Irreducible Indirect Inguinal Hernia Caused by Sigmoid Colon Cancer Entering Right Groin:A Case Report / 中国医学科学院学报

We reported a case of irreducible indirect inguinal hernia caused by sigmoid colon cancer entering the right groin.The patient complained about a right groin mass for more than 60 years with progressive enlargement for 3 years and pain for half a month.Abdominal CT examination at admission showed rectum and sigmoid colon hernia in the right inguinal area and thickening of sigmoid colon wall.Electronic colonoscopy and pathological diagnosis showed sigmoid colon cancer.Therefore,the result of preliminary diagnosis was irreducible indirect inguinal hernia caused by sigmoid colon cancer entering the right groin.We converted laparoscopic exploration to laparotomy followed by radical sigmoidectomy and employed end-to-end anastomosis of descending colon and rectum in combination with repair of right inguinal hernia.The patient recovered well after operation and was discharged.

Anatomical controversies involved in radical resection of rectal cancer / 中华胃肠外科杂志

The concept of total mesorectal resection provides a quality control standard that can be followed for radical resection of rectal cancer, but some anatomical problems are still controversial. Compared with traditional open surgery, laparoscopic radical rectal surgery has better surgical vision, better neurological protection, better operating space. However, if the surgeon has insufficient understanding of the anatomy, collateral damage may occur, such as uncontrollable bleeding during the operation, postoperative urination and defecation dysfunction and so on. Based on the interpretation of the researches at home and abroad, combined with the clinical experience, we elucidate some associated issues, including anatomic variation of inferior mesenteric vessels, the controversy of inferior mesenteric artery ligation plane, the controversy of lymph node dissection in No. 253, the anatomical variation of middle rectal artery, and the anatomical controversy of lateral lymph node dissection in rectal cancer, in order to provide better cognitive process for the clinical front-line surgeons.

A rare anatomical variation of ileocolic veins involving in gastrocolic vein trunk: case report and literature review / 中华胃肠外科杂志

Objective: Due to its various anatomical variations and numerous branches, the gastrocolic vein trunk (Henle trunk) is the most common site to develop bleeding and other complications in laparoscopic right hemicolectomy for colon cancer. This study aims to investigate the role of ileocolic vein (ICV) joining with Henle trunk, a rare anatomical variation. Methods: A rare case whose ICV was newly found to involve in the formation of Henle trunk during laparoscopic resection of right hemicolon cancer was reported as right gastroepiploic vein+ right colic vein+superior right colic vein+ICV. This anatomical variation was confirmed by multi-slice spiral CT coronal two-dimensional reconstruction of right hemicolon angiography. The literatures about ICV participating in formation of Henle trunk were systematically searched from PubMed, The Cochran Library, CNKI net and Wanfang database, and the occurrence probability and composition of its anatomical variation were analyzed. Results: This was a 47-year-old female patient who underwent laparoscopic right hemicolectomy. When the vessels were dissected during operation, it was found that ICV did not accompany the ileocolic artery, but directly flowed into Henle trunk. Two-dimensional reconstructed CT images of right hemicolon vessels showed that the composition of Henle trunk was rarely varied, which was composed of right gastroepiploic vein, right colonic vein, superior right colonic vein and ICV. Five literatures were enrolled from literature retrieval. A total of 12 cases with ICV participating in the construction of Henle trunk were reported, with a probability of 0.27%-6.31% and 6 forms of the formation of Henle trunk. In this case, Henle trunk was made up of right gastroepiploic vein, right colonic vein, upper right colonic vein and ICV, which was reported for the first time. Conclusions: ICV involving in Henle trunk is a rare vascular variation, and this type of variation should be fully recognized. Careful dissection during operation is necessary to prevent intraoperative bleeding caused by improper operation.

Thinking of treatment strategies for colorectal cancer patients in tumor hospitals under the background of coronavirus pneumonia / 中华胃肠外科杂志

In December 2019, a new outbreak of coronavirus pneumonia began to occur. Its pathogen is 2019-nCoV, which has the characteristics of strong infectivity and general susceptibility. The current situation of prevention and control of new coronavirus pneumonia is severe. In this context, as front-line medical workers bearing important responsibilities and pressure, while through strict management strategy, we can minimize the risk of infection exposure. By summarizing the research progress and guidelines in recent years in the fields of colorectal cancer disease screening, treatment strategies(including early colorectal cancer, locally advanced colorectal cancer, obstructive colorectal cancer, metastatic colorectal cancer and the treatment of patients after neoadjuvant therapy), the choice of medication and time limit for adjuvant therapy, the protective measures for patients undergoing emergency surgery, the re-examination of postoperative patients and the protection of medical staff, etc., authors improve treatment strategies in order to provide more choices for patients to obtain the best treatment under the severe epidemic situation of new coronavirus pneumonia. Meanwhile we hope that it can also provide more timely treatment modeling schemes for colleagues.

