The goal of this paper is to establish from Simone de Beauvoir＇s perspective what happens when the situation and rights of French women are examined from the purview of their position as colonial subjects--as women c...The goal of this paper is to establish from Simone de Beauvoir＇s perspective what happens when the situation and rights of French women are examined from the purview of their position as colonial subjects--as women colonizer. Following the analysis of Beauvoir as featured in The Ethics of Ambiguity and The Second Sex, the author first begins by examining the situation and rights of French women colonizer as it relates to the situation of the colonized. And then, the author examines the situation and rights of these women from their own stands as women and in relationships to the situation and rights of white French men. The paper concludes that while French women may have experienced white privilege, they suffered from gender oppression deriving from their second-class status as French colonial subjects.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
Limosilactobacillus reuteri is a vertebrate symbiont that is widely appreciated as being of significant ecological importance for human health.As a unique feature,L.reuteri converts glycerol to the antimicrobial compo...Limosilactobacillus reuteri is a vertebrate symbiont that is widely appreciated as being of significant ecological importance for human health.As a unique feature,L.reuteri converts glycerol to the antimicrobial compound reuterin using enzymes encoded in its propanediol-utilization operon and evolves with host-driven diversification.Reuterin-producing L.reuteri HLRE13 was selectively isolated from poultry previously and confirmed to inhibit the growth of Staphylococcus aureus in vitro.However,it remains unclear whether L.reuteri HLRE13 retains these antagonistic properties when ingested in specific-pathogen-free mice.Here,we investigated the ameliorative effects and potential mechanisms of action of L.reuteri HLRE13 in combination with glycerol on S.aureus-induced infection phenotypes in mice.Firstly,our results confirmed that L.reuteri HLRE13 effectively inhibited the intestinal colonization of S.aureus CMCC26003;Secondly,L.reuteri HLRE13 combined with glycerol could alleviate the intestinal tissues damage caused by S.aureus through increasing the expression of ZO-1,Occludin,and MUC-2,ameliorate the intestinal systemic inflammatory response,and maintain the balance of gut microbiota by increasing the relative abundance of Lactobacillus and reducing the relative abundance of Staphylococcus.Furthermore,the colonization resistance was also found on L.reuteri HLRE13 combined with glycerol against S.aureus in pseudo germ-free mice,and they exerted the similar effects on alleviating intestinal damage and improving immune function.Combining these results,we speculate that reuterin-producing L.reuteri antagonize S.aureus in mice without the gut microbiota-dependent manner.Overall,our findings will provide a theoretical foundation for the scientific cognition of L.reiteri in maintaining intestinal health by producing reuterin.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
BACKGROUND Repeated application of the Pringle maneuver is a key obstacle to safe minimally invasive repeat liver resection(MISRLR).However,limited technical guidance is available.AIM To study the utility of newly dev...BACKGROUND Repeated application of the Pringle maneuver is a key obstacle to safe minimally invasive repeat liver resection(MISRLR).However,limited technical guidance is available.AIM To study the utility of newly developed Pringle taping method guided by liver surface in MISRLR.METHODS We retrospectively reviewed 72 cases of MISRLR performed by a single surgeon at two centers from August 2015 to July 2024.Beginning in October 2019,a liver surface-guided encirclement of hepatoduodenal ligament(LSEH)was used for repeat Pringle taping.Perioperative outcomes including Pringle taping success,operative time,blood loss,conversion rate,morbidity,and mortality were assessed.RESULTS Laparoscopic and robotic approaches were used in 63 patients and 9 patients,respectively.The median operative time,blood loss,and hospital stay were 331.5 minutes,70 mL,and 8 days,respectively.Open conversion occurred in two cases(2.8%)due to severe adhesions and right renal vein injury.Clavien-Dindo grade≥III complications occurred in 5.6%of cases with no mortality.Anti-adhesion barriers were used in 54 patients(75.0%).LSEH was attempted in 57 cases,improving Pringle taping success from 33.0%to 91.4%(P<0.001).LSEH succeeded in all patients with prior open liver resection(n=11).Among 6 patients in whom LSEH failed,3 patients(50.0%)had undergone a third liver resection,and 1 patient had a history of distal gastrectomy with choledochoduodenostomy.CONCLUSION The newly developed LSEH technique for Pringle taping in MISRLR was feasible,enhancing safety and reproducibility even in patients with a history of open liver resection.展开更多
Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopi...Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopic procedures has increased,especially in therapeutic colonoscopies.The recent advancements in endoscopic techniques and gastrointestinal tumoral resection procedures such as endoscopic mucosal resection,endoscopic full-thickness resection,and endoscopic submucosal dissection(ESD)could be a risk factor for this increased risk.The incidence rate of mortality of serious colonoscopic perforations is 7.1%.The management plan for these perforations starts with conservative treatment in mild cases,endoscopic closure,and surgical management in severe cases.Recently,endoluminal vacuum therapy was found to be effective in the management of colorectal perforations and this has been reported in multiple case reports.This editorial provides an overview of the current guidelines for the management of iatrogenic colorectal perforations.These insights are from the perspectives of endoscopists and gastroenterologists.We also present a management algorithm based on the guidelines of the European Society of Gastrointestinal Endoscopy,the American Gastroenterological Association,and the World Society of Emergency Surgery.We also discussed in brief the use of endoluminal vacuum therapy in colorectal perforations.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
In this editorial,we reviewed the article by Fadlallah et al that was recently published in the World Journal of Clinical Oncology.The article provided a comprehensive and in-depth view of the management and treatment...In this editorial,we reviewed the article by Fadlallah et al that was recently published in the World Journal of Clinical Oncology.The article provided a comprehensive and in-depth view of the management and treatment of colorectal cancer(CRC),one of the leading causes of cancer-related morbidity and mortality worldwide.The article analyzed the therapeutic modalities and their sequencing,focusing on total neoadjuvant therapy for locally advanced rectal cancer.It highlighted the role of immunotherapy in tumors with high microsatellite instability or deficient mismatch repair,addressing recent advances that have improved prognosis and therapeutic response in localized and metastatic CRC.Innovations in surgical techniques,advanced radiotherapy,and systemic agents targeting specific mutational profiles are also discussed,reflecting on how they revolutionized clinical management.Circulating tumor DNA has emerged as a promising tool for detecting minimal residual disease,prognosis,and therapeutic monitoring,solidifying its role in precision oncology.This review emphasized the importance of technological and therapeutic advancements in improving clinical outcomes and personalizing CRC treatment.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
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
BACKGROUND Breast cancer(BC)metastasis to the gastrointestinal tract is uncommon,colonic metastasis from BC(CMBC)is even rarer.CASE SUMMARY This report describes a 44-year-old female patient with metastatic triple-neg...BACKGROUND Breast cancer(BC)metastasis to the gastrointestinal tract is uncommon,colonic metastasis from BC(CMBC)is even rarer.CASE SUMMARY This report describes a 44-year-old female patient with metastatic triple-negative BC in the ascending colon who underwent laparoscopic radical right hemicolectomy.The patient had undergone left modified radical mastectomy only 15 months ago and stopped chemotherapy just 3 months ago.The diagnosis of CMBC was made based on the previous history of BC and positive results of several specific immunohistochemical markers(gross cystic disease fluid protein 15,mammaglobin,GATA-binding protein 3,and cytokeratin 7)for breast carcinoma.CONCLUSION CMBC should be highly cautious in patients with a previous history of BC,especially triple-negative BC,and further examination to aid in diagnosis.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
Extensive evidence demonstrates that a healthy and well-balanced gut microbiota profoundly influences host nutrient absorption,immunity,and metabolism.Unlike mammals,early microbiota colonization in commercial poultry...Extensive evidence demonstrates that a healthy and well-balanced gut microbiota profoundly influences host nutrient absorption,immunity,and metabolism.Unlike mammals,early microbiota colonization in commercial poultry largely depends on the environment as chicks hatch in incubators under a relatively sterile environment(egg and incubator sterilization)without maternal-offspring interaction.The early gut microbiota remains unsaturated,providing a critical window for modulation and influencing the subsequent microbiota succession,which may have long-term health outcomes.Microbiota transplantation(MT)involves transferring the microbiota from a donor to a recipient to modulate the recipient’s microbiota toward a desired state.Successfully applied in human medicine,MT is also gaining attention in poultry production to modulate intestinal health.This review comprehensively explores factors affecting MT,its mechanisms,and its potential applications in chickens,providing insights for further research and commercial use.展开更多
we critically review the authors’perspective and analyze the relevance of the results obtained in the original article of clinical research by Liu et al.We consider that additional factors associated with colon cance...we critically review the authors’perspective and analyze the relevance of the results obtained in the original article of clinical research by Liu et al.We consider that additional factors associated with colon cancer progression have recently been described in extensive clinical research,and should be included in this analysis to achieve a more accurate prognosis.These factors include inflammation,gut microbiota composition,immune status and nutritional balance,as they influence the post-surgical survival profile of patients with stage II colorectal cancer.We also address the clinical implementation and limitations of these analyses.Evaluation of the patient´s entire context is essential for selection of the most appropriate therapy.展开更多
