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Patterns of lymph node metastasis are different in colon and rectal carcinomas

World Journal of Gastroenterology 2010年第42期16卷 5375-5379页

作者： Hao Wang Xian-Zhao Wei chuan-gang fu fu-Ao Cao Rong-Hua Zhao Department of Colorectal Surgery Changhai Hospital Second Military Medical University Shanghai 200433 China Department of Surgery College of Medicine University of Saskatchewan Saskatoon SK S7N0W8Canada

AIM:To describe patterns of lymph node metastasis in invasive colon and rectal carcinomas.METHODS:Clinical data of 2340 patients with colorectal carcinoma(stageⅠ to Ⅲ) who received radical resection,was retrospectively reviewed.Of the 2340 patients,1314 patients suffered from rectal carcinoma and 1026 from colon carcinoma.Patients with rectal cancer who received neoadjuvant chemoradiation therapy were excluded.Statistical analysis was performed using MannWhitney,χ 2 and Cochran's and Mantel-Haenszel tests(SPSS 15.0).A two-tailed P < 0.05 was considered statistically significant.RESULTS:Lymph node retrieval in the rectal carcinoma group was significantly lower than that in the colon carcinoma group(P < 0.001),while positive lymph node retrieval in the rectal carcinoma group was significantly higher than that in the colon carcinoma group(P < 0.001).The proportion of lymph node positive(N+) cases was higher(patients with one or more positive lymph nodes) in the rectal carcinoma group(P = 0.004).The number of N+ cases was compared at different T stages(T1-T4) to eliminate background bias and the results were confirmed(P < 0.001).In addition,the lymph node ratio(the ratio of number of positive lymph nodes over the number of lymph nodes examined) of stage Ⅲ cases in the rectal carcinoma group was significantly higher than that in the colon carcinoma group(P < 0.001).CONCLUSION:Rectal carcinomas seem more prone to metastasize to the lymph nodes than colon carcinomas,which may be of potential clinical significance.

关键词： Lymph node Metastasis Colon Rectum Neoplasms

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Massive presacral bleeding during rectal surgery: From anatomy to clinical practice

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World Journal of Gastroenterology 2013年第25期19卷 4039-4044页

作者： Zheng Lou Wei Zhang Rong-Gui Meng chuan-gang fu Department of Colorectal Surgery Changhai Hospital

AIM: To investigate control of two different types of massive presacral bleeding according to the anatomy of the presacral venous system. METHODS: A retrospective review was performed in 1628 patients with middle or low rectal carcinoma who were treated surgically in the Department of Colorectal Surgery, Changhai Hospital, Shanghai, China from January 2008 to December 2012. In four of these patients, the presacral venous plexus (n = 2) or basivertebral veins (n = 2) were injured with massive presacral bleeding during mobilization of the rectum. The first two patients with low rectal carcinoma were operated upon by a junior associate professor and the source of bleeding was the presacral venous plexus. The other two patients with recurrent rectal carcinoma were both women and the source of bleeding was the basivertebral veins.RESULTS: Two different techniques were used to con-trol the bleeding. In the first two patients with massive bleeding from the presacral venous plexus, we used suture ligation around the venous plexus in the area with intact presacral fascia that communicated with the site of bleeding (surrounding suture ligation). In the second two patients with massive bleeding from the basivertebral veins, the pelvis was packed with gauze, which resulted in recurrent bleeding as soon as it was removed. Following this, we used electrocautery applied through one epiploic appendix pressed with a long Kelly clamp over the bleeding sacral neural foramen where was felt like a pit Electrocautery adjusted to the highest setting was then applied to the clamp to "weld" closed the bleeding point. Postoperatively, the blood loss was minimal and the drain tube was removed on days 4-7. CONCLUSION: Surrounding suture ligation and epiploic appendices welding are effective techniques for controlling massive presacral bleeding from presacral venous plexus and sacral neural foramen, respectively.

