Preservation versus resection of Denonvilliers' fascia in total mesorectal excision for male rectal cancer: follow-up analysis of the randomized PUF-01 trial.

Traditional total mesorectal excision (TME) for rectal cancer requires partial resection of Denonvilliers' fascia (DVF), which leads to injury of pelvic autonomic nerve and postoperative urogenital dysfunction. It is still unclear whether entire preservation of DVF has better urogenital function and comparable oncological outcomes. We conducted a randomized clinical trial to investigate the superiority of DVF preservation over resection (NCT02435758). A total of 262 eligible male patients were randomized to Laparoscopic TME with DVF preservation (L-DVF-P group) or resection procedures (L-DVF-R group), 242 of which completed the study, including 122 cases of L-DVF-P and 120 cases of L-DVF-R. The initial analysis of the primary outcomes of urogenital function has previously been reported. Here, the updated analysis and secondary outcomes including 3-year survival (OS), 3-year disease-free survival (DFS), and recurrence rate between the two groups are reported for the modified intention-to-treat analysis, revealing no significant difference. In conclusion, L-DVF-P reveals better postoperative urogenital function and comparable oncological outcomes for male rectal cancer patients.

Effect of Denonvilliers' Fascia Preservation Versus Resection During Laparoscopic Total Mesorectal Excision on Postoperative Urogenital Function of Male Rectal Cancer Patients: Initial Results of Chinese PUF-01 Randomized Clinical Trial.

OBJECTIVE: To compare the outcomes of laparoscopic total mesorectal excision (L-TME) with Denonvilliers' fascia (DVF) preservation versus resection on urogenital function of male patients with rectal cancer. BACKGROUND: The protective effect of DVF during L-TME on pelvic autonomic nerves and postoperative urogenital function remains controversial. METHODS: Between August 26, 2015 and July 18, 2019, 253 male patients with cT1-4 (T1-2 for anterior wall) N0-2M0 rectal cancer from 11 institutions were enrolled, and randomly assigned to L-TME with DVF preservation (Exp-group, n = 123) or resection procedures (Con-group, n = 130). Urinary function was assessed by residual urine volume, maximal flow rate, and International Prostate Symptom Score; sexual function was assessed by 5-item version of the International Index of Erectile Function (IIEF-5) and ejaculation grading. RESULTS: The Exp-group patients showed a lower urinary dysfunction rate (6.8% vs 25.4%, P = 0.003), higher maximal flow rate (16.25 ±â€Š8.02 vs 12.40 ±â€Š7.05 mL/s, P = 0.007), and lower International Prostate Symptom Score (6.55 ±â€Š5.86 vs 8.57 ±â€Š5.85, P = 0.026) than the Con-group patients at 2 weeks after surgery. The incidence of erectile dysfunction (IIEF-5 ≤ 11) at 12 months after surgery was lower in the Exp-group than in the Con-group (12.5% vs 34.2%, P = 0.023); Exp-group manifested superior IIEF-5 (16.63 ±â€Š6.28 vs 12.26 ±â€Š6.83, P = 0.018). The incidence of ejaculation dysfunction was lower in the Exp-group than in the Con-group at 12 months after surgery (10.0% vs 29.4%, P = 0.034). CONCLUSIONS: DVF preservation during L-TME revealed protective effects on postoperative urogenital function, and could be a better choice for male rectal cancer patients with specific staging and location. TRIAL REGISTRATION NUMBER: NCT02435758.

miR-145-5p inhibits tumor occurrence and metastasis through the NF-κB signaling pathway by targeting TLR4 in malignant melanoma.

