Influence of amoxicillin and clavulanate potassium on postoperative infection and inflammatory indexes in emergency intestinal obstruction operation by relaxation suture / 中国生化药物杂志

Objective To study the influence situation of amoxicillin and clavulanate potassium for the postoperative infection and inflammatory indexes of patients with emergency intestinal obstruction operation by relaxation suture .Methods 80 patients with emergency intestinal obstruction operation by relaxation suture in department of general gurgery of our hospital from April 2014 to April 2016 were randomly divided into control group and observation group with 40 cases in each group, the control group were treated with routine treatment, the observation group were treated with amoxicillin and clavulanate potassium on the treatment of control group, then the postoperative infection rates, inflammatory related indexes before and after the treatment of two groups were compared.Results The postoperative infection rate of observation group was 5.00%,and it was obviously lower than the 17.50% of control group, the difference was significant(P<0.05); the serum inflammatory related indexes of two groups before the treatment were compared,the differences were not significant ;the serum anti-inflammatory indexes interleukin-4(IL-4), IL-10, IL-13 and pro-inflammatory indexes tumor necrosis factor-α(TNF-α), IL-6 at 1st, 2nd and 5th day after the treatment were all lower than those of control group,the pro-inflammatory index IL-2 were higher than those of control group, the differences were all significant(P<0.05).Conclusion The amoxicillin and clavulanate potassium can reduce the postoperative infection of patients with emergency intestinal obstruction operation by relaxation suture , and its control role for the related inflammatory indexes is better, so its application value is higher and is worthy of clinical promotion.

Construction of a lentiviral vector of RNA interference against PPARS gene and the establishment of colon cancer cell line KM12C with stable knockdown of PPARdelta expression / 生物医学工程学杂志

Peroxisome proliferator-activated receptordelta (PPARdelta), as a downstream target of adenomatous polyposis coli (APC) signaling pathway, has been presumed to play some roles in colorectal carcinogenesis. However, the exact role of PPARdelta in colorectal cancer remains unclear. An HIV-1-based lentivirus packaging system was used for the construction of a lentiviral vector (lentivector) mediating RNA interference against PPARB. The direct sequencing demonstrated that the resulting lentivector containing the short-hairpin RNA expression cassette specifically targeting PPARdelta (sh-PPARdelta) was successfully constructed, and designated as pLVshPPARdelta. The control vector was designated as pLVControl. After the transduction, we observed highly efficient transduction (> 90%) of lentivirus in KM12C cells by fluorescent microscopy and fluorescence-activated cell sorting. Quantitative RT-PCR showed that pLVshPPARdelta lentivirus reduced PPARdelta mRNA expression by about 70.0% in KM12C cells as compared with that of the untreated cells (P < 0.05), while pLVControl had no significant effect on the PPARdelta mRNA level (P > 0.05). Western blot revealed an obvious reduction of PPARdelta protein expression in pLVshPPARdelta treated cells and showed no obvious difference between the control group and the untreated group. The results demonstrated that the lentivector mediating RNAi against PPARdelta was successfully constructed, which could stably knock down the PPARdelta expression in KM12C cells. This study finally provided a new cell model for the study of PPARdelta's function in colorectal cancer.

Prognostic significance of circumferential resection margin involvement in patients of rectal cancer / 中华普通外科杂志

Objective To study the prognostic value of circumferential resection margin(CRM)status. Methods Specimens of 62 patients with rectal cancer,who underwent total mesorectal excision from December,2001 to June,2002,were examined using whole-mount sections.All patients were followed up for 4～60 months. Results Circumferential resection margin involvement(CRMI)was identified in 12 specimens.while only 4 of them were cancer positive in the resection margin.Analyzed by logistic regression test,the occurrence of CRMI was related to tumor differentiation [ P=0.015,Exp(B)=0.131]and lymph node metastases[P=0.013,Exp(B)=7.488 ],but not tumor distance to anal verge(P=0.246).The difference in local recurrence rate,overall recurrence rate,disease-free survival rate and overall survival rate between CRMI and that of CRM negative,were significant(P=0.002,0.000,0.000 and 0.003,respectively). Conclusions CRMI is an accurate prognostic factor of recurrence and postoperative survival,and its occurrence is mainly determined by biologic characteristics of the tumor.TME could decrease the incidence of CRMI.

The role of digital subtraction angiography in the diagnosis and treatment of small intestinal tumor with massive lower gastrointestinal hemorrhage / 肿瘤研究与临床

Objective To discuss the diagnostic value of DSA for massive hemorrhage in lower gastrointestinal tract resulting from tumour. Methods 24 patients with massive lower gastrointestinal hemorrhage were performed DSA and then operated as tumour. Results Among 24 patients, 17 cases demonstrated direct signs of hemorrhage, 9 cases visible turnout vessels; 24 patients all showed clumping tumour-specifie dyeing. Conclusion DSA is of great value to determining the location and qualitation of the massive lower gastrointestinal hemorrhage resuhing from tumours.

