Objective To establish an HPLC method for concentration determination of emodin in plasma and colon tissues after gavage withHuchang Qingdu Pellets;To explore pharmacokinetic properties and colon tissue distribution ofHuchang Qingdu Pellets in rats.Methods Wistar rats were randomly divided into Pellets group and ordinary capsule group. Blood was taken after gavage withHuchang QingduPellets or capsule content in given time points (1, 2, 3, 4, 5, 6, 8, 12, 24 h) from rat venous sinus and analyzed. Rats were put to death, and gastric and colon tissues were isolated and extracted for analysis. Chromatographic conditions:Phenomenex C18 column (4.6 mm × 150 mm, 10μm), the mobile phase of methanol-0.1% acetic acid solution (80∶20), flow rate of 1 mL/min, the detection wavelength of 254 nm.Results Emodin was in good linear range of 0.102-20.40μg/mL. The regression equations were:plasma solutionA=76 825C + 3567.8,r=0.999 4 (n=6);intestinal tissue solutionA=75 931C + 3384.2,r=0.999 0 (n=6). Day-to-day precision and within-day precision were less than 4%. The recovery rate was more than 90%. Pharmacokinetic parameters of T1/2 and Tmax of emodin in rat blood and intestinal tissues increased compared with the ordinary capsule group;Cmax and AUC0-24 were obviously improved compared with the ordinary capsule group.ConclusionHuchang Qingdu Pellets do have controlled release and colon targeting effect.

BACKGROUND:Internal fixation is commonly used in an early stage of intertrochanteric fractures of the aged worldwide, and can apparently reduce complications and fatality rate. The commonly used internal fixators contain proximal femoral nail anti-rotation and dynamic hip screw, whose comparison is current research hotspot.
OBJECTIVE: To evaluate the hip function and stability after internal fixation with proximal femoral nail anti-rotation and dynamic hip screw in repair of intertrochanteric fractures of the aged.
METHODS:A total of 64 aged patients with intertrochanteric fractures were enroled in this study, and assigned to dynamic hip screw group (n=30) and proximal femoral nail anti-rotation group (n=34). The fracture reduction and healing were evaluated using anterioposterior and lateral X-ray films. Operation time, intraoperative blood loss, complication rate, healing time and postoperative hip function were compared and analyzed between the two groups, and then assessed in accordance with Sander’s scoring system.
RESULTS AND CONCLUSION:Compared with dynamic hip screw group, operation time, intraoperative blood loss, healing time and complication rate after treating unstable intertrochanteric fracture (Tronzo-Evans III, IV and V types) showed significant advantages in the proximal femoral nail anti-rotation group (P < 0.05). Hip function restored better, and the complication rate of stable intertrochanteric fracture (Tronzo-Evans I and II types) was lower after treatment in both groups (P > 0.05). These data show that the effects of proximal femoral nail anti-rotation were better than that of dynamic hip screw for treatment of intertrochanteric fractures, and hip function recovered better. Moreover, proximal femoral nail anti-rotation had biomechanical stability, especialy for unstable fracture.

BACKGROUND:Studies have shown that limited lumbar discectomy can harvest better clinical efficacy, but also face a higher risk of recurrence. In clinic, how to guarantee access to good effect, and meanwhile to reduce the probability of recurrent disc herniation? The annulus repair technology may be an effective way, but it is rarely reported. OBJECTIVE:To investigate the early clinical effects of endoscopic lumbar discectomy associated with annulus repair in the treatment of lumbar disc herniation. METHODS: Totaly 224 patients with lumbar disc herniation who accepted discectomy surgery were selected from the Department of Spinal Surgery, the Third Affiliated Hospital of Southern Medical University from January 2011 to January 2013, including 56 cases of microendoscopic discectomy associated with annulus repair (repair group) and 168 cases of microendoscopic discectomy (control group). Oswestry disability index and visual analog scale scores for lumbago and lower limb pain were recorded before and at 10 days, 3 months, 6 months, 12 months and 18 months after operation. Simultaneously, operative time, blood loss, surgical complications, and postoperative recurrence of lumbar disc herniation were recorded. RESULTS AND CONCLUSION:In the repair group, only 51 patients completed the folow-up, while al the patients in the control group completed the folow-up. There was no difference between the repair and control groups before and after surgery in the Oswestry disability index and visual analog scale scores for lumbago and lower limb pain (P > 0.05), but at 10 days after surgery, the Oswestry disability index and visual analog scale scores for lumbago and lower limb pain were significantly decreased in the repair group (P < 0.05), and this trend continued until the 18th month after surgery. There were no dural tears, disc space infection, hematoma formation in the spinal canal and other serious complications. The recurrence rate was 9.5% in the control group and 3.9% in the repair group. 31.2% of relapsed patients in the control group received the second operation, while on patient in the repair group received reoperation. These findings indicate that microendoscopic discectomy associated with annulus repair can obtain remarkable early clinical results, and effectively reduce the recurrent rate and risk of secondary lumbar disc surgery, which is safe and reliable.