BACKGROUND Colon adenocarcinoma(COAD)ranks second in terms of cancer-related deaths.We found that fatty acid-binding protein 4(FABP4),which is related to cell adhesion and immunity,affects the occurrence and developme...BACKGROUND Colon adenocarcinoma(COAD)ranks second in terms of cancer-related deaths.We found that fatty acid-binding protein 4(FABP4),which is related to cell adhesion and immunity,affects the occurrence and development of COAD.This study focused on the possibility of using FABP4 as a biomarker for COAD and constructed a nomogram for predicting the survival of COAD patients.AIM To verify the possibility of using FABP4 as a biomarker for COAD.METHODS A total of 453 COAD tissue samples,along with 41 normal tissue samples,were obtained from The Cancer Genome Atlas database.The difference in FABP4 expression between COAD tissues and normal tissues was analyzed,and the results were verified by immunohistochemistry.The WGCNA algorithm links FABP4 expression with an enrichment analysis and with immune cell infiltration pathways.The biological functions of FABP4 and its coexpressed genes were explored through enrichment analyses.The ESTIMATE,CIBERSORT and ssGSEA methods were used for the immune infiltration analysis.Finally,risk scores were calculated by a Cox analysis.A nomogram was constructed by combining risk scores with routine clinicopathological factors.We assessed the accuracy of survival predictions based on the C-index.The C-index ranges from 0.5 to 1.0,and in general,a C-index value greater than 0.65 indicates a reasonable estimate.The results were validated using the Gene Expression Omnibus(GEO)database.RESULTS FABP4 was significantly differentially expressed in COAD.It is a promising auxiliary biomarker for screening and diagnosis.Enrichment analyses suggested that FABP4 may influence the invasion and progression of COAD through cell adhesion.The immunological analysis revealed that FABP4 expression in COAD was significantly positively correlated with immune cell infiltration.Moreover,a nomogram to predict the survival of COAD patients was successfully constructed by integrating the calculated risk scores of 15 candidate genes and routine clinicopathological factors.This nomogram could effectively predict 1-year,3-year,and 5-year survival(C-index=0.786)and was verified(C-index=0.73).CONCLUSION This study established FABP4 as an effective biomarker for screening,assisting in the diagnosis and determining the prognosis.展开更多
Background Dietary protein level and amino acid(AA)balance are crucial determinants of animal health and productivity.Supplementing rumen-protected AAs in low-protein diets was considered as an efficient strategy to i...Background Dietary protein level and amino acid(AA)balance are crucial determinants of animal health and productivity.Supplementing rumen-protected AAs in low-protein diets was considered as an efficient strategy to improve the growth performance of ruminants.The colon serves as a crucial conduit for nutrient metabolism during rumen-protected methionine(RPMet)and rumen-protected lysine(RPLys)supplementation,however,it has been challenging to clarify which specific microbiota and their metabolites play a pivotal role in this process.Here,we applied metagenomic and metabolomic approaches to compare the characteristic microbiome and metabolic strategies in the colon of lambs fed a control diet(CON),a low-protein diet(LP)or a LP diet supplemented with RPMet and RPLys(LR).Results The LP treatment decreased the average daily weight gain(ADG)in lambs,while the LR treatment tended to elicit a remission in ADG.The butyrate molar concentration was greater(P<0.05),while acetate molar concentration(P<0.05)was lower for lambs fed the LP and LR diets compared to those fed the CON diet.Moreover,the LP treatment remarkably decreased total AA concentration(P<0.05),while LR treatment showed an improvement in the concentrations of methionine,lysine,leucine,glutamate,and tryptophan.Metagenomic insights proved that the microbial metabolic potentials referring to biosynthesis of volatile fatty acids(VFAs)and AAs in the colon were remarkably altered by three dietary treatments.Metagenomic binning identified distinct microbial markers for the CON group(Alistipes spp.,Phocaeicola spp.,and Ruminococcus spp.),LP group(Fibrobacter spp.,Prevotella spp.,Ruminococcus spp.,and Escherichia coli),and LR group(Akkermansia muciniphila and RUG099 spp.).Conclusions Our findings suggest that RPMet and RPLys supplementation to the low-protein diet could enhance the microbial biosynthesis of butyrate and amino acids,enriche the beneficial bacteria in the colon,and thereby improve the growth performance of lambs.展开更多
