1.Three-dimensional laparoscopic surgery: a revolutionary technique or a transitional technique
Chinese Journal of Digestive Surgery 2016;15(9):858-860
Three-dimensional (3D) laparoscopic surgery has been developed rapidly in China since 2012.Based on mature two-dimensional (2D) laparoscopic surgery,3D laparoscopic surgery has the same technique as 2D,with similar indication as 2D as well.However,3D laparoscopic surgery can offer better depth description,more accurate spatial location,and less error in operation.It might offer better visional experience if hybrid with virtual reality or with 4K in the future.But in current status,laparoscopy with 3D technique is only a technique with innovation,but not a revolutionary technique.
2.Difficulties and disputes about laparoscopic radical resection of rectal cancer
Chinese Journal of Digestive Surgery 2017;16(8):782-786
With the standardized training and spreading,laparoscopic total mesorectal excision for rectal cancer has been spread nationwide.The oncological adequacy and long-term outcomes have also been confirmed by series of randomized controlled trials such as COLOR Ⅱ in Europe.There were still some technical issues,such as safe surgical plane,surgical approach,lymph node dissection,and function-preserving,which were still under debate.In the current article,authors will discuss the issues with clinical experiences about preserving of Denonvilliers facial,preserving of pelvic autonomic nerve,strategy of surgical approach,dissection of lateral lymph nodes,and necessity of protective diverting stoma.
3.An Empirical Research on the Factors Influencing the Selection of Doctors in Online Medical Websites
Juan LIU ; Junjun ZHENG ; Jiang WU
Journal of Medical Informatics 2017;38(5):48-51
The paper collects the network data from www.haodf.com to establish a model,conducts an empirical study on the factors influencing the selection of doctors in online medical websites,and puts forward the suggestions for the construction of online medical websits from 4 aspects of normalizing management,focusing on propaganda,highlighting online public praise,and expanding profit channels.
4.Topical cell growth factors for wound healing after fractional CO2 laser therapy: an experimental study
Junjun AI ; Weimin SONG ; Weifeng ZHA ; Junhui ZHENG ; Bo GUO
Chinese Journal of Dermatology 2012;45(4):255-258
ObjectiveTo compare the accelerating effect of topical recombinant human epidermal growth factor (rhEGF) and recombinant bovine basic fibroblast growth factor (rb-bFGF) on wound healing after fractional CO2 laser therapy.MethodsTwenty male guinea pigs were included in this study.After hair removal and irradiation with fractional CO2 laser,the back of each guinea pig was divided into 4 regions to be topically treated with rhEGF of 10 μg/cm2 (rhEGF group),rb-bFGF of 262.51 IU/cm2 (rb-bFGF group),the combination of rhEGF and rb-bFGF (combination group),or normal saline (control group),twice daily until the healing of wound.Skin physiology parameters including elasticity index and melanin index were detected before the irradiation,7,14 and 28 days after the irradiation,and compared between the 4 groups by analysis of variance.Tissue specimens were obtained from 4 mice at the above time points and subjected to pathological examination for the observation of collagen fibers and quantification of fibroblasts.ResultsAfter fractional CO2 laser therapy,the crusts fall off completely in growth factor-treated regions,while partly in the control regions,within 3 to 7 days; the wounds healed completely in 14 to 28 days in all the groups,with the regenerating tissue being more tender and redder compared with the surrounding unirradiated tissue.The wound surface was smaller in area and redder in color in the 3 growth factor-treated groups than in the control group.At 28 days after the irradiation,the elasticity index was 262.29 ± 62.40 in the combination group,202.00 ± 65.62 in the rhEGF group,188.86 ± 35.02 in the rb-bFGF group,167.14 ± 42.49 in the control group.Statistical difference was observed in elasticity index,but not in skin melanin index among the 4 groups.Pathological examination showed a dense and organized arrangement of collagen fibers in the combination group but a sparse and disorganized arrangement of collagen fibers in the control group.ConclusionThe combined application of rhEGF and rbbFGF can accelerate the healing of wound and increase the elasticity of regenerating tissue after fractional CO2 laser therapy.