Objective To investigate the clinical effect of digital multifunction trauma rinser(DMTR) on wound cleaning .Meth-ods 278 trauma patients from 6 hospitals were divided into groups by hand washing and DMTR .The cleaning time ,the amount of cleaning fluid and the effects of wound cleaning and bacterial clearance and healing were compared between the two groups .Results DMTR save time ,reduced the amount of cleaning fluid ,reduced residual bacteria ,and had better wound healing in patients with large wound area .Conclusion DMTR ,which is worthy of clinical application ,has better effect on cleaning large wounds than the traditional manual debridement w ay .

BACKGROUND:In recent years, vacuum sealing drainage technology has been widely used in the treatment of orthopedic wounds or to facilitate skin graft survival, both of which have achieved good results.
OBJECTIVE:To observe the curative effects of vacuum sealing drainage technology in the wound healing after limb open fractures, soft tissue defects, pressure sores, and chronic osteomyelitis.
METHODS:Fifty-four patients of fractures combined with soft tissue defects, postoperative exposed bone, osteomyelitis, a large area of pressure ulcers or severe infections, selected from the 273rd Hospital of PLA, were randomly divided into test and control groups according to the wishes of patients. The test group included 36 patients who were treated with vacuum sealing drainage using polyethylene ethanol hydration seaweed salt after debridement, and the control group included 18 patients who were treated with conventional dressing. Wound cleaning time, number of dressings, and wound healing time were detected and compared in the two groups.
RESULTS AND CONCLUSION:Compared with the control group, the wound cleaning time and wound healing time were shorter in the test group, and the number of dressings was also decreased in the test group (P<0.05). After removal of sponge dressings, in the test group, wound granulation was fresh and grew obviously with no exudates after the necrotic residue was removed and vacuum sealing drainage was changed. For the bone exposure patients, the wound area was reduced, or even there was no exposed bone any more. After skin grafting, vacuum suction and pressure due to vacuum sealing drainage technology made al skin grafts survive. In the patients with chronic osteomyelitis, the exudates were gradual y reduced until disappeared after vacuum sealing drainage was exchanged three or four times, and pathogens were not found in bacterial culture. After combined treatment of debridement and vacuum sealing drainage, there were many fresh granulations in the patients with large areas of pressure sores;after replacement of vacuum sealing drainage several times, the granulation grew to the same height with the surrounding skin.

OBJECTIVETo evaluate the clinical significance of No.12 lymph node dissection for advanced gastric cancer with D2 lymphadenectomy.

METHODSClinicopathologic data and No.12 lymph node dissection of 256 advanced gastric cancer patients undergoing radical operation in our department between January 2005 and December 2010 were retrospectively summarized and the influence factors of metastasis in No.12 lymph nodes were analyzed.

