RESUMO
BACKGROUND AND AIMS: Now that the debate about the safety and effectiveness of laparoscopic versus open surgery is over, attention has turned to innovations that can verify whether minimizing the impact of laparoscopy on the abdominal wall can further reduce pain, improve patient comfort, lead to superior cosmesis, and reduce morbidity. The aim of this study was to further explore the application value of totally laparoscopic right hemicolectomy with transcolonic natural orifice specimen extraction (NOSE) and to evaluate the short-term efficacy of transcolonic NOSE surgery for resecting specimens of ascending colon cancer. METHODS: From January 2016 to May 2017, a retrospective study was conducted in Guangxi. Propensity score matching was used to minimize the bias from nonrandomized treatment assignment. Patients were followed up through May 2020. RESULTS: Forty-nine patients underwent totally laparoscopic right hemicolectomy with transcolonic NOSE and 116 patients laparoscopic right hemicolectomy with mini-laparotomy (ML) procedures at our institution. After propensity score matching, each group included 45 patients, and all covariate imbalances were alleviated. The transcolonic NOSE group and the ML group did not differ significantly in terms of baseline clinical characteristics. The transcolonic NOSE group was associated with a shorter time to first flatus (NOSE vs ML: 1.8 ± .5 vs 3.2 ± .8, P = .032), a shorter length of hospital stay (11.3 ± 2.5 days vs 13.0 ± 3.1 days, P = .034), a shorter time to first liquid intake (2.6 ± .8 vs 3.8 ± .9, P = .068), less pain (1.8 ± .8 vs 4.2 ± .7, P = .013), less analgesia requirement (6 [13.3%] vs 21 [46.7%], P = .001), and lower C-reactive protein levels on postoperative day 1 (3.6 ± 1.7 vs 8.2 ± 2.2, P = .001) and postoperative day 3 (NOSE 2.4 ± 1.4 vs M: 4.6 ± 1.7 [P = .013]) than the ML group. The median follow-up was 28.4 months (interquartile range, 18.0-36.0). The 3-year overall survival rates were similar between the transcolonic NOSE group and the ML group. CONCLUSIONS: In total, laparoscopic right hemicolectomy with transcolonic specimen extraction appears to be safe for selected patients with ascending colon cancer as a minimally invasive surgery.
Assuntos
Neoplasias do Colo , Laparoscopia , China , Colectomia , Colo Ascendente , Neoplasias do Colo/cirurgia , Humanos , Laparotomia , Tempo de Internação , Pontuação de Propensão , Estudos Retrospectivos , Resultado do TratamentoRESUMO
SIVA-1 has been shown to affect apoptotic processes in various different cell lines, and SIVA-1 significantly contributes to the decreased responsiveness of cancer cells to some chemotherapy agents. However, whether SIVA-1 has potential application in gastric cancer remains unknown. Therefore, the objective of this investigation was to clarify the distinct function of SIVA-1 in chemotherapeutic drug resistance within a living murine model with gastric malignancy, and initially elucidate the underlying mechanisms. In an established multidrug-resistant gastric cancer xenograft mouse model, lentivirus, named Lv-SIVA-1, was injected into xenograft tumors, and increased the mRNA and protein expression of endogenous SIVA-1 in tumors. Immunohistochemical assays of xenograft tumor showed that SIVA-1 was significantly upregulated, and the protein expression levels of SIVA-1 were highly increased, as detected by Western blotting. In addition, we detected the role of SIVA-1 in cell proliferation and cell apoptosis in gastric cancer cells by TUNEL and found that SIVA-1 decreased tumor cell apoptosis and promoted tumor growth in vivo. Using a TMT assay between tumor tissues of experimental and control groups, differentially expressed proteins were examined and three potential biomarkers of multidrug resistance (ARF, MDM2, and p53) were screened. We further investigated the molecular mechanism by which SIVA-1 played an efficient role against chemotherapies and found that overexpressed SIVA-1 leads to increased ARF and MDM2 expression and suppressed expression of p53 in tumor tissue. In conclusion, SIVA-1 plays a significant role in the multidrug resistance of gastric tumors. In addition, overexpressed SIVA-1 positively regulates cell proliferation, adjusts cycle progression, and reduces the response to drug treatment for gastric cancer in an ARF/MDM2/p53-dependent manner. This novel research provides a basis for chemical management of gastric cancer through regulation of SIVA-1 expression.