Compelling evidence shows that deregulated microRNAs (miRNAs) are important regulators in the progression of melanoma. miR-145-5p has been suggested to exhibit antitumorigenic activity in melanoma. However, the molecular mechanism underlying the biological activity of miR-145-5p in melanoma remains to be further understood. Herein, quantitative real-time polymerase chain reaction was used to examine the miR-145-5p expression in malignant melanoma tissues and cells. The interaction between miR-145-5p and toll-like receptor 4 (TLR4) was explored by bioinformatics analyses, luciferase reporter assay, and Western blot. The effects of miR-145-5p or combined with TLR4 on cell proliferation, colony formation, migration, and invasion abilities were investigated by (4,5-Dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide, colony formation, wound healing, and transwell assays, respectively. The melanoma xenograft tumor models were established to determine the biological activity of miR-145-5p in melanoma in vivo. In addition, the changes of the nuclear factor kappa B (NF-κB) pathway were analyzed by detecting the NF-κB activity and the NF-κB p65 protein level. We observed that the miR-145-5p expression was underexpressed in melanoma tissues and cells. miR-145-5p suppressed the TLR4 expression by binding to its 3'untranslated region in melanoma cells. Moreover, TLR4 overexpression abolished the inhibition of cell proliferation, colony formation, migration, and invasion abilities induced by miR-145-5p in melanoma cells. Meanwhile, miR-145-5p was confirmed to restrain melanoma tumor growth in vivo by targeting TLR4. Furthermore, miR-145-5p overexpression inactivated the NF-κB pathway in melanoma in vitro and in vivo, which was reversed by TLR4 overexpression. We concluded that miR-145-5p hindered the occurrence and metastasis of melanoma cells in vitro and in vivo by targeting TLR4 via inactivation of the NF-κB pathway.

Hsa_circ_0136666 promotes the proliferation and invasion of colorectal cancer through miR-136/SH2B1 axis.

Colorectal cancer (CRC) is one of the leading causes of cancer-related death worldwide. Currently, an increasing evidence showed that circular RNAs (circRNAs) play important roles in tumor progression. However, the effects and underlying mechanisms of circRNAs in CRC progression remain unclear. In the present study, through circRNA high-throughput sequencing and quantitative real-time polymerase chain reaction, we identified that hsa_circ_0136666 was significantly overexpressed in CRC tissues and cell lines. High hsa_circ_0136666 expression was associated with poor overall survival of patients with CRC. In vitro function assays showed that hsa_circ_0136666 inhibition suppressed CRC cell proliferation, migration, invasion, and arrested CRC cells in the G0/G1 phase. Furthermore, we showed that hsa_circ_0136666 inhibition reduced CRC cell growth in vivo. Mechanistically, we revealed that hsa_circ_0136666 could increase SH2B1 expression via competitively binding miR-136 in CRC cells. In addition, SH2B1 overexpression could reverse the effects of hsa_circ_0136666 inhibition on CRC cell progression. In conclusion, our data suggested that hsa_circ_0136666 could promote CRC cell progression via the miR-136/SH2B1 axis, elucidating a novel approach to improve the effectiveness of CRC treatment.

Polymorphisms in BER genes and risk of breast cancer: evidences from 69 studies with 33760 cases and 33252 controls.

Recently, numerous studies have reported an association between single nucleotide polymorphisms in base-excision repair genes and the risk of developing breast cancer, however there is no consensus. The aim of this meta-analysis was to review and quantitatively assess the relationship between single nucleotide polymorphisms in base-excision repair genes and breast cancer risk. The results suggested that a mutation of T to G in rs1760944 may lead to a higher risk of developing breast cancer in the Mongoloid population, and G to A of rs25487 significantly reduced the risk of breast cancer in Mongoloid and Caucasoid populations. In contrast to the CC and CG genotypes, the GG genotype of rs1052133 located on theOGG1 gene appeared to be a protective factor against developing breast cancer in both Mongoloid and Caucasoid populations. There was no evidence to suggest that rs25489, rs1799782, rs1130409, rs1805414 and rs1136410 were associated with breast cancer risk. In conclusion, this study provides evidence to support the theory that DNA repair genes are associated with breast cancer risk, providing information to further understand breast cancer etiology. and The potential biological pathways linking DNA repair, ethnic background, environment and breast cancer require further investigation.

