Compared with colorectal adenocarcinoma,neuroendocrine neoplasms(NENs),which affect the colon and rectum,are uncommon tumor conditions that have received relatively limited attention in basic research.Furthermore,the ...Compared with colorectal adenocarcinoma,neuroendocrine neoplasms(NENs),which affect the colon and rectum,are uncommon tumor conditions that have received relatively limited attention in basic research.Furthermore,the scarcity of these NENs has hindered extensive clinical investigations,thereby leading to a dearth of robust evidence for guiding clinical practice and impeding the establishment of standardized approaches for diagnosis and treatment.However,with the increasing awareness of population screening,as well as the increasing popularity of colonoscopy screening programs,the incidence of colorectal NENs has gradually increased.Moreover,some high-grade NENs are highly malignant and invasive,thereby leading to poor treatment outcomes and prognoses.These challenges have elicited increased attention from clinical physicians,thus prompting researchers to explore relevant studies using limited specimens and clinical data.This scenario has resulted in preliminary findings that provide evidence for addressing diagnostic and therapeutic challenges associated with NENs of the colon and rectum.In this article,we review recent literature reports and summarize the advances regarding the diagnosis and treatment of colorectal NENs.展开更多
Background:We present a case of two major complications following insertion of a nephrostomy managed in a minimally invasive way.Our case is the first in the literature to describe this minimally invasive treatment te...Background:We present a case of two major complications following insertion of a nephrostomy managed in a minimally invasive way.Our case is the first in the literature to describe this minimally invasive treatment technique for colon perforation in a completely asymptomatic patient.Case Description:A 75-year-old female patient with a history of bilateral obstructive uropathy secondary to bilateral radiation-induced ureteric strictures attended for bilateral nephrostomy placement.The patient had a history of endometrial cancer,treated previously by total hysterectomy and bilateral salpingo-oophorectomy with adjuvant chemo-radiotherapy and brachytherapy.Her recovery had been further complicated by the development of radiation cystitis,small bowel resection,and short gut syndrome.The strictures had previously been managed with bilateral double J stents,which have now failed.A left-sided nephrostomy insertion was performed.ACT-scan prompted by a repeat deterioration in renal function revealed a right-sided hydronephrosis and suggested transcolic passage of the previously placed leftsided nephrostomy.She had remained clinically well and apyretic.A right-sided nephrostomy was inserted,and the left re-sited following a colonoscopy-guided nephrostomy removal and clip occlusion of the nephrostomy tract.The patient then developed a pseudoaneurysm,which was managed with embolization.The patient was able to return home with corrected kidney function.The three-monthly checks for changes in nephrostomy catheters did not reveal any complications.Conclusions:The patient therefore presented with two major complications of nephrostomy placement:colonic perforation and pseudoaneurysm,classified as Clavien IIIb and IIIa,respectively.Multidisciplinary management,including urologists,gastroenterologists,general surgeons,and radiologists,enabled a minimally invasive management.Minimally invasive management with endoscopic clip placement appears to be a safe alternative to directed fistula of colonic perforation.展开更多
Background Weaning-induced diarrhoea and growth retardation in piglets are associated with impaired intestinal barrier function and decreased levels of colonic short-chain fatty acids(SCFAs).Although SCFA supplementat...Background Weaning-induced diarrhoea and growth retardation in piglets are associated with impaired intestinal barrier function and decreased levels of colonic short-chain fatty acids(SCFAs).Although SCFA supplementation has been proposed to mitigate these issues,the efficacy and optimal dosage of sodium isobutyrate remain unclear.Results We investigated the effects of sodium isobutyrate supplementation(500,1,000,2,000,and 4,000 mg/kg diet)on weaned piglets(Duroc×Landrace×Yorkshire,28 d of age;n=8).After a 28-d feeding trial,supplementation at 500–2,000 mg/kg significantly improved average daily gain and feed efficiency and reduced diarrhoea frequency,with maximal benefits observed at 1,000 mg/kg(P<0.0001).Additionally,500–1,000 mg/kg sodium isobutyrate supplementation increased the apparent digestibility of crude protein,organic matter,and crude fibre(P<0.05).Serum biochemical parameters were unaffected,although secretory immunoglobulin A(SIgA)levels significantly increased upon supplementation with 500–1,000 mg/kg(P<0.05).16S rRNA gene sequencing indicated that sodium isobutyrate increased the abundance of beneficial colonic microbiota.The 1,000 mg/kg group presented the most pronounced effect,with a