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Objective:To explore the precise layered and tension-reducing sutures for skin pigmented mole surgery to promote tissue healing and reduce scar hyperplasia.Methods:From January 2019 to December 2021, the First Department of Surgery of the Civil Aviation General Hospital and Tenth Department of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences treated 56 patients with skin pigmented moles aged 18-52 years, with an average age of 26 years, including 30 males and 26 females. All patients in this group underwent surgical resection of skin pigmented moles, which reached the subcutaneous fat layer. The dermis and subcutaneous tissue under the skin incision were precisely buried and guided suture by using the middle common hole equal-chord and equal-arc buried guide suture with scale marks on both ends of the needle tip.Results:The incision width of skin tissue defect in this group of patients was less than 30 mm. After the suturing was completed, the tension between the tissues on both sides of the incision and the close-fitting of each layer of tissue on both sides of the incision without dead space were realized immediately. 55 cases achieved primary incision healing. After two years of follow-up observation, there was no scar hyperplasia, and the effect was satisfactory. In only one case, local incision was red and swollen due to suture reaction, and a small amount of scar hyperplasia appeared later.Conclusions:This submerged guided suture method is an effective surgical technique for reducing skin incision scars, and it is more suitable for small incisions with a skin incision length of less than 10 mm, which is difficult to achieve layered suture of the deep tissue of the incision with ordinary suture needles.
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Objective:To investigate the risk factors of low anterior resection syndrome (LARS)after low anterior resection of rectal cancer (Dixon).Methods:This retrospective study was conducted in Peking University First Hospital and Traditional Chinese Medicine Hospital of Shanxi Provice from Jan 2012 to Jun 2019. A cohort of 504 patients with rectal cancer was enrolled in the study. All the patients underwent anterior resection. The relationship between clinical-pathological data were analyzed retrospectively. Univariate analysis using χ 2 test. Logistic regression analysis was used to screen the influencing factors of LARS, and the Nomogram method was used to score each factors. Results:Univariate analysis showed that BMI≥28 kg/m 2(χ 2=9.450, P=0.002), the distance from the lower edge of the tumors to the anus <6 cm (χ 2=12.070, P=0.001), high ligation of the inferior mesenteric artery (IMA) (χ 2=8.279, P=0.004), preoperative neoadjuvant therapy (χ 2=11.230, P=0.001), postoperative anastomotic leakage (χ 2=11.840, P=0.001) were associated with severe LARS.Multivariate analysis showed that the distance from the lower edge of the tumors to the anus <6 cm ( OR=1.861, 95% CI: 1.289-2.688, P=0.001), BMI≥28 kg/m 2 ( OR=1.747, 95% CI: 1.022-2.987, P=0.041), high IMA ligation ( OR=1.688, 95% CI: 1.157-2.463, P=0.007), preoperative neoadjuvant therapy ( OR=2.719, 95% CI: 1.343-5.505, P=0.005) were independent risk factors for LARS. Nomogram model showed that the total factor ranged from 2 to 212, and the corresponding risk rate ranged from 30% to 80%. The patients with higher score have greater risk for severe LARS. The area under the predictive power curve of Nomogram model (AUC) was 0.749 (95% CI: 0.705-0.793, P<0.001). Conclusion:Lower tumor location, obesity, preoperative neoadjuvant therapy, high IMA ligation and postoperative anastomotic leakage increase the risk of severe LARS.
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Objective: To compare the short-term clinical efficacy and feasibilities between complete mesocolic excision (CME) and tra-ditional radical resection in emergency surgery for patients with colon cancer. Methods: Clinical data for 53 cases of colon cancer treat-ed by emergency surgery between January 2011 and December 2017 in Civil Aviation General Hospital were analyzed. On the basis of the entry time and various operation procedures, the 53 patients were assigned into two groups: the CME group (n=25) that under-went CME in May 2014 or later and the traditional operative group (n=28) that underwent traditional radical resection before May 2014. Distal and proximal colonic and intestinal lavage were performed in all patients. The short-term clinical effects of these different methods were analyzed. Results: The number of excised lymph nodes in the CME group and traditional group was 31.7±2.9 and 19.5± 4.2, respectively, and the difference between the groups was statistically significant (P<0.05). The operation time of the two groups was (176.0±42.3) min and (157.5±33.5) min and the blood loss was (148.7±74.0) mL and (128.9±50.0) mL, respectively. The length of hospital stay of the two groups was (27.2±10.4) days and (23.1±6.3) days and the first flatus time was (75.0±3.3) h and (75.3±3.7) h, re-spectively. The difference between the two groups in these parameters was not statistically significant (P>0.05). In addition, there was no significant differences in pathological staging, postoperative complications, or mortality between the CME group and traditional op-erative group (P>0.05). Conclusions: The short-term clinical efficacy of CME is similar to that of traditional radical cancer surgery with the advantage of more extensive lymph node dissection. CME can be used safely in patients with colon cancer undergoing an emergen-cy operation.
