Electroacupuncture at Baliao point alleviates post-operative pain and anal distension after procedure for prolapse and hemorrhoids (stapled hemorrhoidopexy): a prospective randomized clinical trial.

PURPOSE: The purpose of this study was to explore the effect of electroacupuncture (EA) at Baliao point on short-term complications, such as anal pain and swelling, after procedure for prolapse and hemorrhoids (PPH) in patients with mixed hemorrhoids. METHODS: A total of 124 eligible patients undergoing PPH surgery were included in this study and randomly divided into a control group (n = 67) and an EA group (n = 57), with patients in the control group receiving only PPH surgery and patients in the EA group receiving PPH surgery and EA at Baliao point. RESULTS: The visual analogue scale (VAS) scores of EA group at 8, 24, 48, and 72 h after operation were significantly lower than those of control group. The anal distension scores at 8, 48, and 72 h after operation were also significantly lower than those of control group. The number of postoperative analgesic drug administration per patient was also significantly lower in the EA group. The incidence of urinary retention and tenesmus in EA group was significantly lower than that in control group within the first day after surgery. CONCLUSION: EA treatment at the Baliao point can alleviate short-term anal pain and anal swelling after the procedure for prolapse and hemorrhoids, reduce the incidence of urinary retention, and decrease the use of postoperative analgesic drugs. TRIAL REGISTRATION: This study was approved and registered by the Chinese Clinical Trial Center, Registration number: ChiCTR2100043519, Registration time: February 21, 2021 ( https://www.chictr.org.cn/ ).

The effects of the oral administration of graphene oxide on the gut microbiota and ultrastructure of the colon of mice.

Background: Graphene oxide (GO) has been widely used in the field of biomedicine and has shown great potential in drug delivery. Oral administration is an important mode of administration, but there are few studies on the effects of oral GO on gastrointestinal tract and gut microbiota. This study sought to explore the effects of oral GO on the gastrointestinal tract and gut microbiota. Methods: In total, 20 C57BL/6 male mice, aged 5 weeks old, were randomly divided into the following 4 groups (n=5): the control group, the GO30 group, the GO60 group, and the GO120 group. The GO sample solution was administered intragastrically at the doses of 30, 60, or 120 mg/kg every 3 days, and the control group was given an equal volume of distilled water. On the 16th day, mouse feces were taken for 16S ribosomal ribonucleic acid (rRNA) sequencing analysis, and the mice were dissected, and the heart, liver, kidney, and colon removed for histological analysis. Additionally, the ultrastructure of the colon was observed by transmission electron microscopy. Results: No obvious damage was observed in the hearts, livers, and kidneys of the mice. However, the intestinal ultrastructure of the mice in the GO group was damaged. The main manifestations were an uneven arrangement and local atrophy of the microvilli, swelling of the mitochondria and endoplasmic reticulum, and the widening of the intercellular spaces. The damage was positively correlated with increasing GO doses. The 16S rRNA sequencing results showed that the structure of the gut microbiota in the GO group was altered, and the contents of Alistipes, Enterobacteriaceae, Eubacterium, and Xanthobacteraceae were decreased. Conclusions: The oral administration of GO had no obvious toxicity effects on the hearts, livers, and kidneys of the mice. However, it did destroy the ultrastructure of the mouse colon and shift the structure of the gut microbiota, decreasing the contents of Alistipes, Enterobacteriaceae, Eubacterium, and Xanthobacteraceae.

Graphene oxide induces autophagy and apoptosis via the ROS-dependent AMPK/mTOR/ULK-1 pathway in colorectal cancer cells.

Aim: To investigate the anticancer effects and action mechanism of graphene oxide (GO) in colorectal cancer (CRC). Materials & methods: Anticancer effects and mechanisms of GO in CRC were investigated both in vivo and in vitro. Results: GO significantly inhibited tumor growth both in vitro and in vivo. GO was able to enter HCT116 cells through endocytosis. GO treatment resulted in cytotoxicity, reactive oxygen species (ROS) production, apoptosis, autophagy and activation of the AMPK/mTOR/ULK1 signal pathway. However, ROS scavenger N-acetylcysteine (NAC) attenuated the above effects and restored the effects of GO on protein expressions related to apoptosis, autophagy and AMPK/mTOR/ULK1 signal pathways. Conclusion: GO exerts anticancer effects against CRC via ROS-dependent AMPK/mTOR/ULK-1 pathway-related autophagy and apoptosis.

Attenuating glucose metabolism by Fbxw7 promotes Taxol sensitivity of colon cancer cells through downregulating NADPH oxidase 1 (Nox1).