5.Current application and prospect of three-dimensional laparoscopic radical resection of colorectal cancer
Zirui HE ; Lu ZANG ; Junjun MA ; Minhua ZHENG
Chinese Journal of Digestive Surgery 2017;16(8):804-807
Most colorectal surgeries now are carried out as minimally invasive surgery along with the development and application of laparoscopy.However,the surgical imaging system does not meet the progressing requirement of laparoscopic surgeons.Thanks to the advent of three-dimensional (3D) laparoscopy,a more sophisticated surgical scene with realer images of anatomy is provided to surgeons.It makes identification and manipulation easier,so that to shorten the learning curve.Meanwhile,the 3D laparoscopy is not perfect.But authors believe it will finally be used broadly in colorectal surgery with the improvement of the technology.
6.Effect of organizational commitment and leader-member exchange on ethical decision-making in nurses
Junjun MO ; Xiao CHEN ; Saisai ZHENG ; Deshuang XIAO
Chinese Journal of Practical Nursing 2016;32(36):2834-2837
Objective To explore the effect of organizational commitment and leader-member exchange on ethical decision-making in nurses. Methods 520 nurses were questionnaired by the Chinese Employees′ Organizational Commitment Scale,Leader-Member Exchange Scale and the Ethical Decision-making Scale. Results The total scores of organizational commitment and leader-member exchange and ethical decision-making in nurses were respectively (2.11 ± 0.39), (3.54 ± 0.51), (286.62 ± 20.14) points. Pearson correlation analysis showed that the scores of organizational commitment and leader-member exchange were positively correlated with ethical decision-making (r=0.352-0.464,P<0.05). Hierarchical regression analysis showed that leader-member exchange, opportunity commitment and affective commitment, economic commitment could explain 35.3%of the total variance of ethical decision-making in nurses. Conclusions The organizational commitment and leader-member exchange are the influencing factors of ethical decision-making in nurses.
7.The correlation between serum miR-21 and miR-34a expression and the efficacy of Flofox chemotherapy regimen in patients with advanced gastric carcinoma
Feng DONG ; Junjun MA ; Zhenghao CAI ; Xuan ZHAO ; Minhua ZHENG
Practical Oncology Journal 2017;31(2):147-151
Objective The objective of this study was to investigate the levels of serum miR-21 and miR-34a in patients with advanced gastric cancer before and after Folfox chemotherapy and its relationship with chemotherapy efficacy.Methods Forty-five patients with advanced gastric cancer who underwent Folfox chemotherapy were enrolled from May 2015 to October 2015.The levels of miR-21 and miR-34a were analyzed by Real-time PCR before and after chemotherapy.The relationship between miR-21 and miR-34a levels and chemotherapy efficacy was analyzed.The predictive values of miR-21 and miR-34a on the efficacy of chemotherapy were evaluated by the receiver operating curve(ROC).Results After chemotherapy,6 cases(13.33%)were relieved,10 cases(22.22%)were stable disease(SD),29 cases(64.44%)were disease progress(PD),the objective response rate(ORR)was 13.33%,the disease control rate(DCR)was 35.56%,the median survival time was 8.1 months.The level of miR-21 was down-regulated and up-regulation for miR-34a after chemotherapy.They were statistically significant(P<0.05).The level of miR-21 in the chemotherapy group was lower than that in the ineffective group,and the level of miR-34a was higher than that of the ineffective group(P<0.05).MiR-21 was negatively correlated with the efficacy of chemotherapy(rs=-0.431,P<0.05),while miR-34a was positively correlated with it(rs=0.504,P<0.05).The median survival time was 7.6 months for low-level patients with miR-21 and 6.0 months for high-level patients.The median survival time of miR-34a patients was 5.5 months,compared with 8.3 months for high-level patients,with a statistically significant difference(P<0.05).The Log-Rank test showed that the median survival of patients with low miR-21 was higher than that of patients with high miR-21(P<0.05).The median survival of patients with high miR-34a was higher than that of patients with low miR-34a(P<0.05).The miR-21 combined with miR-34a in predicting chemotherapy efficacy under the curve(AUC)was 0.865,the sensitivity was 80.9% and the specificity was 89.8%.Conclusion miR-21 and miR-34a are correlated with chemotherapy efficacy median survival time of patients with advanced gastric cancer.
