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OBJECTIVE: To observe the effects of electroacupuncture at bilateral Zusanli(ST36), Shangjuxu(ST37), and Sanyinjiao (SP6) acupoints on gastrointestinal function after laparoscopic cholecystectomy under general anesthesia. METHODS: A total of 150 patients(American Society of Anesthesiologists［ASA］ grades Ⅰ and Ⅱ) undergoing laparoscopic cholecystectomy in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Guangzhou University of Chinese Medicine were randomly assigned into three groups: electroacupuncture group (n=50), simple acupuncture group (n=50), and control group (n=50). Patients in the control group received routine treatment；on the basis of routine treatment, patients in the simple acupuncture group were acupunctured at bilateral ST36, ST37 and SP36；patients in the electroacupuncture group were treated with electroacupuncture at bilateral ST36, ST37 and SP36（50 Hz，5 mA）. In both simple acupuncture group and electroacupuncture group, the corresponding treatments were conducted 1 h after surgery, Patients as well as in the morning (8:00-10:00) and afternoon (14:00-16:00) on the first day after surgery, 30 min each time. The time of bowel sound recovery, the time to the first postope-rative exhaust and defecation, the time of postoperative fluid diet recovery, abdominal pain score, and gastrointestinal reaction score were recorded and analyzed. RESULTS: Compared with the control group, the electroacupuncture group and the simple acupuncture group showed shortened time of bowel sound recovery, shortened time to the first postoperative exhaust and defecation, and shortened time of postoperative liquid diet recovery (P<0.01), as well as decreased postoperative abdominal pain score and gastrointestinal reaction score (P<0.01). Furthermore, the time of bowel sound recovery, the time to the first postoperative exhaust and defecation, and the time of postoperative liquid diet recovery were shortened in the electroacupuncture group compared with those in the simple acupuncture group (P<0.01). The total effective rate of electroacupuncture group was 94.0% (47/50), the total effective rate of simple acupuncture group was 88.0% (44/50), significantly higher than 78.0% (39/50) in the control group (P<0.05). CONCLUSION: Both electroacupuncture and simple acupuncture can promote the recovery of gastrointestinal function in patients after laparoscopic cholecystectomy under general anesthesia, and electroacupuncture is superior to simple acupuncture,but they have no significant difference in alleviating postoperative abdominal pain and gastrointestinal reactions.

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The increasing incidence of hepatocellular carcinoma (HCC) is of great concern globally, but the molecular pathogenesis of these tumors remains unclear. Sorafenib is a first-line drug for the treatment of advanced HCC. However, the efficacy of sorafenib in improving patient survival is limited, and most patients inevitably develop resistance to this drug. Recent studies have demonstrated that the activation of the IRE1α-XBP1s pathway might play a protective role in the response to sorafenib and contribute to malignancy in HCC. Here, we found that RCN1, an endoplasmic reticulum resident protein, is significantly upregulated in sorafenib-resistant HCC cells and promotes tumor progression. Our analysis showed that RCN1 may be an independent predictor of tumor recurrence and overall survival. Mechanistically, RCN1 promotes the dissociation of GRP78 from IRE1α in sorafenib-resistant cells by interacting with GRP78 through its EFh1/2 domain. Subsequently, the IRE1α-XBP1s pathway, a branch of the unfolded protein response, is sustainably activated. Interestingly, IRE1α-XBP1s pathway activity is required for c-MYC signaling, one of the most highly activated oncogenic pathways in HCC. These results suggest that RCN1-targeted therapy might be a feasible strategy for the treatment of HCC.

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Follicular dendritic cell sarcoma (FDCS) is a rare and low incidence tumor. So far, there is no standard treatment for the disease. Surgery is the main treatment for FDCS. Here, we report the case of a 51-year-old woman who was admitted with the chief complaint of "spleen-occupying lesion detected via physical examination more than 1 month ago". Spiral plain scan and enhanced computed tomography (CT) of the upper abdomen showed a vascular-derived tumor, with a high possibility of hemangioma or hemangiolymphangioma. Later, on 25 December 2019, the patient underwent laparoscopic splenectomy, and the pathological diagnosis of primary splenic FDCS was made. The patient did not receive adjuvant chemotherapy or radiotherapy. At a regular follow-up inspection 11 months later, on 18 December 2020, an abdominal scan + enhanced CT revealed multiple new abnormal intrahepatic nodules, which combined with her history, indicated the possibility of metastases. Subsequently, she was readmitted to hospital and surgical treatment was decided upon after multi-disciplinary consultation and discussion. Laparoscopic S1/S3/S4/S5 hepatectomy plus cholecystectomy was performed on 31 December 2020. The postoperative pathology findings revealed (liver tumor, S3, S4, S5) metastatic inflammatory pseudotumor follicular dendritic sarcoma, tumor diameter 0.6-1.2 cm. Due to the lack of clinical reports on postoperative organ metastasis of this disease, less experience, and controversy in drug selection of radiotherapy and chemotherapy, the patient refused to receive radiotherapy and chemotherapy. She now undertakes regular outpatient reexamination, and has been followed-up until now, during which time she has not progressed, and the efficacy is considered satisfactory.

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OBJECTIVE: To identify genetic abnormalities in primary gastric carcinoma. METHODS: Comparative genomic hybridization (CGH) was used in screening DNA copy number changes along all chromosomes in 23 cases of primary gastric cancer. RESULTS: Twenty-one out of 23 cases showed chromosomal losses and gains for at least one of the chromosomal arms in primary gastric cancer. The mean number of chromosomal alterations was 7.52. Chromosomal gains predominated over chromosomal losses in a ratio of 5.38:2.14. The most often involved chromosomal gains were observed in 8q (9/21, 42.9%), 20q (9/21, 42.9%), 17q (8/21, 38.1%), 3q (7/21, 33.3%), 7q (7/21, 33.3%), 11q (6/21, 28.6%), 13q (6/21, 28.6%), 1q (5/21, 23.8%) and 20p (5/21, 23.8%). The chromosomal arms with frequent losses were 17p (7/21, 33.3%), 18q (6/21, 28.6%), 5q (5/21, 23.8%), 8p (5/21, 23.8%), and 9p (5/21, 23.8%). CONCLUSIONS: The phenomenon of gain and loss of chromosomal regions is observed in primary gastric cancer, which may induce the amplification of oncogenes and the loss of tumor suppressor genes to regulate the development and progression of gastric cancer.

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OBJECTIVE: To investigate amplification of zinc finger protein 217(ZNF217) and its association with clinicopathologic parameters in primary gastric carcinoma. METHODS: Semiquantitative polymerase chain reaction (PCR) was used to determine DNA copies of ZNF217 in the specimens from forty- seven cases with primary gastric carcinoma. RESULTS: There was no difference in DNA copies between tumor specimens and paratumor normal tissues. The incidence of ZNF217 amplification was 11.36% in gastric cancer. The amplification of ZNF217 was significantly associated with tumor size(P< 0.01) and intestinal type of stomach cancer(P< 0.05). CONCLUSION: Oncogene ZNF217 may play a role in specific tumor types or subtypes of gastric cancer. There may be other oncogenes associated with gastric carcinoma in 20(q)13.

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