Effect of Sparganii Rhizoma-Curcumae Rhizoma-medicated serum on proliferation, apoptosis, and migration of human ectopic endometrial stromal cells: based on JAK2/STAT3 signaling pathway / 中国中药杂志

Based on the Janus kinase 2/signal transducer and activator of transcription 3(JAK2/STAT3) signaling pathway, this study investigated the effect of medicated serum of Sparganii Rhizoma(SR) and Curcumae Rhizoma(CR) on the proliferation, apoptosis, migration, and secretion of inflammatory factors of ectopic endometrial stromal cells(ESCs). Specifically, human ESCs were primary-cultured. The effect of different concentration(5%, 10%, 20%) of SR-, CR-, and SR-CR combination-medicated serum, and AG490 solution(50 μmol·L~(-1)) on the proliferation of ESCs was detected by methyl thiazolyl tetrazolium(MTT) assay, and the optimal dose was selected accordingly for further experiment. The cells were classified into normal serum(NS) group, SR group(10%), CR group(10%), combination(CM) group(10%), and AG490 group. The apoptosis level of ESCs was detected by flow cytometry, and the migration ability was examined by wound healing assay. The secretion of interleukin(IL)-1β, IL-6, and tumor necrosis factor(TNF)-α was determined by enzyme-linked immunosorbent assay(ELISA). The protein levels of cysteinyl aspartate specific protei-nase-3(caspase-3), B-cell lymphoma(Bcl-2), and Bcl-2-associated X protein(Bax) and the levels of phosphorylated(p)-JAK2 and p-STAT3 were detected by Western blot. The results showed that the viability of ESCs cells was lowered in the administration groups compared with the blank serum group(P<0.01), especially the 10% drug-medicated serum, which was selected for further experiment. The 10% SR-medicated serum, 10% CR-medicated serum, and 10% CM-medicated serum could increase the apoptosis rate(P<0.01), up-regulate the protein expression of caspase-3 and Bax in cells(P<0.05 or P<0.01), down-regulate the expression of Bcl-2(P<0.01), decrease the cell migration rate(P<0.05 or P<0.01), and reduce the secretion levels of IL-1β, IL-6, and TNF-α(P<0.05 or P<0.01), and levels of p-JAK2 and p-STAT3(P<0.05 or P<0.01). Compared with the SR and CR groups, CM group showed low cell viability(P<0.01), high protein expression of caspase-3 and Bax(P<0.05 or P<0.01), and low protein expression of Bcl-2 and p-JAK2(P<0.05). After incubation with CM, the apoptosis rate was higher(P<0.05) and the migration rate was lower(P<0.01) than that of the CR group. The p-STAT3 protein level of CM group was lower than that of the RS group(P<0.05). The mechanism of SR, CR, and the combination underlying the improvement of endometriosis may be that they blocked JAK2/STAT3 signaling pathway, inhibited ESC proliferation, promoted apoptosis, weakened cell migration, and reduced the secretion of inflammatory factors. The effect of the combination was better than that of RS alone and CR alone.

Bowel preparation before elective surgery for colorectal cancer / 中华胃肠外科杂志

For elective surgery of colorectal cancer, current evidence supports preoperative mechanical bowel preparation combined with oral antibiotics. Meanwhile, for patients with varied degrees of intestinal stenosis, individualized protocol is required to avoid adverse events. We hereby summarize recent high-quality evidences and updates of guidelines and consensus, and recommend stratified bowel preparation based on the clinical practice of our institute as follows. (1) For patients with unimpaired oral intake, whose tumor can be passed by colonoscopy, mechanical bowel preparation and oral antibiotics are given. (2) For patients without symptoms of bowel obstruction but with impaired oral intake or incomplete colonoscopy due to tumor-related stenosis, small-dosage laxative is given for several days before surgery, and oral antibiotics the day before surgery. (3) For patients with bowel obstruction, mechanical bowel preparation or enema is not indicated. We proposed this evidence-based, individualized protocol for preoperative bowel preparation for the reference of our colleagues, in the hope of improving perioperative outcomes and reducing adverse events.

