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  • JOURNAL OF CLINICAL SURGERY

    主管单位:湖北省卫生和计划生育委员会
    主办单位:中华医学会湖北分会
    地  址:武汉市武昌区东湖路165号
    邮  编: 430071
    电  话:027-87893476
    电子邮件:whlcwk@126.com
    国际标准刊号:ISSN 1005-6483
    国内统一刊号:CN 42-1334/R
    邮发代号:38-184

Current Issue
20 August 2022, Volume 30 Issue 8
Mechanism study of metformin inhibiting migration and invasion of non-small cell lung cancer A549 cell through LncRNA-H19
LIU Kai, LI Bo, WU Xiangtian, et al
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  719-721.  DOI: 10.3969/j.issn.1005-6483.2022.08.006
Abstract ( 32 )   PDF (735KB) ( 17 )   PDF(mobile) (735KB) ( 1 )  
Objective To study the effects of metformin on the migration and invasion of non-small cell lung cancer cell line A549 through down-regulating the expression of LncRNA-H19. Methods pc-H19 overexpression plasmid was used to increase the expression of LncRNA-H19 in A549 cells.Real-time PCR was used to evaluate the overexpression efficiency of pc-H19 transfection efficiency.Transwell migration and invasion assays were used to test the effect of overexpression of H19 on the motility of tumor cells.Furthermore,the inhibitory effect of metformin on the expression of H19 in A549 cells and the motility of tumor cells were verified in vitro. Results The pcH19 overexpression vector constructed in this study can significantly up-regulate the expression of LncRNA-H19 in A549 cells.Overexpression of LncRNA-H19 can significantly promote the migration and invasion of A549 cells.40 mM metformin can significantly inhibit the expression of H19 in A549 cells,and inhibit the migration and invasion of A549 cells.Conclusion Metformin suppressed the migration and invasion of A549 cells by down-regulating H19 expression.This study suggests that H19 is one of the potential therapeutic targets for non-small cell lung cancer,and metformin exerts potential anti-tumor metastasis effect against lung cancer.
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Comparison of the effects of singleport thoracoscopic lobectomy under two approaches on postoperative rehabilitation process,pulmonary function and internal environment indexes of nonsmall cell lung cancer
NIU Lei, HUO Chengyu, LIU Zongzhi, et al
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  722-726.  DOI: 10.3969/j.issn.1005-6483.2022.08.007
Abstract ( 26 )   PDF (928KB) ( 23 )   PDF(mobile) (928KB) ( 1 )  
Objective To observe and compare the effects of singleport thoracoscopic lobectomy under two approaches(transxiphoid and intercostal) on postoperative rehabilitation progress,pulmonary function and internal environment indexes of nonsmall cell lung cancer.Methods 82 patients with nonsmall cell lung cancer in Civil Aviation General Hospital were divided into two groups according to different surgical approaches.All patients underw ent single hole thoracoscopic lobectomy.43 patients in the transxiphoid group underwent transxiphoid surgery and 39 patients in the intercostal group underwent subcostal surgery.The operation conditions,complications,postoperative pain score(VAS),1 year survival rate after operation,internal environment indexes and pulmonary function indexes before and after operation were compared between the two groups.Results There was no difference in the number of lymph nodes dissected between the two groups(P>0.05).The operation time in the transxiphoid group[(151.72±28.04)min] was longer than that in the intercostal group[(137.35±24.72)min],but the hospitalization,catheter placement and ambulation time were(5.02±0.84) d,(3.91±1.47) d and(10.04±1.83) d,respectively,which were shorter than those in the transcostal group[(5.53±0.96)d,(4.86±1.72)d,(11.85±2.06)d(P<0.05)].The intraoperative blood loss,VAS score at 6h,1d,2d,and 3d after operation in the transxiphoid group were lower than those in the intercostal group(P<0.05).The levels of serum Creactive protein(CRP),interleukin 6(IL-6),and creatine kinase(CK) in the xiphoid group were(10.52±1.83) mg/L,(8.36 ±1.28) mg/L,(121.87±15.74) pg/mL,(106.90±11.82) pg/ml,(247.80±26.57) U/L,(219.74±30.09) U/L,all lower than the intercostal group(15.76±2.48)mg/L,(10.75±1.59)mg/L,(169.20±18.16)pg/ml,(132.62±15.71)pg/ml,(336.27±41.58)U/L,(292.84±34.29)U/L(P<0.05).The levels of maximum spontaneous ventilation(MVV) and forced expiratory flow in 1 second(FEV1)/forced vital capacity(FVC) in the two groups at 1 month after operation were lower than those before operation(P<0.05),but there was no difference between the groups(P>0.05).There was no difference in postoperative complication rate and 1year survival rate between the two groups(P>0.05).Conclusion Compared with the transcostal approach,Subxiphoid singleport thoracoscopic lobectomy in the treatment of nonsmall cell lung cancer is not only effective,but also can reduce surgical trauma,relieve postoperative pain,stabilize the internal environment of the body,and promote postoperative recovery.
