目的 探究miR-200c对人结肠癌SW480细胞侵袭和迁移的影响及其相关机制.方法 将SW480细胞分为类似物转染组(转染miR-200c类似物)、抑制物转染组(转染miR-200c核酸抑制剂)、类似物阴性对照组(转染miR-200c类似物的无义序列)、抑制物阴性对照组[加入miR-200c核酸抑制剂的载体(不含miR-200c核酸抑制剂)]以及空白组(不进行任何处理).实时定量聚合酶链式反应(real-time polymerase chain reaction,RT-PCR)检测12 h和24 h转染效率.细胞划痕实验和transwell侵袭实验检测细胞迁移和侵袭.Western blot法检测转染后β-catenin和E-cadherin的表达.结果 细胞划痕实验显示,类似物转染组12 h和24 h后伤痕宽度均高于类似物阴性对照组(均P＜0.05),抑制物转染组均低于抑制物阴性对照组(均P＜0.05).Transwell实验显示,与类似物阴性对照组和抑制物阴性对照组比较,类似物转染组24 h和48 h通过8μm孔径的细胞数减少,抑制物转染组增多(均P＜0.05).类似物转染组β-catenin和E-cadherin的表达均升高,抑制物转染组各蛋白表达均下降(均P＜0.05).结论 miR-200c可能通过Wnt/β-catenin信号通路抑制SW480细胞的侵袭和迁移.

目的:研究老年非心脏手术患者围手术期心脏不良事件的影响因素.方法:分析112例老年非心脏手术患者围术期的临床资料,分析与发生围手术期心脏不良事件相关的因素,比较有心脏不良事件组与无心脏不良事件组之间的差异.结果:术后42例(37.5％)发生心脏不良事件.与无不良事件组相比,发生心脏不良事件的患者多合并冠心病、行冠状动脉支架及旁路移植手术、合并心脏瓣膜病、存在心律失常、术前射血分数EF＜ 50％、手术规模大、麻醉时间长、术前高敏C反应蛋白(hs-CRP)及B型利钠肽(BNP)增高(P＜0.05).结论:老年非心脏手术患者围手术期危险因素包括合并冠心病、行冠状动脉支架及旁路移植手术、合并心脏瓣膜病、存在心律失常、术前EF值＜50％以及手术规模大、麻醉时间长、术前hs-CRP和BNP增高,其中术前hs-CRP和BNP水平可以作为预测指标,对高危老年患者进行充分评估、从而减少围手术期心脏不良事件的发生.

Objecti To explore the clinical effect of laparoscopic right hemicolectomy by using three-hole method. Methods From November 2009 to December 2014, a retrospective analysis of laparoscopic right hemicolectomy of 95 patients were performed, including 47 cases in five holes group and 48 cases in three holes group.Clinical data were analyzed by using statistical software SPSS 19.0.Measurement data such as perioperative indicators were expressed as mean ±standard deviation(-x ±s), and were examined by using t test.Count data, such as postoperative complication rate and survival rate , were expressed as %, and were examined by using χ2 test.A P value <0.05 was considered as statistically significant difference. Results There were no significantly differenence between χ2 groups in terms of intraoperative blood loss and harvested lymph nodes.Compared with five holes group, operation time, exhaust time, feeding time and drainage time in three holes group were significantly decreased .There were postoperative increase of blood WBC、 CRP and IL-6 in both two groups (P <0.05), however five-hole group were significantly higher than that of the three-hole group (P <0.01).The 12-month survival rate (97.9%) of three holes group was higher than 93.6% of five holes group (χ2 =2.16, P <0.05).The 18-month survival rate (93.8%) of three holes group was higher than 89.4% of five holes group (χ2 =3.67, P <0.05).The 18-month survival rate (91.7%) of three holes group was higher than 82.9% of five holes group (χ2 =4.01, P <0.05).The total number of recurrence, metastasis and complication in the three -hole group was 75 (14.58%) lower than 14 (19.79%) in the five-hole group. Conclusion Minimally invasive surgical procedure by using three -hole method is superior to conventional five -hole method, with higher survival rate, lower recurrence and complication rate.it is worth clinical wider application .

