Expression and significance of miR-654-5p and miR-376b-3p in patients with colon cancer

BACKGROUND

The relationship between microRNAs, such as miR-654-5p and miR-376b-3p, and the prognosis of colon cancer has not been studied until now.

AIM

To evaluate the expression levels of miR-654-5p and miR-376b-3p and their clinical significance in colon cancer.

METHODS

RT-qPCR was performed to evaluate miR-654-5p and miR-376b-3p expression in 34 pairs of colon cancer and adjacent noncancerous tissues. Subsequently, the association of miR-654-5p and miR-376b-3p expression with clinical factors or the survival of patients suffering from colon cancer was determined by using The Cancer Genome Atlas.

RESULTS

miR-654-5p was upregulated and miR-376b-3p was downregulated in colon cancer tissues compared with adjacent noncancerous tissues (P < 0.001). Increased miR-654-5p and decreased miR-376b-3p expression levels were significantly associated with metastasis and clinical stage. Moreover, a univariate analysis demonstrated that colon cancer patients with high miR-654-5p or low miR-376b-3p expression (P = 0.044 and 0.007, respectively) had a poor overall survival rate. A multivariate analysis identified high miR-654-5p expression and low miR-376b-3p expression as independent predictors of poor survival in colon cancer patients.

CONCLUSION

Upregulated miR-654-5p and downregulated miR-376b-3p may be associated with tumour progression in colon cancer, and these microRNAs may serve as independent prognostic markers for colon cancer.

Fast-track rehabilitation vs conventional care in laparoscopic colorectal resection for colorectal malignancy: a meta-analysis

AIM

To evaluate the fast-track rehabilitation protocol and laparoscopic surgery (LFT) vs conventional care strategies and laparoscopic surgery (LCC).

METHODS

Studies and relevant literature comparing the effects of LFT and LCC for colorectal malignancy were identified in MEDLINE, the Cochrane Central Register of Controlled Trials and EMBASE. The complications and re-admission after approximately 1 mo were assessed.

RESULTS

Six recent randomized controlled trials (RCTs) were included in this meta-analysis, which related to 655 enrolled patients. These studies demonstrated that compared with LCC, LFT has fewer complications and a similar incidence of re-admission after approximately 1 mo. LFT had a pooled RR of 0.60 (95%CI: 0.46-0.79, P < 0.001) compared with a pooled RR of 0.69 (95%CI: 0.34-1.40, P > 0.5) for LCC.

CONCLUSION

LFT for colorectal malignancy is safe and efficacious. Larger prospective RCTs should be conducted to further compare the efficacy and safety of this approach.

Effect of huperzine A on working memory in reserpine- or yohimbine-treated monkeys

The effect of huperzine A, a reversible and selective acetylcholinesterase inhibitor, on reserpine- or yohimbine-induced spatial working memory deficits in monkeys has been examined using the delayed response task that depends on the integrity of prefrontal cortex. Reserpine (0.1 mg/kg, i.m.) or yohimbine (0.01 mg/kg, i.m.) led to significant impairments in the monkeys' ability to perform the delayed response task. Huperzine A (0.01 mg/kg, i.m. in reserpine-treated monkeys; 0.01-0.1 mg/kg, i.m. in yohimbine-treated monkeys) significantly improved the reserpine- or yohimbine-induced memory impairments. The effect of huperzine A on memory impairments exhibited an inverted U-shaped dose-response pattern. Our data suggest that huperzine A may improve working memory via an adrenergic mechanism.

The surgical treatment of isolated left-sided hepatolithiasis: a 22-year experience

BACKGROUND

Various therapeutic methods are used in isolated left hepatolithiasis (ILH), and long-term results are not as satisfactory as they should be.

METHODS

A retrospective analysis of 128 patients with ILH who were treated in our center over the last 22 years was undertaken to address patient age, gender, preoperative evaluation, operative findings, treatment modalities, and postoperative courses.

RESULTS

Sixty of the 128 patients were male and 68 were female, with a mean age of 42 years (range, 16-72 years). Among these patients, most (81%) had stones in both left external hepatic duct (LEHD) and left medial hepatic duct; in contrast 13 patients (10%) had stones only in the LEHD, and 7 patients (6%) had stones only in the left hepatic duct. Concomitant strictures were present in the left hepatic duct, left medial hepatic duct, and LEHD in 60%, 76%, and 82%, respectively, most of which were severe. When compared with left lateral segmentectomy, left hepatic lobectomy had a lower rate of residual stones (4% vs 22%; P < .01). Residual/recurrent stones and ductal strictures were the 2 most common causes that affected the long-term results. Before June 1996, left lateral segmentectomy was performed more frequently than left hepatic lobectomy (59% vs 12%; P < .01); after June 1996, left hepatic lobectomy was performed more frequently (77% vs 13%; P < .01). Although there were no differences in length of operation, intraoperative bleeding, and postoperative complications, residual stones were more common after left lateral segmentectomy.

