Comparison of different methods of obturator nerve block in transurethral resection of bladder tumors: A systematic review and network meta-analysis.

BACKGROUND: Bladder cancer is the most common malignancy of the urinary system, and accounts for 3% of newly diagnosed tumors. Transurethral resection of bladder tumor plays a key role in treating bladder cancer, among which one of the most serious complications is bladder perforation caused by obturator nerve reflex. Obturator nerve reflex can be prevented by inducing obturator nerve block after lumbar anesthesia. However, No study so far has compared the inhibitory effect of different obturator nerve block approaches on intraoperative obturator nerve reflex and bladder perforation. METHOD: In this study, we conducted a network meta-analysis (NMA) of studies comparing the efficacy of different obturator nerve block approaches performed after lumbar anesthesia in operation. RESULT: The distal obturator nerve block guided by peripheral nerve stimulator is the best approach for preventing obturator reflex. The proximal obturator nerve block guided by ultrasound is the best approach for preventing bladder perforation. CONCLUSION: Spinal anesthesia combined with the distal obturator nerve block guided by peripheral nerve stimulator is the most optimal approach to prevent the obturator nerve reflex. But the doctor should choose the appropriate anesthesia method according to the patient's general condition, tumor location, and doctor's proficiency in puncture techniques.

The Role of Al4C3 Morphology in Tensile Properties of Carbon Fiber Reinforced 2024 Aluminum Alloy during Thermal Exposure.

The aluminum alloy drill pipe suffers long-term high-temperature conditions during ultra-deep well drilling. In this paper, the samples were prepared by vacuum hot pressing, followed by hot extrusion and T6 heat treatment. The mechanical properties of short carbon fiber reinforced 2024 aluminum alloy composites (SCFs/2024 Al) and the microstructure evolution at the interface region thermal exposure at 160 °C for 500 h are discussed. The experimental results showed that the effect of short carbon fiber on 2024 aluminum alloy remained steady throughout the whole process of the heat exposure experiment. The distribution and volume of interface products (Al4C3) changed with the prolonging of heat exposure time, and connected after coarsening. The evolution of the morphology of Al4C3 relieved the stress of the interface between carbon fiber and aluminum alloy matrix and enhanced the mechanical properties of the composite.

[Concentration Levels and Potential Ecological Risks of Current Use Pesticides in the Surface Seawater of Typical Liaoning Sea Areas].

Fourteen current-use pesticides (CUPs) in the surface seawaters of the typical Liaoning sea areas were analyzed using HPLC-MS/MS. The concentrations, distribution, and ecological risks were studied, as well as their source appointments using principal component analysis (PCA). The results revealed that seven types of CUPs were detected in the surface seawaters of the typical Liaoning sea areas. The total concentrations of these CUPs ranged from 16.7 ng·L-1 to 176.1 ng·L-1. The samples with high concentrations were collected mostly from the estuary, and the concentrations of CUPs in the western Liaodong Bay were generally higher than those in the northeastern Yellow Sea. Atrazine and triadimenol were the predominant CUPs, and their contribution rates accounted for 56.0% and 34.5%, respectively. The PCA results indicated that six types of CUPs might be caused by the runoff from farmlands and the wastewater discharge from the chemical pesticide factory, and fruit planting could be a substantial contributor to the single component acetochlor. Atrazine and acetochlor posed medium-high ecological risks to the microalgae, while all the seven types of CUPs showed relatively lower risks to invertebrates and fish.

Comparison of outcomes of complete mesocolic excision with conventional radical resection performed by laparoscopic approach for right colon cancer.

BACKGROUND: This retrospective study compared the outcomes of laparoscopic complete mesocolic excision (CME) guided by superior mesenteric artery with laparoscopic conventional radical resection (CRR) performed for right-sided colon cancer. METHODS: Patients with right-sided colon cancer underwent CME (n=107; January 2011 to December 2015) or CRR (n=60; January 2008 to December 2010). RESULTS: The 2 groups were comparable regarding age, gender, body mass index, maximum tumor diameter, and tumor stage. In the CME group, the distances between the tumor and the high vascular tie (HVT; 12.6 cm), and between the closest bowel wall and HVT (10.4±0.9 cm) was significantly greater than that of the CRR group (11.5 cm and 9.3±1.0 cm, respectively; P<0.001). In the CME group, the number of retrieved lymph nodes (23.2) was significantly higher, and the volume of intraoperative bleeding (108.4 mL) was less than that of the CRR (14.0 and 128.7 mL; P<0.001). The length of resected bowel in the 2 groups was similar (25.8±0.7 cm and 25.5±2.1 cm; P=0.106), as was the operative time, postoperative hospitalization, time of first bowel movement, and complications. The 3-year recurrence rate of the CME group (8.4%) was significantly lower than that of the CRR (20.0%), the 3-year overall survival was significantly higher (93.5% cf. 85.0%), and the survival rates of T4 stage, N1 stage, pTNM stage II, pTNM stage III and lympho vascular invasion were significantly higher (P<0.05). The 2 groups were similar for survival rates of Tis, T1, T2, T3, N2 stage, pTNM stage I and perineural invasion (P>0.05). CONCLUSION: CME for right-sided colon cancer guided by superior mesenteric artery has similar short-term outcomes, higher lymph node yield, and higher 3-year overall survival compared with CRR.

