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Objective@#To explore the application of endoscopic tattooing with carbon nanoparticles in the treatment of advanced colorectal cancer (ACRC).@*Methods@#A randomized controlled study was used. Inclusion criteria: (1) age more than 18 years old, and colorectal cancer was found for the first time and confirmed by colonoscopy and biopsy; (2) advanced colorectal cancer (preoperative TNM stage of T3/N1 or above, local unresectable lesion, M1 stage and simultaneously resectable metastatic lesion), and patients agreed to receive neoadjuvant therapy; (3) advanced colorectal cancer (TNM stage of T3/N1 or above) with simultaneous unresectable metastatic lesion, and patients refused operation and consented to chemoradiotherapy. Patients with previous abdominal surgery history, radiotherapy and chemotherapy history, urgent need for surgery or endoscopic stent placement and those with severe allergic constitution were excluded. Based on the above criteria, 120 patients diagnosed with ACRC in No.900 Hospital of the Joint Logistics Team from January 2016 to December 2017 were prospectively enrolled and randomly divided into tattoo group and non-tattoo group by random number table method. Tattoo group were tattooed within 1-7 days before chemoradiotherapy. The labeling location of the lesions: (1) if the colonoscopy could pass smoothly, 4 points were injected into the intestinal wall of the both opposite sides 1 cm cephalad and caudad of the tumor; (2) if the colorectal cavity was severely narrow and the colonoscopy could not pass, only 4 points were injected in 4 quadrants at 1 cm caudad of the tumor. Each injection point was injected with 0.1 ml carbon nanoparticles, and the size of the tumor was measured according to the range of carbon nanoparticles staining. The efficacy was evaluated after 8 weeks of chemoradiotherapy. Patients who were defined to be suitable for operation underwent operation 6 weeks after chemoradiotherapy. The following parameters were compared between two groups: lesion identification time, operation time, blood loss, distance from lesion to distal margin, the rate of first positive margin and the rate of anal sphincter preservation (rectal cancer). Among patients who had been evaluated as having no indication for surgery, those who were effective in chemoradiotherapy continued to receive chemotherapy in the original regimen; if the treatment failed, the chemotherapy regimen was replaced, and the efficacy was finally evaluated after six months [referring to the revised RECIST guidelines (version 1.1)].@*Results@#Three patients withdrew from this study, and 117 patients were enrolled in this study finally, including 59 cases in tattoo group and 58 cases in the non-tattoo group. There were no significant differences in baseline data between two groups (all P>0.05). All the patients had slight adverse reactions of radiotherapy and chemotherapy before operation, and could tolerate after symptomatic management without interruption of treatment. All the patients in the tattoo group had no discomfort such as fever, abdominal pain, abdominal distention, hematochezia, etc. and the intestinal mucosa could be seen clearly with black staining after being tattooed. A total of 77 patients were evaluated with surgical indications, including 39 cases in the tattoo group (tattoo-operable) and 38 cases in the non-tattoo group (non-tattoo-operatable). There were no significant differences in baseline data between the two groups (all P>0.05). Forty patients without operation indications continued chemoradiotherapy, including 20 cases in tattoo group (tattoo-inoperable) and 20 cases in non-tattoo group (non-tattoo-inoperable), whose differences in baseline data between the two groups were not significant as well (all P>0.05). No obvious edema, necrosis or abscess were found in the tattooed segments and the black spots could be seen quickly and clearly on the serosa of rectum in tattoo-operable patients. As compared to non-tattoo group, tattoo group had significantly shorter lesion identification time [(3.4±1.4) minutes vs. (11.8±3.4) minutes, t=-14.07,P<0.001], shorter operation time [(155.7±44.5) minutes vs. (177.2±30.2) minutes, t=-2.48,P=0.015], less blood loss [(101.3±36.7) ml vs.