BACKGROUND Colorectal cancer,one of the most common malignancies,is primarily treated through surgery.With the widespread use of laparoscopy,gastrointestinal reconstruction remains a key area of research.The choice be...BACKGROUND Colorectal cancer,one of the most common malignancies,is primarily treated through surgery.With the widespread use of laparoscopy,gastrointestinal reconstruction remains a key area of research.The choice between intraperitoneal anastomosis(IA)and extraperitoneal anastomosis(EA)remains a subject of considerable debate.This study uses intraperitoneal isoperistaltic side-to-side anastomosis(IISSA)with hand-sewn closure of the common opening to evaluate its safety and short-term outcomes.It is hypothesized that this technique may offer better short-term outcomes than EA.AIM To investigate the safety and short-term outcomes of IISSA with hand-sewn closure of the common opening compared to EA.METHODS Patients who underwent laparoscopic radical colon cancer surgery between January 2018 and June 2022 at the First Affiliated Hospital of Xiamen University were retrospectively analyzed.Surgical,postoperative,and pathological features of the IA and EA groups were observed before and after propensity score matching.Patients with right-sided and left-sided colon cancer were separated,each further divided into IA and EA groups(R-IA vs R-EA for right-sided,L-IA vs L-EA for left-sided),for stratified analysis of the aforementioned indicators.RESULTS After propensity score matching,63 pairs were matched in each group.In surgical characteristics,the IA group exhibited less blood loss and shorter incisions than the EA group.Regarding postoperative recovery,the IA group showed earlier recovery of gastrointestinal function.Pathologically,the IA group had greater lymph node clearance.Relative to the R-EA group,the R-IA group experienced reduced blood loss,shorter assisted incisions,earlier recovery of gastrointestinal functions and greater lymph node dissection.When compared to the L-EA group,the L-IA group demonstrated earlier postoperative anal exhaust and defecation,along with a reduced length of hospitalization.Regarding postoperative complications,no statistically significant differences were found between the groups either after matching or in the stratified analyses.CONCLUSION Compared to EA,IISSA with hand-sewn closure of the common opening is a safe and feasible option for laparoscopic radical colon cancer surgery.展开更多
High microsatellite instability(MSI-H)colorectal cancer(CRC),caused by deficient mismatch repair,accounts for about 15%of all CRC cases and is more common in right-sided tumors.While early-stage MSI-H CRC has a relati...High microsatellite instability(MSI-H)colorectal cancer(CRC),caused by deficient mismatch repair,accounts for about 15%of all CRC cases and is more common in right-sided tumors.While early-stage MSI-H CRC has a relatively good prognosis,advanced cases often respond poorly to standard chemotherapy.Immune checkpoint inhibitors,such as pembrolizumab,have shown strong and lasting effects in MSI-H CRC.Pembrolizumab is now approved as a first-line treatment for metastatic MSI-H CRC due to its superior outcomes compared to traditional chemotherapy.CASE SUMMARY A 44-year-old male with MSI-H transverse colon cancer presented with hematochezia,abdominal pain,and significant weight loss.Imaging revealed a bulky tumor with invasion of adjacent structures and multiple liver lesions.A diverting ileostomy was performed followed by 36 cycles of pembrolizumab.The patient achieved a clinical and radiologic complete response.One month after completing the treatment,the patient underwent laparoscopic right hemicolectomy.A spontaneous transection of the colon at the original tumor site was unexpectedly identified.Final pathology confirmed pathological complete response(ypT0N0)with fibrosis.The patient recovered well after surgery,and follow-up showed no evidence of recurrence.CONCLUSION Immune checkpoint inhibitors may cause delayed structural damage to bowel tissue even after apparent complete tumor regression.展开更多
This study aimed to elucidate the role of collagen type XI alpha 1(COL11A1)-positive cancer-associated fibroblasts(CAFs)in modifying the tumor microenvironment of colon cancer(CC)and facilitating immune evasion throug...This study aimed to elucidate the role of collagen type XI alpha 1(COL11A1)-positive cancer-associated fibroblasts(CAFs)in modifying the tumor microenvironment of colon cancer(CC)and facilitating immune evasion through interactions with myeloid-derived suppressor cells(MDSCs).Using single-cell transcriptomic sequencing,we analyzed the interplay between COL11A1-positive CAFs and MDSCs in the CC microenvironment,focusing on how COL11A1 impacts MDSC differentiation and activation.The results demonstrate that COL11A1 expression in fibroblasts significantly enhances matrix metalloproteinase(MMP)3 and MMP13 expression,leading to paracrine induction of MDSC differentiation and activation,which promotes immune evasion and tumor growth.Additionally,we observed that COL11A1 knockout(COL11A1KO)suppresses tumor growth and hinders immune evasion.These findings underscore the essential role of COL11A1-positive CAFs in establishing an immunosuppressive tumor microenvironment conducive to CC progression.By elucidating the molecular pathway through which COL11A1 influences MDSC activity,this research suggests new therapeutic avenues for targeting the tumor microenvironment in CC,particularly through modulating COL11A1 expression in CAFs.展开更多
文摘The goal of this paper is to establish from Simone de Beauvoir＇s perspective what happens when the situation and rights of French women are examined from the purview of their position as colonial subjects--as women colonizer. Following the analysis of Beauvoir as featured in The Ethics of Ambiguity and The Second Sex, the author first begins by examining the situation and rights of French women colonizer as it relates to the situation of the colonized. And then, the author examines the situation and rights of these women from their own stands as women and in relationships to the situation and rights of white French men. The paper concludes that while French women may have experienced white privilege, they suffered from gender oppression deriving from their second-class status as French colonial subjects.
