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Objective The mechanism and signaling mechanisms of fracture healing by vasoactive intestinal peptide (VIP) regulating are not clear.We established an selective cut off sensory/motor nerve combined with tibial fracture rat model to study the effects of VIP and microvessel density(MVD) during the fracture healing process after nerve injury.Methods 60 SD rats were randomly divided into 3 groups: tibial fracture + motor nerve (anterior root) cutting group (group ART);tibial fracture + posterior root (sensory nerve) cutting group (group PRT);tibial fracture group (group SO),and each group were 20.Three groups of rats in the model after the establishment of 1W, 2W, 3W, 4W these time points, were killed.The skeleton specimens were obtained in the vicinity of the fracture 5mm, to observe the expression of VIP and microvessel density of the law of change.Results Histology observation showed: new bone trabecular bone callus maturity of PRT group is lower than SO group and ART group at each time points;the immunohistochemical staining showed that compared with callus VIP average optical density of PRT group at 2w and 3w(0.156±0.015、0.163±0.012), SO group(0.216±0.012、0.223±0.010) and ART group(0.198±0.014、0.212±0.016) increased obviously(P<0.05).The detection of callus MVD indicated that compared with callus MVD average density of PRT group at 2w and 3w(26.4±2.2、32.3±2.0), SO group(38.2±2.3、40.6±2.6) and ART group(36.6±2.2、38.5±2.1) significant increased (P<0.05).At the 2nd, 3rd and 4th week, the wet weight of tibia was significantly increased in group ART and SO compared with group PRT(P<0.05),which increased more significantly at 2 weeks.Conclusion The effect of loss of sensory nerve innervation on the formation of microvessel density, callus maturity and fracture healing rate were more pronounced than loss of motor nerve innervation.
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<p><b>OBJECTIVE</b>To assess the safety, feasibility and clinical outcome of laparoscopic radical resection for low rectal cancer with telescopic anastomosis or with colostomy by stapler through transanal resection without abdominal incisions.</p><p><b>METHODS</b>From January 2010 to September 2014, 37 patients underwent laparoscopic radical resection for low rectal cancer through transanal resection without abdominal incisions. The tumors were 4-7 cm above the anal verge. On preoperative assessment, 26 cases were T1N0M0 and 11 were T2N0M0.</p><p><b>RESULTS</b>For all cases, successful surgery was performed. In telescopic anastomosis group, the mean operative time was (178±21) min, with average blood loss of (76±11) ml and (13±7) lymph nodes harvested. Return of bowel function was (3.0±1.2) d and the hospital stay was (12.0±4.2) d without postoperative complications. Patients were followed up for 3-45 months. Twelve months after surgery, 94.6%(35/37) patients achieved anal function Kirwan grade 1, indicating that their anal function returned to normal.</p><p><b>CONCLUSIONS</b>Laparoscopic radical resection for low rectal cancer with telescopic anastomosis or colostomy by stapler through transanal resection without abdominal incisions is safe and feasible. Satisfactory clinical outcome can be achieved mini-invasively.</p>
Subject(s)
Humans , Anal Canal , Anastomosis, Surgical , Colostomy , Laparoscopy , Lymph Nodes , Operative Time , Postoperative Complications , Rectal Neoplasms , SafetyABSTRACT
Objective:To design ultrasonic atomization device making use of disposable water cup, to improve ventilation therapy in clinical application.Methods: The design take advantage of working principal of ultrasonic atomization, do a simple interface compatible work to the disposable water cup, the water cup can realize the ability of medicine atomization treatment, collecting the water when not do atomization; the water cup access into the ventilator pipe, to test the influence between the atomization and ventilator function.Results: The disposable water cup realized ultrasonic atomization successfully, and shows no influence between the atomization and ventilator self-function.Conclusion: The design has made some simple improvement of the disposable water cup on the structure, proposed a new way of ventilator atomization practically and economically.
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Objective: To investigate the efifcacy of supplemental walking training in patients with coronary artery disease (CAD) combining heart failure (HF) under routine medication. Methods: A total of 80 patients with CAD combining HF were randomly divided into 2 groups: Exercise group,n=40 including 25 male and 15 female at (61.2 ± 9.8) years of age, the patients received additional six-minute walking exercise training based on routine medication and Control group,n=40 including 26 male and 14 female at (58.1 ± 10.9) years of age, the patients received routine medication. All patients were treated for 3 months. Plasma levels of BNP and general conditions at before and after the treatment were compared between 2 groups. Results:①After 3 months treatment, both groups had signiifcantly improved LVESD, LVEDD, LVEF, plasma levels of BNP and six-minute walk test (except LVESD and LVEDD in Control group), allP Conclusion: Walking training may increase the exercise tolerance, which is beneifcial to recover the cardiac function in patients with CAD combining HF in addition to routine medication .
