A nonvel computer-assisted navigation for intraoperative correction of femoral rotation deformity in diaphyseal fractures / 中华创伤骨科杂志

Objective To evaluate the clinical effect of a novel computer-assisted navigation technique for intraoperative correction of femoral rotation deformity in diaphyseal fractures.Methods From November 2015 to November 2016,a navigation system (BrainLAB,Germany) was used in antegrade intramedullary nailing for 13 patients with femoral shaft fracture to intraoperatively restore the normal length and rotation of the fractured femur.They were 11 men and 2 women,with an average age of 38.2 years.The iujury affected the left side in 5 cases and the right side in 8.According to the Winquist Classification,there were 6 cases of type Ⅰ,3 ones of type Ⅱ,3 ones of type m,and one of type Ⅳ.This navigation system allowed the surgeons to detect and set the femoral anteversion (FAV) and length of the injured leg at the desired angle and length of the healthy contralateral femur,precisely matching the contralateral limb and restoring the normal length and rotation of the fractured femur.All the patients underwent postoperative CT scan of bilateral femora for measurement of the lengths and rotations which were conpared with the intraoperative values obtained with the navigation system.Results Additional operative time required for computerized navigation averaged 42.8 min (from 35 to 55 min).The mean length difference between the treated and untreated femora was 4.2 nnn (from 2 to 9 mm).The FAVs obtained from intraoperative navigation and postoperative CT scan were 34.0° ± 8.4° and 33.5° ± 8.3° in the healthy side and 31.2° ± 8.5° and 32.8° ± 9.0° in the injured side,showing no significant differences either between the 2 sides or between intraoperation and postoperation (P ＞ 0.05).The mean rotational difference between the 2 extremities were 4.8° ± 1.6° for the navigation and 3.8° ± 1.9° for the CT scan,showing an insignificant difference (P ＞ 0.05).All the incisions healed well with no intraoperative or postoperative complications.Conclusions This novel navigation technique may serve as a reliable tool to accurately correct the rotational malalignment of femoral shaft fractures intraoperatively,but care should be taken in every step of the navigation procedure to reduce complications.

Advantage of extralevator abdominoperineal excision comparing to the conventional abdominoperineal excision for low rectal cancer: a Meta-analysis / 中南大学学报(医学版)

Objective:Whether extralevator abdominoperineal excision (ELAPE) improves survival and safety remains controversial.Systematic review of all comparative studies to define the superiority of ELAPE to conventional abdominoperineal excision (APE).Methods:Corresponding data,with case-control studies or cohorts regarding intraoperative perforation rate,the local recurrence rate and postoperative complications in the ELAPE group and the APE group,were retrieved from PubMed,Embase,the Cochrane Library,Chinese Biomedical Literature (CMB),VIP,China National Knowledge Infrastructure (CNKI),and Wanfang Database.Meta-analysis was performed by using RenMan 5.2.Results:A total of 10 articles were included.Intraperative perforation rate (MD=0.54,95％ CI 0.31 to 1.39,P=0.03),local recurrence rate (MD=0.30,95％ CI 0.21 to 0.42,P＜0.001) in the ELAPE group was significantly lower than that in the APE group.The difference in positive margin rate between the 2 groups was not statistically significant (P=0.07).Conclusion:Through gap repair of episiotomy and individualized therapy can improve ELAPE postoperative quality of life.ELAPE shows certain advantages in treating lower rectal cancer comparing to APE,but it should pay attention to individualized treatment.More studies through large sample multi-center,medium and long term randomized design are necessary to determine the effect of surgery on tumor.

One case of gastric duplication cyst with ectopic pancreas in adults / 中南大学学报(医学版)

Gastric duplication cyst is a very rare gastrointestinal tract malformation that accounts for 2％-4％ of alimentary tract duplications.It is a diagnostic dilemma for doctors because its clinical and radiological manifest is usually nonspecific.At the present stage,it can only rely on surgery.We should pay attention to ectopic pancreas resection and ligation of pancreatic duct during operation.There was one case of gastric duplication cyst with ectopic pancreas in adults from the Second Affdiated Hospital of Nanchang University.