Interpretation of the 2020 American society of colon and rectal surgeons clinical practice guidelines for the management of rectal cancer / 中华胃肠外科杂志

Located in the pelvic cavity and contiguous to the anal sphincter complex and urogenital organs, the rectum has more intricate anatomical features compared with the colon. Consequently, the treatment of rectal cancer involves more consideration, including pelvic radiation, lateral lymph node dissection, transanal access, postoperative function, sphincter preservation, and nonoperative management. Based on the last set of American society of colon and rectal surgeons (ASCRS) practice parameters for the management of rectal cancer published in 2013, the 2020 guidelines present evidence-based updates for both long-existing and emerging controversies on surgical management of rectal cancer. These updates include the indication for local resection, lymph node dissection for radical proctectomy, minimally invasive surgery, the "watch and wait" strategy for patients with clinical complete response, and prevention of anastomotic leak. Meanwhile, the guidelines recommend a risk-stratified approach for perioperative therapies for non-metastatic disease, and an individualized multimodality treatment based on treatment intent for synchronous metastatic disease.

Effect of tripterygium wilfordii polyglycoside on renal cell autophagy in rats with diabetic nephropathy and its related mechanism / 解剖学报

Objective To investigate the effects of tripterygium glycosides on autophagy of renal cells in rats with diabetic nephropathy and to analyze its molecular mechanism. Methods A rat model of diabetic nephropathy was made by intraperitoneal injection of streptavidin. Thirty SD rats were randomly divided into 5 groups, control group, model group, 0. 1 mg/ kg drug group, 0. 5 mg/ kg drug group and 1. 0 mg/ kg drug group, and each group has 6 rat. After the successful establishment of the diabetic nephropathy model, the 0. 1 mg/ kg drug group, the 0. 5 mg/ kg drug group, and the 1. 0 mg/ kg drug group were intragastric administration with 0. 1, 0. 5, and 1. 0 mg/ kg tripterygium glycosides, respectively, and the control group and the model group were intraperitoneally injected with the same amount of normal saline. The levels of renal function and oxidative stress were compared among groups. The expression levels of p-mammalian target of rapamycin (p-mTOR), mammalian target of rapamycin(mTOR), microtubules associated protein 1 light chain 3β-Ⅱ/ microtubules associated protein 1 light chain 3β-Ⅰ (LC3-Ⅱ/ LC3-Ⅰ) and Beclin1 protein were detected by Western blotting. The expression levels of LC3, LC3-Ⅱ and Beclin1 mRNA in each group were detected by Real-time PCR. Results Compared with the control group, the serum creatinine (Scr), blood urea nitrogen (BUN), protein (Pro) and malondialdehyde (MDA) levels in the model group increased, and the the glutathione peroxidase (GSH-Px) and catalase (CAT) levels decreased significantly (P<0. 05) . Compared with the model group, the Scr, BUN, Pro and MDA levels of the drug group were significantly decreased, and GSH-Px and CAT levels were significantly increased in a dose-dependent manner (P < 0. 05) . Compared with the control group, the expression level of p-mTOR protein in the renal tissue of the model group was increased, and the expression levels of LC3-Ⅱ / LC3-Ⅰ and Beclin1 protein were decreased (P<0. 05) . Compared with the model group, the expression level of p-mTOR protein was decreased in the dose group, and the expression levels of LC3-Ⅱ / LC3-Ⅰ protein in the dose group were significantly increased in a dose-dependent manner (P<0. 05) . The expression levels of Beclin1 protein in the 0. 5 mg / kg drug group and 1. 0 mg / kg drug group, were significantly higher than the model group (P<0. 05) . Compared with the control group, the expression levels of LC3-Ⅱ / LC3-Ⅰ and Beclin1 mRNA in the renal tissue of the model group were significantly lower (P<0. 05) . Compared with the model group, the expression levels of LC3 and Beclin1 mRNA in the drug groups of each dose group were significantly increased (P < 0. 05) . Conclusion Tripterygium wilfordii glycosides can protect kidney function in rats with diabetic nephropathy, and its mechanism might be related to inhibition of oxidative stress and activation of autophagy.