RESULTSOf 256 patients, 179 were male and 77 were female with the average age of 59.2 years. Tumor located in the upper of stomach in 24 cases, middle of stomach in 41 cases, lower of stomach in 174 cases, multi-focus or diffuse distribution of stomach in 17 cases. Tumor diameter was <3 cm in 39 cases, 3 to 5 cm in 100 cases, >5 cm in 117 cases. Serum carcinoembryonic antigen (CEA) level increased in 61 cases, serum carbohydrate antigens (CA)72-4 increased in 56 cases and CA19-9 increased in 61 cases. The number of No.12 lymph nodes resected from all the patients was 1 152, and the average number was 4.5±1.9. The metastasis rate of No.12 lymph nodes was 9.4%(24/256) after hematoxylin eosin staining (positive group). All the patients received effective follow-up to December 2015, and the average follow-up time was 101.2 months. The median survival time of positive No.12 group (24 cases) was 29.8 months and of negative No.12 group (232 cases) was 78.2 months, whose difference was statistically significant (χ=21.715, P=0.000). Univariate analysis found that No.12 lymph node metastasis was not associated with age, gender, tumor differentiation (all P>0.05), but was associated with tumor location, tumor diameter, invasive depth (all P<0.05), and was closely associated with Borrmann type, outside metastatic lymph nodes of No.12 and high levels of serum CEA, CA72-4 and CA19-9 (all P=0.000). Multivariate regression analysis found that tumor location (RR=2.452, 95%CI:1.537 to 3.267, P=0.000), Borrmann type (RR=1.864, 95%CI:1.121 to 3.099, P=0.016) and number of outside metastatic lymph nodes of No.12 (RR=2.979, 95%CI: 2.463 to 3.603, P=0.000) were the independent risk factors of the No.12 metastasis (P<0.05).

CONCLUSIONSMetastasis in No.12 lymph nodes indicates poorer prognosis. The No.12 lymph nodes of advanced gastric cancer patients with curative resection, especially those with the tumor located in the lower part, Borrmann type IIII(, outside metastatic lymph nodes of No.12, should be regularly cleaned.

Antigens, Tumor-Associated, Carbohydrate ; blood ; CA-19-9 Antigen ; blood ; Carcinoembryonic Antigen ; blood ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; methods ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; diagnosis ; pathology ; physiopathology ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Grading ; statistics & numerical data ; Neoplasm Invasiveness ; Neoplasm Staging ; statistics & numerical data ; Prognosis ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; blood ; mortality ; pathology ; Survival Rate

The clinical data of 42 patients undergoing laparoscopic transabdomical preperitoneal ( TAPP) hernia repair in Taizhou People′s Hospital from January 2015 to June 2016 were retrospectively analyzed.In this series, 22 patients used VicrylTM polyglactin suture (group A) and 20 patients used the unidirectional barbed suture (group B).The clinical efficacy and postoperative complications were compared between the two groups.There were no significant differences in volume of intraoperative blood loss [(7.3 ± 3.2) vs.(7.9 ±3.2)ml],length of postoperative hospital stay [(14.6 ±1.2) vs.(4.8 ±1.1)d], pain scores [visual analogue scale (VAS),1.9 ±0.9 vs.2.1 ±1.0] at the first-day after operation,body discomfort(1 vs.0 case),and incidence of chronic pain and recurrence between the two groups (P>0.05). The time of operation and peritoneum suturation in group B was markedly shorter than that in group A [(34.3 ±7.1) vs.(40.4 ±9.9) min, (9.8 ±1.8) vs.(13.1 ±4.8) min, both P <0.05].Both unidirectional barbed suture and VicrylTM polyglactin suture are safe ,effective in peritoneum suturation for inguinal hernia repair; however , the unidirectional barbed suture has advantages of shorter operation time and less difficulty of surgical procedure .

