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Objective To investigate the short-term safety of raltitrexed intraperitoneal perfusion in patients with rectal cancer undergoing laparoscopic Dixon surgery.Methods Totally 175 patients with rectal cancer at the Department of Colorectal Oncological Surgery,Shengjing Hospital of China Medical University were analyzed retrospectively from June 2016 to December 2017.All the patients were divided into raltitrexed intraperitoneal perfusion group (n =89) and saline intraperitoneal peffusion group (n =86) according to whether given raltitrexed intraperitoneal perfusion or not.The hematological indexes of the two groups before operation and 3 days after operation were recorded.The postoperative exhaust time and postoperative drainage volume within 24 hours were calculated.The postoperative complications including anastomotic leakage,peritoneal irritation sign,incision infection and pulmonary infection were evaluated.Results The surgery was performed successfully in all patients.There were no significant differences in the sex (x2 =0.000,P =0.990),depth of tumor invasion (x2 =0.003,P =0.956),degree of lymph node metastasis (Z =-0.590,P =0.556),TNM stage (Z =0.081,P =0.936) or pathological type (Z =1.092,P =0.896) between the two groups.There were no significant differences in postoperative exhaust time [(75.49 ± 3.97) h vs.(74.28 ±3.46) h,t =0.479,P =0.523],postoperative drainage volume within 24 hours [(201.1 ±54.1) ml vs.(242.8±25.7) ml,t=0.338,P=0.656],anastomotic leakage (1.1％ vs.2.3％,x2 =0.351,P=0.554),peritoneal irritation sign (1.1％ vs.2.3％,x2 =0.351,P =0.554),incision infection (2.2％ vs.3.5％,x2 =0.243,P =0.622) and pulmonary infection (2.2％ vs.2.3％,x2 =0.001,P =0.972) between the two groups.Additionally,there were no significant differences in the counts of erythrocytes [(3.56 ±0.27) × 1012/L vs.(3.63 ±0.26) × 1012/L,t =0.716,P =0.152],leukocytes [(7.63 ±0.20) x 109/L vs.(8.24 ±0.26) × 109/L,t =0.176,P =0.872],blood platelets [(170.13 ±20.12) × 109/L vs.(180.18 ±21.03) × 109/L,t =0.103,P =0.975],glutamic-pyruvic transaminase [(13.25 ± 2.31) U/L vs.(13.28 ± 1.46) U/L,t =0.321,P =0.713],glutamic-oxalacetic transaminase [(16.51 ± 1.28) U/L vs.(16.23 ±2.03) U/L,t=0.131,P=0.894] and creatinine [(77.36 ±6.49) μmol/L vs.(78.39 ±6.64)μmol/L,t =0.499,P =0.519] 3 days after operation between the two groups.Conclusion Raltitrexed intraperitoneal perfusion in Dixon surgery exhibits high safety,and no significant effect on postoperative recovery.It is easy to operate and has good feasibility,which is worthy to be used in clinic.
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Objective To explore the difference of the expression level of FK506 Binding Protein 51 (FKBP51) in colorectal adenocarcinoma and normal colorectal tissues,and the correlation between FKBP51 expression level and clinicopathological characteristics,and to clarify whether FKBP51 is involved in the occurrence and development of colorectal cancer.Methods By immunohistochemical staining [streptavidin-peroxidase (SP) method] and Western blotting methods tested 31 cases of colorectal cancer tumor tissues and normal colorectal tissues far from tumor 5 cm,and explored the expression level difference of FKBP51.Combined with clinical data of patients,results were analyzed by statistical method x2 test of four case table data.Results The high expression rate of FKBP51 in tumor tissues was 74.19％ (23/31 cases),while the high expression rate of FKBP51 in normal tissue was 9.68％ (3/31 cases).The difference was significant.The expression level of FKBP51 in patients with colorectal carcinoma had no obvious correlation with gender (P =0.771),age (P =0.474),tumor location (P =0.213),degree of differentiation (P =0.318),lymph node metastasis (P =0.124),distant metastasis (P =0.318) and clinical stage (P =0.171);and the tumor size (P =0.049),depth of invasion related (P =0.031),the difference was statistically significant.Conclusions The expression of FKBP51 in colorectal cancer was strong,while weak expression in normal colorectal tissues.With the increase of tumor infiltration and deepening,the expression of FKBP51 became stronger,which indicated that FKBP51 participated in the genesis and development of colorectal cancer,and it might become a new target for individual therapy of colorectal cancer.