8.Value of urinary nucleosides determination for the diagnosis of colorectal carcinoma
Minhua ZHENG ; Bo FENG ; Aiguo LU ; Yufang ZHENG ; Zhihai MAO ; Junjun MA ; Guowang XU
Chinese Journal of General Surgery 2001;0(10):-
Objective To evaluate urinary nucleosides determination for the diagnosis of colorectal carcinoma. Methods The concentrations of 14 different urinary nucleosides from 42 colorectal carcinoma patients, 10 patients with villous adenoma and 62 normal adults were determined by high-performance liquid chromatography (HPLC); Principal component analysis was applied to classify colorectal cancer patients and normal adults. Results The levels of Pseu、 C、 m1A、 mU、 m22G、 I、 m1G、 ac4C、 m6A in colorectal carcinoma group were (42.67?21.89)、(0.44?0.51)、(2.72?0.83)、(0.13?0.08)、(1.79?0.55)、(0.50?0.36)、(1.44?0.52)、(0.82?0.30)、(0.07?0.08)nmol/(?mol creatinine) respectively, which were much higher than those in normal adults (P
9.Betadine solution irrigation of gastrointestinal tract for infection prevention during natural orifice transluminal endoscopic surgery
Yongzhi ZHENG ; Dong WANG ; Junjun GU ; Yanfang GONG ; Renpei WU ; Zhaoshen LI
Chinese Journal of Digestive Endoscopy 2011;28(5):256-259
Objective To evaluate the feasibility and efficacy of betadine solution irrigation of gastrointestinal tract for infection prevention during the procedure of natural orifice transluminal endoscopic surgery(NOTES).Methods Twelve female porcine were divided into control group(n =4)to receive lavage with 500 ml normal saline and experimental group(n =8)to undergo lavage with 500 ml normal saline followed by 200 ml betadine solution.Fluid from gastrointestinal tract(5 ml)were collected before and after lavage,and after NOTES for culture.Endoscopy was performed 24 hours after NOTES to observe possible existence of inflammation,ulcer or bleeding.The animals were sacrificed 3 weeks after NOTES to explore intra-peritoneal adhesions,abscesses and other infections.Results One swine died of diaphragmatic injury and the other 11 animals successfully survived for 3 weeks.In trans-gastric approach,the average bacterial load of the fluid was 17.5 x 103 CFU/ml before lavage.In control group,the average bacterial load of the fluid was 2.5 × 103 CFU/ml after lavage and 5.5 × 103 CFU/ml after NOTES,while those in experimental group were 0 CFU/ml and 7.5 CFU/ml,respectively.In trans-colonic approach,the average bacterial load of the fluid before lavage was 76.2 × 103 CFU/ml.In control group,the average bacterial load of the fluid was 19.5 × 103 CFU/ml after lavage and 21 × 103 CFU/ml after NOTES,while those in experimental group were 2.25 × 103 CFU/ml and 1 × 103 CFU/ml,respectively.No inflammation,ulcer or bleeding were observed by endoscopy at 24 hours after NOTES.More adhesion and abscess were found in the control group than in the experimental group.In experimental group with trans-colonic approach,only one case of adhesion was observed.Conclusion It is effective and feasible of using betadine solution irrigation of gastrointestinal tract in infection prevention during the procedure of NOTES.However,further clinical studies assessing the effectiveness and safety are still necessary.
10.Effect of CO_2-Insufflation on Invasion Capacity of Colon Cancer Cells in Vitro
Junjun MA ; Bo FENG ; Yi ZHANG ; Aiguo LU ; Weiguo HU ; Jianwen LI ; Mingliang WANG ; Minhua ZHENG
Chinese Journal of Bases and Clinics in General Surgery 2003;0(05):-
Objective To investigate the influence of CO2-insufflation pressure on invasion potential of the colon cancer cells.Methods With an in vitro artificial pneumoperitoneum model,SW1116 human colon cancer cells were exposed to CO2-insufflation of 5 different pressure groups:6,9,12,15 mm Hg and control group,respectively for 1 h.The invasion capacities of SW1116 cells exposed to CO2-insufflation of 5 different pressure groups were detected by cell adhesion/invasion assay in vitro.Results Immediately following exposure to 15 mm Hg CO2 insufflation,the invasion of SW1116 cells decreased significantly compared to the cells before exposure.At the 0 h time point,the cells exposed to 15 mm Hg were significantly less invasive than those exposed to the other insufflation pressure(P