Effect of Action Observation Therapy on Upper Limb Motor Function for Severe Hemiplegics / 中国康复理论与实践

Objective:To explore the effects of action observation therapy on upper limb severe hemiplegia. Methods:From January to June, 2019, 40 patients with severe hemiplegia after stroke were randomly divided into control group (n = 20) and observation group (n = 20). Before routine rehabilitation training, the observation group watched the videos about activities and movements of arms and hands, and then were asked to imagine their affected arms and hands to complete these movements. The control group watched the videos of orderly geometric figures, letters and others without body and animals. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Motor Assessment Scale-Upper Extremities (MAS-UE) and modified Barthel Index (MBI) before and four weeks after treatment. Results:The scores of FMA-UE, MAS-UE and MBI improved after treatment (t > 2.854, P < 0.05), and improved more in the observation group than in the control group (F > 4.395, P < 0.05). Conclusion:action observation therapy can further improve upper limb motor function and activities of daily living in patients with severe hemiplegia after stroke.

Pharmacokinetic Study on Notoginsenoside R1 and Ginsenoside Rg1 in Hushen (Ⅲ) Capsules in Rats / 中国中医药信息杂志

Objective To establish a UHPLC-MS/MS method for the determination of notoginsenoside R1 and ginsenoside Rg1 in rat plasma after oral administration of Hushen (Ⅲ) Capsules; To study its pharmacokinetics. Methods SD rats were given Hushen (Ⅲ) Capsules 2 g/kg and then the blood was collected at time point. Digoxin was used as internal standard. The drug concentrations of notoginsenoside R1 and ginsenoside Rg1 in plasma were determined by UHPLC-MS/MS. And the relative pharmacokinetic parameters were calculated by using DAS2.0 software. Results The linear relationship of notoginsenoside R1 and ginsenoside Rg1 was good (r≥0.997 5). The RSD of intra-day and inter-day precision were less than 13.1%. The results of accuracy, recovery and stability met the requirements for the biology sample analysis. For notoginsenoside R1, the pharmacokinetics parameters T1/2, Tmax, Cmaxin the plasma were (7.86±1.69)h, (4.00±1.04)h, (0.23±0.05)mg/L. For ginsenoside Rg1, the pharmacokinetics parameters T1/2, Tmax, Cmaxin plasma were (4.58±0.95)h, (6.00±0.00)h, (0.32±0.03)mg/L. Conclusion The established UHPLC-MS/MS method is sensitive, accurate and reliable, and is suitable for the pharmacokinetic study of Hushen (Ⅲ) Capsules.

Nasal resorption of prim-O-glucosylcimifugin and 5-O-methylvisammioside in rats / 中国中药杂志

In this experiment, rat nasal mucosa absorption characteristics of prim-O-glucosylcimifugin and 5-O-methylvisammioside were studied to provide a basis for drug delivery of Toutongning nasal spray. The nasal mucosa absorption test in rats was conducted with in situ nasal perfusion method after pH 6 buffer solution was used to prepare high, medium and low concentrations of prim-O-glucosylcimifugin, 5-O-methylvisammioside mixed solution as liquid circulation in nasal cavity. Then the concentrations of the circulating liquid compositions to be measured were determined by HPLC, and the absorption rates of prim-O-glucosylcimifugin and 5-O-methylvisammioside under different pH conditions were also investigated. According to the results, the absorption rate constant was (0.588±0.041)×10⁻³, (0.547±0.023)×10⁻³, (0.592±0.063)×10⁻³ min⁻¹ for prim-O-glucosylcimifugin high, middle and low concentrations, and (0.438±0.041)×10⁻³, (0.407±0.023)×10⁻³, and (0.412±0.063)×10⁻³ min⁻¹ for 5-O-methylvisammioside high, middle and low concentrations. There was no significant difference among high, middle and low concentration groups, and the absorption under pH 6 was better than that under other pH conditions. Therefore, we can get the conclusion that the main active ingredient of Toutongning nasal sprays can be absorbed through the nasal mucosa, and it is feasible to make nasal spray; in addition, pH 6 of nasal spray is scientific and reasonable.

