Gastric cancer (GC) remains one of the leading causes of cancer-related mortality worldwide, presenting significant therapeutic challenges due to its late-stage diagnosis and high metastatic potential. Imbalance in reactive oxygen species (ROS) homeostasis is crucial for the onset, development, and malignant transformation of GC. To address the demand for innovative therapeutic approaches, this study introduces a novel nanocoordination polymer, Zn-Quer nanozymes (NZs), synthesized from quercetin (Quer) and zinc ions. These nanoparticles utilize quercetin's anti-inflammatory and antioxidant properties, improving its bioavailability and therapeutic effectiveness via a nanoparticle delivery system. Zn-Quer NZs were synthesized via coordination chemistry and characterized by using TEM, XRD, and FTIR to confirm their structural integrity and composition. In vitro studies on GC cell lines and in vivo xenograft model experiments demonstrate that Zn-Quer NZs effectively inhibit cell proliferation, induce apoptosis, and reprogram malignant phenotypes such as epithelial-mesenchymal transition (EMT) and angiogenesis, as indicated by changes in the expression of related markers. Moreover, Zn-Quer NZs significantly reduce the overall intracellular ROS levels in epithelial cells under oxidative stress by modulating multiple steps of ROS generation. These findings underscore Zn-Quer NZs as a promising therapeutic strategy for gastric cancer, capable of rebalancing ROS and effectively reversing malignant phenotypic transformation.

Although tamoxifen is commonly utilized as adjuvant therapy for Estrogen Receptor alpha (ERα)-positive breast cancer patients, approximately 30–50% of individuals treated with tamoxifen experience relapse. Therefore, it is essential to investigate additional factors besides ERα that influence the estrogen response. In this study, cross-analysis of databases were performed, and the results revealed a significant association between LINC00626 and ERα signaling as well as increased expression levels of this gene in tamoxifen-resistant cells. LINC00626 is a novel ERα-regulated long non-coding RNA (lncRNA) that has not yet been examined for its potential contribution to endocrine therapy resistance. This study revealed that the upregulation of LINC00626 in breast cancer was associated with poor overall survival in patients. Additionally, ERα signaling was found to transcriptionally regulate LINC00626 expression, thereby promoting cancer progression and enhancing resistance to tamoxifen in breast cancer cells via the regulation of UPF1 expression. Depletion of LINC00626 restored sensitivity to tamoxifen by activating the PERK-ATF4-CHOP signaling pathway via UPF1. These findings support the role of LINC00626 as a potential therapeutic target for combating tamoxifen resistance.

Study objective HR18034, composed of the ropivacaine encapsulated in multi-lamellar, concentric circular structure liposomes as the major component and a small amount of free ropivacaine, has performed well in animal experiments and phase I clinical trials. This trial was to investigate the efficacy, safety, pharmacokinetic profile and the minimum effective dose of HR18034 for postoperative analgesia after hemorrhoidectomy compared with ropivacaine. Design A multicenter, randomized, double-blind trial. Setting 19 medical centers in China. Patients 85 patients undergoing hemorrhoidectomy between October 2022 to November 2022. Interventions Patients were randomly divided into HR 18034 190 mg group, 285 mg group, 380 mg group and ropivacaine 75 mg group, receiving single local anesthetic perianal injection for postoperative analgesia. Measurements The primary outcome was the area under the resting state NRS score -time curve within 72 h after injection. The second outcomes included the proportion of patients without pain, the proportion of patients not requiring rescue analgesia, cumulative morphine consumption for rescue analgesia, etc. Safety was evaluated by adverse events incidence and plasma ropivacaine concentrations were measured to explore the pharmacokinetic characteristics of HR18034. Main results The areas under the NRS score (at rest and moving states)-time curve were significantly lower in HR 18034 380 mg group than ropivacaine 75 mg at 24 h, 48 h, and 72 h after administration. However, this superiority was not observed in HR18034 190 mg group and 285 mg group. There was no difference in cumulative morphine consumption for rescue analgesia between HR 18034 groups and ropivacaine group. Conclusions HR 18034 380 mg showed superior analgesic efficacy and equivalent safety compared to ropivacaine 75 mg after hemorrhoidectomy, thus preliminarily determined as minimum effective dose.

