ABSTRACT
Objective To investigate the effects of laryngeal mask airway combined with lung-protective ventilation on postoperative pulmonary complications in patients undergoing open abdominal surgery with general anesthesia.Methods Eighty-seven patients of both sexes,aged 18-64 yr,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective open abdominal surgery under general anesthesia,were randomly divided into 2 groups:endotracheal intubation plus routine ventilation group (group IC,n =43) and laryngeal mask airway plus protective ventilation group (group LP,n =44).In group IC,single lumen endotracheal tube was inserted and the patients were mechanically ventilated,with inhaled pure oxygen 2 L/min,tidal volume 8-10 ml/kg,respiratory rate 8-12 breaths/min,inspiratory/expiratory ratio 1 ∶ 2.In group LP,the ProSeal laryngeal mask airway was inserted and lung-protective ventilation was performed,with inhaled pure oxygen 2 L/min,tidal volume 6-8 ml/kg,respiratory rate 12-16 breaths/min,inspiratory/expiratory ratio 1 ∶ 2,positive end-expiratory pressure 5 cm H2O,and recruitment maneuvers was performed manually every 30 min during operation.End-tidal pressure of carbon dioxide was maintained at 35-45 mmHg.The development of pulmonary complications such as pneumonia,pleural effusion,pulmonary atelectasis,pneumothorax,bronchospasm and acute respiratory failure was recorded within 7 days after surgery.Results Pulmonary atelectasis,pneumothorax or acute respiratory failure was not found in the two groups.Compared with group IC,no significant change was found in the incidence of pneumonia,pleural effusion and bronchospasm after operation (P＞0.05),and the total incidence of postoperative pulmonary complications was significantly decreased in group LP (P＜0.05).Conclusion Compared with endotracheal intubation and conventional ventilation,laryngeal mask airway combined with lung-protective ventilation can reduce postoperative pulmonary complications in the patients undergoing open abdominal surgery with general anesthesia.
ABSTRACT
Objective To investigate the value of laparoscopy in the diagnosis and treatment of unexplained chronic abdominal pain.Methods From January 2014 to February 2016, clinical data of 56 unexplained chronic abdominal pain undergoing laparoscopic surgery were analyzed retrospectively.Laparoscopic exploration was performed firstly and then the corresponding abnormalities were diagnosed and dealt with accordingly.Results The disease causes were explicit in 48 cases (85.7%), including 25 cases of abdominal adhesions, 8 cases of chronic appendicitis, 2 cases of small intestinal diverticulum, 2 cases of intestinal tuberculosis, 2 cases of lymphoma, 5 cases of endometriosis, 2 cases of tubal adhesions, 1 case of peritoneal metastasis of gastric cancer after surgery, and 1 case of appendiceal mucinous adenocarcinoma.Surgical treatment was performed in 43 cases, 3 of whom were converted to laparotomy.There were no postoperative complications in the 56 cases.The follow-up rate was 92.9% (52/56), and lost of follow-up was in 4 cases.The follow-up duration was from 3 months to 3 years (median, 19.4 months).There was 1 death case (peritoneal carcinomatosis).There were 35 cases (62.5%) of complete relief of abdominal pain (no recurrence of preoperative abdominal pain symptoms) and 12 cases (21.4%) of pain relief (preoperative pain decreased or interval extended).The total effective rate was 83.9% (47/56).Conclusion Laparoscopy is of high value in the diagnosis and treatment of unexplained chronic abdominal pain.
ABSTRACT
Objective To explore anti-EV71 effects of Ganlu Xiaodudan in vitro. Methods Ribavirin was taken as control drug, with the help of cell culture to observe anti-EV71 inhibition rate of Ganlu Xiaodudan in inhibiting-virus-directly experiment, therapeutic-inhibiting-virus experiment, preventive-inhibiting-virus experiment and preventive-therapeutic-inhibiting-virus experiment. Results In inhibiting-virus-directly experiment, therapeutic-inhibiting-virus experiment and preventive-therapeutic-inhibiting-virus experiment, virus inhibition rate of Ganlu Xiaodudan was higher than ribavirin. In preventive-inhibiting-virus experiment, virus inhibition rates of Ganlu Xiaodudan and ribavirin both were almost zero. Conclusion Ganlu Xiaodudan has better antiviral effects on EV71 than ribavirin, and it can affect more than one link of multiplication of EV71.
