RESUMO
The long-term outcome of laparoscopic surgery for geriatric patients with colorectal cancer remains unclear due to decreased functional reserves and increased medical comorbidities. A meta-analysis was performed in the present study to compare the long-term outcome between laparoscopy and laparotomy. Randomized controlled trials and comparative studies regarding laparoscopy vs. open surgery for colorectal cancer in elderly patients were searched in Pubmed, Embase, and Cochrane library between inception and April 20, 2017. The methodological quality of the cohort studies was evaluated using the Newcastle-Ottawa Scale. The meta-analysis was performed using Stata v12.0 software. Eight cohort studies were enrolled in the meta-analysis. Laparoscopic surgery was associated with a higher 3-year survival rate compared with open surgery [risk ratio (RR), 0.74; 95% confidence interval (CI), 0.61-0.90; P=0.003]. No significant difference was identified between laparoscopy and laparotomy regarding the 5-year survival rate (RR, 0.93; 95% CI, 0.78-1.11, P=0.424). The results of the meta-analysis indicated that the use of laparoscopic surgery on geriatric patients with colorectal cancer should be increased due to more improved long-term outcomes. All the studies included in the meta-analysis were case-control studies with selection bias and other confounding factors. Thus, larger sample sizes and multicenter randomized controlled trials are required to further validate the use of laparoscopic surgery as the preferred therapeutic option for elderly patients with colorectal cancer.
RESUMO
Objective To investigate the conditions of family function of rehabilitative breast cancer patients and its related factors. Methods Self-administrated questionnaire and the family APGAR (adaptation, partnership, growth, affection, resolve) index questionnaire were used in 245 breast cancer patients to investigate their general and illness information, and their family APGAR index. The factors relat-ed with the family function of breast cancer patients were analyzed. Results The APGAR score of the participants was (7.51±1.17), and the condition of family was graded from good (73.5%), moderate impairment (21.2%) to severs impairment (5.3%). The multiple regression analysis found that the stage of the disease (β=-9.671), the condition of marriage (β=8.29) and their social activities (β=7.402) related with the APGAR index in rehabilitative breast cancer patients. Conclusion The family function needs attention, especially the metastasis ones in breast cancer patients. A healthy marriage and beneficial socialization contribute to keep good family function.
RESUMO
By introducing the stage management of ethics review for medical research protocols,this paper try to explain the submission requirement,the review procedures,the key points for focusing on,and analyze the issues found in ethical reviewing of research protocols,help to guide the procedures of ethical review,as well as improve the supervision of ethical review for research protocols.
RESUMO
Objective To investigate the effects of gastric bypass on glycometabolism and improvement of islet β cell function and insulin resistance in patients with type 2 diabetes. Methods Eight patients with type 2 diabetes combined with gastric carcinoma who treated with gastric bypass were studied prospectively. Fasting and postprandial plasma glucose levels, fasting and postprandial insulin C-peptide levels, and body mass index (BMI) were measured right before the surgery and at intervals of 1 week, 2 weeks, 1 month and 3 months after the surgery. Glycosylated hemoglobin (HbA1c) levels were measured before and 3 months after the surgery. The outcome of the diabetes after 3 months of the surgery was also monitored. Results Fasting and postprandial plasma glucose levels decreased (P ＜ 0.05) and fasting and postprandial insulin C-peptide levels increased (P ＜ 0.05) after the surgery. HbA1c levels also decreased (P ＜ 0.05) after 3 months of the surgery. There was no significant change of BMI at all intervals after the surgery(P＞ 0.05). All of the 8 patients reached the total effective standard and 6 patients reached the clinical remission standard after 3 months of the surgery. Conclusions It suggests that gastric bypass can significantly lower plasma glucose levels in type 2 diabetes, which does not depend on the loss of weight. The control of plasma glucose by gastric bypass may be due to the improvement of islet β cell function and increasing secretion of endogenous insulin.
RESUMO
Objective To investigate the mechanism of endothelin (ET) in acute biliary pancretitis (ABP)with renal impairment, and examine the improvement of renal function by puerarin. Methods Thirty-two patients of ABP with renal impairment were selected and were randomly divided into group A and group B. Group A were given puerarin post-operatively, while group B were given common manegement postoperatively. Meanwhile, 16 ABP patients without renal impairment were selected as group C, and 16 nonABP patients who had common hepatic or biliary diseases were selected as group D. The levels of plsma ETand creatinine clearance rate(Ccr) of renal function in each group were observed pre-operation and 1 week post operation. Results In pre-operation the ET level in group A, B and C were higher than in group D(P ＜0.001), and the ET level in group A,B was higher than in group C(P＜0.001). Post operation after I week the ET level in group A was lower than in group B(P =0.014), while the Ccr level in group A was higher thanin group B ( P = 0.002). Conclusions The function of endothelin is an important mechanism in biliary pancretitis with renal impairment. Puerarin might reduce the ET level and increase the Ccr level in patients of ABP with renal impairment, improve the renal function of such patients.