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Objective To explore the effect of perioperative continuous use of aspirin on bleeding in laparoscopic anterior resection for rectal cancer (RC) in patients taking low dose aspirin.Methods The prospective study was conducted.The clinicopathological data of 96 RC patients taking low dose aspirin who were admitted to the Shengjing Hospital of China Medical University from September 2014 to September 2016 were collected.All the 96 patients were divided into the aspirin group (perioperative continuous use of aspirin) and non-aspirin group (discontinuation of aspirin at 7 days preoperatively and taking aspirin at 3 days postoperatively)by random number table.Laparoscopic anterior resection for RC was applied to patients by the same team of doctors.Observation indicators:(1) comparison of surgical and postoperative situations between the 2 groups;(2) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative survival of patients up to January 2017.Measurement data with normal distribution were represented as (x)±s.Comparisons between groups were evaluated with the t test.Comparisons of count data were analyzed using the chi-square test and Fisher exact probability.Comparison of ordinal data was analyzed using the nonparametric test.Results All the 96 patients were enrolled into the study,including 50 in the aspirin group and 46 in the non-aspirin group.(1) Comparison of surgical and postoperative situations between the 2 groups:96patients underwent successful laparoscopic anterior resection for RC,including 1 with conversion to open surgery and 95 undergoing laparoscopic anterior resection for RC,without perioperative death,postoperative blood transfusion and rcoperation.Cases with conversion to open surgery,operation time,volume of intraoperative blood loss,decreasing value of postoperative hemoglobin (Hb),time to anal exsufflation,peritoneal drainage volume from 1-3 days postoperatively,cases with postoperative hematoehezia,cardio-cerebrovascular complications and overall complications (including postoperative hematochezia and cardio-cerebrovascular complications),duration of hospital stay,hospital expenses,cases in stage Ⅰ,Ⅱ and Ⅲ of postoperative TNM stage,postoperative coagulation indexes of platelet,prothrombin time,international normalized ratio,prothrombin activity,activated partial thromboplastin time,thrombin time and fibrinogen were 0,(112± 18) minutes,(39± 18) mL,(4.3±2.8)g/L,(57±24)hours,(22±9)mL/d,6,0,10,(8.6±2.5)days,(6 739±481)yuan,11,35,4,(236±80) × 109/L,(12.7± 1.1) seconds,1.00±0.08,101％ ± 15％,(28 ±4) seconds,(15.5 ± 1.9) seconds,(3.2±1.0)g/L in the aspirin group and 1,(118±16)minutes,(38±22)mL,(3.5±3.0)g/L,(55±29)hours,(20±8)mL/d,4,1,8,(9.1±2.3)days,(6606±510)yuan,5,36,5,(211±49)×109/L,(12.5±0.7)seconds,1.00±0.06,103％±11％,(29±3)seconds,(15.3±1.7)seconds,(3.1±0.7)g/L in the non-aspirin group,respectively,with no statistically significant difference between the 2 groups (t =-1.737,0.204,1.416,0.380,1.365,x2=0.038,0.107,t=-1.082,1.322,Z=-1.370,t=1.850,0.978,0.872,-0.712,-1.291,0.311,0.585,P＞0.05).Ten patients with postoperative hematochezia in the 2 groups were cured,without special treatment.One patient in the non-aspirin group was complicated with deep venous thrombosis and then was cured by single anticoagulant drug.Two and 2 patients in the aspirin group were respectively complicated with urinary retention and urinary tract infection.One,1 and 1 patients in the non-aspirin group were respectively complicated with inflammatory intestinal obstruction,urinary retention and urinary tract infection,and then were cured by conservative treatment.(2) Follow-up situations:of 96 patients,95 were followed-up for 4-27 months,with a median time of 13 months.During the follow-up,3 patients died and 92 had survival.Conclusion The perioperative continuous use of aspirin cannot increase risk of bleeding in laparoscopic anterior resection for RC in patients taking low dose aspirin.