RESUMO
Background: SIVA-1 has been reported to play a key role in cell apoptosis and gastric cancer (GC) chemoresistance in vitro. Nevertheless, the clinical significance of SIVA-1 in GC chemotherapy remains unclear. Methods and results: Immunohistochemistry and histoculture drug response assays were used to determine SIVA-1 expression and the inhibition rate (IR) of agents to GC and to further analyze the relationship between these two phenomena. Additionally, cisplatin (DDP)-resistant GC cells were used to elucidate the role and mechanism of SIVA-1 in vivo. The results demonstrated that SIVA-1 expression was positively correlated with the IR of DDP to GC but not with those of 5-fluorouracil (5-FU) or adriamycin (ADM). Furthermore, SIVA-1 overexpression with DDP treatment synergistically inhibited tumor growth in vivo by increasing PCBP1 and decreasing Bcl-2 and Bcl-xL expression. Conclusions: Our study demonstrated that SIVA-1 may serve as an indicator of the GC sensitivity to DDP, and the mechanism of SIVA-1 in GC resistance to DDP was preliminarily revealed.
RESUMO
The global COVID-19 pandemic has increased attention to the relationship between the built environment and health, particularly in educational settings where students spend a significant amount of their time. Traditional side daylighting used in schools, while cost-effective and easy to construct, can result in uneven indoor daylighting. To address this issue, this paper proposes a terraced teaching building design model for primary and secondary schools in Guangzhou based on the design experience of an "open-air school movement" during a historical respiratory epidemic in the early 20th century. The proposed design relies on skylight for lighting, and each classroom has an outdoor platform. An optimization algorithm based on Spatial Daylight Autonomy (sDA), Uniformity of Daylighting (UOD), Annual Sunlight Exposure (ASE), Outdoor Platform Area (OPA), Gable Wall Length (GWL), and Space Utilization (SU) is used to obtain the optimal concrete form of the building. To speed up the simulation process, a set of Artificial Neural Network (ANN) based rapid prediction network models for complex forms is proposed. This group prediction method improves the simulation speed by 357 times and grossly speed up the optimization process based on six indexes in the early design stage, resulting in four terraced teaching buildings that meet the above criteria. Overall, the proposed design provides a novel architectural form that ensures overall visual comfort while promoting students' learning and physical health.
RESUMO
This paper is an attempt to advance research on spatial potential for interdisciplinary innovation of university campuses by proposing a spatial quantitative method. The aim is to develop the campus to adapt to the new pedagogical structure of encouraging interdisciplinary innovation in the era of knowledge society. For this purpose, literature from management, psychology, and architecture are reviewed to provide insight into the relationship between innovation and physical environment. The existing research mainly focused on the characteristics of physical environment that supported individual innovative thinking or innovative interaction between people in building scale, which is relatively limited in this study for the campus scale since people are less likely to exchange academic information with strangers because of a lack of knowledge about their professional background. In this context, this research enriches the understanding of spatial potential for innovation by proposing a more effective way of increasing unexpected encounters with information, which are probably occurred while people passing by laboratories, seminars, or exhibitions of other disciplines. In this process, the unexpected encounters with information act as the medium or promotion factor for face-to-face interaction. This kind of innovative potential requires fewer conditions like acquaintance or face-to-face interaction but depends more on the space organization. Physical connectivity acts as enabler and the effects vary. This article reports on a preliminary study of how Space Syntax as a quantitative approach is applied to evaluate the effects in the case of South China University of Technology. The proposed method aims to sustain a sustainable transition toward a more adaptable relation between people and the campus environment. However, to improve understanding of spatial effects on innovation, more empirical studies must be carried out.