Effect of intermittent pneumatic compression on coagulation function and deep venous hemodynamics of lower limbs after rectal cancer resection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of intermittent pneumatic compression (IPC) on coagulation function, deep venous hemodynamics and prevention of deep venous thrombosis (DVT) of lower limbs in patients after rectal cancer resection.</p><p><b>METHODS</b>A total of 120 patients undergoing rectal cancer resection were randomly divided into non-IPC group (control group, n=60) and IPC group (n=60). The control group received routine treatment after resection and the IPC group received IPC based on the routine treatments. Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), international normalized ratio (INR) and volume of D-dimer (D-D) were detected before operation and 1-, 3-, 5- and 7-day after operation. Meanwhile, blood flow velocity and caliber of external iliac vein, femoral vein and popliteal vein were examined by color Doppler ultrasound, then the average blood flow velocity and blood flow volume were calculated.</p><p><b>RESULTS</b>Incidence of lower limb DVT was 13.3% (8/60) and 1.7% (1/60) in control group and IPC group respectively with significant difference (P<0.05). The differences in PT, APTT and INR were not significant (P>0.05) at 1-day after operation as compared to the preoperative level, while FIB and D-D both increased (P<0.05), all presented no significant difference among the two groups (P>0.05). PT shortened gradually (P<0.05), APTT and INR did not change significantly (P>0.05), FIB and D-D increased gradually (P<0.05), and no significant differences were found between the two groups at the same time point (all P>0.05). All the above parameters in the control group were significantly lower than those in IPC group (all P<0.05).</p><p><b>CONCLUSIONS</b>IPC can improve hemodynamics indexes of deep veins of lower limb in patients after rectal cancer operation, and prevent the lower limb DVT. IPC is a safe, simple and convenient physical therapy.</p>

A multi-center, randomized, double-blind, placebo-controlled trial of glyceryl trinitrate ointment in the treatment of anal fissure / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and safety of glyceryl trinitrate (GTN) ointment in the treatment of anal fissure.</p><p><b>METHODS</b>In this multi-center, randomized, double-blind and placebo-controlled trial, 240 chronic anal fissure patients from 7 clinical centers were randomized to receive eight-week treatment with GTN ointment (treatment group) or vaseline ointment (control group) respectively. Healing rate, visual analogue score (VAS), maximum anal resting pressure (MARP) and adverse reactions were recorded and compared.</p><p><b>RESULTS</b>A total of 221 patients (92.1%) finished the trial, including 114 patients in treatment group (95.0%, 114/120) and 107 in control group (89.2%, 107/120). At the endpoint of treatment (56 d), 90 patients in treatment group (78.9%, 90/114) healed completely compared to 31 patients in control group (29.0%, 31/107), and decrease rates of VAS in the two groups were (94.8±15.7)% and (61.2±35.7)% respectively, both differences were statistically significant (P<0.01). MARP after first administration was (20.2±18.5) mm Hg in treatment group (n=12) and (7.1±14.7) mm Hg in control group (n=6), which was not significantly different (P=0.152). Adverse reaction incidence was higher in treatment group (42.1% vs. 9.3%, P<0.05), while these adverse reactions were mainly headache and fullness in head, which were self-limiting.</p><p><b>CONCLUSION</b>GTN ointment can effectively promote healing and relieve pain in anal fissure with safety and tolerance.</p>

Correlation study of risk of tumble with gradings in patients with leukoaraiosis / 中华神经医学杂志