CONCLUSIONS

Left hepatic lobectomy appears to be the most effective treatment for selected patients with ILH, if other operative procedures cannot remove all the related lesions, which include stones, dilation, stricture, or potential cholangiocarcinoma.

Improving effects of huperzine A on spatial working memory in aged monkeys and young adult monkeys with experimental cognitive impairment

Our previous studies demonstrated that huperzine A, a reversible and selective acetylcholinesterase inhibitor, exerts beneficial effects on memory deficits in various rodent models of amnesia. To extend the antiamnesic action of huperzine A to nonhuman primates, huperzine A was evaluated for its ability to reverse the deficits in spatial memory produced by scopolamine in young adult monkeys or those that are naturally occurring in aged monkeys using a delayed-response task. Scopolamine, a muscarinic receptor antagonist, dose dependently impaired performance with the highest dose (0.03 mg/kg, i.m.) producing a significant reduction in choice accuracy in young adult monkeys. The delayed performance changed from an average of 26.8/30 trials correct on saline control to an average of 20.2/30 trials correct after scopolamine administration. Huperzine A (0.01-0. 1 mg/kg, i.m.) significantly reversed deficits induced by scopolamine in young adult monkeys on a delayed-response task; performance after an optimal dose (0.1 mg/kg) averaged 25.0/30 correct. In four aged monkeys, huperzine A (0.001-0.01 mg/kg, i.m.) significantly increased choice accuracy from 20.5/30 on saline control to 25.2/30 at the optimal dose (0.001 mg/kg for two monkeys and 0.01 mg/kg for the other two monkeys). The beneficial effects of huperzine A on delayed-response performance were long lasting; monkeys remained improved for about 24 h after a single injection of huperzine A. This study extended the findings that huperzine A improves the mnemonic performance requiring working memory in monkeys, and suggests that huperzine A may be a promising agent for clinical therapy of cognitive impairments in patients with Alzheimer's disease.

Anatomic bases of the vascularized hepatic teres ligament flap

The hepatic ligamentum teres was investigated in 30 adult specimens. The ligament represents a fibrous remnant of the umbilical v. and a small irregular lumen still exists in the ligament in adult life. The ligament is supplied by one set of independent round ligament a. and paraumbilical vv. Since the proximal segment of the ligament is easily mobilised and since the ligamentous a. originates from the right hepatic a. near the hilum, a proximal vascularized pedicle flap of the ligamentum teres has been recommended. Surgical repair of the extrahepatic bile duct using a vascularized pedicle flap of the ligamentum teres has been carried out successfully in 12 patients.

Dose-dependent effects of the dopamine D1 receptor agonists A77636 or SKF81297 on spatial working memory in aged monkeys

With advancing age, monkeys develop deficits in spatial working memory resembling those induced by lesions of the prefrontal cortex (PFC). Aged monkeys also exhibit marked loss of dopamine from the PFC, a transmitter known to be important for proper PFC cognitive function. Previous results suggest that D1 agonist treatment can improve spatial working memory abilities in aged monkeys. However, this research was limited by the use of drugs with either partial agonist actions or significant D2 receptor actions. In our study, the selective dopamine D1 receptor full agonists A77636 and SKF81297 were examined in aged monkeys for effects on the working memory functions of the PFC. Both compounds produced a significant, dose-related effect on delayed response performance without evidence of side effects: low doses improved performance although higher doses impaired or had no effect on performance. Both the improvement and impairment in performance were reversed by pretreatment with the D1 receptor antagonist, SCH23390. These findings are consistent with previous results demonstrating that there is a narrow range of D1 receptor stimulation for optimal PFC cognitive function, and suggest that very low doses of D1 receptor agonists may have cognitive-enhancing actions in the elderly.