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SRGAP3-AS2 regulates non-small cell lung cancer cell proliferation,migration and invasion via JAK signaling pathway
LI Xin, GAI Huirong, SONG Lei, et al
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  727-730.  DOI: 10.3969/j.issn.1005-6483.2022.08.008
Abstract ( 20 )   PDF (979KB) ( 7 )   PDF(mobile) (979KB) ( 1 )  
Objectives To elucidate the function and underlying mechanism of lncRNA(long non-coding RNA) SRGAP3-AS2(SRGAP3 antisense RNA 2) on the proliferation,migration and invasion of non-small cell lung cancer(NSCLC).Methods The expression of SRGAP3-AS2 in NSCLC tissues and H23 cells was detected,and the relationship between the expression of SRGAP3-AS2 and the clinicopathology of NSCLC was analyzed.H23 cells were divided into the NC group,pc-SRGAP3-AS2 group and pc-SRGAP3-AS2+JAK2 activator group.Cell proliferation,migration,invasion,MMP-2,Bcl-2,p-JAK2 and p-STAT3 expressions were detected in each group.Results The expression of SRGAP3-AS2 was lower in NSCLC tissues,which was related to lymph node metastasis and TNM stage(P<0.05).Compared with the NC group,the cell viability,the wound healing rate,the number of invasive cells,the expressions of MMP-2,Bcl-2,p-JAK2 and p-STAT3 in the pc-SRGAP3-AS2 group were decreased(P<0.05).Compared with the pc-SRGAP3-AS2 group,the cell viability,wound healing rate,number of invasive cells,MMP-2,Bcl-2,p-JAK2 and p-STAT3 expression in the pc-SRGAP3-AS2+JAK2 activator group increased(P<0.05).Conclusion The lower expression of SRGAP3-AS2 in NSCLC tissue is related to lymph node metastasis and TNM.Overexpression of SRGAP3-AS2 can inhibit JAK2/STAT3 signaling and inhibit the proliferation,migration and invasion of NSCLC cells H23.
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Efficacy of video-assisted thoracoscopic anatomical segmental resection for early non-small cell lung cancer and its influence on serum CRP,IL-1β,IL-6 and TNF-α levels
WANG Yongfu, WU Yuanlin, XIE Shaoqiang, et al
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  731-734.  DOI: 10.3969/j.issn.1005-6483.2022.08.009
Abstract ( 20 )   PDF (640KB) ( 7 )   PDF(mobile) (640KB) ( 1 )  
Objective To investigate that efficacy of video-assisted thoracoscopic surgery(VATS) and total video-assisted thoracoscopic lobectomy in the treatment of early-stage non-small cell lung     canc(NSCLC) and the effects on serum inflame matory factor.Methods A total of 86 patients with early NSCLC who were treated in the thoracic surgery of Yibin Second People’s Hospital from January 2018 to January 2020 were selected and divided into the research group(n=45) of anatomic segmentectomy under VATS and the control group(n=41) of lobectomy under VATS according to the surgical method.The surgical effects and changes in pulmonary function indexes of the two groups were compared.The serum levels of Creacive protein(CRP),interleukin-1β(IL-1β),interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) before and after treatment were detected.Results The operation time,intraoperative bleeding volume,postoperative drainage volume and postoperative drainage time in the research group were significantly higher than those in the control group(P<0.05).The hospital stay in the research group was significantly lower than that in the control group(P<0.05).There was no statistical difference in the number of lymph node cleanings between the two groups(P>0.05).Preoperative FEV1%,FVC% and PEF pulmonary function indexes showed no significant difference between the two groups(P>0.05).The percentages of FEV1% and FVC% after surgery in the two groups were significantly lower than those before surgery,and the PEF was significantly higher than that before surgery with statistical significance(P<0.05).The levels of FEV1%,FVC% and PEF in the postoperative study group were significantly higher than those in the control group(P<0.05).Serum CRP,IL-1β,IL-6,and TNF-α levels of the two groups on day 1 and day 3 after surgery were significantly higher than those before surgery(P<0.05).The levels of serum CRP,IL-1β,IL-6,and TNF-α on day 1 after surgery were significantly higher than those on day 3 after surgery(P<0.05).The levels of serum CRP,IL-1β,IL-6,and TNF-α in the study group were significantly lower than those in the control group 1d and 3d after surgery(P<0.05).Conclusion VATS anatomical segmentectomy in the treatment of early NSCLC can effectively improve lung function of patients and significantly reduce the body inflammatory response.