Methods and significance of the combined detection of HER2 gene amplification and chemosensitivity in gastric cancer.

OBJECTIVE: This study aims to investigate the significance of combined detection of HER2 gene amplification and chemosensitivity in gastric cancer. METHODS: Immunohistochemistry (IHC), fluorescence in situ hybridization (FISH) and fluorescence reverse-transcription polymerase chain reaction (RT-PCR) were used to analyze the expression of HER2 protein, HER2 gene amplification and the mRNA expression of ERCC1, TUBB3 and TYMS genes in 135 cases of gastric carcinoma. RESULTS: The expression rate of HER2 protein was 39.3% (53/135). Among these positive cases, patients with HER2 protein (3+) accounted for 9.6% (13/135), patients with HER2 protein (2+) accounted for 13.3% (18/135), and patients with HER2 protein (1+) accounted for 16.3% (22/135). The amplification rate of the HER2 gene was 35.8% (19/53). In the detection of the mRNA expression of ERCC1, TUBB3 and TYMS, 45 patients had low and moderate single gene expression, 50 patients had low and moderate double gene expression, 22 patients had low and moderate mRNA expression for ERCC1, TUBB3 and TYMS, and 18 patients had no low and moderate expression. Among the 53 patients with HER2 protein expression and 22 patients with low and moderate mRNA expression of ERCC1, TUBB3 and TYMS, 12 patients received chemotherapy and trastuzumab. Follow-up results revealed that HER2 gene status was positively correlated with the therapeutic effect of the combined treatment in patients with low mRNA expression of ERCC1, TUBB3 and TYMS. Among these patients, five patients with extensive HER2 (3+), HER2 cluster-specific amplification, and low mRNA expression of ERCC1, TUBB3 and TYMS had a total survival of up to 19.1 months. CONCLUSIONS: The detection of HER2 in gastric cancer is highly heterogeneity, and the combined detection of HER2 protein expression, HER2 gene amplification and chemosensitivity can provide important reference markers for the benefit of antitumor drugs.

Expression of ERO1L in gastric cancer and its association with patient prognosis.

The present study aimed to assess the expression of endoplasmic reticulum oxidoreductin-1-like (ERO1L) in gastric cancer and determine its association with patient prognosis. A total of 105 patients with gastric cancer undergoing radical gastrectomy were selected for the current study. Gastric cancer tissues (the observation group) and normal gastric tissue adjacent to the carcinoma (the control group) were resected from patients. Levels of ERO1L mRNA and protein in tumor tissues and adjacent tissues were detected using reverse transcription-quantitative polymerase chain reaction, western blotting and immunohistochemistry. Patients were divided into two groups: A positive group and negative group, according to the expression of ERO1. The expression of ERO1L in gastric cancer and its association with patient prognosis was analyzed. Levels of ERO1 mRNA and protein in gastric cancer were significantly higher than those of adjacent tissues (P<0.05). Immunohistochemical analysis demonstrated that there were 22 patients exhibiting negative expression of ERO1L and 83 patients exhibiting positive expression of ERO1L. The cumulative recurrence rates over 3 years in patients with positive expression of ERO1L were significantly higher than in patients with negative expression of ERO1L (P<0.05); the cumulative survival rates over 3 years in patients with positive expression of ERO1L were significantly lower than those of patients with negative expression of ERO1L (P<0.05). Thus, the current study determined that ERO1L was highly expressed in gastric cancer tissue. The high expression of ERO1L was associated with adverse prognoses in patients with gastric cancer. ERO1L may therefore be a therapeutic target for the prevention of gastric cancer.

A natural product toosendanin inhibits epithelial-mesenchymal transition and tumor growth in pancreatic cancer via deactivating Akt/mTOR signaling.

