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Objective To compare the clinical data and postoperative complications between defunctioning stoma and non-defunctioning stoma in laparoscopic low anterior resection for rectal carcinoma,and study the clinical significance of non-defunctioning stoma.Methods The clinical data of 70 cases who accepted laparoscopic low anterior resection was collected.According to the operative methods,all patients were divided into two groups,defu ctioning stoma group included 42 cases and non-defunctioning stoma group induded 28 cases.The situation of postoper rative complications of patients bob two groups were compared by SPSS 19.0.Results The operation time,bleeding volume,eating time in defunctioning stoma groups and non-defunctioning stoma groups were no statistical significant.The time staying in hospital in defunctioning stoma groups was longer than that of non-defunctioning stoma groups (P ＜ 0.05).defunctioning stoma groups,anastomotic leakages happened in 2 case,anastomotic hemorrhage in 1 case,incision complications in 2 cases,anastomotic strictures in 8 cases,stoma complications in 1 case.The total morbidity was 28.5％.In non-defunctioning stoma group anastomotic leakages happened in 1 case,anastomotic hemorrhage happened in 1 case,incision complications happened in 1 case,internal complications happened in 1 case.The postoperative morbidity was 17.8％.The total complications had significant difference in the two groups(P ＜0.05).The anastomotic leakage and hemorrhage in two groups had no difference significantly.Conclusion Defunctioning stoma with no indication can not decrease the complication in laparoscopic low anterior resection for rectal cancer case.
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Objective To compare the clinical data and postoperative complications between defunctioning stoma and non-defunctioning stoma in laparoscopic low anterior resection for rectal carcinoma,and study the clinical significance of non-defunctioning stoma.Methods The clinical data of 70 cases who accepted laparoscopic low anterior resection was collected.According to the operative methods,all patients were divided into two groups,defu ctioning stoma group included 42 cases and non-defunctioning stoma group induded 28 cases.The situation of postoper rative complications of patients bob two groups were compared by SPSS 19.0.Results The operation time,bleeding volume,eating time in defunctioning stoma groups and non-defunctioning stoma groups were no statistical significant.The time staying in hospital in defunctioning stoma groups was longer than that of non-defunctioning stoma groups (P ＜ 0.05).defunctioning stoma groups,anastomotic leakages happened in 2 case,anastomotic hemorrhage in 1 case,incision complications in 2 cases,anastomotic strictures in 8 cases,stoma complications in 1 case.The total morbidity was 28.5％.In non-defunctioning stoma group anastomotic leakages happened in 1 case,anastomotic hemorrhage happened in 1 case,incision complications happened in 1 case,internal complications happened in 1 case.The postoperative morbidity was 17.8％.The total complications had significant difference in the two groups(P ＜0.05).The anastomotic leakage and hemorrhage in two groups had no difference significantly.Conclusion Defunctioning stoma with no indication can not decrease the complication in laparoscopic low anterior resection for rectal cancer case.
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The treatment strategy for infected acute necrotizing pancreatitis is that enables recovery but at the same time limits the morbidity and mortality.The current gold standard remains open necrosectomy.Recent literature contains scattered reports of percutaneous drainage,endoscopic,and laparoscopic approaches to managing patients with this condition.This review addresses the role of minimally invasive approaches and treatment strategy in patients with infected acute necrotizing pancreatitis.
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Objective To investigate whether the implanted spike wave electrical stimulation (ES) can improve survival of mesenchymal stem cells (MSCs) after transplantation in spinal cord injury (SCI) rats. MethodsIn the study,60 male SD rats were used to prepare the SCI induced by a digital weight drop apparatus.The MSCs from each rat' s femurs were collected and then labeled by Bromodeoxyuridine (Brdu) seven days after SCI.The rats were randomly assigned into four groups,ie,group A (receiving a transplantation of MSCs only),group B (receiving electro-stimulant therapy only),group C ( receiving a transplation of MSCs and electro-stimulant therapy) and the control group ( receiving a single injection of phosphate buffer solution,PBS).Functional status was assessed regularly before and after SCI by using the Basso-Beattie-Bresnahan (BBB) locomotor rating score and somatosensory evoked potential (SEP).The recovery of spinal cord was checked by diffusion tensor imaging (DTI) and the survivorship of the labeled MSCs was observed with immunohistochemical method. Results BBB score of group C demonstrated significant difference in comparison with that of the other three groups ( P ＜ 0.05 )and was significantly higher than that of the control group (P ＜0.01 ) four weeks after surgery,which indicated an obvious functional improvement of the extremity mobility in group C.At the 8th week postoperatively,SEP study displayed significant difference in group C from the other three groups in terms of latency and wave amplitude (P ＜0.05 ),indicating the fast neurofunctional recovery of the spinal cord in group C.MR images of the spinal cords by DTI showed the same outcome.Immunohistochemistry confirmed a large number of the labeled MSCs positive cells in the lesion site of group C.ConclusionTheimplanted spike wave ES promotes the bioactivity and survival of MSCs and improves the therapeutic effect in combination with MSCs transplantation.