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Correlation between CT signs and the expression of golgi phosphoprotein 3,Ki-67 in patients with lung cancer  
HOU Haiwen, LI Juhui, TANG Xiaowu
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  734-735.  DOI: 10.3969/j.issn.1005-6483.2022.08.010
Abstract ( 22 )   PDF (1030KB) ( 10 )   PDF(mobile) (1030KB) ( 1 )  
Objective To analyze the correlation between CT signs and the expression of Ki-67,golgi phosphoprotein 3(GOLPH3) in patients with lung cancer.Methods 120 patients with lung cancer admitted tofrom January 2019 to April 2021 were selected.They were examined by CT.The CT signs(tumor diameter,location,burr sign,deep lobulation sign and necrotic cavity) were collected.The expression of Ki-67,GOLPH3 in lung cancer tissue was detected by immunohistochemistry,and the correlation between CT signs and the expression of Ki-67,GOLPH3 was analyzed.Results Among the 120 cases of lung cancer,76 cases(63.33%) had lesion diameter > 3cm,61 cases(50.83%) had peripheral lung cancer,84 cases(70.00%) had no necrotic cavity,71 cases(59.17%) had no burr sign,79 cases(65.83%) had deep lobulation sign.The positive rate of Ki-67 was 88.33%(106/120) and the positive rate of GOLPH3 was 79.17%(95/120).The expression of Ki-67,GOLPH3 in lung cancer tissues was positively correlated(r=0.381,0.271,P=0.000,0.018).The expression of Ki-67 and GOLPH3 in lung cancer was correlated with cavity,burr and deep lobulation.The expression of Ki-67 and GOLPH3 were significantly different among the four pathological types(P<0.05).The expression of Ki-67 and GOLPH3 in the pathological grade Ⅲ~Ⅳ were significantly higher than that in gradeⅠ~Ⅱ(P<0.05).Conclusion There is a correlation between CT image features and Ki-67,GOLPH3 positive expression in lung cancer,which can provide reliable basis for evaluating tumor proliferation and predicting prognosis.
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The study of conversion therapy with carrelizumab combined with chemotherapy in unresectable locally advanced esophageal cancer
TIAN Wenze, XIONG Xinkui, XU Dafu, et al
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  741-743.  DOI: 10.3969/j.issn.1005-6483.2022.08.012
Abstract ( 15 )   PDF (690KB) ( 6 )   PDF(mobile) (690KB) ( 1 )  
Objective To investigate the value of carrelizumab combined with chemotherapy in conversion therapy of primary unresectable locally advanced esophageal cancer.Methods A descriptive case series study was used to retrospectively analyze 22 patients with unresectable locally advanced esophageal squamous cell carcinoma who underwent conversion therapy from February 2020 to December 2021.They were treated with “carrelizumab + albumin paclitaxel+cisplatin” regimen for 3 ~ 4 cycles before operation.The patients who were evaluated as radical surgery after multidisciplinary joint consultation were treated with surgery.The effect,adverse reactions and surgical index during conversion therapy were analyzed.Results After conversion therapy,Among the 22 patients,6 had complete remission and 14 had partial remission.The objective remission rate was 90.91%(20/22);16 patients underwent surgery after transformation.The conversion rate was 72.73%(16/22);The resection rate of R0 was 93.75%(15/16).Conclusion Carrelizumab combined with chemotherapy can achieve better clinical remission and higher R0 resection in the conversion therapy of primary advanced unresectable esophageal cancer.
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Relationship between the expression levels of microRNA-138 and microRNA-145 and Th1/Th2 drift and prognosis in esophageal squamous cell carcinoma
YUAN Ye, LIU Tao, LIU Hua
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  744-748.  DOI: 10.3969/j.issn.1005-6483.2022.08.013
Abstract ( 12 )   PDF (848KB) ( 6 )   PDF(mobile) (848KB) ( 1 )  
Objective To analyze the expression levels of microRNA(miR) -138 and miR-145 in esophageal squamous cell carcinoma and their relationship with type 1 helper T cell(Th1) / type 2 helper T cell(Th2) drift and prognosis.Methods 112 patients with esophageal squamous cell carcinoma treated in our hospital from May 2015 to may 2018 were selected as esophageal squamous cell carcinoma group.The expression levels of miR-138 and miR-145 in esophageal squamous cell carcinoma tissues and adjacent tissues were detected by realtime fluorescence quantitative polymerase chain reaction(qRT-PCR).70 healthy people in the same period were used as the control group,serum Th1 cytokines γ Interferon(IFN)γ,Levels of interleukin(IL)-2 and Th2 cytokines IL-4 and IL-10 in esophageal squamous cell carcinoma group and control group were detected by enzyme linked immunosorbent assay(ELISA).The relationship between the expression levels of miR-138 and miR-145 and clinicopathological parameters was analyzed.The correlation between miR-138,miR-145 and Th1 and Th2 cytokines in cancer tissues were analysised by pearson correlation.To analyze the expression of miR-138 and miR-145 in patients with esophageal squamous cell carcinoma.Results The expression of miR-138 and miR-145 in esophageal squamous cell carcinoma tissues were 1.155±0.232 and 1.110±0.217,respectively,and in paracancerous tissues were 4.155±0.732 and 3.910±0.617,respectively.The expression of miR-138 and miR-145 was significantly lower than that in adjacent tissues(P<0.05).There were significant differences in the expression levels of miR-138 and miR-145 in esophageal squamous cell carcinoma tissues of different tumor stages(P<0.05).The expression of miR-138 and miR-145 in cancer tissues were positively correlated with IFN-γ and IL-2(r=0.451、0.543;0.520、0.401,P<0.05),and IL-4,IL-10 were negatively correlated(r=-0.391,-0.510;-0.402,0.553,P<0.05).The 3 year overall survival(OS) rate of patients with high expression of miR-138 was 58.49%(31/53),which was significantly higher than that of patients with low expression of 17.24%(10/58)(P<0.05);the 3 year OS of patients with high miR-145 expression was 52.73%(29/55),which was significantly higher than 21.43%(12/56) of patients with low expression(P<0.05).Conclusion The expression levels of miR-138 and miR-145 in esophageal squamous cell carcinoma are decreased,which is related to the poor prognosis of patients.MiR-138 and miR-145 may promote the malignant progression of esophageal squamous cell carcinoma by affecting Th1 / Th2 drift.
