Surgical treatment of retrorectal tumors: a retrospective study of a ten-year experience in three institutions.

BACKGROUND/AIMS: The relative rarity and anatomical position of retrorectal tumors may lead to difficulty in diagnosis and surgical management. METHODOLOGY: This was a retrospective review of 93 patients who had resection of retrorectal tumors between 2002 and 2011. RESULTS: All patients in this study were treated with excision of the retrorectal tumors. Surgical approach included transsacral approach (78 cases), transabdominal approach (12 cases) and combined approach (3 cases). Seventy-two benign lesions (77.4%) and 21 malignant (22.6%) were confirmed by histological examination. The 72 benign cases included dermoid cysts (26 cases), simple cysts (12 cases), teratomas (12 cases), neurofibromas (12 cases), fibrolipomas (6 cases), neurilemmomas (3 cases) and synovioma (1 case). The twenty-one malignant cases included lymphomas (6 cases), malignant teratomas (5 cases), fibrosarcomas (3 cases), interstitialomas (6 cases) and malignant mesothelioma (1 case). Complications occurred in 16.1% of patients including intra-operative bleedings (6 cases), rectal injury (6 cases) and presacral infection (3 cases). CONCLUSIONS: Primary retrorectal tumors are very rare. Successful treatment of these tumors requires extensive knowledge of pelvic anatomy and expertise in pelvic surgery.

Deep insights into fungal diversity in traditional Chinese sour soup by Illumina MiSeq sequencing.

Sour soup is a traditional condiment in Guizhou Province, China. The purpose of this study was to investigate the differences in the fungi present in 5 types of sour soup (tomato sour soup, chili sour soup, cherry tomato sour soup, spoiled tomato sour soup, and red sour soup made from blended tomato and chili sour soup subjected to secondary fermentation) and to determine the reasons for the deterioration of tomato sour soup by comparing the fungal communities in normal and deterioratedtomato sour soup. A total of 5 phyla were detected in all 5 samples, including Ascomycota (69.38%), Basidiomycota (7.63%), Zygomycota (1.59%), Chytridiomycota (0.01%) and unclassified phyla (21.39%). Ascomycota was the main phylum in each sample except the red sour soup made from blended tomato and chili sour soup subjected to secondary fermentation. That sour soup contained many unrecognized phyla. At the genus level, there were major differences among the different samples. Dekkera spp. and Pichia spp. were the main dominant fungus in tomato sour soup, Saccharomyces spp. and Pichia spp. were the dominant fungus in chili sour soup, and Pichia spp. were the dominant fungus in cherry tomato sour soup. When sour soup went bad, the fungus of sour soup changed greatly, and the unknown fungal genera, Cladospora spp., Saccharomyces spp. and Emericella spp. became the dominant fungal genera. In addition, after the secondary fermentation of tomato and chili sour soup mixed with garlic and ginger, the fungal genera of the base fermentation were replaced by unknown fungal genera. Moreover, there were various spoilage fungi in sour soup, which indicated that there were safety risks in naturally fermented sour soup and should be further controlled. This study revealed the fungal flora in sour soup made from different vegetables and compared the fungal diversity of spoiled and normal tomato sour soup and thereby provided a basis for understanding the fungal diversity of sour soup in China and guiding the production of sour soup.

Dynamic Changes in the Bacterial Community During the Fermentation of Traditional Chinese Fish Sauce (TCFS) and Their Correlation with TCFS Quality.

This study revealed for the first time the dynamic changes of the bacterial community during the fermentation of traditional Chinese fish sauce (TCFS) using high-throughput sequencing. In the early phase of TCFS fermentation, Shewanella (approximately 90%) within Proteobacteria was the dominant bacteria. Then, Halanaerobium (3%-86%) within Firmicutes rapidly replaced Shewanella as the dominant genus until the 12th month. Lactococcus (3.31%) and Bacillus (45.56%) belonging to Firmicutes were detected abundantly in the 3rd and 9th months after fermentation, respectively. In the late phase (12-15 months), Tetragenococcus within Firmicutes replaced Halanaerobium as the most dominant bacteria (29.54%). Many other genera including Pseudomonas, Psychrobacter, Tissierella, Carnobacterium and Gallicola were abundantly present in the 15th month after fermentation. Furthermore, the relationships between the bacterial community and major functional substances of TCFS, including amino nitrogen (AAN), free amino acids (FAAs), total soluble nitrogen (TSN), and trimethylamine (TMA), were investigated by partial least squares regression (PLSR). Tetragenococcus was positively correlated with the formation of TMA, while Halanaerobium showed the opposite result, suggesting that Tetragenococcus might be a good starter for TCFS fermentation. These results contribute to our knowledge about bacterial participation in the process of TCFS fermentation and will help improve the quality of fermented seafood.