significant increase of the relative abundance of Prevotella and the greatest improvement in SCFA concentrations(P<0.05).Metabolomics revealed elevated levels of colonic indole-3-lactic acid and 3-hydroxybutyrate upon supplementation with 1,000 mg/kg(P<0.05).Transcriptomic analyses indicated activation of protein digestion and absorption pathways,and PI3K-Akt signalling,marked by TSG-6 upregulation and the suppression of ISG15 and DDIT4 expression(P<0.05).Supplementation with 1,000 mg/kg was associated with improved intestinal barrier-related markers,including reduced serum D-lactate,diamine oxidase,and lipopolysaccharide levels,increased tight junction protein expression;activation of G protein-coupled receptors;and inhibition of TLR4/MyD88/NF-κB signalling(P<0.05),suggesting enhanced barrier function.Conclusions In conclusion,dietary supplementation with 1,000 mg/kg sodium isobutyrate was associated with improved intestinal morphology,reduced serum permeability,increased expression of tight junction proteins,and enhanced immune function in weaned piglets,suggesting enhanced colonic barrier function and providing dosage guidance and mechanistic insights for future applications.展开更多
The metastatic pattern of colon cancer is typically well characterized,with initial dissemination occurring through regional lymphatics,followed by hematogenous spread.The most frequent sites of metastasis in colorect...The metastatic pattern of colon cancer is typically well characterized,with initial dissemination occurring through regional lymphatics,followed by hematogenous spread.The most frequent sites of metastasis in colorectal cancer(CRC)include regional lymph nodes(50%–70%),liver(35%–50%),lungs(21%),peritoneum(15%),and ovaries(13%).1 Isolated distant lymph node metastasis,particularly in the absence of concurrent systemic disease,is exceedingly rare in CRC.To date,only six cases of isolated axillary lymph node metastasis(ALNM)from colorectal primaries have been documented in the literature.1–6 Even more uncommon is the incidental discovery of malignant cells in anastomotic doughnuts following stoma reversal procedures.Herein,we report a rare case involving both the incidental histopathological detection of tumor cells within doughnuts during stoma closure and the subsequent development of isolated ALNM after curative resection of sigmoid colon carcinoma.展开更多
In this review, I outline the characteristic endoscopic findings of serrated lesions of the colorectum based on image enhanced endoscopy(IEE). Histopathologically, lesions with serrated structures are typically classi...In this review, I outline the characteristic endoscopic findings of serrated lesions of the colorectum based on image enhanced endoscopy(IEE). Histopathologically, lesions with serrated structures are typically classified into the following three types based: hyperplastic polyps(HPs), traditional serrated adenomas(TSAs), and sessile serrated adenoma/polyps(SSA/Ps). Both HP and SSA/P often present as dark-green colors on auto fluorescence imaging(AFI) colonoscopy that are similar to the normal surrounding mucosa. In contrast, TSAs often have elevated shapes and present as magenta colors that are similar to the tubular adenomas. The superficial type of TSA also includes many lesions that present as magenta colors. When SSA/Ps are associated with cytological dysplasia, many lesions present with magenta colors, whereas lesions that are not associated with cytological dysplasia present with dark-green colors. When observed via narrow band imaging(NBI), many SSA/P include lesions with strong mucous adhesions. Because these lesions are observed with reddish mucous adhesions, we refer to them as "red cap sign" and place such signs among the typical findings of SSA/P. Because the dilatation of the pit in SSA/P is observed as a round/oval black dot on magnified observations, we refer to this finding as Ⅱ-dilatation pit(Ⅱ-D pit) and also positioned it as a characteristic finding of SSA/P. In contrast, dilatations of the capillary vessels surrounding the glands, such as those that occur in tubular adenoma, are not considered to be useful for differentiating HPs from SSA/Ps. However, in cases in which SSA/P is associated with cytological dysplasia, the dilatation of capillary vessels is observed in the same area. When submucosal layer invasion occurs in the same area, the blood flow presents with irregularities that are similar to those of common colorectal cancer at an early stage and disappears as the invasion proceeds deeply. The surface pattern of invasive cancer that is observed at the tumor surface is also likely to disappear. Based on the above results, we considered that the differentiations between HP and TSA, between TSA and SSA/P, and between HP and SSA/P might become easier due to the concomitant use of white light observation and IEE. We also concluded that AFI and NBI can be useful modalities for SSA/P lesions associated with cytological dysplasia.展开更多