The pancreatic cancer is among the most aggressive malignancies with strong proclivity to metastasis. The malignancy during pancreatic cancer progression is largely ascribed to epithelial-mesenchymal transition (EMT). Here we showed that toosendanin (TSN), which is an active component in traditional Chinese medicine, can strongly attenuate pancreatic cancer progression. TSN suppressed the viability and grow of pancreatic cancer cells in a dose-dependent manner. The migration and invasion of pancreatic cancer cells were also consistently inhibited dose-dependently. TSN can reverse the TGF-ß induced EMT and morphological change in pancreatic cancer cells by increasing Ecadherin expression while reducing Vimentin, ZEB1 and SNAIL levels. Furthermore, TSN evidently repressed xenograft tumor growth in mouse pancreatic cancer models without significantly toxic side effects. Mechanistic studies suggested that TSN mediated pancreatic cancer inhibition by blocking Akt/mTOR signaling pathway. Our results showed that TSN inhibits pancreatic cancer progression via downregulating Akt/mTOR signaling. Since the concentrations of TSN used in current study is very low, our results demonstrated that TSN can inhibit pancreatic cancer progression thereby implying that TSN can be used as a potential pharmacological agent especially in treatment of pancreatic cancer.

Expression of GOLPH3 protein in colon cancer tissues and its association with the prognosis of patients.

The present study aimed to investigate the expression of Golgi phosphoprotein-3 (GOLPH3) protein in colon cancer tissues and the association with the prognosis of patients. In total, 98 patients with colon cancer admitted to The First Affiliated Hospital of Henan University of Science and Technology for surgery between June 2011 and June 2013 were taken as the observation group. In addition, 15 healthy individuals, determined by enteroscopy, were taken as the control group. The expressions of GOLPH3 mRNA and protein were detected by reverse transcription-polymerase chain reaction and immunohistochemistry, respectively. The patients were divided into GOLPH3-positive and GOLPH3-negative groups according to the expression of GOLPH3. The expression of GOLPH3 in colon cancer and its association with the prognosis of patients was analyzed. The expression of GOLPH3 mRNA and protein in colon cancer tissues was significantly increased compared with normal colon mucosa (P<0.05); among the tissues, GOLPH3 was not expressed in 29 patients and positively expressed in 69 patients. The expression of GOLPH3 was negatively associated with the tumor differentiation degree, and positively associated with tumor invasion depth, lymph node metastasis and clinical stages in GOLPH3-positive patients. The cumulative recurrence rates at 1, 2 and 3 years were significantly lower in GOLPH3-negative patients (P<0.05). The survival rates at 1, 2 and 3 years in the GOLPH3-positive group were significantly higher than that of the GOLPH3-negative patients (P<0.05). In conclusion, the positive expression of GOLPH3 mRNA and protein in colon cancer tissue was significantly increased compared with the control group. GOLPH3 expression was closely associated with the pathological features, consisting of tissue typing, clinical stage, degree of tumor invasion and lymph node metastasis, and GOLPH3 expression. Patients with GOLPH3 overexpression also had a poor prognosis.

The diagnosis value of promoter methylation of UCHL1 in the serum for progression of gastric cancer.

BACKGROUND: Aberrant promoter methylation has been considered as a potential molecular marker for gastric cancer (GC). However, the role of methylation of FLNC, THBS1, and UCHL1 in the development and progression of GC has not been explored. METHODS: The promoter methylation status of UCHL1, FLNC, THBS1, and DLEC1 was assessed by quantitative methylation-specific PCR (QMSP) in the serum of 82 GC patients, 46 chronic atrophic gastritis (CAG) subjects, and 40 healthy controls. RESULTS: All four genes had significantly higher methylation levels in GC patients than in CAG and control subjects. However, only UCHL1 methylation was significantly correlated with the tumor stage and lymph node metastasis. While THBS1 methylation was altered in an age-dependent manner, FLNC methylation was correlated with differentiation and Helicobacter pylori infection. DLEC1 methylation was only associated with tumor size. Moreover, methylated UCHL1 with or without THBS1 in the serum was found to be significantly associated with a poor prognosis. CONCLUSION: The promoter methylation degree of FLNC, THBS1, UCHL1, and DLEC1 in serum could tell the existence of GC and only UCHL1 in the serum was also associated with poor prognosis of GC.

