Clinical study of open versus laparoscopic management for gastroduodenal perforation

Background: This study was organized to compare the clinical efficacy of laparoscopic and open repair of gastroduodenal perforation, and to provide the impressive surgical method of treatment for gastroduodenal perforation.Methods: The present study was conducted with 174 consecutive patients treated for gastroduodenal perforations. These patients included 121 with perforated gastric ulcers, 53 with perforated duodenal ulcers, Whereas 31 patients were treated laparoscopically, and 143 patients underwent conventional (open) surgery.Results: A total of 174 patients were studied with men and women ratio of 4:1. This observational study revealed 80% male preponderance, with mean age of 48 years. Gastric perforations (n=77, i.e., 84.62%) were more common than duodenal perforations (n=14, i.e., 15.38%). Simple closure with omental patch (n=74, i.e., 81.32%) was the most common surgical method for duodenal perforation. While for gastric perforations were repaired primarily with two layered sutures.  The mean operating time of open were 61 min and 86 min for laparoscopic surgery. Wound infection was the commonest post-operative complication which was seen in 31 (17.81%) patients.Conclusions: Laparoscopic gastroduodenal perforation repair is safe and reliable, has good clinical efficacy, the incidence of complications compared with open surgery does not increase, and has less surgical trauma, less bleeding, advantages of fast recovery of gastrointestinal function and short hospitalization time, Thus it has great clinical significance and should be promoted in surgery

Galectin-1 Promotes Metastasis in Gastric Cancer Through a Sphingosine-1-Phosphate Receptor 1-Dependent Mechanism

Background/Aims: Increased expression of galectin-1 (Gal-1) in gastric cancer (GC) promotes metastasis and correlates with poor prognosis. The mechanisms by which Gal-1 promotes GC metastasis remain unknown. Methods: Gal-1and Sphingosine-1-phosphate receptor 1 (S1PR1) were determined by immunohistochemistry(IHC) and quantitative real time polymerase chain reaction (qRT-PCR) in GC specimens. Stably transfected Gal-1 or S1PR1 into SGC7901 and MGC-803 cells, western blot and invasion assays in vitro and nude mice tumorigenicity in vivo were also employed. Results: Overexpression of Gal-1 enhanced expression of S1PR1 in SGC-7901 cells, and increased cell invasion, while knockdown Gal-1 in MGC-803 cells reduced S1PR1 expression and diminished invasion. Simultaneous knockdown of Gal-1 and overexpression of S1PR1 in MGC803 cells rescued invasive ability of MGC803 cells. S1PR1 was associated with expression of epithelial-to-mesenchymal transition (EMT) markers in vitro and in clinical samples. EMT induced in MGC-803 cells by TGF-β1 was accompanied by S1PR1 activation, while knockdown of S1PR1 reduced response to TGF-β1, suggest that Gal-1 promotes GC invasion by activating EMT through a S1PR1-dependent mechanism. Overexpression of S1PR1 promoted subcutaneous xenograft growth and pulmonary metastases, and enhanced expression of EMT markers. Conclusion: Galectin-1 promotes metastasis in gastric cancer through a S1PR1- dependent mechanism, our results indicate that targeting S1PR1 may be a novel strategy to treat GC metastasis

Clinicopathological and prognostic significance of HER-2/neu and VEGF expression in colon carcinomas

<p>Abstract</p> <p>Background</p> <p>HER-2/neu and VEGF expression is correlated with disease behaviors in various cancers. However, evidence for their expression in colon cancer is rather contradictory both for the protein expression status and prognostic value. HER-2/neu is found to participate in VEGF regulation, and has known correlation with VEGF expression in some tumors. In this study, we investigated HER-2/neu and VEGF expression in Chinese colon patients and explored whether there was any correlation between their expression patterns.</p> <p>Methods</p> <p>HER-2/neu and VEGF were investigated immunohistochemically using tumor samples obtained from 317 colon cancer patients with all tumor stages. Correlation of the degree of staining with clinicopathological parameters and survival was investigated.</p> <p>Results</p> <p>Positive expression rates of HER-2/neu and VEGF in colon cancer were 15.5% and 55.5% respectively. HER-2/neu expression was significantly correlated with tumor size and distant metastases (<it>P </it>< 0.05), but was not an independent prognostic marker of survival <it>(P > 0.05)</it>. Expression of VEGF was significantly correlated with tumor size, tumor stage, lymph node metastases, and distant metastases (<it>P </it>< 0.05). The 5-year survival rate in patients with negative and positive VEGF expression was 70.2% and 61.9% respectively; the difference was not statistically significant <it>(P = 0.146)</it>. No correlation between HER-2/neu and VEGF expression was detected (<it>P = </it>0.151).</p> <p>Conclusions</p> <p>HER-2/neu and VEGF are not important prognostic markers of colon cancer. The present results do not support any association between HER2/neu and VEGF expression in this setting.</p

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Postoperative outcomes in robotic gastric resection compared with laparoscopic gastric resection in gastric cancer: A meta‐analysis and systemic review