RESUMO
Objective To assess the clinical value and safety of VenaTech LP permanent inferior vena cava filter (IVCF) for preventing pulmonary embolism (PE) in patients with deep vein thrombosis (DVT). Methods One hundred and seven DVT patients receiving VenaTech LP permanent IVCF implantation from October 2005 to November 2009 were selected. In hospital and following up data were analyzed. Results All the filters were successfully implanted. No symptomatic PE took place during acute stage of thrombosis after filter implantation. No complication took place during following up 1 to 36 months.Conclusion Implantation of VenaTech LP permanent IVCF is safe and effective in the prevention of PE.
RESUMO
Objective To evaluate the application of Herniamesh in repairing adult umbilical hernia.Methods The data of 12 aduh patients with umbilical hernia were treated with Hemiamesh from January 2007 to March 2009 was analyzed retrospectively,included characteristics,methods and effects of Hemiamesh Oval Patch 0812 on the repair of hernia.Results All cases were cured.The average stay in hospital was (5±2)d.No postoperative complication,no recurrence follow-up visited 1 to 25 months.Conclusion Repairing umbilical hernia in adult with Hemiamesh Oval Patch 0812 is a kind of simple,safe,effective operation and the ring of hernia no more than 4cm.
RESUMO
Objective To discuss the clinical features,diagnosis and operative treatment in Crohn disease(CD)characterized by acute abdomen.Method The clinical data of 26 CD cases testified by pathology after emergency operations from April 1997 to February 2009 were retrospectively analyzed.Results In 26 cases of acute abdomen,17 cases characterized by mechanical obstruction,6 cases characterized by peritonitis,3 cases characterized by hemorrhage of digestive tract.Eight cases(30.8%)were diagnosed before operation,and 13 cases(50.0%)were diagnosed during operation,totally 80.8%(21/26).All patients received surgical operations as following:resection and anastomosis in 21 eases,resection and fistulation in 4 cases,ileotransverso-stomy in 1 case.Two cases died after operation,and others discharged including 1 case received second operation within 5 days.Conclusion It is difficult to be diagnosed before operation when CD characterized by acute abdomen,and appropriate emergency operations are needed according to the particular cases.
RESUMO
Objective To develop a method of adult porcine pancreatic islet isolation.Methods The tails of adult porcine pancreas were perfused through the pancreatic duct with 0.1% cold collagenase(type Ⅺ) and incubated at 38.5 ℃.The digested tissue was dispersed in 4 ℃ Hanks balanced salt solution(HBSS).The tissue suspensions were filtered through a 600 ?m mesh.The residual tissue was resuspended in cold HBSS,and put in the Ricordi’s chamber and shaken for 5 minutes,then filtered again.The isolated islets were divided into three groups: control group( n =14),Pefabloc(trypsin inhibitor, n =8) group and FOY(trypsin inhibitor, n =5) group.The collagenase solution of the Pefabloc and FOY group was supplemented with 1.0 mmol/L Pefabloc and FOY respectively. Results The islet yields of the Pefabloc group and FOY group 〔(11 848?3 530) islet/g pancreas and (14 496?3 693) islet/g pancreas〕 were significantly higher than that of the control group 〔(8 505?3 349) islet/g pancreas〕, P
RESUMO
<p><b>OBJECTIVE</b>To regain bile excretory function of hepatocytes cultured in vitro.</p><p><b>METHODS</b>Sandwich configuration was used to culture hepatocytes and the structure of bile canaliculi as well as the function of bile excretion was observed by immunocytochemistry and the test of FDA metabolism with a single collagen configuration as a control.