CD9 modulates proliferation of human glioblastoma cells via epidermal growth factor receptor signaling.

The tetraspanin CD9 has previously been shown to be involved in various cellular activities, including proliferation and migration. In addition, CD9 has been shown to be associated with epidermal growth factor receptor (EGFR). A common characteristic of glioblastoma multiforme histology is EGFR amplification, which affects signal transduction processes. The anti-proliferative effects of CD9 have been linked to EGFR signaling pathways, including phosphorylation of phosphoinositide-3-kinase (PI3K)/Akt and activation of mitogen-activated protein kinase (MAPK)/extracellular signal-regulated protein kinase (Erk). The present study demonstrated that CD9 decreased the phosphorylation of EGFR at specific sites. In addition, CD9 attenuated EGFR signaling of PI3K/Akt and MAPK/Erk, which was associated with cell growth and proliferation. Conversely, small hairpin RNA-mediated knockdown of CD9 expression enhanced the activation of EGFR signal transduction pathways, including PI3K/Akt and MAPK/Erk. These results suggested that the mechanism underlying CD9-induced suppression of cell proliferation may involve the inhibition of phosphorylation of EGFR and the activity of PI3K/Akt and MAPK/Erk signaling pathways.

Risk factors for the Long-Term Efficacy, Recurrence, and Metastasis in Small Hepatocellular Carcinomas.

We tried to determine the risk factors for the long-term efficacy, recurrence, and metastasis of small hepatocellular carcinoma (HCC, diameter <5 cm). One hundred sixty-eight small liver cancer patients received percutaneous cryoablation therapy by argon-helium superconducting surgery system under the ultrasound guidance. Clinical parameter and the efficacy were analyzed after follow-up. After cryoablation treatment, the median follow-up time for the 168 patients was 36 (7-41) months. Liver functions were impaired as indicated by increased alanine aminotransferase, total bilirubin, total protein, albumin, and prothrombin activity. The difference of VEGF expression in liver cancer and the surrounding tissue is significant. 1-, 2-, and 3-year overall survival were 92.9, 83.9, and 65.5 %, respectively. Relapse-free survival was 76.8, 53.0, and 41.1 %. Less tumor number, higher tumor differentiation, and low VEGF expression predict higher metastasis-free and relapse-free survival rate. Lower Child-Pugh classification is correlated with the higher overall survival after cryoablation. There was no statistical significance in in situ intrahepatic recurrence patients, but VEGF changes were statistically significant for metastasis in other parts of liver or extrahepatic metastasis. Tumor number, differentiation, VEGF expression, large vessel invasion, lymph node, and extrahepatic metastasis all affect the overall and relapse-free survival. VEGF expression can be a predictable factor for liver cancer recurrence and metastasis.

Biocompatibility of quantum dots (CdSe/ZnS ) in human amniotic membrane-derived mesenchymal stem cells in vitro.

BACKGROUND AND AIM: Amniotic membrane-derived mesenchymal stem cells (hAM-dMSCs) are a potential source of mesenchymal stem cells which could be used to repair skin damage. The use of mesenchymal stem cells to repair skin damage requires safe, effective and biocompatible agents to evaluate the effectiveness of the result. Quantum dots (QDs) composed of CdSe/ZnS are semiconductor nanocrystals with broad excitation and narrow emission spectra, which have been considered as a new chemical and fluorescent substance for non-invasively labeling different cells in vitro and in vivo. This study investigated the cytotoxic effects of QDs on hAM-dMSCs at different times following labeling. METHODS: Using 0.75, 1.5 and 3.0 µL between quantum dots, labeled human amniotic mesenchymal stem cells were collected on days 1, 2 and 4 and observed morphological changes, performed an MTT cell growth assay and flow cytometry for mesenchymal stem cells molecular markers. RESULTS: Quantum dot concentration 0.75 µg/mL labeled under a fluorescence microscope, cell morphology was observed, The MTT assay showed cells in the proliferative phase. Flow cytometry expression CD29, CD31, CD34, CD44, CD90, CD105 and CD106. CONCLUSIONS: Within a certain range of concentrations between quantum dots labeled human amniotic mesenchymal stem cells has good biocompatibility.

