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Objective:To investigate the efficacy of enhanced recovery after surgery(ERAS)combined with laparoscopy for the treatment of colorectal cancer in the elderly and its effects on proinflammatory factors and immune responses.Methods:A total of 158 elderly patients with colorectal cancer treated with surgery were retrospectively analyzed.According to different treatment methods, they were divided into the control group(76 cases)and the study group(82 cases). The control group received traditional open surgery and routine perioperative care.The study group received laparoscopic radical resection of colorectal cancer plus perioperative ERAS.Surgery parameters, complications, postoperative immune function and proinflammatory factor levels were compared between the two groups.Results:The operation duration of the study group was significantly longer than that of the control group[(128.5±33.7)min vs.(117.4±28.7)min, t=2.220, P=0.028], whereas the intraoperative blood loss[(100.8±20.5)ml vs.(250.7±62.3)ml, t=20.621, P<0.01]and the incision length[(4.5±1.2)cm vs.(17.5±3.0)cm, t=36.243, P<0.01]were significantly less than those in the control group.The time to first flatus[(2.0±0.9)d vs.(3.8±1.8)d, t=8.037, P<0.01], time to first defecation[(2.8±0.8)d vs.(4.5±1.1)d, t=11.167, P<0.01], time to first ambulation[(1.2±0.2)d vs.(3.8±1.3)d, t=17.888, P<0.01]and hospitalization length[(7.1±0.2)d vs.(11.4±2.2)d, t=17.625, P<0.01]were also significantly shorter than those in the control group.The incidences of surgical site infections(2.4% vs.10.5%, χ2=4.351, P=0.037), abdominal distension(7.3% vs.19.7%, χ2=5.279, P=0.023)and intestinal obstruction(9.8% vs.22.4%, χ2=4.711, P=0.030)in the study group were significantly lower than those in the control group.The levels of C-reactive protein, interleukin-6 and tumor necrosis factor-α in the study group were significantly lower than those in the control group at 1 d, 3 d and 7 d after surgery( t= 9.612, 7.300, 5.446, 8.762, 12.138, 15.370, 10.186, 10.432, 13.512, respectively, all P<0.05). The levels of CD3 + , CD4 + and CD4 + /CD8 + in the study group were significantly higher than those in the control group at 1 d, 3 d and 7 d after surgery( t= 2.128, 2.957, 2.313, 2.914, 2.937, 2.809, 5.089, 5.623, 5.409, respectively, P<0.05 for all), and the levels of CD8 + were significantly lower than those of the control group( t= 2.008, 2.580, 4.902, all P<0.05). Conclusions:Laparoscopy combined with ERAS for the treatment of colorectal cancer in the elderly can reduce surgical injury and complications and mitigate inflammatory responses with little impact on immune responses.
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Objective: To discuss the clinical effect of Dahuang Zhechong Wan on pelvic pain caused by endometriosis with Qi stagnation and blood stasis syndrome and study the mechanism of action. Method: One hundred and twenty-six patients were randomly divided into control group (64 cases) and observation group (62 cases) by random number table. Both groups' patients got Duphaston from the 5th to 25th days of menstrual cycle, 1 tablet/day, 2 times/days. Patients in control group got Sanjie Zhentong Jiaonang at the first day of menstruation, 4 grains/time, 3 times/days. Patients in observation group got Dahuang Zhechong Wan, 3 g/time, 2 times/days. The treatment in two groups continued for 3 menstrual cycles. Before treatment and at the first, second and third menstrual cycles after the treatment, visual analogue score (VAS) of pain was used for dysmenorrheal. Before AND after the treatment, scores of symptoms, signs, Qi stagnation and blood stasis syndrome and endometriosis were scored by endometriosis health profile-5 (EHP-5). And hemorheology was detected, and levels of matrix metalloproteinases-2 (MMP-2), MMP-9, tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), prostaglandin E2 (PGE2), prostaglandin F2α(PGF2α) and substance P (SP) were detected. Result: By rank sum test, the clinical effect of disease in observation group was better than that in control group (Z=2.198, PPPPα, IL-1, PGF2α and SP were lower than those in control group (P2 was higher than that in control group (PConclusion: In addition to treatment of progestogen, Dahuang Zhechong Wan can relieve pelvic pain, improve quality of life and clinical effect, and regulate levels of prostaglandins, matrix metalloproteinases and proinflammatory factors.
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Objective: To observe the clinical efficacy of addition and subtraction therapy of Taohong Siwutang combined with Chaihu Shugansan to unstable angina pectoris with type A behavior pattern (Qi stagnation and blood stasis syndrome), and investigate its effects on proinflammatory factors and serotonin (5-HT). Method: One hundred twenty-four patients were randomly divided into control group (60 cases) and observation group(64 cases) by random number table. Patients in control group got Aspirin enteric-coated tablets, 100 mg/time, 1 time/day. Tigrillo tablets, 90 mg/time, 2 times/days. Metoprolol tartrate tablets, 50 mg/time, 2 times/days. Simvastatin tablets, 10 mg/time, 1 time/day. Nitroglycerin tablets, 0.5 mg/time. Based on the treatment in control group, patients in observation group also received addition and subtraction therapy of Taohong Siwutang combined with Chaihu Shugansan, 1 dose/day. The treatment course was 8 weeks in both groups. Number of attacks, duration, degree of pain and usage of nitroglycerin were recorded for every week. Before and after treatment, electrocardiogram was also recorded. And levels of triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), hypersensitive C-reactive protein and 5-HT were detected. In addition, scores of Seattle Angina Scale (SAQ) and Qi stagnation and blood stasis syndrome were graded. Result: In the rank sum test, the curative effect in electrocardiogram of observation group was better than that of control group (Z=1.965, PPPPα and 5-HT in observation group were lower than those in control group (PPConclusion: On the basis of conventional western medicine, addition and subtraction therapy of Taohong Siwutang combined with Chaihu Shugansan can further control angina attack, relieve clinical symptoms, improve quality of life, regulate lipid metabolism, and can inhibit expression of proinflammatory factors and 5-HT, so it can play a role in stabilizing the disease.
