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Objective To investigate the clinical effects of the stent-laparoscopy approach in treatment of elderly patients with malignant colorectal obstruction.Methods Clinical data of 55 elderly hospitalized patients with colorectal cancer-induced bowel obstruction in Wenzhou Central Hospital from January 2009 to January 2014 were evaluated retrospectively.All patients were treated with expandable metallic stents for remission of bowel obstruction.Patients were divided to laparoscopy surgeryobservation group (n =14) receiving laparoscopic surgery after decompression and the laparotomy surgery-control group (n=41) receiving conventional open colorectal cancer operation.The intraoperative information,postoperative complications and long-term curative effect were compared between the laparoscopy surgery-observation vs laparotomy surgery-control group.Results During laparoscopy surgery period,two patients operated by laparoscopy surgery were converted to laparotomy surgery.Surgical time was significantly longer in the laparoscopy surgery-observation group than in laparotomy surgery-control group[(178 ± 33) min vs.(145 ± 31) min,t =3.384,P =0.001],and bowel function recovery and postoperative hospital stay were significantly shorter in the laparoscopy surgery-observation group than in laparotomy surgery-control group[3.1 ± 0.9) d vs.(4.3 ± 1.3) d and (7.1±1.3) d vs.(12.6±5.7) d,t=3.193 and t=2.911,P=0.002 and P=0.005].Intraoperative blood loss was less in the laparoscopy surgery-observation group than in the laparotomy surgery-control group[(63 ± 29) ml vs (86 ± 37) ml,t =2.11,P =0.04],with no significant differences in postoperative complications between the two groups (0.0 vs 9.76 ％,x2 =1.47,P=0.225).Fifty-five patients were followed up for 2 years.All patients survived in the laparoscopy surgery-observation group,but one patient died from the cerebrovascular accident in the laparotomy surgery-control group.Conclusions The stent-laparoscopy approach to treat colorectal cancer (CRC) patients with acute colorectal obstruction is a safe,effective,recovery quick and minimally invasive option for elderly patients.Emergency surgery may be converted to a limited operation by this method.Laparoscopic radical surgery with one-stage anastomosis is feasible.
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Objective To evaluate the effects of exposure to MALs on immunity against Mycobacterium tuberculosis in human alveolar macrophages .Methods Plate counting were used to evaluate the effect of resisting Mycobacterium tuberculosis in human alveolar macrophages .Culture supernatants were harvested and human TNF‐α was measured by ELISA kit .Total nitrite levels in the media were measured using the Griess reagent .Results MALs stimulation attenuated the control of intracellular mycobacterial growth in human alveolar macrophages .The production of proinflammatory cytokines TNF‐α and Nitric oxide in human alveolar macrophages induced by Mycobacterium tuberculosis purified protein derivatives tuberculin (Mt‐PPD) and human interferonγwere attenuated by pretreatment in vitro with MALs .Conclusion MALs attenuated the responses of human alveolar macrophages a‐gainst Mycobacterium tuberculosis ,which may provide the new evidence to explain the phenomena in which some component of Mycobacteria in environment impacts the immunity against Mycobacterium tuberculosis infection .
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Objective To evaluate the role of nucleotide‐binding oligomerization domain 2(NOD2) stimulation in innate immuni‐ty against M ycobacterium tuberculosis .Methods Plate counting as used to evaluate the effect of resisting M ycobacterium tubercu‐losis in human alveolar macrophages .Intracellular NOD2 expression were detected by flow cytometry .Quantitative real‐time PCR was performed to determine the NOD2 ,inducible nitric oxide synthase(iNOS) ,and DEF4B mRNA expression levels using the com‐parative threshold cycle method of relative quantitation .Reactive oxygen species(ROS) were detected by the DFCH probe .Results NOD2 stimulation enhanced the control of intracellular mycobacterial growth in human alveolar macrophages .Although ROS con‐centration did not changed ,the secretion of Nitro Oxygen and the expression of cathelicidin DEFB4 were significantly increased fol‐lowing NOD2 stimulation in human alveolar macrophages .Conclusion NOD2 stimulation may be involved in the early innate con‐trol of Mycobacterium tuberculosis primary infections inducing the generation of Nitro Oxygen and the peptides cathelicidin DEFB4 .
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Objective To evaluate left ventricular(LV) twist and untwist using velocity vector imaging(VVI) in patients with apical hypertrophic cardiomyopathy (ApHCM). Methods Twenty-three patients diagnosed with ApHCM were consecutively enrolled and compared with normal controls. After a standard echocardiographic examination, parasternal basal and apical short-axis planes were scanned to quantify LV rotations,twist and LV untwist using VVI. Results Compared with the normal controls, the rotation and rotaional velocity of apical subendocardial myocardium were markedly decreased in ApHCM patients during the period of systole ( P＜0.05) ,but the decreases in basal planes were not significant. As a consequence,LV twist was significantly lower in ApHCM patients (P＜ 0.05). Compared to normal controls,the velocity of LV untwisting was also significantly decreased in ApHCM patients ( P＜0.05).Conclusions The twist and untwist of LV subendocardial myocardium were decreased in ApHCM patients.VVI is a useful method to assess the characteristics of LV twist and untwist in ApHCM patients.
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Objective To study the effects of Leptin on the expression of CD86 and HLA-DR in human monocytes.Methods The expression of CD86 and HLA-DR in THP-1 Cells and human primary monocytes were detected by flow cytometry.Results Expression of CD86 and HLA-DR in THP-1 cells was significantly increased after treatment with high-dose Leptin ( CD86Untreated group:8.78 ± 1.66,CD86leptin10:50.76 ± 4.29,CD86leptin100:95.20 ± 4.90; HLAUntreated group:20.75 ± 2.12,HLAleptin10:102.14 ± 5.75,HLAleptin100:104.32 ± 4.75;).The similar results were observed in human primary monocytes ( CD86Untreated group:17.91 ± 1.78,CD86leptin100:48.80 ± 3.60; HLAUntreated group:34.10 ± 2.76,HLAleptin100:88.86 ± 3.53).Conclusions By up-regulating CD86 and HLA-DR expression,Leptin might enhance the ability to present antigen in THP - 1 cells and human monocytes.
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Objective To monitor the distribution of class 1 integrons of Acinetobacter baumannii and interpret the association of class 1 integrons with the resistance in clinical isolates.Methods Susceptibility to 14 different antimicrobial agents was determined by agar dilution method.DNA of all clinical isolates was extracted to detect class 1 integrons by PCR.Results The differences between integron-positive isolates and integron-negative isolates was significant in the resistance to all tested antibiotics except for Imipenem,Cefepime and Cefoperazone plus Sulbactam.Different types of class 1 integrons showed different resistance types.Conclusions There were some close relations of class 1 integrons with multi-drug resistance as well as resistance types in Acinetobacter baumannii.