ObjectiveTo compare the properties of hernia repair mesh of different materials used in clinical practice, so as to provide reference for clinical selection of numerous meshes at present. MethodThe literatures of different materials of hernia mesh in the treatment of abdominal hernia and inguinal hernia at home and abroad were reviewed.ResultsThe synthetic mesh, especially the polypropylene mesh with wide-pore mesh in the midweight mesh, might be the most ideal synthetic mesh. The new coating material improved the defect of polypropylene material to a great extent. The status of biological mesh in complex hernia repair had been waxed, and it had a tendency to be replaced by absorbable synthetic mesh.ConclusionsCurrently, there is no single mesh suitable for all types of hernia repair. Polypropylene mesh is still an effective and low cost mesh material, and there may be more room for the development of absorbable synthetic materials and antimicrobial coatings.
ObjectiveTo summarize the research status of risk factors of chronic postoperative inguinal pain (CPIP).MethodWe searched and summarized the domestic and foreign literatures about the risk factors of CPIP in recent years.ResultsThere was no doubt that the risk factors of CPIP included preoperative pain, acute pain at postoperative, recurrent inguinal hernia, smaller hernia sac, higher body mass index (BMI), and surgical methods. These effects were controversial such as age, gender, and the mesh. In recent years, hypertension and a past history of chronic pain may also be risk factors for the development of CPIP.ConclusionsThe risk factors of CPIP still need the further study.
ObjectiveTo summarise the influencing factors of gut microbiota in the perioperative period and its regulatory mechanism in postoperative pain, with the aim of providing clinical reference for postoperative pain management. MethodRelevant literatures on gut microbiota and postoperative pain in recent years were systematically reviewed and synthesised. ResultsAnaesthesia, preoperative mechanical bowel preparation, surgical stress, etc. could cause gut microbiota dysbiosis. Gut microbiota directly or indirectly modulated the excitability of primary sensory neurons through their derived metabolites and pathogen-associated molecular patterns and influenced the pain signalling process by activating immune cells to release cytokines. ConclusionsGut microbiota play an important role in the development and progression of postoperative pain. Future studies should further clarify its role in different types of postoperative pain and develop innovative therapeutic strategies based on the regulation of gut microbiota to improve the management of postoperative pain.
目的 探讨胃大部切除术后吻合口溃疡的诊治方法。方法 1985年3月至2008年6月期间兰州大学第一医院收治的胃大部切除术后吻合口溃疡患者29例,均经胃镜证实,其中男16例,女13例; 年龄30~51(40±3.0)岁; 19例为十二指肠球部溃疡术后,10例为胃溃疡术后。初次手术到溃疡再发症状的时间,最短1例为1个月,其余28例为3~4年。2例吻合口溃疡穿孔及4例吻合口溃疡出血者行包括吻合口在内的残胃部分切除、胃空肠Roux-Y吻合术; 其余均给予非手术治疗。结果 行再手术治疗者术后发生切口感染1例,行保守治疗; 所有患者均治愈,随访1~5年,未出现溃疡复发。结论 吻合口溃疡首选保守治疗,多数可治愈。再次手术方式可采用残胃部分切除加胃空肠Roux-Y吻合术。
Objective To construct the eukaryotic expressive vector of human tissue factor (TF),and to abserve the effect of TF on invasion and metastasis of gastric cancer cells line. Methods The human TF cDNA was obtained from human placenta by nest PCR, and the constructed eukaryotic expressive vector TF-pcDNA3 was transfected into SGC7901 cells by lipofectamine. Stable-transfected cells were screened by G418. The expressions of TF mRNA and protein on the cells were detected by RT-PCR and Western blot. Cell motility was assessed by using Transwell experiments and wound-healing assays. Results The eukaryotic expressive vector TF-pcDNA3 was successfully constructed and transfected into SGC7901. Compared with blank control group and negative control group, the expressions of TF mRNA and TF protein in transfection group were increased, the cell motility in vitro was enhanced. Conclusion TF can enhance the ability of invasion and metastasis of gastric cancer cells in vitro.
ObjectiveTo understand the research progress of Aurora kinase A (AURKA) in colorectal cancer, so as to provide new ideas for treatment of colorectal cancer. MethodThe relevant to literature on AURKA and its relation with colorectal cancer was searched and reviewed. ResultsThe AURKA was a member of the polygenic family of mitosis/threonine protein kinases. The studies in recent years had found that the AURKA not only played an important role in the regulation in the cell cycle processes, but also played a different role outside the cell cycle. The AURKA abnormally expressed in a variety of malignancies, including colorectal cancer, and was associated with a poor prognosis in patients, and many inhibitors against AURKA were developed and evaluated at different stages of clinical study. ConclusionAs a key gene in the occurrence and development of colorectal cancer, AURKA should be further studied to clarify its specific mechanism of action, and targeted drugs may be developed.
ObjectiveTo systematically summarize the research progress in risk prediction models for postoperative anastomotic leakage in gastric cancer, and to explore the advantages and limitations of models constructed using traditional statistical methods and machine learning, thereby providing a theoretical basis for clinical precision prediction and early intervention. MethodBy analyzing domestic and international literature, the construction strategies of logistic regression, least absolute shrinkage and selection operator (LASSO) regression, and machine learning models (support vector machine, random forest, deep learning) were systematically reviewed, and their predictive performance and clinical applicability were compared. ResultsThe traditional logistic regression and LASSO regression models performed excellently in terms of interpretability and in small-sample scenarios but were limited by linear assumptions. The machine learning models significantly enhanced predictive capabilities for complex data through non-linear modeling and automatic feature extraction, but required larger data scales and had higher demands for interpretability. ConclusionsDifferent prediction models have their own advantages and limitations; in practical clinical applications, they should be flexibly selected or complementarily applied based on specific scenarios. Current anastomotic leakage prediction models are evolving from single factor analysis to multi-modal dynamic integration. Future efforts should combine artificial intelligence and multi-center prospective clinical studies to validate, so advancing the development of precise and individualized anastomotic leakage predictive tools for patients after gastric cancer resection.
Objective To summarize the stemness regulation mechanism of microRNA on invasion, metastasis and chemoresistance of gastric cancer stem cells (GCSCs), and to explore the anti-tumor therapy based on miRNA targeting GCSCs. Method The literatures about the research progress of miRNA and GCSCs at home and abroad in recent years were collected and reviewed. Results MiRNA could regulate a series of important cellular processes such as proliferation, apoptosis, differentiation and epithelial-mesenchymal transition of GCSCs by participating in the expression of related target genes, which was associated with poor prognosis and high mortality of gastric cancer patients. Silencing or restoring the expression of candidate miRNA of GCSCs could provide a novel and promising approach for the treatment of gastric cancer. Conclusions GCSCs have an important relationship with the malignant biological behavior of gastric cancer, and studies have confirmed that miRNA play an important regulatory role in GCSCs. Therefore, miRNA can be used as a potential target for the treatment of gastric cancer. By regulating the expression of specific miRNA, it can inhibit tumor invasion and metastasis, and improve the sensitivity of chemotherapy drugs.