ABSTRACT
Objective To investigate expression of the phosphatase and tensin homolog (PTEN) gene in breast cancer cell line and its effect on biologic characteristics.Methods The normal PTEN expression cell line MDA-MB-231 (M231) was used in this study.PTEN-shRNA plasmid was transected into M231 breast cancer cells to knock down the expression of PTEN.The changes of PTEN expression,proliferation,invasion and metastasis of PTEN knocked down cell were tested by RT-PCR,Western blot,CCK-8,scratch and Transwell.Results PTEN-shRNA was successfully transected into M231 cells.PTEN mRNA and protein expression was efficiently inhibited in M231-3001 cell lines than that in control group M231-scr(P ＜ 0.01),M231-3001 cell lines showed a greater capability of colony formation,migration and invasion than that in control group M231-scr (all P ＜ 0.05).Conclusions PTEN,as a suppression gene,its low expression can promote the proliferation,migration and invasion of breast cancer cells.
ABSTRACT
Objective To explore the clinical efficacy of early breast cancer patients underwent breast-conserving surgery with postoperative chemotherapy and radiotherapy.Methods A retrospective analysis of 128 early breast cancer patients underwent routine breast-conserving surgery was conducted.The clinical effect and cosmetic results were analyzed by the follow-up results of 128 cases.Results (1) The 5-year follow-up rate was 100％,overall survival rate was 95.3％,1-year survival rate was 100％ (128/128) ;3-year survival rate was 98.4％ (126/128) ;5-year survival rate was 95.30％ (122/128).Postoperative follow-up 6 patients died,3 patients died of liver metastases,2 patients died of lung metastases,1 patient died of non-cancerous reasons.The local recurrence rate was 2.34％ (3/128),axillary lymph node recurrence rate was 1.56％ (2/128).The average recurrence time was three years and two months after operation,distant metastasis rate was 3.91％ (5/128).(2) Beauty evaluations of 128 patients with breast-conserving surgery were excellent in 71 cases (55.5％),good in 55 cases (43.0％),and poor'in 2 cases (1.6％).Good,acceptable as acceptance criteria,the acceptance rate was 98％.Conclusion Breast-conserving surgery is not only to a certain extent to solve the pursuit of female beauty,but also improve their quality of life.But only the complete elimination of residual lesions in order to truly ensure that no recurrence of tumor.Therefore,the appropilate survival rate of patients for radiotherapy and chemotherapy can be extended so that the patient's breast to maintain a good shape.Breast-conserving surgery combined with radiotherapy and chemotherapy is superior to the modified radical surgery,and popularization in the hospital.
ABSTRACT
Objective To explore the microRNA expression changes and related characteristics and analyze the corresponding miRNA target genes and their bioinformatics in colorectal cancer with liver metastasis.Methods The fresh specimens of primary CRC were collected in 10 patients during operation,with liver metastasis or without.The miRNA expression levels were compared by miRNA microarray between two groups.Then,target genes were identified using target prediction algorithms.The liver metastasis related miRNA-target networks and gene ontology (GO) bioinformatics analysis were further performed.Results A total of six dysregulated miRNAs were identified in colorectal cancer liver metastasis comparing with no metastasis,including 3 up-regulated miRNAs (miR-224,miR-1236,miR-622) and 3 downregulated miRNAs (miR-155,miR-342-5p,miR-363).miR-224 with most significantly up-regulation played regulation role not only with corresponding target-genes but also downstream genes.Conclusions As a core of the regulation networks,miR-224 can regulate the related gene functional groups simultaneously and asynchronously.It further implements the post-transcriptional regulation and plays a vital role in liver metastasis of colorectal cancer.
ABSTRACT
Objective To study the feasibility of laparoscopic total mesorectal excision(TME) for low rectal cancer.Methods Laparoscopic total mesorectal excision was performed in 126 patients with low rectal cancer according to TME principle.Results The operation time was 95 - 180 min,with an average time of ( 117 ± 21 ) min,the amount of bleeding 50 - 200 ml,with an average amount of (90 ± 27 ) ml.2 - 3 days after surgery,gastrointestinal function was restored.Hospital stay was 6 - 14 days,with an average of (8 ± 2)days.Four cases converted to open surgery,the conversion rate for laparotomy was 3.2％.The proportion of sphincter-preserving operation was 95.24％ (120/126).No instant or delayed injury of ureters,large bleeding in front of sacrum and other operation-related severe complications happened intra-and after operation.Conclusion Laparoscopic surgery for low rectal cancer is safe and feasible.