BACKGROUND:Cervical rotatory manipulation is widely used in the treatment of neck-related diseases with a clear curative effect,but it also has some risks in clinical practice.The previous study of our group found that cervical rotatory manipulation can reduce the tensile mechanical properties of the atherosclerotic carotid artery,but it is not clear about the effects of different cervical rotatory manipulations(positioning/non-positioning)and different degrees(mild/moderate/severe)of atherosclerosis on the tensile mechanical properties of the carotid artery. OBJECTIVE:To explore the effects of different cervical rotatory manipulations and different degrees of atherosclerosis on the tensile mechanical properties of the internal carotid artery. METHODS:The 120 male New Zealand rabbits were randomly divided into eight experimental groups with different degrees of atherosclerosis and different cervical rotatory manipulations:severe atherosclerosis + positioning/non-positioning cervical rotatory manipulation,moderate atherosclerosis + positioning/non-positioning cervical rotatory manipulation,mild atherosclerosis + positioning/non-positioning cervical rotatory manipulation,and normal rabbit + positioning/non-positioning cervical rotatory manipulation,as well as three model control groups:mild/moderate/severe atherosclerosis + non-cervical rotatory manipulation,and the blank control group.Two-factor analysis of variance was used to explore the main effects and interactive effects of different cervical rotatory manipulations and different degrees of atherosclerosis on the tensile mechanical properties of the internal carotid artery.One-way analysis of variance was applied to explore the influence of different cervical rotatory manipulations on the tensile mechanical properties of the internal carotid artery under the same degree of atherosclerosis. RESULTS AND CONCLUSION:(1)Both different cervical rotatory manipulations and different degrees of atherosclerosis were the main effect factors affecting the tensile mechanical properties of the internal carotid artery.(2)For both mild and severe atherosclerosis,both positioning and non-positioning cervical rotatory manipulations reduced the maximum stress of the internal carotid artery(P<0.05)and also increased the physiological elastic modulus of the internal carotid artery(P<0.05).(3)For moderate atherosclerosis,positioning and non-positioning cervical rotatory manipulations also increased the physiological elastic modulus of the internal carotid artery(P<0.05).Non-positioning cervical rotatory manipulation reduced the maximum strain of the internal carotid artery(P<0.05),and its maximum strain was also less than the internal carotid artery of the positioning cervical rotatory manipulations(P<0.05).(4)For the normal internal carotid artery,in addition to the maximum strain,both positioning and non-positioning cervical rotatory manipulations had no statistically significant effects on other tensile mechanical indicators of the internal carotid artery(P>0.05).(5)The results suggest that both positioning and non-positioning cervical rotatory manipulations may increase the stiffness of the atherosclerotic internal carotid artery,reducing its elasticity and brittleness.Therefore,both positioning and non-positioning cervical rotatory manipulations may increase the risk of cardiovascular events in mild/moderate/severe atherosclerotic internal carotid artery,and the more severe the atherosclerosis is,the greater the risk of positioning/non-positioning cervical rotatory manipulation treatment,but the risk of positioning cervical rotatory manipulation is not lower than that of non-positioning cervical rotatory manipulation.

OBJECTIVETo evaluate the feasibility, safety, radicality and short-term outcome of preserving left colic artery (LCA) during laparoscopic total mesorectal excision (TME) for the treatment of rectal cancer.

METHODSFrom January 2013 to December 2016,136 patients with mid-lower rectal cancer received laparoscopic TME in the Gastrointestinal Surgery Department of Taizhou People's Hospital of Jiangsu Province. Patients with rectal tumor within 10 cm to the anal verge were enrolled into the study. All the enrolled patients had complete data of pathology and follow-up. Those receiving neoadjuvant chemoradiotherapy, with severe base diseases, multifocal tumor, tumor invasion of surrounding tissues, fixation of tumor, recurrent tumor, complications such as acute ileus, bleeding, perforation were excluded. In this study, 72 patients did not undergo preservation of LCA (high ligation group) and 64 patients underwent preservation of LCA (low ligation group). Operative parameters, clinicopathological data and short-term outcome were collected and compared between two groups.

