Evaluating the initial result of transanal and transvaginal NOTES for colorectal cancer

Objective: Natural Orifice Transluminal Endoscopic Surgery (NOTES) is an important evolution in minimally invasive surgery (MIS) nowaday. This paper presents the techniques and early results of the pure transanal and transvaginal laparoscopies (NOTES) used for the treatment of colorectal cancer. Material and method: Prospective studies were conducted at Hue Central Hospital, Vietnam. Patients: From December 2013 to September 2015, 22 cololorectal cancer patients (18 rectum, 3 sigmoid tumors and 1 descending colon), adenocarcinoma, T≤ T3N1M0. Methods: The patients were placed in lithotomy and Trendelenburg positions, and the lone-star retractor was placed in the anus (rectum cancer) or vagina (sigmoid cancer). The surgical cavity was then inflated with CO 2 and set at 12 mm/Hg. Dissection was continued until inside of the abdominal cavity (transanal technique). After that, the rectum was pushed into the abdominal cavity. The IMA and IMV were divided (TME included) in both techniques. After finishing dissection, the specimens were pulled out through the anus or vagina to prepare anastomosis. Coloanal and colorectal anastomosis were either hand-sewn (6 cases) or sealed with EEA staplers (16 cases). Results: 2 patients needed one more 5 mm umbilical port in RLQ, 2 patients needed two 5 mm trocars (post radiation hemorrhage, and urethral perforation). One patient converted to open and 1 patient converted to the HYBRID-NOTES procedure. The operation time was 258±40 (190-300) minutes. All patients required minimal analgesia. Bowel movement returned on the first day to 16 patients (average: two days, maximum: three days). The hospital stay was 7±2.8 (4-14) days. Kirwan classification (sphincter function) was very good (stage I: 18). Conclusions: Pure transanal and transvaginal laparoscopies for the treatment of colorectal cancer are feasible and safe. We believe that this is the first pure transvaginal laparoscopy (NOTES) for human in the world. A multicentric study in a large numbers of patients and a long follow-up is necessary

Investigation of acute, sub-chronic toxicity, effects of mangiferin and mangiferin solid dispersion (HPTR) on Triton WR1339-induced hyperlipidemia on Swiss albino mice

Mangiferin is a xanthonoid found in Mango leaves in abundance with many effects as a hypoglycemic, antioxidant, and anti-inflammatory agent, plant metabolite, and so on. However, nowadays, mango leaves are merely a waste product in Vietnam. To take advantage of this valuable medicinal resource, extraction conditions of mangiferin using classical and ultrasound methods were researched, and mangiferin was purified from Cat Chu mango leaves (Mangifera indica L., Anacardiaceae) collected in Dong Thap. Ultrasound-assisted extraction method was conducted with the following conditions and mangiferin was extracted at a percentage of 6.728% with a purity of 91.11%. Purified mangiferin was evaluated using molecular absorption spectroscopy UV-Vis, scanning electron microscopy (SEM), X-ray diffraction (XRD) spectroscopy, simultaneous thermal analysis (STA: TGA/DSC), and dissolution measurement method. To optimize the solubility and permeability of mangiferin, the solid dispersion system (HPTR) was made by the combination of HPMC 6M:mangiferin at the ratio of 1:5. To investigate the acute, sub-chronic toxicity and hypolipidemia effect of HPTR as compared to purified mangiferin, we followed guidelines for preclinical and clinical trials of Traditional Medicine and Herbal Medicines by the Vietnam Ministry of Health and OECD, and used tyloxapol (Triton WR1339, 400 mg/kg, i.p.) to induce hyperlipidemia. Our results indicated that purified mangiferin and HPTR extract showed no acute toxicity and sub-chronic toxicity and has potential as an antihyperlipidemic agent. The HPTR brought about a significant decrease in total cholesterol, triglycerides and LDL-c when compared to mangiferin, however there was no significance between them

The first genome sequences of human bocaviruses from Vietnam

As part of an ongoing effort to generate complete genome sequences of hand, foot and mouth disease-causing enteroviruses directly from clinical specimens, two complete coding sequences and two partial genomic sequences of human bocavirus 1 (n=3) and 2 (n=1) were co-amplified and sequenced, representing the first genome sequences of human bocaviruses from Vietnam. The sequences may aid future study aiming at understanding the evolution of the virus

Reclamation of beneficial bioactivities of herbal antioxidant condensed tannin extracted from Euonymus laxiflorus

[[abstract]]Natural condensed tannins (CT) have received great interest due to their vast beneficial bioactivities. Recently, Euonymus laxiflorus, an edible medicinal herb collected in the Central Highlands of Vietnam, was newly recognized as a natural source rich in antioxidant CT. The aim of this study is to scale up extraction and investigate various novel bioactivities of the isolated CT. The screening of the parts used rich in CT, such as heartwood, trunk bark, branch, and the leaves of EL, indicated that the EL trunk bark (ELTB) has the highest CT content. E. laxiflorus CT (ELCT) was extracted with high-level scale from ELTB via several techniques and then was qualified by NMR spectra and HPLC finger printing. A condensed tannin ELBT-3.1.d was isolated and showed its high molecular weight of ≥ 10 kDa and various in vitro bioactivities. ELBT-3.1.d demonstrated high antioxidant capacity (IC50 = 6.11 µg/mL), and potent enzymes inhibition targets in anti-diabetes, especially showing novel potential inhibition against human salivary α-amylase with IC50 value of 3.01 µg/mL. ELBT-3.1.d displayed no anti-NO effect but did show moderate to effective anticancer activities against A549, MCF-7, HepG2, and WiDr. Notably, condensed tannin ELBT-3.1.d displayed no toxicity to normal cells and a novel potential prebiotic effect on Lactobacillus paracasei BCRC14023 and Lactobacillus rhamnosus BCRC16000. In the animal test, ELCT demonstrated significant effect on reducing plasma glucose in mice at the doses of 50–100 mg/kg BW. The current study contributes to enrich the novel bioactivities of ELCT which may be suggested as functional food or drugs due to processing numerous beneficial bioactivities.[[sponsorship]]MOST[[notice]]補正完

Multimodal analysis of methylomics and fragmentomics in plasma cell-free DNA for multi-cancer early detection and localization

Despite their promise, circulating tumor DNA (ctDNA)-based assays for multi-cancer early detection face challenges in test performance, due mostly to the limited abundance of ctDNA and its inherent variability. To address these challenges, published assays to date demanded a very high-depth sequencing, resulting in an elevated price of test. Herein, we developed a multimodal assay called SPOT-MAS (screening for the presence of tumor by methylation and size) to simultaneously profile methylomics, fragmentomics, copy number, and end motifs in a single workflow using targeted and shallow genome-wide sequencing (~0.55×) of cell-free DNA. We applied SPOT-MAS to 738 non-metastatic patients with breast, colorectal, gastric, lung, and liver cancer, and 1550 healthy controls. We then employed machine learning to extract multiple cancer and tissue-specific signatures for detecting and locating cancer. SPOT-MAS successfully detected the five cancer types with a sensitivity of 72.4% at 97.0% specificity. The sensitivities for detecting early-stage cancers were 73.9% and 62.3% for stages I and II, respectively, increasing to 88.3% for non-metastatic stage IIIA. For tumor-of-origin, our assay achieved an accuracy of 0.7. Our study demonstrates comparable performance to other ctDNA-based assays while requiring significantly lower sequencing depth, making it economically feasible for population-wide screening