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The study of vacuum sealing drainage(VSD) in the wound healing after thoracic tuberculosis surgery
ZHANG Lei, DUAN Xiaoliang, PENG Haijun, et al
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  749-751.  DOI: 10.3969/j.issn.1005-6483.2022.08.014
Abstract ( 21 )   PDF (625KB) ( 9 )   PDF(mobile) (625KB) ( 2 )  
Objective To investigate the clinical efficacy of vacuum sealing drainage(VSD) in the treatment of postoperative wound healing of chest wall tuberculosis.Methods From January 2014 to may 2021,40 patients with poor wound healing after chest wall tuberculosis debridement in Hebei chest hospital were selected and randomly divided into observation group and control group,with 20 patients in each group.The observation group was treated with vacuum sealing drainage,and the control group was treated with general surgical dressing changeThe differences of pain perception,dressing time,healing evaluation after 7 days,secondary suture time and hospitalization time between the two groups were compared.Results The pain perception of dressing change was (3.27±0.80 )in the observation group and (5.67±0.72 )in the control group.There was significant difference between the two groups(P<0.05);The dressing change time was (5.33±14.08) minutes in the observation group and (22.07±2.52) minutes in the control group.There was significant difference between the two groups(P<0.05).The second suturing time of the wound was (14.06±2.14) days in the observation group and (23.14±3.38) days in the control group,which was statistically significant(P<0.05);the length of hospital stay was(23.80±2.81) days in the observation group and (35.73±4.43) days in the control group,which was statistically significant(P<0.05);there were 17 patients in the observation group and 10 patients in the control group(P<0.05).Conclusion The application of VSD in the treatment of chest wall tuberculosis,promote wound healing effect is significant.
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Clinical study of neuroendoscopic hematoma removal in the treatment of severe intraventricular hemorrhage cast
ZHOU Xiang, WANG Yangyang, JI Qiankun, et al
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  752-756.  DOI: 10.3969/j.issn.1005-6483.2022.08.015
Abstract ( 19 )   PDF (943KB) ( 9 )   PDF(mobile) (943KB) ( 1 )  
Objective To investigate the clinical effect of neuroendoscope guided hematoma evacuation in the treatment of severe intraventricular hemorrhage cast. Methods 40 patients with severe intraventricular hemorrhage and casting treated in the Department of Neurosurgery of the First Affiliated Hospital of Xinxiang Medical College from December 2018 to June 2021,20 in the control group and 20 in the endoscopy group were retrospectively analyzed.The hematoma clearance of each group was compared and evaluated according to the preoperative and postoperative MGS scores.The dosage of urokinase,the indwelling time of drainage tube,and the incidence of complications such as rebleeding,hydrocephalus and intracranial infection were compared and evaluated.The prognosis was evaluated 3 months after operation.ADL grade Ⅰ - Ⅲ was effective.Results In the endoscopic group,the preoperative MGS score was 24.55±3.00 and the postoperative MGS score was 14.45±4.72.In the control group,the preoperative MGS score was 24.70±3.71 and the postoperative MGS score was 20.40±3.70.The data compared within groups before and after operation was statistically significant( P<0.05).The preoperative MGS score between the two groups was no significant difference.(P>0.05),the postoperative MGS score btween the two groups were statistically significant( P<0.05),and the amount of residual hematoma in the endoscopic group was less.The dosage of urokinase was (3.65±3.24)million U in the endoscopic group and (10.15±3.26)million U in the control group.The retention time of extraventricular drainage was (8.3±1.7)days in the endoscopic group and (11.6±1.7)days in the control group.The incidence of postoperative complications was 10.0% in the endoscopic group and 35.0% in the control group.Three months after operation,the effective rate of ADL score in endoscopic group was 70.0%(14 / 20).The effective rate of the control group was 30.0%(6/20),and the prognosis of the endoscopic group was better.Conclusion Neuroendoscopic hematoma removal in the treatment of severe intraventricular hemorrhage casting can quickly reduce the volume of hematoma,alleviate acute obstructive hydrocephalus,reduce complications and improve prognosis.It is safe and effective.