A Randomized Controlled Study of rhTPO and rhIL-11 for the Prophylactic Treatment of Chemotherapy-Induced Thrombocytopenia in Non-Small Cell Lung Cancer.

Background: rhTPO and rhIL-11 are both recommended for the prophylactic treatment of chemotherapy-induced thrombocytopenia (CIT). However, there has been no head to head comparative study on the prophylactic administration of rhTPO and rhIL-11 to alleviate CIT in non-small cell lung cancer (NSCLC). Methods: In this open-label prospective multi-center phase II clinical trial, 108 NSCLC patients who experienced severe CIT after prior chemotherapy were randomized into study and control arms. Patients in the study arm were prophylactically administered rhTPO on day 2, day 4, day 6 and day 9 of the subsequent chemotherapy cycle, while patients in the control arm accepted prophylactic rhIL-11 from day 9 to day 15 of the subsequent chemotherapy cycle. Results: During the trial, the median time required for recovery of the platelet count to ≥ 75 × 109/L was 3 days (range: 2-4) in the study arm and 4 days (range: 2-6) in the control arm (P = 0.398). The lowest platelet counts were 61.8 ± 39.9 × 109/L in the study arm, values higher than those measured in the control arm 52.8 ± 36.8 × 109/L (P = 1.044). Platelet counts < 50 × 109/L occurred in 46.2% of patients in the study arm vs 58.6% in the control arm (P = 0.368). There were no drug-related adverse reactions in the study arm, but 4 cases (12.9%) in the control arm (P = 0.008), especially cardiotoxicity (P = 0.022). Conclusion: Prophylactic administration of rhTPO helps to alleviate CIT in NSCLC as well as rhIL-11, but is safer to use and more convenient to administer.

Antitumor effect of FP3 in combination with cetuximab on patient-derived tumor tissue xenograft models of primary colon carcinoma and related lymphatic and hepatic metastases.

FP3 is an engineered protein which contains the extracellular domain 2 of vascular endothelial growth factor (VEGF) receptor 1 (Flt-1) and the extracellular domain 3 and 4 of VEGF receptor 2 (Flk-1, KDR) fused to the Fc portion of human immunoglobulin G1. Previous studies have demonstrated its antiangiogenic effects in vitro and in vivo, and its antitumor activity in vivo. Cetuximab is a monoclonal antibody against epidermal growth factor (EGF) receptor. Combined inhibition of VEGF and EGF signaling may act additively or synergistically. In this study, patient-derived tumor tissue (PDTT) xenograft models of primary colon carcinoma and lymphatic and hepatic metastases were established for assessment of the antitumor activity of FP3 in combination with cetuximab. Xenografts were treated with FP3 and cetuximab, alone or in combination. After tumor growth was confirmed, volume and microvessel density in tumors were evaluated. Levels of VEGF, EGFR and PCNA in the tumor were examined by immunohistochemical staining, and levels of related cell signaling pathway proteins were examined by western blotting. FP3 in combination with cetuximab showed significant antitumor activity in three xenograft models (primary colon carcinoma, lymphatic metastasis and hepatic metastasis). The microvessel density in tumor tissues treated with FP3 in combination with cetuximab was lower compared to that of the control. Antitumor activity of FP3 in combination with cetuximab was significantly higher than that of each agent alone in two xenograft models (colon carcinoma lymphatic metastasis and hepatic metastasis). This study indicated that addition of FP3 to cetuximab significantly improved tumor growth inhibition in the PDTT xenograft models of colon carcinoma lymphatic and hepatic metastases. Combination anti-VEGF (FP3) and anti-EGFR (cetuximab) therapies may represent a novel therapeutic strategy for the management of metastatic colon carcinoma.