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Objective:To evaluate the effect of pedicled omentum packing of pelvic floor after laparoscopic Miles precedure in the prevention of short-term postoperative complications.Methods:Seventy-two patients undergoing laparoscopic combined abdominal perineal resection for rectal cancer at He'nan Tumor Hospital from Jan 2014 to Aug 2021 were retrospectively reviewed. The observation group underwent pelvic floor reconstruction with pedicled omentum, while in control group the pelvic floor was leaving unconstructed.Results:There was no intestinal obstruction in the observation group. There were 5 cases of intestinal obstruction in the control group. Three were recovered by conservative treatment, 2 cases underwent laparotomy and 1 case underwent anastomosis between small intestine and small intestine. The incidence of intestinal obstruction between 2 groups was statistically different (0 vs. 14%, χ2=5.083, P=0.024 ). The operation time, hospital stay between the two groups were statistically different [(195±13) min vs. (159±9) min, t=10.047, P=0.000; (11.9±0.9) d vs. (14.9±2.1) d, t=-5.996, P=0.000 ). Between the two groups, there were no significant differences in the incidence of presacral infection , pulmonary infection, venous thrombosis and intraoperative blood loss (all P>0.05) . Conclusion:Pedicled greater omentum used in pelvic floor reconstruction after laparoscopic Miles procedure reduces the incidence of short-term postoperative complications, especially of intestinal obstruction.
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Objective:To investigate the application value of transverse perineal arc incision approach in complete resection of presacral cyst in the lithotomy position.Methods:The retrospec-tive cohort study was conducted. The clinicopathological data of 114 patients who underwent com-plete resection of presacral cyst in Henan Cancer Hospital from August 2012 to October 2021 were collected. There were 14 males and 100 females, aged (35±9)years. All patients were diagnosed as presacral cysts by preoperative magnetic resonance imaging. Of the 114 patients, 76 patients undergoing intraoperative perineal arc incision approach in the lithotomy position were divided into the innovative group, and 38 patients undergoing intraoperative Kraske approach were divided into the traditional group. Observation indicators: (1) surgical situations and specimen; (2) postoperative situations; (3) Follow-up. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and com-parison between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Surgical situations and specimen. The operation time, volume of intraoperative blood loss, cases with intraoperative combined transabdominal approach or sacrectomy were (137±20)minutes, (261±101)mL, 0 in the innovation group, versus (136±34)minutes, (261±116)mL, 15 in the tradi-tional group, showing no significant difference in the operation time and volume of intraoperative blood loss between the two groups ( t=0.18, 0, P>0.05) and showing a significant difference in cases with intraoperative combined transabdominal approach or sacrectomy between the two groups ( P<0.05). Results of postoperative specimen anatomy in patients of the two groups showed complete removal of the cyst. (2) Postoperative situations. The time to postoperative removing presacral drainage tube, duration of postoperative hospital stay, cases with postoperative second stage healing of incision were (11.4±2.1)days, (13.5±3.5)days, 23 in the innovation group, versus (11.5±1.9)days, (13.7±3.8)days, 4 in the traditional group, showing no significant difference in the time to post-operative removing presacral drainage tube and duration of postoperative hospital stay between the two groups ( t=-0.20, -0.24, P>0.05) and showing a significant difference in cases with postoperative second stage healing of incision between the two groups ( χ2=5.46, P<0.05). Cases with postoperative severe complications were 4 and 2 in the innovation group and the traditional group, respectively, showing no significant difference between the two groups ( P>0.05). (3) Follow-up. All 114 patients were followed up for 48(range, 6?108)months. Cases with recurrence of cysts were 2 and 0 in the innovation group and the traditional group, respectively, showing no significant difference between the two groups ( P>0.05). During the follow-up period, the anal defecation control function of all patients was classified as grade A?B of Williams score. Conclusions:The transverse perineal arc incision approach in complete resection of presacral cyst in the lithotomy position is safe and feasible. Compared with Kraske approach, the transverse perineal arc incision approach in the lithotomy position is more suitable for patients with high presacral cyst.
