LADG may be a technically feasible alternative for EGC when it is performed in experienced surgical centers in which patients undergoing LADG may benefit from the faster postoperative recovery. However, the currently available evidence cannot exclude the potential clinical benefits or harms, especially in the node-positive cases. Methodologically high-quality comparative studies are needed for further evaluation.

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.

BackgroundSepsis is now the leading cause of death in the non-cardiovascular intensive care unit (ICU). Recent research suggests that sepsis is likely to be due to an interaction between genetic and environmental factors. Genetic mutations of toll-like receptor 4 (TLR4) and cluster of differentiation 14 (CD14) genes are involved in the immune and (or) inflammatory response. These may contribute to the susceptibility to sepsis in patients. This study was designed to evaluate whether the TLR4 and cluster CD14 gene polymorphisms are associated with susceptibility to sepsis.MethodsThe single nucleotide polymorphisms (SNPs) of TLR4 (rs10759932, rs11536889, rs7873784, rs12377632, rs1927907, rs1153879) and CD14 (rs2569190 and rs2563298) in patients with sepsis and control subjects in the Guangxi Province were analyzed by using the polymerase chain reaction-single base extension (PCR-SBE) and DNA sequencing methods.ResultsThe rs11536889 polymorphism in TLR4 and rs2563298 polymorphism in CD14 were significantly associated with the risk of sepsis when compared to the control group. The frequencies of rs11536889 and rs2563298 polymorphisms in the group with sepsis were higher than that in the control group (OR = 1.430, 95% CI, 1.032-1.981, P<0.05; OR = 2.454, 95% CI, 1.458-4.130, P<0.05, respectively). Followed up haplotype analysis suggested that there were two haplotypes in which increased risk factors for sepsis were indicated.ConclusionsThe rs11536889 polymorphism in TLR4 and rs2563298 polymorphism in CD14, and two haplotypes were associated with increased susceptibility to sepsis.

Glass-free three-dimensional (3D) endoscopic provide excellent depth perception without decreasing light quality and fog formation. Herein we report our first case-serial of trans-oral endoscopic thyroidectomy by means of our newly developed glasses-free 3D endoscopic system. Four patients with thyroid goiter undergone trans-oral glasses-free 3D endosocpic thyroidectomy were reviewed. Mean BMI of these patients was 20.98±2.91 kg/m. The dominate nodule of the thyroid was no more than 5 cm in diameter in all patients. Operation duration was 189.00±39.14 min, and mean Intraoperative blood loss was 7.50±2.89 mL. No postoperative complications were observed. All patients were satisfied with the cosmetic result. The use of a glasses-free 3D system in trans-oral endoscopic thyroidectomy is safe and effective. The clear image casted to the surgeon can greatly facilitate precise surgical movement and reduce eye fatigue. Further comparative studies should be conducted to confirm our conclusions.

Abstract. With the increase in life expectancy, surgical intervention for colorectal cancer (CRC) is more frequently performed in elderly patients. This retrospective study was designed to compare short-term outcomes between laparoscopy-assisted colorectomy (LC) and open colorectomy (OC) in elderly patients with CRC. A total of 89 CRC patients aged ≥75 years undergoing LC were matched with 89 counterparts undergoing OC. The matching criteria included general information and preoperative status. The operative data and short-term postoperative outcomes were compared. Following analysis, patients in the LC and OC groups were comparable for the matching criteria. Compared with the OC group, the operative time was longer (P=0.046), but the estimated blood loss (P<0.001) and intraoperative transfusion (P=0.042) were less in the LC group. As regards short-term postoperative outcomes, the duration of postoperative hospital stay was shorter (P=0.001) and the incidence of wound complications was lower (P=0.044) with LC. The overall complication, other complications, reoperation and mortality rates were comparable between the two groups. In conclusion, considering the operative variables and short-term outcomes, LC is a safe procedure and appears to be superior to OC for elderly patients with CRC. IntroductionDue to the significant advances in life quality and health care, life expectancy continues to increase worldwide, with a consequent increase in the elderly population. The incidence of colorectal diseases necessitating surgical intervention, particularly colorectal cancer (CRC), usually increases with advancing age. In fact, approximately one half of patients with CRC are aged >70 years and CRC is the second leading cause of cancer-related mortality in this age group (1,2). Aging per se, regardless of other factors, is not a prognostic factor in gastrointestinal surgery (3). However, advanced age is usually accompanied by underlying comorbidities, such as cardiovascular and pulmonary diseases, which may significantly affect the outcomes of surgical treatment for CRC. Thus, surgery for elderly CRC patients is a major medical care issue.Surgeons usually select colorectomy for CRC treatment in resectable cases, which may be performed as open colorectomy (OC) or laparoscopy-assisted colorectomy (LC). The laparoscopic procedure, compared with laparotomy, is considered to be a safe and feasible procedure, associated with a milder immunological and inflammatory response (4). Furthermore, LC is reportedly associated with decreased morbidity and mortality, faster recovery and shorter hospital stay (5,6). However, LC usually requires longer operative time and results in specific physiological changes affecting the cardiovascular and pulmonary systems (7). Due to these concerns and underlying comorbidities in elderly patients, surgeons face a dilemma when considering LC for CRC.The availability of recent reports comparing LC and OC for elderly patients is limited (8-12), with data on CRC being even more scarse (12). To the best...