关键词： Massive presacral bleeding Rectal surgery Suture ligation Welding

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Preoperative carcinoembryonic antibody is predictive of distant metastasis in pathologically T1 colorectal cancer after radical surgery

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World Journal of Gastroenterology 2013年第3期19卷 389-393页

作者： Zheng Lou Rong-Gui Meng Wei Zhang En-Da Yu chuan-gang fu Department of Colorectal Surgery Changhai Hospital

AIM:To identify the predictors of distant metastasis in pathologically T1(pT1)colorectal cancer(CRC)after radical resection. METHODS:Variables including age,gender,preoperative carcinoembryonic antibody(CEA)level,tumor location,tumor size,lymph node status,and histological grade were recorded.Patients with and without metastasis were compared with regard to age,gender,CEA level and pathologic tumor characteristics using the independent t test orχ 2 test,as appropriate.Risk factors were determined by logistic regression analysis. RESULTS:Metastasis occurred in 6(3.8%)of the 159 patients during a median follow-up of 67.0(46.5%) mo.The rates of distant metastasis in patients with pT1 cancer of the colon and rectum were 6.7%and 2.9%, respectively(P<0.001).The rates of distant metastasis between male and female patients with T1 CRC were 6.25%and 1.27%,respectively(P<0.001).The most frequent site of distant metastasis was the liver. Age(P=0.522),gender(P=0.980),tumor location(P =0.330),tumor size(P=0.786),histological grade(P =0.509),and high serum CEA level(P=0.262)were not prognostic factors for lymph node metastasis.Univariate analysis revealed that age(P=0.231),gender(P =0.137),tumor location(P=0.386),and tumor size (P=0.514)were not risk factors for distant metastasis after radical resection for T1 colorectal cancer.Postoperative metastasis was only significantly correlated with high preoperative serum CEA level(P=0.001).Using multivariate logistic regression analysis,high preoperative serum CEA level(P=0.004;odds ratio 15.341; 95%CI 2.371-99.275)was an independent predictor for postoperative distant metastasis. CONCLUSION:The preoperative increased serum CEA level is a predictive risk factor for distant metastasis in CRC patients after radical resection.Adjuvant chemotherapy may be necessary in such patients,even if they have pT1 colorectal cancer.

关键词： Colorectal cancer Risk factor Metastasis Pathologically T1 Carcinoembryonic antigen

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Appropriate treatment of acute sigmoid volvulus in the emergency setting

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World Journal of Gastroenterology 2013年第30期19卷 4979-4983页

作者： Zheng Lou En-Da Yu Wei Zhang Rong-Gui Meng Li-Qiang Hao chuan-gang fu Department of Colorectal Surgery Changhai Hospital

AIM:To investigate an appropriate strategy for the treatment of patients with acute sigmoid volvulus in the emergency setting.METHODS:A retrospective review of 28 patients with acute sigmoid volvulus treated in the Department of Colorectal Surgery,Changhai Hospital,Shanghai from January 2001 to July 2012 was performed.Following the diagnosis of acute sigmoid volvulus,an initial colonoscopic approach was adopted if there was no evidence of diffuse peritonitis.RESULTS:Of the 28 patients with acute sigmoid volvulus,19(67.9%)were male and 9(32.1%)were female.Their mean age was 63.1 ± 22.9 years(range,21-93 years).Six(21.4%)patients had a history of abdominal surgery,and 17(60.7%)patients had a history of constipation.Abdominal radiography or computed tomography was performed in all patients.Colonoscopic detorsion was performed in all 28 patients with a success rate of 92.8%(26/28).Emergency surgery was required in the other two patients.Of the 26 successfully treated patients,seven(26.9%)had recurrent volvulus.CONCLUSION:Colonoscopy is the primary emergency treatment of choice in uncomplicated acute sigmoid volvulus.Emergency surgery is only for patients in whom nonoperative treatment is unsuccessful,or in those with peritonitis.

关键词： Sigmoid colon Volvulus Emergency Colonoscopy

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Upregulation of nemo-like kinase is an independent prognostic factor in colorectal cancer

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World Journal of Gastroenterology 2015年第29期21卷 8836-8847页

作者： Wei Zhang Jian He Yan Du Xian-Hua Gao Yan Liu Qi-Zhi Liu Wen-Jun Chang Guang-Wen Cao chuan-gang fu Department of Colorectal Surgery Changhai Hospital The Second Military Medical University Department of Epidemiology The Second Military Medical University