</p><p><b>RESULTS</b>First, the formation of bile canaliculi was observed by immunocytochemistry. In sandwiched hepatocytes, the gradual development of bile canaliculi-like structures into an anastomotic network was observed. At 24 h after cell culture, the formation of bile canaliculi was observed. With time progressed, the bile canaliculi became more clear and the network was established at 120 h. In contrast, hepatocytes in single collagen configuration showed almost no network of bile canaliculi. Second, the ability for hepatocytes to internalize, metabolize and excrete compounds into bile was indicated by FDA metabolized in the hepatocytes. In sandwiched hepatocytes, the bile excretory function was shown at 96 h, but in single collagen system, no bile excretion was observed.</p><p><b>CONCLUSION</b>Cultured hepatocytes are able to regain bile excretion in a given certain condition. Sandwich-cultured hepatocytes can reestablish bile canalicular structure and regain bile excretory function.</p>
Assuntos
Animais , Feminino , Ratos , Bile , Secreções Corporais , Canalículos Biliares , Fisiologia , Células Cultivadas , Hepatócitos , Secreções Corporais , Imuno-Histoquímica , Ratos Sprague-DawleyRESUMO
Objective To discuss the role of activation of nuclear factor ?appa B(NF-?B) in apoptosis of alveolar macrophages(AM) induced by gadolinium chloride(GdCl3) in acute necrotizing pancreatitis(ANP).Methods Thirty sixty adult SD rats were randomized into three groups: normal control group,ANP group and the group treated by GdCl3.ANP was induced by intraductal administration of 5% sodium taurocholate,while the normal control rats received an infusion of normal saline.In GdCl3 treatment group,GdCl3 was injected into dorsal vein of penis right after ANP model was established.AM were harvested by bronchoalveolar lavage six hours after model was established.The generation of TNF-? and IL-1? in bronchoalveolar lavage fluid(BALF),and the level of myeloperoxidase in lung tissue were evaluated.The expression of NF-?B protein in AM was determined by western blot.The apoptosis of AM was detected by agarose gel electrophoresis and flow cytometer.The histological examination of lung tissue was checked.Results The levels of TNF-? and IL-1? in ANP group were significantly higher than the control group and GdCl3 treatment group(P
RESUMO
Objective To explore the effect of nitric oxide(NO) on pulmonary tumor necrosis factor?(TNF?) in murine acute necrotizing pancreatitis(ANP). Method Ninety-six SD rats were randomized into four groups:normal control group, ANP group, L-Arginine(L-Arg) pretreatment group and L-NAME pretreatment group (n=24 for each group). The protein content of bronchoalveolar lavage fluids(BALF), the myeloperoxidase(MPO) of lung tissue and TNF? produced by alveolar macrophages were evaluated. The expression of TNF? mRNA was measured. ResultMPO and protein of BALF reached a peak level at 12nd hr (10.78?0.58U/g for MPO and 2011?106?g/ml for protein content respectively).TNF? peaked on the sixth hour(1624?149)pg/ml. The expression of AM TNF?mRNA also peaked on the sixth hour (1.127?0.069) along with an increase of TNF? mRNA. A similar tendency was seen in L-Arg and L-NAME pretreatment groups, with changes being statistically different in the three groups when compared with that of normal control group(P
RESUMO
Objective To explore the method of isolation, identification and in vitro differentiation of islet stem cells in neonatal rat. Methods The whole pancreata of neonatal rats were digested with collagenase, then,under the (condition) of pH 7.4～7.6,the digested tissue fragments were cultured with serum and serum-free RPMI 1640 (( bFGF), EGF, N2).The whole formation process of new islet cell-like cell masses was examined.The insulin (release) test was used to detect islet function. The expression of nestin was tested by immunocytochemistry. Results The nestin positive cells can be found within 36 h of culture of the digested pancreatic fragments.After addition of bFGF,ECF,N2,nestin positive cells proliferated fast and formed new islets-like cell masses after 18～24 d, and (insulin)ssion could be confirmed. Conclusions The nestin positive cells of pancreatic cells possess the character of islet stem cells, and can form islet like cell masses through culture in vitro.