Protective effect of curcumin against irinotecan­induced intestinal mucosal injury via attenuation of NF­κB activation, oxidative stress and endoplasmic reticulum stress.

Irinotecan (CPT­11) is a DNA topoisomerase I inhibitor which is widely used in clinical chemotherapy, particularly for colorectal cancer treatment. However, late­onset diarrhea is one of the severe side­effects of this drug and this restricts its clinical application. The present study aimed to investigate the protective effects of curcumin treatment on CPT­11­induced intestinal mucosal injury both in vitro and in vivo and to elucidate the related mechanisms involved in these effects. For this purpose, mice were intraperitoneally injected with CPT­11 (75 mg/kg) for 4 days to establish a model of late­onset diarrhea. Curcumin (100 mg/kg) was intragastrically administered 8 days before the injection of CPT­11. Injury to small intestinal tissues was examined by H&E staining. The protein expression of prolyl 4­hydroxylase subunit beta (P4HB) and peroxiredoxin 4 (PRDX4) was detected by immunohistochemistry, as well as western blot analysis. IEC­6 cell viability was detected by MTT assay. Flow cytometry was performed to examine the cell apoptotic rate, mitochondrial membrane potential and reactive oxygen species (ROS) generation. Immunofluorescence was used to observe the localization of nuclear factor (NF)­κB. The levels of cleaved caspase­3, glucose­regulated protein, 78 kDa (GRP78), P4HB, PRDX4 and CHOP were detected by western blot analysis. The results revealed that in vivo, curcumin effectively attenuated the symptoms of diarrhea and abnormal intestinal mucosa structure induced by CPT­11 in nude mice. Treatment with curcumin also increased the expression of P4HB and PRDX4 in the tissue of the small intestine. In vitro, curcumin, exhibited little cytotoxicity when used at concentrations <2.5 µg/ml for 24 h in IEC­6 cells. At this concentration, curcumin also improved cell morphology, inhibited apoptosis, maintained mitochondrial membrane potential and reduced the elevated levels of ROS induced by CPT­11 (20 µg/ml). Furthermore, curcumin abolished NF­κB signal transduction and protected the cells from CPT­11­induced apoptosis by upregulating the expression of molecular chaperones, such as GRP78, P4HB and PRDX4, and suppressing the levels of the apoptosis­related proteins, CHOP and cleaved caspase­3. On the whole, our data indicate that curcumin exerted protective effects against CPT­11­induced intestinal mucosa injury. The protective effects of curcumin are mediated by inhibiting the activation of NF­κB, and suppressing oxidative stress and endoplasmic reticulum stress.

Laparoscopic versus Open Surgery in Lateral Lymph Node Dissection for Advanced Rectal Cancer: A Meta-Analysis.