Objective To explore the correlation of risk of tumble with gradings in patients with leukoaraiosis.Methods One hundred patients with leukoaraiosis,admitted to our hospital from June 2010 to June 2012,were selected as an observation group; another 100 elderly controls accepted physical examinations in our physical examination center at the same period were also selected.All subjects from the observation group underwent head CT or MRI examination to compare the cerebral white matter.The Berg balance scale was used to evaluate the ability of balance and divided into poor balance (0-20 scores),balance (21-40 scores) and better balance (41-56 scores).Results In the observation group,the proportion of poor balance and balance patients was averagely higher than that of control group; and the ratio of better balance function was lower than the control group.About the Berg balance scale scores with less than 40,the observation group was higher than that of the control group (P＜0.05).Spearman rank correlation analysis showed a positive correlation between leukoaraiosis grading and balance dysfunction (Ts=0.790,P=0.000).Conclusion Senile leukoaraiosis patients have different degrees of balance dysfunction and the higher leukoaraiosis degrees they have,the severer of balance dysfunction they will get.

Treatment of hyperlipoidemia by xiaozhi capsule: a clinical efficacy research / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the clinical effect and efficacy of Xiaozhi Capsule (XZC), a Chinese medicine preparation for tonifying Gan-Shen, invigorating Pi to dissipate dampness (TGSIPDD) on total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and endothelin (ET) in treating patients with hyperlipidemia.</p><p><b>METHODS</b>Totally 120 primary hyperlipidemia patients were randomly assigned to the treatment group (80 cases) and the control group (40 cases). Those in the treatment group took XZC, while those in the control group took Xuezhikang Capsule (XZKC). The serum TC, TG, HDL-C, LDL-C, and ET were detected and evaluated after 8 weeks of treatment.</p><p><b>RESULTS</b>In the treatment group TC was reduced by 25.60%, TG by 33.70%, LDL-C by 32.90%, and ET by 11.02%, while HDL-C was elevated by 24.20%. In the control group, TC was reduced by 24.80%, TG by 33.50%, LDL-C by 31.30%, and ET by 12.05%, while HDL-C was elevated by 20.90%. There was statistical difference in the two groups when compared with before treatment (P < 0.01). But there was no statistical difference in the aforesaid indices between the two groups after treatment (P > 0.05). The integrals for main symptoms after treatment obviously decreased in the two groups, showing statistical difference when compared with before treatment in the same group (P < 0.01). But there was no statistical difference in the aforesaid indices between the two groups (P > 0.05). After 8 weeks of treatment, symptoms such as vertigo, heavy sensation of head, palpitation, chest distress, dry mouth and thirsty were obviously improved after treatment. There was statistical difference in the improvement of tinnitus after treatment in the treatment group (P < 0.01). The total effective rate was 86.25% in the treatment group and 82.50% in the control group, showing no statistical difference (P > 0.05).</p><p><b>CONCLUSIONS</b>XZC showed certain effects on each blood lipid index and ET of hyperlipidemia patients. It had better improvement of clinical symptoms with reliable efficacy.</p>

Therapeutic role of bone marrow mononuclear cells in cerebral infarction through autologous transplantation / 中华神经医学杂志

Objective To investigate the therapeutic role of autologous bone marrow mononuclear cells (BM-MNCs) in cerebral infarction by detecting the infarct volume, integrity of blood-brain barrier (BBB) and functional recovery in rats with middle cerebral artery occlusion (MCAO).Methods Seventy-two adult male SD rats were randomly divided into sham-operated group, vehicle group,normal saline treatment group and BM-MNC treatment group.MCAO in rats of the later 3 groups was induced by occlusion of the right middle cerebral artery using an intra luminal filament technique.BM-MNCs,selected from their femur,were isolated with gradient centrifugation,and the proportion of CD45 + cells was detected by flow cytometry before infusion.BM-MNCs were re-injected by jugular vein infusion.Infarct volumes were determined with 2,3,5-triphenyltetrazolium chloride (TTC) staining; the content of Evans blue and brain water content were detected to evaluate the damage of BBB; in addition,neurological deficits were also assessed by Zea-Longer tests. Results Flow cytometry revealed that the proportion of CD45 +cells in BM-MNCs was 91.2％.The infarct volumes,contents of Evans blue and brain water in rats of BM-MNC treatment group were significantly decreased as compared with those in rats of the normal saline treatment group and vehicle group (P＜0.05); however,no significant difference of those was noted between rats of the normal saline treatment group and vehicle group (P＞0.05).Except for the sham-operated group, all the other rats had neurological deficits of varied degrees; the neurological deficits in rats of the BM-MNC treatment group were obviously improved as compared with those in rats of the vehicle group and normal saline treatment group (P＜0.05). Conclusion The separation of BM-MNCs is simple; BM-MNCs can significantly reduce the extent of brain injury and promote recovery of neurological function in rats with cerebral infarction,which indicate that BM-MNCs may have high therapeutic value in cerebral infarction.