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Objective To investigate the effect of recombinant human growth hormone (rhGH) on rat liver injury with severe acute pancreatitis.Methods Severe acute pancreatitis model was established by injection of sodium taurocholate into the pancreatobiliary duct in 40 male Sprague-Dawley rats.Rats were randomly divided into experiment group (n =20) and control group (n =20).Another 20 male SD rats injected saline served as negative control group.The experiment group were treated with subcutaneously injected rhGH for 3 days,1 U·kg-1 ·d-1.12 h and 24 h after operation,the level of ALT,AST,TNF-α,IL-1 β,SOD,MDA,endotoxin and D-lactate was detected respectively;the degree of live cell apoptosis and pathological score of pancreatic tissue were compared among these groups.Results In comparison with negative control group,the level of ALT,AST,TNF-α,IL-1β,MDA,endotoxin and D-lactate,the liver cell apoptosis index and pathological score of pancreatic tissuc were significantly higher in the control group and experiment group at 12 h and 24 h after operation (P ＜ 0.05).ALT,AST,TNF-α,endotoxin and D-lactate at 12 h and 24 h were significantly lower in the experiment group (P ＜ 0.05).MDA level significantly declined at 12 h and 24 h after operation in experiment group(P ＜ 0.05).Liver cell apoptosis index of the control group was higher than experiment group (P =0.003).Conclusion rhGH pretreatment relieves liver injury in rat with severe acute pancreatitis.
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Objective To study the effect of peroxisome proliferator-activated receptor garama (PPARγ) ligand on hepatic fibrosis in rats. Methods Forty Wistar rats were randomly divided into two groups: the control group(20 rats) ,in which liver cirrhosis was induced by adding 0. 3‰ thioacetamide in the fodder for 6 months, and rosiglitazone group(20 rats) in which 200 ppm of rosiglitazone in combination with 0. 3‰ thioacetamide was added in the fodder. Liver tissue's mRNA expression of PPARγ, TGF-β1 ,type Ⅰ pro-collagen and α-smooth muscle actin(α-SMA) was detected by RT-PCR. The protein expression of PPARγ, TGF-β1 ,type Ⅰ collagen and α-SMA was detected by Western blot. The expression of collagenof liver histological section was evaluated by Van Gieson (VG) staining. Results The expression ofPPARγ at mRNA level significantly increased in rosiglitazone group compared with those in the control group ( t = 6. 93, P < 0. 01 ), while the expression of TGF-β1 ( t = 3. 89, P < 0. 01 ) and type Ⅰ pro-collagen ( t =5.67,P <0. 01 ) were lower than that in the control group. The protein expression of PPARγ, TGF-β1 and type Ⅰ collagen was in similar tendence with that of mRNA expression. The expression of α-SMA decreased significantly in rosiglitazone group compared with that in the control group (t = 3. 12,P < 0.01 ). The collagen stainings of liver histological section in rosiglitazone group was lower than those in the control group (t = 3.47, P < 0. 01 ). Conclusion PPARγ ligand inhibits the production of collagen in fibrofic livers in rats and prevents hepatic fibrosis in vivo.
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Objective To study the effects of peroxisome proliferators-activated receptor gamma (PPA?r) on the biological characteristics of hepatic stellate cells (HSCs); Methods The activated HSCs were divided into four groups: control group, rosiglitazone group, GW9662 + rosiglitazone group and GW9662 group. The cell proliferation was determined with MTT colorimetric assay, The cell apoptosis was studied with flow cytometry. The expression of PPA?r, Type I collagen were detected by RT-PCR, Western blot and immunocytochemistry. Results MTT of HSCs in rosiglitazone group was (0. 49?0. 06) significantly lower than in control group ( 1. 00?0. 045 ), GW9662 group (0. 89?0. 043 ) , GW9662 + rosiglitazone group (0.78?0.049)(t = 15.59,14.68,8.07, P
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Objective To investigate the mRNA and protein expression of somatostatin receptors in hepatocellular carcinoma HCCLM3 cell lines and to explore the mechanism by which somatostatin effects on hepatocellular carcinoma. Methods RT-PCR., immunocytochemistry and MTT were used to detect mRNA and protein expression of somatostatin receptors in hepatocellular carcinoma cells and evaluate the antiproliferative effect of somatostatin. Results The effect of somatostatin on the cellular proliferation was verified. Immunocytochemistry study revealed a mainly intracellular distribution of all SSTRs with unique patterns for each of them. mRNA expression of all 5 subtypes of somatostatin receptors was different, SSTR2 and SSTR1 mRNA expressions were significantly higher than SSTR3, SSTR4 and SSTR5 ( P