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Effectiveness Of Percutaneous Closure on Migraineurs with Patent Foramen Ovale and Related Influencing Factors
WUYUN Qidamugai, WANG Yunyun, MA Fei, et al
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  758-761.  DOI: 10.3969/j.issn.1005-6483.222.08.017
Abstract ( 24 )   PDF (640KB) ( 6 )   PDF(mobile) (640KB) ( 1 )  
Objective To evaluate the efficacy and related factors of patent foramen ovale(PFO) occlusion in patients with migraine.Methods From January 2017 to December 2019,116 migraineurs with PFO successfully underwent transcatheter PFO closure in our hospital.Patients completed a migraine burden questionnaire at baseline and at 6 and 12 months of follow-up after the PFO closure.Migraine severity is reported as Headache Impact Test-6(HIT-6) scores and migraine frequency(days/month).The relevant clinical characteristics of the patients were also collected.Results Of 116 patients,a total of 107 patients obtained data for analysis except for 9 cases that were lost to follow-up.One year after PFO closure,migraine was significantly relieved in 53 cases(50%) and effectively relieved in 85 cases(79%).There was significant difference in HIT-6 score before and 1 year after PFO closure(64.36 vs.49.99,P<0.01),and the number of headache days per month was significantly lower than that before PFO closure(6.88 vs.2.46,P<0.01).Clinical multivariate logistic regression analysis showed that the HIT-6 score and duration of headache before occlusion were correlated with headache relief(both P<0.05).The mean HIT-6 score of patients with no residual shunt and small residual shunt after occlusion was significantly lower than that of patients with moderate-large residual shunt(48.41 ± 9.014 vs.55.18 ± 8.658,P<0.05).Conclusions PFO closure in migraine patients with PFO can effectively alleviate headache.Severe preoperative headache and short course of disease are independent predictors of headache relief.The moderate-large residual shunts affect the effectiveness of percutaneous Closure on Migraineurs with PFO.
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The effect of circ_0007385 silence on the proliferation,migration and apoptosis of colon cancer cells
YIN Junfeng, GU Ming
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  762-766.  DOI: 10.3969/j.issn.1005-6483.2022.08.018
Abstract ( 11 )   PDF (1334KB) ( 5 )   PDF(mobile) (1334KB) ( 1 )  
Objective To explore the effect of silencing circ_0007385 on the biological behavior of colon cancer cells and its possible mechanism. Methods qRT-PCR was performed to detect the circ_0007385 and miR-485-3p expression in colon cancer tissues and adjacent tissues.The correlation of circ_0007385 and miR-485-3p expression levels in colon cancer tissues was analyzed by Pearson method.In vitro cultured human colon cancer cells SW480,si-NC,si-circ_0007385,miR-NC,miR-485-3p mimic,si-circ_0007385 and miR-485-3p Inhibitor were transfected into SW480 cells(si-NC group,si -circ_0007385 group,miR-NC group,miR-485-3p mimic group,si-circ_0007385+miR-485-3p Inhibitor group).The dual luciferase reporter experiment was used to verify the targeting relationship between circ_0007385 and miR-485-3p.CCK-8 method and plate colony formation experiment were used to detect cell proliferation and colony formation.Scratch test and Transwell test were used to detect cell migration.Flow cytometry was used to detect cell apoptosis rate.Western blot method was used to detect the expression of cleaved caspase3 protein.Results The expression level of circ_0007385 in colon cancer tissue was higher than that in adjacent tissues(P<0.05),while the expression level of miR-485-3p was lower than that in adjacent tissues(P<0.05).circ_0007385 was negatively correlated with miR-485-3p(r=-0.972,P<0.001).circ_0007385 could be targeted to bind miR-485-3p.Transfection of si-circ_0007385 or miR-485-3p mimic could inhibit cell proliferation and migration,the number of colonies formed and migration cells were reduced,and the rate of apoptosis was increased(P<0.05).Co-transfection of si-circ_0007385 and miR-485-3p Inhibitor could restore the effect of transfection of si-circ_0007385 on the biological behavior of cells.Conclusion Silencing circ_0007385 could induce cell apoptosis and inhibit the proliferation and migration in colon cancer by targeting miR-485-3p.
