Combined gastroscopic and choledochoscopic transabdominal nasobiliary drainage / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Common bile duct (CBD) stones are a frequent problem in Chinese populations, and their incidence is particularly high in certain areas (Wang et al., 2013). In recent years, laparoscopic common bile duct exploration (LCBDE) and endoscopic retrograde cholangiopancreatography (ERCP) have been the main surgical procedures for CBD stones, although each has different advantages and disadvantages in the treatment of choledocholithiasis (Loor et al., 2017; Zhou et al., 2017). For patients with large stones, a dilated CBD, especially concurrent gallstones, LCBDE is the preferred and most economical minimally invasive procedure (Koc et al., 2013). However, a T-tube is often placed during LCBDE to prevent postoperative bile leakage; this is associated with problems such as bile loss, electrolyte disturbance, and decreased gastric intake (Martin et al., 1998). In addition, the T-tube usually must remain in place for more than a month, during which time the patient's quality of life is seriously compromised. Many skilled surgeons currently perform primary closure of the CBD following LCBDE, which effectively speeds up rehabilitation (Hua et al., 2015). However, even in sophisticated medical centers, the incidence of postoperative bile leakage still reaches ≥10% (Liu et al., 2017). Especially for a beginner, bile leakage remains a key problem (Kemp Bohan et al., 2017). Therefore, a safe and effective minimally invasive surgical approach to preventing bile leakage during primary closure of the CBD after LCBDE is still urgently needed.

Assessment of ¹⁸⁸Re marked anti MHC class II antibody by peripheral blood mononuclear cells stimulated by donor alloantigen / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous studies showed that anti MHC-II monoclone antibody (MAb) only had partial inhibiting effect of alloreactive mixed lymphocyte reaction (MLR) in vitro and it was unsteady and non-persistent. The aim of this research was to determine whether radioactive isotope (188)Re marked MHC-II antibody could benefit the allograft acceptance in transplantation as compared to normal MHC-II antibody.</p><p><b>METHODS</b>188Re was incorporated to 2E9/13F (ab')(2) which is against swine MHC class II antigen (MAb-(188)Re). Porcine peripheral blood mononuclear (PBMC) cells were examined for proliferation and cytokine mRNA expression after stimulation with MHC-II MAb or MAb-(188)Re.</p><p><b>RESULTS</b>The proliferative response of recipient PBMCs in mixed lymphocyte reaction (MLR) to donor alloantigen showed that the stimulation index of MAb-(188)Re group was significantly lower than the MHC-II MAb group and control (P < 0.05). mRNA expression of interleukin 2, interferon Υ and tumor necrosis factor α (type 1 cytokines) was lower in MAb-(188)Re group than the MHC-II MAb group, while interleukin 10 (type 2 cytokines) was higher in MAb-(188)Re group in the first 24 hours.</p><p><b>CONCLUSION</b>MAb-(188)Re could help the graft acceptance by inhibiting T cell proliferation, lowering the expression of type 1 cytokines and elevating the type 2 cytokines produced by PBMC.</p>

Roles of nutrition risk screening and preventive enteral nutritional support before radical resection of gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the potential role of the preventive nutritional support in patients with nutritional risk defined by nutrition risk screening 2002(NRS 2002) before radical resection of gastric cancer.</p><p><b>METHODS</b>Patients with gastric cancer were evaluated by NRS 2002 preoperatively. Elective patients with nutritional risk were randomly assigned into 3 d preventive enteral nutrition(EN) group versus control group. The preventive nutrition regimen was 1000 ml Nutrison Multi Fibre(4184 kJ/L). The changes in body weight lost, serum albumin, immunoglobulin were recorded postoperatively.</p><p><b>RESULTS</b>One week after operation, the preventive EN group showed less decrease in body weight as compared to control group, which was statistically significant. The levels of serum albumin and IgA on day 1 and day 3 after operation in preventive EN group were significantly higher than those in control group.</p><p><b>CONCLUSION</b>Before operation for gastric cancer, patients with nutritional risk defined by NRS 2002 may benefit from preventive enteral nutrition, which improves the patients' nutritional condition and enhances their immunologic function.</p>

Influence of CO2 pneumoperitoneum on intracellular pH and signal transduction in cancer cells / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECT</b>The authors studied the influence of CO(2) pneumoperitoneum on intracellular pH and signal transduction arising from cancer cell multiplication in laparoscopic tumor operation.</p><p><b>METHOD</b>They set up a simulation of pneumoperitoneum under different CO(2) pressure, and then measured the variation of intracellular pH (pHi) at different time and the activity of protein kinase C (PKC) and protein phosphatase 2a (PP2a) at the end of the pneumoperitoneum. After 1 week, the concentration of cancer cells in the culture medium was calculated.</p><p><b>RESULT</b>When the pressure of CO(2) pneumoperitoneum was 0, 10, 20, 30 mmHg respectively, the average pHi was 7.273, 7.075, 6.783, 6.693 at the end of the pneumoperitoneum; PKC activity was 159.4, 168.5, 178.0, 181.6 nmol/(g.min) and PP2a was 4158.3, 4066.9, 3984.0, 3878.5 nmol/(g.min) respectively. After 1 week, the cancer cells concentration was 2.15 x 10(5), 2.03 x 10(5), 2.20 x 10(5), 2.18 x 10(5) L(-1).</p><p><b>CONCLUSION</b>CO(2) pneumoperitoneum could promote acidosis in cancer cells, inducing the activation of protein kinase C and deactivation of protein phosphatase 2a, but it could not accelerate the mitosis rate of the cancer cells.</p>

Research on telerobotic laparoscopic surgery and its applications / 中国医疗器械杂志

A general review is here presented on the development, composition, existing problems and prospects of telerobotic laparoscopic surgery systems, based on the related literatures and informations in recent years.