[Report on the application of endoscopic intermuscular dissection for diagnostic resection of early rectal cancer].

Objective: This report presents the initial outcomes of endoscopic intermuscular dissection (EID), a novel technique introduced by our team for the diagnostic resection of early rectal cancer, focusing on the postoperative status of the vertical margins. Methods: On January 26, 2024, a patient with early rectal cancer (cT1-2N0M0) underwent Endoscopic Intermuscular Dissection. The EID procedure consists of six steps: (1) mucosal incision; (2) submucosal dissection; (3) superficial muscular layer incision; (4) intermuscular dissection; (5) complete tumor removal; (6) wound management. Results: The patient was a 70-year-old male with rectal cancer (cT1-2N0M0). The tumor was located on the left anterior wall of the rectum, approximately 9 cm from the anal margin, and measured 20mm in size. The dissection rate was 2.68 mm²/minute, and the total duration of the surgery was 109 minutes. The patient was successfully discharged on the fifth day after surgery. Pathological examination of the post-endoscopic surgery specimen revealed pT1b, with negative vertical margins. Follow-up after more than one month showed good recovery with no complications such as bleeding, perforation, infection, or stricture occurring. Colonoscopy indicated the presence of a granulation tissue suggestive of inflammation. Conclusion: Endoscopic Intermuscular Dissection for the diagnostic resection of early rectal cancer is potentially safe and may achieve negative vertical margins.

[Association of systemic immune-inflammation index with protein-energy wasting and prognosis in patients on maintenance hemodialysis].

Objective: To explore the association of systemic immune-inflammation index (SII) with protein-energy wasting (PEW) and prognosis in maintenance hemodialysis (MHD) patients. Methods: A multicenter cohort study was conducted in 11 hemodialysis centers of Guizhou province from July to September 2019. The patients were divided into the PEW group and non-PEW group. After 12 months of follow-up, death was the endpoint event. Multivariate logistic regression analysis was used to assess the independent risk factors of PEW in MHD patients. The receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of SII for PEW, and the optimal cut-off value of SII was calculated. The Kaplan-Meier method was used to draw the survival curve, and log-rank test was employed to compare the difference of survival rate between the two groups. Results: A total of 859 patients were included [540 males and 319 females, aged (54±15) years], and there were 220 cases (25.6%) and 639 cases (74.4%) in PEW and non-PEW groups, respectively. SII was higher in the PEW group than that of the non-PEW group [600 (440, 915) vs 475 (353, 633), P<0.01]. Multivariate logistic regression analysis showed that SII was an independent predictor for PEW (OR=1.001, 95%CI: 1.000-1.002, P=0.02). ROC curve analysis showed that the area under the curve for SII to predict PEW in MHD patients was 0.725 (95%CI: 0.683-0.766), with the sensitivity and specificity of 69% and 70%, respectively. All patients were followed up for 12 months, and 45 died (with a mortality rate of 5.24%). Patients were divided into SII>520 group and SII≤520 group according to the optimal cut-off value, and subsequent Kaplan-Meier survival analysis showed that the 1-year cumulative survival rate of the SII>520 group (92.3%) was lower than that of SII≤520 group (97.1%) (χ2log-rank=9.707, P=0.002). Further subgroup analysis revealed that, in PEW patients with MHD, the 1-year cumulative survival rate of the SII>520 group (88.5%) was also lower than that of SII≤520 group (92.3%) (χ2log-rank=7.226, P=0.007). Conclusion: SII is an independent risk factor for PEW in MHD patients, and the higher the SII level, the lower the long-term survival rate and the prognosis.

Disrupting G6PD-mediated Redox homeostasis enhances chemosensitivity in colorectal cancer.

Glucose-6-phosphate dehydrogenase (G6PD) is a key enzyme that generates NADPH to maintain reduced glutathione (GSH), which scavenges reactive oxygen species (ROS) to protect cancer cell from oxidative damage. In this study, we mainly investigate the potential roles of G6PD in colorectal cancer (CRC) development and chemoresistance. We discover that G6PD is overexpressed in CRC cells and patient specimens. High expression of G6PD predicts poor prognosis and correlated with poor outcome of oxaliplatin-based first-line chemotherapy in patients with CRC. Suppressing G6PD decreases NADPH production, lowers GSH levels, impairs the ability to scavenge ROS levels, and enhances oxaliplatin-induced apoptosis in CRC via ROS-mediated damage in vitro. In vivo experiments further shows that silencing G6PD with lentivirus or non-viral gene delivery vector enhances oxaliplatin anti-tumor effects in cell based xenografts and PDX models. In summary, our finding indicated that disrupting G6PD-mediated NADPH homeostasis enhances oxaliplatin-induced apoptosis in CRC through redox modulation. Thus, this study indicates that G6PD is a potential prognostic biomarker and a promising target for CRC therapy.