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Objective To study the clinical efficacy of anus-preserving rectectomy by using telescopic anastomosis of colon and rectal mucosa for the middle and lower rectal cancer. Methods A retrospective analysis was carried out in 402 cases with middle and lower rectal cancer undergoing telescopic anastomosis for anus-preserving procedure, including 241 males and 161 females, age ranging from 21 to 99 years, averaging at 55. 7 years. The distal margins of the tumors were within 6 - 9 cm to anal verge. According to TNM staging, there were 123 cases in Stage Ⅰ , 244 cases in Stage Ⅱ , 31 cases in Stage Ⅲ,and 4 cases in Stage Ⅳ. Results 345(345/402, 85. 8% ) cases were followed up, the median time of the follow-up was 6. 1 years. Postoperative complications included 17(4.2%) cases of stomal leakage, 11(2.7% ) cases of stomal stenosis. All patients recovered normal defecating function 12-24 weeks post operation. Local recurrence rate was 6. 3% (22/345). Hepatic and lung metastasis was 13. 6% (47/345) and 2. 6% (9/345)respectively. The five year survival rate was 68. 7% (112/163). Conclusions Anuspreserving rectectomy by using telescopic anastomosis is safe and effective procedure to treat middle and lower rectal cancer, with the preservation of anal function and without the increasing rate of local recurrence.
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Objective To study clinical therapeutic effects of anus-preserving operation with resecting anal intersphincter to treat ultra-low rectal cancer through abdominal cavity. Methods We retrospectively analyzed 52 cases of ultra-low rectal cancer, with the inferior border of the cancers within 2 cm to anocutaneous line or 5 cm to the edge of anus treated by anus-preserving operation with resecting archos internal sphincter muscles through abdominal cavity and anus. There were 29 males, and 23 females, with age 28 to 76 years old, averaging 56. 3 years old. The inferior border of the cancer were within 4 cm to the edge of anus in 18 cases, including 6 cases of adenoma cancerization, and 5 cm to the anus in 34 cases. Pathologic diagnosis was well-differentiated adenocarcinoma in 21 cases, moderately differentiated in 29 cases, low differentiated in 2 cases, there were 6 cases with adenoma cancerization. 28 cases were Dukes A stage, and 24 B stage. Results The follow-up rate was 88. 4% (46/52), and the median time was 5.9 years. 2 case developed stoma leak (3.8%), and 3 developed stoma stenosis(5.7% ) after operation. The anus could roughly control defecation in 6 ～ 12 mouths after operation. The local recurrence rate was 5.7%, and the 5-year-survival rate was 72.7%. Conclusion By anus-preserving operation with resecting archos internal sphincter muscles, defecation controlling was well reserved by anus, and the 5-year-survival rate was not cut down. This operation is one of the safe and effective operations of anus-preserving procedure.
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Objective To evaluate the target killing effect and metastasis prevention effect of soluble Fas combined with PKC inhibitor on the growth of human colorectal carcinoma implant in nude mice. Methods Orthotopic implantation and metastasis model of human colorectal carcinoma was reproduced in nude mice. Tumor tissue of tumor cell line HR-8348 with positive expression of FasL was implanted to the colonic wall of nude mice. After one week of tumor growth, mice were randomly divided into four groups according to the different agents injected into the peritoneal cavity. Twelve mice were in each group. The mice in the combined treatment group (recombinant soluble Fas coupled with PKC inhibitor + 5-Fu) were injected intraperitoneally 100?l (3mg/ml) recombinant soluble Fas coupled with PKC inhibitor and 0.5 mg of 5-Fu. (On the day of 0, 4, 8, 12 and16). At the same time, a group of tumor bearing mice were given recombinant soluble Fas coupled with PKC inhibitor only, and another group with 5-Fu only, and in the control group only normal saline was given. One month after implantation, tumor weight, inhibition rate and the presence of metastasis were evaluated respectively after the mice were sacrificed. Results Compared with control group, the orthotopically implanted tumors were significantly reduced in weight in mice treated with 5-Fu, recombinant soluble Fas coupled with the PKC inhibitor, and combined treatment, with respective inhibited rates of 43.1%, 79.9%, and 86.3%. Liver metastasis was also inhibited with significant decrease in incidence in 5-Fu group, recombinant soluble Fas coupled with the PKC inhibitor, and combined group compared with that in control group (75.0% vs 36.4%, 16.7%, and 0%). The incidence of peritoneal metastasis was also decreased significantly in 5-Fu, recombinant soluble Fas coupled with PKC inhibitor, and combined treatment compared with that in control group (100% vs 45.5%, 16.7%, and 8.3%, P