Dopamine D2 receptor mechanisms contribute to age-related cognitive decline: the effects of quinpirole on memory and motor performance in monkeys

The D2 dopamine (DA) receptor agonist, quinpirole, was characterized in young adult monkeys, young reserpine-treated monkeys and aged monkeys to assess the contribution of DA to age-related loss of prefrontal cortical (PFC) cognitive function. Monkeys were tested on a delayed response memory task that depends on the PFC, and a fine motor task that taps the functions of the motor cortex. In young adult monkeys, low quinpirole doses impaired performance of the PFC and fine motor tasks, while higher doses improved memory performance and induced dyskinesias and "hallucinatory-like" behaviors. The pattern of the quinpirole response in reserpine-treated monkeys suggested that the impairments in delayed response and fine motor performance resulted from drug actions at D2 autoreceptors, while the improvement in delayed response performance, dyskinesias and "hallucinatory-like" behaviors resulted from actions at postsynaptic receptors. In aged monkeys, low doses of quinpirole continued to impair fine motor performance, but lost their ability to impair delayed response performance. The magnitude of cognitive improvement and the incidence of "hallucinatory-like" behaviors were also reduced in the aged animals, suggesting some loss of postsynaptic D2 receptor function. The pattern of results is consistent with the greater loss of DA from the PFC than from motor areas in aged monkey brain (Goldman-Rakic and Brown, 1981; Wenk et al., 1989), and indicates that DA depletion contributes significantly to age-related cognitive decline.

Dopamine D1 receptor mechanisms in the cognitive performance of young adult and aged monkeys

Dopamine (DA) D1 receptor compounds were examined in monkeys for effects on the working memory functions of the prefrontal cortex and on the fine motor abilities of the primary motor cortex. The D1 antagonist, SCH23390, the partial D1 agonist, SKF38393, and the full D1 agonist, dihydrexidine, were characterized in young control monkeys, and in aged monkeys with naturally occurring catecholamine depletion. In addition, SKF38393 was tested in young monkeys experimentally depleted of catecholamines with chronic reserpine treatment. Injections of SCH23390 significantly impaired the memory performance of young control monkeys, but did not impair aged monkeys with presumed catecholamine depletion. Conversely, the partial agonist, SKF38393, improved the depleted monkeys (aged or reserpine-treated) but did not improve young control animals. The full agonist, dihydrexidine, did improve memory performance in young control monkeys as well as in a subset of aged monkeys. Consistent with D1 receptor mechanisms, agonist-induced improvements were blocked by SCH23390. Drug effects on memory performance occurred independently of effects on fine motor performance. These results underscore the importance of DA D1 mechanisms in cognitive function, and provide functional evidence of DA system degeneration in aged monkeys. Finally, high doses of D1 agonists impaired memory performance in aged monkeys, suggesting that excessive D1 stimulation may be deleterious to cognitive function.

Postsynaptic alpha-2 receptor stimulation improves memory in aged monkeys: indirect effects of yohimbine versus direct effects of clonidine

Very low doses (0.00001 mg/kg) of the alpha-2 adrenergic antagonist, yohimbine, improved working memory performance in a subset of aged monkeys. Improvement appeared to result from increased norepinephrine (NE) release onto postsynaptic alpha-2 adrenoceptors, as the response was blocked by the "postsynaptic" alpha-2 antagonist, SKF104078. Cognitive-enhancing effects of low dose yohimbine treatment may depend on aged animals retaining an intact, endogenous NE system. In contrast to yohimbine, the alpha-2 agonist, clonidine, has improved working memory in all aged animals examined. In the present study, clonidine's beneficial effects were also blocked by the postsynaptic antagonists SKF104078 and SKF104856, suggesting that clonidine acts by directly stimulating postsynaptic alpha-2 adrenoceptors. Beneficial doses of clonidine (0.01 mg/kg) and yohimbine (0.00001 mg/kg) were combined to see if they would produce additive effects on memory enhancement. This strategy was successful in young monkeys with intact NE systems but was not effective in the aged monkeys. These findings demonstrate that drugs that indirectly stimulate postsynaptic alpha-2 receptors by increasing NE release are not as reliable in aged monkeys as directly acting agonists that can replace NE at postsynaptic alpha-2 receptors.

