ObjectiveTo investigate the application significance of serum histidine decarboxylase (HDC) and D-lactate for early-stage of strangulated intestinal obstruction in rats. MethodsThirty male Wistar rats were randomly divided into two groups:blank control group (n=10) and experimental group (n=20). Rats of experimental group were established to be strangulated intestinal obstruction model by ligating 4 cm-long ileum, and were divided into obstruction-1 hour group (n=10) and obstruction-3 hour group (n=10) according to the time of intestinal obstruction. Rats of blank control group only underwent sham operation. When intestinal obstruction models were built, the change of pathology in ileum tissue was observed by light microscope. The Park/Chiu scale was used to evaluate the severity of intestinal lesion. At the same time, blood was drawn from the heart to measure the concentration of serum HDC and D-lactate by ELISA method. Real time quantitative PCR was used to detect the expression of HDC mRNA in ileum tissues. ResultsThe median injury score of ileum tissues of rats in blank control group, obstruction-1 hour group, and obstruction-3 hour group were 0 (0-1), 2 (2-3), and 5 (4-5) respectively, and increased in blank control group, obstruction-1 hour group, and obstruction-3 hour group one by one (P<0.01). The median concentrations of serum HDC of rats in blank control group, obstruction-1 hour group, and obstruction-3 hour group were 10.5 pg/mL (4.60-17.18 pg/mL), 87.93 pg/mL (41.33-119.03 pg/mL), and 150.67 pg/mL (67.33-198.14 pg/mL) respectively, and increased in blank control group, obstruc-tion-1 hour group, and obstruction-3 hour group one by one (P<0.05). The median concentrations of serum D-lactate in rats of blank control group, obstruction-1 hour group, and obstruction-3 hour group were 0 ng/mL (0-3.90 ng/mL), 0 ng/mL (0-15.63 ng/mL), and 4.92 ng/mL (0-48.13 ng/mL) respectively, and there was no significant difference among the 3 groups (P>0.05). The median expression levels of HDC mRNA in ileum tissue of rats in obstruction-3 hour group was 7.81 (7.05-8.39), which was significantly higher than those of the obstruction-1 hour group[1.77 (1.74-1.94)] and blank control group[0.97 (0.88-1.15)], P<0.01, but there was no significant difference between obstruction-1 hour group and blank control group (P>0.05). ConclusionsConcentration of serum HDC can be used for early diagnosis of strangulated intestinal obstruction. Serum D-lactate has no significant change at early-stage of strangulated intestinal obstruction.
Objective To investigate the reasonable indication of splenectomy in radical resection for advanced proximal gastric cancer (APGC). Methods Fifty patients with APGC were studied and classified into total gastrectomy with splenectomy (TGS) group (n=18) and total gastrectomy without splenectomy (TG) group (n=32). The operation time, hospitalized duration, complications, and lymphe node metastasis at the spleen hilus were compared between two groups. Results The operation time, hospitalized duration and subphrenic infection rate in the TGS group were significantly higher than those in the TG group (Plt;0.05). The rate of lymph node metasitasis of No.10 and No.11 in the TG group was not different from that in TGS group (Pgt;0.05). Conclusion Direct spleen and its vessel invasion are the reasonable indication of splenectomy in radical resection for APGC.
Objective To evaluate the clinical application of modified Orr Roux-en-Y type digestive tract reconstruction. Methods Thirty-eight patients with gastric cancer were randomly classified into modified group （accepted modified Orr Roux-en-Y type digestive tract reconstruction, 18 cases） and ρ group （accepted ρ type esophagojejunostomy, 20 cases） according to the date of operation. Operative time, blood loss in operation, complications after operation, emptying time of pouch, and change of body weight before and 3 months after operation were compared between two groups. Results Compared with the ρ group 〔(283±35) min〕, the operative time of modified group 〔(229±18) min〕 was significantly shorter （Plt;0.05）. The holo-empyting time of pouch in modified group 〔(35.7±4.9) min〕 was longer than that in ρ group 〔(3.0±0.5) min〕, Plt;0.01. Blood loss in operation, complications after operation, and the body weight change had no statistical difference between two groups （Pgt;0.05）. Conclusion Modified Orr Roux-en-Y type reconstruction with a pouch function is useful in clinical application， which is not only easy to operate, but also can reduce the operative time and the complications.