Serum CA242, CA199, CA125, CEA, and TSGF are Biomarkers for the Efficacy and Prognosis of Cryoablation in Pancreatic Cancer Patients.

This study aimed to compare the changes and determine the clinical significance of carbohydrate antigens CA242, CA199, CA125, carcinoembryonic antigen (CEA), and tumor-specific growth factor (TSGF) before and after cryoablation by Cryocare system. Thirty-one pancreatic cancer patients were selected to receive cryoablation by Cryocare system. The serum expression levels of CA242, CA199, CA125, CEA, and TSGF before and 1 month after treatment were determined. Meanwhile, the serum level of these factors was also determined in 31 healthy volunteers. The parameter changes were analyzed with the clinical pathological data. The serum levels of CA242, CA199, CA125, CEA, and TSGF in the pancreatic cancer group were significantly higher than those of the control group both before and after the cryoablation treatment (P < 0.05). The serum CA199, CEA, and TSGF dramatically decreased 1 month after the treatment, which were statistically different (P < 0.05). The positive rates of serum CA242, CA199, CA125, and CEA in the pancreatic cancer group were much higher than those in the control group both before and after treatment (P < 0.05), and the positive rate of TSGF was significantly higher than that of the control group before the treatment (P < 0.05). The positive rate of CA199, CEA, and TSGF after the treatment was significantly lower than that before the treatment (P < 0.05). Serum level of CA242 was correlated with the tumor diameter, clinical staging, tumor differentiation, lymph node, and liver metastasis (P < 0.05). Except gender, CA199 was correlated with all the other clinical pathological parameters (P < 0.05). The serum levels of CA125 and CEA were correlated with all the other clinical pathological parameters (P < 0.05). The serum level of TSGF was only correlated with tumor differentiation (P < 0.05). Cryoablation treatment by Cryocare system can decrease the serum levels of CA199, CEA, TSGF, and the positive rate. Serum CA199, CEA, and TSGF can be important index for pancreatic cancer treatment assessment. Serum levels of CA242, CA199, CA125, and CEA are of great clinical value for metastasis assessment and prognosis in pancreatic cancer patients.

[Two types of digestive tract reconstruction after proximal gastrectomy for early gastroesophageal junction adenocarcinoma: a randomized controlled study].

OBJECTIVE: To investigate the better method of digestive tract reconstruction in proximal gastrectomy for early gastroesophageal junction adenocarcinoma. METHODS: A total of 153 cases of early gastroesophageal junction adenocarcinoma who were planned to receive radical proximal gastrectomy from January 2003 to December 2011 were prospectively enrolled and randomly divided into two groups by table of random number according to methods of digestive tract reconstruction, including 3S anastomosis group (80 cases, 3S jejunal interposition) and traditional anastomosis group (73 cases, esophageal remnant gastric posterior wall anastomosis). Postoperative complications, operative time, mortality, nutritional parameters and postoperative quality of life were compared between these two groups. RESULTS: There were no significant differences between two groups in postoperative complications, operative time and mortality (all P>0.05). 3S anastomosis group was better in nutritional parameters than traditional group six months after operation (P<0.05). As compared to traditional group, incidence of reflux esophagitis decreased [20.0%(16/80) vs. 46.6%(34/73), P<0.01] and gastric emptying time prolonged obviously [(160.8±8.1) min vs. (61.1±10.8) min, P<0.01] in 3S anastomosis group 18 months after operation. Postoperative QLQ-C30 rating scale revealed quality of life was significantly higher in 3S anastomosis group as compared to traditional group. CONCLUSION: Jejunal interposition is a better method of digestive tract reconstruction in proximal gastrectomy for early gastroesophageal junction carcinoma.