Proteomic study on serum of asymptomatic children with Wilson's disease / 中华神经医学杂志

[Objective]To search the serum specific biomarkers in asymptomatic patients with Wilson's disease (WD).[Methods]Twenty asymptomatic children with WD,admitted to our hospital from July 2006 to October 2011,and 13 healthy controls were chosen in our study;redundant proteins in the serum of these patients were dislodged by multiple affinity removal colunms (MARC);using two-dimensional gel electrophoresis (2-DE) and auxiliary laser desorption matrix ionization time-of-flight mass spectrometry (MALDI-TOF-MS),we compared the serum protein profiles;Western blotting was employed to detect the expression of differentially expressed proteins.[Results] Fourteen spots (5 up-regulated ones:spots 4-7 and spot 9,and 9 down-regulated ones:spots 1-3,spot 8 and spots 10-14) in WD patients were differentially expressed as compared with those in normal controls on 2-DE.Among them,spots 1 and 3,spot 8 and spot 11 were down-regulated in both male and female WD;and MS/MS analysis revealed that spot 2,sopts 1 and 3,and spot 1 1 were complement component C3,complement factor B and alpha-2 macroglobulin,respectively;Western blotting indicated that the expressions of complement component C3,complement factor B and alpha-2 macroglobulin in WD patients were decreased as compared with those in the controls.[Conclusion] Complement component C3,complement factor B and alpha-2 macroglobulin might turn out to be good candidates for novel diagnostic biomarkers for early stages of WD.

Relationship between levels of Annexin A1, lipoprotein-associated phospholipase A2 and Bax and human carotid atherosclerotic plaques / 中华神经医学杂志

Objective To investigate the correlation between levels of Annexin A1,Bax and lipoprotein-associated phospholipase A2 (Lp-PLA2) and both formation and stability of human carotid atherosclerotic plaques.Methods Forty-five specimens from patients with carotid atherosclerotic plaques (test group,group A),admitted to our hospital from May 2010 to June 2011 and performed carotid endarterectomy (CEA),and 20 specimens from patients with mesenteric artery and 20 healthy subjects (control groups,group B and group C,respectively) were collected in our study.The carotid atherosclerotic plaque specimens were divided into soft plaque group A1 (n=15),mixed plaque group A2 (n=15) and hard plaque group A3 (n=15) according to the results of carotid artery ultrasound.The Lp-PLA2 level in group A and group C was measured by enzyme linked immunosorbent assay (ELISA),and the mRNA and protein expressions of Annexin A1 and Bax in group A and group B were determined by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting.Results The level of Lp-PLA2 in all patients with carotid atherosclerotic plaques was significantly increased as compared with that in group C (P＜0.05); that in group A1 was significantly higher than that in group A3 (P＜0.05).The mRNA and protein expressions of Annexin A1 and Bax in all patients with carotid atherosclerotic plaques were significantly increased as compared with those in group B (P＜0.05); group A1 exhibited lower mRNA and protein expressions of Annexin A1 than group A3 (P＜0.05),while group A1 exhibited higher mRNA and protein expressions of Bax than group A3 (P＜0.05).Conclusion Annexin A1,Lp-PLA2 and Bax participate in the formation and stability of human carotid atherosclerotic plaques.