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Objective:To investigate the types, surgical treatments of complex intestinal fistula after radiotherapy for cervical cancer.Methods:The clinical data and treatment of 26 patients with complex intestinal fistula after radiotherapy for cervical cancer at Cancer Hospital of Zhengzhou University from Jan 2013 to Jan 2020 were reviewed .Results:Eleven patients were with recto-vaginal fistula, 1 patient with sigmoido-vesical fistula, 5 patients with combined rectal, vaginal and vesical fistula, 7 patients with low rectal fistula and peripheral infection, and 2 patients with ileo-vaginal stump fistula after radical resection of cervical cancer and adjuvant radiotherapy. All patients were underwent the surgery, including 9 patients for total pelvic or posterior pelvic resection, 6 patients for rectum or sigmoid colectomy, bladder or vaginal repair, 7 patients were done for Hartmann surgery, and 1 patient underwent segmental resection, enteroanastomosis and vaginal repair, 3 patients for transverse colostomy or proximal ileostomy. No major postoperative complications occurred . The symptoms of intestinal fistula in all patients were dissolved, and the perineal pain was significantly relieved in 23 patients. The symptoms of ileal fistula reccurred in 2 patients within 1 year after operation, and there was no mortality.Conclusions:The rectal related intestinal fistula is the most common complex intestinal fistula after radical radiotherapy for cervical cancer. The point of surgical treatment is to remove the diseased rectum or ileum.
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Objective To explore the feasibility and potential application value of establishing the neonatal pig models of islet transplantation under the renal capsule. Methods Nine wild-type neonatal Duroc pigs were selected, including 1 animal as the control (p6307), 6 as islet transplant donors and 2 as islet transplant recipients (p6210, p6207). After islet isolation and differentiation in vitro, islet transplantation under the renal capsule of the pig was performed. Immunosuppressive therapy of tacrolimus (Tac) combined with sirolimus was given after operation. Postoperative body weight, blood glucose and serum creatinine levels of the recipients were monitored. The p6210 recipient neonatal pig was sacrificed at postoperative 4 weeks, while the p6207 recipient and the control neonatal pig were sacrificed at postoperative 8 weeks. The islet grafts under the renal capsule were collected for pathological staining and insulin immunofluorescent staining. Results After islet transplantation under the renal capsule of the pigs, the growth rate of body weight of the recipients was significantly slower than that of the control neonatal pig, accompanied with intermittent symptoms, such as anorexia and diarrhea, etc. However, the blood glucose and serum creatinine levels of the recipients did not significantly differ from preoperative levels and those of the control neonatal pig. Evident islet mass was observed under the renal capsule of the p6210 recipient. Pathological staining and insulin immunofluorescent staining confirmed that the islet mass had the function of secreting insulin, whereas no obvious islet mass could be seen under the renal capsule of the p6207 recipient. Pathological staining detected no evident islet mass, suggesting the possibility of islet transplantation failure caused by rejection in the p6207 recipient. Conclusions The establishment of neonatal pig models of islet transplantation under the renal capsule is a feasible technique, which provides preliminary evidence for the establishment of composite islet-kidney donor graft in pig models for xenotransplantation in the treatment of end-stage diabetic nephropathy.
