Controversy and progress on whether to retain left colonic artery in radical resection of rectal cancer / 中华胃肠外科杂志

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.

Analysis of hidden blood loss after percutaneous kyphoplasty for osteoporotic vertebral compression fracture and its influencing factors / 中国骨伤

OBJECTIVE@#To investigate the hidden blood loss and related risk factors of osteoporotic vertebral compression fractures after percutaneous kyphoplasty.@*METHODS@#The clinical data of 153 patients with osteoporotic vertebral compression fractures who underwent percutaneous kyphoplasty from March 2015 to December 2017 were retrospectively analyzed, including 55 males and 98 females, aged 68 to 87(78.6±11.4) years old. Erythrocyte specific volume was collected before and after operation to calculate the hidden blood loss. The influence of sex, age, body mass index, bone mineral density, diabetes mellitus and hypertension, operation mode (unilateral or bilateral), operation time, operative segment and number, loss height of vertebral body and recovery height ratio on hidden blood loss was analyzed by multiple linear regression model.@*RESULTS@#Postoperative hidden blood loss was (287.7±68.5) ml. Multivariate linear regression analysis showed that the history of diabetes mellitus (β=2.405, =0.012), the mode of operation(β=3.042, <0.001), the time of operation (β=2.043, =0.038), the operative segment (β=1.993, =0.043), the number (β=0.374, <0.001), the loss of vertebral height (β=2.785, =0.003) and the recovery ratio(β=7.301, <0.001) were correlated with occult hemorrhage.@*CONCLUSIONS@#There is a certain degree of occult hemorrhage in kyphoplasty for osteoporotic vertebral compression fractures. The risk factors of hidden hemorrhage are diabetes history, operation method, operation time, operative segment and number, loss of vertebral height and recovery ratio.

Changes in circumpapillary thickness parameters measured by optical coherence tomography in patients with optic disc edema / 眼科新进展

Objective To observe the changes in the circumpapillary thickness parameters measured by optical coherence tomography (OCT) in patients with optic disc edema (ODE).Methods Together 36 patients (36 eyes) diagnosed with ODE from October 2012 to October 2015 were included in the study,and 51 age-and gendermatched control subjects (51 eyes) were recruited from among healthy individuals with no history or evidence of current ocular disease.All the subjects were examined for visual acuity,slit lamp,fundus and fundus photography,and all the eyes underwent OCT scan to detect the circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and circumpapillary total retinal thickness (cpTRT).Results After OCT scan,25 ODE patients (5 mild,14 moderate and 6 severe patients) and 30 patients (5 mild,15 moderate and 10 severe patients) were in line with the requirements of cpRNFLT analysis and cpTRT analysis respectively;there were 50 controls meeting the requirements of this study.There was no significant difference in age and sex between ODE patients and the controls (all P ＞0.05).The mean cpRNFLT and cpRNFLT in each quadrant of ODE patients were significantly thickened than those of controls,and the superior cpRNFLT was the thickest,followed by the inferior,then the nasal and temporal cpRNFLT,and the difference was statistically significant (P ＜0.001).The mean cpTRT and cpTRT in each quadrant of ODE patients were significantly thickened than those of controls,and the inferior cpRNFLT was the thickest,followed by the superior,then the nasal and temporal cpRNFLT,and the difference was statistically significant (P ＜0.001).Conclusion Significantly thickening of cpRNFLT and cpTRT has been observed in patients with ODE as compared with controls,so both circumpapillary thickness parameters measured by OCT can be considered as a new non-invasive quantitative index for the detection and research of ODE.

Erectile dysfunction in men with lower urinary tract symptoms / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the incidence of erectile dysfunction (ED) in men with lower urinary tract symptoms (LUTS) and the correlation between LUTS and ED.</p><p><b>METHODS</b>We enrolled 1 000 men aged 40 - 80 years with regular sex partners, evaluated their erectile function using IIEF-5, and investigated LUTS among them by International Prostate Symptom Score (IPSS). We studied the relationship between ED and LUTS by univariate conditional Logistic regression analysis.</p><p><b>RESULTS</b>LUTS were found in 42.81% of the men investigated (426/995), and ED in 76.18% of the subjects (758/995) and 82.16% of those with LUTS (350/426). Logistic regression analysis revealed a significant relation of ED with aging and LUTS (P < 0.01).</p><p><b>CONCLUSION</b>The The incidence of ED is high in men with LUTS and increases with aging and the severity of LUTS.</p>

