Re-optimized technology of protective ileostomy with no need of reversal / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the clinical application of aoptimizedtechniquebased onpreviouslyreported protecting stoma with no need forreversal.</p><p><b>METHODS</b>Thetechniquealso used "the assembly of drainage device" to performprotecting ileostomy. The original method includes enterotomy at the terminal ileum to placedrainage device, which was optimized as follows: two intestinal pursestring with 0.5 cm distance were placed 5 cm away from the ileocecal valve. Transverse enterotomy was performed in the anti-mesenteric side. The assembly was placed at the root of the appendix between two pursestring, and then the intestine purse suture was tighten. Ligation of the small intestine anastomosis between the anastomosis ring at both ends was carried out, and theanastomosis ring was deployed. From the root of the appendix in the cecum wall, the assembly was embedded about 2 cm and pulled out of abdominal cavitythough the Trocar hole.</p><p><b>RESULTS</b>Seventeen cases of ultra-low rectal cancer completed protecting stoma, including 11 cases through ileocecal protective stoma. All the anastomosis healed well. Defecation drainage tube was removed 3-5 weeks after anastomosis ring degradation. Drainage nozzle healed after 3 to 5 days, and no complications occurred.</p><p><b>CONCLUSION</b>The optimized ileocecal protective ileostomy has the following advantages: (1)wound healing time is significantly shorter. (2)secondary intestinal fistula can be prevented. (3)no need to fix ileum and less chance of subsequent volvulus, intestinal obstruction.</p>

Effects of Testosterone on Norepinephrine Release in Isolated Rat Heart / 华中科技大学学报（医学）（英德文版）

The effects of testosterone on norepinephrine release were investigated in the isolated rat hearts.Sprague-Dawley male rats (n=120) were randomized to testosterone and control groups.The rats in testosterone group were perfused with modified Krebs-Henseleit buffer containing different concentrations of testosterone (0.1,1.0,10.0,and 100.0 nmol/L,respectively).Myocardial ischemia was induced by globally stopping the perfusion flow.Exocytotic norepinephrine release was induced by electrical field stimulation at 5 V (effective voltage) and 6 Hz (pulse width of 2 ms) for 1 min.The overflow of norepinephrine was determined by high pressure liquid chromatography and electrochemical detection (HPLC-EC).Following acute ischemia,testosterone (1.0,10.0 and 100.0 nmol/L) significantly reduced norepinephrine release (P＜0.01),and the norepinepherine overflow was similar between the control and 0.1 nmol/L testosterone group (P＞0.05).Electrical stimulation of the ventricle evoked norepinepherine release,and this was diminished by the perfusion with testosterone at the concentrations of 1.0,10.0 and 100.0 nmol/L (P＜0.01).It is suggested that testosterone suppresses ischemia- and electrical stimulation-induced norepinepherine release in the isolated rat hearts.

Role of integrin α4β7 in the pathogenesis of ulcerative colitis in rats / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the role of integrin α4β7 in the development of ulcerative colitis (UC) in rats.</p><p><b>METHODS</b>Sixty Sprague-Dawley rats were randomly divided into the control group (acetone enema), the model group (2,4-dinitrochlorobenzene, DNCB enema), and the α4 intervention group. Colonic mucosa of different groups was observed and compared in terms of pathology and cytokine changes(IL-2 and IL-6) using ELISA. Semi-quantitative RT-PCR was used to detect the colon α4β7 expression. Integrin α4β7(+) lymphocytes in the portal vein of rats were determined by flow cytometry.</p><p><b>RESULTS</b>The expression of α4 mRNA was 0.68±0.24 in the model group and 0.58±0.37 in the intervention group, and the expression of β7 mRNA was 0.84±0.37 in the model group and 0.65±0.30 in the intervention group, which were all significantly higher as compared to those in the control group(0.15±0.13 for α4 and 0.24±0.62 for β7, P<0.01). The proportions of integrin α4β7 positive lymphocytes in the portal vein in the model group and intervention group were significantly higher than that in the control group [(76.7±8.2)% and (68.2±7.6)% vs. (14.7±6.7)%, P<0.01]. The expression of IL-2 and IL-6 and the result of macroscopic and microscopic scores in the intervention group were lower than those in the model group(P<0.05).</p><p><b>CONCLUSIONS</b>High expression of α4β7 may play an important role in experimental colon mucosa inflammation in rats with ulcerative colitis. The blockade of integrin α4β7 may be a potential target to reduce colonic mucosa inflammation.</p>

