Efficacy comparison of robotic and laparoscopic radical resection of rectal cancer for overweight and obese patients / 中华胃肠外科杂志

Objective: During laparoscopic pelvic operational procedure for obese patients with rectal cancer, the large amount of fat in the abdominal cavity often impairs the exposure of the surgical field, resulting in technical difficulty. In contrast, robotic surgery has the advantages of being more minimally invasive, precise, and flexible. This study compared the clinical efficacy of robotic and laparoscopic radical resection of rectal cancer for overweight and obese patients. Methods: A retrospective cohort study was conducted. Clinical data of 173 patients with rectal cancer and a body mass index (BMI) ≥ 25 kg/m(2) who received robotic or laparoscopic radical rectal resection at the First Affiliated Hospital of Nanchang University from January 2015 to February 2019 were retrospectively collected. Of 173 patients, 90 underwent robotic surgery and 83 underwent laparoscopic surgery. The intraoperative parameters, postoperative short-term and follow-up status were analyzed and compared between the two groups. The follow-up ended in December 2019. Results: Of 173 patients, 103 were male and 70 were female with a median age of 62 (range 29 to 86) years. The average BMI was (27.2±1.6) kg/m(2) in the robotic group and (27.3±1.5) kg/m(2) in the laparoscopic group. No significant differences in baseline data were observed between two groups (all P>0.05). As compared to the laparoscopic group, the robotic group had less intraoperative blood loss [(73.0±46.8) ml vs. (120.9±59.9) ml, t=-5.881, P<0.001] and higher postoperative hospitalization expense [(61±15) thousand yuan vs (52±13) thousand yuan, t=3.468, P=0.026]. The conversion rate in the robotic group was 1.1% (1/90), which was lower than 6.0% (5/83) in the laparoscopic group, but the difference was not statistically significant (P=0.106). There were no statistically significant differences between the two groups in operative time, number of intraoperative blood transfusion, number of harvested lymph nodes, time to the first flatus, postoperative hospital stay and morbidity of total postoperative complications (all P>0.05). Five (6.0%) patients in the laparoscopic group developed urinary dysfunction, while no case in the robotic group developed postoperative urinary dysfunction (P=0.024). The 173 patients were followed up for 8-59 months, with a median follow-up of 36 months. The 3-year overall survival rate of robotic group and laparoscopic group was 89.8% and 86.6%, respectively without significant difference between the two groups (P=0.638). The 3-year disease-free survival rate of the robotic group and the laparoscopic group was 85.6% and 81.5%, respectively without significant difference as well (P=0.638). Conclusions: Robotic radical surgery is safe and feasible for overweight and obese patients with rectal cancer. Compared with laparoscopic radical surgery, it has advantages of clear vision of surgical exposure, less intraoperative blood loss, less pelvic autonomic nerve damage, and operation in a narrow space.

Cardamine komarovii flower extract reduces lipopolysaccharide-induced acute lung injury by inhibiting MyD88/TRIF signaling pathways / 中国天然药物

In the present study, we investigated anti-inflammatory effect of Cardamine komarovii flower (CKF) on lipopolysaccharide (LPS)-induced acute lung injury (ALI). We determined the effect of CKF methanolic extracts on LPS-induced pro-inflammatory mediators NO and prostaglandin E2 (PGE2), production of pro-inflammatory cytokines (IL-1β, TNF-α, and IL-6), and related protein expression levels of MyD88/TRIF signaling pathways in peritoneal macrophages (PMs). Nuclear translocation of NF-κB-p65 was analyzed by immunofluorescence. For the in vivo experiments, an ALI model was established to detect the number of inflammatory cells and inflammatory factors (IL-1β, TNF-α, and IL-6) in bronchoalveolar lavage fluid (BALF) of mice. The pathological damage in lung tissues was evaluated through H&E staining. Our results showed that CKF can decrease the production of inflammatory mediators, such as NO and PGE2, by inhibiting their synthesis-related enzymes iNOS and COX-2 in LPS-induced PMs. In addition, CKF can downregulate the mRNA levels of IL-1β, TNF-α, and IL-6 to inhibit the production of inflammatory factors. Mechanism studies indicated that CKF possesses a fine anti-inflammatory effect by regulating MyD88/TRIF dependent signaling pathways. Immunocytochemistry staining showed that the CKF extract attenuates the LPS-induced translocation of NF-kB p65 subunit in the nucleus from the cytoplasm. In vivo experiments revealed that the number of inflammatory cells and IL-1β in BALF of mice decrease after CKF treatment. Histopathological observation of lung tissues showed that CKF can remarkably improve alveolar clearance and infiltration of interstitial and alveolar cells after LPS stimulation. In conclusion, our results suggest that CKF inhibits LPS-induced inflammatory response by inhibiting the MyD88/TRIF signaling pathways, thereby protecting mice from LPS-induced ALI.

Study of the Growth Rate and Comparative Analysis of Esterase Isoenzyme from Two Isolates of Polyporus umbellatus / 微生物学通报

Comparative analysis of characteristic of species and esterase-isoenzyme of isolates of Polyporus umbel-latus from different regions were processed. The results indicated that isolates of Jizhaoling ( Z) and Zhushiling (ZJ) have significant differences in characteristic, and enzymatic band types of the two species also have significant differences. The homology at genetics between the two isolates is 0% , and consanguinity between the two i-solates is the farthest.