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ObjectiveTo study the expressions of p75NTR,Bax and Bcl-2 and cell apoptosis in rat cortical neurons following mechanical injury and discuss the mechanism and mutual action way during the apoptosis of rat neurons after mechanical injury.Methods Cortical neuron cultures were prepared from the brain tissues of day 17 rat embryos and were exposed to mechanical injury seven days after seeding.After the traumatic neuron injury models were created,the apoptosis ratio of neurons was tested at several time points.The models were divided into the minor,moderate,severe injury groups according to the injury severity and the control group.The expressions of Bax and Bcl-2 in each group were detected by immunohistochemistry method and that of p75NTR by Western-blot.Combining with cellular apoptosis ratio in each group shown after FCM analysis,the correlation between the expressions of p75NTR,Bax and Bcl-2 and the apoptosis in rat neurons after mechanical injury could be analyzed.ResultsThe apoptosis ratio of the neurons in all the injury groups was obviously higher than that in the control group,with significantly higher apoptosis ratio of the neurons in the severe injury group than the minor and moderate injury groups (P ＜0.05).P75NTR,Bax and Bcl-2 were all expressed in all the injury groups,with statistical differences between groups.The expression of Bax in the severe injury group was significantly higher than that in the minor and moderate injury groups(P ＜ 0.05 ). Conclusions p75NTR expression and Bax/Bcl-2 ratio are closely correlated with neuron apoptosis.The early expression of p75NTR may be one of mechnisms for neuronal apoptosis after neuron injury,when Bax and Bcl-2 may be involved.
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Objective To discuss the effect of the interval between neoadjuvant therapy and surgery on downstaging for local advanced rectal cancer.Method s From May 2003 to December 2008 as earlier period,32 patients with clinical stage T3 or T4 rectal cancer received neoadjuvant therapy followed by surgery after 4 -6 weeks.From January 2009 to December 2010 as later period,21 patients with clinical stage T3 or T4 rectal cancer received neoadjuvant therapy followed by surgery after 8 weeks.Dworak classification,TNM stage and clinical outcome after surgery were compared between two group paitents.Results All patients with local advanced rectal cancer received R0 resection.No surgical complications and mortality were observed in all cases.Pathological results showed that 0 and 2 cases were Dworak classification Ⅳ,5 cases were Dworak classification Ⅲ,3 and 6 cases were Dworak classification Ⅱ and 24 and 8 cases were Dworak classification Ⅰ in earlier period and later period,respectively (x2 = 9.109,P = 0.028).The postoperative staging showed that 6 and 13 cases were ypT1N0M0,22 and 6 cases were ypT2N0M0,1 case was ypT3 N0M0,3 and 1 cases were ypT3N1 M0,respectively (x2 = 10.909,P = 0.012).There were 65.6% or 81.0% cases reserved anus in earlier period and later period,respectively(x2 = 1.468,P = 0.226).Conclusions The neoadjuvant therapy followed by surgery after 8 weeks is associated with a more significant downstaging effect for local advanced rectal cancer.However,the effect of an extended interval between neoadjuvant therapy and surgery on clinical outcome still needs further investigation.
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Methods involved in the treatment of malignant tumor are surgical therapy, radiotherapy, chemotherapy and immunotherapy. Although some effects have been showed in tumor therapy, the limits of single use of those methods can not be avoided. Therefore, combined therapy has been pursued in order to achieve better results. The effects of those combined methods such as chemotherapy combined with cytokine, chemotherapy combined with tumor vaccine, chemotherapy combined with adjuvants have been approved both experimentally and clinically. These results, in some extent, will provide us a new way to fight against tumor.