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Objective@#To assess the clinical value of neutrophil-to-lymphocyte ratio (NLR) in predicting anastomotic leak of postoperative rectal cancer patients.@*Methods@#The clinical data of 787 rectal cancer patients who underwent anterior resection from January 2014 to December 2017 in Affiliated Tumor Hospital of Zhengzhou University were collected. The postoperative numbers of white blood cell (WBS) on postoperative day (POD)1, 3 and 5 were detected, and the NLR was calculated. The relationship of NLR and the incidence of anastomotic leak was analyzed, and the area under the receiver-operating characteristic (ROC) curves was calculated. The accuracy of postoperative NLR in predicting the incidence of anastomotic leak was evaluated.@*Results@#WBC counts of patients with leak on POD1, POD3 and POD5 were 13.2×109/L, 9.1×109/L and 8.9×109/L, respectively, while those of patients without leak were 12.9×109/L, 9.0×109/L and 8.8×109/L. The WBC count was not significantly different between patients with or without leak (P>0.05). The average NLR values of patients with or without leak were 13.3 and 11.6 on POD1, 10.9 and 7.6 on POD3, 9.3 and 5.3 on POD5, respectively. The NLR values of patients with leak on POD3 and POD5 were significantly higher than those of patients without leak (P<0.05). The cutoff value of NLR on POD3 was 8.6, the sensitivity and specificity of detecting the leakage was 73.2% and 75.6%, respectively, and the area under curve (AUC) was 0.744. The cutoff value of NLR on POD5 was 5.5, the sensitivity and specificity was 69.6% and 75.5%, the AUC was 0.726. The multivariate analysis result showed that NLR >8.6 was an independent factor for anastomotic leak prediction.@*Conclusion@#Postoperative NLR on day 3 is useful in predicting anastomotic leak and can decrease the incidence of complication in rectal cancer patients who underwent anterior resection.
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Objective@#To explore the method of relieving intestinal obstruction in patients with recurrent cervical cancer accompanied with intestinal obstruction after radical radiotherapy.@*Methods@#The data of 10 recurrent cervical cancer patients accompanied with high risk weak constitution and intestinal obstruction after radical radiotherapy from May 2012 to May 2018 were retrospectively analyzed, including preoperative radiotherapy dose, physique and obstruction status, operation time, operation blood loss, postoperative digestive tract patency and diet. All of the 10 patients with cervical cancer recurrence accompanied with intestinal obstruction and disturbance of independent walking after radical radiotherapy.@*Results@#The median fasting time of the 10 patients was 21 days, the median weight was 35.5 kg, the median body mass index (BMI) was 13.3 kg/m2, the median value of hemoglobin was 67 g/L, and the median value of platelet was 44×109 /L. All of the patients underwent enterostomy. the median operation time was 6.0 min and the median amount of bleeding was 5.0 ml. All of the patients defecated after operation, fed on the first day after operation, and were able to walk on their own 5 days after operation.@*Conclusions@#Although the cervical cancer patients with recurrent intestinal obstruction after radical radiotherapy are extremely weak, some patients still have the opportunity to relieve intestinal obstruction if the treatment strategy and surgical method are appropriate.
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Objective@#To establish a scoring system to predict the risk of anastomotic leakage in patients with rectal cancer older than 60 years.@*Methods@#The study included 995 patients (≥ 60 years) with rectal cancer locating 3-12 cm from the anal verge who underwent anterior resection or intersphincteric resection at the Department of General Surgery, Henan Cancer Hospital from January 2012 to December 2016. Potential risk factors for leakage were subjected to univariate analysis. Multivariate logistic regression analysis was used to identify the independent risk factors for anastomotic leakage. The scoring system was developed based on regression coefficient for each significant risk factor. One point was allocated to the risk factor with a regression coefficient β < 1, and two points were allocated to the risk factor with β > 1. The proposed scoring system was tested by the area under curve (AUC) of the receiver operating characteristic curve (ROC) .