This clinical study was designed to determinate the value of colon microbiota microflora in colorectal cancer patients.We investigate pre-and post-operation stool samples in patients with different tumor localizations...This clinical study was designed to determinate the value of colon microbiota microflora in colorectal cancer patients.We investigate pre-and post-operation stool samples in patients with different tumor localizations,trying to correlate those to postoperative complications.Our findings shows that if opportunistic pathogenic microflora levels are elevated before operations,it can lead to further microbiota disbalance in postoperative period,especially in cases of antibacterial prophylaxis or treatment.Further,this changes increase a chance of receiving some complications after surgery.So,we suggest an analysis of stool microbiota in patients with colorectal cancer to be performed prior and after the operation.Furthermore,aperioperative decontamination therapy should be performed in cases of pathogenic microflora levels elevation.Still,monitoring aperioperative microbiota changes is not a routine in most recommendations and we assume that including this relatively unencumbered patient testing in preoperative survey will help to reduce a number of postoperative complications.展开更多
In pediatric age group, Intussusception is the most common cause of acute intestinal obstruction. They present with the classic clinical triad of colicky abdominal pain, vomiting and bloody stools. But clinically very...In pediatric age group, Intussusception is the most common cause of acute intestinal obstruction. They present with the classic clinical triad of colicky abdominal pain, vomiting and bloody stools. But clinically very few patients (20%) present with this classical symptoms. This article highlights an importance of suspecting intussusception by physician and rare presentations of intussusception lump in abdomen in a child with abdominal pain, gastrointestinal symptoms. Here a case reported of 16-year-old male child who presented with migrating lump in abdomen on and off with varied clinical presentation every time in single admission. Patient underwent laparotomy and manual reduction of intussusception was done. It is advisable to have high suspicion of intussusception while dealing with such cases.展开更多
BACKGROUND Type Ⅱ diabetes mellitus(T2DM)has been associated with increased risk of colon cancer(CC)and worse prognosis in patients with metastases.The effects of T2DM on postoperative chemoresistance rate(CRR)and lo...BACKGROUND Type Ⅱ diabetes mellitus(T2DM)has been associated with increased risk of colon cancer(CC)and worse prognosis in patients with metastases.The effects of T2DM on postoperative chemoresistance rate(CRR)and long-term disease-free survival(DFS)and overall survival(OS)in patients with stage Ⅲ CC who receive curative resection remain controversial.AIM To investigate whether T2DM or glycemic control is associated with worse postoperative survival outcomes in stage Ⅲ CC.METHODS This retrospective cohort study included 278 patients aged 40-75 years who underwent surgery for stage Ⅲ CC from 2018 to 2021.Based on preoperative T2DM history,the patients were categorized into non-DM(n=160)and DM groups(n=118).The latter was further divided into well-controlled(n=73)and poorly controlled(n=45)groups depending on the status of glycemic control.DFS,OS,and CRR were compared between the groups and Cox regression analysis was used to identify risk factors.RESULTS Patients in the DM and non-DM groups demonstrated similar DFS,OS,and CRR(DFS:72.03%vs 78.75%,P=0.178;OS:81.36%vs 83.12%,P=0.638;CRR:14.41%vs 7.5%,P=0.063).Poorly controlled DM was associated with a significantly worse prognosis and higher CRR than well-controlled DM(DFS:62.22%vs 78.07%,P=0.021;OS:71.11%vs 87.67%,P=0.011;CRR:24.40%vs 8.22%,P=0.015).High preoperative fasting plasma glucose[DFS:Hazard ratio(HR)=2.684,P<0.001;OS:HR=2.105,P=0.019;CRR:HR=2.214,P=0.005]and glycosylated hemoglobin levels(DFS:HR=2.344,P=0.006;OS:HR=2.119,P=0.021;CRR:HR=2.449,P=0.009)indicated significantly poor prognosis and high CRR,while T2DM history did not(DFS:HR=1.178,P=0.327;OS:HR=0.933,P=0.739;CRR:HR=0.997,P=0.581).CONCLUSION Increased preoperative fasting plasma glucose and glycosylated hemoglobin levels,but not T2DM history,were identified as risk factors associated with poor postoperative outcomes and high CRR in patients with stage Ⅲ CC.展开更多
930530 Experience with colonoscopic polypec-tomy in 716 patients.YAO Liqing(姚礼庆),etal.Dept Surg,Zhongshan Hosp,Shanghai MedUniv,Shanghai,200000.Chin J Digest 1992; 12(6):330—332.Seven hundred and sixteen patients ...930530 Experience with colonoscopic polypec-tomy in 716 patients.YAO Liqing(姚礼庆),etal.Dept Surg,Zhongshan Hosp,Shanghai MedUniv,Shanghai,200000.Chin J Digest 1992; 12(6):330—332.Seven hundred and sixteen patients with 1356coloreetal polyps were treated with eolonoscopicpolypectomy.Most polyps were located in therectum(441,34.3%)and sigmoid colon(552,展开更多
