Objective: To perform a meta-analysis comparing laparoscopic versus open gastrectomy (LG vs. OG) for early gastric cancer (EGC) in Asia. Methods: PubMed, Embase, CINAHL, AMED, the Cochrane database of Systematic Reviews, the Cochrane Controlled Trials Register, and the China National Knowledge Infrastructure electronic databases were systematically searched for studies published between January 1, 1992 and July 1, 2012. A series of clinical indices, including operative time, incision length, blood loss, harvested lymph nodes, time to flatus postoperatively, time to first oral intake postoperatively, use of analgesics, complications, duration of hospital stay, recurrence, and mortality were compared using weighted mean differences (WMDs) and odds ratios (ORs). Results: Five randomized controlled trials and 11 case controls were included, including 1665 patients with EGC (919 LG, 746 OG). LG was associated with less trauma (incision length: WMD −12.91 cm; P<0.00001), less blood loss (WMD −121.04 mL, P<0.00001), less postoperative pain (number of times to use analgesics: WMD −1.64; P=0.001), faster bowel recovery (time to flatus: WMD −0.62 d; P=0.0001), fewer serious complications (OR 0.57; P=0.01), and shorter postoperative hospital stay (WMD −3.73 d; P=0.0007). However, LG had longer operative times (WMD 44.09 min; P<0.00001). LG also had fewer harvested lymph nodes, although this difference was not statistically significant (WMD −3.43 lymph nodes; P=0.04). There was no difference in recurrence rates (OR 0.58; P=0.33) and mortality between LG and OG. Conclusions: For the treatment of EGC in Asia, LG has several advantages, including safety, less trauma, and faster recovery. Our results should be validated in western studies.
Hexokinase-2(HK-2) plays dual roles in glucose metabolism and mediation of cell apoptosis, making it an attractive target for cancer therapy. Chrysin is a natural flavone found in plant extracts which are widely used as herb medicine in China. In the present study, we investigated the antitumor activity of chrysin against hepatocellular carcinoma (HCC) and the role of HK-2 played for chrysin to exert its function.The expression of HK-2 in HCC cell line and tumor tissue was examined by western blotting and immunohistochemistry staining. The activities of chrysin against HCC cell proliferation and tumor glycolysis were investigated. Chrysin-induced apoptosis was analyzed by flow cytometry. The effect of chrysin on HK-2 expression and the underlying mechanisms by which induced HCC cell apoptosis were studied. In HK-2 exogenous overexpression cell, the changes of chrysin-induced cell apoptosis and glycolysis suppression were investigated. HCC cell xenograft model was used to confirm the antitumor activity of chrysin in vivo and the effect on HK-2 was tested in chrysin-treated tumor tissue.In contrast with normal cell lines and tissue, HK-2 expression was substantially elevated in the majority of tested HCC cell lines and tumor tissue. Owing to the decrease of HK-2 expression, glucose uptake and lactate production in HCC cells were substantially inhibited after exposure to chrysin. After chrysin treatment, HK-2 which combined with VDAC-1 on mitochondria was significantly declined, resulting in the transfer of Bax from cytoplasm to mitochondria and induction of cell apoptosis. Chrysin-mediated cell apoptosis and glycolysis suppression were dramatically impaired in HK-2 exogenous overexpression cells. Tumor growth in HCC xenograft models was significantly restrained after chrysin treatment and significant decrease of HK-2 expression was observed in chrysin-treated tumor tissue.Through suppressing glycolysis and inducing apoptosis in HCC, chrysin, or its derivative has a promising potential to be a novel therapeutic for HCC management, especially for those patients with high HK-2 expression.
Background/Aims: MafB, a member of the Maf transcription factor family, plays a key role in the regulation of pancreatic alpha and beta cell differentiation. However, its function in the control of cancer cell proliferation remains unknown. Methods: The mRNA and protein expression levels of MafB in hepatocellular carcinoma tissues and adjacent non-tumor normal specimens were determined by real-time RT-PCR and Western blot, respectively. Report assay was performed to determine whether the regulation of Cyclin D1 by MafB is at the transcriptional level. The binding of MafB to the Cyclin D1 promoter was determined by Chromatin Immunoprecipitation (ChIP) assays. To determine the potential oncogenic effects of MafB in vivo, HepG2 cells transfected with adenovirus containing empty vector or MafB were injected subcutaneously to the skin under the front legs of the nude mice. Results: In the current study, we showed that MafB was markedly up-regulated in hepatocellular carcinoma (HCC) tissues and cells. Enforced overexpression of MafB enhanced, while its deficiency inhibited HCC cell proliferation. Mechanistically, Cyclin D1, an important regulator of cell cycle progression, was identified as a direct transcriptional target of MafB. Consistently, knockdown of Cyclin D1 largely attenuated the proliferative roles of MafB in HCC cells. Importantly, MafB overexpression significantly promoted cancer cell growth in mice. Conclusions: Collectively, our results identified a novel HCC regulatory pathway involving MafB and Cyclin D1, the dysfunction of which drives proliferative character in HCC.
aDepartment of Colorectal Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang 110801, China bDepartment of Gastrointestinal Surgery, The Fourth Affiliated Hospital, China Medical University, Shenyang 110032, China Rui Zhang, Zhe-Ming Zhao: These authors contributed equally as co-first author. Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding author. Address: Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital, China Medical University, No.4 Chongshan East Road, Shenyang 110032, China. Tel: +86-189-0091-2404. Fax: +86-24-6204-3110. E-mail address: [email protected] (C-D. Zhang). This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/
Objective: A systematic review and meta-analysis was performed to investigate the efficacy of neoadjuvant chemotherapy for nonmetastatic esophago-gastric adenocarcinomas. Methods: Electronic databases were searched systematically from January 1980 to July 2012 and a total of 2,587 patients from 17 randomized controlled trials were subjected to meta-analysis. The odds ratios (ORs) for overall survival (OS) and progression-free survival (PFS) were calculated. Results: Seventeen randomized controlled trials were obtained and various comparisons of treatment approaches were performed.
This study was conducted retrospectively to investigate the survival of patients undergoing gastric cancer surgery with epidural combined with general anesthesia (EGA) and general anesthesia alone (GA).
Review question / Objective: To compare the efficacy of high flow nasal oxygen with conventional oxygen therapy to prevent hypoxemia in gastrointestinal endoscopy with conscious sedation. Condition being studied: High flow nasal oxygen, a novel technique, may be an alternative to conventional oxygen therapy. High flow nasal oxygen can deliver heated and humidified oxygen via special nasal cannula with high flow (up to 70 L/min). It has been applied to improve oxygenation in clinical entities, favored by increasing evidence supporting its efficacy. Recently, the use of high flow nasal oxygen has spreaded to gastrointestinal endoscopy. However, the efficacy of high flow nasal oxygen in gastrointestinal endoscopy has not yet been well evaluated due to small sample size of the individual study and conflicting results.
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