Norepinephrine attenuates injury of vascular endothelial cells induced by LPS / 中国病理生理杂志

AIM: To investigate the effects of norepinephrine(NE)on vascular endothelial cell damage in-duced by lipopolysaccharides(LPS).METHODS: Human umbilical vein endothelial cells(HUVEC-12)were cultured with LPS at 100 mg/L to establish the cell damage model.Real-time PCR and Western blot were used to determine the ex-pressions of VE-cadherin at mRNA and protein levels.The levels of TNF-α,IL-1β,IL-2 and IL-10 in culture supernatant were measured by ELISA.The reactive oxygen species(ROS)production in the endothelial cells was detected by ROS as-say kit.RESULTS: LPS decreased both mRNA and protein levels of VE-cadherin accompanied by increased levels of TNF-α,IL-1β,IL-2 and intracellular ROS,and decreased level of IL-10 in the endothelial cells.NE reversed the expres-sion of VE-cadherin at mRNA and protein levels under the condition of LPS treatment in a dose -dependent manner,and al-so alleviated the intracellular oxidative stress.CONCLUSION: NE reverses the endothelial damage induced by LPS, which may be related to the up-regulation of VE-cadherin level and the decreases in oxidative stress and inflamatory media-tors.

Laparoscopic versus open intersphincteric resection for low rectal cancer: a clinical comparative study / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the clinical and oncological outcomes between laparoscopic and open intersphincteric resection in patients with low rectal cancer.</p><p><b>METHODS</b>From January 2007 to January 2010, patients with low rectal cancer treated by laparoscopic or open intersphincteric resection were included in a retrospective comparative study. Patients were classified into laparoscopy group (n=27) and open group (n=41). The operative procedures, postoperative complications, anal function and clinicopathological data were compared.</p><p><b>RESULTS</b>Compared to the open group, the laparoscopic group had longer operative time [(242.2±42.5) min vs. (199.1±44.3) min, P=0.000], less blood loss [(150.5±102.2) ml vs. (258.4±149.2) ml, P=0.002], faster recovery of bowel function [(2.9±1.1) d vs. (3.6±1.5) d, P=0.032] and resumption of regular diet [(6.6±1.2) d vs. [(7.5±1.7) d, P=0.012], and shorter postoperative hospital stay [(7.7±1.4) d vs. (9.1±2.4) d, P=0.006]. The postoperative complication rate between the laparoscopic and open groups was not significantly different [18.5% (5/27) vs. 19.5% (8/41), P=0.464]. Oncological parameters were comparable between the two groups including lymph node harvested [(14.1±4.1) vs. (16.4±6.8), P=0.113], distal resection margin [(1.4±0.7) cm vs. (1.6±0.8) cm, P=0.311], and circumferential margin [7.4% (2/27) vs. 2.4% (1/41), P=0.709]. Local recurrence rates in laparoscopic and open groups were 7.4% (2/27) and 2.4% (1/41), and distant metastasis rates were 0 and 4.9% (2/41) respectively, and the differences were not significant (both P>0.05).</p><p><b>CONCLUSIONS</b>Laparoscopic intersphincteric resection possesses same efficacy of open intersphincteric resection with less blood loss, shorter recovery time and hospital stay, and similar oncological outcomes, and no increased postoperative morbidity and mortality.</p>

Accuracy of endorectal ultrasonography in preoperative staging of rectal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the accuracy of endorectal ultrasonography in preoperative staging of rectal carcinoma.</p><p><b>METHODS</b>The 319 patients with rectal adenocarcinoma underwent endorectal ultrasonography evaluation from January 2007 to March 2010. There were 175 males and 144 females, and the age of patients were 22-82 year old (median 59 years). According their visiting time, 319 patients were divided into 3 groups (period A: January to December 2007; period B: January to December 2008; and period C: January 2009 to March 2010). All patients underwent endorectal ultrasonography, and the 3 doctors had finished evaluations with 272 cases (Doctor 1, 2, 3 had finished evaluations with 162, 64 and 46 cases respectively). The endorectal ultrasonography staging was compared with the pathology findings based on the surgical specimens in 319 patients who had surgery.</p><p><b>RESULTS</b>Overall accuracy in assessing the level of rectal wall invasion was 67%. The accuracy of uT2 and uT3 were 43% and 81% respectively, and the difference was statistically significant (χ(2) = 30.54, P < 0.01), and the accuracy of uT4a was 59%, which was lower than uT3 (81%,χ(2) = 13.77, P < 0.01). Overall accuracy in assessing nodal involvement in the 311 patients treated with radical surgery was 66%. Staging accuracy tends to improve with experience, the accuracy with Doctor 1 in period C(staging accuracy of T and N were 84% and 81% respectively) were higher than period A(staging accuracy of T and N were 55% and 41% respectively) (χ(2) = 6.65 and 13.27, P < 0.01).</p><p><b>CONCLUSIONS</b>Transrectal ultrasound for preoperative staging of rectal has higher accuracy with mastered ultrasound doctor.</p>