AIM: To compare the clinical efficacies between laparoscopic and conventional open surgery in lateral lymph node dissection (LLND) for advanced rectal cancer. METHODS: We comprehensively searched PubMed, Embase, Cochrane Library, CNKI, and Wanfang Data and performed a cumulative meta-analysis. According to inclusion criteria and exclusion criteria, all eligible randomized controlled trials (RCTs) or retrospective or prospective comparative studies assessing the two techniques were included, and then a meta-analysis was performed by using RevMan 5.3 software to assess the difference in clinical and oncological outcomes between the two treatment approaches. RESULTS: Eight studies involving a total of 892 patients were finally selected, with 394 cases in the laparoscopic surgery group and 498 cases in the traditional open surgery group. Compared with the traditional open group, the laparoscopic group had a longer operative time (WMD = 81.56, 95% CI (2.09, 142.03), P = 0.008), but less intraoperative blood loss (WMD = -452.18, 95% CI (-652.23, -252.13), P < 0.00001), shorter postoperative hospital stay (WMD = -5.30, 95% CI (-8.42, -2.18), P = 0.0009), and higher R0 resection rate (OR = 2.17, 95% CI (1.14, 4.15), P = 0.02). There was no significant difference in the incidence of surgical complications between the two groups (OR = 0.52, 95% CI (0.26, 1.07), P = 0.08). Lateral lymph node harvest, lateral lymph node metastasis, local recurrence, 3-year overall survival, and 3-year disease-free survival did not differ significantly between the two approaches (P > 0.05). CONCLUSION: Laparoscopic LLND has a similar efficacy in oncological outcomes and postoperative complications to the conventional open surgery, with the advantages of reduced intraoperative blood loss, shorter postoperative hospital stay, and higher R0 resection rate, and tumor radical cure is similar to traditional open surgery. Laparoscopic LLND is a safe and feasible surgical approach, and it may be used as a standard procedure in LLND for advanced rectal cancer.

[Occurrence and Gas-particle Partitioning of Polycyclic Aromatic Hydrocarbons in the Air of Liaodong Bay].

The gas-and particle-phase polycyclic aromatic hydrocarbons (PAHs) were collected from the air of Liaodong Bay in May and August to investigate their occurrence and gas/particle distribution. The 24 PAHs were analyzed for gas-and particle-phase samples, and the concentrations of total gas-and particle-phase PAHs were found to be 28.8 ng·m-3 and 24.0 ng·m-3, respectively. The concentrations of the gas-phase PAHs were higher in August than in May, and the concentrations of the particle-phase PAHs were higher in May than in August. The low molecular weight PAHs were mainly distributed in the gas-phase, and the high molecular weight PAHs were mainly distributed in the particle-phase; the medium molecular weight PAHs were more easily affected by the environmental conditions than the low and high molecular weight PAHs. The value of Kp increased with an increase in the molecular weight. The slopes m for regressed lgKp-lgPL and lgKp-lgKOA plots were -0.35 and 0.37, deviated from -1 and+1 for the equilibrium states of gas/particle partitioning. The equilibrium states of the lgKp-lgKOA, lgKp-lgPL, and soot-air models were applied; the predicted results of the 5-ring PAHs fitted well with the field measure results. The predicted results of the soot-air model were much closer to the field measure results than the results of the lgKP-lgKOA and lgKP-lgPL models; compared to their heavier counterparts, the low and medium molecular weight PAHs were influenced to a greater extent by soot.

Alisertib Induces Cell Cycle Arrest, Apoptosis, Autophagy and Suppresses EMT in HT29 and Caco-2 Cells.

Colorectal cancer (CRC) is one of the most common malignancies worldwide with substantial mortality and morbidity. Alisertib (ALS) is a selective Aurora kinase A (AURKA) inhibitor with unclear effect and molecular interactome on CRC. This study aimed to evaluate the molecular interactome and anticancer effect of ALS and explore the underlying mechanisms in HT29 and Caco-2 cells. ALS markedly arrested cells in G2/M phase in both cell lines, accompanied by remarkable alterations in the expression level of key cell cycle regulators. ALS induced apoptosis in HT29 and Caco-2 cells through mitochondrial and death receptor pathways. ALS also induced autophagy in HT29 and Caco-2 cells, with the suppression of phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR), but activation of 5' AMP-activated protein kinase (AMPK) signaling pathways. There was a differential modulating effect of ALS on p38 MAPK signaling pathway in both cell lines. Moreover, induction or inhibition of autophagy modulated basal and ALS-induced apoptosis in both cell lines. ALS potently suppressed epithelial to mesenchymal transition (EMT) in HT29 and Caco-2 cells. Collectively, it suggests that induction of cell cycle arrest, promotion of apoptosis and autophagy, and suppression of EMT involving mitochondrial, death receptor, PI3K/Akt/mTOR, p38 MAPK, and AMPK signaling pathways contribute to the cancer cell killing effect of ALS on CRC cells.

[Determination of benzene series in marine sediment by headspace solid phase microextraction-gas chromatography-mass spectrometry].