Background Lysine demethylase 5C (KDM5C) has been implicated in the development of several human cancers. This study aims to investigate the role of KDM5C in the progression of colorectal cancer (CRC) and explore the associated molecular mechanism. Methods Bioinformatics tools were employed to predict the target genes of KDM5C in CRC. The expression levels of KDM5C and prefoldin subunit 5 (PFDN5) in CRC cells were determined by RT-qPCR and western blot assays. The interaction between KDM5C, H3K4me3, and PFDN5 was validated by chromatin immunoprecipitation. Expression and prognostic values of KDM5C and PFDN5 in CRC were analyzed in a cohort of 72 patients. The function of KDM5C/PFDN5 in c-Myc signal transduction was analyzed by luciferase assay. Silencing of KDM5C and PFDN5 was induced in CRC cell lines to analyze the cell malignant phenotype in vitro and tumorigenic activity in nude mice. Results KDM5C exhibited high expression, while PFDN5 displayed low expression in CRC cells and clinical CRC samples. High KDM5C levels correlated with poor survival and unfavorable clinical presentation, whereas elevated PFDN5 correlated with improved patient outcomes. KDM5C mediated demethylation of H3K4me3 on the PFDN5 promoter, suppressing its transcription and thereby enhancing the transcriptional activity of c-Myc. KDM5C knockdown in CRC cells suppressed cell proliferation, migration and invasion, epithelial-mesenchymal transition, and tumorigenic activity while increasing autophagy and apoptosis rates. However, the malignant behavior of cells was restored by the further silencing of PFDN5. Conclusion This study demonstrates that KDM5C inhibits PFDN5 transcription, thereby activating c-Myc signal transduction and promoting CRC progression.

Objective To investigate the clinical efficacy and prognostic implication of hand-sewn anastomosis in laparoscopic total gastrectomy (LTG). Methods Retrospective analysis is adopted to the clinicopathologic data of 112 patients with gastric cancer (GC) who went through LTG in the Department of General Surgery, the Second Affiliated Hospital of Anhui Medical University between October 2020 and October 2022. Among them, 60 individuals receiving medical care were split into the hand-sewn anastomosis group (Group H, N = 60); while, 52 individuals were split into the circular stapler anastomosis group (Group C, N = 52) The clinical efficacy and prognostic conditions of hand-sewn anastomosis are compared with those of circular stapler anastomosis in the application of LTG. Results The analysis results indicated that no notable difference was observed in intraoperative bleeding volume, time to first flatus (TFF), postoperative hospitalization duration and postoperative complications among the two groups ( P > 0.05). Group H had shorter esophagojejunal anastomosis duration (20.0 min vs. 35.0 min) and surgery duration (252.6 ± 19.4 min vs. 265.9 ± 19.8 min), smaller incisions (5.0 cm vs. 10.5 cm), and lower hospitalization costs (58415.0 CNY vs. 63382.5 CNY) compared to Group C ( P < 0.05). Conclusion The clinical efficacy and the postoperative complications of hand-sewn esophagojejunostomy are basically equivalent in comparison to the circular stapler anastomosis in the application of LTG. Its advantage lies in shorter esophagojejunal anastomosis duration, shorter surgery duration, smaller incisions, lower hospitalization costs and wider adaptability of the location of the tumor.

