Objective To study the application of ultracision harmonic scalpel in laparoscopic radical gastrectomy. Methods Ten patients with gastric cancer were given laparoscopic-assisted radical gastrectomy by using ultracision harmonic scalpel. Results All operations were successfully performed with ultracision harmonic scalpel, and none of which converted into open surgery. The operation time was 300-492 min, mean (385±64) min. The blood loss was 100-500 ml, mean (401±70) ml. The number of harvested lymph nodes was 21-43, mean 31±6. The time for gastrointestinal function recovery was 3-6 d, mean (4.2±1.0) d. The time of patients’ taking out-of-bed activity was 3-７ d, mean (4.5±1.3) d. The time of taking liquid food was 4-６ d, mean (5.0±0.9) d. No case had relapse or metastasis after 4-20 months (mean 12.6 months) of follow-up. Conclusions Laparoscopic radical gastrectomy by using ultracision harmonic scalpel is safe and feasible. Ultracision harmonic scalpel has the advantage of minimal invasion, less bleeding and shorter operation time, which is a very important equipment and useful for laparoscopic gastrointestinal surgery.
【Abstract】ObjectiveTo study the specific cytotoxicity of amygdalin(a new prodrug) to LoVo cells in antibody directed enzyme prodrug therapy (ADEPT). MethodsThe specific activation of amygdalin by anti-CEA McAb-β-glucosidase conjugate and the cytotoxicity of amygdalin to LoVo cells were assessed throughTrypan blue exclusion. ResultsThe cytotoxicity of amygdalin itself to LoVo cells was low. However, when amygdalin was combinated with anti-CEA McAb-β-glucosidase conjugate, its cytotoxic effect was enhanced by nearly 40 times, and that effect was specific to to LoVo cells expressing CEA . When LoVo cells and MCF-7 cells were co-cultured in various ratios, the cytotoxic effect of amygdalin combinated with anti-CEA McAb-β-glucosidase conjugate was measured. The survival rate of cultured cells decreased while the percentage of LoVo cells increased, suggesting the cytotoxic effect to be specific to LoVo cells. ConclusionThe toxicity of amygdalin is low，and it can be activated by anti-CEA McAb-β-glucosidase conjugate effectively to kill targetd cells specifically which may be a new way for colorectal tumor therapy.
Objective To construct and verify a genetically engineered mouse model which is similar to clinical sporadic colorectal cancer and simultaneously expresses KrasLSL-G12D/- and Smad4loxp/loxp genes. Methods The Krastm4Tyj/J mouse and Smad4tm2.1Cxd/J mouse were transformed into the genetic background, and the genotypes of the offspring mice were identified by the PCR to obtain the mice expressed simultaneously KrasLSL-G12D/- and Smad4loxp/loxp genes. The LentivirusCre-IRES-Luciferase was injected into the submucosa of the model mice and the tumorigenicity was observed under the IVIS system. The tumor tissues of the model mice were sampled and the HE staining was used to verify the tumorigenicity of the model mice. Results The genetically engineered mouse model which could simultaneously express KrasLSL-G12D/- and Smad4loxp/loxp genes was obtained by the breeding and selection. The mouse intestinal epithelial cell carcinogenesis was successfully induced by the viral vector containing Cre recombinase. Conclusion Mouse model expressed simultaneously KrasLSL-G12D/- and Smad4loxp/loxp genes is capable of sporadic tumorigenicity by Cre recombinase and could simulate pathological process of human sporadic colorectal cancer.
Objective To evaluate the real-time contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of retroperitoneal occupying lesions. Methods Thirty patients with retroperitoneal occupying lesions, including 10 benign and 20 malignant lesions, were performed with CEUS, thus describing the perfusion of contrast agent, the entering style of contrast agent and the vascular morphous. And the entering styles were divided into two patterns: peripheral type or central type while the vascular morphous were divided into 4 levels: level 0, level 1, level 2 and level 3. All of these were compared between benign and malignant lesions. Compared the results of diagnosis malignant lesions by common ultrasonography with CEUS. Results 1/5 case of benign substantive lesions presented as contrast agent perfusion defect, and 11/20 cases of substantive malignant lesions presented as contrast agent perfusion defect. 14/20 of malignant lesions were central type; 9/10 of benign lesions were peripheral type (P=0.005 2). In benign lesions, level 0 had 7/10， level 1 had 2/10 and level 3 had 1/10. In malignant lesions, level 0 had 1/20, level 1 had 3/20, level 2 had 8/20 and level 3 had 8/20, too (P=0.000 5). The rate of missed diagnosis was 40.00% and the accuracy was 66.67% by common ultrasonography, while the rate of missed diagnosis was 10.00% and the accuracy was 86.67% by CEUS combined with the entering style of contrast agent and the vascular morphous. Conclusion The CEUS applies a new way to discriminate malignant from benign in retroperitoneal occupying lesions.