RESULTSThe baseline data including gender, age, body mass index, tumor stage, and distance of tumor from anal verge of two groups were comparable (P>0.05). The differences between two groups about the mean time of operation and the operative blood loss were not significant [(164.0±12.6) min vs. (167.3±9.4) min, (30.0±3.6) ml vs. (30.1±3.0) ml, all P>0.05]. There was no operative death in both groups. Differences in the lymph node dissection (13.7±2.6 vs. 13.3±2.1) and the specimen length of proximal resection margin [(16.4±1.9) cm vs. (16.7±2.1) cm] or distal resection margins [(3.9±0.6) cm vs. (4.1±0.9) cm] between high and low ligation groups were not significant (all P>0.05). Compared with high ligation group, the low ligation group had higher rate of sphincter preservation [92.2% (59/64) vs. 79.2% (57/72), χ=4.580, P=0.032], lower rate of anastomotic leakage [1.6% (1/64) vs. 9.7% (7/72), χ=4.075, P=0.044], anastomotic stenosis [3.1% (2/64) vs. 12.5%(9/72), χ=4.006, P=0.045], and voiding and sexual dysfunction [6.3%(4/64) vs. 18.1%(13/72), χ=4.317, P=0.038]. Mean time of follow-up was 19 months. In high ligation group, the local recurrent rate was 5.56%, distant metastasis rate was 13.89%, overall survival rate was 90.28%, disease-free survival rate was 80.56%, while in low ligation group, the local recurrence rate was 4.69%, distant metastasis rate was 12.50%, overall survival rate was 90.63%, disease-free survival rate was 82.81%, whose differences between two groups were not significant (all P>0.05).

CONCLUSIONPreservation of LCA during laparoscopic TME for the treatment of rectal cancer is safe and feasible, which can reduce the incidence of anastomotic leakage and stenosis, and voiding and sexual dysfunction.

OBJECTIVETo explore the feasibility, safety and efficacy of intraoperative regional infusion chemotherapy by celiac trunk in advanced gastric cancer patients.

METHODSOne hundred and twenty-six patients with advanced gastric cancer(stageII(-III() were screened from database of Gastrointestinal Surgery Department of Taizhou People's Hospital between January 2008 and December 2010 who underwent R0 resection and D2 lymphadenectomy, received postoperative chemotherapy(XELOX or FOLFOX), and had complete follow-up data. They were divided into infusion chemotherapy group (65 cases) and control group (61 cases) according to regional infusion chemotherapy or not (fluorine 1 000 mg and cisplatin 60 mg). The side effects of chemotherapy, parameters related to the operation, long-term survival and relapse rate were compared between the two groups.

RESULTSThe baseline data between the two groups were comparable(all P>0.05). Postoperative III( and IIII( adverse reaction of chemotherapy was not significantly different between the two groups (P>0.05). The time of postoperative intestinal function recovery [(67.9±14.8) hours vs. (68.9±15.0) hours, t=-0.380, P=0.705), volume of postoperative 1-week drainage [(66.1±17.1) ml vs.(61.9±18.2) ml, t=1.478, P=0.142], recent morbidity of complications[55.4%(36/65) vs. 49.2%(30/61), χ=0.256, P=0.613], and the long-term morbidity of complications [16.9% (11/65) vs. 14.8% (9/61), χ=0.111, P=0.739] were all not significantly different between the two groups. The 3-year survival rate and 3-year relapse-free survival rate in infusion chemotherapy group were significantly higher than those in control group(58.4% vs. 37.7%, χ=5.382, P=0.020; 58.4% vs. 34.4%, χ=6.636, P=0.010).

CONCLUSIONRegional infusion chemotherapy by celiac trunk during operation for advanced gastric cancer patients is safe and feasible, and can reduce the risk of local recurrence and improve survival rate.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Celiac Artery ; Chemotherapy, Cancer, Regional Perfusion ; adverse effects ; methods ; mortality ; Cisplatin ; administration & dosage ; adverse effects ; therapeutic use ; Deoxycytidine ; analogs & derivatives ; therapeutic use ; Disease-Free Survival ; Fluorine ; administration & dosage ; adverse effects ; therapeutic use ; Fluorouracil ; analogs & derivatives ; therapeutic use ; Gastrectomy ; Humans ; Leucovorin ; therapeutic use ; Lymph Node Excision ; Neoplasm Recurrence, Local ; prevention & control ; Organoplatinum Compounds ; therapeutic use ; Postoperative Complications ; Recovery of Function ; Stomach Neoplasms ; drug therapy ; mortality ; surgery ; Survival Rate