Objective To explore the clinical advantages of the un-cut Roux-en-Y esophagojejunostomy compared with ρ-looped jejunal pouch Roux-en-Y esophagojejunostomy in patients undewent total gastrectomy,to provide the reference for the reconstruction of digestive tract after total gastrectomy.Methods From Jan 2012 to May 2016,62 patients underwent total gastrectomy were enrolled in thi study,including the 31 cases in un-cut Roux-en-Y esophagojejunostomy group (URY group) and 31 cases in the p-looped jejunal pouch Roux-en-Y esophagojejunostomy group (PRY group).Follow-up were performed within 12 months after surgery.Statistical analysis were performed by using SPSS 22.0 software.Measurement data were expressed as mean ± standard deviation ((x) ± s),and were examined by using t test,including operation time,hospital stay,nutrition indicators.Count data,such as postoperative complication rate,mortality,gastrointestinal complications after reconstruction indicators and quality of life indicators,were expressed as ％,and were examined by usingx2 test.A P value ＜0.05 was considered as statistically significant difference.Results In terms of operation time,length of hospital stay,complications and death cases in URY group were significantly better than those in PRY group respectively,with significant difference (t =3.728,P =0.003;t =4.002,P =0.002;x2 =3.649,P =0.010;x2 =4.334,P =0.001).The change of total protein and the indicators of nutrition in URY group were significantly superior than those in PRY group,with significant difference (t =3.886,P =0.011;t =3.922,P =0.002).The incidences of postoperative complications (abdominal distention,dumping syndrome in December,reflux esophagitis and Visick grading) in URY group were significantly lower than those in PRY group,with significant difference (x2 =2.952,P =0.032;x2 =4.004,P =0.021;x2 =3.441,P =0.014;x2 =3.940,P =0.003).The score in URY group was significantly higher on 3 months and 6 months after surgery than those in PRY group (t =3.802,P =0.030;t =4.036,P =0.012).Conclusion The URY surgery had the characteristics of fast,efficient,fewer complications and good safety,with high clinical value for the reconstruction of digestive tract after total gastrectomy.

PURPOSE:Colorectal cancer (CRC) is a frequent malignant tumor with high death rate and poor prognosis. Few reports have explored the association between CRC development and long non-coding (lnc) RNAs expression. This study focused on the important role of a novel lncRNA XIST in the development of CRC.METHODS:To investigate the function of long lncRNA XIST in CRC, its expression level was monitored in both CRC cells and 50 pairs of human CRC tissues and adjacent tissues by RT-qPCR. Moreover, the associations between lncRNA XIST expression level and clinicopathological characteristics and 5-year survival rate of CRC patients were evaluated. Furthermore, function assays containing cell proliferation assay, flow cytometry and colony formation were conducted to investigate the role of lncRNA XIST in CRC. Western blotting assay and luciferase assay were used to explore the regulation mechanism of lncRNA XIST in the development.RESULTS:The expression level of XIST was significantly increased in both CRC tissues sample and CRC cells. XIST promoted CRC cell proliferation by affecting the cell cycle. In addition, XIST and miR-132-3p were inhibited by each other reciprocally. MAPK1 was proved to be a direct target spot of miR-132-3p. We claim that XIST was responsible for CRC cell proliferation working by the miR-132-3p/MAPK1 axis.CONCLUSION:The present study suggests that lncRNA XIST is a potential oncogene in CRC, and could promote CRC cell proliferation through inhibiting miR-132-3p, which may provide a new therapeutic target of CRC.

tumor with high death rate and poor prognosis. Few reports have explored the association between CRC development and long non-coding (lnc) RNAs expression. This study focused on the important role of a novel lncRNA XIST in the development of CRC. Methods: To investigate the function of long lncRNA XIST in CRC, its expression level was monitored in both CRC cells and 50 pairs of human CRC tissues and adjacent tissues by RT-qPCR. Moreover, the associations between lncRNA XIST expression level and clinicopathological characteristics and 5-year survival rate of CRC patients were evaluated. Furthermore, function assays containing cell proliferation assay, flow cytometry and colony formation were conducted to investigate the role of lncRNA XIST in CRC. Western blotting assay and luciferase assay were used to explore the regulation mechanism of lncRNA XIST in the development. Results: The expression level of XIST was significantly increased in both CRC tissues sample and CRC cells. XIST promoted CRC cell proliferation by affecting the cell cycle. In addition, XIST and miR-132-3p were inhibited by each other reciprocally. MAPK1 was proved to be a direct target spot of miR-132-3p. We claim that XIST was responsible for CRC cell proliferation working by the miR-132-3p/MAPK1 axis. Conclusion: The present study suggests that lncRNA XIST is a potential oncogene in CRC, and could promote CRC cell proliferation through inhibiting miR-132-3p, which may provide a new therapeutic target of CRC.

