A case report of encapsulating peritoneal sclerosis followed by cesarean section: Clinical diagnosis and treatment experience.

RATIONALE: Encapsulating peritoneal sclerosis (EPS), also known as abdominal cocoon syndrome, is an uncommon condition that typically presents with features of bowel obstruction. EPS followed by cesarean section is extremely rare. Intestinal obstruction caused by EPS lacks specificity and poses clinical difficulties for diagnosis and treatment. We present the case of a patient with recurrent intestinal obstruction followed by cesarean section, and the diagnosis of EPS was confirmed intraoperatively. The patient recovered well postoperatively, and achieved satisfactory therapeutic results. Management of this condition tests the surgeon's knowledge and experience of the disease. PATIENT CONCERNS: A 27-year-old woman with recurrent abdominal pain and distention accompanied by reduced anal discharge and defecation there months. The patient had a history of cesarean section 4 months earlier and recovered well after operation. She had no other history of abdominal surgery or diseases. On examination, a 10-cm long transverse incision was made in the lower abdomen, and marking on the intestinal movements were observed in the left mid-abdomen. A long, soft lump with good mobility was touched in the left lower abdomen. The abdominal computed tomography and small bowel barium meal examination revealed incomplete intestinal obstruction. DIAGNOSIS: Incomplete small bowel obstruction due to abdominal adhesions after the cesarean section was initially considered. INTERVENTIONS: After conservative treatment, the symptom of intestinal obstruction still recurred. Thus, we decided to perform a surgery of repeated decortication of fibrous peritoneal membranes. OUTCOMES: The operation successfully released the intestinal obstruction and abdominal pain, postoperative course recovered smoothly. LESSONS: After cesarean section could develop EPS. Intestinal obstruction caused by EPS lacks specificity and poses clinical difficulty in diagnosis and treatment. The management of this condition tests the surgeon's knowledge and experience, and surgery is an effective treatment measure.

Acquisition of multidrug resistance by overexpression of Twist1 in colorectal cancer cells SW620 and its mechanism / 中国免疫学杂志

Objective: To investigate the effect of overexpression of Twist1 on multidrug resistance( MDR) in colorectal cancer SW620 cells and its possible mechanism. Methods: The colorectal cancer SW620 cells were transfected with Twist1 overexpressing lentivirus and negative control virus, which were called experimental group ( SW620-Twist1) and control group ( SW620-NC) respectively. The protein and mRNA expression of Twist1、ABCB1 and ABCG2 in two groups were detected by Western blot and RT-qPCR, respectively. The growth inhibitory rate of 5-Fluorouracil(5-FU) and Oxaliplatin( OXA) at 24 ,48 and 72 h in two groups were determined by CCK8 assay. Cancer stem cell markers CD133,CD44 expression levels were detected by Flow cytometry. Results: The experimental group was compared with the control group, the expressions of Twsit1 gene mRNA and protein increased significantly( P<0. 01) ,Twist1 gene overexpressing SW620 cell line was successfully constructed. The inhibition rates of cell proliferation of the three chemotherapeutic drugs at 48 h and 72 h were significantly decreased ( 48 h, P<0. 05 ; 72 h, P<0. 01) . The mRNA and protein expression levels of ABCB1,ABCG2 were significantly increased( P<0. 01). The expression of CSCs markers CD133 and CD44 increased significantly (P<0. 01). Conclusion: Overexpression of Twist1 can promote the expression of ABCB1 and ABCG2 genes in SW620 cells and make the tumor cells acquire MDR. This phenomenon may be related to the promotion of stemness.

Apoptosis induced by Octamer 4 gene silencing and its potential mechanism in colorectal cancer / 解放军医学杂志

Objective To investigate the effect of Oct4 gene silencing on apoptosis in human colorectal cancer SW480 cell lines and its possible mechanism. Methods SW480480 cells at the late logarithmic phase were divided into 3 groups. (1) control group (Con): no virus transfection; (2) negative control group (NC): transfected with negative control viruses; (3) RNA interference group (RNAi): transfected with Oct4-shRNA lentiviral vector plasmids. In the above three groups, the Oct4 mRNA level was detected by real-time quantitative PCR, the protein levels of Oct4 and p-Akt were detected by Western blotting, and the proportion of Oct4+ and CD44+ cells and apoptosis of the tumor were analyzed by flow cytometry. Results Compared with those in the NC group, the Oct4 mRNA levels (1.00 vs 0.19±0.02), the Oct4 protein levels (0.032±0.004 vs 0.007±0.001), the p-Akt protein levels (0.11±0.03 vs 0.03±0.01), the proportion of Oct4+ cells (91.53% vs 10.70%) and the proportion of CD44+ cells (59.69% vs 23.58%) in the RNAi group significantly reduced, while cells apoptosis in the RNAi group significantly increased (43.2%±4.5% vs 12.1%±1.8%, P<0.01). Conclusion Oct4 gene silencing could significantly reduce the proportion of Oct4+ and CD44+ cells, and obviously increase apoptosis in SW480 cells, which may be related to the PI3K/Akt pathway.

Apoptosis induced by Octamer 4 gene silencing and its potential mechanism in colorectal cancer / 解放军医学杂志

Objective To investigate the effect of Oct4 gene silencing on apoptosis in human colorectal cancer SW480 cell lines and its possible mechanism. Methods SW480480 cells at the late logarithmic phase were divided into 3 groups. (1) control group (Con): no virus transfection; (2) negative control group (NC): transfected with negative control viruses; (3) RNA interference group (RNAi): transfected with Oct4-shRNA lentiviral vector plasmids. In the above three groups, the Oct4 mRNA level was detected by real-time quantitative PCR, the protein levels of Oct4 and p-Akt were detected by Western blotting, and the proportion of Oct4+ and CD44+ cells and apoptosis of the tumor were analyzed by flow cytometry. Results Compared with those in the NC group, the Oct4 mRNA levels (1.00 vs 0.19±0.02), the Oct4 protein levels (0.032±0.004 vs 0.007±0.001), the p-Akt protein levels (0.11±0.03 vs 0.03±0.01), the proportion of Oct4+ cells (91.53% vs 10.70%) and the proportion of CD44+ cells (59.69% vs 23.58%) in the RNAi group significantly reduced, while cells apoptosis in the RNAi group significantly increased (43.2%±4.5% vs 12.1%±1.8%, P<0.01). Conclusion Oct4 gene silencing could significantly reduce the proportion of Oct4+ and CD44+ cells, and obviously increase apoptosis in SW480 cells, which may be related to the PI3K/Akt pathway.