[Effect of a new ROCK inhibitor thiazovivin on the morphology and function of human corneal endothelial cells].

OBJECTIVE: To evaluate the effect of thiazovivin, a novel ROCK inhibitor, on the morphology and function of human corneal endothelial cells(HCECs). METHODS: The primary HCECs were identified by light microscopy and immunofluorescence staining of neuron-specific enolase. To screen the optimal concentration and action time of thiazovivin for maintaining the morphology and function of primary HCECs, Na (+)/K (+)-ATPase and N-cadherin were chosen as indicators, and the morphology and function of HCECs in various concentrations(0 µmol/L, 2 µmol/L, 4 µmol/L, and 6 µmol/L)for different durations(24 h and 48 h)were examined by immunofluorescence experiments. The effect of thiazovivin on the expression of ROCK was investigated by immunofluorescence and Western blot. RESULTS: The primary HCECs cultured were hexagonal, closely packed, homogeneously and obviously stained by neuron-specific enolase. The immunofluorescence staining of Na(+)/K(+)-ATPase showed that when the primary HCECs cultured with various concentrations of thiazovivin(0, 2, 4, 6 µmol/L)for 24 h, the fluorescence were obvious, and the average absorbance values(A)were 1.27±0.08, 3.72±0.17, 21.07±4.67, 3.69±0.34, respectively. And the immunofluorescence staining of N-cadherin revealed that when the primary HCECs treated with 4 µmol/L thiazovivin for 24 h, the cell boundary was clear and the structure of the cells was intact. While the treating time of thiazovivin(4 µmol/L)on HCECs extended to 48 h, the immunofluorescence staining of Na(+)/K(+)-ATPase and N-cadherin showed that compared to HCECs treated with thiazovivin(4 µmol/L)for 24 h, the fluorescence intensity did not change significantly, but the cells arranged slightly untidy. In addition, the immunofluorescence staining of ROCK was weakened and the expression of ROCK was reduced by thiazovivin. Thiazovivin was effective for protecting the morphology and function of HCECs. An optimal improvement in the morphology, connection and function of HCECs was found when the primary HCECs were cultured with 4 µmol/L thiazovivin for 24 h. Moreover, the expression of ROCK protein could be significantly inhibited by thiazovivin. (Chin J Ophthalmol, 2016, 52: 686-692).

Chemokine C-C motif ligand 18 expression correlates with tumor malignancy in breast cancer.

PURPOSE OF THE STUDY: To investigate whether CCL18 is involved in breast cancer, and the relationship between CCL18 and MVD (MVD was recognized by CD34) which is a well-accepted angiogenic maker of multiple cancers including breast cancer. PATIENTS AND METHODS: Immunohistochemistry staining for CCL18 and CD34 was performed on 179 cases, including 29 normal cases as control, 47 cases with benign breast diseases, and 103 cases with breast cancer. RESULTS: We found that CCL18 was significantly up-regulated in breast cancer samples as compared with benign tumors or normal breast tissues. Moreover, the expression level of CCL18 increased with the size of tumors, the number of lymph node metastasis, and advancing tumor stage, suggesting that CCL18 expression correlates with tumor malignancy scales. At the same time, we found that MVD was also significantly over-expressed in cancer tissues as compared with normal control group and benign tumor group, but it was not significantly differentially expressed among tumors with different malignancy scale like CCL18, while the expression of MVD in CCL18 positive breast cancer cases was higher than in the CCL18 negative breast cancer cases (P=0.016, P<0.05). CONCLUSION: CCL18 is involved in the development of breast cancer. CCL18 is a better biomarker than MVD in determining whether the tumor is malignant and the severity of malignancy of breast cancer.

G-2964A and C734A genetic polymorphisms of CYP1A2 in Chinese population.

AIM: To observe the G-2964A and C734A genetic polymorphisms of human CYP1A2 in Chinese population. METHODS: Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was employed in genotyping analysis. RESULTS: The allele frequencies of A-2964 were 0.25 and 0.22 in Qidong and Changsha populations, respectively. The incidences of A734 were 0.68 in Qidong population and 0.66 in Changsha population. No more than two low-inducibility/activity alleles were presented in one person. CONCLUSION: The distribution of the G-2964A and C734A genetic polymorphisms did not show significant difference between Chinese and Japanese populations. The incidence of C734A in Chinese was also similar to that in Caucasian population.

[On the types and distribution of crystals in medical plants].

Crystals in medical plants are classified into organic and inorganic according to their chemical components. This paper gives an account of the types, chemical compositions, appearances structures and existing ways in plant tissue and distribution patterns in plant kingdom of various kinds of crystals.