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Objective To explore the application value and clinical efficacy of the transanal specimen extraction via prolapsing approach in laparoscopic anterior resection for ultra-low rectal cancer.Methods The clinical data of 27 patients with ultra-low rectal cancer who underwent transanal specimen extraction via prolapsing approach in laparoscopic anterior resection for ultra-low rectal cancer at the Shengjing Hospital of China Medical University from July 2010 to July 2013 were analyzed retrospectively.The average operation time, average volume of intraoperative blood loss, average number of lymph nodes dissection, average distance to resection margin, average length of resected specimen, results of postoperative pathological examination, time for postoperative outoff-bed activity, time to anal exsufflation, gastric tube removal time and postoperative complications were recorded.The visual analogue scale (VSA) pain score and Wexner score for evaluating fecal incontinence were performed at postoperative week 1 and at postoperative month 1, respectively.The anal function was tested at postoperative month 3 and 12.The follow-up including tumor metastasis and recurrence, Wexner score and anorectal anometry was performed by outpatient examination and telephone interview once every 3 months for 2 years after operation and then once every year up to October 2014.Measurement data with normal distribution was presented as-x ± s and average (range).Repeated measures data were analyzed by the repeated measures ANOVA.Results All the patients received successful operations without procedure change or intraoperative accident.The average operating time, average volume of intraoperative blood loss, average number of lymph nodes dissection, average distance to distal resection margin and average length of resected specimen were 140 minutes (range, 115-173 mintues), 27 mL(range, 15-55 mL), 17(range, 14-20), 1.7 cm(range, 1.3-2.2 cm) and 18.5 cm(range, 14.7-22.4 cm), respectively.Postoperative TNM stages: T2N0M0 was detected in 19 patients, T2N1M0 in 3 patients,T3N0M0 in 4 patients and T3N1M0 in 1 patients.The time for postoperative out-off-bed activity and time to anal exsufflation were 8.8 hours (range, 7.0-13.0 hours) and 51 hours (range, 30-79 hours).Twenty-seven patients had the gastric tube removal after operation with fluid diet intake at postoperative hour 24 and semi-fluid diet intake at postoperative hour 48.One male patient was complicated with urinary retention at postoperative day 3 and 1 with anastomotic leakage at postoperative day 9, they were cured by symptomatic treatment.VSA pain scores in all patients from 1 day to 6 days postoperatively were 5.6, 4.6, 4.0, 3.2, 2.2 and 1.3.The average duration of hospital stay was 11.1 days (range, 7.0-19.0 days).Patients had good healing of abdominal incision at postoperative week 2.All the patients were followed up for a average time of 24.8 months (range, 15.0-32.0 months) without tumor metastasis and recurrence.Wexner score was 2.6 (range, 1.0-4.0) at postoperative month 1.The results of anorectal anometry: maximum anorectal resting pressure (MARP) and maximum anorectal systolic pressure were (267 ±23)mmHg (1 mmHg =0.133 kPa) and (305 ± 23)mmHg before operation, (266 ± 40)mmHg and (300 ± 38)mmHg at postoperative month 3, (267 ± 33)mmHg and (315 ± 30)mmHg at postoperative month 12, respectively, with no significant difference in the changing trend between pre-and post-operation (F =0.510, 1.390, P ＞ 0.05).Anorectal resting vector volume and anorectal systolic vector volume were (45 594 ± 1 981) cm (mmHg) 2 and (98 480 ± 8 165) cm (mmHg) 2 before operation, (40 310 ±3 465)cm(mmHg)2 and (78 461 ±6 777)cm(mmHg)2 at postoperative month 3, (40 385 ± 3 379) cm(mmHg) 2 and (82 082 ± 10 383) cm(mmHg) 2 at postoperative month 12, respectively, with significant differences in the changing trend between pre-and post-operation (F =26.845, 48.090, P ＜ 0.05).Conclusion Transanal specimen extraction via prolapsing approach in laparoscopic anterior resection for ultra-low rectal cancer is safe, aesthetic and minimally invasive compared with the traditional laparoscopic surgery, with the advantages of radical cure of tumor and protection of anal function.
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Objective To investigate the relationship between C-C chemokinereceptor type 2 (CCR2) and p38 mitogen-activated protein kinase (p38MAPK) signaling pathway in the dorsal root ganglion of rats and further clarify the mechanism of inflammatory pain.Methods Sevemy-two female Sprague-Dawley rats,weighing 150-180 g,aged 3-4 months,were randomly divided into 3 groups (n =24 each) using a random number table:control group (group C),inflammatory pain group (IP group) and CCR2 inhibitor RS102895 group (group RS).Inflammatory pain was induced by subcutaneous injection of Freund's adjuvant 100μl into the plantar surface of the right hindpaw.RS102895 20 mg/kg was injected subcutaneously once a day for 7 consecutive days in addition to Freund's adjuvant in group RS.Mechanical paw withdrawal threshold (MWT) was measured before injection and at 1,3,5 and 7 days after injection.At 3,5 and 7 days after injection,8 rats in each group were sacrificed and the dorsal root ganglions were removed for determination of the expression of CCR2 and phosphor-p38MAPK (p-p38MAPK) (by immuno-histochemical staining),and CCR2 and p38MAPK mRNA (using fluorescent quantitative PCR).Immuno-histochemical staining was scored.Results Compared with group C,MWT was significantly decreased after injection,the number of p-p38MAPK positive neurons and immuno-histochemical staining score were increased,and CCR2 and p38MAPK mRNA expression was up-regulated in IP and RS groups.Compared with group IP,MWT was significantly increased after injection,the number of p-p38MAPK positive neurons and immuno-histochemical staining score were decreased,and CCR2 and p3gMAPK mRNAexpression was down-regulated in RS group.Conclusion CCR2 in the dorsal root ganglion is involved in the development of inflammato pain possibility through activating p38MAPK signaling pathway in rats.