ABSTRACT
Objective To study the clinical feasibility and effect of totally endoscopic resection of axillary accessory breast.Methods Totally endoscopic resection of axillary accessory breast was performed in 48 cases(59 sites).On the basis of liposuction,a camera port and two 5-mm working trocars were made.By using forceps,dissecting scissors,or harmonic knife,were inserted.The cobweb-like fibropartition around the accessory breast was dissected.Results Postoperatively,there were 1 case of subcutaneous liquid accumulation and 2 cases of subcutaneous petechia,and no hematoma or infection developed.All wounds healed by first intention.Follow-up observations for 2～58 months(mean,23.6 months) showed good appearance and satisfactory effects.Conclusions Totally endoscopic resection of axillary accessory breast is safe,offering good cosmetic effects and being worthy of recommendation.
ABSTRACT
Objective To discuss the angiogenic e ffects on tumor micrometastasis. Methods Literatures on the relation between tumor angiogenesis and micrometastasis were reviewed. Results Tumor angiogenesis was a basis of the devel opment of micrometastasis.Conclusion Micrometastic dependence on angiogenesi s gestates a novel revolution of tumor treatment.
ABSTRACT
Objective To evaluate the safety and efficacy of endoscopic techniques for diagnosis and treatment of breast diseases. Methods Related literatures of recent years were reviewed. Results A minimally invasive endoscopic technique can be performed through small incisions. This can contribute greatly to reducing postoperative pain, shortening recovery time, and achieving a good cosmetic outcome. Under endoscopy, meticulous dissection and hemostasis can be achieved. Endoscope assisted subcutaneous mastectomy, immediate mammary reconstruction, sentinel lymph node biopsy and axillary lymph node dissection, for breast cancer can be performed safely. Endoscopic surgery can also be applied for the diagnosis and treatment of benign breast tumor and transaxillary removal of glandular tissue in gynecomastia. In addition, fiberoptic ductoscopy can be used to diagnose patients with nipple discharge. Endoscopic surgery for patients with breast diseases can offer an excellent cosmetic outcome and maintain normal physiologic functions without a noticeable scar. It helps to give the patients confidence and improve the quality of life. Conclusion Breast surgery is a good candidate for endoscopic techniques.
ABSTRACT
<p><b>OBJECTIVE</b>To study the expression of human mammaglobin (hMAM) mRNA in the peripheral blood of breast cancer patients and its implication.</p><p><b>METHODS</b>The expression of human mammaglobin mRNA was determined by using RT-PCR method in 56 patients with peripheral blood breast cancer, 8 patients with breast hyperplasia and 8 women with normal breast. The expression of hMAM mRNA was compared with biological significance and change of hMAM mRNA in chemotherapy after operation.</p><p><b>RESULTS</b>The expression of hMAM mRNA was negative in 8 patients with breast hyperplasia, 8 women with normal breast and 56 patients with breast cancer, The positive rate was 30.4% (17/56) (chi(2) = 19.766, P < 0.01). The expression of hMAM mRNA in peripheral blood was not correlated with clinical stage, primary tumor size and patients age (chi(2) = 1.256, P > 0.05). After short-term large dose of chemotherapy, 41.2% (7/17) patients turned positive before operation to negative hMAM mRNA expression and negetive expression before operation positive expression after chemotherapy.</p><p><b>CONCLUSIONS</b>This study suggests that hMAM is sensitive and specific for breast cancer. Detection of the expression of hMAM mRNA in peripheral blood of breast cancer is of value in the diagnosis and judgement of prognosis of breast cancer.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Biomarkers, Tumor , Blood , Breast Neoplasms , Blood , Diagnosis , Gene Expression , Leukocytes, Mononuclear , Metabolism , Mammaglobin A , Neoplasm Proteins , Blood , Genetics , Prognosis , RNA, Messenger , Blood , Uteroglobin , Blood , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To study the prevention of colorectal cancer liver metastasis by adenoviral transduction of the endostatin gene.</p><p><b>METHODS</b>The recombinant adenovirus expressing endostatin was constructed. Its biological activities were surveyed in vitro, as determined in human umbilicus vein endothelium cell (HUVEC) proliferation inhibition, and in vivo, by reduction of liver metastasis.</p><p><b>RESULTS</b>HUVEC proliferation was obviously inhibited by the infecting supernatant of recombinant adenovirus. Persistent high serum levels of endostatin in peripheral blood, especially in the liver vein were observed. The production of liver metastasis was intervened.</p><p><b>CONCLUSIONS</b>The single injection in the vein of the recombinant adenovirus realizes the high effective and stable expression of endostatin in general body and liver, which brings about the ideal prevention of liver metastasis.</p>
