Outcome of a modified Park's submucosal hemorrhoidectomy versus Milligan-Morgan for grade III-IV circumferential prolapsed hemorrhoids.

BACKGROUND: This prospective randomized controlled study compared the short- and long-term efficacy and advantages of modified Park's submucosal over Milligan-Morgan hemorrhoidectomy (MMH) in the treatment of grade III and IV circumferential prolapsed hemorrhoids (CPH). METHODS: A total of 186 consecutive patients with grade III or IV CPH were enrolled. The patients were randomized to MPSH (n = 93) or MMH (n = 93) treatment groups. Patient data included demographics, clinical characteristics, surgical parameters, underlying or arising complications, and CPH recurrence. The patients were closely followed up for at least 24 months. RESULTS: The patient demographic data and clinical parameters were comparable in the two groups (P > 0.05). MPSH took significantly longer operative time (P < 0.05). Although there was no significant difference in mean postoperative pain between the two groups at days 3 and 14, pain at day 7 was significantly more frequent and severe in the MMH group (P < 0.05). There were no significant group differences in postoperative bleeding, intraoperative blood loss, or development of anal stenosis (P > 0.05). However, the cumulative relapse-free rate was substantially higher in the MPSH group (P < 0.05). CONCLUSION: MPSH and MMH are both practical and safe techniques for treating grade III and IV CPH disease. However, MPSH is safer, easier, and faster to perform and is associated with fewer recurrences within 24 months of surgery. Additional clinical studies are needed to validate these conclusions.

Effects of oligosaccharides on particle structure, pasting and thermal properties of wheat starch granules under different freezing temperatures.

The effects of fructooligosaccharides (FOS), galactooligosaccharides (GOS), and xylooligosaccharides (XOS) on gelatinization, retrogradation, thermal properties and particle size of wheat starch at different freezing temperatures were studied. The results showed that the wheat starch porosity, particle size, peak viscosity increased with increasing freezing temperature. With the addition of 16% oligosaccharides to starch, the porosity, particle size, crystallinity, initial gelatinization temperature, peak value, breakdown and retrogradation viscosity of the starch granules significantly decreased in the order of XOS > GOS > FOS. However, the pasting temperature of the granules increased. The addition of oligosaccharides (especially XOS, which has the most significant effect in inhibiting starch retrogradation) can inhibit the formation of starch crystal structures to a certain extent, reduce the damage from ice crystals to starch granules and delay starch retrogradation. Therefore, functional oligosaccharides can be used as a potentially effective additive to increase freezing stability in frozen starch-based foods.

Novel recombinant immunotoxin of EGFR specific nanobody fused with cucurmosin, construction and antitumor efficiency in vitro.

Epidermal growth factor receptor (EGFR) overexpression is related to the increased aggressiveness, metastases, and poor prognosis in various cancers. In this study, we successfully constructed a new EGFR nanobody-based immunotoxin rE/CUS containing cucurmosin (CUS), The immunotoxin was expressed by prokaryotic system and we obtained a yield of 5 mg protein per liter expression medium. The percentage of it's binding ability totumor cell lines A549, HepG2, SW116, which highly expressed EGFR was 55.6%, 79.6% and 97.1%, respectively, but SW620 was only 4.45%. rE/CUS has the ability to bind A549, HepG2, SW116 cells specifically, and the antigen binding capability was not affected because of extra part of CUS component. The rE/CUS significantly inhibited the cell viability against EGFR over expression tumor cell lines in a dose-and time-dependent manner. Moreover, rE/CUS also induced apoptosis of HepG2 and A549 mightily. Our results demonstrate that rE/CUS is a potential therapeutic strategy for treating EGFR-positive solid tumors.