Laparoscopic Appendectomy in Pregnancy With Acute Appendicitis: Single Center Experience With World Review.

OBJECTIVES: This clinical study is aiming to discuss the therapeutic benefit of laparoscopic appendectomy (LA) by comparing with conventional open appendectomy (OA) in pregnancy. MATERIALS AND METHODS: The clinical data of 26 pregnant women who underwent appendectomy from 2012 to 2016 was retrospectively analyzed. The variables analyzed included baseline information, operation characteristics, maternal complications, and infant health outcomes. The patients were divided in 2 LA and OA groups according to the surgical approach and their clinical characteristics were compared. RESULTS: Of reported 26 patients, 7 underwent LA whereas the remaining 19 patients underwent OA. The median age of the patients was 28 years (range, 19 to 39 y). The median gestational period was 21.5 weeks (range, 5 to 33 wk). The postoperative pathology showed complicated appendicitis 7 cases. The result showed significantly shorter operation time (42.14±8.63 vs. 65.21±26.58 min, P=0.003), hospital stay (4.14±1.77 vs. 6.47±2.72 d, P=0.021), and earlier recovery of gastrointestinal function in the LA group compared with OA group. There were no maternal and fetal deaths occurred in perioperative period in both groups. CONCLUSIONS: LA has not increased morbidity and mortality but displayed shorter hospital stay, operation time and recovery of gastrointestinal function to OA as well as good cosmetic results. Therefore, LA in patients with pregnancy can be considered as preferred approach in sophisticated hands without increased risks.

Cystatin C is a moderate predictor of acute kidney injury in the early stage of traumatic hemorrhagic shock.

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.

Research on mechanism of GM-CSF secreting liver cancer vaccine on CTL killing activity of transplanted liver cancer mice / 中国生化药物杂志

Objective To study the effect of granulocyte-macrophage colony-stimulating factor ( GM-CSF) secreting liver cancer vaccine on killing activity of cytotoxic T lymphocytes ( CTL) of transplanted liver cancer mice and its mechanism.Methods There were three groups:liver cancer vaccine group (A group), liver cancer group (B group) and PBS group (C group).The transplanted liver cancer model was builded with injection of H 22 hepatoma cells, while the GM-CSF secreting liver cancer vaccine group and PBS group was builded.GM-CSF secreting liver cancer vaccine group and PBS group were establised.The levels of CD8 +T cell in peripheral blood were detected by flow cytometry.The killing activity of cytotoxic T lymphocytes ( CTL) of spleen cells was detected by MTT method.The expression levels of tumor necrosis factor-α( TNF-α) and interferon-γ(γ-INF) were detected by Western blot.Results The flow cytometry results showed that, compared with B group, the levels of CD8 +T cell of A group significantly increased (P<0.01).MTT results showed that, compared with B group, the killing activity of cytotoxic T lymphocytes (CTL) in A group significantly increased (P<0.01).Western blot results showed that, compared with B group, the expression levels of tumor necrosis factor-α(TNF-α) and interferon-γ(γ-INF) in A group significantly decreased (P<0.01).Conclusion GM-CSF secreting liver cancer vaccine can significantly inhibit the activity of H22 cell, and its possible mechanism of action may be to activated CD8 +T expression, improve cytotoxic activity of CTL of spleen cells, and reduce TNF-αand γ-INF protein expression.

Effect of Zinc and Salvia on some whole blood metal ion distribution caused by noise in rats / 国际中医中药杂志

Objective To observe the protective effect of the separate zinc gluconate oral and combined of Salvia injection on whole blood metal ion of calcium,magnesium,iron,copper and zinc concentration in noise-induced rats.Methods 50 female SD rats were randomly divided into a control group,a noise group,a zinc gluconate noise group (plus zinc group),a Salvia injection noise group (plus Salvia group) and a Zinc gluconate oral liquid and Salvia injection noise group (combined group),with10 rats in each group.Except the control group did not expose to noise,the rest groups were continuously exposed to high frequency steady noise for two weeks.Each group was compared for the concentration differences of whole blood metal ion of calcium,magnesium,iron,copper and zinc after the intervention of noise.Results ① In each group at the comparison of the calcium ion concentration: Calcium ion concentration of the control group(1.25± 0.16)mmol/L and the combination group(1.27 ± 0.10) mmol/L was significantly lower than the noise group (1.42 ± 0.18) mmol/L.The rest groups compared to each other were not statistically significant.②Magnesium ion concentration was highest in the noise group (1.53 ± 0.10)rmtmol/L),and lowest in the control group (130 ± 0.29) mmol/L,and the noise group was significantly higher than that of the control group.The mean of magnesium ion concentration in plus zinc group (1.42± 0.27) mmol/L,plus Salvia group (1.38± 0.15) mmol/L and combined group(l.37±0.11)mmol/L were lower than the noise group,but the difference was not significant (P＞0.05).③ The iron ion concentration of the noise group (5.47± 1.29)mmol/L was significantly lower than the other four groups (P＜0.05).The control group,plus zinc group,plus Salvia group,the combined group showed no significant differences.④ Whole blood copper ion concentration of the noise group (16.69 ± 4.18) μmol/L was significantly lower than the control group (21.53 ± 3.78) μmol/L and the combination group(19.53± 1.92)μmol/L with a statistical difference; compared with the control group,the concentration of copper ions in plus zinc group(16.19± 1.93)mμol/L was significantly lower (P＜0.05).⑤The whole blood zinc ion concentration in the noise group (50.83±7.99)μmol/L was significantly lower than the other groups,zinc ion concentration in the plus Salvia group (53.87±6.77)μmol/L was significantly lower than the control group (63.86± 8.83) μmol/L; the whole blood zinc ion concentration showed no difference between the plus zinc group (54.81 ± 5.90) μmol/L,plus Salvia group and combined group (59.21 ± 3.90) μmol/L.Conclusion Combined zinc gluconate oral solution and Salvia injection had protective effect on whole blood metal ion concentration affected by noise.The protection effect of zinc gluconate oral solution and Salvia injection combination was stronger than any individual.