AIM: To investigate the expression and oncogenic role of nemo-like kinase(NLK) in colorectal cancer.METHODS: Expression of NLK protein was assessed by immunohistochemistry in tissue specimens from 56 cases of normal colorectal mucosa, 51 cases of colorectal adenoma, and 712 cases of colorectal cancer. In addition, NLK expression was knocked down using a lentivirus carrying NLK small hairpin RNA in colorectal cancer cells. Cell viability methylthiazoletetrazolium assays, colony formation assays, flow cytometry cell cycle assays, Transwell migration assays, and gene expression assays were performed to explore its role on proliferation and migration of colorectal cancer.RESULTS: Expression of NLK protein progressively increased in tissues from the normal mucosa through adenoma to various stages of colorectal cancer. Overexpression of NLK protein was associated with advanced tumor-lymph node-metastasis stages, poor differentiation, lymph node and distant metastases, and a higher recurrence rate of colorectal cancer(P furthermore, knockdown of NLK expression in colorectal cancer cell lines reduced cell viability, colony formation, and migration, and arrested tumor cells at the G0/G1 phase of the cell cycle. At the gene level, knockdown of NLK expression inhibited matrix metalloproteinase-2 expression in colorectal cancer cells. CONCLUSION: NLK overexpression is an independent prognostic factor in colorectal cancer and knockdown of NLK expression inhibits colorectal cancer progression and metastasis.

关键词： Colorectal cancer Gene regulation Nemolikekinase Prognosis

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Trace formula of the integro-differential operator on a quantum graph

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Applied Mathematics(A Journal of Chinese Universities) 2024年第2期39卷 311-318页

作者： WEI Li-xiao YANG chuan-fu School of Mathematics and Statistics Nanjing University of Science and TechnologyNanjing 210094China.

In this paper we study the eigenvalue problem for integro-differential operators on a lasso graph.The trace formula of the operator is established by applying the residual technique in complex analysis.

关键词： integro-differential operators eigenvalue trace formula

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A novel alternative for pyrogen detection based on a transgenic cell line

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Signal Transduction and Targeted Therapy 2024年第3期9卷 1221-1229页

作者： Qing He chuan-Fei Yu gang Wu Kai-Qin Wang Yong-Bo Ni Xiao Guo Zhi-Hao fu Lan Wang De-Jiang Tan Hua Gao Can Wang gang Chen Xu-Hong Chen Bo Chen Jun-Zhi Wang National Institutes for Food and Drug Control BeijingChina School of Life Science and Biopharmaceutics Shenyang Pharmaceutical UniversityShenyangChina Shanghai Institute for Food and Drug Control ShanghaiChina KeyMed Biosciences Inc. ChengduChina

Pyrogen,often as a contaminant,is a key indicator affecting the safety of almost all parenteral drugs(including biologicals,chemicals,traditional Chinese medicines and medical devices).It has become a goal to completely replace the in vivo rabbit pyrogen test by using the in vitro pyrogen test based on the promoted‘reduction,replacement and refinement’principle,which has been highly considered by regulatory agencies from different countries.We used NF-κB,a central signalling molecule mediating inflammatory responses,as a pyrogenic marker and the monocyte line THP-1 transfected with a luciferase reporter gene regulated by NF-κB as an in vitro model to detect pyrogens by measuring the intensity of a fluorescence signal.Here,we show that this test can quantitatively and sensitively detect endotoxin(lipopolysaccharide from different strains)and nonendotoxin(lipoteichoic acid,zymosan,peptidoglycan,lectin and glucan),has good stability in terms of NF-κB activity and cell phenotypes at 39 cell passages and can be applied to detect pyrogens in biologicals(group A&C meningococcal polysaccharide vaccine;basiliximab;rabies vaccine(Vero cells)for human use,freeze-dried;Japanese encephalitis vaccine(Vero cells),inactivated;insulin aspart injection;human albumin;recombinant human erythropoietin injection(CHO Cell)).The within-laboratory reproducibility of the test in three independent laboratories was 85%,80%and 80%and the interlaboratory reproducibility among laboratories was 83.3%,95.6%and 86.7%.The sensitivity(true positive rate)and specificity(true negative rate)of the test were 89.9%and 90.9%,respectively.In summary,the test provides a novel alternative for pyrogen detection.

关键词： pyrogen rabbit replace

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Ambarzumyan's Theorem for the Dirac Operator on Equilateral Tree Graphs

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Acta Mathematicae Applicatae Sinica 2024年第2期40卷 568-576页

作者： Dong-Jie WU Xin-Jian XU chuan-fu YANG Department of Mathematics School of Mathematics and StatisticsNanjing University of Science and TechnologyNanjing 210094China

The classical Ambarzumyan’s theorem states that if the Neumann eigenvalues of the Sturm-Liouville operator-d^(2)/dx^(2)+q with an integrable real-valued potential q on[0,π] are {n^(2):n≥0},then q=0 for almost all x∈[0,π].In this work,the classical Ambarzumyan’s theorem is extended to the Dirac operator on equilateral tree graphs.We prove that if the spectrum of the Dirac operator on graphs coincides with the unperturbed case,then the potential is identically zero.