BACKGROUND:Chronic wounds that fail to progress through normal phases of healing present a significant healthcare burden owing to prolonged treatment and associated costs. Traditional wound care typically involves regular dressing changes, which can be painful. Recent approaches have explored the use of lidocaine to manage pain and red-light irradiation (RLI), known for its anti-inflammatory and cell proliferation effects, to potentially enhance wound healing.AIM:To investigate the therapeutic efficacy of lidocaine wet compression (LWC) combined with RLI for chronic wounds.METHODS:We enrolled 150 patients with chronic wounds from the Wound and Ostomy Outpatient Clinic of the Second Hospital of Anhui Medical University from April to September 2022. The wounds were treated with dressing changes. The patients were randomly assigned to the control and experimental groups using a random number table and given the same first dressing change (2% LWC for 5 min and routine dressing change). From the second dressing change, in addition to 2% LWC for 5 min and routine dressing change, the experimental group received RLI, whereas the control group continued to receive the same LWC and dressing change. The first and second dressing changes were performed on days 1 and 2, respectively. The third dressing change was performed 3 d after the second change. The frequency of subsequent dressing changes was determined based on wound exudation and pain. Pain during the first three dressing changes was evaluated in both groups. The average number of dressing changes within 28 d and the degree of wound healing on day 28 were also recorded.RESULTS:During the initial dressing change, no noticeable differences were observed in the pain levels experienced by the two groups, indicating similar pain tolerance. However, during the second and third dressing changes, the experimental group reported significantly less pain than the control group. Furthermore, over 28 d, the experimental group required fewer dressing changes than the control group.CONCLUSION:Notably, the effectiveness of wound healing on the 28th day was significantly higher in the experimental group than that of in the control group. The combination of LWC and RLI was effective in reducing early-stage pain, promoting wound healing, decreasing the frequency of dressing changes, and enhancing patients' overall quality of life with chronic wounds.

目的 通过与Roux-en-Y吻合比较来评估Ω形吻合在腹腔镜全胃切除术中应用的安全性和可行性.方法 采用回顾性队列研究的方法,收集在我院行腹腔镜全胃切除术的患者资料.根据消化道重建方式将患者分成Ω形吻合组(Ω组)和Roux-en-Y吻合组(R组),比较2组患者手术时间、吻合时间、通气时间、术后住院时间、吻合费用及并发症发生情况,并对2组患者进行随访以评估其术后生活质量.结果 与R组比较,Ω组的手术时间及吻合时间更短,通气时间更早,吻合费用更少,差异均具有统计学意义(P<0.05).2组患者的术后住院时间及术后并发症的发生率比较,差异均无统计学意义(P>0.05).术后第6个月,EORTC-QLQ-C30量表显示,Ω组的总体健康状况评分高于R组,恶心呕吐症状评分低于R组,差异均具有统计学意义(P<0.05);2组其余功能领域及症状领域评分比较,差异均无统计学意义(P>0.05).EORTC-QLQ-STO22量表显示,Ω组的反流症状领域评分低于R组,差异具有统计学意义(P<0.05);2组其余症状领域评分比较,差异均无统计学意义(P>0.05).结论 Ω形吻合用于重建腹腔镜全胃切除后消化道的连续性是安全可行的,并且能够提高患者术后生活质量.

目的 探讨反穿刺侧位布孔法于腹腔镜完全腹膜外疝修补术(TEP)中的应用观察及对术后并发症、机体应激反应状态的影响.方法 选取2020年1～12月于安徽医科大学第二附属医院普外科住院治疗的79例腹股沟疝患者为研究对象,抽签法随机分为观察组(n=40)、传统组(n=39).两组患者均行TEP,观察组术中采取反穿刺侧位布孔,传统组采取常规穿刺下腹正中布孔.比较两组患者围术期指标、并发症,术前与术后1天、2天应激反应指标[醛固酮(ALD)、去甲肾上腺素(NE)、皮质醇(COR)]、免疫功能指标(CD3+、CD4+、CD4+/CD8+)水平,术前与术后1、2、3天视觉模拟评分量表(VAS)评分,术前与术后1、2、3个月生活质量综合评定量表(GQOLI-74)评分.结果 观察组腹膜前间隙建立时间、疝囊剥离时间、总手术时间均较传统组短,术中出血量较传统组少,差异均有统计学意义(P<0.05).手术前后不同时间ALD、NE、COR水平组间差异有统计学意义(P<0.05).手术前后不同时间CD3+、CD4+水平组间差异有统计学意义(P<0.05),CD4+/CD8+组间差异无统计学意义(P>0.05).观察组与传统组术后并发症发生率分别为7.50％和12.82％,差异无统计学意义(P=0.681).手术前后不同时间点,VAS评分组间差异有统计学意义(P<0.05),GQOLI-74评分组间差异有统计学意义(P<0.05).结论 反穿刺侧位布孔法应用于TEP中临床效果较好.

