【Abstract】ObjectiveTo investigate the effects of endogenous photodynamic therapy (PDT) on intracellular cAMP and cGMP concentrations of human colon carcinoma cell lines SW480. MethodsSW480 cells were divided into control group, light group, δaminolevulinic acid （ALA） group (ALA group) and endogenous PDT group (ALAPDT group). Intracellular cAMP and cGMP concentrations of each group were detected by radioimmunoassay at 30, 60, 90 and 120 min after irradiation. ResultsThere was a significant increase in intracellular cAMP concentration of ALAPDT group at 30 min after irradiation (P＜0.001) and sequent decrease, but intracellular cAMP concentrations of ALAPDT group at 60, 90 and 120 min after irradiation had no statistical difference than the other groups (Pgt;0.05). Intracellular cGMP concentration of different time point of each group was not significantly different. ConclusionThese results indicate that the cytoprotection of SW480 cell are produced by an instantaneous increase in the intracellular cAMP concentration while endogenous PDT is killing SW480 cell.
Objective To observe effects of enhanced recovery after surgery (ERAS) technique on stress indicators in patients undergoing laparoscopic rectal cancer surgery. Methods One hundred and twenty patients underwent laparoscopic rectal cancer surgery (Dixon) in the Xinqiao Hospital of the Third Military Medical University were included in this study and then were randomly divided into an ERAS group (n=60) and a conventional treatment group (n=60). The patients in the ERAS group were treated with an ERAS concept during the perioperative period. The patients in the conventional treatment group were treated with a traditional treatment concept during the perioperative period. The stress indicators including white blood cell count (WBC) and C-reactive protein (CRP) and interleukin (IL)-6 levels were compared in the two groups at admission, 1 h before operation, and 24 h, 48 h, and 72 h after operation. The first postoperative anal exhaust time, the first postoperative defecation time, the total hospitalization time, and readmission rate were also recorded after operation. Results ① The age, gender, tumor diameter, and TNM stage had no significant differences in these two groups (P>0.05). ② There were no significant differences in the WBC, CRP and IL-6 levels at admission and 1 h before operation between the two groups (P>0.05). The levels of CRP, IL-6, and WBC in the ERAS group were significantly lower than those in the conventional treatment group at 24 h, 48 h and 72 h after operation (P<0.05). ③ The first postoperative anal exhaust time, the first postoperative defecation time, and the total hospitalization time in the ERAS group were significantly shorter than those in the conventional treatment group (P<0.05). There was no significant difference in readmission rate between the two groups (P<0.05). Conclusion ERAS concept is helpful in reducing stress response and could promote earlier recovery of patients with rectal cancer.
Objective To explore effect of enhanced recovery after surgery (ERAS) on maintaining homeostasis of patient body and role of ERAS in alleviating stress response of physiological and psychological of patient and promoting recovery of patient from operative trauma as soon as possible. Method The related literatures published at home and abroad about the ERAS and its influence on the perioperative stress degree of patient were reviewed and analyzed. Results The ERAS was a new perioperative management mode established under the guidance of evidence-based medicine, whose core was to reduce the perioperative physiological and psychological stress level of the patient through a series of optimized measures, and to promote the postoperative rehabilitation. At the same time, the ERAS had been more and more widely accepted by the surgeons and patients because of its unique advantages, especially in shortening the hospital stay and reducing the operating costs. Conclusions Although concept of ERAS is not yet accepted by most clinicians, ERAS does provide a more optimal perioperative management strategy for patient, could obviously reduce perioperative stress level, improve patient outcome, accelerate postoperative recovery of patient, and provide benefit for patient underwent surgery.
ObjectiveTo understand the current evaluation methods and treatment progress of low anterior resection syndrome (LARS) after rectal cancer surgery.MethodThe recent literatures on the progress of LARS studies were reviewed.ResultsThe occurrence mechanism of LARS was closely related to the function state of anus before operation, the nerve and muscle injuries around the anus and rectum during the operation, as well as the new rectal volume and compliance. For this symptom group, there were various clinical evaluation methods, including the various quality of life score scales, fecal incontinence related scales, LARS score scale, anorectal pressure measurement, and imaging examination of anal sphincter, etc. The treatment included the anal lavage, comprehensive rehabilitation training, sacral nerve stimulation, traditional Chinese medicine therapy, and other treatment methods.ConclusionLARS might be prevented or alleviated through accurately preoperative evaluation, standardized and reasonable surgery and adjuvant therapy, and effective postoperative intervention.
