Objective:To investigate the effect of high glucose on invasion and migration of colorectal cancer（CRC）through hepatocyte growth factor（HGF）/c-met pathway.Methods:Forty CRC patients from January 2022 to December 2022 were selected and divided into hyperglycemic group（blood glucose ≥6.1 mmol/L，n=22）and normal blood glucose group（blood glucose 3.96.1 mmol/L，n=18）according to fasting blood glucose. The clinicopathological features and high expression rates of HGF and c-met were compared between the two groups. HCT116 cells were divided into control group（n=5），high glucose group（n=5）and high glucose +sull274 group（n=5）. The proliferation，invasion，migration，HGF and c-met protein expression levels of the three groups were compared. SPSS 20.0 statistical software was used to process the data. The measurement data were expressed as（xˉ±s）. One-way ANOVA analysis of variance was used for multi-group comparison，and LSD-t test was used for pin-group comparison. The comparison of counting data between the two groups was performed using the χ2 test. P < 0.05 was considered statistically significant.Results:The proportion of CRC differentiation and lymph node metastasis in hyperglycemia group were higher than those in normal glycemia group（P < 0.05）. The high expression rates of HGF and c-met in hyperglycemia group were higher than those in normal blood glucose group（P < 0.05）. Compared with the control group，the proliferation activity，invasion，migration，HGF and c-met protein expression levels of HCT116 cells in high glucose group were increased，with statistical significance（P < 0.05）. Compared with the high sugar group，the above indexes in the high sugar +sull274 group were lower，and the difference was statistically significant （P < 0.05）.Conclusion:High glucose can promote CRC invasion and migration by upregulating HGF/c-met pathway.
Objective:To investigate the application of perioperative comprehensive management in patients with choledocholithiasis combined with acute cholangitis by endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy (LC).Methods:Eighty patients with choledocholithiasis complicated with acute cholangitis who received ERCP+LC were randomly divided into two groups. The control group was given perioperative routine management, and the observation group was given perioperative comprehensive management. SPSS 25.0 software was used to analyze the data. Perioperative indexes, hemodynamic indexes, inflammatory emergency indexes and myocardial injury markers were presented with (), independent t test was used for comparison between groups; The statistical data such as complication rate were compared by χ2 test. P<0.05 was considered statistically significant.Results:The length of hospital stay in the observation group was better than that in the control group (P<0.05). After induction of anesthesia (T1), immediately after intubation (T2), 5?min after pneumoperitoneum (T3), and at the end of operation (T4), the fluctuation of heart rate (HR) and mean arterial pressure (MAP) in the observation group was smaller than that in the control group (P<0.05). One day after operation, the inflammatory stress indexes in the observation group were lower than those in the control group(P<0.05). 3 days after operation, the myocardial injury indexes in the observation group were lower than those in the control group(P<0.05). There was no significant difference in the total complication rate between the two groups (P>0.05).Conclusion:Perioperative comprehensive management intervention for choledocholithiasis patients with acute cholangitis treated with ERCP+LC can effectively maintain the hemodynamic stability of patients, reduce postoperative inflammatory stress response and myocardial damage, which is conducive to postoperative rehabilitation of patients, and is safe and feasible.
Liver regeneration (LR) is a complex set of mechanisms between liver cells and molecules in which the initiation, proliferation, and termination processes of liver repair are regulated. In the face of various liver diseases and treatment measures, the liver's regenerative capacity is significantly affected. In addition, whether liver diseases can be alleviated or even cured depends to a large extent on the regenerative ability of liver cells to achieve the recovery of liver function. Exploring the pathogenesis of LR and the related cell sources is of great significance for accelerating the recovery of liver function under different pathological modes and formulating therapeutic strategies. Although LR has been extensively studied, many challenges remain to fully understand it. This article reviews the mechanism of liver regeneration in order to have a new understanding of the changes of liver diseases and provide a new direction for the treatment of liver diseases.
Objective:To analyze the short-term and long-term prognosis and influencing factors of primary liver cancer (PLC) with spontaneous ruptured hemorrhage after emergency transcatheter arterial chemoembolization (TACE) surgery.Methods:Clinical data of 96 PLC patients with spontaneous ruptured hemorrhage underwent emergency TACE surgery from January 2017 to December 2019 were retrospectively analyzed, and they were included in this study and divided into poor prognosis group (n=45) and good prognosis group (n=51) based on one-year survival status after surgery. Statistical analysis were performed by using SPSS 25.0 software. Count data were expressed as [Example (%)] and were examined by using χ2 test ; Measurement data exhibiting a normal distribution, were represented by (), and were exmined by using independent sample t test. By using multiple factor COX regression analysis was performed to identify independent prognostic factors of patients. Furthermore, the area under the curve (AUC) of the receiver operating characteristic (ROC) curve were used to evaluate the predictive value of the mortality of patients within 1 year after surgery. P <0.05 was considered as a statistically significant difference.Results:All patients completed emergency TACE surgery, with a short-term hemostasis success rate of 91.7%. The median survival time of all patients was 10.9 months, and the one-year survival rate after surgery was 46.9% (45/96). Age, the proportions of Child Pugh grade C, TNM stage IV, portal vein tumor thrombus, the maximum diameter of cancer focus, blood levels of prothrombin time, total bilirubin, glutamic transaminase, creatinine and alpha-fetoprotein in poor prognosis group were significantly higher than those in the good prognosis group, and the blood level of hemoglobin (HB) and prognostic nutritional index (PNI) were significantly lower than those in the good prognosis group (P<0.05). The multivariate COX regression analysis result showed that Child Pugh grade, TNM stage, preoperative Hb and PNI were the independent influencing factors for the prognosis of patients after emergency TACE surgery (P<0.05). The ROC curve analysis result indicated that Hb and PNI before emergency TACE have high predictive value for mortality within one-year after surgery (P<0.05).Conclusion:The short-term hemostatic effect of emergency TACE for PLC patients with spontaneous ruptured hemorrhage is good, and Child Pugh grade, TNM stage, preoperative Hb and PNI were the independent influencing factors for postoperative prognosis of patients.
Objective:To investigate the ability of preoperative urea-creatinine ratio (UCR) to predict long-term postoperative prognosis and to validate the relationship between UCR and muscle mass in patients with colorectal cancer.Methods:Clinical data of 221 colorectal cancer patients from January 2015 to January 2019 were retrospectively analyzed. The patients were divided into two groups according to the UCR optimal cut-off value of 2.65 to explore the relationship between UCR and 3-year prognosis of the patients. Kaplan-Meier plotting of survival curves was done and compared by Log-Rank test. Correlation analysis was performed between patients' preoperative UCR and muscle parameters. Independent t test and nonparametric rank-sum test were used for normally and non-normally data, respectively. Categorical variables were tested using the χ2 test. P<0.05 was statistically significant.Results:There were 22 deaths and 29 recurrences within 3 years. Multivariate analysis showed that UCR and tumor stage were significantly associated with postoperative overall survival (OS) and recurrence-free survival (RFS) （P<0.05）. In all patients, the ROC area predicting 3-year overall survival and recurrence was 0.789 （P<0.001） and 0.739 （P<0.001）, respectively; the risk of death and recurrence was more significant in the high UCR group compared with the low UCR group （P<0.007）. In addition, UCR level was significantly associated with skeletal muscle mass （P<0.01）.Conclusion:UCR levels are effective in predicting the long-term prognosis of colorectal cancer patients after surgery. Patients with a higher UCR have an increased risk of death and tumor recurrence. In addition, UCR is positively correlated with skeletal muscle mass.