Clinical efficacy of transanal endoscopic microsurgery for the rectal tumor / 中华消化外科杂志

Objective To explore the clinical efficacy of transanal endoscopic microsurgery (TEM) for the rectal tumor.Methods The clinical data of 35 patients with rectal tumors who were admitted to the Second Affiliated Hospital of Nanchang University between November 2012 and March 2014 were retrospectively analyzed.The preoperative endorectal ultrasonography (ERUS) was applied to patients for evaluating local invasion and lymph node metastasis,and confirming the pathological types of tumors,size and location of tumors,depth of invasion and with or without lymph node enlargement around the rectal wall,and then patients underwent TEMs.Patients were followed up by outpatient examination,telephone interview and instant messenger (WeChat) till August 2014.Results The tumors of 6 patients were located in the anterior wall of rectum,11 were in the posterior wall of rectum,9 were in the left and 9 in the right side walls of rectum.The diameter of tumor,distances between distal margin of tumor and anal verge,volume of intraoperative blood loss and operation time were (2.3 ± 0.9) cm (range,0.7-4.8 cm),(8 ±4)cm(range,4-17 cm),(32 ±19)mL (range,5-60 mL) and (79 ±35)minutes (range,31-150 minutes),respectively.Tumors with positive margin showed the negative margin after supplementary resection.All the patients didn't receive the specific analgesic therapy with the intake of liquid diets at postoperative day 1-3,and they were discharged after anal exsufflation.The duration of hospital stay was (4.2 ±1.2)days (range,2.0-9.0 days).The results of pathological examination showed that rectal adenoma were detected in 12 patients,rectal carcinoma in situ in 2 patients (Tis stage),rectal carcinoid in 2 patients,low-risk T1 stage of rectal cancer in 9 patients,high-risk T1 stage in 7 patients and T2 stage in 3 patients who received chemotherapy.Seventeen patients had postoperative complications,including 9 with perineum swelling and frequent defecation,4 with functional impairment of anal sphincter,2 with acute urinary retention and 2 with mild errhysis with the eased symptoms after symptomatic treatment.A total of 35 patients were followed up for 5-22 months with a median time of 11 months.The recurrence rate of rectal cancer was 2/19,including in the low-and high-risk T1 stage of 1/16 and in T2 stage of 1/3.Two of 12 patients without adjuvant therapy had recurrence of tumors,and other patients had no recurrence of tumors after adjuvant therapy.Conclusion TEM is safe and feasible in the treatment of rectal adenoma,carcinoma in situ,rectal carcinoid as well as rectal cancer in the low-and high-risk T1 stage.

Research progress on Nrf-2/ARE signaling pathway regulated by tumor-related signals / 中国肿瘤临床

The Nrf-2/ARE signaling pathway is not only affected by itself but also influenced by multiple tumor-related signals. To expand our understanding about the Nrf-2/ARE signaling pathway and lay a theoretical foundation for further research, we reviewed the effects of multiple tumor-related signals on the Nrf-2/ARE signaling pathway and studied the possible underlying mechanisms.