930312 Test of colonic transit for the diagno-sis of constipation.LIU Shixin (刘世信),et al.Binjiang Hosp Tianjin,300022.Natl Med J China 1993;73(2)75—77.This study consists of the design of the ex-perimental markers...930312 Test of colonic transit for the diagno-sis of constipation.LIU Shixin (刘世信),et al.Binjiang Hosp Tianjin,300022.Natl Med J China 1993;73(2)75—77.This study consists of the design of the ex-perimental markers for the colonic transit andthe application to clinical examination.Themarkers were displayed distinctly in the transittest.The study of clinical application showedthat colonic transit test is of diagnostic value inscreening patients with constipation.The indexof transit test,an authoritatively significant tar-get.has an imnortant valuta for the展开更多
920331 Alterations of ulex europaeusagglutinin-I receptor in human colorectalbenign and malignant tumors.HAN Bing(韩兵),et al.Digest Dis Instit,Hubei Med Coll,
920116 A study on chromosome instabiltyin patients with large bowel carcinoma andlarge bowel adenoma.Li Minglie (李明烈),etal.Shanghai Cancer Instit.Tumor 1991; 11 (5):215-217.The chromosome instability of peripheral ...920116 A study on chromosome instabiltyin patients with large bowel carcinoma andlarge bowel adenoma.Li Minglie (李明烈),etal.Shanghai Cancer Instit.Tumor 1991; 11 (5):215-217.The chromosome instability of peripheral lym-phocytes was studied in 10 patients with largebowel carcinoma (LBC),10 patients with展开更多
930135 Induction of expression of HLA anti-gens,carcinoembryonic antigen and oncogeneproduct on human colorectal cancer cell lineswith interferon-γ.WANG Ling(王聆),et al.Immunol Instit,Shanghai 2nd Med Univ.Chin
950328 Stepwise regression analysis on affective fac-tor of the changes in gastrin and somatostatin in col-orectal cancer patients.WANG Yuanhe(王元和),etal.2nd Milit Med Univ,Shanghai,200003.Med J ChinPLA 1995:20(1):4...950328 Stepwise regression analysis on affective fac-tor of the changes in gastrin and somatostatin in col-orectal cancer patients.WANG Yuanhe(王元和),etal.2nd Milit Med Univ,Shanghai,200003.Med J ChinPLA 1995:20(1):48-51.Gastrin and somatostatin (SS) levels in peripheralblood,tumor and its surrounding mucosa were deter-mined in 40 colorectal cancer patients by RIA with theserum gastrin (SG),plasma SS(PS),tumor SS(TS)or cancer-adjacent mucosa (CAMS)SS(CAMS)lev-els were taken as dependent variables and the remain-ing variables(including gastrin and SS levels,age展开更多
This article explored the application of dexmedetomidine(Dex),a highly selective alpha-2 agonist,in managing postoperative cognitive dysfunction(POCD)in elderly patients undergoing radical colon cancer surgery.Aging i...This article explored the application of dexmedetomidine(Dex),a highly selective alpha-2 agonist,in managing postoperative cognitive dysfunction(POCD)in elderly patients undergoing radical colon cancer surgery.Aging is associated with a progressive decline in physiological functions and an increased risk of adverse surgical outcomes,including POCD,which encompasses many neurocognitive disorders that manifest during the perioperative period.The aging population is at a higher risk for POCD,which can lead to prolonged hospital stays,delayed recovery,and increased healthcare costs.Dex has neuroprotective,opioid-sparing,and sympatholytic properties,which reduces the incidence and severity of POCD.Dex was introduced for sedation in patients receiving mechanical ventilation but has since been adopted in anesthesia due to its multifaceted benefits.Its appli-cation extends to sedation,analgesia,maintenance of anesthesia,and controlling delirium.Its neuroprotective and anti-inflammatory effects have been explored in managing POCD.This article discussed the broad range of patient and procedure-related risk factors for POCD.Early identification and intervention are crucial to prevent the progression of POCD,which can have severe physical,psychological,and economic consequences.The article underscored the importance of a mul-tidisciplinary approach in managing POCD,involving the optimization of comor-bidities,depth of anesthesia monitoring,hemodynamic stability,and cerebral oxygenation monitoring.展开更多
Colon cancer is one of the malignant tumors with high morbidity and mortality worldwide[1],and its early diagnosis is crucial for improving patient survival.However,due to the lack of obvious early symptoms of colon c...Colon cancer is one of the malignant tumors with high morbidity and mortality worldwide[1],and its early diagnosis is crucial for improving patient survival.However,due to the lack of obvious early symptoms of colon cancer,many patients are in the middle to late stage when diagnosed and miss the best time for treatment.Therefore,developing an efficient and accurate diagnostic method for colon cancer is of great clinical significance and scientific value.Currently,the current colon cancer biomarkers carcinoembryonic antigen and carbohydrate antigen 19-9[2]have low sensitivity and specificity,the emerging markers circulating tumor DNA(ctDNA)and miRNA face high cost and standardization challenges,and the existing methods lack spatial resolution,prompting the incorporation of spatial metabolomics technologies to enhance diagnostic capabilities.展开更多