Association between polymorphisms of gamma-aminobutyric acid B receptor 1 gene and prodynorphin promoter region gene and epilepsy secondary to cerebral infarction / 中华神经医学杂志

Objective To investigate the relationship between the polymorphisms of gamma-aminobutyric acid B receptor 1 (GABABR1) gene (G1465A) and prodynorphin (PDYN) promoter region gene and epilepsy secondary to cerebral infarction in Han population.Methods Sixty-seven patients with epilepsy secondary to cerebral infarction,93 patients diagnosed as having cerebral infarction without epilepsy and 104 healthy volunteers were selected in our hospitals from July 2010 to August 2011.EDTA-blood specimens were collected from test objects.DNA samples were extracted with column chromatography.The polymorphism of GABABR1 (G1465A) gene was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique,and the polymorphism of PDYN gene promoter region was detected by PCR technique.Results Only genotype G/G was observed in the three groups without noting genotypes A/G and A/A in our study.The frequency of L/L genotype in patients with epilepsy secondary to cerebral infarction (76.1％) was slightly higher than that in patients with cerebral infarction without epilepsy (73.2％) and normal control group (73.1％) without significant difference (P＞0.05).The frequency of L allele in patients with epilepsy secondary to cerebral infarction,patients with cerebral infarction without epilepsy and normal control group was 85.8％,85.5％ and 84.6％,respectively,without significant difference (P＞0.05).Conclusion There may be no association between the polymorphisms of GABABR1 (G 1465A) gene and PDYN promoter region gene and epilepsy secondary to cerebral infarction in Han population.

Meta-analysis of efficacy and safety on neoadjuvant therapy for rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To assess the value of neoadjuvant therapy for resectable rectal cancer and the impact on postoperative complications.</p><p><b>METHODS</b>Literature search was performed in PubMed, Ovid, Web of Science, Springer-Link and Elsevier ScienceDirect for randomized controlled trials published before May 2010 that compared neoadjuvant therapy with surgery alone or postoperative adjuvant therapy. The computer search was supplemented with hand search of reference lists for available primary studies. Inclusion criteria and quality assessment were performed.</p><p><b>RESULTS</b>Eleven studies including 7407 patients were enrolled for analysis. Neoadjuvant therapy group had significant advantages in local recurrence (OR=0.43, 95%CI:0.37-0.50, P<0.01), distant recurrence (OR=0.85, 95%CI:0.76-0.95, P<0.01), 5-year overall survival (RR=1.15, 95%CI:1.04-1.28, P<0.01), and sphincter-saving surgery (RR=1.48, 95%CI:1.17-1.87, P<0.01). There were no significant difference in postoperative mortality rate(OR=1.20, 95%CI:0.68-2.13, P=0.53) and anastomotic complications (OR=1.04, 95%CI:0.73-1.48, P=0.84).</p><p><b>CONCLUSION</b>Neoadjuvant therapy improves local control, distant recurrence and long-term survival without increasing postoperative complications.</p>

Lymph nodes distribution and metastatic pattern of ultra-low rectal cancer after neoadjuvant therapy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the lymph nodes distribution and metastatic pattern of the ultra-low rectal cancer after neoadjuvant therapy.</p><p><b>METHODS</b>A total of 21 rectal cancer gross specimen after neoadjuvant therapy and 23 rectal cancer gross specimen without neoadjuvant therapy were investigated by whole mount section and tissue microarray techniques with CK20. All the patients were treated by abdominoperineal resection.</p><p><b>RESULTS</b>There were 138 lymph nodes retrieved from the mesorectum in the neoadjuvant group including 39 metastatic lymph nodes and 12 micro-metastatic lymph nodes. Among these nodes, there were 7 rectal cancer cases with lymph nodes and 2 cases with micro-metastatic lymph nodes, and 6 cases had pathological complete remission. There were 415 lymph nodes retrieved from the mesorectum in the group without neoadjuvant therapy including 169 metastatic lymph nodes and 59 micro-metastatic lymph nodes. Among these nodes, there were 12 rectal cancer cases with lymph nodes and 4 cases with micro-metastatic lymph nodes. The proportions of metastatic lymph nodes in outer zone between the two groups were 21.5% and 29.0%, and those in pre-zone were 17.6% and 17.2% respectively. The ratio of metastatic lymph nodes in ischiorectal fossa between the two groups were 25.0% vs. 22.2% respectively. The rate of metastatic or micro-metastatic lymph nodes cases between the two groups were 4.8% vs. 13.0% respectively.</p><p><b>CONCLUSIONS</b>The lymph nodes distribution and metastatic pattern of the ultra-low rectal cancer are affected by neoadjuvant therapy. The proportions of the anal sphincter invasion and metastatic or micro-metastatic lymph nodes in ischiorectal fossa are lower after neoadjuvant therapy. Abdominoperineal resection as the standard treatment of the ultra-low rectal cancer after neoadjuvant therapy should be re-evaluated.</p>