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OBJECTIVE: We have repeatedly demonstrated that electroacupuncture (EA) stimulation of "Shenmen" (HT 7)- "Tongli" (HT 5) segment of the Heart Meridian can improve acute myocardial ischemia (AMI). This study aimed at observing the effect of EA on contents of hippocampal norepinephrine (NE), and interleukin 6 (IL-6), IL-1 β and tumor necrosis factor- α (TNF-α) in AMI rats, so as to explore its underlying mechanism. METHODS: SD rats were randomly divided into 3 groups: sham operation (sham), model and EA(n=6 rats in each). The anterior descending branch (ADB) of the left coronary artery was occluded to make an AMI model. For rats of the sham group, a surgical suture was simply threaded beneath the ADB without ligation. EA (2 Hz/15 Hz, 1 mA) was applied to bilateral "Shenmen" (HT 7)- "Tongli" (HT 5) and the middle-point between HT 7 and HT 5 for 30 min, once daily for 3 days. Electrocardiogram (ECG) of the neck-thoracic lead was recorded by using PowerLab 16. The contents of serum creatine kinase (CK), hippocampal IL-6, IL-1 β and TNF-α were assayed by ELISA. The concentration of NE in hippocampal CA 1 area was detected by microdialysis combined with electrochemical detector. RESULTS: Compared with the sham group, the ECG-ST height, serum CK, hippocampal NE, IL-6, IL-1 β and TNF-α contents of the CA 1 region were significantly increased in the model group (P<0.001). Whereas, after EA intervention, the serum CK, hippocampal NE, IL-6, IL-1 β and TNF-α contents were obviously down-regulated relevant to the model group (P<0.05, P<0.001), and the IL-6, IL-1 β and TNF-α contents were positively correlated with the NE level (P<0.001, P<0.01). CONCLUSION: EA stimulation of the Heart Meridian may improve ischemic myocardial injury in AMI rats, probably by reducing the proinflammatory factors and hippocampal NE.
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Objective To investigate the effects of Atorvastatin on reducing the levels of inflammatory factors and on improving the quality of life in elderly patients with chronic kidney disease complicated with hyperlipidemia.Methods One hundred patients with chronic kidney disease accompanied with hyperlipidemia were enrolled from March 2016 to March 2017,and randomized into two groups:a control group undergoing conventional treatment with anticoagulant,diet control and standard glucocorticosteroid,and an observation group receiving Atorvastatin as add-on therapy to conventional treatment.Improvements of serum levels of inflammatory factors and blood lipid indices as well as total curative effect were compared between the two groups.Results The total effective rate was significantly higher in the observation group[94.0％ (47/50)]than in the control group (76.0％,38/50)(x2 =6.352,P＜0.05).After treatment,the improvements of blood lipid indices(TC,TG,LDL-C,HDL-C)were more in the observation group than in the control group(t =71.804,10.544,15.266,3.499,all P＜0.05).Before treatment,the serum levels of TNF-alpha,CRP and the 24h urine protein had no statistically significant differences between control and observation groups(P =0.406 or 0.678,respectively),but the levels in post-vs.pre-treatment were statistically significant lower in TNF-alpha[(1.1 ± 0.2) vs.(1.8 ± 0.3) μg/L],CRP [(8.2 ± 0.1) vs.(9.3 ± 0.1) mg/L] and 24h urine protein[(1.1±0.7)vs.(2.3±1.1)g/24 h](all P＜0.05).Conclusions Atorvastatin as add-on treatment to conventional therapy of chronic kidney diseases complicated with hyperlipidemia in the elderly has significant effects on controlling dyslipidemia and reducing inflammatory reactions so as to improve patients' quality of life.
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Objective To establish a mouse model of H.pylori infection, and to evaluate the chronic pathological changes in the gastric mucosa associated with H.pylori infection.Methods 34 male 5~6-week old SPF C57BL/6 mice were used in this study.The mice were intragastrically administrated with a suspension of H.pylori SS1 strain.Two weeks after infection, rapid urease test and PCR were performed to confirm the H.pylori infection.Successfully infected mice were randomly divided into 3 groups including the control group, 6-week and 12-week infected groups.Samples of gastric mucosa were taken for pathological analysis using HE and borax methylene blue staining.The contents of myeloperoxidase (MPO), superoxide dismutase (SOD), malondialdehyde (MDA) and catalase (CAT) in the gastric tissues were detected by biochemistry, and the expression levels of COX-2, iNOS, TNF-α and IL-1β were examined by RT-qPCR.Results Compared with the control group, H.pylori colonization was observed in the gastric mucosa of the 6-week and 12-week infected mice, with chronic inflammatory cell infiltration, glandular atrophy and intestinal metaplasia to varying extents.The contents of CAT and SOD were significantly decreased, while the levels of MPO and malonaldehyde MDA, and the expression levels of COX-2,iNOS,TNF-α and IL-1β were significantly increased (P<0.05 or P<0.01).Conclusions Intragastric administration with H.pylori in C57BL/6 mice can be successfully used to generate the bacterial colonization, leading to chronic inflammatory cell infiltration, enhanced oxidative stress, and up-regulated expression of proinflammatory genes in the gastric glandular tissues at 6 and 12 weeks after inoculation.However, the inflammatory changes are more extensive in the mice at 12 weeks after infection, with glandular atrophy and intestinal metaplasia.