目的:探讨区域引流在完全腹腔镜全胃手术后瘘并发症诊疗中的应用价值.方法:回顾分析2016年11月至2020年2月为280例胃癌患者行完全腹腔镜全胃切除术的临床资料.术中根据胃的4支固有血管及系膜的集束化分布特点,将术野"区域化"后放置引流管,对引流管相关指标进行研究.结果:本研究共纳入280例患者,25例发生瘘,其中吻合口漏2例(0.7％)、十二指肠残端漏15例(5.4％),胰瘘8例(2.9％).吻合口漏、十二指肠残端漏、胰瘘组间引流管相关指标(引流管侧别、引流液性状、日均引流量、伴随症状)差异均有统计学意义(P<0.05);瘘患者与未发生瘘患者留置引流管时间[(24.1±5.7)d vs.(6.6±1.5)d,P<0.05]、管周疼痛(5 vs.1,P<0.05)、拔管困难(2 vs.0,P<0.05)差异均有统计学意义;留置引流管后腹痛(1 vs.0,P>0.05)差异无统计学意义.患者均未发生拔管断裂或疝.结论:全胃手术后准确放置引流管建立区域引流是必要且安全的,掌握其规律对瘘并发症的诊断与治疗具有指导意义.

目的 探讨胃腺癌淋巴转移过程中的细胞学特征及相关分子机制的改变.方法 收集2019年9-12月该院胃肠外科13例行胃癌根治术患者的胃癌组织及癌旁组织,利用单细胞RNA测序技术揭示标本中的细胞学特征及相关标记基因.利用实时定量PCR(RT-qPCR)检测主细胞3的标记基因XIST和窝状黏液细胞3标记基因CXCL5的表达水平.分析XIST、CXCL5在淋巴结转移阳性和阴性胃癌患者表达水平的差异.结果 主细胞3和窝状黏液细胞3在胃癌淋巴转移阳性的癌组织明显富集.主细胞3的标记基因XIST在淋巴转移阳性患者胃癌组织表达水平为(0.297±0.261),高于淋巴转移阴性患者胃癌组织的表达水平(0.025±0.023),差异有统计学意义(P＜0.05).窝状黏液细胞3的标记基因CXCL5在淋巴转移阳性患者胃癌组织表达水平为(0.036±0.019),高于其在淋巴转移阴性患者胃癌组织的表达水平(0.008±0.007),差异有统计学意义(P＜0.05).拟时序分析发现主细胞可能是胃癌发生的起源.结论 XIST、CXCL5可能是胃腺癌淋巴转移的潜在信号.

目的 研究幽门下淋巴结清扫在右半结肠癌手术中的应用价值.方法 回顾性分析2016-2021年安徽医科大学第二附属医院胃肠外科收治的140例接受根治手术的右半结肠癌患者的临床资料,根据是否术中加做幽门下淋巴结清扫分为观察组(加做幽门下淋巴结清扫,60例)和对照组(未做幽门下淋巴结清扫,80例).比较两组患者术中、术后相关临床指标,并分析观察组患者病理分布情况,以探究幽门下淋巴结清扫的应用价值.结果 观察组患者手术时间[(234.5±34.7)min]、术后通气时间[(3.2±0.9)d]、住院时间[(9.1±1.6)d]均明显长于对照组[分别为(213.0±51.3)min、(1.6±1.1)d、(7.8±0.8)d],术中出血量[(88.8±35.1)mL]、清扫淋巴结个数[(28±7)个]均明显多于对照组[分别为(65.4±17.8)mL、(22±5)个],术后首次疼痛评分[(4±2)分]明显大于对照组[(3±2)分],胃瘫、胰瘘发生率[分别为6.7％(4/60)、18.3(11/60)]均明显高于对照组[分别为0、3.8(3/80)],差异均有统计学意义(P<0.05);肠瘘发生率[1.7(1/60)]与对照组[2.5(2/80)]比较,差异无统计学意义(P>0.05).清扫的276枚幽门下淋巴结的阳性数为0.结论 右半结肠癌行幽门下淋巴结清扫会增加手术风险,却不能获得更多阳性淋巴结.

