ABSTRACT
Objective To evaluate the clinical efficacy and safety of laparoscopic adhesiolysis for patients with adhesive ileus. Methods Clinical data and follow-up data of 95 cases of adhesive ileus were retrospectively analyzed. Based on the surgical approach, patients were divided into laparotomy group (43 cases) and laparoscopic group (52 cases), and the intraoperative situation postoperative complications and recurrence were compared. Results The operation time of laparoscopy group was less than the laparotomy group [(68.35 ± 36.47) vs (82.54 ± 23.27) min, t = 2.21, P = 0.029]; blood loss was less than the laparotomy group [(69.51 ± 20.33) vs (198.37 ± 50.04) ml, t = 16.97, P = 0.000]; postoperative analgesic dosage was less than the laparotomy group [(1.01 ± 0.99) vs (3.46 ± 1.53), t = 9.41, P = 0.000]; time of posterior ambulation was less than the laparotomy group [(11.05 ± 1.32) vs (20.36 ± 2.59) d, t = 16.97, P = 0.000]; gastrointestinal function recovery time was less than laparotomy group [(2.30 ± 1.38) vs (4.05 ± 1.74) d, t = 5.47, P = 0.000]; catheter removal time was lower than the laparotomy group [(3.04 ± 2.11) vs (5.36 ± 2.24) d, t = 5.19, P = 0.000]; hospital stay was less than the laparotomy group [(5.89 ± 1.57) vs (10.36 ± 2.65) d, t = 10.02, P = 0.000]; the postoperative complication rate of laparoscopy group and laparotomy group was 3.84% (2 cases) and 16.27% (7 cases), respectively, the difference was not statistically significance (χ2 = 4.24, P = 0.074); followed up from 8 to 36 months, there were 2 cases, 6 cases of intractable abdominal pain and intestinal obstruction recurrence in laparoscopy group and laparotomy group respectively, the relapse outcomes of laparotomy group was higher than laparoscopy group, but the difference was not statistically significant (χ2 = 3.64, P = 0.056). Conclusion Laparoscopic adhesiolysis is safe, effective, and have the characteristics with less trauma, less interference on the abdominal cavity, it is better than open surgery.
ABSTRACT
Patients with traumatic hemorrhagic shock are highly susceptible to the development of acute kidney injury (AKI), but little data are available regarding the changes in cystatin C (CysC) in patients with traumatic hemorrhagic shock. The aim of the present study, therefore, was to investigate whether CysC has a higher value than serum creatinine (SCr) and urea for use in monitoring glomerular function in traumatic hemorrhagic shock. Data from a cohort of patients with traumatic hemorrhagic shock, who had been admitted to a trauma center, were collected. Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic value of serum CysC, SCr and urea for the identification of renal dysfunction, and the data were expressed as the area under the curve (AUC). CysC was not significantly affected by gender, age, mechanism of injury or time between injury and arrival at the center in the patients with traumatic hemorrhagic shock. The CysC level of the patients was significantly higher than that of the normal subjects (1.10±0.36 vs. 0.91±0.34 mg/l); the SCr and urea levels of the patients were also significantly increased compared with those of the normal subjects. Nonparametric ROC plots of the sensitivity and specificity of SCr, CysC and urea for the detection of AKI revealed AUC values of 0.901 [95% confidence interval (CI), 0.791-1.000], 0.728 (95% CI, 0.570-0.886) and 0.709 (95% CI, 0.552-0.865) for SCr, CysC and urea, respectively. No significant correlation between mortality and CysC, SCr or urea was found. These data indicate that the level of CysC is significantly increased in the early stage of traumatic hemorrhagic shock and that CysC can be used as a marker to predict AKI; however, the diagnostic utility of CysC remains lower than that of SCr in the early stage of the condition.
ABSTRACT
A new dimeric phenylpropanoid namely podonaka A (1), along with the 13 known compounds including diterpenes (2 and 3), norditerpenes (4 and 5), benzenoids (6-10), steroids (11 and 12), chalcone (13), and megastigmane (14), was isolated from the EtOH extract of Podocarpus nakaii Hayata. The structure of 1 was elucidated on the basis of spectroscopic analysis including 1D and 2D NMR and MS techniques. Biological evaluation showed that norditerpenes, inumakilactone B (4), and podolactone E (5) have potent cytotoxic activities against Daoy, WiDr, KB, and HeLa tumor cell lines. Moreover, low dosage of 5 may induce early apoptosis in KB cells before 12 h.