Subject(s)
Animals , Mice , Adenoviridae , Genetics , Cell Division , Collagen , Genetics , Therapeutic Uses , Colorectal Neoplasms , Pathology , Disease Models, Animal , Endostatins , Endothelium, Vascular , Pathology , Genetic Therapy , Genetic Vectors , Liver Neoplasms , Mice, Inbred BALB C , Neoplasm Metastasis , Neoplasm Transplantation , Peptide Fragments , Genetics , Therapeutic Uses , Transduction, GeneticABSTRACT
Objective To evaluate effects of neoadjuvant chemotherapy on axillary lymph node status in patients with breast cancer.Methods A total of 45 patients with stage Ⅱ or Ⅲ breast cancer treated with neoadjuvant chemotherapy followed by surgery(Combination Group) were compared with 79 patients with breast cancer treated with initial surgery only(Surgery Group) in respect of axillary lymph node status,including the total number of the lymph nodes and the number of positive and negative lymph nodes,according to findings of physical examination,B-ultrasonography,and molybdenum target radiography.Results The total number of the lymph nodes and the number of positive lymph nodes were significantly less in the Combination Group(16.9?5.9 and 2.5?2.2) than in the Surgery Group(20.8?8.0 and 3.9?3.0)(t=-2.856,P=0.005;t=2.790,P=0.006),whereas the number of negative lymph nodes were 14.4?5.4 and 16.7?7.0 in the Combination Group and the Surgery Group,respectively,without statistical significance(t=-1.904,P=0.055).Four patients were found loco-regional relapse in each group during follow-up checkups for 6~19 months(mean,10 months) in 40 patients in the Combination Group and 7~21 months(mean,12 months) in 67 patients in the Surgery Group.Conclusions Total and positive axillary lymph nodes retrieved after axillary lymph node dissection decrease in number after neoadjuvant chemotherapy.
ABSTRACT
Objective To explore the feasibility of endoscopic thyroidectomy through the approach of areola of breasts.Methods Endoscopic thyroidectomy via areola of breasts approach was carried out in 26 cases from March 2003 to September 2005.Thyroid nodules were right-sided in 13 cases,left-sided in 10 cases,bilateral in 1 case,and not palpable in 2 cases of hyperthyroidism(grade 1).There were 9 cases of solitary nodule and 15 cases of multiple nodules.The nodules were cystic in 5 cases,solid in 13 cases,and mixed in 6 cases,with 1~4 cm in diameter.Preoperative diagnoses included 9 cases of thyroid adenoma,15 cases of nodular goiter,and 2 cases of primary hyperthyroidism.Results The thyroidectomy was performed successfully under endoscope in 25 cases,with an operation time of 50~210 min(mean,112 min),including 4 cases of tumor enucleation,10 cases of unilateral partial thyroidectomy,8 cases of bilateral partial thyroidectomy,and 3 cases of bilateral subtotal thyroidectomy with isthmus resection.A conversion to open surgery was required in 1 case owing to thyroid carcinoma with trachea involvement.Pathological findings showed 4 cases of thyroid adenoma,18 cases of nodular goiter,2 cases of primary hyperthyroidism,and 2 cases of thyroid carcinoma.The drainage tubes were removed at 24~48 hours after operation.No nerve or parathyroid injuries occurred.The length of postoperative hospital stay was 3~6 d(mean,4.2 d).Follow-up observations in 25 cases for 3~33 months(mean,13 months) revealed no local recurrence.The patients were satisfied with cosmetic effects.The 2 cases of thyroid carcinoma were followed for 9 and 11 months,respectively,presenting no recurrence or metastasis.Conclusions Endoscopic thyroidectomy via areola of breasts approach is feasible and effective,offering satisfactory cosmetic outcomes.
ABSTRACT
Objective To probe the effect of transareolar or mastoscopy assisted breast-conserving surgery combined with open axillary lymph node dissection in the treatment of breast cancer. Methods Nineteen patients, with breast cancer of a diameter cm from the nipple, were treated by transareolar or mastoscopy assisted breast-conserving surgery from August 2001 to November 2003.After the lipolysis and suction of axillary fat,open axillary lymph node dissection was performed. Results Intraoperative frozen pathological examination had showed positive margin in 1 case, in which an enlarged excision was required to obtain a negative result. Postoperative subcutaneous edema underlying the operated site occurred in 2 cases and was cured by needle aspiration and pressure dressing. Excellent cosmetic outcomes were obtained with symmetrical breast development and all the patients were satisfied with the treatment. Postoperative follow-up for 2～19 months (mean, 10.6 months) found no recurrence in the breast or the axillary fossa. Conclusions Breast-conserving surgery can be expediently carried out by means of transareolar incision or with the help of mastoscopy. The combination with open axillary lymph node dissection may give favorable effect.