Abstract Background Robotic gastrectomy is a commonly used procedure for early gastric cancer and it also overcomes the limitation of laparoscopic. However, the complications of robotic gastrectomy (RG) still need to be assessed. Our study was designed to compare postoperative complications of RG with laparoscopic gastrectomy (LG). Materials and Methods A meta‐analysis and systemic review were prospectively collected using the PubMed, Cochrane Library, and MEDLINE database of published studies by comparing the RG and LG with gastric cancer up to December 2021. To evaluate the postoperative outcomes, odds ratios were calculated for Dichotomous data and the mean difference with 95% confidence interval (CI) was calculated for continuous data, and measured by the random‐effect model. Results Thirty‐two retrospective studies describing 13,585 patients (4484 RG and 9101 LG) satisfied the inclusion criteria. A statistically significant result was in blood loss (MD = −17.97, 95% Cl: −25.61 to 10.32, p < 0.001), Clavien−Dindo grade Ⅲ (odds ratio (OR) = 0.60, 95% CI: 0.48−0.76, p < 0.01), and harvested lymph node (MD = 2.62, 95% CI: 2.14−3.11, p < 0.001). There was no significant difference between robotic gastrectomy surgery (RGS) and laparoscopic gastrectomy surgery (LGS) regarding distal resection margin (DRM), proximal resection margin (PRM), conversion rate, anastomotic leakage, and overall complications. Conclusion Having significant outcomes in Clavien–Dindo grade III, and blood loss, harvested lymph nodes are more common in RGS, and they also help in increasing the quality of life

Petrology and Tectonic Geophysics of Massive and Foliated Eclogites in the North Qilian Orogenic Belt: Changes in Mineral Composition, Oxygen Fugacity, and Fabric during Exhumation

The North Qilian orogenic belt is a typical area of “cold” subduction of the early Paleozoic oceanic plate, forming a series of high pressure and low temperature metamorphic rock assemblages. Among them, eclogite is a kind of protolith, which is basaltic or gabbro high pressure metamorphic rock, mainly composed of garnet and chlorite which are two kinds of minerals. Eclogites record the entire history of subduction zone metamorphism and later exhumation. Due to the crystal habit and the developed joints, the strength of the pyroxene in the matrix is weak, so it is subjected to the main strain during deformation, whereas garnet tends to show only passive rotational deformation. This paper presents some new results in petrology and tectonic geophysics of eclogite block-like and planar eclogite. The massive and facial eclogite rocks contain eclogite facies mineral assemblages, and the peak temperature and pressure conditions are t=450~520°C and P=1.9~2.3 GPa, which are consistent with the adjacent eclogite. Combined with the characteristics of in situ Lu-Hf isotopes, Ce4+/Ce3+ ratios of zircons, relative oxygen fugacity, and absolute oxygen fugacity, it is shown that the oxygen fugacity of the granodiorite porphyry (BL023, BLO31, DB048) of the folio chemical and massive eclogite deposits are all located in MH (magnetite-hematite) buffer zone. Through the calculation results of absolute oxygen fugacity of rock mass, it can be seen that the absolute oxygen fugacity of ore-bearing rock mass is significantly higher than that of non-ore-bearing rock mass. This paper systematically summarizes the research progress of the microscopic and ultrastructural deformation of eclogite minerals in high-pressure metamorphic zones, and discusses the changes of mineral composition, oxygen fugidity, and fabric of eclogite deformation characteristics during the recovery of subduction and reentry

Robotic versus laparoscopic surgery for rectal cancer in male urogenital function preservation, a meta-analysis

Abstract Background Urogenital dysfunction after rectal cancer surgery can largely affect patients’ postoperative quality of life. Whether robotic surgery can be a better option when comparing with laparoscopic surgery is still not well-known. Methods Comprehensive search in PubMed, Embase, Cochrane Library, and Clinical Trials was conducted to identify relevant studies in March 2018. Studies comparing robotic surgery with laparoscopic surgery were included. Measurement of urogenital function was through the International Prostate Symptom Score and International Index of Erectile Function. Results Six studies with 386 patients in robotic group and 421 patients in laparoscopic group were finally included. Pooled analysis indicated that bladder function was better at 12 months in the robotic group after the procedures (mean difference, − 0.30, 95% CI, − 0.52 to − 0.08). No significant difference was found at 3 and 6 months postoperatively (mean difference, − 0.37, 95% CI, − 1.48 to 0.73; mean difference, − 1.21, 95% CI, − 2.69 to 0.28). Sexual function was better at 3 months in the robotic group after surgery (mean difference, − 3.28, 95% CI, − 6.08 to − 0.49) and not significantly different at 6 and 12 months. (mean difference, 3.78, 95% CI, − 7.37 to 14.93; mean difference, − 2.82, 95% CI, − 8.43 to 2.80). Conclusion Robotic surgery may offer faster recovery in urogenital function compared to laparoscopic surgery for rectal cancer