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Objective:To compare and analyze the clinical efficacy of hand-assisted laparoscopic surgery (HALS) and laparoscopic assisted surgery (LAS) in the treatment of advanced gastric cancer.Methods:Articles of the efficacy comparison of HALS and LAS in D2 radical gastrectomy for gastric cancer from 2000 to 2019 published in PubMed, Cochrane library, EM-BASE, China National Knowledge Infrastructure (CNKI), Wanfang, Weipu, Chinese full-text database of Chinese Sci-Tech journals, Chinese biomedical literature database were retrieved, and the literatures were screened according to the pre-established inclusion and exclusion criteria. The quality of the two groups was evaluated, and the short-term indexes and complications for meta-analysis of the two groups were analyzed by using Revman 5.3 software.Results:A total of 1277 patients were included in 10 articles, including 629 in the HALS group and 648 in the LAS group. The results of the meta-analysis showed that compared with the LAS group, the operation time was shorter in the HALS group (WMD=24.02, 95% CI: -40.41--7.62, P=0.004), but the auxiliary incision was slightly longer (WMD=0.27, 95% CI: 0.06-0.47, P=0.01), and there were no statistically significant difference in the remaining number of lymph node dissections (WMD=0.58, 95% CI: -1.22-2.39, P=0.53), intraoperative blood loss (WMD=-7.94, 95% CI: -16.21-0.33, P=0.06), gastrointestinal tract recovery time (WMD=0.00, 95% CI: -0.03- 0.04, P=0.85), total length of hospital stay (WMD=-0.14, 95% CI0: -0.36-0.09, P=0.23) and postoperative complications ( OR=0.89, 95% CI: 0.58-1.37, P=0.61). Conclusions:Compared with the LAS for D2 radical surgery of advanced gastric cancer, HALS has significantly shorter operation time and is easier to perform than LAS, but the incision length is slightly increased. Physicians can choose the appropriate operation method according to the specific conditions of the operation and themselves.
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Objective@#To explore the effects of various forms of prostatic apex on positive apical margin rate (PAM) and biochemical recurrence (BCR) after laparoscopic radical prostatectomy.@*Methods@#A retrospective analysis of 309 patients (aging (65±6) years) who were experienced laparoscopic radical prostatectomy from January 2010 to December 2016 at the Department of Urology, First Affiliated Hospital of Fujian Medical University. According to the relationship between prostate apex and membrane urethra at the mid-sagittal plane of preoperative MRI, all patients were classified into 4 categories. There were 31 patients for type 1, apex covering both anterior and posterior aspects of membranous urethra, 139 patients for type 2, apex covering anterior side of membranous urethra, 63 patients for type 3, apex covering posterior aspect of membranous urethra, 76 patients for type 4, apex not covering membranous urethra. PAM and BCR after operation were compared between this four groups respectively. The χ2 test was used to compare PAM among the 4 types. Logistic regression analysis were undertaken to analyze the factors affecting PAM. Cox′s proportional hazards regression model was undertaken to identify the variables influencing BCR.@*Results@#There was no significant difference in the 4 groups concerning age, body mass index, prostate volume, preoperative prostate-specific antigen (PSA) value, postoperative Gleason score and pathological stage (P>0.05).The median follow-up time was 32 months (ranged from 12 to 60 months).The data showed that the apical type 3 patients has the highest PAM. There was statistical difference among the 4 groups in PAM (χ2=15.592, P=0.001). Preoperative level of PSA (OR=20.356, 95% CI: 2.440 to 169.810, P=0.005), postoperative Gleason score (OR=4.113, 95% CI: 1.911 to 8.849, P=0.001), pathological stage (OR=3.422, 95% CI: 1.600 to 7.319, P=0.002) and apical type 3 (OR=6.134, 95% CI: 2.196 to 17.132, P=0.001) were independent relactive factors of PAM. Preoperative level of PSA (HR=1.362, 95% CI: 1.006 to 1.843, P=0.045), postoperative Gleason score (HR=1.920, 95% CI: 1.384 to 2.665, P=0.001), pathological stage (HR=1.476, 95% CI: 1.098 to 1.983, P=0.010), PAM (HR=3.497, 95% CI: 2.407 to 5.081, P=0.001)and apical type 3 (HR=1.828, 95% CI: 1.266 to 2.639, P=0.001) were independent prognosis factors of BCR.@*Conclusion@#Prostate apical type 3 could be a significant independent predictor of PAM, and an independent prognosis factor for BCR.