Objective:To investigate the clinical effect of total laparoscopic radical gastrectomy with different esophagogastrostomy.Methods:The clinical data of 126 patients with laparoscopic radical gastrectomy from January 2018 to June 2020 were analyzed retrospectively. According to the different methods of anastomosis，they were divided into overlap group，π Roux-en-Y group（π group）and Roux-en-y anastomosis group（regular group），42 cases in each group. SPSS 23.0 was used for data analysis. Perioperative indicators，nutritional indicators and other measurement data were expressed as（xˉ±s）. One-way ANOVA was performed for comparison between multiple groups. χ2 test was used for counting data such as complications，and P<0.05 indicated statistically significant differences.Results:Patients in π shape group were superior to Overlap group and routine group in terms of total operation time，anastomosis time，intraoperative blood loss，postoperative hospital stay and liquid diet time（P<0.05），and Overlap group was superior to routine group（P<0.05）. The incidence of postoperative complications in π shaped group was significantly lower than that in the other two groups（P<0.05）.Conclusion:π Roux-en-Y anastomosis is effective in operation time，anastomotic time and hospital stay. It is simple and safe，and the incidence of postoperative complications is low，which is conducive to the early recovery of patients，and is worth popularizing in clinical.

Aberrant DNA methylation of genes is closely linked to many aspects of tumor development. This study focuses on the effect of DNA hypermethylation of von Willebrand factor C domain containing 2 (VWC2) on colorectal cancer (CRC) progression and the underpinning mechanism. According to data in the bioinformatic systems, VWC2 had the highest degree of DNA methylation in colonic adenocarcinoma, and it showed DNA hypermethylation in rectal adenocarcinoma as well. CRC and the para-tumorous tissues were collected from 86 patients. VWC2 was expressed at low levels in CRC samples and inversely correlated with tumor stage and tumor biomarker expression. DNA hypermethylation and reduced expression of VWC2 were also detected in CRC cell lines HCT-116 and HT29. VWC2 overexpression suppressed the malignant growth of cells in vitro and in vivo. Co-immunoprecipitation and western blot assays showed that small ubiquitin-like modifier 1 (SUMO1) mediated SUMOylation of DNA methyltransferase 1 (DNMT1) and strengthened its protein stability, which promoted DNA methylation and suppression of the VWC2 gene. In summary, this study demonstrates that SUMO1-mediated activation of DNMT1 induces DNA methylation and downregulation of VWC2 in CRC to augment cancer development.

Purpose:To assess the association between intestinal venous blood (IVB) circulating tumor cells (CTCs) and clinicopathological parameters in stage I-III colorectal cancer (CRC) patients.Methods:Participants were retrospectively retrieved, who were admitted to our hospital or took annual physical exams between December 1, 2015 and December 31, 2018. A negative enrichment-immunofluorescence in situ hybridization (NE-imFISH) technique was used to isolate and identify CTCs. Receiver operating characteristic (ROC) curves and Youden index values were used to determine the critical CTC cutoff value for the diagnosis of CRC. Kaplan-Meier and log-rank methods were used to conduct survival analyses, and multivariate Cox regression analyses were employed for multivariate corrections to comprehensively evaluate the value of CTCs in the diagnosis of CRC. Relationships between IVB CTCs, clinicopathological parameters, and prognosis were then analyzed based upon patient postoperative follow-up data.Results:In total, we retrieved 282 patients including 48 healthy controls, 72 patients with benign colorectal tumors, and 162 CRC patients. CRC patients exhibited significantly higher numbers of CTCs relative to control patients or those with benign disease. CTC numbers in CRC patient peripheral blood (PB) and IVB were closely associated with tumor node metastasis (TNM) staging (P < 0.01), carbohydrate antigen-125 (CA-125) levels (P < 0.001), and KRAS (Kirsten rat sarcoma virus oncogene) mutation status (P < 0.001). The disease-free survival (DFS) of patients in the CTC-negative group was significantly longer than that of patients in the CTC-positive group (24.60 ± 13.31 months vs. 18.70 ± 10.19 months, P < 0.05), with the same being true with respect to their overall survival (OS) (30.60 ± 12.44 months vs. 35.25 ± 11.57 months, P < 0.05). A multivariate analysis revealed that the detection ≥2 CTCs/3.2 ml was independently associated with poorer DFS and OS. CTC counts were independently predictive of CRC patients TNM staging, CA-125, and KRAS mutation status in both univariate and multivariate Cox proportional hazards regression analyses.Conclusion:CTCs are valuable biomarkers that can be monitored to predict CRC patient disease progression.