RESUMO
Siva1 is a wellknown antiapoptosis protein that serves a role in multiple types of cancer cells. However, whether Siva1 affects multidrug resistance via the NFκB pathway in gastric cancer is currently unknown. The present study aimed to determine the possible involvement of Siva1 in gastric cancer anticancer drug resistance in vitro. A vincristine (VCR)resistant KATO III/VCR gastric cancer cell line with stable Siva1 overexpression was established. The protein expression levels of Siva1, NFκB, multidrug resistance 1 (MDR1) and multidrug resistance protein 1 (MRP1) were detected via western blotting. The effect of Siva1 overexpression on anticancer drug resistance was assessed by measuring the 50% inhibitory concentration of KATO III/VCR cells to VCR, 5fluorouracil and doxorubicin. The rate of doxorubicin efflux and apoptosis were detected by flow cytometry. Additionally, colony formation, wound healing and Transwell assays were used to detect the proliferation, migration and invasion of cells, respectively. The results of the current study revealed that the Siva1overexpressed KATO III/VCR gastric cancer cells exhibited a significantly decreased sensitivity to VCR, 5fluorouracil and doxorubicin. The results of flow cytometry revealed that the percentage of apoptotic cells decreased following overexpression of Siva1. The colony formation assay demonstrated that cell growth and proliferation were significantly promoted by Siva1 overexpression. Additionally, Siva1 overexpression increased the migration and invasion of KATO III/VCR cells in vitro. Western blot analysis determined that Siva1 overexpression increased NFκB, MDR1 and MRP1 levels. The current study demonstrated that overexpression of Siva1, which functions as a regulator of MDR1 and MRP1 gene expression in gastric cancer cells via promotion of NFκB expression, inhibited the sensitivity of gastric cancer cells to certain chemotherapies. These data provided novel insight into the molecular mechanisms of gastric cancer, and may be of significance for the clinical diagnosis and therapy of patients with gastric cancer.
Assuntos
Proteínas Reguladoras de Apoptose/fisiologia , Carcinoma , Resistência a Múltiplos Medicamentos , Resistencia a Medicamentos Antineoplásicos , Neoplasias Gástricas , Subfamília B de Transportador de Cassetes de Ligação de ATP/metabolismo , Antineoplásicos/uso terapêutico , Apoptose , Carcinoma/tratamento farmacológico , Carcinoma/metabolismo , Linhagem Celular Tumoral , Proliferação de Células , Regulação Neoplásica da Expressão Gênica , Células HEK293 , Humanos , Proteínas Associadas à Resistência a Múltiplos Medicamentos/metabolismo , NF-kappa B/metabolismo , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/metabolismoRESUMO
We sought to assess light characteristics and user acceptability of a prototype Bright Classroom (BC), designed to prevent children's myopia by exposing them to light conditions resembling the outdoors. Conditions were measured throughout the school year in the glass-constructed BC, a traditional classroom (TC) and outdoors. Teachers and children completed user questionnaires, and children rated reading comfort at different light intensities. A total of 230 children (mean age 10.2 years, 57.4% boys) and 13 teachers (36.8 years, 15.4% men) completed questionnaires. The median (Inter Quartile Range) light intensity in the BC (2,540 [1,330-4,060] lux) was greater than the TC (477 [245-738] lux, P < 0.001), though less than outdoors (19,500 [8,960-36,000] lux, P < 0.001). A prominent spectral peak at 490-560 nm was present in the BC and outdoors, but less so in the TC. Teachers and children gave higher overall ratings to the BC than TC, and light intensity in the BC in summer and on sunny days (>5,000 lux) was at the upper limit of children's comfort for reading. In summary, light intensity in the BC exceeds TC, and is at the practical upper limit for routine use. Children and teachers prefer the BC.