| Background:The effect of perioperative acupuncture on accelerating gastrointestinal function recovery has been reported in colorectal surgery and distal gastrectomy(Billroth-?).However,the evidence in pancreatectomy and other gastrectomy is still limited.Material and methods:A prospective,randomized controlled trial was conducted between May 2018 to August 2019 in our hospital.Consecutive patients undergoing pancreatectomy or gastrectomy were randomly assigned to electroacupuncture(EA)group and the shame EA(SEA)group.The patients in EA group received transcutaneous EA on Bai-hui(GV20),Nei-guan(PC6),Tian-shu(ST25)and Zu-san-li(ST36)once a day in the afternoon,and the SEA group received not transcutaneous EA.Primary outcomes were the first time of flatus and defecation.Result:In total,385 patients were analyzed finally(EA group,n=201;SEA group,n=184).Time of first flatus(3.0±0.7 vs 4.2±1.0,P<0.001)and first defecation(4.2±0.9 vs 5.4±1.2,P<0.001)in the EA group were significantly shorter than in SEA control group.Those patients who underwent pancreaticoduodenectomy and intraoperative radiation therapy(IORT)surgery could benefitted from EA in time of first flatus(P<0.001)and first defecation(P<0.001),while those undergoing distal pancreatectomy could not(Pflatus=0.157,Pdefecation=0.007)completely.Of patients undergoing gastrectomy,those undergoing total gastrectomy and distal gastrectomy(Billroth-?)benefitted from EA(P<0.001),as did those undergoing proximal gastrectomy(P=0.015).Patients undergoing distal gastrectomy(Billroth-?)benefitted from EA in time of first defecation(P=0.012)but flatus(P=0.051).The time of parenteral nutrition,hospital stay,and time to first independent walk in the EA group were shorter than those in the control group.No severe EA complications were reported.Conclusion:1.Patients undergoing pancreaticoduodenectomy,IORT surgery,total gastrectomy,proximal gastrectomy and distal gastrectomy(Billroth-?)could benefit from EA in postoperative recovery.2.EA could shorten the time of parenteral nutrition,hospital stay,and time to first independent walk Perioperative Electroacupuncture can Prevent Postoperative ileus in Cancer Patients Undergoing Pancreatectomy or Gastrectomy3.EA was safe and effective in accelerating postoperative gastrointestinal function recovery.Background:To investigate the prognostic value of alkaline phosphatase-to-cholesterol ratio(ACR)in patients undergoing radical pancreaticoduodenectomy(PD)with Pancreatic Ductal Adenocarcinoma.Material and Method:The medical records of a total of 102 PDAC patients undergoing radical PD were retrospectively enrolled.R(pROC)software was used for the optimal cutoff value of biological markers such as preoperative ACR.Kaplan-Meier method and log-rank test for univariate survival analysis,and Cox regression model for multivariate survival analysis.Student t test was used to compare the mean value for continuous variables,and cross table was used for classification variables.Results:The area under the receiver(AUC)of operating characteristic curve(ROC)was used to analyze the detection efficiency of ACR.The optimal cutoff value of preoperative ACR was 32.988.The patients with higher preoperative ACR values had worse OS(P<0.001).Higher preoperative ACR was significantly correlated with degree of tumor differentiation(P<0.018),alanine aminotransferase(ALT)(P<0.001),aspartate aminotransferase(AST)(P<0.001),total bilirubin(TBIL)(P<0.001),carbohydrate antigen 19-9(P=0.016)and clinical symptoms(P=0.001).Multivariate analysis showed that tumor differentiation(P<0.001),ACR value(HR:2.225,95%CI:1.33-3.724,P=0.002),Tbil(HR:1.651,95%CI:1.002-2.720,P=0.049)and sex(HR,1.725,95%CI:1.1-2.704,P=0.018)were independent factors associated with the prognosis of PD AC patients undergoing radical PD.Conclusion:Elevated preoperative ACR correlated with poorer prognosis in patients undergoing radical PD with PD AC.ACR could be used to predict the prognosis in PDAC patients undergoing radical PD.Objective:rs1026654 mutation has been found in patients who received intraoperative radiotherapy and may be related to the degree of malignancy of the tumor.However,it has not been studied in patients with resectable pancreatic cancer and cell lines.In this study,we preliminarily explore the relationship between mutations and malignant degree in tumor tissues and cell lines by detecting the mutation and protein expression regulated by the mutation.Methods:Extract DNA from 30 cancer and its para cancerous tissues,pancreatic cancer cell lines of ASPC-1,SW1990,CAPAN-2,CFPAC-1,and BXPC-3.The target fragments were amplified by PCR,and rs1026654A/G mutation was sequencing by Sanger method.Proteins were extracted from tissues and cells,and the KITLG expression,regulated by the mutation,were detected by Western Blot.The relationship between mutation,KITLG expression and tumor malignancy was concluded by comparing the mutant and wild-type tissues and cells lines.Results:The mutation of rs1026654G was found in pancreatic cancer tissues(1/30)and ASPC-1 cell line.The expression of KITLG in the tumor tissues with mutation was lower than that in adjacent normal tumor tissues,and there was no significant difference in the expression of KITLG in the unmutated samples.The expression level of KITLG in ASPC-1 cell line was lower than that in SW1990,CAP AN-2,CFPAC-1,and BXPC-3 cell lines without mutation.Conclusion:1.rs1026654A/G is mutated in resectable pancreatic cancer and ASPC-1 cell line.2.The mutation of rs1026654A/G may lead to the down-regulation of KITLG expression. |
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