Clinical applications of sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To observe the clinical therapeutic effects of sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation.</p><p><b>METHODS</b>From June 2010 to June 2012, 7 patients with sternoclavicular joint dislocation were treated with sternoclavicular hook plate fixation. Among the 7 patients, 5 patients were male and 2 patients were female, and the average age was 42.3 years, ranging from 38 to 54 years. The course of the disease ranged from 1 to 4 weeks. All the patients had trauma history. The clinical manifestations included: obvious swelling and pain of sternoclavicular joint, restricted shoulder joint activity. The sternoclavicular joint dislocation was proved by preoperative X-ray and CT. The postoperative curative effect was evaluated according to Rockwood scoring method.</p><p><b>RESULTS</b>According to Rockwood scoring method, the excellent results obtained in 6 cases, good in 1. There were no complications such as internal fixation loosening or broken, second dislocation, pain in the sternoclavicular joint, and deformity. The function of shoulder joint was good, and the limb activity was free and no pain appeared.</p><p><b>CONCLUSION</b>The sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation has follow advantages: simple procedure, stable fixation, definite therapeutic effects.</p>

Comparison of diagnostic value between DR and MSCT in fracture and dislocation of foot and ankle / 中国骨伤

<p><b>OBJECTIVE</b>To compare the diagnostic value between digital photography (DR) and multi-slice spiral CT (MSCT) in fracture and dislocation of foot and ankle.</p><p><b>METHODS</b>From August 2010 to August 2012, the DR and MSCT data of 52 patients with fracture and dislocation of foot and ankle were compared according to results of surgery or discharge diagnosis. There were 37 males and 15 females, aged from 15 to 49 years old. Wilcoxon signed rank test was used for statistical analysis.</p><p><b>RESULTS</b>The results of 52 cases of MSCT were matched with the postoperative or discharge diagnosis. A total of 172 fractures were found on MSCT and 98 fractures were found on DR, the results had significant difference in detecting fracture (V=1 081, P<0.05); A total of 24 dislocations were found on MSCT and 16 dislocations were found on DR,the results also had significant difference in detecting dislocation (V=21, P<0.05). Fractures of 6 cases with DR diagnosis were corrected and located by MSCT.</p><p><b>CONCLUSION</b>MSCT is significantly better than DR in diagnosis of fracture and dislocation of foot and ankle. The examination of two parts should be performed in DR. MSCT and multi-planar reconstruction (MPR) examination should be further performed if DR results are unclear or do not match with clinical symptoms, missed diagnosis and misdiagnosis can be avoided.</p>

Regulating effects of arsenic trioxide on cell death pathways and inflammatory reactions of pancreatic acinar cells in rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It is accepted that inflammatory cytokines play a key role in the development of acute pancreatitis, so blocking the initiation of inflammatory reactions may alleviate pathological changes of acute pancreatitis. We studied the regulatory effect of arsenic trioxide (As(2)O(3)) on apoptosis and oncosis of pancreatic acinar cells in vitro and in vivo and its therapeutic effect on acute pancreatitis.</p><p><b>METHODS</b>Pancreatic acinar cells were isolated by collagenase digestion method. Apoptosis and oncosis of isolated pancreatic acinar cells were detected with Hoechst 33258 + PI or Annexin V + PI double fluorescent staining. Amylase and lactate dehydrogenase release were measured. Acute pancreatitis was induced in Wistar rats by intraperitoneal injections of caerulein, and apoptosis was detected with terminal dUTP nick-end labeling method. Tumor necorsis factor alpha (TNF-alpha) mRNA, myeloperoxidase, nuclear factor-kappaB and histological grading of pancreatic damage were measured.</p><p><b>RESULTS</b>There was an increased apoptosis but a decreased oncosis of pancreatic acinar cell after the treatment with As(2)O(3). The levels of lactate dehydrogenase and amylase release were markedly decreased in As(2)O(3) treated group. Myeloperoxidase content, TNF-alpha mRNA level, nuclear factor-kappaB activation and pathological score in As(2)O(3) treated group were significantly lower than in the untreated group.</p><p><b>CONCLUSIONS</b>As(2)O(3) can induce apoptosis and reduce oncosis of pancreatic acinar cell, thus resulting in reduced release of endocellular enzyme of acinar cells, reduced inflammatory cell infiltration and decreased the production of inflammatory cytokines, so that the outcome of alleviated pathological changes was finally achieved.</p>