@*Results@#Surgery was successfully performed in all 995 patients. The incidence of anastomotic fistula was 4.6% (46/995) . Among these 46 patients, 31 recovered after conventional treatment, and 13 patients underwent transverse colostomy, and 2 died of multiple organ failure. Independent risk factors included age (β = 0.643, OR = 1.902, 95%CI: 1.020 - 3.614, P = 0.048) , body mass index (BMI) (β = 1.218, OR = 3.379, 95%CI: 1.607 - 7.105, P = 0.001) , albumin levels (β = 0.986, OR = 2.681, 95%CI: 1.432-5.021, P = 0.002) , and level of anastomosis from the anal verge (β = 1.395, OR = 4.034, 95%CI: 2.086-7.801, P = 0.000) . The scoring system was created base on coefficient β of the independent risk factors (age≥70 years for 1, BMI≥25 kg/m2 for 2, albumin levels < 35 g/L for 1, level of anastomosis from anal verge < 4.0 cm for 2) . All the scores were added up, and all patients were divided into the high-risk group (4-6 points, n=71) and intermediate-low-risk group (0-3 points, n=924) based on the scoring system. The incidence of anastomotic leakage in the two groups was 23.9% (17/71) and 3.1% (29/924) , respectively (χ2 = 60.092, P = 0.000) . The AUC of age, BMI, albumin levels, and level of anastomosis from the anal verge were 0.598, 0.591, 0.622, and 0.635 respectively. The AUC of the scoring system was 0.656, which was higher than above parameters with a sensitivety of 0.37 and specificity of 0.94.@*Conclusions@#The scoring system is effective and accurate for identifying a subgroup at high risk for postoperative anastomotic leakage in rectal cancer patients over 60 years old.
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Objective To explore the clinical effects of pedicled ligamentum teres hepatis in preventing duodenum stump fistula after resection of gastric cancer.Methods The clinicopathological data of 563 patients with gastic cancer who underwent resection from Jan.2013 to Dec.2016 were analyzed.Results Fourteen patients in the control group developed duodenum stump fistula.Four patients in the experimental group developed duodenum stump fistula.The incidence of duodenum stump fistula in the control group was 4.6％,while that in the experimental group was 1.5％ (x2 =4.356,P =0.037).All the 14 patients in the control group had high fever and 2 died of multiple organ failure,8 were cured with conservative treatment,and 4 received reoperation.For patients in the experimental group,moderate fever was observed in 2 patients and all were cured by conservative treatment.Conclusion Pedicled ligamentum teres hepatis was safe and effective to prevent duodenum stump fistula after resection of gastric cancer.
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Objective To evaluate the under-registration rate related to mortality surveillance program in Jinan city,from 2013 to 2014,using the capture-mark-recapture method.Methods Under the stratified cluster random sampling method,samples were stratified,according to urban and rural areas.Two districts and three counties were chosen,with three towns/streets in each county/district and eight villages/communities in each township/street,randomly selected.With the participation of departments as civil affairs,public security,maternal/child institutions and community committees as well as individuals as village doctors and community leaders,a list of deaths from January 1,2013 to December 31,2014 was collected and compared to the National Mortality Surveillance System on the rates related to under-registration.Results A total of 2 903 records on deaths were collected from 2013 to 2014,while 3 113 deaths were reported in the surveillance system of the same period.3 772 (95％ CI:3 741-3 802) deaths were estimated by the capture-mark-recapture method.The two-year total under-registration rate was 17.46％.The under-registration rates in 2013 and 2014 appeared as 19.29％ and 15.57％ (x2 =8.92,P＜0.01),respectively,with the rates in urban and rural areas as 20.91％ and 11.93％ (x2 =47.35,P＜0.01).The rates on male and female were 17.87％ and 16.98％ (x2 =0.48,P＞0.05).The rates of ＜5 years old group and ≥5 years old group were 21.57％ and 17.45％ (x2 =0.03,P＞0.05) respectively.Conclusions Under-registration in the mortality surveillance was noticed in Jinan.The capture-mark-recapture method seemed useful for evaluating the under-registration rate in the mortality surveillance program.It is suggested that the survey on under-registration rate should be carried out on the regular base.The under-registration rate seemed useful in adjusting the mortality rate.