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Establishment and analysis of patient-derived xenograft models of human renal cell carcinoma
LI Jinnan, CUI Liang, XIAO Xuren, et al
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  767-770.  DOI: 10.3969/j.issn.1005-6483.2022.08.019
Abstract ( 17 )   PDF (913KB) ( 5 )   PDF(mobile) (913KB) ( 1 )  
Objective Establishment of human renal cell carcinoma in NOD-SCID mice subcutaneous xenograft model and subcapsular of renal transplantation tumor model(for example,orthotopic transplantation tumor model),its biological characteristics were analyzed.Methods Tissue specimens were obtained from patients with clinically preoperative diagnosis of renal cell carcinoma.And then sheared the tissue to subcutaneous and orthotopic inoculated to NOD-SCID mice.To prepare xenograft models of primary and passage xenograft models.It was obseved of tumor xenograft model of the incubation period,the rate of tumor formation,tumor volume,tumor invasion and metastasis.Results PDX tumor patients,5 males and 2 females,which accounted for 85.7%(6 cases) of renal clear cell carcinoma,renal parenchyma of pleomorphic epithelioid cell tumor accounted for 14.3%(1 case).One patient was with renal vein tumor thrombus.NOD/SCID mice transplanted tumor latent period was 63.83 days,the rate of tumor formation was about 42.86%,the growth rate of transplanted tumor was different,and the volume was different,for:6.426-197.856 mm-3.It was found that the transplanted tumor was similar to the human renal cell carcinoma from pathological changes of transplanted tumor.Conclusion Compared with orthotopic transplantation,subcutaneous transplantation tumor model was easy to operate,easy to evaluate,measure and observe the tumor.But orthotopic transplantation of the best advantages of the biological behavior of renal cell carcinoma which could better simulate the occurrence and development of the tumor.The transplanted tumor of mice was similar to the structure of human renal cell carcinoma,which could be used as a powerful tool for preclinical study of renal cell carcinoma.
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Relationship between preoperative peripheral blood miR-21,VEGF,CA19-9 and clinical staging,postoperative recurrence,metastasis in patients with colorectal cancer
WU Yongli, FANG Hangang, CHEN Jing, et al
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  771-774.  DOI: 10.3969/j.issn.1005-6483.2022.08.020
Abstract ( 15 )   PDF (732KB) ( 4 )   PDF(mobile) (732KB) ( 1 )  
Objective To explore the relationship between preoperative peripheral blood MicroRNA-21(miR-21),vascular endothelial growth factor(VEGF),carbohydrate antigen 19-9(CA19-9) and clinical staging,postoperative recurrence,metastasis in patients with colorectal cancer(CRC).Methods A total of 62 patients with CRC treated in the hospital were enrolled as CRC group between October 2019 and October 2020,while other 62 healthy controls(HC) without CRC by laboratory and imaging examinations during the same period were enrolled as HC group.The relative expression level of peripheral blood miR-21 in both groups was detected by real-time fluorescence quantitative PCR(qRT-PCR).The level of preoperative VEGF in both groups was detected by enzyme-linked immunosorbent assay.The level of preoperative CA19-9 in both groups was detected by chemiluminescence method.All were followed up for 12 months after surgery to record postoperative recurrence and metastasis.The relationship between preoperative peripheral blood miR-21,VEGF,CA19-9 levels and clinical staging in CRC patients was analyzed by Spearman correlation analysis.The predictive value of miR=21,VEGF and CA19=9 for recurrence and metastasis of CRC was detected by receiver operating characteristic(ROC) curves.Results The relative expression level of miR-21 and levels of VEGF and CA19-9 in CRC group were higher than those in HC group(P<0.05),which were significantly higher in patients at stages III-IV than stage I-II(P<0.05).The relative expression level of miR-21 and levels of VEGF and CA19-9 were positively correlated with clinical staging of TNM(r=0.451,0.339,0.307,P<0.05).In CRC group,relative expression level of miR-21 and levels of VEGF and CA19-9 in patients with recurrence and metastasis were higher than those without recurrence and metastasis(P<0.05).The area under the ROC curve(AUC) of miR-21 combined with VEGF and CA19-9 for evaluating recurrence and metastasis was 0.843(P<0.05).Conclusion The levels of preoperative peripheral blood miR-21,VEGF and CA19-9 are correlated with clinical staging of CRC patients.Their combined detection has good predictive value for postoperative recurrence and metastasis of CRC,which can be applied as assessment indexes for preoperative clinical staging and postoperative recurrence metastasis.
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Comparison of the difference between the minimally invasive direct anterior approach and the SuperPATH approach for early balance and functional recovery after total hip arthroplasty
YUE Pengju, ZHANG Qizhu, XUE Shusheng, et al.