Effects of Ulinastatin on Renal Apoptosis and Expression of bcl-2 in Rats with Severe Acute Pancreatitis / 中国普外基础与临床杂志

Objective To explore the effects of ulinastatin(UTI) on renal apoptosis and expression of bcl-2 in rats with severe acute pancreatitis(SAP).Methods Sixty rats weighing 250-300 g were randomized divided into 3 groups:pseudo-operation group(SO group,n=20),SAP group(n=20) and UTI treated group(UTI group,n=20).The model of SAP was established by retrograde injection of 5% sodium taurocholate solution into the biliopancreatic duct in the rats.Serum Cr and BUN were determined.The left kidneys were resected for light and electronic microscopic study.Renal cell apoptosis was determined by TUNEL.Expression of bcl-2 was detected by immunohistochemical staining of SABC.Results Serum Cr,BUN,renal cell apoptotic index and bcl-2 expression were markedly increased in SAP group compared with SO group(P

Hemorheology and expression of neutrophil adhesion molecules CD18 and CD62L in pancreatic microcirculation of Caerulein induced experimental acute pancreatitis / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the changes in hemorheology and expression of neutrophil adhesion molecules CD18 and CD62L in pancreatic microcirculation of Caerulein induced experimental acute pancreatitis (AP).</p><p><b>METHODS</b>The Wistar rats (n = 21) were randomized into three groups. The model of AP was established by subcutaneous injection of Caerulein. The changes of apparent viscosity of whole blood were measured by Low- shear 30 rheometer. The expression of adhesion molecules on the surface of neutrophil in duced by shear stress was used with stationary control. CD18 expression was increased on neutrophils treated with shear rate, and andanalyzed using flow cytometry.</p><p><b>RESULTS</b>Rat treated with Caerulein showed hyperamyleimia (t = 69.029, t = 79.734, P < 0.05). Blood viscosity of two AP groups were significantly elevated (0.512 s(-1): t = 10.725, t = 16.945; 5.96 s(-1): t = 12.781, t = 11.992, P < 0.05). Compared with stationary control, CD18 expression was increased on neutrophil treated with shear rate, and significantly induced with shear rate >/= 94.5 s(-1) (94.5 s(-1): t = 7.403, t = 13.323, t = 16.655; 128.5 s(-1): t = 10.092, t = 28.531, t = 24.563, P < 0.05). The expression of CD62L was less sensitive to low shear rate, and began to be down-regulated significantly when the shear rate >/= 94.5 s(-1) (94.5 s(-1): t = 10.687, t = 19.376, t = 12.848; 128.5 s(-1): t = 26.152, t = 48.402, t = 56.814, P < 0.05).</p><p><b>CONCLUSIONS</b>The changes of apparent viscosity of whole blood, and the effect of fluid shear stress on the expression of neutrophil adhesion molecules CD18, CD62L may play an important role in the pancreatic microcirculatory failure of acute pancreatitis.</p>

Laparoscopic total mesorectal excision for low or ultralow anterior resection of rectal cancer with anal sphincter preservation / 中华外科杂志

<p><b>OBJECTIVE</b>To assess the feasibility of laparoscopic total mesorectal excision (TME) for low or ultralow anterior resection of rectal cancer.</p><p><b>METHODS</b>Excision of the mesorectum and low (ultralow) colo-anal anastomoses were performed laparoscopically in 62 patients with low rectal cancer based on the concept of TME and double stapling technique (DST).</p><p><b>RESULTS</b>Sixty-two operations with TME and DST were performed in a totally laparoscopic manner, and only one was converted to open procedures because of dysfunction of coagulation. The operative time was 125 min (110-210 min) and the operative blood loss 20 ml (5-80 ml). The time for bowel function recovery and post-operatively dietary intake was 1-2 days. Twenty-eight patients received postoperative analgesics. Average hospital stay was 8 days (5-14 days). Complications were observed in only 2 of the 62 patients, one had suffered from urinary retention and the other, anastomotic leakage.</p><p><b>CONCLUSIONS</b>Totally laparoscopic excision of the mesorectum for low or ultralow anterior resection of rectal cancer is a minimally invasive technique with sphincter preservation, less postoperative pain, and rapid recovery.</p>

Immune response to open and laparoscopic total mesorectal excision with anal sphincter preservation in patients of rectal carcinoma / 中国普通外科杂志

0.05). Conclusions There is no difference in immune responses to rectal cancer patients undergoing laparoscopic total mesorectal excision with anal sphincter preservation and those having open surgery.