Objective To compare and analyze the efficacy of laparoscopic and open surgery in the treatment of patients with advanced colon cancer.Methods 78 cases of patients with colorectal cancer,including 25 cases with traditional open surgery and laparoscopic surgery 53 cases,compare with intraoperative blood loss,surgery duration,number of resected lymph nodes and positive margin rate;postoperative hospital stay,pain in continuous time,eating time;and 1-,3-,5-year survival rate in the 2 groups of patients.Results In intraoperative,bleeding volume and operation time in laparoscopic surgery groups were better than traditional open surgery;recovery after surgery,in spectroscopy surgery groups patients with low trauma were recovered significantly faster than the laparotomy group;in the postoperative prognosis,open resection of colon cancer was better than laparoscopic resection.Conclusion Laparoscopic resection of colon cancer has obvious advantages of lower trauma,but long-term prognosis is less than laparotomy.

The histone deacetylase (HDACs) family contains a family of enzymes, which are involved in modulating a wide range of cellular processes, such as proliferation, differentiation, apoptosis, and cell cycle progression. However, the biological function of HDAC5 in colorectal cancer has not been well established. In the current research, our data showed that the mRNA and protein levels of HDAC5 were up-regulated in human colorectal cancer cell lines. CCK-8 assay showed that overexpression of HDAC5 significantly promoted the proliferation of colorectal cancer cell lines including SW480 and HCT116. On the contrary, HDAC5 knockdown using small interfering RNA suppressed cell growth in colorectal tumor cells. At the molecular level, we demonstrated that HDAC5 promoted the expression of DLL4. In addition, down-regulation of DLL4 diminished the proliferative effects of HDAC5 in human colorectal cancer cells. Taken together, these results suggest that HDAC5 elevates the proliferation of colorectal cancer cells through up-regulation of DLL4. The current study might provide novel potential therapeutic targets in the treatment of colorectal cancer.

Objective To evaluate the therapeutic effect of laparoscopic and open radical resection on rectal carcinoma.Methods The clinical data of 235 cases of rectal carcinoma operated in in our hospital from January 2006 to December 2012 were analyzed retrospectively.Among them,132 cases underwent laparoscopic radical resection of rectal carcinoma and 103 cases underwent open radical resection of rectal carcinoma.The mean operation time,the intra-operative blood loss,the number of cleared lymph nodes,the length of distal margin of rectal anterior resection,the exsufflation time,the intake time of liquid diet,the intake time of solid diet,the duration of urethral catheterization,the short term postoperative complications,the length of hospitalization and the cost of hospitalization and the survival of the patients were compared between the two groups.Results There were no severe complications or dead cases occurring in both groups.Five cases in the laparoscopic group were converted to open during the operations.The mean operation time of laparoscopic group and open group was (258 ± 76) min and (186 ± 18) min respectively,the difference between two groups was statistically significant (P ＜ 0.05).The intra-operative blood loss of laparoscopic group was significantly less than that of open group [(144 ± 22) ml vs (320± 30)ml,P ＜ 0.05].The number of cleared lymph nodes between two groups had no significant difference [(12.5 ± 2.4) vs (11.5 ± 3.4),P ＞ 0.05].The length of distal margin of rectal anterior resection in the laparoscopic group was obviously longer than that in the open group [(3.5 ± 0.6) cm vs (2.9 ± 0.5) cm,P ＜ 0.05].The function recovery of gastrointestinal and urinary of laparoscopic group was more quickly than that of open group [(2.1 ± 0.8) vs (3.5 ± 1.2) d for period of exhaust ; (2.4 ± 0.7) d vs (3.6 ± 0.8) d for intake of liquid diet ;(3.5 ± 1.2) d vs (4.6 ± 1.3) d for intake of solid diet ; (2.4 ± 0.3) d vs (4.5 ± 1.1) d for duration of urethral catheterization,all P ＜ 0.05].The length of hospitalization in the laparoscopic group was shorter than that in the open group [(8.6 ± 0.8) d vs (12.7 ± 0.9) d,P ＜ 0.05].But the cost of hospital stay in the laparoscopic group was higher than that in the open group[(3.72 ±0.36) × 104 RMBs vs (2.54 ±0.24) × 104 RMBs,P ＜0.05].127 cases in the laparoscopic group and 99 cases in the open group received follow-up for 12-102 months.The survival rates of 1 year,3 year and 5 year between the two groups had no statistically significant (P ＞ 0.05).Conclusion The laparoscopic radical resection of rectal carcinoma is safe and effective.