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funded by the National Natural Science Foundation of China(32101915)Natural Science Foundation of Jiangxi Province(20224BAB205005)+1 种基金Training Program for Academic and Technical Leaders of Major Disciplines in Jiangxi Province(20232BCJ23090)Natural Science Foundation of Chongqing(CSTB2023NSCQMSX0497).
文摘Limosilactobacillus reuteri is a vertebrate symbiont that is widely appreciated as being of significant ecological importance for human health.As a unique feature,L.reuteri converts glycerol to the antimicrobial compound reuterin using enzymes encoded in its propanediol-utilization operon and evolves with host-driven diversification.Reuterin-producing L.reuteri HLRE13 was selectively isolated from poultry previously and confirmed to inhibit the growth of Staphylococcus aureus in vitro.However,it remains unclear whether L.reuteri HLRE13 retains these antagonistic properties when ingested in specific-pathogen-free mice.Here,we investigated the ameliorative effects and potential mechanisms of action of L.reuteri HLRE13 in combination with glycerol on S.aureus-induced infection phenotypes in mice.Firstly,our results confirmed that L.reuteri HLRE13 effectively inhibited the intestinal colonization of S.aureus CMCC26003;Secondly,L.reuteri HLRE13 combined with glycerol could alleviate the intestinal tissues damage caused by S.aureus through increasing the expression of ZO-1,Occludin,and MUC-2,ameliorate the intestinal systemic inflammatory response,and maintain the balance of gut microbiota by increasing the relative abundance of Lactobacillus and reducing the relative abundance of Staphylococcus.Furthermore,the colonization resistance was also found on L.reuteri HLRE13 combined with glycerol against S.aureus in pseudo germ-free mice,and they exerted the similar effects on alleviating intestinal damage and improving immune function.Combining these results,we speculate that reuterin-producing L.reuteri antagonize S.aureus in mice without the gut microbiota-dependent manner.Overall,our findings will provide a theoretical foundation for the scientific cognition of L.reiteri in maintaining intestinal health by producing reuterin.
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BACKGROUND Repeated application of the Pringle maneuver is a key obstacle to safe minimally invasive repeat liver resection(MISRLR).However,limited technical guidance is available.AIM To study the utility of newly developed Pringle taping method guided by liver surface in MISRLR.METHODS We retrospectively reviewed 72 cases of MISRLR performed by a single surgeon at two centers from August 2015 to July 2024.Beginning in October 2019,a liver surface-guided encirclement of hepatoduodenal ligament(LSEH)was used for repeat Pringle taping.Perioperative outcomes including Pringle taping success,operative time,blood loss,conversion rate,morbidity,and mortality were assessed.RESULTS Laparoscopic and robotic approaches were used in 63 patients and 9 patients,respectively.The median operative time,blood loss,and hospital stay were 331.5 minutes,70 mL,and 8 days,respectively.Open conversion occurred in two cases(2.8%)due to severe adhesions and right renal vein injury.Clavien-Dindo grade≥III complications occurred in 5.6%of cases with no mortality.Anti-adhesion barriers were used in 54 patients(75.0%).LSEH was attempted in 57 cases,improving Pringle taping success from 33.0%to 91.4%(P<0.001).LSEH succeeded in all patients with prior open liver resection(n=11).Among 6 patients in whom LSEH failed,3 patients(50.0%)had undergone a third liver resection,and 1 patient had a history of distal gastrectomy with choledochoduodenostomy.CONCLUSION The newly developed LSEH technique for Pringle taping in MISRLR was feasible,enhancing safety and reproducibility even in patients with a history of open liver resection.