BACKGROUND Magnetic compression anastomosis(MCA)offers a simple and reliable technique for inducing anastomoses at any point along the digestive tract.Evidence regarding whether the design of the MCA device influences...BACKGROUND Magnetic compression anastomosis(MCA)offers a simple and reliable technique for inducing anastomoses at any point along the digestive tract.Evidence regarding whether the design of the MCA device influences the anastomosis effect is lacking.AIM To investigate any difference in the side-to-side colonic anastomosis effect achieved with cylindrical vs circular ring magnets.METHODS We designed cylindrical and circular ring magnets suitable for side-to-side colonic anastomosis in rats.Thirty Sprague-Dawley rats were randomly divided into a cylindrical group,circular ring group,and cylindrical–circular ring group(n=10/group).Side-to-side colonic anastomosis was completed by transanal insertion of the magnets without incision of the colon.Operation time,perioperative complications,and magnet discharge time were recorded.Rats were euthanized 4 weeks postoperatively,and anastomotic specimens were obtained.The burst pressure and anastomotic diameter were measured sequentially,and anastomosis formation was observed by naked eye.Histological results were observed by light microscopy.RESULTS In all 30 rats,side-to-side colonic anastomosis was completed,for an operation success rate of 100%.No postoperative complications of bleeding and intestinal obstruction occurred,and the postoperative survival rate were 100%.The operation time,magnet discharge time,anastomotic bursting pressure,and anastomotic diameter did not differ significantly among the three designs(P>0.05).Healing was similar across the groups,with gross specimens showing good anastomotic healing and good mucosal continuity observed on histological analysis.CONCLUSION This study found no significant difference in the establishment of rat side-to-side colonic anastomosis with the use of cylindrical vs circular ring magnets.展开更多
文摘Compared with colorectal adenocarcinoma,neuroendocrine neoplasms(NENs),which affect the colon and rectum,are uncommon tumor conditions that have received relatively limited attention in basic research.Furthermore,the scarcity of these NENs has hindered extensive clinical investigations,thereby leading to a dearth of robust evidence for guiding clinical practice and impeding the establishment of standardized approaches for diagnosis and treatment.However,with the increasing awareness of population screening,as well as the increasing popularity of colonoscopy screening programs,the incidence of colorectal NENs has gradually increased.Moreover,some high-grade NENs are highly malignant and invasive,thereby leading to poor treatment outcomes and prognoses.These challenges have elicited increased attention from clinical physicians,thus prompting researchers to explore relevant studies using limited specimens and clinical data.This scenario has resulted in preliminary findings that provide evidence for addressing diagnostic and therapeutic challenges associated with NENs of the colon and rectum.In this article,we review recent literature reports and summarize the advances regarding the diagnosis and treatment of colorectal NENs.
文摘Background:We present a case of two major complications following insertion of a nephrostomy managed in a minimally invasive way.Our case is the first in the literature to describe this minimally invasive treatment technique for colon perforation in a completely asymptomatic patient.Case Description:A 75-year-old female patient with a history of bilateral obstructive uropathy secondary to bilateral radiation-induced ureteric strictures attended for bilateral nephrostomy placement.The patient had a history of endometrial cancer,treated previously by total hysterectomy and bilateral salpingo-oophorectomy with adjuvant chemo-radiotherapy and brachytherapy.Her recovery had been further complicated by the development of radiation cystitis,small bowel resection,and short gut syndrome.The strictures had previously been managed with bilateral double J stents,which have now failed.A left-sided nephrostomy insertion was performed.ACT-scan prompted by a repeat deterioration in renal function revealed a right-sided hydronephrosis and suggested transcolic passage of the previously placed leftsided nephrostomy.She had remained clinically well and apyretic.A right-sided nephrostomy was inserted,and the left re-sited following a colonoscopy-guided nephrostomy removal and clip occlusion of the nephrostomy tract.The patient then developed a pseudoaneurysm,which was managed with embolization.The patient was able to return home with corrected kidney function.The three-monthly checks for changes in nephrostomy catheters did not reveal any complications.Conclusions:The patient therefore presented with two major complications of nephrostomy placement:colonic perforation and pseudoaneurysm,classified as Clavien IIIb and IIIa,respectively.Multidisciplinary management,including urologists,gastroenterologists,general surgeons,and radiologists,enabled a minimally invasive management.Minimally invasive management with endoscopic clip placement appears to be a safe alternative to directed fistula of colonic perforation.
