Usefulness of self-made gasbag double-cannula stool drainage device for prevention of anastomotic leakage following anterior resection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of self-made gasbag double-cannula stool drainage device for prevention of anastomotic leakage following anterior resection.</p><p><b>METHODS</b>Clinical data of 169 rectal cancer patients in the 8th Affiliated Hospital of Sun Yat-sen University between October 2010 and October 2016 were retrospectively analyzed. Among them, a self-made gasbag double-cannula stool drainage device was placed in 71 patients(stool drainage group), and the remaining 98 patients were taken as control. After an anastomosis, the drainage device was transanally placed by the assistant and the distal tube of drainage device was stretched more than 15 cm from anastomosis. The gasbag was inflated to fully expand the intestine. The main tube was fixed on perianal skin with 7-0 suture, kept more than 3-5 cm outside the anus, and connected to the drainage bag. The incidence of anastomotic leakage was compared between the two groups.</p><p><b>RESULTS</b>The baseline data were similar between the two groups (all P>0.05). The differences in operative time, intraoperative blood loss, and time to bowel function recovery were not statistically significant (all P>0.05), however, time to oral intake and postoperative stay were shorter in stool drainage group as compared to the control group (both P<0.05). There was no perioperative death in both groups. In stool drainage group, there were 6 cases whose drainage device was pulled out within 48 hours due to intolerance. The ruptured gasbag was replaced 5 times and the tube was clogged by fecal material 21 times. After flushing, the tube did not recanalized and was pulled out in 3 cases. The incidence of anastomotic leakage in stool drainage group was significantly lower than that in the control group (2.8% vs. 11.2%, P=0.043). As for the low anastomosis (the distance to anal verge less than 5 cm), the incidence of anastomotic leakage in stool drainage group was also significantly lower than that in the control group (2.3% vs. 15.4%, P=0.028), while as for the high anastomosis, the difference was not statistically significant (3.6% vs. 3.0%, P=0.906). Logistic regression analysis revealed that the presence of a stool drainage device was an independent protective factor for anastomotic leakage (OR=0.316, 95%CI:0.114 ~ 0.769, P=0.003).</p><p><b>CONCLUSIONS</b>The self-made gasbag double-cannula stool drainage device effectively prevents anastomotic leakage after anterior resection of rectal cancer. However it is not suitable for those patients with high anastomosis.</p>

Reasons for anastomotic leakage following the learning curve by laparoscopic anterior resection of rectal cancer / 中南大学学报(医学版)

Objective:To investigate the reasons of anastomotic leakage following learning curve by laparoscopic anterior resection of rectal cancer.Methods:From December,2011 to March,2015,the clinical information of 179 patients in our hospital who underwent dixon of rectal cancer were collected.The patients were divided into a laparoscopic learning group,a laparotomy group and a laparoscopic group,The reasons of anastomotic leakage for each group were comparatively analyzed.Repeated cutting of anastomotic stoma was compared between the laparoscopic learning group and the laparoscopic group.The male,age,obesity,nutrition complications and the position of anastomotic stoma were compared among the 3 groups.Results:The rate of anastomotic leakage in the laparoscopic learning group was significantly higher than that in the laparotomy group and the laparoscopic group (P＜0.05).Repeated cutting was a significant risk factor in the laparoscopic learning group (P＜0.05),but not in the laparoscopic group.Except obesity,the four factors were significant risk factors in the laparoscopic learning group (P＜0.05).All of the five factors were not the significant risk factors in the laparotomy group and the laparoscopic group (P＞0.05).Conclusion:The operation technical shortcoming is the major factor in the learning of the laparoscopic anterior resection of rectal cancer.In order to reduce the rate of anastomotic leakage in the learning curve period,the selection of patients following the laparoscopic anterior resection of rectal cancer should avoid the following factors:male,older age,the low position of the tumor and the nutrition complications.

Early gastroscopy after closure of gastroduodenal perforation by conservative treatment / 中华普通外科杂志

Objective To evaluate early diagnosis by gastroscopy for the causes of gastroduodenal perforation after successful non-surgical treatment.Method Gastroduodenal perforation patients suspected of benign ulcer in origin on hospital admission undergoing successful non-surgical treatment were examined by gastroscopy within days after the closure.Results Among 284 patients undergoing gastroscopy,277 cases (97.5％) were diagnosed as gastroduodenal ulcer,3 cases (1.1％) as gastric carcinoma,1 case (0.4％) of duodenal diverticulum.There were not major complications developing after gastroscopy.Conclusion Early gastroscopy performed after closure by non-surgical treatment in gastroduodenal perforation patients is safe,helping make definite diagnosis for the cause of perforation.