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  775-779.  DOI: 10.3969/j.issn.1005-6483.2022.08.021
Abstract ( 14 )   PDF (1107KB) ( 4 )   PDF(mobile) (1107KB) ( 1 )  
Objective To investigate the difference between the minimally invasive direct anterior approach(DAA) and the SuperPATH approach for early balance and functional recovery after total hip arthroplasty(THA).Methods A total of 82 patients with THA who were admitted to the Eastern Theater General Hospital from August 2016 to August 2020 were divided into DAA group(minimally invasive DAA approach for THA) and SuperPATH group(SuperPATH approach) according to the random number table.THA),41 cases in each group.The acetabular angles(anterior angle,abduction angle) of the two groups of patients were compared with operation related indicators on the 3rd postoperative day.Two groups of patients before operation(T0),1 week after operation(T1),1 month after operation(T2),3 months after operation(T3) and 6 months after operation(T4) Berg Balance Scale(BBS) The score was compared with the Harris score of hip joint function.The postoperative complications of the two groups of patients were compared.Results The length of incision in SuperPATH group [(6.83±0.72) vs(8.06±0.84) cm],intraoperative blood loss [(61.54±10.08)ml vs(80.23±15.74) ml] was shorter(less) than that in DAA group(P<0.05),The operation time [(125.13±11.27)min vs(115.76±10.8 5) min] was longer than that in the DAA group(P<0.05).The postoperative drainage volume [(70.25±11.36)ml vs(65.87±10.43) ml] of the two groups of patients was compared,and the difference was not statistically significant(P>0.05).The anteversion angle of the acetabulum [(15.72±1.76)° vs(15.96±1.85)°] and the abduction angle [(43.28±3.56)° vs(42.75±3.19)°] were compared between the two groups of patients after surgery,and the difference was not statistically significant(P>0.05).There were statistically significant differences in BBS scores between groups,time,and interaction(P<0.05).There was no significant difference in BBS scores between the two groups at T0(P>0.05).Compared with T0,the BBS scores of the two groups of patients at T1,T2 and T3 were reduced(P>0.05),and at T1 [(38.25±5.42)points vs(34.86±6.08) points],T2 time [(41.25±4.96)points vs(37.17±4.03) points],the BBS score of the SuperPATH group was higher than that of the DAA group(P>0.05).There was no significant difference in BBS scores between the two groups at T3 and T4(P>0.05).There were statistically significant differences in the Harris scores of hip joint function between groups,time,and interaction(P<0.05).There was no significant difference in Harris scores of hip joint function between the two groups at T0(P>0.05).Compared with T0,the Harris scores of hip joint function of the two groups of patients at T1,T2,T3,and T4 increased(P>0.05),and T1 [(66.92±3.87)minutes vs(62.35±3.29) minutes],T2 [(77.85±4.06)points vs(75.02±3.75) points] The Harris score of hip joint function in SuperPATH group was higher than that in DAA group(P>0.05).There was no significant difference in Harris scores of hip joint function between the two groups at T3 and T4(P>0.05).The incidence of complications in the SuperPATH group and DAA group were 4.88% and 9.76%,respectively,and the difference was not statistically significant(P>0.05).Conclusion Compared with minimally invasive DAA,the SuperPATH approach for THA has a shorter incision length and less intraoperative blood loss.The two approaches for THA have better early balance and functional recovery,and both are safe and reliable.
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Application of ultrasound-guided sciatic nerve block in anesthesia for patients with ankle fracture
ZHANG Haihua, XIONG Huaping, ZHUANG Haibin, et al.
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  780-782.  DOI: 10.3969/j.issn.1005-6483.2022.08.022
Abstract ( 12 )   PDF (692KB) ( 3 )   PDF(mobile) (692KB) ( 1 )  
Objective During the anesthesia of ankle fractures,ultrasound-guided sciatic nerve block with different approaches is used to analyze the safety and effectiveness of anesthesia.Methods A retrospective analysis of 176 patients with ankle fractures admitted to our hospital from June 2020 to June 2021,patients in group P received sciatic nerve block(PA) in the superior popliteal approach(PA,92 cases),and patients in group G received The sciatic nerve block of the greater trochanteric plane approach(GTA)(84 cases).The operation time, onset time, sciatic nerve depth and pain score of nerve block were compared between the two groups.Results The operation time of nerve block[(3.16±0.68)min vs (6.07±0.94)min],onset time[(1.46±0.36)min vs (2.18±0.43)min] and sciatic nerve depth[(2.76±0.32)cm vs (3.45±0.58)cm] of patients between group P and group G were significant(P<0.05),the maintenance time of nerve blockin group P[(571.27±37.43)min vs (440.42±31.16)min] was significantly better than that in group G(P<0.05).The ankle pain score of patients in group P was significantly lower than that in group G(1.21±0.36 vs 2.26±0.46)(P<0.05);the proportion of muscle strength of grade Ⅲ and above patients in group P was significantly better than that in group G(97.83% vs 8.33%)(P<0.05).Conclusion The use of ultrasound-guided PA sciatic nerve block in patients with ankle fracture is satisfactory in relieving pain symptoms,maintaining muscle strength,and avoiding motor block.It can also effectively simplify surgical operations and avoid surgical trauma to rehabilitation influence.