[Promotion of postoperative recovery with fast track surgery for gastric cancer patients undergoing gastrectomy: a prospective randomized controlled study].

OBJECTIVE: To study the safety and feasibility of fast track surgery (FTS) in the promotion of postoperative recovery for gastric cancer patients undergoing gastrectomy. METHODS: From January to December in 2013, 71 gastric cancer patients were prospectively enrolled and randomized into the FTS group and the control group. Patient in the FTS group received FTS management and those in the control group received routine management. The postoperative recovery and stress were compared between the two groups. RESULTS: FTS was associated with shorter time to bowel function return [(67.8±19.7) h vs. (90.0±20.6) h, P<0.01], shorter hospital stay [(13.5±3.0) d vs. (17.8±7.3) d, P=0.01], lower hospital cost [(23.8±3.7) thousand Yuan vs. (27.8±6.1) thousand Yuan, P<0.05], and less stress response (lower pain score, WBC count, C-reactive protein, all P<0.01). The postoperative complications including ileus, infection, anastomotic leakage were similar (all P>0.05). CONCLUSION: Fast track surgery decreases postoperative stress response and promotes recovery.

Prevalence and age, gender and geographical area distribution of esophageal squamous cell carcinomas in North China from 1985 to 2006.

OBJECTIVE: To establish the prevalence and distribution profile of esophageal squamous cell carcinomas (ESCCs) over a 22-yr period in North China. METHODS: Using endoscopy for primary diagnosis and histological analysis for the further confirmation, a total of 74,854 ESCC patients aged 20-89 between January 1985 and December 2006 were investigated to analyze the epidemiological profile including prevalence rates, distribution of age-of-onset, gender and geographical area of ESCC in Luoyang, the highest incidence area of North China. RESULTS: A total of 4092 cases of ESCC were finally diagnosed among 74,854 patients who had their first endoscopies. The prevalence among males was higher than that among females (p<0.01), resulting in an overall male:female OR of 1.2 (95%CI, 1.2-1.3). The prevalence in rural areas was higher than in urban areas (p<0.01), resulting in an overall rural:urban OR of 2.6 (95%CI, 2.4-2.9). The rural:urban ORs and the 95% CI increased continuously from 2.6, 2.3-3.0 to 2.7, 2.2-3.3, respectively, for 4 consecutive periods during the 22-yr study period. Moreover, the median age of onset among females was higher than that among males (p<0.01). For both sexes and in both areas, the prevalence rates declined and the median age of onset rose for 4 consecutive periods in the 22-yrs time frame (p<0.01). CONCLUSIONS: [corrected] These data reveal the epidemiological profile of ESCC in the area of North China, and suggest that urban areas and rural people account for a growing proportion of the ESCC patients although the prevalence of ESCC significantly declined and the median age-of-onset postponed over the 22-yrs period. Moreover, the prevalence status of ESCC in rural areas also underlines the need for public health initiatives aimed at reducing risk factors of this fatal disease.

Meta-analysis of two types of digestive tract reconstruction modes after total gastrectomy.

BACKGROUND/AIMS: This study aims to evaluate the application value of two reconstruction technique types, namely, Roux-en-Y reconstruction with pouch (RYP) and jejunal interposition with pouch (JIP), after total gastrectomy. METHODOLOGY: MEDLINE, EM-BASE, PubMed, CBM, and Vol. 2, 2010 of the Cochrane Library were indexed using computers, whereas relevant Chinese journals were manually indexed. After including total gastrectomy, random RYP and JIP control tests and evaluations on their methodological quality were conducted. Revman 5.1 software was utilised for the statistical analysis. RESULTS: Three random control tests that included patients of 166 cases were performed. Meta-analysis results indicated that RYP involved a shorter operation time than JIP (WMD = -17.27, 95% CI = -29.58 to -4.96). For postoperative complications (OR = 0.73, 95% CI = 0.33 to 1.59), no substantial differences were found in bile reflux (OR = 0.19, 95% CI = 0.04 to 0.94), postoperative nutritional status, and weight. CONCLUSIONS: The application value of RYP and JIP clinical results need further random control research to fully evaluate their efficacies.