Artificial intelligence system of faster region-based convolutional neural network surpassing senior radiologists in evaluation of metastatic lymph nodes of rectal cancer / 中华医学杂志(英文版)

BACKGROUND@#An artificial intelligence system of Faster Region-based Convolutional Neural Network (Faster R-CNN) is newly developed for the diagnosis of metastatic lymph node (LN) in rectal cancer patients. The primary objective of this study was to comprehensively verify its accuracy in clinical use.@*METHODS@#Four hundred fourteen patients with rectal cancer discharged between January 2013 and March 2015 were collected from 6 clinical centers, and the magnetic resonance imaging data for pelvic metastatic LNs of each patient was identified by Faster R-CNN. Faster R-CNN based diagnoses were compared with radiologist based diagnoses and pathologist based diagnoses for methodological verification, using correlation analyses and consistency check. For clinical verification, the patients were retrospectively followed up by telephone for 36 months, with post-operative recurrence of rectal cancer as a clinical outcome; recurrence-free survivals of the patients were compared among different diagnostic groups, by methods of Kaplan-Meier and Cox hazards regression model.@*RESULTS@#Significant correlations were observed between any 2 factors among the numbers of metastatic LNs separately diagnosed by radiologists, Faster R-CNN and pathologists, as evidenced by rradiologist-Faster R-CNN of 0.912, rPathologist-radiologist of 0.134, and rPathologist-Faster R-CNN of 0.448 respectively. The value of kappa coefficient in N staging between Faster R-CNN and pathologists was 0.573, and this value between radiologists and pathologists was 0.473. The 3 groups of Faster R-CNN, radiologists and pathologists showed no significant differences in the recurrence-free survival time for stage N0 and N1 patients, but significant differences were found for stage N2 patients.@*CONCLUSION@#Faster R-CNN surpasses radiologists in the evaluation of pelvic metastatic LNs of rectal cancer, but is not on par with pathologists.@*TRIAL REGISTRATION@#www.chictr.org.cn (No. ChiCTR-DDD-17013842).

Effects of moxibustion at 45 ℃ on blood lipoids and serum level of ox-LDL and NO in rats with hyperlipidemia / 中国针灸

OBJECTIVE@#To observe the effects of moxibustion at different temperatures (38 ℃ and 45 ℃) on blood lipoids and serum level of oxidized low density lipoprotein (ox-LDL) and nitric oxide (NO) in rats with hyperlipidemia, and to explore the correlation between regulating blood fat and anti-oxidative stress and protection of vascular endothelium of moxibustion at 45 ℃.@*METHODS@#According to random number table, 60 SD rats were randomly divided into a normal group, a model group, a moxibustion at 38 ℃ group and a moxibustion at 45 ℃ group, 15 rats in each group. The rats in the normal group received no treatment; the rats in the remaining three groups were fed with high-fat diet for 8 weeks to prepare rat models of hyperlipidemia. After successful modeling, the rats in the model group received no treatment; the rats in the moxibustion at 38 ℃ group and moxibustion at 45 ℃ group were treated with moxibustion at "Shenque" (CV 8) and "Zusanli" (ST 36), and the temperature was controlled at (38±1) ℃ and (45±1) ℃, respectively. The moxibustion was given for 10 min at each acupoint, once every two days, and totally 4-week treatment was given. After treatment, the levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured by using biochemical colorimetric method; the levels of ox-LDL and NO were measured by using ELISA method.@*RESULTS@#① Compared with the normal group, the levels of TC, TG and LDL-C were significantly increased in the model group (all 0.05). ② Compared with the normal group, the level of ox-LDL was increased but that of NO was decreased in the model group (both <0.01); compared with the model group and moxibustion at 38 ℃ group, the level of ox-LDL was decreased but that of NO was increased in the moxibustion at 45 ℃ group (<0.01, <0.05); compared with the model group, the level of ox-LDL was decreased but that of NO was increased in the moxibustion at 38 ℃ group (both <0.05).@*CONCLUSION@#Moxibustion at 45 ℃ has regulating effects on blood lipid in rats with hyperlipidemia, which can regulate blood lipid through various ways, such as anti-oxidative stress and protection of vascular endothelium.