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Objective To evaluate the under-registration rate related to mortality surveillance program in Jinan city,from 2013 to 2014,using the capture-mark-recapture method.Methods Under the stratified cluster random sampling method,samples were stratified,according to urban and rural areas.Two districts and three counties were chosen,with three towns/streets in each county/district and eight villages/communities in each township/street,randomly selected.With the participation of departments as civil affairs,public security,maternal/child institutions and community committees as well as individuals as village doctors and community leaders,a list of deaths from January 1,2013 to December 31,2014 was collected and compared to the National Mortality Surveillance System on the rates related to under-registration.Results A total of 2 903 records on deaths were collected from 2013 to 2014,while 3 113 deaths were reported in the surveillance system of the same period.3 772 (95％ CI:3 741-3 802) deaths were estimated by the capture-mark-recapture method.The two-year total under-registration rate was 17.46％.The under-registration rates in 2013 and 2014 appeared as 19.29％ and 15.57％ (x2 =8.92,P＜0.01),respectively,with the rates in urban and rural areas as 20.91％ and 11.93％ (x2 =47.35,P＜0.01).The rates on male and female were 17.87％ and 16.98％ (x2 =0.48,P＞0.05).The rates of ＜5 years old group and ≥5 years old group were 21.57％ and 17.45％ (x2 =0.03,P＞0.05) respectively.Conclusions Under-registration in the mortality surveillance was noticed in Jinan.The capture-mark-recapture method seemed useful for evaluating the under-registration rate in the mortality surveillance program.It is suggested that the survey on under-registration rate should be carried out on the regular base.The under-registration rate seemed useful in adjusting the mortality rate.
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Objective@#To explore the surgical results and clinicopathological features of gastric cancer patients with liver metastases.@*Methods@#The clinicopathological data and post-operative survival of 37 patients who underwent resection of liver metastasis from gastric cancer at our department from Dec. 2007 to Dec. 2014 were analyzed.@*Results@#The 1-, 3-, and 5-year overall survival rates after resection were 91.4%, 57.9%, and 22.0%, respectively, with a median survival of 37 months. Univariate analysis revealed that lymph node metastasis, multiple hepatic metastases and no preoperative chemotherapy are unfavorable prognostic factors for overall survival. Multivariate analysis identified that lymph node metastasis and number of liver metastasis are independent prognostic factors.@*Conclusions@#Gastric cancer patients with a solitary liver metastasis may be good candidates for gastric D2 resection combined with liver R0 resection.
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OBJECTIVE:To improve the hospital workflow and efficiency in temporary drug purchase approval process. METHODS:The approval function for temporary drug purchase was introduced into office automation(OA)system in our hospi-tal,and the effects were evaluated. RESULTS:According to ensuring the administrative approval process,system function permis-sion assignment and approval process design in temporary drug purchase in our hospital,functions for approving temporary drug purchase were established in OA system. It achieved convenient,efficient,timely,networking and paperless approval work,as well as standardized record,checking out at any time and automatic statistics for drug purchase. CONCLUSIONS:Introducing tem-porary drug purchase approval function into hospital OA system can simplify workflow,provide better service for clinic,and pro-mote development of hospital pharmacy management.
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Objective To study the inhibitory effect and mechanism of dipeptide peptidase inhibitors analogues on LPS -induced inflam-matory response on microglia .Methods Microglia cells were cultured ,isolated and purified from the neonatal Sprague-Dawley rats.Divided them into blank group ,negative control ,LPS group and medicine group ( parallel determination for 3 times each group ) after pharmacological preconditioning for 48 hours.The optimal concentration of microglia proliferation induced by LPS were measured by MTT assay .Observed the role of dipeptide peptidase inhibitors analogues on LPS-induced microglia in different concentrations .The interleukin1β( IL-1β) ,tumor necro-sis factor alpha ( TNF-α) were assayed by enzyme-linked immunorrbent assay ( ELISA ) .The expression of TLR-4 was detected by Western blotting and the expression of NF-κB was detected by RT-PCR.Results LPS induced the proliferation of microglia and significantly in-creased the release of inflammatory cytokines in LPS-stimulated primary microglia .Compared with the blank group ,dipeptide peptidase inhibi-tors analogues could inhibit this effect and the IC 50 values was 1.014 ×10 -2 mol/L to MG after pretreatment for 48 hours.Dipeptide peptidase inhibitors analogues could inhibit the release of TNF-αand IL-1 significantly(P<0.01),and it decreased the expression of TLR4 and NF-κB signif-icantly(P<0.01).Conclusion This research suggests that dipeptide peptidase inhibitors analogues restrain cell proliferation and inflammatory re-sponse of LPS-stimulated microglia,and the possible mechanism may be related to the inhibition of the expression of TLR-4 and NF-κB.