Relationship between expression and prognostic ability of PTEN, STAT3 and VEGF-C in colorectal cancer.

Expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN), signal transducer and activator of transcription-3 (STAT3) and vascular endothelial growth factor-C (VEGF-C) and their relationship with clinico-pathological features and prognostic ability was determined using immunohistochemistry in 68 cases of colorectal cancer with follow-up data. Kaplan-Meier survival analysis was performed and the prognostic value was determined using univariate analysis. PTEN, STAT3 and VEGF-C expression was detected in 32.4, 60.3 and 63.2% of colorectal carcinoma cases and 90.0, 0 and 0% of normal colon samples, respectively. PTEN and STAT3 were correlated with pathological grade (p=0.011, p=0.001, respectively), but not with tumor size, lymph node metastasis or clinical stage. VEGF-C was correlated with lymph node metastasis (p=0.002), but not with tumor size, pathological grade or clinical stage. Expression of STAT3 and VEGF-C was negatively correlated with PTEN (r=-0.402, r=-0.320, respectively), whereas STAT3 and VEGF-C expression was positively correlated with PTEN (r=0.254). The 3- and 5-year survival rates of PTEN protein-positive patients (68.1 and 50.0%, respectively) were significantly higher than those of PTEN protein-negative patients (32.6 and 19.6%, respectively; p=0.008). The 3- and 5-year survival rates of STAT3-positive (29.3 and 17.1%, respectively) were significantly lower than those of STAT3-negative patients (66.7 and 48.1%, respectively; p=0.005). The 3- and 5-year survival rates of VEGF-C-positive patients (29.3 and 17.1%, respectively) were significantly lower than the rates of VEGF-C-negative patients (66.7 and 48.1%, respectively; p=0.003, p=0.004, respectively). Multivariate analysis revealed that VEGF-C expression was an independent prognostic factor. In conclusion, this study indicates that PTEN, STAT3 and VEGF-C expression are beneficial prognostic factors, which may aid in the accurate assessment of prognosis and guide clinical treatment of colorectal cancer patients.

[Comparative study on two types of 3S and P-loops digestive reconstruction after total gastrectomy for gastric cancer].

OBJECTIVE: To compare the clinical effect of 3S-type and P-loops digestive reconstruction after total gastrectomy for gastric cancer. METHODS: From February 2005 to February 2009, 85 cases underwent total gastrectomy in The First Affiliated Hospital of Henan University of Science and Technology. Two types of digestive reconstruction were performed with 3S-type jejunum(n=46) and P-loops Roux-en-Y esophagojejunostomy(n=39). The postoperative complications, nutrition index and the quality of life at half a year after surgery were comparatively analyzed. RESULTS: Two types of digestive reconstruction had no statistical differences in operative time, postoperative complications and mortality(P>0.05). Compared with P-loops Roux-en-Y esophagojejunostomy at 6 months after operation, 3S-type jejunum had a lower incidence in dumping syndrome[4.3% (2/46) vs. 10.3% (4/39), P<0.05] and reflux esophagitis [10.8% (5/46) vs. 33.3% (13/39), P<0.05]. 3S-type jejunum was superior to P-loops Roux-en-Y esophagojejunostomy in serum total protein(55.7±3.1 g/L vs 50.3±5.1 g/L, P<0.05), albumin(36.5±3.6 g/L vs. 31.6±4.4 g/L, P<0.05), hemoglobin(120.2±13.4 g/L vs. 110.4±23.0 g/L, P<0.05), and nutritional assessment index(73.2±4.8 vs. 56.0±6.3, P<0.05). CONCLUSION: Reconstruction of stomach with 3S-type jejunum may be an effective way to prevent reflux esophagitis and dumping syndrome, and to improve the nutritional status and the quality of life.