基金The National Natural Science Foundation of China(32302759,32372924)the CAST Youth Talent Support Project-Special Program for Doctoral Students(156-O-230-0000375-5)。
文摘Background Weaning-induced diarrhoea and growth retardation in piglets are associated with impaired intestinal barrier function and decreased levels of colonic short-chain fatty acids(SCFAs).Although SCFA supplementation has been proposed to mitigate these issues,the efficacy and optimal dosage of sodium isobutyrate remain unclear.Results We investigated the effects of sodium isobutyrate supplementation(500,1,000,2,000,and 4,000 mg/kg diet)on weaned piglets(Duroc×Landrace×Yorkshire,28 d of age;n=8).After a 28-d feeding trial,supplementation at 500–2,000 mg/kg significantly improved average daily gain and feed efficiency and reduced diarrhoea frequency,with maximal benefits observed at 1,000 mg/kg(P<0.0001).Additionally,500–1,000 mg/kg sodium isobutyrate supplementation increased the apparent digestibility of crude protein,organic matter,and crude fibre(P<0.05).Serum biochemical parameters were unaffected,although secretory immunoglobulin A(SIgA)levels significantly increased upon supplementation with 500–1,000 mg/kg(P<0.05).16S rRNA gene sequencing indicated that sodium isobutyrate increased the abundance of beneficial colonic microbiota.The 1,000 mg/kg group presented the most pronounced effect,with a significant increase of the relative abundance of Prevotella and the greatest improvement in SCFA concentrations(P<0.05).Metabolomics revealed elevated levels of colonic indole-3-lactic acid and 3-hydroxybutyrate upon supplementation with 1,000 mg/kg(P<0.05).Transcriptomic analyses indicated activation of protein digestion and absorption pathways,and PI3K-Akt signalling,marked by TSG-6 upregulation and the suppression of ISG15 and DDIT4 expression(P<0.05).Supplementation with 1,000 mg/kg was associated with improved intestinal barrier-related markers,including reduced serum D-lactate,diamine oxidase,and lipopolysaccharide levels,increased tight junction protein expression;activation of G protein-coupled receptors;and inhibition of TLR4/MyD88/NF-κB signalling(P<0.05),suggesting enhanced barrier function.Conclusions In conclusion,dietary supplementation with 1,000 mg/kg sodium isobutyrate was associated with improved intestinal morphology,reduced serum permeability,increased expression of tight junction proteins,and enhanced immune function in weaned piglets,suggesting enhanced colonic barrier function and providing dosage guidance and mechanistic insights for future applications.
文摘The metastatic pattern of colon cancer is typically well characterized,with initial dissemination occurring through regional lymphatics,followed by hematogenous spread.The most frequent sites of metastasis in colorectal cancer(CRC)include regional lymph nodes(50%–70%),liver(35%–50%),lungs(21%),peritoneum(15%),and ovaries(13%).1 Isolated distant lymph node metastasis,particularly in the absence of concurrent systemic disease,is exceedingly rare in CRC.To date,only six cases of isolated axillary lymph node metastasis(ALNM)from colorectal primaries have been documented in the literature.1–6 Even more uncommon is the incidental discovery of malignant cells in anastomotic doughnuts following stoma reversal procedures.Herein,we report a rare case involving both the incidental histopathological detection of tumor cells within doughnuts during stoma closure and the subsequent development of isolated ALNM after curative resection of sigmoid colon carcinoma.
文摘In this review, I outline the characteristic endoscopic findings of serrated lesions of the colorectum based on image enhanced endoscopy(IEE). Histopathologically, lesions with serrated structures are typically classified into the following three types based: hyperplastic polyps(HPs), traditional serrated adenomas(TSAs), and sessile serrated adenoma/polyps(SSA/Ps). Both HP and SSA/P often present as dark-green colors on auto fluorescence imaging(AFI) colonoscopy that are similar to the normal surrounding mucosa. In contrast, TSAs often have elevated shapes and present as magenta colors that are similar to the tubular adenomas. The superficial type of TSA also includes many lesions that present as magenta colors. When SSA/Ps are associated with cytological dysplasia, many lesions present with magenta colors, whereas lesions that are not associated with cytological dysplasia present with dark-green colors. When observed via narrow band imaging(NBI), many SSA/P include lesions with strong mucous adhesions. Because these lesions are observed with reddish mucous adhesions, we refer to them as "red cap sign" and place such signs among the typical findings of SSA/P. Because the dilatation of the pit in SSA/P is observed as a round/oval black dot on magnified observations, we refer to this finding as Ⅱ-dilatation pit(Ⅱ-D pit) and also positioned it as a characteristic finding of SSA/P. In contrast, dilatations of the capillary vessels surrounding the glands, such as those that occur in tubular adenoma, are not considered to be useful for differentiating HPs from SSA/Ps. However, in cases in which SSA/P is associated with cytological dysplasia, the dilatation of capillary vessels is observed in the same area. When submucosal layer invasion occurs in the same area, the blood flow presents with irregularities that are similar to those of common colorectal cancer at an early stage and disappears as the invasion proceeds deeply. The surface pattern of invasive cancer that is observed at the tumor surface is also likely to disappear. Based on the above results, we considered that the differentiations between HP and TSA, between TSA and SSA/P, and between HP and SSA/P might become easier due to the concomitant use of white light observation and IEE. We also concluded that AFI and NBI can be useful modalities for SSA/P lesions associated with cytological dysplasia.