BACKGROUND: Colorectal cancer (CRC), one of the most common malignancies worldwide, is associated with poor survival and has a high mortality rate. Taxol is a chemotherapeutic agent that has been clinically applied as a first-line drug against diverse cancers. Yet, development of drug resistance has become the major challenge for anti-cancer treatments. F-box and WD40 domain protein 7 (Fbxw7) is a known tumor suppressor which is frequently downregulated in cancers. However, the biological roles and mechanisms of Fbxw7 in Taxol resistance are still under investigation. METHODS: We report that Fbxw7 is significantly inactivated in CRC tumors and cell lines compared with normal tissues and colon cells. Expressions of Fbxw7 and Nox1 were detected from human colon tumors and cells by qRT-PCR and Western blot. Glycolysis rate was assessed by glucose uptake and lactate product assay. Interactions between Fbxw7 and Nox1 were determined by co-immunoprecipitation (Co-IP). Chemosensitivity and resistance of colon cancer cells were determined by MTT assay and Annexin V-FITC assay. RESULTS: Overexpression of Fbxw7 sensitized colon cancer cells to Taxol. Moreover, we observed a negative correlation between Fbxw7 and glucose metabolism. From the established Taxol-resistant (TR) cell line from HCT-116, Fbxw7 was found to be markedly downregulated in HCT-116 TR cells. We detected that NADPH oxidase 1 (Nox1), a superoxide-generating NADPH oxidase, is negatively regulated by Fbxw7. The Co-IP assay showed that Fbxw7 interacted with Nox1, which was observed to be significantly upregulated in CRC tissues. Nox1 therefore promotes the Taxol resistance and glucose metabolism of colon cancer cells. Finally, rescue experiments demonstrated that the Fbxw7-promoted Taxol sensitivity was partially through the Nox1-glycolysis axis. Restoration of Nox1 in Fbxw7-overexpressed TR colon cancer cells significantly recovered the Taxol resistance, which could be further overridden by glycolysis inhibition. CONCLUSIONS: Collectively, this study uncovered that targeting the Fbxw7-Nox1-glucose metabolism axis could be an effective strategy against chemoresistant colon cancer.

Transanal minimally invasive surgery (TAMIS) for rectal tumor: a case report and literature review.

Transanal minimally invasive surgery (TAMIS) is mainly used for benign tumors of the rectum, but there are few reports on treating malignant tumors of the rectum with a large volume. The aim of this study was to evaluate the feasibility and safety of TAMIS for resection of rectal malignant tumors. A 57-year-old patient was pathologically diagnosed as rectal malignancy before surgery. Computed tomography (CT), magnetic resonance imaging (MRI), fludeoxyglucose-18F (18F-FDG), and endoscopic mucosal biopsy were performed to assess the tumor location and preoperative size. There were no contraindications in all preoperative examinations. We applied TAMIS technology to perform the operation on this patient, And the operative time, the amount of blood loss, the length of hospital stay, the cost of hospital stay, surgical complications, postoperative complications and other relevant data were all collected. The operation was successful, the operation time was 45 min, 10 mL of intraoperative blood loss, and the length of stay was 3 days, a tumor of a maximum diameter of 4 cm being completely removed. There were no related complications or recurrence during postoperative follow-up. The pathological results were tubular villous adenoma with low-grade intraepithelial neoplasia, and a focal area of high-grade intraepithelial neoplasia. The pathological stage was T1N0M0. At 3-month follow-up there were no signs of recurrence. The patient was followed up for 5 years after the operation and there was no tumor recurrence or metastasis in other parts and no other discomfort. TAMIS is less commonly used in rectal malignancies, especially for tumors with larger diameters. We successfully performed complete resection of a 4-cm rectal malignant tumor with TAMIS. Given its low risk, low cost, simple operation, and few complications, TAMIS can be used for more indications of rectum diseases.

Transanal minimally invasive surgery vs endoscopic mucosal resection for rectal benign tumors and rectal carcinoids: A retrospective analysis.

BACKGROUND: Transanal minimally invasive surgery (TAMIS) is a good choice for resection of rectal neoplasms. Endoscopic mucosal resection (EMR) is also widely used in the treatment of benign rectal tumors such as rectal polyps and rectal adenomas. However, no studies have compared the outcome of TAMIS and EMR. AIM: To compare the short-term outcomes after TAMIS and EMR for rectal carcinoid and benign tumors (including rectal polyps and adenomas). METHODS: From January 2014 to January 2019, 44 patients who received TAMIS and 53 patients who received EMR at The Fifth People's Hospital of Shanghai were selected. Primary outcomes (surgical-related) were operating time, blood loss, length of postoperative hospital stay, rate of resection margin involvement and lesion fragmentation rate. The secondary outcomes were complications such as hemorrhage, urinary retention, postoperative infection and reoperation. RESULTS: No significant differences were observed in terms of blood loss (12.48 ± 8.00 mL for TAMIS vs 11.45 ± 7.82 mL for EMR, P = 0.527) and length of postoperative hospital stay (3.50 ± 1.87 d for TAMIS vs 2.72 ± 1.98 d for EMR, P = 0.065) between the two groups. Operating time was significantly shorter for EMR compared with TAMIS (21.19 ± 9.49 min vs 49.95 ± 15.28 min, P = 0.001). The lesion fragmentation rate in the EMR group was 22.6% (12/53) and was significantly higher than that (0%, 0/44) in the TAMIS group (P = 0.001). TAMIS was associated with a higher urinary retention rate (13.6%, 6/44 vs 1.9%, 1/53 P = 0.026) and lower hemorrhage rate (0%, 0/44 vs 18.9%, 10/53 P = 0.002). A significantly higher reoperation rate was observed in the EMR group (9.4%, 5/53 vs 0%, 0/44 P = 0.036). CONCLUSION: Compared with EMR, TAMIS can remove lesions more completely with effective hemostasis and lower postoperative hemorrhage and reoperation rates. TAMIS is a better choice for the treatment of rectal carcinoids.