Effect of hydrogen sulfide on human colon cancer SW480 cell proliferation and migration in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of hydrogen sulfide (H2S) on the proliferation and migration of human colon cancer SW480 cells and explore its molecular mechanisms.</p><p><b>METHODS</b>The proliferation of SW480 cells exposed to different concentrations of NaHS for varying time lengths was analyzed by MTT assay, and the changes in cell migration was evaluated using wound-healing assay. The changes in the expression levels of MMP-2, MMP-9 and SIRT1 protein were detected by Western blotting in the exposed cells.</p><p><b>RESULTS</b>Compared with the control cells, SW480 cells exposed to 50, 100, 200, or 400 µmol/L NaHS for 24, 48 and 72 h all showed increased proliferative activity. NaHS treatment at 100 µmol/L significantly promoted the cell migration (P<0.01) and enhanced the cellular expressions of MMP-2 (P<0.05) and MMP-9 (P<0.01) proteins; NaHS exposure (100 µmol/L) also resulted in up-regulation of SIRT1 expression in SW480 cells.</p><p><b>CONCLUSIONS</b>H2S can promote proliferation and migration of SW480 cells in vitro, the mechanism of which may involve up-regulated expression of SIRT1.</p>

Influence of silica on intestinal absorption of solid self-microemulsifying drug delivery systems / 药学学报

Solid carriers had important effects on the properties of solid self-microemulsifying drug delivery systems (S-SMEDDS). In order to make the basis for further development of S-SMEDDS, the influences of silica on the absorption of S-SMEDDS were investigated. An in vitro lipolysis model was used to evaluate the influence of silica on self-microemulsifying drug delivery system digestion from intestinal tract. S-SMEDDS containing silica were prepared by extrusion/spheronization. The drug release and absorption were investigated. The results showed that lipolysis rate and drug concentration in aqueous phase after intestinal lipolysis both increased by adding silica, which was benefit to drug absorption. And silica was not benefit to absorption for slowing drug release. Consistently, there was no significant influence of silica on intestinal absorption. This study implied that the influences of silica on lipolysis rate and drug release were both amount dependent and it is suggested that silica could be used as the solid carrier but the proportion needs to be optimized.

Optimization of novel self-microemulsifying mouth dissolving films by response surface methodology / 药学学报

This paper report the development of a new dosage form - self-microemulsifying mouth dissolving films, which can improve the oral bioavailability of water insoluble drugs and have good compliance. A three factor, three-level Box-Behnken design was used for optimizing formulation, investigated the effect of amounts of microcrystalline cellulose, low-substituted hydroxypropyl cellulose and hypromellose on the weight, disintegration time, cumulative release of indomethacin after 2 min, microemulsified particle size and stretchability. Optimized self-microemulsifying mouth dissolving films could fast disintegrate in (17.09 +/- 0.72) s; obtain microemulsified particle size at (28.81 +/- 3.26) nm; and release in vitro at 2 min to (66.18 +/- 1.94)%. Self-microemulsifying mouth dissolving films with broad application prospects have good compliance, strong tensile and can be released rapidly in the mouth through fast self-microemulsifying.

Establishment and evaluation of a dynamic in vitro intestinal absorption model of lipid formulations / 药学学报

A new dynamic in vitro intestinal absorption model for screening and evaluating lipid formulations was established by means of the characteristics of the intestinal digestion and absorption of the lipid formulations. This model was composed of two systems, including intestinal digestion and the intestinal tissue culture, which drew the evaluation method of intestinal absorption into the in vitro lipolysis model. The influence of several important model parameters such as Ca2+, D-glucose, K+ on the two systems of this model has been investigated. The results showed that increasing of Ca2+ concentration could be significantly conductive to intestinal digestion. The increasing of D-glucose concentration could stepped significantly down the decay of the intestinal activity. K+ was able to maintain intestinal activity, but the influence of different concentration levels on the decay of the intestinal activity was of no significant difference. Thus the model parameters were set up as follows: Ca2+ for 10 mmol x L(-1), D-glucose for 15 mmol x L(-1) and K+ for 5.5 mmol x L(-1). Type I lipid formulation was evaluated with this model, and there was a significant correlation between the absorption curve in vitro and absorption curve in vivo of rats (r = 0.995 6, P < 0.01). These results demonstrated that this model can be an attractive and great potential method for the screening, evaluating and predicting of the lipid formulations.