(120.2±38.2) ml, t=-2.22,P=0.029], shorter distance from lesion to distal margin [(3.7±1.0) cm vs. (4.6±1.7) cm, t=-2.20, P=0.034], while tattoo group had slightly higher rate of anal sphincter preservation [66.7%(16/24) vs. 45.5%(10/22), χ2=2.10,P=0.234] and lower rate of first positive resection margin [0 vs. 4.5%(1/22), χ2=0.62,P=0.480], but their differences were not significant. There were no significant differences in the degree of tumor differentiation and TNM stage between two groups. Patients without operative indication were evaluated for efficacy of chemoradiotherapy again after half a year. One case of complete response (CR), 8 of partial response (PR), 10 of stable disease (SD) and 1 of progressive disease (PD) were found and the improvement rate was 45.0% (9/20) in tattoo-inoperable patients. No case of CR, 6 of PR, 11 of SD and 3 of PD were found and the improvement rate was 30.0% (6/20) in non-tattoo-inoperable patients. There was no significant difference in the improvement rate between the two groups (P=0.514).@*Conclusions@#Endoscopic tattooing with carbon nanoparticles injection is safe and reliable for colorectal tumor positioning. It can assist rapid detection of lesions during surgery after neoadjuvant treatment, perform accurate resection, significantly shorten the operation time and reduce surgical trauma; can assist colonoscopy accurately to measure the size of the lesions before and after chemoradiotherapy, and increase the means of assessing the efficacy to guide the follow-up treatment plan. This technique is worth clinical promotion and application.
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Intestinal flora plays an important role in promoting digestion,maintaining intestinal physiological function and regulating immune system. In recent years,it is found that intestinal flora not only regulates intestinal activity,but also affects the brain function and behavior. Early studies have shown that changes in probiotics may lead to alteration in brain function and mood. Studying the influence of intestinal flora on brain function helps us to catch on the pathogenesis of mental disorders such as autism,and expand our comprehension on the mechanism of brain activity as well. This article reviewed the advances in study on affecting pathway of intestinal flora on brain.
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AIM:To study the difference of the chemical constituents between raw Radix Aucklandiae and Radix Aucklandiae roasted with wheat bran.METHODS:UV,HPLC and TLC were performed to analyze the chemical constituents before and after the processing.The constituents absorbed by wheat bran during the processing A.lappa.were isolated by silica gel CC.Their structures were identified by spectral analysis.RESULTS:The result of UV,HPLC and TLC showed that change of the chemical constituents in after the roasting had taken place.Two maior chemical constituents absorbed by wheat bran were dehydrocostus lactone and costunolide.CONCLUSION:The difference in sesquiterpeneoide before and after the processing of Radix Aucklandiae may be the evidence that the roasting with bran is to the benefit oftherapeutic effect.
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Objective To explore the comprehensive therapy of infants with urinary calculus induced by melamine.Methods Clinical data of 228 infants(aged from 4 months to 3 years,mean age 11 months)with urinary calculus induced by melamine were analyzed. Bilateral renal calculi were found in 144 cases and one-side renal calculus in 54 cases,of which the diameter ranged from 0.5-2.5 cm.Ureteral calculi with moderate to severe hydronephrosis were found in 15 cases,of which the diameter ranged from 0.4-1.1 cm. Bladder calculi with urinary retention were found in 5 cases and urethral calculi with urinary retention in 10 cases,of which the diameter ranged from 0.5-1.3 cm. All the urinary calculi were confirmed by B-uhrasound examination and CT. Group 1 : Of the 15 cases with acute renal failure, 13 underwent shattering and dissolving renal and ureternal calculus by pelvis clysis with alkalinity drug, detaining double J tubes through ureteroscope. After operation, these patients were treated with alkalinity drugs. Two cases were treated by percutaneous nephrostomy guided by B ultrasound and underwent shattering and dissolving renal calculus by intermittent pelvis clysis with alkinity drug. Group 2:15 cases of ureteral calculus with serious nephrohydrops underwent shattering and detaining double J tubes through ureteroscope, then treated with alkalinity drug. Group 3:15 cases of infant bladder and urethral caleus with acute urinary retention