文摘Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopic procedures has increased,especially in therapeutic colonoscopies.The recent advancements in endoscopic techniques and gastrointestinal tumoral resection procedures such as endoscopic mucosal resection,endoscopic full-thickness resection,and endoscopic submucosal dissection(ESD)could be a risk factor for this increased risk.The incidence rate of mortality of serious colonoscopic perforations is 7.1%.The management plan for these perforations starts with conservative treatment in mild cases,endoscopic closure,and surgical management in severe cases.Recently,endoluminal vacuum therapy was found to be effective in the management of colorectal perforations and this has been reported in multiple case reports.This editorial provides an overview of the current guidelines for the management of iatrogenic colorectal perforations.These insights are from the perspectives of endoscopists and gastroenterologists.We also present a management algorithm based on the guidelines of the European Society of Gastrointestinal Endoscopy,the American Gastroenterological Association,and the World Society of Emergency Surgery.We also discussed in brief the use of endoluminal vacuum therapy in colorectal perforations.
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In this editorial,we reviewed the article by Fadlallah et al that was recently published in the World Journal of Clinical Oncology.The article provided a comprehensive and in-depth view of the management and treatment of colorectal cancer(CRC),one of the leading causes of cancer-related morbidity and mortality worldwide.The article analyzed the therapeutic modalities and their sequencing,focusing on total neoadjuvant therapy for locally advanced rectal cancer.It highlighted the role of immunotherapy in tumors with high microsatellite instability or deficient mismatch repair,addressing recent advances that have improved prognosis and therapeutic response in localized and metastatic CRC.Innovations in surgical techniques,advanced radiotherapy,and systemic agents targeting specific mutational profiles are also discussed,reflecting on how they revolutionized clinical management.Circulating tumor DNA has emerged as a promising tool for detecting minimal residual disease,prognosis,and therapeutic monitoring,solidifying its role in precision oncology.This review emphasized the importance of technological and therapeutic advancements in improving clinical outcomes and personalizing CRC treatment.
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.
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.
基金The Science and Technology Bureau of Wuhu,Anhui Province,China,Under The Key Research and Development and Achievement Transformation Project,No.2023yf099.
文摘BACKGROUND Breast cancer(BC)metastasis to the gastrointestinal tract is uncommon,colonic metastasis from BC(CMBC)is even rarer.CASE SUMMARY This report describes a 44-year-old female patient with metastatic triple-negative BC in the ascending colon who underwent laparoscopic radical right hemicolectomy.The patient had undergone left modified radical mastectomy only 15 months ago and stopped chemotherapy just 3 months ago.The diagnosis of CMBC was made based on the previous history of BC and positive results of several specific immunohistochemical markers(gross cystic disease fluid protein 15,mammaglobin,GATA-binding protein 3,and cytokeratin 7)for breast carcinoma.CONCLUSION CMBC should be highly cautious in patients with a previous history of BC,especially triple-negative BC,and further examination to aid in diagnosis.
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.
基金Haoran Zhao would like to acknowledge the support provided by China Scholarship Council(CSC)of the Ministry of Education,P.R.China(CSC No.202206850006)supported by funding from VLAIO with project number(HBC.2023.0172),HEPPY Markers-Establishment of biomarkers of Health and Eubiosis in Pigs and Poultry.
文摘Extensive evidence demonstrates that a healthy and well-balanced gut microbiota profoundly influences host nutrient absorption,immunity,and metabolism.Unlike mammals,early microbiota colonization in commercial poultry largely depends on the environment as chicks hatch in incubators under a relatively sterile environment(egg and incubator sterilization)without maternal-offspring interaction.The early gut microbiota remains unsaturated,providing a critical window for modulation and influencing the subsequent microbiota succession,which may have long-term health outcomes.Microbiota transplantation(MT)involves transferring the microbiota from a donor to a recipient to modulate the recipient’s microbiota toward a desired state.Successfully applied in human medicine,MT is also gaining attention in poultry production to modulate intestinal health.This review comprehensively explores factors affecting MT,its mechanisms,and its potential applications in chickens,providing insights for further research and commercial use.
基金Supported by Consejo Nacional de Investigaciones Científicas y Técnicas,No.PIP11220200103061COAgencia Nacional de promoción Científica y Tecnológica,No.PICT-2020-SERIEA-03440Universidad Nacional del Sur,No.PGI 24/B303 and No.PGI 24/ZB01.
文摘we critically review the authors’perspective and analyze the relevance of the results obtained in the original article of clinical research by Liu et al.We consider that additional factors associated with colon cancer progression have recently been described in extensive clinical research,and should be included in this analysis to achieve a more accurate prognosis.These factors include inflammation,gut microbiota composition,immune status and nutritional balance,as they influence the post-surgical survival profile of patients with stage II colorectal cancer.We also address the clinical implementation and limitations of these analyses.Evaluation of the patient´s entire context is essential for selection of the most appropriate therapy.