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Objective:To evaluate the effects of neoadjuvant chemoradiotherapy on anal function after intersphincteric resection (ISR) with low rectal cancer. Methods:A total of 103 patients were classified into the chemoradiotherapy (CRT) group and control group according to whether they received neoadjuvant chemoradiotherapy. Anal function was assessed using vectorial manometry, Saito function questionnaires, and Wexner incontinence scores. Results:The resting vector volume and squeezing vector volume of the CRT group were significantly lower than those of the control group prior to the operation. Both groups showed decreasing manometric re-sults after ISR. However, all indices of the CRT group were significantly lower than those of the control group (P<0.05). At 6 and 12 months after operation, the Saito questionnaire results reveal poor function for the CRT group compared with the control group, except for dyschesia. After 24 months, the stool frequency, ability to distinguish between feces and flatus, fragmentation, and alimentary re-striction remained poor for the CRT group (P<0.05). Although both groups showed decreasing Wexner scores with time, the score of the CRT group remained significantly higher than that of the control up to 24 months after operation. Conclusion:Neoadjuvant chemo-radiotherapy significantly affects the anal sphincter function for intersphincteric resection with low rectal cancer. This effect continues for at least 2 years after operation.
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Objective To study the therapeutic effect of pulse-activating injection on acute poisoning by pa-raquat(PQ). Methods 50 Sprague-Dawley (SD) rats were randomly divided into five experimental groups: blank group, negative control group, positive control group, low-dose pulse-activating injection group (LDG), and high-dose pulse-activating injection group(HDG) (n = 10 for each group). Blank group were injected with normal suline,30 ml/kg,and other groups were established as acute paraquat poisoning models. Macroscopic and histopathological ex-aminations were performed and biological indexes were measured for the lung specimens. The indexes included lung wet weight/dry weight,the rats of neutrophils and protein content in the pulmonary alveolar lavage fluid. In the mean time, the level of malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) both in plasma and bronchoalveolar lavage flui(BALF) were detected. Results Compared with that in negative control group,lung congestion and lung edema of LDG group were mitigated; and the MDA level decreased from (5.04± 0.50) nmol/ml,(1. 19±0.18) nmol/ml to (4.04±0.21) nmol/ml,(0.79±0.04) nmol/ml both in plasma and BALF;the SOD activities were increased from (123.30±20. 39) U/ml, (26.43±2.22) U/ml to (277.09± 11.66) U/ml,(37.10± 2.49) U/ml as well; the GSH-Px activities were increased from (1796.63 ±81. 12) U/ml, (598.24 ± 62.50) U/ml to (2151.54 ± 148.32) U/ml, ( 1788.44 ± 175.11 ) U/ml as well ( P < 0. 01 ). Conclusions Administration of pulse-activating injection could improve the lipid peroxidation damage caused by a-cute poisoning of PQ.
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Objective:To study the healing effect of Chitin dressing on second-degree scalds in mice and rabbits respectively.Methods:The model of the second-degree scald was established in mice and rabbits respectively by vapour and hot water;the healing time was observed and the tissue specimens were obtained from the scalds for pathologic analysis.Results:Compared with the contrast group,the healing time in chitin dressing treated group was shorter(P
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Objective To evaluate the curative effects and side effects of burcea javanica oil emulsion(BJOE) in the treatment of pleural effusion of lung cancer by thoracic injection.Methods 40 cases with pleural effusion of lung cancer were treated by using BJOE.A dose of 50～100ml BJOE was injected intrapleurally,once every 5～7 days,4 time for a course of treatment,then the effects and side effects were observed after one month.Results The effective rate was 90%(36/40).The side effects were fever(n=4) and digestive sickness(n=2) as well thoracalgia(n=1).Conclusion Brucea javanica oil emulsion has good curative effect and low side effect in the treatment of pleural effusion of lung cancer.