Role of secondary lymphoid tissue chemokine in the pathogenesis of rat ulcerative colitis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of secondary lymphoid tissue chemokine (SLC) on experimental colon lesions in rats with ulcerative colitis.</p><p><b>METHODS</b>Sixty Sprague-Dawley rats were randomly divided into control group, model group and SLC intervention group. Colonic mucosal lesions of different groups were observed with HE staining for inflammation and lymphocyte homing situation. Cytokine IL-2 and IL-6 levels were measured by ABC-ELISA. Semi-quantitative RT-PCR was used to examine the colonic SLC expression.</p><p><b>RESULTS</b>Intestinal inflammation score and colonic cytokine levels were significantly different among three groups (P<0.05, P<0.01). Abnormal lymphocyte homing phenomenon under colonic mucosa was found in the model group and the intervention group. SLC mRNA expression of the model and intervention groups increased significantly compared with the control group (0.846+/-0.047, 0.768+/-0.135 vs 0.312+/-0.112, P<0.01). However, there was no significant difference between model group and intervention group.</p><p><b>CONCLUSIONS</b>SLC may play an important role in experimental colonic mucosal inflammation in rats with ulcerative colitis. Blockade of SLC may be one of effective ways in reducing colonic mucosal inflammation.</p>

Expression and effect of secondary lymphoid tissue chemokine in experimental ulcerative colitis in rats / 中华消化杂志

Objective To investigate the expression and effect of secondary lymphoid tissue chemokine(SLC)in experimental ulcerative colitis(UC)in rats.Methods Thirty Spague-Dawley rats were divided into control group and UC group.SLC expression in colon tissues was detected by RT-PCR and immunohistochemistry,respectively.Results The transcriptional level of SLC in UC tissues was significantly higher than that in the control group(0.846?0.07 vs 0.312?0.12,P＜0.01).The positive expression of SLC was concentrated mainly on submucosa,and the positive rate of SLC protein expression in UC group significantly higher than that in control group(P＜0.01).Conclusion SLC overexpression could contribute to the pathological processes in UC rats,thus SLC may be an ideal ther- apeutic target for UC.

Cecal Duplication: A case report

Duplications of the alimentary tract are relatively rare congenital malformations usually present during infancy or young childhood. They can occur anywhere in the intestinal tract. The most common site is the terminal ileum, and the least common site is the colon. Duplication of the cecum is very rare. The importance of these congenital lesions lies in the fact that they mimic other surgical disease processes and may result in significant morbidity if left untreated. Prompt recognition and treatment using combined radiologic and surgical management are associated with an excellent outcome. We experienced a case of cystic duplication in the cecum, which gave rise to partial intestinal obstruction and bleeding. We performed a resection of the cecum, including a part of the terminal ileum, and anastomosed in end-to-end fashion with a good result.

A Clinical Review of Breast Cancer

BACKGROUND : The incidence of breast cancer has steadily increased through the years. The establishment of the cause of breast cancer plays an important role for the diagnosis, management and prevention of breast cancer. METHODS : We analysed 241 cases of breast cancer that were treated during the 13 years from January 1985 to December 1997 at the Department of General Surgery, Inje University Paik Hospital, Seoul. RESULTS : The peak incidence of breast cancer was in the 5th decade (100 cases, 41.5%). The most common age of menarche ranged from 14 to 20 years (89.9%). The most common age of first full-term delivery ranged from 25 to 29 years (54.5%). The normal group was the most frequent body mass index (156 cases, 65.8%). The most common chief complaint was a painless palpable breast mass (166 cases, 68.9%). Most patients (181 cases, 75.1%) visited the hospital within 6 months of developing symptoms. The upper outer quadrant was the most frequent location for breast cancer (146 cases, 60.6%). The most common type of operative technique was a modified radical mastectomy (225 cases, 93.4%). The most common size of the breast mass ranged from 2 to 5 cm (151 cases, 62.7%). A pathologically positive axillary lymph node was present in 122 cases (52.4%). The predominant type of pathological classi fication was invasive ductal carcinoma (215 cases, 90.7%). According to the TNM system, the most common stage was stage II (161 cases, 66.8%). The five-year survival rates for the patients in stages I, II, III were 96.7%, 82.2%, 68.9%, respectively. CONCLUSIONS : We conclude that women with mass or mass-related symptoms needed more careful evaluation and aggressive approaches for discovering breast cancer.