关键词： dirac operator quantum graph Ambarzumyan’s theorem inverse spectral problem

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Sedimentary Environment and Mineralization of the Black Shale Polymetallic Layer in the Early Cambrian,SW China:Constraints from in situ LA-ICP-MS Analysis of Pyrite

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Acta Geologica Sinica(English Edition) 2024年第2期98卷 416-429页

作者： YANG Zhen fu Yong LI Chao CAI Xi GUO chuan College of Eco-Environmental Engineering Guizhou Minzu UniversityGuiyang 550025China College of Resources and Environmental Engineering Guizhou UniversityGuiyang 550025China Key Laboratory of Karst Georesources and the Environment Ministry of EducationGuizhou UniversityGuiyang 500025China National Research Center for Geoanalysis Chinese Academy of Geological SciencesBeijing 100037China

A polymetallic layer is usually developed at the bottom of the early Cambrian black shale in Guizhou Province.The mineral that makes up the polymetallic layer is related to the sedimentary facies.To analyze the differentiation mechanism between polymetallic deposits(Ni-Mo and V),the Zhijin Gezhongwu profile located in the outer shelf and the Sansui Haishan V deposit located in the lower slope are selected to study the in situ sulfur isotopes and trace elements of pyrite.The results show that δ^(34)S values of pyrite vary widely from−7.8‰to 28‰in the Gezhongwu profile,while the δ^(34)S values are relatively uniform(from 27.8‰to 38.4‰)in the Haishan profile.The isotopic S composition is consistent with the transition that occurs in the sedimentary phase from the shelf to the deep sea on the transgressive Yangtze platform;this indicates that the δ^(34)SO_(4)^(2−)values in seawater must be differently distributed in depositional environments.The sulfur in the Ni-Mo layer is produced after the mixing of seawater and hydrothermal fluid,while the V layer mainly originates from seawater.Overall,the Ni-Mo and V deposits have been differentiated primarily on the basis of the combined effect of continental weathering and hydrothermal fluid.

关键词： sedimentary environment black shale polymetallic layer pyrite early Cambrian

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Casual associations between blood metabolites and colon cancer

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1995-2005页

作者： Ke-Yue Hu Yi-Quan Cheng Zhi-Long Shi fu-Peng Ren gang-Feng Xiao Department of Hematology and Oncology Ningbo No.2 HospitalNingbo 315000Zhejiang ProvinceChina

BACKGROUND Limited knowledge exists regarding the casual associations linking blood metabolites and the risk of developing colorectal cancer.AIM To investigate causal associations between blood metabolites and colon cancer.METHODS The study utilized a two-sample Mendelian randomization(MR)analysis to investigate the causal impact of 486 blood metabolites on colorectal cancer.The primary method of analysis used was the inverse variance weighted model.To further validate the results several sensitivity analyses were performed,including Cochran's Q test,MR-Egger intercept test,and MR robust adjusted profile score.These additional analyses were conducted to ensure the reliability and robustness of the findings.RESULTS After rigorous selection for genetic variation,486 blood metabolites were included in the MR analysis.We found Mannose[odds ratio(OR)=2.09(1.10-3.97),P=0.024],N-acetylglycine[OR=3.14(1.78-5.53),P=7.54×10^(-8)],X-11593-O-methylascorbate[OR=1.68(1.04-2.72),P=0.034],1-arachidonoylglycerophosphocholine[OR=4.23(2.51-7.12),P=6.35×10^(-8)]and 1-arachidonoylglycerophosphoethanolamine 4[OR=3.99(1.17-13.54),P=0.027]were positively causally associated with colorectal cancer,and we also found a negative causal relationship between Tyrosine[OR=0.08(0.01-0.63),P=0.014],Urate[OR=0.25(0.10-0.62),P=0.003],N-acetylglycine[0.73(0.54-0.98),P=0.033],X-12092[OR=0.89(0.81-0.99),P=0.028],Succinylcarnitine[OR=0.48(0.27-0.84),P=0.09]with colorectal cancer.A series of sensitivity analyses were performed to confirm the rigidity of the results.CONCLUSION This study showed a causal relationship between 10 blood metabolites and colorectal cancer,of which 5 blood metabolites were found to be causal for the development of colorectal cancer and were confirmed as risk factors.The other five blood metabolites are protective factors.

关键词： Metabolites Colon cancer Mendelian randomization Genome-wide association studies Casual

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