Experimental study on treatment of femoral head necrosis with arterial perfusion of marrow stem cells / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effect of arterial perfusion of marrow multifunctional stem cells (MFSC) in treating femoral head necrosis and its mechanism.</p><p><b>METHODS</b>The rabbit model of femoral head necrosis was established by large dose of methyl-prednisone through Shwartzman response. Bone marrow was extracted from femoral bone of model rabbit and isolated in vitro for culturing and proliferating MFSC. The experimental rabbits were randomly divided into 4 groups, treated with normal saline (A), Salvia + urokinase (B), MFSC (C) and MFSC + Salvia + urokinase (D), respectively, they were sacrificed in batches at 2 and 4 weeks after treatment, and changes in various parameters, including molybdenum target roentgenogram, routine pathology with HE staining, tetracycline labeled fluorescent microscopy and ultrastructure alteration by scanning electron microscope (SEM), were observed.</p><p><b>RESULTS</b>Typical appearance of femoral head necrosis was shown in the successfully modeled rabbits. Two and 4 weeks after treatment by high selective drug via medial and lateral femoral circumflex arterial perfusion, the X-ray examination showed significant improvement of bone density; pathohistologic manifestation showed decrease of empty bone lacuna, increase of osteoblast and new bone formation; tetracycline fluorescent labeled microscopic picture showed bright fluorescent band of increased osteoblasts in necrosis repairing region with widened border; SEM displayed irregularly arranged fibrosis in necrosis region, abundant organelles in osteoblasts with few empty bone lacuna. The above-mentioned improvement was more significant in rabbits treated by MFSC.</p><p><b>CONCLUSION</b>High selective femoral drug arterial perfusion in treating femoral head necrosis could accelerate the process of revascularization and re-ossification in rabbits. As compared with Salvia, MFSC showed quicker and more potent effect.</p>

Effects of culture medium of amniotic cells on NO and NOS in retina tissues in vitro / 中华眼底病杂志

Objective To observe the effects of culture medium of a mn iotic cells on NO and NOS in retinal tissues of rabbits in vitro in order to pro vide a protective method for antioxidation in retina transplantation. M ethods Thirty adult healthy rabbits (30 right eyes) were divided into 3 groups. Group Ⅰ: fresh retinal tissue; group Ⅱ: routine culture medium; group Ⅲ: culture medium of amniotic cells. The retinal tissues in group Ⅱ and Ⅲ we re cultured in the corresponding culture medium for 1 week. The content of NO an d NOS in retinal tissues in the 3 groups were determined. Results Compared with group I, the content of NO and NOS of group Ⅱ increased obvio usly (t=3.821, 3.854; P0.05) . Conclusion Culture medium of amniotic cells may remove free r adicals and enhance the ability of antioxidation.

Increase of thromboxane A_2 and prostacyclin in optic nerves after acute intraocular hypertension injury in rabbits / 第二军医大学学报

Objective: To determine the contents of thromboxane (TXA_2) and prostacyclin (PGI_2) in optic nerves after acute intraocular hypertension injury so as to provide experimental data for the treatment of the clinical intraocular hypertension. Methods: A rabbit acute intraocular hypertension injury model was established by 90-min anterior chamber douche. Thirty adult rabbits were equally randomized into 5 groups: 4 intraocular hypertension injury groups (60 min, 90 min, 24 h and 48 h after intraocular tension normalization) and a normal control group. The eyes of all rabbits were removed and the homogenate of optic nerves was used to determine the contents of TXB_2 and 6-Keto-PGF_ 1?, and the metabolites of TXA_2 and PGI_ 2 by radioimmunoassay. Results: The contents of TXB_2 and 6-Keto-PGF_ 1? in the 60 min and 90 min groups were significantly higher than those of the normal control group (P

Effects of taurine on NO and NOS activities of retina tissue after hemorrhagic shock and resuscitation in rabbit / 第三军医大学学报

Objective To investigate the NO and NOS activities of retina tissue after hemorrhagic shock and resuscitation in rabbit and the effects of taurine on them. Methods Twenty four New Zealand rabbits were randomly divided into three groups: control group, shock and resuscitation (SR) group and taurine group. Chromatometry was used to detect the NOS activities. Results The ON content and NOS activities, either in retina tissue or in plasm, increased significantly 3 h after hemorrhagic shock and resuscitation (P