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Vacuum sealing drainage technology combined with forearm flap transplantation to repair the deep wound of the forearm and hand in elderly patients
XIANG Feng, SHEN Jian, WENG Zhiyong
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  783-785.  DOI: 10.3969/j.issn.1005-6483.2022.08.023
Abstract ( 14 )   PDF (891KB) ( 5 )   PDF(mobile) (891KB) ( 1 )  
Objective To explore the clinical effects of applying VSD technology combined with forearm flap transplantation to repair the deep wound on the forearm and hand of elderly patients.Methods There were 21 old people with deep wounds on their forearms and hands.VSD technology was applied to make the wounds clean and fresh,and treatment methods were made to cure underlying diseases simultaneously.Different types of forearm flaps were designed according to the locations of the wounds,sizes of the wounds,and soft tissue conditions around the wounds.Furthermore,portable Doppler blood flow detector was used to locate the rotation points of the flaps,so that the flaps could be cut and wounds could then be repaired.Results 21 cases which used VSD technology combined with various types of forearm flap transplants to repair the elders' arm and hand deep wound surfaces were successful.VSD application average time was 7 days;the average bleeding volume was about 75ml;no local hematoma,infection and limb ischemia,etc.occurs after surgery;all the flaps were completely alive;follow-up results showed that the patients were satisfied with the duration and cost of treatment,appearance of the wound repair and recovery of limb function.Conclusion The application of VSD technology combined with forearm flap transplantation to repair the old arm and hand depth wound has some characters:tolerable to elderly patients,short flap surgery time,easy and fast operation,small damage,less surgical complications,high success rate of flap repair,and limb function can be saved to a greater extent.Although the appearance is not that satisfying,the application is safe enough for elderly patients.
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Applications of near-infrared-Ⅱ window fluorescence imaging in surgery
MI Jiahui, ZHOU Jian, YANG Fan
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  786-789.  DOI: 10.3969/j.issn.1005-6483.2022.08.024
Abstract ( 23 )   PDF (653KB) ( 12 )   PDF(mobile) (653KB) ( 6 )  
Fluorescence imaging technology is an efficient,non-invasive imaging method without radioactivity,which was widely used in the medical field.In a variety of surgical scenarios,real-time imaging and reorganization of the target structure can be achieved with this technology,so as to promote the further development of precision surgery.However,the conventional visible light(400-700nm) and near-infrared-Ⅰ window(NIR-Ⅰ,700-900nm) are still insufficient in some aspects such as lower tissue penetration ability,which limit the development of fluorescence intraoperative imaging in the field of surgery.At present,with the rapid development of near-infrared-Ⅱ window(NIR-Ⅱ,1000-1700nm) fluorescence probes and devices,increasing studies have shown that NIR-Ⅱ fluorescence can improve the effect of near-infrared fluorescence imaging in operation.With longer wavelength,NIR-Ⅱ fluorescence can significantly reduce the absorption and scattering of photons in tissue and diminish autofluorescence of normal tissue.Besides,NIR-Ⅱ fluorescence has enhanced tissue penetration ability,micrometre resolution and higher signal-to-background ratio(SBR) for target structure.Therefore,we reviewed the progression of applications of NIR-Ⅱ fluorescence in solid tumor imaging,sentinel lymph node tracing,vascular,ureter and bile duct imaging in surgery and discusses its future development prospects.
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Advances of ubiquitin-proteasome system in the development of esophageal squamous cell carcinoma
SONG Naicheng, HUANG Zhihong, LIU Quan, et al
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  790-792.  DOI: 10.3969/j.issn.1005-6483.2022.08.025
Abstract ( 21 )  
The proteasome is a multi-protein complex capable of regulating the stability of hundreds of cellular proteins involved in almost all cellular processes.In most cases,proteins must be linked to a chain of ubiquitin molecules in order to be recognized and processed by the proteasome.The ubiquitin-proteasome system(UPS) regulates cell proliferation,apoptosis,angiogenesis and motility,processes that are particularly important in carcinogenesis.There is growing evidence that alterations in the UPS are associated with malignancy.Esophageal squamous cell carcinoma has a high incidence and a poor treatment prognosis in China and Southeast Asia.Therefore,we summarize the current literature on the involvement of UPS in esophageal squamous cell carcinoma to highlight its role in tumor development and to provide information for the study of therapeutic targets.
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Application and progress of small lung nodule localization technology in lung cancer surgery
HUANG Ankang, GONG Yongsheng
JOURNAL OF CLINICAL SURGERY. 2022, 30 (8):  793-796.  DOI: 10.3969/j.issn.1005-6483.2022.08.026
Abstract ( 22 )   PDF (668KB) ( 11 )   PDF(mobile) (668KB) ( 4 )  
The development of the popularity of chest CT has led to an increasing number of lung cancer patients being detected at an early stage.Early lung cancer is often presented in the form of small lung nodules on chest CT,and small lung nodules are often clinically wedge-shaped or pulmonary segment resection.Because small lung nodules are small in diameter and low in density,surgeons cannot determine whether the resection range is sufficient.With the development of science and technology,the technology of localization of small lung nodules has also been greatly developed,but the specific role of each method in lung cancer surgery is not clear.We review the clinically relevant studies such as computed tomography-guided percutaneous puncture localization technique,bronchoscopic assisted positioning technology,computed tomography virtual 3D assisted positioning technology and intraoperative anatomical localization technique and summary the application progress of various localization techniques in lung cancer surgery.
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