferation of SW480 cells with overexpression of hLRH-1. Meanwhile, the expression of proliferation-related genes cyclin E1 and cyclin D1, and apoptosis-related genes PTEN and Rb1, were analyzed by real- time RT-PCR. Results: The proliferation of SW480 cells was promoted under the condition of overexpression of hLRH-1. The expression of cyclin E1 was up-regulated significantly, while that of PTEN and Rb1 were down-regulated in SW480 cells with overexpressed hLRH-1. Conclusion: The expression of exogenous hLRH-1 in SW480 cells induced the proliferation resulting form up-regulation of cyclin E1, as well as participated in the regulation of apoptosis via influencing the expression of PTEN and Rb1.

Increasing BMI Z-Scores 3 Years after Diagnosis among a Multiethnic Cohort of Childhood Cancer Survivors Treated in South Los Angeles

Background: Due to successful treatment modalities, the majority of pediatric cancer patients will survive. Increased body mass index (BMI) is a complication among pediatric cancer survivors. Methods: This retrospective single-center study examined BMI changes among a cohort of predominantly Hispanic patients who were treated in South Los Angeles. Data were collected at diagnosis, 1, 2 and 3 years after. Analyses included z-scores derived from calculated BMIs compared over 3 years per gender, diagnosis, and treatment modality. The unhealthy BMI z-score was defined as >1.04. Results: Thirty-four percent of the predominantly Hispanic sample had unhealthy BMI z-scores of >1.04 correlating to at or greater than the 85th percentile for age and gender. The study cohort’s BMI z-scores significantly increased from 0.15 to 1.29 at year 3 (P < 0.0001), putting 55% of this population in the unhealthy category. Median BMI z-score significantly increased to the unhealthy category at 3 years. Conclusions: Due to the predominance of Hispanic patients in this group, culturally sensitive interventions beginning at diagnosis should be considered.

多层螺旋CT增强及重建在结肠癌术前TNM分期评估中的价值

目的评价多层螺旋CT(multislice spiral CT,MSCT)增强及重建在结肠癌术前临床病理分期(tumor-node-metastasis,TNM)评估中的价值。方法回顾性分析2018年1月—2020年12月广东省廉江市人民医院收治的60例结肠癌患者影像学资料,所有患者均进行MSCT检查,以病理结果作为参照的金标准,分析MSCT增强及重建对于评估结肠癌术前TNM分期的价值。结果以病理结果为金标准,MSCT增强诊断结肠癌T_(1)、T_(2)、T_(3)与T_(4)分期与病理结果的符合率分别为75.00%、61.54%、79.31%、40.00%,T分期诊断总符合率为68.33%,Kappa值为0.528;诊断N_(0)、N_(1)与N_(2)分期的符合率分别为92.31%、86.11%与54.55%,N分期诊断总符合率为81.67%;诊断M0、M1分期的符合率为94.00%、80.00%,M分期诊断总符合率为91.67%;MSCT检出转移性淋巴结的准确率为90.00%,敏感度为89.36%、特异度为92.31%,Kappa值为0.735。结论MSCT增强及重建对于结肠癌术前TNM分期评估具有较高的临床应用价值。