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Objective To explore the clinical effects of pedicled omentum in preventing anastomotic leakage after resection of colorcctal cancer complicated with intestinal obstruction.Methods The clinicopathologic data and anastomotic leakage rate of 102 patients with colorectal cancer undergoing resection from Dec.2012 to Dec.2015 were analyzed.Results Seven patients in the control group developed anastomotic leakage.Only 1 patient in the experimental group developed anastomotic leakage.The incidence of anastomotic leakage in the control group was 12％,while that in the experimental group was 2％ (x2 =4.250,P =0.039).Of the 7 patients complicating anastomotic leakage in control group,1 died of multiple organ failure,1 was cured with conservative treatment,and 5 were done with diverting stoma.The one leakage in experimental group was cured by conservative treatment.Conclusion Pedicled omentum is useful in the prevention of anastomotic leakage after resection of colorectal cancer in settings of intestinal obstruction.
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Objective To investigate the effects of pancreaticoenterostomy by separating and continuous suture on pancreatoduodenectomy.Methods The clinical data of 76 patients who underwent curative pancreaticoduodenectomy from March 2002 to October 2014 in Tumor Hospital of Zhengzhou University were retrospectively analyzed.Of all the patients,43 received pancreaticoenterostomy by separating and continuous suture (study group),and the other 33 patients received BPJ anastomosis (control group).All the patients used Child reconstruction,the diagnosis of pancreatic fistula was made according to ISGPF criteria.The operation time of pancreaticoenterostomy,the incidence of hemorrhage of anastomosis and the incidence of pancreatic fistula were retrospectively analyzed.Results The age,sex,hemoglobin,albumin,total bilirubin,the incidence of co-morbidity of diabetes,extent of surgical resection between 2 groups were comparable without significant difference.In study group,the time of pancreaticoenterostomy was 11 min(8 ～ 15 min),there were 4 patients with class Ⅰ pancreatic fistula,and 1 patient with class Ⅱ pancreatic fistula.No patient developed class Ⅲ pancreatic fistula or anastomotic bleeding.In control group,the time of pancreaticoenterostomy was 16 min(12 ～25 min) which was only available for 5 patients,and no records for other patients.There were 6 patients with pancreatic fistula including 4 patients with class Ⅱ,2 patients with class Ⅲ,while no records for class Ⅰ.Four patients were found to have anastomotic bleeding.Conclusions With the pancreaticoenterostomy by separating and continuous suture method,the surgical field is fully exposed,the suture time is shortened and the incidence of anastomotic bleeding and pancreatic fistula is reduced.
