Background. Kangai injection is a traditional Chinese medicine (TCM) mixed by extracts from astragalus, ginseng, and kurorinone with modern technology. It is a commonly used antitumor injection in China, but the mechanism of Kangai injection in the treatment of colorectal cancer (CRC) is still unclear. The purpose of this study is to explore the mechanism of Kangai injection against CRC using network pharmacology and molecular docking technology. Methods. Targets of Kangai injection in CRC were predicted by SwissTargetPrediction and DisGeNET databases. Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) were performed by using the DAVID database. A component-disease-target gene-pathway network was constructed by Cytoscape 3.8.0 software. Results. 114 overlapping targets of Kangai injection and CRC were used to construct a PPI network, and the top 10 hub targets of Kangai injection were rated from high to low as TP53, VEGFA, EGFR, TNF, ESR1, STAT3, HSP90AA1, HDAC1, AR, and MMP9. The ingredient-target-disease interactive network was constructed, which included 22 compounds and 114 overlapping targets with 161 nodes and 707 edges. Entries of enrichment analysis were obtained based on P value (<0.05), which included 19 of GO-MF, 217 of GO-BP, 8 of GO-CC, and 13 KEGG. Molecular docking analysis showed that Kangai injection strongly interacted with top 10 hub target proteins. Conclusion. Network pharmacology intuitively showed the multicomponent, multiple targets, and multiple pathways of Kangai injection in the treatment of CRC. The molecular docking experiment verified that compounds of Kangai injection had good binding ability with top 10 hub target proteins as well.

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Background The maintenance treatment of metastatic colorectal cancer (mCRC) after first-line treatment is still controversial. Meta analysis was used to analyze whether there was survival benefit after first-line treatment of mCRC from the effectiveness and safety of capecitabine maintenance treatment. Methods In April, 2022, the following biomedical electronic databases were searched: PubMed, EMBASE, Google Scholar and Cochrane Library, including capecitabine maintenance therapy versus active monitoring randomized controlled trials (RCTs) and clinical trials (CT) of mCRC patients after first-line treatment. The primary outcome was progression free survival (PFS) of capecitabine maintenance therapy, and secondary outcomes included overall survival (OS), toxicity, and BRAF and RAS gene mutation status. Extract the hazard ratio (HR) of 95% confidence interval (CI) or HR data that can calculate 95% confidence interval (CI). All data were analyzed by Revman5.4 software. Results Five eligible studies included 1672 patients. Meta analysis showed that capecitabine maintenance therapy had more significant benefits for PFS than active monitoring PFS (HR 0.59; 95%CI: 0.52–0.66; P < 0.00001); In addition, capecitabine maintenance therapy was also beneficial to OS (HR 0.85; 95% CI: 0.76–0.95; p = 0.003). Subgroup analysis showed that BRAF/RAS wild-type patients were more likely to benefit from capecitabine maintenance, based on the significant interaction between BRAF/RAS status (P = 0.002). The most common adverse reaction was hand-foot skin reaction to capecitabine maintenance therapy compared with active monitoring (2.3% vs 0.4%; OR 5.53, 95%CI: 1.42–21.58, I2 = 0%, P = 0.01) was slightly increased. Conclusion This meta-analysis suggests that capecitabine was beneficial in PFS and OS compared with active monitoring. Adverse reactions are common but acceptable. Subgroup analysis showed that the differential effect of capecitabine maintenance treatment was beneficial to BARF/RAS wild-type patients. In specific cases, capecitabine monotherapy maintenance therapy can be considered, such as cumulative toxicity to fluoropyrimidine or patient rejection, especially for BRAF/RAS wild-type patients.

Introduction: Patch infection after inguinal hernioplasty as an annoyance perplexed surgeon, Because its processing is very tricky. When conservative treatment fails, the surgical that played a pivotal role in the future therapies. Our target was to evaluate the safety and effectiveness of path removal for delayed patch infection after inguinal hernioplasty and give a summary of our experience in surgical treatment.Methods: A retrospective cross-sectional study was undertaken at the Department of General Surgery from March 2018 to May 2021 to gather the clinical data of 35 patients with delayed cloth patch infection following tension-free hernioplasty. Record clinical information about the patient which included patient age, underlying disease, primary hernia repair, meantime of infection diagnosis, patient clinical symptoms, the intraoperative complications included the relevant postoperative conditions, the placement and time of drainage tubes, the postoperative hospital stay, the bacterial culture results of patch infection, and the choice and use of antibiotics.The follow-up included postoperative reinfection and long-term complications. Patients or their families were contacted by telephone to understand their postoperative recovery as well as any long-term complications. Results: All patients have undergone laparoscopic or open surgical operation were smooth and steady. All patients with postoperative infection after tension-free repair of inguinal Hernia received patch removal, all of them were treated with antibiotics, open wound drainage or negative pressure drainage, 2 cases had a perforation of a sigmoid foreign body. The mean postoperative hospital stay was (23.74±15.91) days. A total of 35 patients with patch infection were followed up postoperatively During the follow-up period, no postoperative complications occurred. There was no recurrence of inguinal hernia during postoperative follow-up. Conclusion: When dealing with patch infection after tension-free repair of an inguinal hernia, it is safe and efficacious to perform patch extraction.

BackgroundThere is controversy about the outcomes of prophylactic ileostomy via the specimen extraction site (SES) after laparoscopic rectal cancer surgery (LRCS). We, therefore, performed a meta-analysis to determine the efficacy and safety of stoma through the SES versus new site (NS).MethodsAll relevant studies from 1997 to 2022 were searched in the PubMed, EMBASE, Cochrane Library, CNKI, VIP databases. This meta-analysis was performed using RevMan software 5.3 for statistical analysis.Results7 studies with 1736 patients were included. The present meta-analysis noted that prophylactic ileostomy via SES was associated with a higher risk of overall stoma-related complications, especially parastomal hernia (OR, 2.39, 95% CI 1.43-4.00; p=0.0008). No statistical difference was found in terms of wound infection, ileus, stoma edema, stoma prolapse, stoma necrosis, stoma infection, stoma bleeding, stoma stenosis, skin inflammation around the stoma, stoma retraction and postoperative pain score on postoperative day 1 and 3 between SES group and NS group. However, prophylactic ileostomy via SES was associated with lesser blood loss (MD = -0.38, 95% CI: -0.62 - -0.13; p=0.003), shorter operation time(MD = -0.43, 95% CI: -0.54 - -0.32 min; p&lt;0.00001), shorter post-operative hospital stay (MD = -0.26, 95% CI: -0.43 - -0.08; p=0.004), shorter time to first flatus(MD = -0.23, 95% CI: -0.39 - -0.08; p=0.003) and lower postoperative pain score on postoperative day 2.ConclusionProphylactic ileostomy via SES after LRCS reduces new incision, decreases operative time, promotes postoperative recovery, and improves cosmetic outcomes, but may increase the incidence of parastomal hernias. The vast majority of parastomal hernias can be repaired by closing the ileostomy, therefore SES remain an option for temporary ileostomy after LRCS.