RESUMO
Objective To investigate the effect of TLCK(N-alpha-tosyl-L-lysyl-chloromethylketone) on acute hemorrhagic necrotizing pancreatitis(AHNP) associated with lung injury.Methods Seventy SD rats were randomized into seven groups(n=10 in each group): group1,normal control group(rats were treated with 0.9% sodium chloride i.v.);group 2,AHNP control group(AHNP rats were treated with 0.9% sodium chloride i.v.);group 3,AHNP rats were treated with 5?g/kg TLCK;group 4,AHNP rats were treated with 10?g/kg TLCK;group5,AHNP rats were treated with 20 ?g/kg TLCK;Group3,4,5were treated with TLCK i.v.immediately after the establishment of SAP rat model;group 6,AHNP rats were treated with TLCK i.v.30 minutes before the establishment of AHNP model;group 7,AHNP rats were treated with TLCK i.v.30 minutes after the establishment of AHNP rat model;Group 6,7 were treated with 10 ?g/kg TLCK.Group 1-7 were used to select the best dosage and administration time of TLCK by observing the survival rate for seven days.Then,according to the result of selecting,the SD rats were divided into three groups(n=6 in each group): group N,Sham operated control group(0.9% sodium chloride was reversely injected into SD rat′s pancreas and rats were treated with 0.9% sodium chloride i.v.);group P: AHNP group;group T: TLCK treatment group(AHNP rats were treated with 10 ?g/kg TLCK immediately after the establishment of AHNP rat model).The rats of the last three groups were killed 6 hours after operation.Alveolar macrophages(AMs) were harvested by bronchoalveolar lavage.The protein content of bronchoalveolar lavage fluids(BALF),the myeloperoxidase(MPO) of lung tissue,and tumor necrosis factor ?(TNF?) secreted by AMs were determined.The expression of NF-?B in AM was checked as well as lung histology.Results The survival rate of group 1-7 was100%,0%,70%,100%,80%,0%,and 90% respectively.The level of MPO of lung tissue and protein content of BALF ingroup N were lower than that,in groups P and T(P
RESUMO
With the development of systemic therapy for the treatment of breast cancer, the incidence of brain metastases from breast cancer is gradually increasing. Treatment with surgery,stereotactic radiosurgery, and wholebrain radiotherapy (WBRT) are still the first-line therapies for the majority of patients with brain metastases. Recently, chemotherapy, hormone therapy and targeted therapy have been widely used for breast cancer. This review summarizes the efficiency of those strategies for the breast cancer patients with brain metastases.
RESUMO
Objective:To study the safety and effect of enteral nutrition in preoperative bowel preparation and postoperative early enteral nutritional support for patients with colorectal cancer.Methods:42 patients with colorectal cancer were randomized into 2 groups.21 patients in the experimental group(enteral nutrition group) were applied with Nutrison Fibre as a kind of liquid diet in preoperative bowel preparation and postoperative early(in 12~24 hours) enteral nutritional support.21 patients in the control group(traditional therapy group) made the bowel preparation by the traditional method of semiliquid-liquid-fasting with infusion and managed with ordinary process after operation.The times of intestinal lavage the evening before operation,the satisfaction of colon cleaning,recovery time of passing flatus,occurrence of ill reaction and complication were observed.Parameters including body weight,hemoglobin(Hb),lymphocyte count(LY),plasma total protein(TP),serum albumin(ALB),prealbumin(PA) were measured and compared before bowel preparation(3th day before operation),before operation and on the 8th day after operation.Results:There were no statistical difference in the two groups about the satisfaction of colon cleaning.In the experimental group,the time of intestinal lavage was fewer(P(0.05).) But in the control group,Hb,LY,TP,ALB and PA were all significantly lower(P
RESUMO
Objective To construct and appraise a series of shRNA eukaryotic expression plasmid which contains vary spots of human SKP2 gene.Methods Three pairs of hairpin-like oligonucleotide sequences specific for human SKP2 gene were designed and synthesized. They were cloned into the eukaryotic expression pSIREN-RetroQ plasmid. The recombinated plasmids were confirmed by PCR and sequencing.Results The shRNA sequences were constructed successfully, and could be inserted into the eukaryotic expression vector pSIREN-RetroQ.Conclusions Three shRNA transcripting plasmids pSIREN-RetroQ are successfully constructed, and form a basis for research in cancer gene target therapy against SKP2 gene.
RESUMO
Objective To investigate the relationships between the expression of cyclooxygenase-2 (COX-2) , vascular endothelial growth factor (VEGF) and the degree of vascularization, clinicopathological feature, survival time of the patients with gallbladder carcinoma. Methods Routine paraffin-embeded sections of gallbladder carcinoma tissues in 64 cases were evaluated for COX-2, VEGF expression and MV by the streptavidin-peroxidase complex immunohistochemical method. Results COX-2, VEGF immunoreactivity were observed in 72%,and 55% cases, respectively. The average MVC was (57?14)/ HP. The status of MVC was closely correlated with Nevin staging, tumor differentiation and lymph node metastasis (P well differentiated,P0.05). There was a positive correlation between COX-2 expression and clinical stages. The positive rate of COX-2 was higher in cases of Nevin stages S4-S5 (82%) with lymph node metastasis than in those of Nevin stages S1 -S3 (50%) and without metastasis (P0.05 ). The expression of VEGF and COX-2 was significantly correlated with that of MVC (t=5.424, P