目的 探讨全腹腔镜下三角吻合联合经自然腔道取标本(NOSES)用于近端胃癌根治术的效果.方法 选取安徽医科大学第二附属医院2019年10月至2020年10月收治的62例近端胃癌患者,按照治疗方法的不同分为研究组与对照组,各31例.研究组行近端胃部分切除腹腔镜下三角吻合消化道重建联合NOSES治疗,对照组行食管残胃吻合术联合经腹部切口取标本治疗.比较两组的手术效果、手术前后炎症反应及免疫功能指标,以及并发症发生情况.结果 两组患者的性别、年龄、体质指数(BMI)、美国东部肿瘤协作组(ECOG)评分、肿瘤直径、美国麻醉医师协会(ASA)分级及病理分期比较差异无统计学意义(P>0.05).研究组的手术时间、吻合时间、淋巴结清扫数大于对照组,术中出血量、术后首次排气时间、流质饮食时间、术后下床时间小于对照组,差异有统计学意义(P<0.05),两组术后住院时间比较差异无统计学意义(P>0.05).两组手术前后炎症反应指标[白细胞计数(WBC)、C反应蛋白(CRP)]及免疫功能指标[CD3+、CD4+、CD8+、CD4+/CD8+]比较差异无统计学意义(P>0.05).两组术后并发症发生率比较差异无统计学意义(19.4％vs.25.8％,P>0.05).随访6个月,两组均无肿瘤复发、转移及死亡患者.结论 近端胃癌患者采用全腹腔镜下三角吻合消化道重建联合NOSES治疗比食管残胃吻合术联合经腹部切口取标本治疗的效果更优,术后恢复更快,安全可靠.

Colorectal cancer is a major public health problem and fourth guiding cause of cancer-induced mortality worldwide. The five-year survival rate for patients with colorectal cancer remains poor, and almost half of colorectal cancer patients present recurrence and die within five years. The increasing studies showed that long non-coding RNA (lncRNA) was involved in colorectal cancer. Therefore, this study was used to explore molecular mechanisms of nuclear paraspeckle assembly transcript 1 (NEAT1) in colorectal cancer. The real-time quantitative polymerase chain reaction (RT-qPCR) was employed to estimate the expression levels of NEAT1, Nuclear receptor 4 A1 (NR4A1), and miR-486-5p in colorectal cancer tissues and cells. Kaplan-Meier curve was conducted to analyze relationship between survival time of colorectal cancer patients and level of NEAT1. The protein levels of NR4A1, β-catenin, c-Myc, and cyclinD1 were assessed with western blot assay. 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl-2H-tetrazol-3-ium bromide (MTT) and flow cytometry assays were performed to evaluate proliferation and apoptosis of colorectal cancer cells, respectively. The migration and invasion abilities of cells were examined by transwell assay. The relationship between miR-486-5p and NEAT1 or NR4A1 was confirmed by dual-luciferase reporter assay. We found NEAT1 and NR4A1 were highly expressed in colorectal cancer tissues and cell lines compared with controls. Loss-functional experiments revealed that knockdown of NEAT1 or NR4A1 repressed proliferation and motility, while inducing apoptosis of colorectal cancer cells. The gain of NR4A1 could abolish NEAT1 silencing-induced effects in colorectal cancer cells. In addition, NEAT1 contributed to colorectal cancer progression through mediating NR4A1/Wnt/β-catenin signaling pathway. In conclusion, NEAT1 stimulated colorectal cancer progression via acting as competing endogenous RNA to sponge miR-486-5p and regulate NR4A1/Wnt/β-catenin signaling pathway.