A method was developed for the determination of benzene series (BTEX) in marine sediment by headspace solid phase microextraction (HS-SPME) and gas chromatography-mass spectrometry (GC-MS). The conditions for extraction and gas chromatography, such as the amount of salt added, equilibrium time, extraction temperature, extraction time, desorption time and injection temperature, were optimized. The analytes were quantitatively analyzed by the internal standard method. The results showed that the linear correlation coefficients of BTEX compounds were from 0.995 to 0.999 in the range of 0.500-20.0 ng/g. The detection limits of this method were from 0.081 8 to 0. 175 ng/g, with the RSDs of inter- and intra-day of 1.2%-3.6% (n = 5) and 0.4%-6.3% (n = 3). The average recoveries under two different spiked concentrations (2.0 and 15.0 ng) were 61.7%-79.5% and 77.1%-85.6% with RSDs of 5.4%-9.6% and 3.9%-7.6% (n = 5), respectively. This method is quick, sensitive, simple, accurate and reproducible. It can be used to analyze the marine sediment samples with trace BTEX.

[Effect of perioperative intestinal probiotics on intestinal flora and immune function in patients with colorectal cancer].

OBJECTIVE: To investigate the effect of perioperative application of intestinal probiotics to substitute oral intestinal antimicrobial agents on intestinal flora and immune function in surgical patients with colorectal cancer. METHODS: Sixty patients with colorectal cancer undergoing elective laparoscopic radical surgery were randomized to receive preoperative bowel preparation using oral intestinal antimicrobial agents (n=20) or using oral intestinal probiotics (Jinshuangqi Tablets, 2.0 g, 3 times daily) since the fifth day before the operation and at 24 h after the operation for 7 consecutive days. Upon admission and 7 days after the operation, fecal samples and fasting peripheral venous blood were collected from the patients to examine the intestinal flora and serum levels of interleukin-2 (IL-2), IgA, IgG, and IgM, NK cell activity, T lymphocytes subsets CD3(+), CD4(+), CD8(+) and CD4(+)/CD8(+) ratio. RESULTS: At 7 days after the operation, the patients receiving probiotics showed significantly increased counts of intestinal Bifidobacterium, Lactobacillus, and Enterococcus (P<0.05) and significantly lowered counts of Escherichia coli and Staphylococcus aureus (P<0.05). The serum levels of IL-2, IgA, IgG and IgM as well as CD4(+) cell percentage all increased significantly in probiotics group compared with those in patients with conventional intestinal preparation (P<0.05). CONCLUSIONS: Perioperative application of intestinal probiotics to replace preoperative oral intestinal antimicrobial agents can effectively correct intestinal flora imbalance and improve the immune function of surgical patients with colorectal cancer.

[Laparoscopic anterior resection of rectal carcinoma with preservation of the left colonic artery].

OBJECTIVE: To evaluate the feasibility and efficacy of laparoscopic anterior resection of rectal carcinoma with preservation of the left colonic artery. METHODS: From February 2006 to February 2009, 52 patients with rectal carcinoma formerly scheduled for Dixon operation (clinical stage I and II) received laparoscopic Dixon surgery. The inferior mesenteric artery, left colonic artery, sigmoid artery or superior rectal artery, and lymph nodes were dissected through the vasa vasorum approach. The left colonic artery was retained by transecting the inferior mesenteric artery inferior to the left colonic artery. The operative time, intraoperative hemorrhage volume, intraoperative complications, anastomotic tension, number and histopathological features of the dissected lymph nodes surrounding the inferior mesenteric artery, and the rates of local recurrence, lymph node metastasis and anastomotic leakage were analyzed. RESULTS: The operation was successfully completed in all the 52 cases. The operative time ranged from 115 to 320 min with a mean of 150 min. The mean intraoperative hemorrhage was 25 ml (range 15-75 ml). None of the patients had perforation of the rectum, injuries to blood vessel, ureter or adjacent organs, or anastomotic tension. The number of dissected lymph nodes surrounding the inferior mesenteric artery ranged from 4 to 8, with a mean of 6.2. The dissected lymph nodes in the base of the inferior mesenteric artery showed no cancer cell metastasis, while 4 patients had cancer cell metastasis in the lymph nodes surrounding superior rectal artery. None of patients had anastomotic leakage. Local recurrence was found in only 1 case at 7 months after the operation. CONCLUSION: Laparoscopic anterior resection of the rectal carcinoma with preservation of the left colonic artery can be completed in patients with rectal carcinoma planning to receive Dixon operation (clinical stage I or II). This surgical approach preserves more supplying vessels and prevents anastomotic leakage without increasing the anastomotic tension or affecting lymph node dissection surrounding the inferior mesenteric artery.