were treated by EMS through ureterscope per urethra. Group 4: The rest 183 cases without urinary obstruction received 1-8 week'surine alkalization therapy. Among them, 113 cases received sodium bicarbonate 0.15 g twice per day,23 cases received potassium sodium hydrogen citrate 2.4g/d, and 47 cases received 10% potassium citrate solution 5 ml 3 times per day. Sixty-one cases who were of no effect with alkalinity drug were treated by extracorporeal shock wave lithotripsy (ESWL) and dissolving calculus with sodium bicarbonate. During treatment with alkalinity drug, urine Ph was observed by urine analysis once per day.When it exceeded 7.5, alkalinity drug. Was withdrawn. All the patients were followed up for 1 to 3 months. Statistical analysis was done with the SPSS 13.0 software. ResultsHyperdiuresis emerged 12-24 h after operation in group 1. The duration of hyperdiuresis was 24-72 h with the urine volume of 800-2500 ml/24h. Urine volume revived gradually 48--96h after operation while serum BUN and Cr revived 1-5 d after operation. Four cases with renal and ureteral calculus became almost stone-free in 1-2 weeks and 14 cases became completely stone-free in 2-4 weeks after operation. Patients of group 2 became completely stone-free in 1-2 weeks. Patients of group 3 were cured by one EMS session through ureterscope per urethra and smooth urination was seen immediately after operation. No retained calculus in the bladder and urethra was found by B ultrasound 3 days later. In the sodium bicarbonate group, 4 cases became completely stone-free in 2 weeks, 18 cases in 4 weeks, 15cases in 13 weeks. The stones lessened and faded in 34 cases and had no changes in 42 cases. In the potassiun sodium hydrogen citrate group, 4 cases became completely stone-free in 1 weeks, 7 cases in 2 weeks, 10 cases in 4 weeks, 2 cases in 6 weeks. In the potassium citrate group, 3 cases became completely stone-free in 1 weeks, 5 cases in 2 weeks, 16 cases in 4 weeks, 11 cases in 8 weeks. The stones lessened and faded in 8 cases in 8 weeks and had no changes in 4 cases. The efficacy of the sodium bicarbonate group was significantly different with the efficacy of the citrate group (P=0. 001). No significant difference was found between the potassium sodium hydrogen citrate group and the potassium citrate solution group(P=0. 372). ConclusionsConservative treatment should be employed mainly in the earlier stage for the infant urinary calculus induced by melamine . When the diagnosis of acute renal failure, moderate to severe hydronephrosis and acute lower urinary tract obstruction are established, surgical intervention should be the main method to relieve obstruction, protect renal function and resume normal rnicturition. With the development of the characteristics of the stones later,the oral dissolution therapy with alkalirtity drug could not dissolve the calculi and ESWL should be employed.
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Objective To study the effect of Xin Kang Injection on cardiac function of rats with adriamycin-induced myocarditis and to explore its pharmacological mechanism.Methods Seventy Wistar rats were randomly divided into seven groups:normal control group,model group,three-dosage Xin Kang Injection groups(high-,moderate-and low-dosage respectively),deslanoside group,and Huangqi group.The myocarditis rat model was established by intraperitoneal injection of adriamycin.Left ventricular end-diastolic pressure(LVEDP),left ventricular systolic pressure(LVSP),heart rate(HR),T value,and ? DP/DTmax were observed.Results LVSP,+ DP/DTmax in the treatment groups were higher and-DP/DTmax lower than those in the model group(P
ABSTRACT
AIM:To study the difference of the chemical constituents between raw Radix Aucklandiae and Radix Aucklandiae roasted with wheat bran.METHODS:UV,HPLC and TLC were performed to analyze the chemical constituents before and after the processing.The constituents absorbed by wheat bran during the processing A.lappa.were isolated by silica gel CC.Their structures were identified by spectral analysis.RESULTS:The result of UV,HPLC and TLC showed that change of the chemical constituents in after the roasting had taken place.Two major chemical constituents absorbed by wheat bran were dehydrocostus lactone and costunolide.CONCLUSION:The difference in sesquiterpeneoide before and after the processing of Radix Aucklandiae may be the evidence that the roasting with bran is to the benefit of therapeutic effect.