Effect of antisense miR-224 on gastric cancer cell proliferation and apoptosis / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To observe the effects of miR-224 antisense oligonucleotide (ASO) on the proliferation and apoptosis of gastric cancer cells in vitro and vivo.</p><p><b>METHODS</b>The expression of miR-224 in the cancer tissues and their adjacent tissues in 120 gastric cancer patients were detected by real-time quantitative PCR. The biological effects of miR-224 ASO on human gastric cancer SGC7901 cells was assessed by MTT assay, clone formation assay, flow cytometry and in vivo experiment in nude mice.</p><p><b>RESULTS</b>Compared with the control group (0.50 ± 0.07), miR-224 ASO significantly reduced the miR-224 mRNA expression in the cancer patients (0.09 ± 0.01, P < 0.05). MTT assay results showed that the survival rate of gastric cells at 24 h, 48 h and 72 h was 53.6%, 59.1% and 70.1% in the miR-224 ASO group, and 12.3%, 17.4% and 24.7%, respectively, in the control group (P < 0.05 for all). Clone formation assay revealed that clone formation rate in the miR-224 ASO group was (5.33 ± 0.74)%, significantly lower than the (33.33 ± 8.38)% in the control group (P < 0.05). Flow cytometry indicated that the apoptotic index was (15.68 ± 1.46)% in the miR-224 ASO group and (3.36 ± 0.88)% in the control group (P < 0.01). In addition, the expressions of Bcl2 mRNA and protein were 1.05 ± 0.04 and 0.21 ± 0.03 in the miR-224 ASO group, significantly lower than that in the control group (4.87 ± 0.96 and 0.88 ± 0.09, P < 0.01). The in vivo study further showed that the tumor volume in the experimental group is significantly smaller than that in the control group (P = 0.01).</p><p><b>CONCLUSIONS</b>MiR-224 is overexpressed in human gastric cancer. Reducing the expression of miR-224 can effectively inhibit the growth and promote apoptosis of gastric cancer cells. miR-224 may become a new target for the regulation of gene expression in gastric cancer.</p>

A New Triterpene Saponin from Gynostemma pentaphyllum / 中草药·英文版

Objective To study the triterpene saponins from Gynostemma pentaphyllum with antitumor activities.Methods The 75% EtOH extract of G.pentaphyllum was used for isolation by silica gel column chromatography and preparative HPLC.The structures of pure compounds isolated were identified by the spectral analysis and chemical evidence.Results Two compounds were isolated and identified as 23(S)-3β,20ξ,21ξ-trihydroxy-19-oxo-21,23-epoxydammar-24-ene 3-O-α-L-rhanmopyranosyl(1→2)-[β-D-xylopyranosyl(1→β)]-β-D-arabinopyranoside(1)and23(S)-21(R)-O-n-butyl-3β,20ξ-dihydroxy-21,23-epoxydammar-24-ene 3-O-α-L-rhamnopyranosyl(1→2)-[β-D-xylo-pyranosyl(1→3)]-β-D-arabinopyrannside(2).Conclusion Compound 2 is a new triterpene saponin with moderate antitumor activities against the HL-60,Colon205,and Du145 cell lines.

Isolation and identification of a new biotransformation compound by Fusarium sacchari from saponin of Panax notoginseng leaves / 中草药

Objective To study the chemical constituents of transformed products by Fusarium sacchari and to find the rare ginsenosides with anti-tumor effects from the leaves of Panax notoginseng. Methods The compound isolated was separated by repeated silica gel,Sephadex LH-20,and HPLC chromatography. The structure was identified by analysis of its spectral data.Results A dammarane-type triterpene, notoginsenoside-LZ,20(S)-3?-hydroxy-12?,23-epoxy-dammar-24-ene-20-O-?-D-xylopyranosyl (1→6)-?-D-glucopyranoside,was isolated from the transformed products.Conclusion Notoginsenoside-LZ is a new compound.

Left gastric venous caval shunt for esophageal varices: a report of 8 cases / 中国普通外科杂志

Objective To evaluate the effect of left gastric venous caval shunt in the treatment of portal hypertension. Methods Eight patients suffering from portal hypertension underwent left gastric venouscaval shunt. The graft was of autogenous vein in 5 cases and artificial vein in 3 cases. Results There was no mortality and major complication nor early rebleeding. All patients were followed up from 10 mos to 10 years with an average of 5 years and 2 mos.Postoperatively,5 cases retrieved active living style. Two cases died, and one was lost during the follow-up. Conclusion Left gastric venous caval shunt decreasesthe venous pressure of the portal system within pericardiac and lower esophageal area. The shunt is a safe and effective surgical treatment presenting less alterations to splanchnic hemodynamics and with an additionaladvantage for pericardial devascularization.