Objective:To explore the clinical manifestations,treatment and particularity of patients with hemobilia taking anticoagulant in perioperative period.Method:The clinical manifestations,diagnosis and treatment process of 23 cases with hemobilia in our hospital from January 1998 to December 2012 were analyzed retrospectively.Result:Most of patients with biliary tract hemorrhage of upper gastrointestinal bleeding symptoms,there were 6 cases with cholangitis as the first symptom.Can generally be found by B-ultrasound and CT primary lesion,and the celiac artery through duodenoscopy angiography.12 cases were given surgery,4 cases selective arterial embolization,conservative treatment in 7 cases.For patients taking warfarin anticoagulation vitamin K1 was available,depending on the circumstances of aspirin treatment in patients with perioperative available low molecular weight heparin(LMWH) transition.19 cases cured,accounting for 82.6%,4 cases were deaths,accounting for 17.4%.Conclusion:The good results of hemilia patient could be achieved by accurate diagnosis,exact operation and active perioperative management or effective conservative therapy.

Objective To summarize our experience of laparoscopic cholecystectomy(LC)in the treatment of acute cholecystitis.Methods Totally 212 cases of acute cholecystitis underwent LC in our hostpial from January 2004 to January 2009.During the operation,we performed intraoperative gallbladder decompression to the impacted stone back into the gallbladder,and restore the anatomical relationship of the Calot triangle.Afterwards,the cystic duct and cystic artery closed to the gallbladder neck were separated,and titanium or absorbable clips was used after ligation of the thickening cystic duct with 7# suture;in patients with local heavy disease and unclear triangle anatomy,the residual gallbladder underwent electrocoagulation to destroy the mucosa and then the gallbladder stump was sutured;for patients with short cystic duct,we used a titanium clip to sever the cystic duct after exploring the relationship among the cystic duct,hepatic duct and common bile duct,the gallbladder neck was remained to prevent the titanium clip from falling off.Abdominal drainage was employed in all of the patients postoperatively.Results LC was completed in 201 patients,the other 11 patients were converted to open surgery because of Mirizzi syndrome type Ⅰ(2 cases),close adhesion between the gallbladder,stomach,duodenum,and transverse colon(2 cases),and severe adhesion of the gallbladder triangle resulting in an unclear anatomy(7 cases).Four patients developed biliary leakage after the surgery and was then cured by conservative therapy.Totally 186 patients received follow-up for 1-12 months(mean,4.6 months),during which no residual stones or complications occurred.Conclusions LC is feasible and safe for patients with acute cholecystitis.Deep understanding of LC technique,correct position for abdominal drainage and appropriate time for conversion to open surgery are keys to success of the operation.

Objective To report our experience on laparoscopic cholecystectomy(LC) for elderly patients with cholecystitis and cardiopulmonary diseases.Methods Totally 225 elderly patients,who had undergone laparoscopic cholecystectomy in our hospital between January 2000 and June 2008,were retrospectively analyzed. Results Among the cases,LC were completed in 222 patients,the other 3 were converted to open surgery.No bile duct injury or biliary leakage occurred.After the operation,7 cases developed pulmonary infection,and 3 cases showed urinary infection,all of them were cured by antibiotics.Three cases suffered from cardiac ischemia without further damage.Conclusions With strict enrollment criteria,careful preoperative preparation,skillful operation,and intensive intra-and postoperative monitor,the LC is safe for elderly patients as a minimally invasive surgery.

cteristic manifestation.Endoscopy and image examinations play an important role in detecting lesions of GIST,but the final diagnosis depends on pathological examination.Surgical local resection is an effective treatment procedure for GIST.

Objective To study the surgical techniques and effects of laparoscopy-assisted sigmoid colon vaginoplasty.MethodsClinical data of 27 patients,who underwent laparoscopy-assisted sigmoid colon vaginoplasty at Beijing Anzhen Hospital between June 2006 and June 2007,were retrospectively analyzed.A 15-cm segment of pedicled sigmoid colon was isolated using an ultrasound knife.The distal end of the segment was pulled into the vaginal space in the cul-de-sac of Douglas under a laparoscopic vision as the neovagina.The continuity of the intestinal tract(end-to-end bowel anastomosis) was restored using a circular mechanical suture through the rectum.ResultsThe surgery was successfully completed in all the cases,no intra-operative complication occurred.The mean blood loss and operation time was 82 ml(50-180 ml) and 168 min(120-246 ml) respectively.One patient developed incomplete intestinal obstruction 16 days after the operation,and was cured by conservative treatment.Follow-up was available in 21 patients for 14-20 months.Five patients had no sexual partner during the follow-up,while the other 16 patients were satisfied with their sexual lives after the surgeries.ConclusionLaparoscopic vaginal reconstruction using a sigmoid colon segment is satisfying for cosmetic,functional,and anatomic results.