Early cardiac injury in patients with obstructive sleep apnea / 中国应用生理学杂志

OBJECTIVE@#To evaluate the early cardiac injury caused by obstructive sleep apnea (OSA) before the development of cardiovascular symptoms of OSA.@*METHODS@#Ninety-two patients without any known cardiovascular disorders who underwent polysomnography (PSG) were enrolled in the study. Subjects were divided into mild, moderate, and severe OSA groups by their apnea hypopnea index (AHI), and 25 healthy individuals were identified as controls. After PSG examination, fasting blood samples for the evaluation of N-terminal pro-brain natriuretic peptide (NT-proBNP) and heart-type fatty acid binding protein (h-FABP) were collected in the morning, and left ventricular(LV) functions were assessed by using echocardiographic methods. Thirty moderate and severe OSA patients were treated with continuous positive airway pressure respectively (CPAP).@*RESULTS@#The levels of h-FABP and NT-proBNP were obviously higher in all OSA groups than those in the control group (<0.01), and were positively correlated with AHI (<0.01). The Em/Am values of all OSA groups and E/A values of the moderate and severe OSA groups were significantly reduced (<0.01). The difference in Em/Am values among the groups was statistically significant (<0.01). Compared with those before treatment, h-FABP and NT-BNP levels in serum of OSA patients after CPAP treatment were significantly reduced (<0.01), and Em/Am and E/A values were significantly increased (<0.01).@*CONCLUSIONS@#Left ventricular diastolic dysfunction and early myocardial microtrauma are major manifestations of early heart damage in patients with OSA. CPAP therapy could significantly improve early cardiac damage in OSA patients.

Impacts of exposure to 900 MHz mobile phone radiation on liver function in rats / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To study the impacts of exposure to electromagnetic radiation (EMR) on liver function in rats.</p><p><b>METHODS</b>Twenty adult male Sprague-Dawley rats were randomly divided into normal group and radiated group. The rats in normal group were not radiated, those in radiated group were exposed to EMR 4 h/ d for 18 consecutive days. Rats were sacrificed immediately after the end of the experiment. The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and those of malondialdehyde (MDA) and glutathione (GSH) in liver tissue were evaluated by colorimetric method. The liver histopathological changes were observed by hematoxylin and eosin staining and the protein expression of bax and bcl- 2 in liver tissue were detected by immunohistochemical method. Terminal-deoxynucleotidyl transferase mediated nick and labelling (TUNEL) method was used for analysis of apoptosis in liver.</p><p><b>RESULTS</b>Compared with the normal rats, the serum levels of ALT and AST in the radiated group had no obvious changes (P>0.05), while the contents of MDA increased (P < 0.01) and those of GSH decreased (P < 0.01) in liver tissues. The histopathology examination showed diffuse hepatocyte swelling and vacuolation, small pieces and focal necrosis. The immunohistochemical results displayed that the expression of the bax protein was higher and that of bcl-2 protein was lower in radiated group. The hepatocyte apoptosis rates in radiated group was higher than that in normal group (all P < 0.01).</p><p><b>CONCLUSION</b>The exposure to 900 MHz mobile phone 4 h/d for 18 days could induce the liver histological changes, which may be partly due to the apoptosis and oxidative stress induced in liver tissue by electromagnetic radiation.</p>

Study on signal transmission characteristics of meridian based on electrical network theory and experiments / 中国针灸

Study on features of acupoints with resistance test in the past half century is reviewed in this article. Mechanism and technology of the method are introduced as well as its shortcomings. The determination method of signal transmission along meridians with the combination of electrical network theories and practice is advanced. And the result of a series experiments on one meridian at the superficial part of the body are given as well. Thus, it is concluded that the signals of the point-in/point-out and the signals along a non-meridian path with the same distance are significantly different, which gives a verification of the feasibility of the method by using electrical network theories to set out characteristics of signal transmission along meridians dynamically.

Effect of resveratrol on heart function of rats with adriamycin-induced heart failure / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the protective effects of resveratrol (RES) on the heart function of the rats with adriamycin-induced heart failure.</p><p><b>METHOD</b>Thirty adult male SD rats were randomly divided into 5 groups: normal control (NC) group, adriamycin (ADR) group, RESL + ADR group, RES(H) + ADR group and RES group. RES of 30, 120, 120 mg x kg(-1) x d(-1) was given intraperitoneally (ip) once a day for 3 days in RES(L) + ADR group, RES(H) + ADR group and RES group respectively. The other two groups were given the same amount of normal saline the same way. On the 4h day,ADR of 10 mg x kg(-1) was given intraperitoneally once to induce myocardium injury model. After twenty-four hours, the pathological and biochemical changes of the myocardium were examined.</p><p><b>RESULT</b>As compared with NC group, the MDA, NO and NOS of the ADR group were significantly higher (P < 0.05), and the SOD of the ADR group were markedly lower (P < 0.05). As compared with ADR group, the indexes in RES(L) + ADR group, RES(H) + ADR group were exactly opposing, and took on dose dependance (P < 0.05). Light microscopic morphometry of the heart samples of the rats in ADR + RES(L, H) groups revealed typical diminishing of damage.</p><p><b>CONCLUSION</b>RES can relieve the toxic effects of ADR on myocardium, and the cardioprotective effects may be correlated with its antioxidant activity and downregulation of NO.</p>

