Multiple Gastrointestinal Stromal Tumor with Neurofibromatosis Type Ⅰ:Report of One Case / 中国医学科学院学报

Gastrointestinal stromal tumors(GISTs)in the stomach,duodenum,and rectum have low occurrence,and the coexistence GISTs in three parts with neurofibromatosis type Ⅰ(NF-Ⅰ)is even rare.This paper reports a case of GISTs with a family history of NF-Ⅰ.There were multiple nodular masses of different sizes on the patient's face,trunk,and limbs.The patient was admitted due to chest tightness for 5 days and black stools for 1 day.Enhanced CT examination of the abdomen suggested multiple space-occupying lesions in the upper abdomen with multiple small nodules under the abdominal wall,and neurofibromatosis and intestinal stromal tumor cannot be excluded.Finally,surgical pathology confirmed that the multiple tumors in the abdominal cavity were GISTs.The case was confirmed as wild-type GISTs by genetic testing,and the patient recovered well nearly one year after the operation.

Effects of ginsenoside Rb1 on the oxidative stress in the skeletal muscles of rats with postoperative fatigue syndrome / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effects of ginsenoside Rb1 (GRb1) on the oxidative stress in the skeletal muscles of rats with postoperative fatigue syndrome (POFS) and to study its anti-fatigue mechanisms.</p><p><b>METHODS</b>The POFS model was established using resection of 70% of mid-small intestine. Ninety-six Sprague-Dawley (SD) rats were screened using grasping test. The rats were randomly divided into the control group, the model group, and the GRb1 treated group (at 10 mg/kg) by the body weight. The maximum grip strength of rats was detected on the 1st, 3rd, 7th, and 10th day after operation, respectively. The contents of malondialdehyde (MDA), the activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-PX) were detected.</p><p><b>RESULTS</b>Compared with the model group, the maximum grip strength was obviously enhanced on the postoperative day 7 and 10 (P < 0. 05), the MDA content obviously decreased on the postoperative day 3 and 7 (P < 0.05), the SOD activity obviously increased in the GRb1 treated group (P < 0.05). There was no obvious change in the activities of CAT and GSH-PX among the three groups at each time point (P > 0.05).</p><p><b>CONCLUSION</b>GRb1 could reduce the oxidative stress injury in the skeletal muscles, improve the activities of antioxidant enzymes, and enhance the functions of the skeletal muscles in POFS rats, which may be important reasons for fighting against POFS.</p>

Association of the changes of central serotonin and peripheral blood free amino acids with postoperative fatigue after abdominal surgery / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the mechanism of postoperative fatigue syndrome(POFS) by detecting the change of central monoamine neurotransmitters in a rat model after major abdominal surgery.</p><p><b>METHOD</b>Eighty-four rats were randomly divided into fatigue assessment groups (including model group and sham group) and experimental groups (including postoperative day 1, 3, 5, 7, and 14 recovery groups and the corresponding control groups). Postoperative fatigue was evaluated after surgery. The brains were removed thereafter to detect the levels of 5-hydroxytryptamine (5-HT), norepinephrine (NE), dopamine (DA) in the hippocampus, midbrain, hypothalamus by high performance liquid chromatography. Serum free tryptophan (f-Trp) and branched-chain amino acids (BCAA) were measured.</p><p><b>RESULTS</b>The level of 5-HT increased to the highest at postoperative day 3, but reduced rapidly to the minimum at postoperative day 5, and then gradually recovered to the preoperative level. There was significant difference of 5-HT among experimental groups (P<0.05), also between the postoperative 24 hrs group and control groups (P<0.05). f-Trp and the ratio of f-Trp/BCAA increased in the early postoperative period, reduced to minimum at postoperative day 5. f-Trp was still lower compared to the control group at postoperative day 14, while the ratio of f-Trp/BCAA and BCAA restored to control level. Both of them were significantly different among experimental groups (P<0.05), also between the experimental groups and control groups (P<0.05).</p><p><b>CONCLUSION</b>Changes of f-Trp, the ratio of f-Trp/BCAA, and central 5-HT may play an important role in the development of POFS.</p>

Integrated Chinese and Western medical treatment on postoperative fatigue syndrome in patients with gastric cancer / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the effect of the combined use of Shenmai Injection (SMI) and enteral nutrition on postoperative fatigue syndrome (POFS) in patients with gastric cancer (GC).</p><p><b>METHODS</b>Fifty-eight GC patients were randomized into the parenteral nutrition group (PNG, 19 cases), enteral nutrition group (ENG, 19 cases) and combined treatment group (CTG, 20 cases). The post-operative recovery in patients was observed; patients' conditions of fatigue, mood and sleep were evaluated respectively by visual analogue scale of fatigue, profile of mood states (POMS) and Pittsburgh sleep quality index (PSQI). Meanwhile, nutritional variables, such as serum contents of total protein, albumin, pre-albumin, were measured at different time points: before operation (d0) and the 1st, 5th, and 9th day (d1, d5 and d9) after operation. Immune variables such as subsets of lymphocytes (CD3, CD4, CD8), serum immunoglobulins (IgG, IgM, IgA) were also determined.</p><p><b>RESULTS</b>Conditions of recovery, POMS and PSQI were better and the postoperative fatigue reduced more significantly in CTG than those in the other two groups (P < 0.05). On d9, levels of pre-albumin, CD3, CD4, CD4/CD8 in CTG were significantly higher than those in the PNG and ENG (P < 0.05), meantime, levels of albumin and IgA were higher in CTG than those in PNG (P < 0.05).</p><p><b>CONCLUSION</b>Combined treatment of SMI and enteral nutrition can regulate mood and sleep to some extents, and reduce the postoperative fatigue through improving nutritional status and immune function, thus speeding up the recovery of patients.</p>