BACKGROUND:Mucin 16 (MUC16), a cell surface-associated mucin, has been implicated to be upregulated in a large repertoire of malignances. However, its function in the pathogenesis of colorectal cancer (CRC) is unknown.AIMS:Here, we explored the regulatory role of MUC16 in CRC.METHODS:First, tumor and paracancerous tissues, and serum samples from 162 CRC patients, peripheral blood samples from 48 healthy volunteers and 72 benign colorectal patients were collected. The correlation between the MUC16 expression and the clinical phenotypes of the patients was analyzed. Subsequently, HCT116 and SW480 cells with deletion of MUC16 were established to detect changes in the growth and metastatic capacities of CRC cells. The genes with the highest correlation with MUC16 were predicted by bioinformatics, and their binding relationships were detected by Co-IP and double-labeled immunofluorescence, followed by functional rescue experiments.RESULTS:Overexpression of MUC16 in CRC patients was positively correlated with serum biomarkers and poor prognosis of patients. It was demonstrated by in vitro and in vivo experiments that knocking-down the expression of MUC16 could significantly inhibit the growth and metastasis of CRC cells. MUC16 activated janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) by interacting with JAK2. Further overexpression of JAK2 in cells with poor expression of MUC16 revealed a significant increase in the proliferative and metastatic capacities of CRC cells.CONCLUSIONS:MUC16 contributes to the development and progression of CRC by binding to JAK2, thereby promoting phosphorylation of JAK2 and further activating STAT3 phosphorylation.

Objective:To systematically evaluate manual suture versus mechanical anastomosis in esophagojejunostomy, two methods of digestive tract reconstruction after laparoscopic total gastrectomy. Methods:A computer-based online search of PubMed, CBM, Wanfang database and CNKI database was performed to retrieve clinical studies related to manual suture (manual suture group) and mechanical anastomosis (mechanical anastomosis group) in esophagojejunostomy after laparoscopic total gastrectomy published between January 2015 and October 2020. The quality of eligible literature was evaluated and data were extracted for meta-analysis using Review Manager 5.4 software.Results:Four clinical studies involving 746 patients were included in the final analysis. Meta-analysis results revealed that there was no significant difference in operative time between manual suture and mechanical anastomosis methods [ MD = 8.32, 95% CI (-5.94, 22.57), P > 0.05]. The intraoperative blood loss in manual suture group was significantly less than that in mechanical anastomosis group [ MD = -9.54, 95% CI (-15.54, -3.55), P < 0.05]. The time to exhaust in the manual suture group was shorter than that in the mechanical anastomosis group [ MD = -0.38, 95% CI (-0.59, -0.18), P < 0.05]. The length of hospital stay in the manual suture group was less than that in the mechanical anastomosis group [ MD = -0.88, 95% CI (-1.23, -0.54), P < 0.05]. The incidence of anastomotic leakage in the manual suture group was significantly lower than that in the mechanical anastomosis group [ OR = 0.23, 95% CI (0.06, 0.93), P < 0.05]. The incidence of anastomotic stenosis in the manual suture group was significantly lower than that in the mechanical anastomosis group [ OR = 0.14, 95% CI (0.04, 0.54), P < 0.05]. Conclusion:After total gastrectomy, continuous suture of oesophago-jejuno ends with barbed threads under laparoscopy is safer and less expensive and needs less time to postoperative recovery and shorter length of hospital stay compared with mechanical anastomosis.

目的 探讨完全腹腔镜食管空肠手工吻合的安全性和可行性.方法 回顾性分析2016年11月～2020年2月280例完全腹腔镜全胃切除食管空肠手工吻合的临床资料.肿瘤位于胃体64例,贲门216例.术前分期cT2～4 N0～1 M0期.均在腹腔镜下完成全胃切除,3-0倒刺线食管空肠手工吻合.结果 280例均完成手术,无中转开腹.手术时间(246±36)min,其中食管空肠吻合时间(18±5)min,无术中并发症.术后吻合口漏2例,十二指肠残端漏15例,均保守治疗痊愈.无术后并发症者进食流食时间4～6 d,拔除空肠营养管时间5～7 d,拔除引流管时间7～9 d.随访时间4～40月,中位时间11.6月.5例良性吻合口狭窄.12例肿瘤复发死亡,2例吻合口复发,24例带瘤生存(腹腔、远处转移),242例无瘤生存.结论 完全腹腔镜下完成食管空肠手工吻合安全有效.