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Objective To investigate the association between rs7744 polymorphism in the 3'?untranslated region(3'?UTR)of myeloid differen?tiation factor 88(MyD88)gene and the risk and severity of coronary artery disease(CAD)in a North Chinese Han population. Methods The CAD and control groups consisted of 540 patients and 270 subjects,respectively. The genotypes of rs7744 were detected by polymerase chain reac?tion?restriction fragment length polymorphism(PCR?RFLP),and clinical data were collected. Results The distributions of MyD88 rs7744 were in HWE(P>0.1). In the<50?year?old age group,a lower risk of CAD was observed for subjects carrying the variant AG genotype in comparison to subjects carrying the wild AA genotype(OR=0.38,95%CI:0.17-0.93,P=0.029). The MyD88 rs7744 polymorphism was also related to the modified Gensini score(P=0.011),which was lower in subjects carrying the variant GG genotype than the wild AA genotype(5.23±3.85 vs 7.49± 4.96). Conclusion Our results revealed that MyD88 rs7744 polymorphism in the 3'?UTR is correlated with the risk and severity of CAD.
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AIM:To investigate the role of Rho-associated kinase ( ROCK) inhibitor fasudil in the formation of rabbit urethral stricture after injury and to observe the cell activity , migration and extracellular matrix synthesis in the rabbit urethra fibroblasts.METHODS:The rabbit model of urethral stricture was established by microsurgical techniques .The rabbits were divided into sham operation group , operation group and fasudil (3 mg/kg, 10 mg/kg, 30 mg/kg) groups.The diameter of the stenosis was measured by retrograde urethrography 3 months after surgery .The fibroblasts were isolated from urethral scar, and then incubated with fasudil (12.5 μmol/L, 25 μmol/L, 50 μmol/L) in the presence of transforming growth factor-β1 (TGF-β1, 10 μg/L).The untreated cells were used for control .The cell activity was measured by MTT assay.The cell migration ability was tested by the method of Transwell chambers .The protein expression of ROCK , α-smooth muscle actin (α-SMA) , collagen I and collagen III was determined by Western blot analysis .RESULTS:Fasudil significantly reduced formation of urethral stricture after injury (P<0.05).Cultured rabbit fibroblasts with different con-centrations of fasudil inhibited the cell activity and cell migration ability (P<0.05).The protein expression of ROCK,α-SMA, collagen I and collagen III was also inhibited by treatment with fasudil in a dose -dependent manner ( P<0.05 ) . CONCLUSION:Fasudil inhibits the formation of extracellular matrix and reduces the incidence of urethral stricture after injury by down-regulating TGF-β1-induced Rho/ROCK pathway activation in the rabbit urethra fibroblasts .
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AIM: To study the quality standard for Shuwei Capsule (Resina Ferulae, Rhizoma Corydalis, Radix Aucklandiae, etc.). METHODS: Radix Aucklandiae, Rhizoma Cyperi were identified by TLC, and ferulic acid was determined by HPLC. RESULTS: TLC spots developed were fairly clear, and the blank test showed no interference. Ferulic acid showed a good linear relationship in the concentration range of 0.007～0.056?g and the average recovery was up to 98.51%, RSD was 2.64%. CONCLUSION: The method is simple with strong specificity and good reproducibility, and can be used as the quality control of this preparation.