[Controversy and progress on whether to retain left colonic artery in radical resection of rectal cancer]

Japanese Society for Cancer of the Colon and Rectum (JSCCR) guideline 2019 recommended that lymph node dissection for advanced rectal cancer should include the lymphatic adipose tissue at the root of the inferior mesenteric vessels, but the ligation site of the inferior mesenteric artery (IMA) was not determined, and the NCCN guideline did not indicate clearly whether to retain the left colonic artery (LCA). Controversy over whether to retain LCA is no more than whether it can reduce the incidence of anastomotic complications or postoperative functional damage without affecting the patients' oncological outcome. Focusing on the above problems, this paper reviews the latest research progress. In conclusion, it is believed that the advantages of retaining LCA are supported by most studies, which can improve the blood supply of the proximal anastomosis, and technically can achieve the same range of lymph node dissection as IMA high ligation. However, whether it affects the survival of patients, reduces the incidence of anastomotic leakage, and improves the quality of life of patients, more high-quality evidence-based medical evidence is still needed.

Neuroepithelial stem cells differentiate into neuronal phenotypes and improve intestinal motility recovery after transplantation in the aganglionic colon of the rat

The purpose of this study was to elucidate the possibility and the biological significance of intracolonic grafting of neuroepithelial stem cells (NESCs) as a therapeutic strategy for neuronal replacement in disorders of the enteric nervous system (ENS) such as aganglionosis. The enteric plexus of rat colon were eliminated by serosal application of the cationic surfactant benzalkonium chloride. NESCs were harvested from the neural tube of embryonic rat, labelled with bromodeoxyuridine (BrdU), and transplanted into the denervated colon. After 2, 4 and 8 weeks, grafted cells were visualized in colon sections by fluorescent double-staining for BrdU and neuronal, astrocytic, neurochemical or stem cell markers. Eight weeks post-transplantation, the intestinal motility was assessed by measuring the changes of intraluminal pressure responding to inflating stimulation and the responses to electrical field stimulation (EFS). Our results indicate that when transplanted into the denervated gut, NESCs survived and could differentiate into neurons and glial cells in vivo. Furthermore, inflation stimulated contraction and EFS-induced response were observed in NESCs grafted group compared with no reaction in denervated group. Therefore, NESCs can survive and function in the denervated rat colon in vivo, which indicates that NESCs provide a promising cellular replacement candidate for ENS.

In vitro fusion of lung lamellar bodies and plasma membrane is augmented by lung synexin

Lamellar bodies of lung epithelial type II cells undergo fusion with plasma membrane prior to exocytosis of surfactant into the alveolar lumen. Since synexin from adrenal glands promotes aggregation and fusion of chromaffin granules, we purified synexin-like proteins from bovine lung cytosolic fraction, and evaluated their effect on the fusion of isolated lamellar bodies and plasma membrane fractions. Synexin activity, which co-purified with an approx. 47 kDa protein (pI 6.8), was assessed by following calcium-dependent aggregation of liposomes prepared from a mixture of phosphatidylcholine:phosphatidylserine (PC:PS, 3:1, mol/mol). Lung synexin caused aggregation of liposomes approximating lung surfactant lipid-like composition, isolated lamellar bodies, or isolated plasma membrane fraction. Lung synexin promoted fusion only in the presence of calcium. It augmented fusion between lamellar bodies and plasma membranes, lamellar bodies and liposomes, or between two populations of liposomes. However, selectivity with regard to synexin-mediated fusion was observed as synexin did not promote fusion between plasma membrane and liposomes, or between liposomes of surfactant lipid-like composition and other liposomes. These observations support a role for lung synexin in membrane fusion between the plasma membrane and lamellar bodies during exocytosis of lung surfactant, and suggest that such fusion is dependent on composition of interacting membranes.