Effect of postoperative early enteral nutrition on the recovery of humoral immune function in patients with colorectal carcinoma undergoing elective resection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of postoperative early oral feeding on humoral immune function and clinical outcome in colorectal cancer patients.</p><p><b>METHODS</b>Seventy patients with colorectal carcinoma requiring elective colorectal resection were prospectively enrolled and randomized into two groups: early oral feeding group(n=35) and conventional oral feeding group(n=35). The patients in early oral feeding group were started on oral feeding within 12 hours after operation, while patients in conventional group were started on oral feeding after the postoperative first passage of flatus. Postoperative parameters of clinic and humeral immune function were compared between two groups.</p><p><b>RESULTS</b>Sixty-two patients eventually completed the study, including 32 cases in early oral feeding group and 30 cases in conventional oral feeding group. The average time to first passage of flatus[(2±1) d vs. (4±2) d, P<0.01], the first passage of stool [(3.8±1.6) d vs. (6.4±2.5) d, P<0.01], resumption of regular diet [(4±2) d vs. (8.2±2.2) d, P<0.01] and the postoperative hospital stay [(6±1) d vs. (11.7±3.8) d, P<0.01] were significantly shorter in early oral feeding group as compared to conventional oral feeding group. Significantly faster recovery of postoperative humoral immunity was found. Plasma levels of globulin [(24.1±2.4) g/L vs. (22.1±3.3) g/L, P<0.05], immunoglobulin G[(10.8±2.4) g/L vs. (8.7±2.1) g/L, P<0.01] and complement 4 [(0.24±0.09) g/L vs. (0.17±0.05) g/L, P<0.05] on postoperative day 3 were higher in early oral feeding group as compared to conventional oral feeding group.</p><p><b>CONCLUSION</b>Application of postoperative early oral feeding in patients undergoing elective colorectal resection is safe and effective, which can lead to faster recovery of postoperative humoral immune function and bowel function, and shorter postoperative hospital stay.</p>

Fast track surgery accelerates the postoperative rehabilitation and recovery of insulin sensitivity in elective operation for colorectal carcinoma: a randomized controlled clinical trial / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of fast track surgery on postoperative insulin sensitivity on the basis of clinical benefits in patients undergoing elective open colorectal resection.</p><p><b>METHODS</b>During May 2008 to December 2008, Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups: a fast track group (35 cases) and a conventional care group (35 cases). All included patients received elective open colorectal resection with combined tracheal intubation and general anesthesia. Clinical parameters, stress markers and insulin sensitivity were evaluated in both groups.</p><p><b>RESULTS</b>The 62 patients finally completed the study, 32 cases in the fast-track group and 30 cases in the conventional care group. The speed of recovery of postoperative insulin sensitivity on 7 days postoperative in the fast-track group (97% ± 9%) was significantly faster than the conventional care group (88.5% ± 9.0%, t = 2.552, P = 0.016). The hospitalization days in the fast-track group was 6 days (M(50)), and it was significantly shorter than the conventional care group ((11.7 ± 3.8) days, Z = 4.360, P = 0.000). The time of recovery of bowel function were faster in the fast-track group (time to pass flatus was 2 days (M(50))) than the conventional care group (4 days, Z = 3.976, P = 0.000). The Infectious complication rate in the fast-track group (2/32) is lower than the other group (8/30, P = 0.040).</p><p><b>CONCLUSION</b>Fast track surgery accelerates recovery of postoperative insulin sensitivity in elective surgery for colorectal carcinoma with a lower rate of postoperative infectious complications and a shorter length of postoperative hospital stay.</p>

Fast track surgery accelerates the recovery of postoperative insulin sensitivity / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Few clinical studies or randomized clinical trial results have reported the impact of fast track surgery on postoperative insulin sensitivity. This study aimed to investigate the effects of fast track surgery on postoperative insulin sensitivity in patients undergoing elective open colorectal resection.</p><p><b>METHODS</b>Controlled, randomized clinical trial was conducted from November 2008 to January 2009 with one-month post-discharge follow-up. Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups: a fast track group (35 cases) and a conventional care group (35 cases). All included patients received elective open colorectal resection with combined tracheal intubation and general anesthesia. Clinical parameters (complication rates, return of gastrointestinal function and postoperative length of stay), stress index and insulin sensitivity were evaluated in both groups perioperatively.</p><p><b>RESULTS</b>Sixty-two patients finally completed the study, 32 cases in the fast-track group and 30 cases in the conventional care group. Our findings revealed a significantly faster recovery of postoperative insulin sensitivity on postoperative day 7 in the fast-track group than that in the conventional care group. We also found a significantly shorter length of postoperative stay and a significantly faster return of gastrointestinal function in patients undergoing fast-track rehabilitation.</p><p><b>CONCLUSION</b>Fast track surgery accelerates the recovery of postoperative insulin sensitivity in elective surgery for colorectal carcinoma with a shorter length of postoperative hospital stay.</p>

Study on the preparation of resveratrol chitosan nanoparticles with free amino groups on the surface / 中国中药杂志

<p><b>OBJECTIVE</b>To prepare resveratrol chitosan nanoparticles with free amine groups on the surface so as to conjugate ligands, which will actively target to special tissues or organs.</p><p><b>METHOD</b>The chitosan nanoparticles with free amine on the surface was prepared by sodium chloride precipitation. Nanoparticles with different solidification degrees were studied on turbidity, in vitro release, encapsulation efficiency, drug loading and diameter.</p><p><b>RESULT</b>The turbidity of nanoparticles with various solidification degrees decreased at different rates after ultrasonic or water bath heating treatment. All nanoparticles mentioned above obviously shew sustained release. The rate of release was slowed down with the increase of solidification agents. Solidification had no obvious effects on the encapsulation efficiency and drug loading. The diameter of chitosan nanoparticles with 200 microL solidification agents was 487 nm. The polydispersion was 0.144.</p><p><b>CONCLUSION</b>The diameter of the prepared nanoparticles was relatively small. The amine on the surface was free, which offered the possibility of designing the acive target drug delivery system.</p>

Preparation and in vitro release of tetramethylpyrazine phosphate pulsincap capsule controlled by an erodible plug / 药学学报

<p><b>AIM</b>To develop a novel pulsatile drug delivery system of which the lag-time is controlled by an erodible plug (EP) and evaluate its release characteristics in vitro.</p><p><b>METHODS</b>The impermeable capsule body was prepared by fulfilling method and the drug tablet and the erodible plug were made by wet granulating compression. Tetramethylpyrazine phosphate (TMPP) pulsincap capsule was prepared by sealing the drug tablet and fillers inside the impermeable capsule body with the EP. The influence factors on the lag-time such as the EP pharmaceutical properties and the dissolution condition were investigated by dissolution testing.</p><p><b>RESULTS</b>Both the composition and the weight of EP influenced the lag-time of the tetramethylpyrazine phosphate pulsincap capsule significantly. The lag-time prior to the drug release was enhanced when the content of gel-forming excipient (hydroxypropylmethylcellulose, HPMC) in the EP or the weight of EP was increased. The hardness of EP showed minor influence on the lag-time. In addition, the lag-time was shortened when the paddle speed was higher, while the pH value of the dissolution medium exhibited no significant influence on it.</p><p><b>CONCLUSION</b>To meet the chronotherapeutic requirements, a pulsatile drug delivery system with a suitable lag-time can be achieved by adjusting the composition and the EP weight.</p>