Current status of the treatment of colorectal cancer in China--development and limitations / 中华胃肠外科杂志

There is a significant gap between China and the optimal international level in terms of the treatment outcomes of colorectal cancer. In recent years, progresses have been made while limitations still exist in the management of colorectal cancer. Advances are seen including use of multi-disciplinary therapy, neoadjuvant chemoradiation, laparoscopic surgery and management of liver metastasis. Individualized therapy is also applied in colorectal cancer. However, randomized controlled trials based on Chinese population are still lacking. Radiation therapy is inadequate and standardization of surgical technique is to be improved. Although standardization of management of colorectal cancer has gained attention from the government, there is a long way to go. The establishment of subspecialty training and practice has not been satisfactory. National efforts are needed to improve the treatment outcomes of colorectal cancer in China.

Efficacy and safety of domestic biofragmentable anastomotic ring in the intestinal anastomosis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and safety of the domestic biofragmentable anastomotic ring (BAR) from Hangzhou in the intestinal anastomosis.</p><p><b>METHODS</b>A total of 134 patients who underwent intestinal anastomosis from February 2010 to April 2011 in the First Municipal People's Hospital of Guangzhou and the First Affiliated Hospital of Zhejiang University were randomized into two groups. The Valtrac BAR from USA was employed in the control group while the experimental group used domestic BAR. The operative performance of the BARs, as well as the patients vital signs and bowel function, complications, fragmentation status of the rings were compared between two groups.</p><p><b>RESULTS</b>No significant difference was found between two groups in the operative performance, the fragmentation status of the BARs, the temperature, blood pressure, heart rate, and bowel function (P>0.05).</p><p><b>CONCLUSION</b>The domestic BAR possesses similar safety and efficacy with the Valtrac BAR in intestinal anastomosis.</p>

Meta-analysis of safety and efficacy of self-expending metallic stents as bridge to surgery versus emergency surgery for left-sided malignant colorectal obstruction / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of self-expending metallic stents (SEMS) as bridge to surgery versus emergency surgery for left-sided malignant colorectal obstruction.</p><p><b>METHODS</b>A comprehensive literature search of CENTRAL, PubMed, EMBASE, Medline, Ovid LWW, CMB, CNKI and Wanfang Databases were performed for all randomized controlled trials or retrospective studies comparing self-expending metallic stents as bridge to surgery(SABS group) with emergency surgery (ES group). A meta-analysis was carried out by RevMan5.1 software on the outcomes concerning safety and efficacy of the two groups.</p><p><b>RESULTS</b>Fourteen studies matched the criteria including 1083 patients. Five were randomized controlled trials and nine were retrospective analysis. Compared with the ES group, the SABS group had a lower short-term mortality(RR=0.52, 95% CI:0.30-0.93, P<0.05), lower overall complications(RR=0.46, 95% CI:0.31-0.70, P<0.05), higher resection rate(RR=1.90, 95%CI:1.33-2.70, P<0.01), shorter operative time(MD=-59.77, 95%CI:-87.51--32.04, P<0.01), and shorter interval to first flatus(MD=-10.78, 95%CI:-16.67--4.90, P<0.01). There were no statistically significant differences between the two groups in permanent stomy and hospital stay.</p><p><b>CONCLUSION</b>The safety and efficacy of self-expending metallic stents as bridge to surgery for left-sided malignant colorectal obstruction is superior to emergency surgery.</p>