Background Crosstalk between mesenteric adipose tissue [MAT] and the intestines affects the progression of Crohn’s disease [CD]. The adipokine metrnl regulates adipocyte function and has anti-inflammatory activity. We aimed to explore metrnl expression in CD MAT, investigate the influence of metrnl on the experimental colitis disease course and determine the mechanism underlying this effect. Methods Metrnl expression in MAT specimens obtained from patients with and without CD was tested by immunohistochemistry. Male Il-10–/– mice with spontaneous enteritis were divided into positive control and metrnl-treated [Metrnl-Fc, 10 mg/kg/d, intraperitoneally, 8 weeks] groups. Age-matched male wild-type [WT] mice were used as negative controls. The effects of metrnl on enteritis and mesenteric lesions and the potential controlling mechanisms were evaluated. Results Metrnl expression was higher in human CD MAT than in control MAT. Systemic delivery of metrnl significantly ameliorated chronic colitis in Il-10–/– mice, as demonstrated by decreases in the disease activity index, inflammatory score and proinflammatory mediators. The protective effects of metrnl on MAT included reduced mesenteric hypertrophy, increased adipocyte size, improved adipocyte intrinsic function and ameliorated inflammation. Metrnl treatment activated STAT5/PPAR-γ signaling and promoted adipocyte differentiation in the MAT. Conclusions Metrnl expression was increased in the MAT of CD patients. Metrnl administration attenuated mesenteric lesions by promoting adipocyte function and differentiation partly through STAT5/PPAR-γ signaling pathway activation, thereby ameliorating CD-like colitis in mice.

BackgroundAnastomotic leakage is a serious complication that can occur after anterior resection of the rectum. There is a question regarding whether the placement of a transanal tube can decrease the rate of anastomotic leakage. The aim of this systematic review and meta-analysis was to evaluate the efficacy of transanal tube placement after anterior resection.MethodsWe searched three major databases (PubMed, Embase, and the Cochrane Library) up until January 2015 for studies evaluating the benefit of transanal tubes after anterior resection for rectal cancer. The primary outcome measure was the rate of clinical anastomotic leakage. Secondary outcome was the rate of reoperation. Pooled risk ratios (RR) with 95 % confidence intervals (CI) were obtained using random effects models.ResultsOne randomized controlled trial and three observational studies involving 909 patients met inclusion criteria. Clinical anastomotic leakage occurred in 3.49 % (14 of 401) of patients with transanal tubes and 12.01 % (61 of 508) of patients without transanal tubes. Meta-analysis of the studies showed a lower risk of anastomotic leakage (RR, 0.32; 95 % CI 0.18–0.58) and reoperation related to leakage (RR, 0.19; 95 % CI 0.08–0.46) when the transanal tube was placed.ConclusionsWhile studies are few and mostly observational, the data to date indicate that placement of a transanal tube decreases the rate of clinical anastomotic leakage and reoperation related to leakage. More studies are needed to confirm these findings.

BackgroundEndoscopic resection and gastrectomy are treatment modalities for early gastric cancer, but their relative benefits and risks are unclear. We conducted a systematic review and meta-analysis to compare endoscopic resection and gastrectomy for treating early gastric cancer.MethodsWe searched PubMed, Embase, and the Cochrane Library until April 2015 for studies comparing endoscopic resection with gastrectomy for treatment of early gastric cancer. Outcome measures were five-year overall survival (OS), length of hospital stay and postoperative morbidity. We calculated pooled hazard ratio (HR), weighted mean difference (WMD) and odds ratio (OR) using random effects models.ResultsSix studies comprising 1,466 patients (618 endoscopic resection and 848 gastrectomy) met inclusion criteria. Five-year OS was similar between endoscopic resection and gastrectomy (HR, 1.06; 95%CI: 0.61 to 1.83). Endoscopic resection was associated with shorter hospital stays (WMD, -6.94; 95%CI: -7.59 to -6.29) and reduced overall postoperative morbidity (OR, 0.36; 95%CI: 0.17 to 0.74).ConclusionsWhile five-year OS is similar between endoscopic resection and gastrectomy, endoscopic resection offers a shorter hospital stay and fewer complications than gastrectomy for treating early gastric cancer. Endoscopic resection is a reasonable treatment for early gastric cancer with a negligible risk of lymph node metastasis.

Background: This study aims to investigate the effect of LncRNA-CASC7 (cancer susceptibility candidate 7) on the proliferation and migration of colon cancer cells and its possible mechanism.Methods: In this study, quantitative real-time polymerase chain reaction (qRT-PCR) was employed for the detection of lncRNA-CASC7 expression in 54 colon cancer tissues and 5 colon cancer cell lines. This study aimed to evaluate the significant correlation between the lncRNA-CASC7 expression, the clinical features, and the survival rate of patients. LncRNA-CASC7 was overexpressed by lipofectin transfection. Cell proliferation was detected by the methyl thiazolyl tetrazolium (MTT) assay. Transwell assay was conducted to examine cell migration and invasion. The target gene was verified by dual fluorescein. The expression of proliferation and invasion-related proteins was detected via western blotting (WB).Results: The LncRNA-CASC7 expression in colon cancer was considerably decreased than in nearby healthy tissues (P<0.01). Its expression level was linked to survival rate, lymph node metastasis, and tumor node metastasis (TNM) stage. Similarly, the expression of lncRNA-CASC7 was decreased in 5 colon cancer cell lines. The proliferative, invasive, and migratory potential of cells was considerably decreased by lncRNA-CASC7 overexpression. Overexpression of lncRNA-CASC7 significantly inhibited the expression of proteins Ki-67 and PNCA (associated with proliferation) and proteins N-cadherin, E-cadherin, and vimentin (linked with metastasis). Further studies showed that overexpression of LncRNA-CASC7 could significantly inhibit the PI3K/Akt signaling pathway in colon cancer cells. Conclusions:The PI3K/Akt signaling cascade is negatively regulated by LncRNA-CASC7, which serves as a tumor suppressor gene by attenuating colon cancer cell proliferation, invasion, and migration, thus affecting the tumor progression and prognosis of colon cancer patients.