Roles of potassium channel in effects of resveratrol on isolated myocardial contractility and heart rate research in guinea pig / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effects of resvaratrol derivatives on spontaneous HR and CF of isolated guinea pig atrium.</p><p><b>METHOD</b>The dose-effect curve of resvaratrol was observed. The possible mechanism of potassium channels responsible for changes of CF and HR after administering with resvaratrol was measured.</p><p><b>RESULT</b>Resvaratrol reduced the spontaneous HR and weakened the CF in a dose-dependent manner ranging from 10(-6) to 3 x 10(-4) mol x L(-1) (P < 0.05). As compared with Res group, the effects were partly blocked by Gli (P < 0.05) and TEA (P < 0.01), but not blocked by 4-AP, BaCl2, Atropine.</p><p><b>CONCLUSION</b>Resvaratrol can induce negative chronotropic action and negative (inotropic action. The mechanism(s) may relate to the opening of K(ATP) and Kc(Ca).</p>

Study on the association between STK15 Phe31Ile polymorphisms and esophageal squamous cell carcinoma / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the relation between single nucleotide polymorphism(SNP) at the 91T-->A(Phe31Ile) position of the STK15 gene and the susceptibility of esophageal squamous cell carcinoma (ESCC) in She county--a ESCC high incidence region in North China.</p><p><b>METHODS</b>Polymerase-chain reaction(PCR)-restriction fragment length polymorphism (RFLP) analysis was used to detect the genotypes of STKl5 Phe31Ile(91T-->A) SNP, and the samples came from 296 ESCC patients and 302 healthy controls.</p><p><b>RESULTS</b>The risk of ESCC significantly increased in the group which had been smoking or having a family history of upper gastrointestinal cancer (UGIC) (the OR = 1.68 and 1.77, 95% CI: 1.34-2.10 and 1.44-2.19, respectively). Rates of the three genotypes (Phe/Phe, Phe/Ile, Ile/Ile) of the STK15 Phe31Ile (91T-->A) SNPs in ESCC patients were 11.5%, 34.8% and 53.7%, respectively, and were not significantly different from that in the healthy group (11.9%, 36.8% and 51.3%) (chi2 = 0.35, P = 0.84). When compared to Phe/Phe genotype, Phe/Ile and Ile/Ile of STK15 91T-->A(Phe31Ile)did not show effect on the risk of ESCC according to the odds ratio results which were 0.98 (95% CI: 0.57-1.69) and 1.09 (0.65-1.82) respectively. STK15 91T-->A (Phe31Ile) SNP also did not significantly influence on the development of ESCC even the samples were stratified by sex, smoking status and family history of upper gastrointestinal cancer.</p><p><b>CONCLUSION</b>The STK15 Phe31Ile(91T-->A) polymorphisms seemed irrelevant with the risk of ESCC in She county.</p>

Clinical observation on photoelectric treatment instrument combined with acupuncture for treatment of simple obesity / 中国针灸

<p><b>OBJECTIVE</b>To observe therapeutic effect of photoelectric treatment instrument on simple obesity.</p><p><b>METHODS</b>Sixty cases of simple obesity were randomly divided into two groups, 30 cases in each group. The treatment group were treated with photoelectric treatment instrument combined with acupuncture, i.e. after acupuncture, the electrodes of XS-998A photoelectric treatment instrument were placed at points of the abdomen, with the laser out-put head on Shenque (CV 8), Shuifen (CV 9) or the parts with much fat, or close to the liver area for the patient of fat liver. The control group were treated with routine acupuncture alone. Changes of main symptoms and signs, and BMI before and after treatment were investigated in the two groups.</p><p><b>RESULTS</b>The symptoms and signs, and BMI were more significantly improved in the treatment as compared with the control group with a significant difference between the two groups (P < 0.05).</p><p><b>CONCLUSION</b>Acupuncture combined with laser radiation at the relative area on the abdomen can increase the therapeutic effect on obesity.</p>

Thinking about increasing therapeutic effect of acupuncture and moxibustion for slimming / 中国针灸

<p><b>OBJECTIVE</b>To probe into the factor of increasing the therapeutic effect of acupuncture and moxibustion for slimming.</p><p><b>METHODS</b>The factors of increasing the therapeutic effect of acupuncture and moxibustion for slimming were thought by analysis of the physician and the patient, and combination of theory with clinical treatment, and opinions were put forward.</p><p><b>CONCLUSION</b>There are a lot of factors influencing the therapeutic effect of acupuncture and moxibustion for slimming, and only both the physician and the patient cooperate each other and pay attention to the factors, can the therapeutic effect be better increased.</p>