心脏瓣膜置换术后,患者长期服用华法林以预防瓣膜血栓形成.在抗凝下行急诊手术增加术中和术后出血的危险性,影响患者的预后.1997年6月至2007年6月我院收治25例心脏瓣膜置换术后急腹症患者,效果满意,报告如下.

Objective To study the alteration of CK20mRNA in the peripheral blood samples by laparoscope and open radical operation of colorectal carcinoma micrometastasis, and investigate the value of laparoscopic surgery in with colorectal cancer. MethodsThe expression of CK20mRNA in the peripheral blood samples of 37 patients with colorectal carcinoma and 8 patients with non-malignant disease by operations on abdomen. Results The expressions of CK20mRNA are negative in the peripheral blood samples of 8 patients with non-malignant disease by operations on abdomen. Meanwhile, the total positive rate of expression with CK20mRNA are 39.6%(44/111)in the patients with colorectal carcinoma. The positive expression rates of CK20mRNA in patients of the two groups pre-, during and post-operation do not have significant difference(P>0.05). Conclusion There are no significant differences in the efficacy of radical operation in patients with colorectal carcinoma by laparoscope and open radical surgery.

Objective To investigate the characteristics of laparoscopic cholecystectomy(LC) in the elderly. Methods A retrospective analysis was made on clinical data of 118 elderly patients treated with LC in this hospital between January 2000 and January 2005. Results The LC was successfully completed in 116 patients,while conversions to open surgery were required in 2 patients due to low level of insertion of the cystic duct(1 patient) and common bile duct injury(1 patient).The operation time was(30~120 min)(mean,50 min).The postoperative recovery was uneventful in all the patients.The length of hospital stay after operation was 3~7 d(mean,4.5 d).The patient with common bile duct injury was followed for 2 years and 6 months.Transient onsets of abdominal pain and fever were noted and cured with antibiotics for 2~5 days.No biliary tract stenosis or bile duct calculus was seen.Follow-up observations in the remaining 117 patients for 6~12 months(mean,10.5 months) revealed no abdominal pain,fever,or jaundice. Conclusions Laparoscopic cholecystectomy is acceptable and safe for elderly patients.Proper peri-operative management and careful surgical performance are essential to the success of surgery.

Objective To explore the procedures and the clinical significance of total laparoscopic vaginoplasty using a vascularized pedicled ileal flap. Methods A retrospective analysis was made on 13cases of total laparoscopic vaginoplasty by using a vascularized pedicled ileal flap. Results Operations were successfully completed in all the 13cases. Short-term complications in the immediate postoperative period included 1case of intestinal obstruction,which was cured by a secondary surgery, and 2 cases of stricture of vaginal orifice,which were cured by a vaginal dilatation and an orifice reconstruction respectively. 10 cases were followed up for 3～6 months. No abnormal smelling vaginal discharge were found in 7cases and mild abnormal smelling in 3cases. Among 6 patients who had sexual life,5 were satisfied with their sexual experience, 1 had small amounts of hemorrhage. Conclusions Total laparoscopic vaginoplasty using a vascularized pedicled ileal flap is safe and effective. It may meet most expectations of the patients, It is an ideal approach of minimal invasive vaginoplasty.

目的总结心肌梗死病人急腹症的围手术期处理体会.方法分析1998～2001年收治的18例病人的临床资料.结果 18例病人其心功能Ⅰ～Ⅱ级13例,Ⅲ级5例;5例心功能Ⅲ级病人行超声心动图检查,射血分数为40.4%～46.2%,术中行中心静脉压监测;18例术中、术后均静脉滴注0.5～2蘥*kg-1*min-1硝酸甘油,未出现心肌缺血的症状.术后2例肺部感染,1例死亡.结论患心肌梗死的围手术期处理中,硝酸甘油对再次心肌梗死的发生有很好的预防作用.