Dexamethasone impairs the differentiation and maturation of murine dendritic cells by Toll-like receptor 4-nuclear factor-kappaB pathway / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Recent studies have demonstrated that dexamethasone (DEX) interferes with immune responses by targeting key functions of dendritic cells (DCs) at the earliest stage. However, the cellular and molecular mechanisms are still incompletely understood. This study aimed to explore the possible mechanisms by investigating the roles of DEX on differentiation, maturation & function of murine DCs and the effects of DEX on DCs via Toll-like receptor 4 (TLR4)-nuclear factor (NF)-kappaB mediated signal pathway.</p><p><b>METHODS</b>Immature DCs (imDCs) were cultured from murine bone marrow (BM) cells. We added DEX into culture medium at different time. The expression of CD11c, CD86 and I-A(b) (mouse MHC class II molecule) was determined by flow cytometry. We determined the expression of NF-kappaB and its inhibitory protein I-kappaBalpha by electrophoretic mobility shift assay (EMSA) and Western blotting, respectively. The productions of interleukin (IL)-12p70 and IL-10 in cell culture supernatants were determined by enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>DEX impaired differentiation of DCs from murine bone marrow progenitors, and inhibited lipopolysaccharide (LPS) induced maturation of DCs. DEX significantly inhibited NF-kappaB expression of normal DCs, the higher the DEX concentration or the longer the DEX treatment time, the more obvious the effect. However, DEX had little effect on LPS-induced NF-kappaB activation, and partially impaired LPS-induced I-kappaBalpha degradation. DEX significantly decreased LPS induced IL-12p70 production by DCs. Interestingly, our results showed a synergistic effect between DEX and LPS on the production of IL-10 by DCs.</p><p><b>CONCLUSIONS</b>DEX inhibits the differentiation and maturation of murine DCs involved in TLR4-I-kappaB-NF-kappaB pathway, and also indirectly impairs Th1 development and interferes with the Th1-Th2 balance through IL-12 and/or IL-10 secretion by DCs.</p>

An optoelectronic cervical cancer screening system for screening cervical cancer: comparison with cervical cytology / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the clinical value of optoelectronic cervical cancer screening system (TruScreen, TS) in the screening of cervical cancer in comparison with cervical cytology test.</p><p><b>METHODS</b>A total of 392 patients were screened by TS, Pap, TCT, and HPV using the pathological and colposcopical results as the golden standard. The sensitivity, specificity, Kappa value and the area of under ROC of each method and their combinations (parallel tests) were compared.</p><p><b>RESULTS</b>The sensitivity of TS, Pap, TCT and HPV were 32.2%, 42.2%, 74.4% and 47.8%, with specificity of 96.7%, 93.7%, 78.8% and 84.8% in detecting cervical cancer, respectively. The sensitivity of the parallel tests, namely TCT/HPV, TCT/TS, Pap/TS and HPV/TS were 65.6%, 87.8%, 82.2% and 86.7%, with the specificity of 81.1%, 74.5%, 75.8% and 67.2%, respectively. In light of the areas of under ROC, significant differences were noted between the parallel tests of TS/Pap and TS/TCT (P<0.05), but not between TCT/Pap and TCT/TS (P>0.05); significant differences were found between the parallel tests with TS and those without TS (P<0.05), but not between TS alone and the parallel tests incorporating TS (P>0.05), nor between the 4 parallel tests (P>0.05).</p><p><b>CONCLUSION</b>As a new modality for early screening of cervical carcinoma, TS offers a means for real-time cancer detection with better diagnostic efficacy than Pap and HPV and equivalent efficacy to TCT. The combination of TS and cytological tests can further enhance the diagnostic accuracy.</p>