基金Supported by the University Scientific Research Project of Anhui Province,No.2024AH051916the Quality Engineering Project of Anhui Province,No.2022sx159 and No.2022sdxx031the Key Research and Development Project of Anhui Province,No.2022e07020036.
文摘BACKGROUND Colon adenocarcinoma(COAD)ranks second in terms of cancer-related deaths.We found that fatty acid-binding protein 4(FABP4),which is related to cell adhesion and immunity,affects the occurrence and development of COAD.This study focused on the possibility of using FABP4 as a biomarker for COAD and constructed a nomogram for predicting the survival of COAD patients.AIM To verify the possibility of using FABP4 as a biomarker for COAD.METHODS A total of 453 COAD tissue samples,along with 41 normal tissue samples,were obtained from The Cancer Genome Atlas database.The difference in FABP4 expression between COAD tissues and normal tissues was analyzed,and the results were verified by immunohistochemistry.The WGCNA algorithm links FABP4 expression with an enrichment analysis and with immune cell infiltration pathways.The biological functions of FABP4 and its coexpressed genes were explored through enrichment analyses.The ESTIMATE,CIBERSORT and ssGSEA methods were used for the immune infiltration analysis.Finally,risk scores were calculated by a Cox analysis.A nomogram was constructed by combining risk scores with routine clinicopathological factors.We assessed the accuracy of survival predictions based on the C-index.The C-index ranges from 0.5 to 1.0,and in general,a C-index value greater than 0.65 indicates a reasonable estimate.The results were validated using the Gene Expression Omnibus(GEO)database.RESULTS FABP4 was significantly differentially expressed in COAD.It is a promising auxiliary biomarker for screening and diagnosis.Enrichment analyses suggested that FABP4 may influence the invasion and progression of COAD through cell adhesion.The immunological analysis revealed that FABP4 expression in COAD was significantly positively correlated with immune cell infiltration.Moreover,a nomogram to predict the survival of COAD patients was successfully constructed by integrating the calculated risk scores of 15 candidate genes and routine clinicopathological factors.This nomogram could effectively predict 1-year,3-year,and 5-year survival(C-index=0.786)and was verified(C-index=0.73).CONCLUSION This study established FABP4 as an effective biomarker for screening,assisting in the diagnosis and determining the prognosis.
基金jointly supported by the International Partnership Program of Chinese Academy of Sciences(161343KYSB20200015)Guangxi Provincial Natural Science Foundation of China(2023GXNSFAA026107)+1 种基金the Science and Technology Innovation Program of Hunan Province(2022RC1158)Youth Innovation Promotion Association CAS(2023382)。
文摘Background Dietary protein level and amino acid(AA)balance are crucial determinants of animal health and productivity.Supplementing rumen-protected AAs in low-protein diets was considered as an efficient strategy to improve the growth performance of ruminants.The colon serves as a crucial conduit for nutrient metabolism during rumen-protected methionine(RPMet)and rumen-protected lysine(RPLys)supplementation,however,it has been challenging to clarify which specific microbiota and their metabolites play a pivotal role in this process.Here,we applied metagenomic and metabolomic approaches to compare the characteristic microbiome and metabolic strategies in the colon of lambs fed a control diet(CON),a low-protein diet(LP)or a LP diet supplemented with RPMet and RPLys(LR).Results The LP treatment decreased the average daily weight gain(ADG)in lambs,while the LR treatment tended to elicit a remission in ADG.The butyrate molar concentration was greater(P<0.05),while acetate molar concentration(P<0.05)was lower for lambs fed the LP and LR diets compared to those fed the CON diet.Moreover,the LP treatment remarkably decreased total AA concentration(P<0.05),while LR treatment showed an improvement in the concentrations of methionine,lysine,leucine,glutamate,and tryptophan.Metagenomic insights proved that the microbial metabolic potentials referring to biosynthesis of volatile fatty acids(VFAs)and AAs in the colon were remarkably altered by three dietary treatments.Metagenomic binning identified distinct microbial markers for the CON group(Alistipes spp.,Phocaeicola spp.,and Ruminococcus spp.),LP group(Fibrobacter spp.,Prevotella spp.,Ruminococcus spp.,and Escherichia coli),and LR group(Akkermansia muciniphila and RUG099 spp.).Conclusions Our findings suggest that RPMet and RPLys supplementation to the low-protein diet could enhance the microbial biosynthesis of butyrate and amino acids,enriche the beneficial bacteria in the colon,and thereby improve the growth performance of lambs.
