Study on early postoperative nutritional support in elderly patients with gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the optimal postoperative nutritional support in elderly patients with gastric cancer.</p><p><b>METHODS</b>One hundred and twenty elderly patients with gastric cancer undergoing radical gastrectomy were prospectively enrolled from January 2010 to March 2013 and randomly divided into total parenteral nutrition group(TPN, n=40), early total enteral nutrition group (TEN, n=40) and enteral plus parenteral nutrition group(EN+PN, n=40). Clinical charasteristics including treatment tolerance, nutritional indexes, immune indexes, time to first flatus, incidence of postoperative infection and anastomotic leakage, were analyzed and compared.</p><p><b>RESULTS</b>Treatment tolerance in EN+PN group(97.5%, 39/40) was significantly higher than that in TPN group(82.5%, 33/40) and TEN group(80.0%, 32/40)(both P<0.05). The nutritional indices, including prealbumin, albumin, transferrin, body mass index, and the incidence of anastomotic leakage were similar in the 3 groups(P>0.05). The immune indices, including CD3, CD4, CD4/CD8, were significantly reduced after operation in each group. However, they were significantly higher in EN+PN group and TEN group than those in TPN group(both P<0.05). Furthermore, compared to the TPN group, the incidence of postoperative infection(surgical site infection, pulmonary infection, abdominal infection) was significantly lower and time to first flatus was significantly shorter in EN+PN group and TEN group.</p><p><b>CONCLUSIONS</b>Early enteral nutrition after gastric cancer surgery is safe, simple and feasible. EN plus PN is the best way to administer postoperative nutritional support in elderly patients with gastric cancer.</p>

The effect of cell killing and apoptosis by human herpes simplex virus- thymidine kinase/ganciclovir system combined with allitride in BIU87 cells / 中华外科杂志

<p><b>OBJECTIVE</b>To study the killing effect of human herpes simplex virus-thymidine kinase/ganciclovir (HSV-TK/GCV) system combined with allitride and the possible apoptosis mechanism in BIU87 cells.</p><p><b>METHODS</b>The cytotoxicity after combination were estimated by theamine blue tetrazolium bromide (MTT). The morphological changes were observed with inverted microscope and in-situ cell apoptosis detection kit. Changes of apoptosis rate and cell cycle were assessed by flow cytometry. B-cell lymphoma-2 (bcl-2), bax, caspase-3 (cysteine aspartate specific proteinase) mRNA changes were detected by reverse transcriptase polymerase chain reaction, and caspase-3 activity was estimated with colorimetry.</p><p><b>RESULTS</b>For combination group, the cell killing rate was raised to 72.50% to compare with 35.00% of GCV and 37.00% of allitride separately and there was a synergistic effect between these two drugs. The cell apoptosis was induced in all three groups and for the combination group the time of S-phase and G(2)-phase arrest were earlier than other two groups. Both drugs could inhibit the expression of bcl-2 and promote the expression and activity of caspase-3.</p><p><b>CONCLUSIONS</b>The combination of HSV-TK/GCV system with allitride can inhibit the proliferation of BIU87 cells congenerously through apoptosis, which may be correlated with S- and G(2)-phase arrest, down-regulation of bcl-2 and increased caspase-3 expression and its activity.</p>