ABSTRACT
Objective To explore the diagnosis and treatment of abdominal cocoon. Methods This article retrospectively summarized clinical data of 6 cases of abdominal cocoon. Results All the 6 cases of abdominal cocoon were misdiagnosed preoperatively: 5 cases were diagnosed as having intestinal obstruction and 1 case,abdominal mass.Partial or total capsule resection was adopted in all the 6 cases,1 of which simultaneously underwent intestinal arrangement. Conclusions Abdominal cocoon is not specific,which is difficult to diagnose preoperatively.Upper digestive tract radiography,B-ultrasonography and CT scanning help to make the diagnosis.Partial or total capsule resection,intestinal arrangement,intestinal resection and release for intestinal adhesion are usually adopted as the treatment.
ABSTRACT
Objective To study the significance of monitoring postoperative hematogenous micrometastasis of colorectal cancer． Methods The micrometastatic cancer cells in peripheral blood and bone marrow of the perioperative patients were investigated by CK20 mRNA RT-PCR. Results The positive rates(16.3%) of hematogenous dissemination without relapse or metastasis after operation were significantly lower than that(88.9%) in patients with postoperative relapse or metastasis. There were four types of hematogenous dissemination. (1) Postoperative temporary negatives.(2)Consistant positives. (3) CK-20 turned positive postoperatively. (4) Consistant negatives. All the 6 patients that died had positive CK-20 preoperatively. Conclusions The hematogenous dissemination of colorectal cancer plays an important role in postoperative relapse. The dynamic monitoring of CK-20 predicts hematogenous dissemination of colorectal cancer.
ABSTRACT
ObjectiveTo explore the recurrence inhibition of colorectal cancer by adenoviral transducted endostatin gene. Methods The recombinant adenovirus expressing endostatin was constructed. Its biological activities were observed. The levels of endostatin in mice peripheral blood, tumor local recurrence and tumor cell apotosis were analyzed after the endostatin gene transduction by adenovirus. Results The infecting supernatant of recombinant adenovirus significantly inhibited HUVEC proliferation. After the injection of the recombinant adenovirus, persistent high serum levels of endostatin in peripheral blood was observed, local recurrence rate decreased, and apotosis of recurrence tumor cells increased.Conclusions The intraveneously injection of recombinant adenovirus mediated endostatin gene produces high concentration and stable expression of endostatin,which effects prevention of local recurrence after surgical resection of colorectal cancer.
ABSTRACT
Objective To evaluate the clinical significance of CEA mRNA expression in gallbladder bile for early diagnosis of liver metastasis from primary colorectal cancer. Methods [WT5”BZ] A CEA specific nest RT PCR assay was used to detect CEA mRNA expression in the gallbladder bile of 46 patients with colorectal cancer. Results The positive rate of CEA mRNA in gallbladder bile was 74%. The rate was directly proportional to that of live metastasis. Liver metastasis developed in 33% of patients with positive CEA mRNA expression. Conclusions The positive expression of CEA mRNA in gallbladder bile is a proof of prospective liver metastasis.
ABSTRACT
Objective To study the feasibility and effect of endoscopic breast conserving surgery in the treatment of early stage of breast cancer(EBC) via transaxillary small concealing incision. Methods Twenty -one cases of EBC were treated by endoscopic breast conserving surgery,combined with the lipolysis and suction of the fat in axilla, via transaxillary small incision. Results There was no cancer residue in all the resected margins of all samples confirmed by the frozen sections. The lymph nodes metastasis was found in 3 cases. The average operation time was 81.6 minutes. Subcutaneous liquid collection occurred in one case postoperatively,the liquid disappeared quickly after treatment. All patient′s had a good breast configuration. All patients were followed-up for 3.1 months to 15.6 months after operation. There were no recurrence and distant metastasis in this series. Conclusions Breast conserving surgery can be smoothly performed by a small concealing incision with endoscope. This operation has many advantages, such as the incision is small and concealing, so it can improve the patients′ quality of life. The suction of the fat in axilla makes axillary dissection easier.