Reserpine impairs spatial working memory performance in monkeys: reversal by the alpha 2-adrenergic agonist clonidine

Repeated daily treatment with the catecholamine-depleting agent, reserpine, dramatically reduced performance on the delayed response task, a test of spatial working memory that depends upon the integrity of the prefrontal cortex. Delayed response performance fell from an average of 27.2/30 trials correct before reserpine treatment to an average of 20.4/30 trials correct after repeated reserpine administration. Injection of the alpha 2-adrenergic agonist, clonidine (0.0001-0.05 mg/kg), to chronic reserpine-treated monkeys significantly restored performance on the delayed response task; performance after an optimal dose averaged 27.8/30 trials correct. Clonidine's beneficial effects on delayed response performance were longlasting; monkeys remained improved for more than 24 h after a single clonidine injection. The finding that clonidine is efficacious in reserpinized animals supports the hypothesis that alpha 2-adrenergic agonists improve cognitive function through actions at postsynaptic, alpha 2-adrenergic receptors on non-adrenergic cells. In contrast to the delayed response task, reserpine had little effect on performance of a visual discrimination task, a reference memory task which does not depend on the prefrontal cortex. These results emphasize the importance of postsynaptic, alpha 2-adrenergic mechanisms in the regulation of working memory.

[Effect of distal splenocaval shunt on splanchnic hemodynamics in patients with liver cirrhosis and portal hypertension]

Measurements of portal pressure and angiography were done to evaluate the hemodynamic changes after a distal splenocaval shunt (DSCS) in 25 patients with liver cirrhosis and portal hypertension. It was demonstrated that the portal pressure and portal perfusion were maintained in these patients in the early postshunting stage compared with the preshunting stage. Moreover, the diameter of the hepatic arteries increased following shunt, suggesting an increment in hepatic arterial flow. These hemodynamic effects probably contribute to the highly satisfactory outcomes in appropriately selected patients. The findings indicate that DSCS is effective and safe in the treatment of portal hypertension.

[Long-term results of side-to-side and H-graft mesocaval shunt]

From January, 1966 to January, 1988, mesocaval shunt was performed on 47 patients with the variceal hemorrhage secondary to portal hypertension. Of these, 30 patients underwent side-to-side mesocaval shunt, the remaining 17 had H-graft mesocaval shunt. Postoperative follow-up averaged 6 years and 11 months for the patients surviving operation. The rebleeding rate was 21.1%, and the shunt related encephalopathy rate 25.5%. The 5-, 10-, 15- and 20-year survival rates of the whole series were 65.8%, 51.8%, 37.5% and 20.0% respectively. We conclude that mesocaval shunt is the procedure of choice for treatment of variceal bleeding, especially for the control of postoperatively recurrent variceal bleeding.

The alpha-2 adrenergic agonist guanfacine improves memory in aged monkeys without sedative or hypotensive side effects: evidence for alpha-2 receptor subtypes

The present study attempted to identify an alpha-2 agonist that could improve working memory in aged nonhuman primates without the marked hypotensive and sedative side effects produced by clonidine. Toward this end, the hypotensive, sedative, and memory-altering properties of the alpha-2 adrenergic agonists, B-HT920 and guanfacine, were compared with clonidine's effects in 9 aged rhesus monkeys. Memory capacity was assessed by a variable delay, spatial delayed response paradigm that requires the animal to remember information over short temporal intervals and to update this information on every trial. B-HT920 was found to produce a dose-response profile qualitatively similar to, but weaker than, clonidine: low doses impaired memory and began to lower blood pressure and produce sedation, while high doses improved memory. In contrast, guanfacine produced a dose-response profile opposite to that seen with clonidine: low doses improved memory without inducing hypotension or sedation, while the memory-impairing, hypotensive, and sedating properties of the drug were observed at higher doses. The potency of the 3 agonists to lower blood pressure was clonidine = B-HT920 greater than guanfacine; sedation was affected in the order clonidine greater than B-HT920 greater than guanfacine; for memory impairment, as measured by performance on the delayed response task, the rank order potency was clonidine greater than B-HT920 greater than guanfacine, while for memory improvement it was guanfacine greater than clonidine greater than B-HT920. These differences in rank order potency are consistent with the recent proposal of alpha-2 receptor subtypes, a rauwolscine-sensitive site (Rs) that binds clonidine greater than B-HT920 greater than guanfacine and a rauwolscine-insensitive site (Ri) that binds guanfacine greater than clonidine greater than B-HT920 (Boyajian and Leslie, 1987). The data suggest that the hypotensive, sedating, and memory-impairing effects of alpha-2 agonists may be due to actions at one subtype of receptor (Rs), while the memory-enhancing effects of these drugs may result from actions at another alpha-2 receptor subtype, the Ri site. The ability of low doses of guanfacine to improve memory without inducing hypotension or sedation indicates that this agonist may be an excellent candidate for treating memory disorders in man.