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Background Human replication factor C4 (RFC4) is involved in DNA replication as a clamp loader and is aberrantly regulated across a range of cancers. The current study aimed to investigate the function of RFC4 in colorectal cancer (CRC). Methods The mRNA levels of RFC4 were assessed in 30 paired primary CRC tissues and matched normal colonic tissues by quantitative PCR. The protein expression levels of RFC4 were evaluated by western blotting (n = 16) and immunohistochemistry (IHC; n = 49), respectively. Clinicopathological features and survival data were correlated with the expression of RFC4 by IHC analysis in a tissue microarray comprising 331 surgically resected CRC. The impact of RFC4 on cell proliferation and the cell cycle was assessed using CRC cell lines. Results RFC4 expression was significantly increased in CRC specimens as compared to adjacent normal colonic tissues (P

The purpose of this study was to evaluate the outcomes of second salvage surgery with extended vertical lower trapezius island myocutaneous flap (TIMF) reconstruction for patients with re-recurrent oral cavity and oropharyngeal squamous cell carcinoma (SCC). The subjects were 23 patients with advanced re-recurrent oral and oropharyngeal SCC undergoing second salvage surgery and reconstruction with a TIMF. A TIMF with a skin paddle measuring 6 cm × 7 cm to 10 cm × 22 cm was used to reconstruct the major defects. Three patients experienced minor complications: minor flap failure ( n = 1), wound dehiscence at the donor site ( n = 1), and an orocutaneous fistula ( n = 1). The patients were followed for 3–72 months. Fifteen patients were alive with no evidence of disease, two were alive with disease, and six died of local recurrence or distant metastases. Second salvage surgery remains an effective treatment modality for select patients with advanced re-recurrent oral and oropharyngeal SCCs, and the extended vertical lower TIMF is a large, simple, and reliable flap for reconstructing the major defect following second salvage surgery.

Research on molecular mechanisms of carcinogenesis plays an important role in diagnosing and treating gastric cancer. Metabolic profiling may offer the opportunity to understand the molecular mechanism of carcinogenesis and help to non-invasively identify the potential biomarkers for the early diagnosis of human gastric cancer. The aims of this study were to explore the underlying metabolic mechanisms of gastric cancer and to identify biomarkers associated with morbidity. Gas chromatography/mass spectrometry (GC/MS) was used to analyze the serum metabolites of 30 Chinese gastric cancer patients and 30 healthy controls. Diagnostic models for gastric cancer were constructed using orthogonal partial least squares discriminant analysis (OPLS-DA). Acquired metabolomic data were analyzed by the nonparametric Wilcoxon test to find serum metabolic biomarkers for gastric cancer. The OPLS-DA model showed adequate discrimination between cancer and non-cancer cohorts while the model failed to discriminate different pathological stages (I-IV) of gastric cancer patients. A total of 44 endogenous metabolites such as amino acids, organic acids, carbohydrates, fatty acids, and steroids were detected, of which 18 differential metabolites were identified with significant differences. A total of 13 variables were obtained for their greatest contribution in the discriminating OPLS-DA model [variable importance in the projection (VIP) value >1.0], among which 11 metabolites were identified using both VIP values (VIP >1) and the Wilcoxon test. These metabolites potentially revealed perturbations of glycolysis and of amino acid, fatty acid, cholesterol, and nucleotide metabolism of gastric cancer patients. These results suggest that gastric cancer serum metabolic profiling has great potential in detecting this disease and helping to understand its metabolic mechanisms.

This study was to investigate the clinicopathologic characteristics and prognosis of colorectal cancer (CRC) patients aged 44 years and younger. Patients were identified from a prospectively maintained CRC database and divided into two groups by age: younger and older group (≤44 and >44 years). Clinicopathologic characteristics and postoperative outcomes were compared. There were 530 patients aged ≤44 years at diagnosis. More patients in the younger group had a family history of CRC compared with older patients. Younger patients were more likely than older patients to have larger tumours, infiltrative growth type tumours, poorly differentiated tumours, mucinous and signet-ring cell adenocarcinoma, and advanced TNM stages. Compared to older patients, more younger patients received chemotherapy and died of cancer-related causes. Overall survival, disease-free survival and cancer-specific survival of younger patients were comparable to older patients. Blood transfusion, TNM stage, histological grade and disease recurrence were independently associated with survival in the younger group. Despite younger patients having unfavourable clinicopathologic features, younger age at diagnosis of CRC appears to be associated with similar oncologic outcomes as compared to older patients.

Background Nuclear factor κB (NFκB) plays a key role in the regulation of apoptosis. The function of NFκB is inhibited by binding to NFκB inhibitor (IκB), and disruption of the balance of NFκB and IκB is related to the development of many diseases, including tumors. Therefore, we hypothesized that the NFκB1 (-94del/insATTG) and NFκBIA (2758 A>G) polymorphisms were associated with colorectal cancer (CRC) susceptibility. Methods In a hospital-based case–control study of 1001 CRC patients and 1005 cancer-free controls frequency matched by age and sex, we genotyped polymorphisms using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method and performed luciferase assays and Western blotting analysis to identify whether genetic variants in NFκBIA alter its gene expressions and functions and thus cancer risk. Results We found that both NFκB1-94 ins/delATTG and NFκBIA 2758 A>G polymorphisms were correlated with CRC risk (OR = 1.47; 95%CI = 1.14–1.86, and OR = 1.38; 95% CI = 1.14–1.66, respectively). Furthermore, when evaluated these two polymorphisms together, the combined genotypes with 2 variant (risk) alleles (2758GG and -94ins/ins+del/ins) were associated with an increased risk of CRC (OR = 1.71; 95% CI = 1.23–2.38) compared to 0 variant, and the significant trend for 2 variant (risk) alleles were more pronounced among subgroups of aged