基金Bethune Charitable Foundation Project,No.HZB-20190528-10Natural Science Foundation of Fujian Province,No.2020J011230.
文摘BACKGROUND Colorectal cancer,one of the most common malignancies,is primarily treated through surgery.With the widespread use of laparoscopy,gastrointestinal reconstruction remains a key area of research.The choice between intraperitoneal anastomosis(IA)and extraperitoneal anastomosis(EA)remains a subject of considerable debate.This study uses intraperitoneal isoperistaltic side-to-side anastomosis(IISSA)with hand-sewn closure of the common opening to evaluate its safety and short-term outcomes.It is hypothesized that this technique may offer better short-term outcomes than EA.AIM To investigate the safety and short-term outcomes of IISSA with hand-sewn closure of the common opening compared to EA.METHODS Patients who underwent laparoscopic radical colon cancer surgery between January 2018 and June 2022 at the First Affiliated Hospital of Xiamen University were retrospectively analyzed.Surgical,postoperative,and pathological features of the IA and EA groups were observed before and after propensity score matching.Patients with right-sided and left-sided colon cancer were separated,each further divided into IA and EA groups(R-IA vs R-EA for right-sided,L-IA vs L-EA for left-sided),for stratified analysis of the aforementioned indicators.RESULTS After propensity score matching,63 pairs were matched in each group.In surgical characteristics,the IA group exhibited less blood loss and shorter incisions than the EA group.Regarding postoperative recovery,the IA group showed earlier recovery of gastrointestinal function.Pathologically,the IA group had greater lymph node clearance.Relative to the R-EA group,the R-IA group experienced reduced blood loss,shorter assisted incisions,earlier recovery of gastrointestinal functions and greater lymph node dissection.When compared to the L-EA group,the L-IA group demonstrated earlier postoperative anal exhaust and defecation,along with a reduced length of hospitalization.Regarding postoperative complications,no statistically significant differences were found between the groups either after matching or in the stratified analyses.CONCLUSION Compared to EA,IISSA with hand-sewn closure of the common opening is a safe and feasible option for laparoscopic radical colon cancer surgery.
文摘High microsatellite instability(MSI-H)colorectal cancer(CRC),caused by deficient mismatch repair,accounts for about 15%of all CRC cases and is more common in right-sided tumors.While early-stage MSI-H CRC has a relatively good prognosis,advanced cases often respond poorly to standard chemotherapy.Immune checkpoint inhibitors,such as pembrolizumab,have shown strong and lasting effects in MSI-H CRC.Pembrolizumab is now approved as a first-line treatment for metastatic MSI-H CRC due to its superior outcomes compared to traditional chemotherapy.CASE SUMMARY A 44-year-old male with MSI-H transverse colon cancer presented with hematochezia,abdominal pain,and significant weight loss.Imaging revealed a bulky tumor with invasion of adjacent structures and multiple liver lesions.A diverting ileostomy was performed followed by 36 cycles of pembrolizumab.The patient achieved a clinical and radiologic complete response.One month after completing the treatment,the patient underwent laparoscopic right hemicolectomy.A spontaneous transection of the colon at the original tumor site was unexpectedly identified.Final pathology confirmed pathological complete response(ypT0N0)with fibrosis.The patient recovered well after surgery,and follow-up showed no evidence of recurrence.CONCLUSION Immune checkpoint inhibitors may cause delayed structural damage to bowel tissue even after apparent complete tumor regression.
文摘This study aimed to elucidate the role of collagen type XI alpha 1(COL11A1)-positive cancer-associated fibroblasts(CAFs)in modifying the tumor microenvironment of colon cancer(CC)and facilitating immune evasion through interactions with myeloid-derived suppressor cells(MDSCs).Using single-cell transcriptomic sequencing,we analyzed the interplay between COL11A1-positive CAFs and MDSCs in the CC microenvironment,focusing on how COL11A1 impacts MDSC differentiation and activation.The results demonstrate that COL11A1 expression in fibroblasts significantly enhances matrix metalloproteinase(MMP)3 and MMP13 expression,leading to paracrine induction of MDSC differentiation and activation,which promotes immune evasion and tumor growth.Additionally,we observed that COL11A1 knockout(COL11A1KO)suppresses tumor growth and hinders immune evasion.These findings underscore the essential role of COL11A1-positive CAFs in establishing an immunosuppressive tumor microenvironment conducive to CC progression.By elucidating the molecular pathway through which COL11A1 influences MDSC activity,this research suggests new therapeutic avenues for targeting the tumor microenvironment in CC,particularly through modulating COL11A1 expression in CAFs.