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<p><b>OBJECTIVE</b>To evaluate the clinical significance of preoperative serum albumin level and its association with survival in colon cancer patients.</p><p><b>METHODS</b>Clinicopathological data of 621 consecutive patients with colon cancer admitted in Henan Cancer Hospital between January 2000 and December 2008 were retrospectively analyzed. These patients were divided into hypoalbuminemic and normal groups according to the definition of hypoalbuminemia (serum albumin < 35 g/L). Clinicopathological features were compared between two groups. The association of preoperative serum albumin level and the prognosis was analyzed by Kaplan-Meier and Log-rank test. Multivariate Cox model was used to evaluate the survival.</p><p><b>RESULTS</b>Sixty-seven(10.8%) patients were defined as preoperative hypoalbuminemia and were mostly found in those with right hemicolon cancer. Preoperative serum albumin level was associated with depth of tumor (χ(2)=35.609, P=0.000), lymph node metastasis (χ(2)=8.110, P=0.004), distant metastasis (χ(2)=9.064, P=0.003), advanced TNM T staging (χ(2)=23.070, P=0.000), and not associated with age, gender, tumor gross type, histological type, and degree of tumor differentiation (all P>0.05). 5-year survival rate of hypoalbuminemia group and normal group was 55.2% and 66.1% respectively (P=0.032). Univariate analysis revealed age (P=0.000), tumor gross type (P=0.014), degree of tumor differentiation (P=0.014), depth of tumor (P=0.000), lymph node metastasis (P=0.001), distant metastasis (P=0.000), advanced TNM T staging (P=0.000), operative method (P=0.000) and preoperative serum albumin level (P=0.032) were associated with survival. Cox multivariate analysis revealed the albumin level was the independent prognostic factor of the 5-year overall survival (HR:0.694, 95% CI: 0.492-0.980, P=0.038). The patients with higher albumin level had better survival outcome.</p><p><b>CONCLUSIONS</b>Preoperative serum albumin level is an independent prognostic factor for colon cancer. Colon cancer patients with hypoalbuminemia have worse clinicopathological manifestation and poorer overall survival.</p>
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Humanos , Neoplasias del Colon , Metástasis Linfática , Análisis Multivariante , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Albúmina Sérica , Tasa de SupervivenciaRESUMEN
Objective To observe the Interference effects of siRNA( small interference RNA) intrathecal injection on the expression of mRNA and protein of MrgC, on PWTs ( paw withdrawal thresholds) and the phosphorylation of PKCεSer729 in ipsilateral DRG( dorsal root ganglion) of rats with chronic inflammatory pain induced by CFA( complete freund’ s adjuvant).Methods 16 health adult male SD (Sprague-Dawley) rats were randomly divided into 2 groups: control siRNA group and MrgC siRNA group, 8 rats in each group.After success of intrathecal catheterization, corresponding siRNA was injected in rats for 4d, once a day, 5μg/d per rat.The model of chronic inflammatory pain was established by CFA (0.1ml per rat) subcutaneously injected into the right hind paw at 4th day post-administration, then two groups were administrated corresponding siRNA on alternate day and executed at the 11th day post-administration.The PWTs were measured at 5 time points of pre-intrathecal catheterization, pre-administration, 4th day post-administration(0h post-CFA injection), 5th day post-administration(24h post-CFA injection), 11th day post-administration(7 d post-CFA injection). The expression of MrgC mRNA in ipsilateral DRG was detected by fluorogenic quantitative PCR, and the expression of MrgC and the phosphorylation of PKCε Ser729 in ipsilateral DRG was detected by immumofluorescence method.Result Compared with 4th day post-administration, PWTs of both two groups at 5th day post-administration decreased significantly ( P<0.01 ) .While there was no significant difference of PWTs between two groups at every detective time point. Compared with control siRNA group, the expression of MrgC mRNA and the rate of MrgC positive cells in MrgC siRNA group both decreased significantly ( P<0.01,P <0.05), whereas the rate of p-PKCε Ser729 positive cells increased obviously ( P<0.05) at 11th day post-administration.Conclusion MrgC siRNA can effectively interfere the expression of mRNA and protein of MrgC in L4-L6 ipsilateral DRGs of rats with chronic inflammatory pain induced by CFA, and the siRNA interference on MrgC can obviously up-regulate the phosphorylation of PKCε Ser729, while it has no significant effect on PWTs of rats.
