ObjectivesTo assess the efficacy and safety of propofol sedation for gastrointestinal endoscopy, we conducted a meta-analysis of randomized controlled trials (RCTs) comparing propofol with traditional sedative agents.MethodsRCTs comparing the effects of propofol and traditional sedative agents during gastrointestinal endoscopy were found on MEDLINE, the Cochrane Central Register of Controlled Trials, and EMBASE. Cardiopulmonary complications (i.e., hypoxia, hypotension, arrhythmia, and apnea) and sedation profiles were assessed.ResultsTwenty-two original RCTs investigating a total of 1,798 patients, of whom 912 received propofol only and 886 received traditional sedative agents only, met the inclusion criteria. Propofol use was associated with shorter recovery (13 studies, 1,165 patients; WMD –19.75; 95% CI –27.65, 11.86) and discharge times (seven studies, 471 patients; WMD –29.48; 95% CI –44.13, –14.83), higher post-anesthesia recovery scores (four studies, 503 patients; WMD 2.03; 95% CI 1.59, 2.46), better sedation (nine studies, 592 patients; OR 4.78; 95% CI 2.56, 8.93), and greater patient cooperation (six studies, 709 patients; WMD 1.27; 95% CI 0.53, 2.02), as well as more local pain on injection (six studies, 547 patients; OR 10.19; 95% CI 3.93, 26.39). Effects of propofol on cardiopulmonary complications, procedure duration, amnesia, pain during endoscopy, and patient satisfaction were not found to be significantly different from those of traditional sedative agents.ConclusionsPropofol is safe and effective for gastrointestinal endoscopy procedures and is associated with shorter recovery and discharge periods, higher post-anesthesia recovery scores, better sedation, and greater patient cooperation than traditional sedation, without an increase in cardiopulmonary complications. Care should be taken when extrapolating our results to specific practice settings and high-risk patient subgroups.

CAF-derived galectin-1 significantly promotes angiogenesis in gastric cancer and may be a target for angiostatic therapy.

Pancreatic ductal adenocarcinoma (PDAC) is one of the most common malignant tumors with poor prognosis due to extremely high malignancy, low rate of eligibility for surgical resection and chemoradiation resistance. Increasing evidence indicate that the interaction between activated pancreatic stellate cells (PSCs) and PDAC cells plays an important role in the development of PDAC. By producing high levels of cytokines, chemotactic factors, growth factors and excessive extracellular matrix (ECM), PSCs create desmoplasia and a hypoxic microenvironment that promote the initiation, development, evasion of immune surveillance, invasion, metastasis and resistance to chemoradiation of PDAC. Therefore, targeting the interaction between PSCs and PDAC cells may represent a novel therapeutic approach to advanced PDAC, especially therapies that target PSCs of the pancreatic tumor microenvironment.Pancreatic ductal adenocarcinoma (PDAC) is the most common and lethal malignant tumors in humans with very poor prognosis, due to a variety of causes including the insidious onset, absence of efficient screening methods for early detection, low rate of surgical resection at the time of clinical presentation and chemoradiation resistance. 1 Although scholars have been committed during the last three decades to studying genetic and/or epigenetic molecular changes of PDAC cells and chemotherapy with a combination of cytotoxic drugs have been implemented, the survival of patients with PDAC has not yet significantly improved.2,3 Until recently, an encouraging FOLFIRINOX scheme was reported to provide a statistically and clinically significant benefit over single-agent gemcitabine in patients with advanced PDAC but Key words: pancreatic ductal adenocarcinoma, pancreatic stellate cells, tumor microenvironment Abbreviations: ADMR: adrenomedullin receptor; AM: adrenomedullin; ATRA: all-trans retinoic acid; CTGF: connective tissue growth factor; DCs: dendritic cells; ECM: extracellular matrix; EGF: epidermal growth factor; EMMPRIN: extracellular matrix metalloproteinase inducer; EMT: epithelial-mesenchymal transition; ET-1: endothelin-1; FGF: fibroblast-growth-factor; GFAP: glial-fibrillary-acidic protein; HGF: hepatocyte growth factor; HPDE: human pancreatic duct epithelial; HSCs: hepatic stellate cells; HUVEC: endothelial cells; IGF-1: insulin-like growth factor-1; IL: interleukin; MMPs: matrix metalloproteinases; NADPH: nicotinamide adenine dinucleotide phosphate; NO: nitric oxide; PAEE: palmitic acid ethyl ester; PCLMs: pancreatic cancer liver metastases; PDAC: pancreatic ductal adenocarcinoma; PDGF: platelet-derived growth factor; PEDF: pigment epithelium-derived factor; PK: prokineticin; PKR: prokineticin receptor; PSCs: pancreatic stellate cells; ROS: oxygen species; Runx-2: Runt-related transcription factor-2; SDF-1: stromal cell-derived factor-1; sFRP4: secreted frizzled-related protein 4; SMO: smoothened; a-SMA: a-smooth muscle actin; SPARC: secreted protein acidic and rich in cysteine; TFF1: trefoil factor 1; TGF-b: transforming gr...

The occurrence of in-hospital postoperative complications was an independent predictor of worse 5-year overall survival rate after radical resection of gastric cancer.

Colorectal cancer is the third largest cancer in worldwide and has been proven to be closely related to the intestinal microbiota. Many reports and clinical studies have shown that intestinal microbial behavior may lead to pathological changes in the host intestines. The changes can be divided into epigenetic changes and carcinogenic changes at the gene level, which ultimately promote the production and development of colorectal cancer. This article reviews the pathways of microbial signaling in the intestinal epithelial barrier, the role of microbiota in inflammatory colorectal tumors, and typical microbial carcinogenesis. Finally, by gaining a deeper understanding of the intestinal microbiota, we hope to achieve the goal of treating colorectal cancer using current microbiota technologies, such as fecal microbiological transplantation.