目的 探讨胃大部切除术中应用直线型切割缝合器的临床经验及优点。方法 总结直线型切割缝合器的使用方法，并比较分析传统胃大部切除术和采用直线型切割缝合器行胃大部切除术的手术时间和术后并发症。结果 使用直线型切割缝合器使手术时间缩短60～120 min (P=0.000)，术后出血并发症明显减少(P=0.024)。结论 应用直线型切割缝合器行胃大部切除术可以缩短手术时间和减少术后出血的发生。
目的 总结手助式腹腔镜结肠癌根治术的临床经验。方法 回顾性分析我科2002年7月至2007年5月期间40例采用手助式腹腔镜结肠癌根治术治疗的结肠癌患者的临床资料。结果 40例手术均获成功，无中转开腹手术，无死亡病例。全部患者均未发生切口感染、吻合口漏、肠梗阻等并发症。随访0.5~4.0年，平均2.8年，未见肿瘤复发。结论 对于肿块直径大于5 cm的结肠癌患者采用手助式腹腔镜实施结肠癌根治术，可以保证手术的安全性和有效性。
ObjectiveTo systematically review the efficacy of percutaneous cannulated screw (PCS) versus plate fixation (PF) in the treatment of ankle fractures. MethodsThe Cochrane Library (Issue 5, 2014), PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were searched up to May 28th 2014, for studies concerning the efficacy of percutaneous cannulated screw versus plate fixation for ankle fractures. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed by using RevMan 5.1 software. Result A total of 10 studies (3 RCTs and 7 CCTs) involving 627 patients were included. The results of meta-analysis showed that:compared with the PF group, the PCS group was superior in time of the operation (RCT:MD=-6.78, 95%CI -11.95 to -1.60, P=0.01; CCT:MD=-9.76, 95%CI -13.68 to -5.84, P<0.000 01), blood loss during the operation (RCT:MD=-36.14, 95%CI -40.02 to -32.17, P<0.000 01; CCT:MD=-34.80, 95%CI -37.78 to -31.81, P<0.000 01) and the time of the fracture healing (RCT:MD=-1.16, 95%CI -1.51 to -0.81, P<0.000 01; CCT:MD=-1.55, 95%CI -2.97 to -0.13, P=0.03); However, there were no statistical differences between the two groups in complication rate (CCT:OR=0.48, 95%CI 0.08 to 2.81, P=0.41), AOFAS score excellent rate (RCT:OR=2.11, 95%CI 0.81 to 5.49, P=0.12; CCT:OR=1.58, 95%CI 0.75 to 3.30, P=0.23), and postoperative malleolus pain rate (CCT:OR=0.68, 95%CI 0.00 to 148.82, P=0.89). ConclusionCurrent evidence shows that PCS is superior to PF in shorting time of the operation, reducing blood loss during the operation, and shorting time of the fracture healing. However, the complication rate, AOFAS score excellent rate, and postoperative malleolus pain rate are similar for each operation. Due to the quality limitation of the CCTs, the conclusion are needed to be verified by more high quality RCTs in future.
Objective To summarize clinical diagnosis and treatment of 1 case of hypothyroidism complicated with postoperative gastroparesis syndrome (PGS) after radical resection of right colon cancer. Method The multi-disciplinary (MDT) mechanism was used to discuss the MDT consultations of the departments of general surgery, endocrinology, nutrition, radiology, and pathology in a patient with hypothyroidism and right colon cancer after the radical resection. Results The MDT discussion concluded that the patient had a clear diagnosis of right colon cancer before the surgery, and the PGS occurred after the radical resection of right colon cancer. The patient had the hypothyroidism before the operation, and the occurrence of PGS might be related to the hypothyroidism. The experts of MDT recommended to treat with the thyroxine sodium and nutritional support treatment after the surgery. According to the results of the MDT discussion, the patient’s PGS was gradually cured and discharged smoothly after the thyroxine supplementation and nutritional support. Conclusions Hypothyroidism may be a risk factor for occurrence of PGS after radical resection of right colon cancer. MDT mechanism can provide an individualized optimal treatment for patients with hypothyroidism complicated with PGS after radical resection of right colon cancer and benefit these patients.