The aim of this retrospective study was to analyze the clinicopathologic characteristics and short-term and long-term outcomes of colorectal cancer patients with obstruction compared to those of non-obstructive colorectal cancer patients.Between January 1998 and December 2005, 1,672 colorectal cancer patients undergoing operation were enrolled in this study. Patients were classified into two groups according to the presentation: patients with complete obstructive colorectal cancer (COC, n = 215) receiving emergency procedures and patients with non-obstructive colorectal cancer (NOC, n = 1,457) receiving elective procedures. The data on the clinicopathologic characteristics and short-term and long-term outcomes of patients were analyzed retrospectively.Among 1,672 colorectal cancer patients, 215 cases presented with complete obstruction. The distribution of tumor location and size, macroscopic type, depth of invasion, liver metastasis, peritoneal carcinomatosis, and TNM stage were found to be different between the COC and NOC groups. Logistic regression analysis showed that tumor location, depth of invasion, and peritoneal carcinomatosis were independent factors associated with obstruction. Patients with obstruction had an increased risk of death by a factor of 2.251 compared to patients without obstruction. Peritoneal carcinomatosis and TNM stage were independent factors for the survival of the COC group. Obstruction, peritoneal carcinomatosis, tumor macroscopic type, and TNM stage were independent indicators for postoperative recurrence. Postoperative mortality was significantly higher in the COC group than the NOC group. The overall 5- and 10-year survival rates in the COC group were 47.8% and 42.8%, respectively, compared to 67.2% and 59.8% in the NOC group, respectively (p 0.05). The postoperative recurrence rates were 43.1% in the COC group and 32.8% in the NOC group (p 0.05).Obstruction is an independent indicator for the survival and postoperative recurrence for patients with colorectal cancer. Patients in the COC group have worse overall survival with high postoperative recurrence rate compared to those in the NOC group.

BACKGROUND AND OBJECTIVE With the application of laparoscopy, laparoscopic gastrectomy for the treatment of patients with early gastric cancer has been performed, but the safety and effectiveness of this method need to be explored. This study evaluated the safety and effectiveness of laparoscopy-assisted and conventional open distal gastrectomy for patients with early gastric cancer. METHODS A search of MEDLINE, EMBASE, the Chinese Biomedical Database (CBM), and Cochrane Central Register of Controlled Trials (CENTRAL) identified all the randomized clinical trials that compared laparoscopy-assisted gastrectomy with open distal gastrectomy for patients with early gastric cancer published in the last 10 years. Quality assessment was done on each trial and relevant data were extracted from qualified trials. Meta-analysis was performed using RevMan 4.2.2 software (Cochrane). RESULTS Six randomized controlled trials (RCTs) involving 218 patients were included. Comparing laparoscopic resection with open resection, results showed less estimated blood loss (WMD (weighted mean difference): -121.86; 95% CI (confidence interval): -145.61, -98.11; P < 0.001), earlier postoperative first flatus (WMD: -0.95; 95% CI: -1.09, -0.81; P < 0.001), and shorter durations of hospital stays (WMD: -2.27; 95%CI: -3.47, -1.06; P = 0.0002), but longer surgery times (WMD: 58.71; 95% CI: 52.69, 64.74; P < 0.001) and fewer lymph nodes dissected (WMD: -3.64; 95% CI: -5.80,-1.47; P = 0.001). There was no significant difference between the two groups in postoperative complications (OR (odds ratio): 0.57; 95% CI: 0.31,1.03; P = 0.06). CONCLUSIONS The short-term outcome of laparoscopy-assisted distal gastrectomy for patients with early gastric cancer is superior to the open procedure, but its long-term outcome should be proven by further outcomes of RCTs.

This study explored an effective method for repairing cranio-maxillofacial soft-tissue defects following radical craniofacial surgery in four patients with malignant tumours involving the skull base and frontal region. The large cranio-maxillofacial soft-tissue defects were reconstructed using an extended vertical lower trapezius island myocutaneous flap based on the transverse cervical artery. The flap was 8-12 cm long and 5-7 cm wide. No major flap failure occurred, and there was no shoulder dysfunction. The patients were followed for 3-12 months. One patient suffered a local recurrence, and another died of lung metastasis 12 months postoperatively. The extended vertical lower trapezius island myocutaneous flap is a simple, reliable and large flap. It is preferred for reconstructing cranio-maxillofacial soft-tissue defects when a pedicled flap is used following craniofacial surgery for cancer.

AIM: To investigate gut barrier damage and intestinal bacteria translocation in severe acute pancreatitis (SAP), a simple rat model of SAP was induced and studied. METHODS: Pancreatitis was induced by uniformly distributed injection of 3.8% Na taurocholate (1 mL/kg) beneath the pancreatic capsule. Rats in the control group were injected with normal saline in the identical location. RESULTS: Serum amylase, plasma endotoxin, intestinal permeability, and pancreatitis pathology scores were all markedly higher in the pancreatitis group than in the control group (P < 0.01). The bacterial infection rate was significantly higher in the SAP group than in the control group (P < 0.01), observed in parallel by both bacterial culture and real-time polymerase chain reaction. Acute damage of the pancreas was observed histologically in SAP rats, showing interstitial edema, leukocyte infiltration, acinar cell necrosis and hemorrhage. The microstructure of the intestinal mucosa of SAP rats appeared to be destroyed with loose, shortened microvilli and rupture of the intercellular junction, as shown by electron microscopy. CONCLUSION: Significant gut barrier damage and intestinal bacterial translocation were definitely observed with few potential study confounders in this SAP rat model, suggesting that it may be an appropriate animal model for study of gut barrier damage and bacterial translocation in SAP.