基金International Cooperation Project of China,France and Russia(87E2A0313397)
文摘This clinical study was designed to determinate the value of colon microbiota microflora in colorectal cancer patients.We investigate pre-and post-operation stool samples in patients with different tumor localizations,trying to correlate those to postoperative complications.Our findings shows that if opportunistic pathogenic microflora levels are elevated before operations,it can lead to further microbiota disbalance in postoperative period,especially in cases of antibacterial prophylaxis or treatment.Further,this changes increase a chance of receiving some complications after surgery.So,we suggest an analysis of stool microbiota in patients with colorectal cancer to be performed prior and after the operation.Furthermore,aperioperative decontamination therapy should be performed in cases of pathogenic microflora levels elevation.Still,monitoring aperioperative microbiota changes is not a routine in most recommendations and we assume that including this relatively unencumbered patient testing in preoperative survey will help to reduce a number of postoperative complications.
文摘In pediatric age group, Intussusception is the most common cause of acute intestinal obstruction. They present with the classic clinical triad of colicky abdominal pain, vomiting and bloody stools. But clinically very few patients (20%) present with this classical symptoms. This article highlights an importance of suspecting intussusception by physician and rare presentations of intussusception lump in abdomen in a child with abdominal pain, gastrointestinal symptoms. Here a case reported of 16-year-old male child who presented with migrating lump in abdomen on and off with varied clinical presentation every time in single admission. Patient underwent laparotomy and manual reduction of intussusception was done. It is advisable to have high suspicion of intussusception while dealing with such cases.
基金Supported by the Leading Innovation Specialist Support Program of Guangdong Provincethe Science and Technology Planning Project of Ganzhou,No.202101074816the National Natural Science Foundation of China,No.82260501.
文摘BACKGROUND Type Ⅱ diabetes mellitus(T2DM)has been associated with increased risk of colon cancer(CC)and worse prognosis in patients with metastases.The effects of T2DM on postoperative chemoresistance rate(CRR)and long-term disease-free survival(DFS)and overall survival(OS)in patients with stage Ⅲ CC who receive curative resection remain controversial.AIM To investigate whether T2DM or glycemic control is associated with worse postoperative survival outcomes in stage Ⅲ CC.METHODS This retrospective cohort study included 278 patients aged 40-75 years who underwent surgery for stage Ⅲ CC from 2018 to 2021.Based on preoperative T2DM history,the patients were categorized into non-DM(n=160)and DM groups(n=118).The latter was further divided into well-controlled(n=73)and poorly controlled(n=45)groups depending on the status of glycemic control.DFS,OS,and CRR were compared between the groups and Cox regression analysis was used to identify risk factors.RESULTS Patients in the DM and non-DM groups demonstrated similar DFS,OS,and CRR(DFS:72.03%vs 78.75%,P=0.178;OS:81.36%vs 83.12%,P=0.638;CRR:14.41%vs 7.5%,P=0.063).Poorly controlled DM was associated with a significantly worse prognosis and higher CRR than well-controlled DM(DFS:62.22%vs 78.07%,P=0.021;OS:71.11%vs 87.67%,P=0.011;CRR:24.40%vs 8.22%,P=0.015).High preoperative fasting plasma glucose[DFS:Hazard ratio(HR)=2.684,P<0.001;OS:HR=2.105,P=0.019;CRR:HR=2.214,P=0.005]and glycosylated hemoglobin levels(DFS:HR=2.344,P=0.006;OS:HR=2.119,P=0.021;CRR:HR=2.449,P=0.009)indicated significantly poor prognosis and high CRR,while T2DM history did not(DFS:HR=1.178,P=0.327;OS:HR=0.933,P=0.739;CRR:HR=0.997,P=0.581).CONCLUSION Increased preoperative fasting plasma glucose and glycosylated hemoglobin levels,but not T2DM history,were identified as risk factors associated with poor postoperative outcomes and high CRR in patients with stage Ⅲ CC.