Use of an in vitro lipolysis model to evaluate type I lipid formulations / 药学学报

The distribution fate and solubilization behavior of indomethacin through the intestinal tract were investigated with in vitro lipolysis model, by comparing the Capmul MCM and Labrafil M 1944 CS type I lipid formulations. The results showed that the more favorable solubilization was in the aqueous digestion phase from each lipid formulations for indomethacin. The lipolysis rate and extent were decided with chemical constitution of the lipid excipients, which meant that less indomethacin was transferred from the long chain polar oil lipid solution into the aqueous digestion phase. Increasing the concentration of indomethacin in the lipid formualitons from a solution to a suspension led to a linear increase in the concentration of indomethacin attained in the aqueous digestion phase from lipid formulations. This study also implied that adverse effects of the lipolysis rate and extent on drug absorption were could be taken into consideration when screening lipid formulations. Lipid suspensions likely had better enhancement of drug absorption. Last, this study demonstrated that a potential basis for optimizing and assessing type I lipid formulations and also researching in vivo-in vitro correlations of lipid formulations were provided by an in vitro lipolysis model.

A study about posture changing to ameliorate dysuria for patients with femoral artery puncture and catheterization / 中国实用护理杂志

ObjectiveTo explore whether the posture changing can ameliorate the dysuria for patients with femoral artery puncture and catheterization, and observe the influence of posture changing on blooding in the point of puncture. Methods Changing patients′ posture under the order of nurses, and then observed the amelioration condition of dysuria. Results After using intervention method, the rate of urinary stasis decreased from 31.67% to 4.17%, the rate of using urethral catheterization also decreased from 8.33% to 1.67%. Conclusion Posture changing was an effective method to ameliorate the dysuria for patients with femoral artery puncture and catheterization.

Effects of extract of Ginkgo biloba with venlafaxine on brain injury in a rat model of depression / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Recent studies have indicated that chronic stress may give rise to brain damage, which is related to the genesis of depression. The purpose of this study is to investigate the effects of extract of Ginkgo biloba (EGb) and venlafaxine on depression.</p><p><b>METHODS</b>Rats were treated with chronic and comprehensive stress to create a depression model. Immunohistochemistry was used to detect the expression of brain-derived neurotrophic factor (BDNF) in the hippocampal CA3 neurons of rats treated with different drugs. Behavioral changes of these rats were also examined.</p><p><b>RESULTS</b>The expression of BDNF in the hippocampal CA3 neurons of the depression model decreased with a reduction in exploring behavior and a significant increase in fecal production. The expression of neuron nitric-oxide synthase (nNOS) protein also increased in the rats compared to normal controls. The rats treated with EGb and venlafaxine showed an increase in expression of BDNF and exploring behavior compared to untreated rats, but a decrease in nNOS and fecal production.</p><p><b>CONCLUSIONS</b>Rats sustain damage to the brain after being subjected to chronic and comprehensive stress. Our research has indicated that combined EGb with venlafaxine enhances the protection of neurons and decreases damage to the brain, while relieving the side effects of synthetic antidepressants.</p>

Application of Orem self-care theory to the patients after renal transplantation / 中国康复理论与实践

@# ObjectiveTo observe the effect of Orem self-care theory on the patients after renal transplantation.Methods102 patients after renal transplantation into were randomly divided into the observation group(52 cases),which received Orem self-care,and comparison group(50 cases),which received general care.Self-care ability,rate of infection and mental status of the 2 groups patients were observed and recorded.ResultsFor patients of the observation group,self-care ability of was obviously better(P<0.01),the rate of infection was lower(P<0.05),and mental status was improved(P<0.01) compared with patients of the observation group.ConclusionThe application of Orem self-care on patients after renal transplantation can promote self-care ability and decrease post-operation complications.

Study of hepatic cellular injury due to hepatic ischemia in dogs / 中国普通外科杂志

Objective To investigate the ischemic injury of hepatic cell caused by hepatic artery occlusion.Methods The hepatic artery was occluded in 20 dogs via operation,while the portal vein remained patent.Specimens were gained from the right liver at four time points:before occlusion of the hepatic artery,20(minutes),40 minutes and 60 minutes after artery occlusion.Each specimen was examined by HE and BCL-2 by immunohistochemistry.The gray scale of BCL-2 in HE sections was detected.Results Hepatic cellular injury was obvious 20 minutes after occlusion of the hepatic artery.Irreversible hepatic cellular injury was(observed) 60 minutes after hepatic artery occlusion.The results showed that the gray scale of BCL-2 at every time point after hepatic artery occlusion were significantly different from that before hepatic artery occlusion(P