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Objective To study the treatment and prevention of allergic response in IVP by ominipaque. Methods 39 cases with allergic reaction were divided into four grades of slight, moderate, moderately severe and severe. Results Of the 39 cases, 38 ones were with slight slight allergic reaction, and 1 case was with moderate reaction. Conclusion Rapid and proper treatment can eliminate the allergic reaction by ominipaque.
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Objective To use high and low condition to get contrast radiography of nasal bone photograph to raise the image quality. Methods 75 cases with nasal bone injury were adopted as the subjects. Results In 75 cases of nasal bone wound,93% could meet the demand. Conclusion Nasal bone side position photography in high and low codition can rasie the image quality and meet the clinical diagnosis demand in maxium degraee.
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Objective To evaluate the results of anal function and oncologic effect of intersphincteric resection(ISR) for very low rectal cancer Methods Sixteen patients who had ISR from March 1999 to March 2006 in our hosptal.After complete dissection of the rectum and mesorectum down to the pelvic floor,the internal sphincter was separated from the external sphincter and puborectalis and resected together with the rectum,then the coloanal anastomosis was performed.On postoperative day 7,the anal contraction function training was started;on week 4,biofeedback training was started;on week 2,chemotherapy was used for Dukes B,C stage,and on week 4 radiotherapy was used.Results There was no operative mortality,and no anastomotic leakage.Colonic mucosa prolapse developed in two patients,two developed late strictures of the coloanal anastomosis and one had wound problem.At follow-up of 3 months to 7 years,there were 2 deaths from liver metastasis and 1 death from lung metastasis;no patient developed local recurrence.According to Williams continence status level,acceptable postoperative anal function were obtained in 62.5 %,80.0 %,and 84.6 % of patients at 3,6,and 12 months respectively.Conclusions ISR is safe for selected patients with very low rectal tumor,operative morbidity is low,and the curability rate and anal functional results are satisfactory.
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Objective To study the clinical significance of expression of survivin gene in transitional mucosa(TM) adjacent to rectal carcinoma.Methods Mucinhistochemical methods were used to observe the distribution of TM adjacent to rectal carcinoma, and using immunohistochemical methods to observe the expression of survivin gene product in TM,normal mucosa,atypical dysplasia and cancer tissue.Results The positive expression level of survivin gene product was lowest in normal rectal mucosa,and gradually increase in TM,dysplasia and carcinoma tissue(all P
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Objective To detect the correlation of serum p53 antibody and p53 protein expression of cancer tissue in patients with colorectal cancer (CRC), and to evaluate if the serum p53 antibody might reflect the mutation of p53 gene in CRC. Methods One hundred and thirty-two patients with CRC and 36 patients with non-tumor disease were included in this prospective study. The presence of serum p53 antibody was determined by enzyme-linked immunosorbent assay (ELISA). Immunohistochemical analysis of tumors was performed to detect the accumulation of p53 protein. Results The positive rate of p53 antibody was 40.2% in patients with colorectal cancer and 2.9% in non-tumor patients,( P
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Objective To investigate the outcome of low anterior resection of rectal cancer with double stapling technique.Methods A retrospective analysis of clinical records of 78 rectal cancer patients who had anal preservation operation using double stapling technique was performed.Results In all of the cases,the rectal closing and anastomosis were satisfactorily completed.All the resection margins were negative for tumor infiltration.There was no operative mortality or anastomosis leakage.Seventy-three(93.6%)cases were followed up for 9-65 months,pelvic recurrence occurred in 2 cases(2.7%),multiple metastasis of peritoneal cavity occurred in 1 case(1.4%),liver metastasis was found in 7 cases(9.6%),one patient suffered from local recurrence and Miles operation was performed 11 months later.Conclusions Double stapling technique can provide more chances for sphincter preservation operation in patients with lower rectal cancer.If the technique is properly used,it also may effectively reduce the rate of anastomosis leakage and other complications.
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AIM:To explore the effects of galangal (Alpinia officinarum Hance) extract on learning ability and memory consolidation and clearance of the free radical in mice. METHODS:Ninety mice receiving sodium nitrite to form the dysmnesic model ones,which were used to observe the walking behaviours in Morris water maze under the administration of galangal extact. SOD activity and the MDA content were measured with colorimetry,The morphological change in hippocampus slices were assessed using H-E staining and microscopic examination. RESULTS:To compare with the model group,the escape latency was markedly shortened(P