文摘930530 Experience with colonoscopic polypec-tomy in 716 patients.YAO Liqing(姚礼庆),etal.Dept Surg,Zhongshan Hosp,Shanghai MedUniv,Shanghai,200000.Chin J Digest 1992; 12(6):330—332.Seven hundred and sixteen patients with 1356coloreetal polyps were treated with eolonoscopicpolypectomy.Most polyps were located in therectum(441,34.3%)and sigmoid colon(552,
文摘930312 Test of colonic transit for the diagno-sis of constipation.LIU Shixin (刘世信),et al.Binjiang Hosp Tianjin,300022.Natl Med J China 1993;73(2)75—77.This study consists of the design of the ex-perimental markers for the colonic transit andthe application to clinical examination.Themarkers were displayed distinctly in the transittest.The study of clinical application showedthat colonic transit test is of diagnostic value inscreening patients with constipation.The indexof transit test,an authoritatively significant tar-get.has an imnortant valuta for the
文摘920331 Alterations of ulex europaeusagglutinin-I receptor in human colorectalbenign and malignant tumors.HAN Bing(韩兵),et al.Digest Dis Instit,Hubei Med Coll,
文摘920116 A study on chromosome instabiltyin patients with large bowel carcinoma andlarge bowel adenoma.Li Minglie (李明烈),etal.Shanghai Cancer Instit.Tumor 1991; 11 (5):215-217.The chromosome instability of peripheral lym-phocytes was studied in 10 patients with largebowel carcinoma (LBC),10 patients with
文摘930135 Induction of expression of HLA anti-gens,carcinoembryonic antigen and oncogeneproduct on human colorectal cancer cell lineswith interferon-γ.WANG Ling(王聆),et al.Immunol Instit,Shanghai 2nd Med Univ.Chin
文摘950328 Stepwise regression analysis on affective fac-tor of the changes in gastrin and somatostatin in col-orectal cancer patients.WANG Yuanhe(王元和),etal.2nd Milit Med Univ,Shanghai,200003.Med J ChinPLA 1995:20(1):48-51.Gastrin and somatostatin (SS) levels in peripheralblood,tumor and its surrounding mucosa were deter-mined in 40 colorectal cancer patients by RIA with theserum gastrin (SG),plasma SS(PS),tumor SS(TS)or cancer-adjacent mucosa (CAMS)SS(CAMS)lev-els were taken as dependent variables and the remain-ing variables(including gastrin and SS levels,age
文摘This article explored the application of dexmedetomidine(Dex),a highly selective alpha-2 agonist,in managing postoperative cognitive dysfunction(POCD)in elderly patients undergoing radical colon cancer surgery.Aging is associated with a progressive decline in physiological functions and an increased risk of adverse surgical outcomes,including POCD,which encompasses many neurocognitive disorders that manifest during the perioperative period.The aging population is at a higher risk for POCD,which can lead to prolonged hospital stays,delayed recovery,and increased healthcare costs.Dex has neuroprotective,opioid-sparing,and sympatholytic properties,which reduces the incidence and severity of POCD.Dex was introduced for sedation in patients receiving mechanical ventilation but has since been adopted in anesthesia due to its multifaceted benefits.Its appli-cation extends to sedation,analgesia,maintenance of anesthesia,and controlling delirium.Its neuroprotective and anti-inflammatory effects have been explored in managing POCD.This article discussed the broad range of patient and procedure-related risk factors for POCD.Early identification and intervention are crucial to prevent the progression of POCD,which can have severe physical,psychological,and economic consequences.The article underscored the importance of a mul-tidisciplinary approach in managing POCD,involving the optimization of comor-bidities,depth of anesthesia monitoring,hemodynamic stability,and cerebral oxygenation monitoring.
文摘Colon cancer is one of the malignant tumors with high morbidity and mortality worldwide[1],and its early diagnosis is crucial for improving patient survival.However,due to the lack of obvious early symptoms of colon cancer,many patients are in the middle to late stage when diagnosed and miss the best time for treatment.Therefore,developing an efficient and accurate diagnostic method for colon cancer is of great clinical significance and scientific value.Currently,the current colon cancer biomarkers carcinoembryonic antigen and carbohydrate antigen 19-9[2]have low sensitivity and specificity,the emerging markers circulating tumor DNA(ctDNA)and miRNA face high cost and standardization challenges,and the existing methods lack spatial resolution,prompting the incorporation of spatial metabolomics technologies to enhance diagnostic capabilities.
基金Supported by the Key Research and Development Program of Shaanxi,No.2024SF-YBXM-447the Institutional Foundation of The First Affiliated Hospital of Xi’an Jiaotong University,No.2022MS-07the Fundamental Research Funds for the Central Universities,No.xzy022023068.
文摘BACKGROUND Magnetic compression anastomosis(MCA)offers a simple and reliable technique for inducing anastomoses at any point along the digestive tract.Evidence regarding whether the design of the MCA device influences the anastomosis effect is lacking.AIM To investigate any difference in the side-to-side colonic anastomosis effect achieved with cylindrical vs circular ring magnets.METHODS We designed cylindrical and circular ring magnets suitable for side-to-side colonic anastomosis in rats.Thirty Sprague-Dawley rats were randomly divided into a cylindrical group,circular ring group,and cylindrical–circular ring group(n=10/group).Side-to-side colonic anastomosis was completed by transanal insertion of the magnets without incision of the colon.Operation time,perioperative complications,and magnet discharge time were recorded.Rats were euthanized 4 weeks postoperatively,and anastomotic specimens were obtained.The burst pressure and anastomotic diameter were measured sequentially,and anastomosis formation was observed by naked eye.Histological results were observed by light microscopy.RESULTS In all 30 rats,side-to-side colonic anastomosis was completed,for an operation success rate of 100%.No postoperative complications of bleeding and intestinal obstruction occurred,and the postoperative survival rate were 100%.The operation time,magnet discharge time,anastomotic bursting pressure,and anastomotic diameter did not differ significantly among the three designs(P>0.05).Healing was similar across the groups,with gross specimens showing good anastomotic healing and good mucosal continuity observed on histological analysis.CONCLUSION This study found no significant difference in the establishment of rat side-to-side colonic anastomosis with the use of cylindrical vs circular ring magnets.