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Objective To investigate the clinical efficacy of three dividing lines in radical right hemicolectomy for right colon cancer.Methods The clinical data of 166 patients with right colon cancer (including ileocecal cancer,ascending colon carcinoma and hepatic flexure of the colon) who were admitted to the Affiliated Tumor Hospital of Zhengzhou University from March 2009 to August 2014 were retrospectively analyzed.Eightythree patients who underwent radical right hemicolectomy via three dividing lines were allocated to the modified group and 83 patients who underwent radical right hemicolectomy via medial approach were allocated to the control group.The operation time,volume of intraoperative blood loss,number of lymph node dissection and processing time and volume of the superior mesenteric vein (surgical trunk) hemorrhage were analyzed between the 2 groups.Patients were followed up by outpatient examination and telephone interview till November 2014.The measurement data with normal distribution were presented as x ± s.The comparison between groups was analyzed using t test.The count data were analyzed by the chi-square test.Results The operation time in the modified group and in the control group were (75 ± 7) minutes and (109 ± 13) minutes,respectively,with a significant difference (t =-36.700,P ＜0.05).The volume of intraoperative blood loss and number of lymph node dissection in the modified group were (118 ± 15)mL and 19 ±4,which were not significantly different from (116 ±22)mL and 18 ± 3 in the control group (t =0.104,12.300,P ＞ 0.05).During D3 lymph node dissection,the incidence of hemorrhage of the superior mesenteric vein,processing time of hemostasis and volume of blood loss were 3.6％ (3/83),(7 ± 3) minutes and (103 ± 25) mL in the modified group and 9.6％ (8/83),(20 ± 5) minutes and (209 ± 37)mL in the control group,respectively.There was no significant difference in the incidence of hemorrhage of the superior mesenteric vein between the 2 groups (x2 =2.434,P ＞ 0.05).There were significant differences in the processing time of hemostasis and volume of blood loss between the 2 groups (t =38.100,29.200,P＜0.05).The patients were followed up for 3 months to 5 years with a median time of 22 months.Of 166 patients,23 died,11 were loss to follow-up and others survived at the end of follow-up.Conclusion Three dividing lines is safe and feasible in radical right hemicolectomy for right colon cancer,with a good clinical efficacy.
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<p><b>OBJECTIVE</b>To compare the efficacy of proximal gastrectomy(PG) and total gastrectomy(TG) for adenocarcinoma of esophagogastric junction.</p><p><b>METHODS</b>Clinical trials comparing PG with TG for adenocarcinoma of esophagogastric junction published from 1990 to 2012 were searched in Cochrane library, Medline, Embase and China National Knowledge Infrastructure (CNKI), Wanfang Data. Review manager 5.0 was used for meta-analysis and outcome measures included mortality and complication morbidity, as well as nutritional state.</p><p><b>RESULTS</b>A total of 10 studies including 2481 patients were identified and analyzed. The results showed no significant differences in the mortality(OR=1.00, P=0.99) and complication morbidity(OR=2.14, P=0.12) between PG and TG. However, anastomotic stenosis(OR=5.40, P<0.01) and reflux esophagitis(OR=7.12, P=0.01) were more frequently observed in PG group. The nutritional state in TG group was comparable with PG group(WMD=2.09, P=0.57).</p><p><b>CONCLUSION</b>TG is superior to PG in reducing the morbidity of anastomotic stenosis and reflux esophagitis.</p>
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Humanos , Adenocarcinoma , Cirugía General , China , Ensayos Clínicos como Asunto , Unión Esofagogástrica , Cirugía General , Gastrectomía , Métodos , Neoplasias Gástricas , Cirugía GeneralRESUMEN
Increasing detection of unruptured intracranial aneurysms,catastrophic outcomes from subarachnoid hemorrhage,and risks and cost of treatment necessitate defining objective predictive parameters of aneurysm rupture risk.However,long-term follow-up have shown the risk of intracranial aneurysm rupture is associated with its morphologic characteristics,hemodynamic factors and patient's own situation.