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Objective:To evaluate the safety and feasibility of enhanced recovery after surgery (ERAS) in the Radical Distal Gastrectomy.Methods:The clinical data of 52 patients who underwent radica distal gastrectomy surgery from Jan 2016 to Jan 2017 were collected,and divided into the ERAS group and the control group.Results:(1) Operation condition:the operative time,volume of intraoperative blood loss,number of patients with conversion to open surgery showed no statistically significant difference between the 2 groups (P＞0.05).(2)postoperative clinical indexes:time for initial anus exhaust,time for initial liquid diet intake,time for out-of-bed activity,time of urinary catheter removal,duration of hospital stay of patients without complications days in the ERAS group and days in the control group,respectively,have been with statistically significant differences between the 2 groups(P＜0.05).But the time to initial defecation,time of abdominal drainage-tube removal and the number of postoperative complications during hospitalization between the 2 group had no statistically difference(P＞0.05).(3)Postoperative complications:at the first days and the third days after operation,WBC,CRP and IL-6 in ERAS group were lower than thoese in the control group,the differences were statistically significant.Conclusion:The perioperative ERAS program in distal gastrectomy is safe and effective and should be popularized.
RESUMO
In order to brought S-naproxen into small intestine, an optically pure [S]-naproxen starch ester was produced by lipase through enantio-selective trans-esterification of racemic naproxen methyl ester with pretreatment starch in solvent system. With carefully selection of the reaction medium [isooctane], lipase [Carica Papaya Lipase, CPL] and the reaction mode [intermittent opening], a high conversion rate [48.6%] and enantiomeric excess of product [99.6%] was obtained. The slow release macromolecular [S]-Naproxen had been synthesized to improve the efficacy of racemic naproxen and overcome its side effects. The enanitomeric ratio of CPL [E=52.5] was higher than CRL [E=22] and greatly influenced by the byproduct methyl alcohol. The intermittent opening reaction mode was the effective way to remove the inhibition of methyl alcohol and to improve the enantio-selectivity of CPL. S-naproxen starch was confirmed by HPLC and [1]H NMR. This method may also apply to preparation the other optically pure 2-phenylpropionic acid derivatives. S-naproxen starch was a new optically pure derivatives possessing emulsifying and slow release properties would be widely applied to the food, pharmaceutical and biomedical industries