Objective To evaluate the efficacy and safety of laparoscopic technique in the treatment of refractory adhesive intestinal obstruction. Methods In a retrospective matched?pair analysis, 68 patients of re?fractory adhesive intestinal obstruction whose relapsed more than 3 times were included in the research. All patients were treated with laparoscopic operation or continued follow?up observation after conservative treatment from Janu?ary 2011 to January 2016. The patients were divided into 2 groups, laparoscopic surgery (32 cases) and observation group (36 cases), to contrast the recurrence rate and safety of the two types of treatment. Results The recurrence rate of laparoscopic surgery group was significantly lower in the observation group (18.8%vs. 77.8%, P<0.05). Re?fractory adhesive intestinal obstruction is further divided into Mixed type, Patchy adhesion type and Cable Belt Com?pression type, in the laparoscopic surgery subgroup analysis, hybrid recurrence rate (66.7%, 4/6 cases) was signifi?cantly higher than that of patchy adhesion type (10.0%, 1/10 cases) and cord compression type (6.3%, 1/16 cases). Conclusion Laparoscopic operation is safe and feasible in the treatment of refractory adhesive intestinal obstruc?tion, and then it can effectively reduce the recurrence rate of refractory adhesive intestinal obstruction;the curative effect is closely related to the type of adhesion.

Objective To observe the inhibitory effect of matrine on K-ras gene mutation colon cancer, and to clarify the inhibitory mechanism. Methods SW480 cells were treated with different concentrations of matrine. MTS method was used to detect the proliferation of SW480 cell lines. The apoptosis of SW480 cells was measured by flow cytometry. The migration of SW480 cells was examined by the scratch test. The expression of MEK1/2 protein was detected by Western blotting method. Results Compared with the blank control group, matrine (0.125-1 mg/mL) could inhibit the growth and proliferation of human colorectal cancer SW480 cell lines, promote the apoptosis, restrain the migration of SW480 cells, and inhibit the expression of MEK1/2 protein(P < 0.05), the effect showing a dose-dependent trend. Conclusion Matrine can effectively inhibit the proliferation and migration of SW480 cells, and promote SW480 cell apoptosis through the down-regulation of MEK1/2 protein expression in MAPK signal pathway system.

OBJECTIVETo investigate the safety and feasibility of laparoscopic radical right hemicolectomy using caudal-to-cranial approach (yellow-white borderline between right mesostenium and retroperitoneal is firstly cut as the entry to dissect the fusion fascial space between the visceral and parietal peritoneum, which is called caudal-to-cranial approach for right hemicolectomy).

METHODSFrom January 2014 to May 2015, 76 consecutive patients with right side colon cancer underwent laparoscopic radical right hemicolectomy using caudal-to-cranial approach. The baseline characteristics, intraoperative and postoperative outcomes were prospective collected and reviewed retrospectively.

RESULTSAll the 76 patients completed operations successfully, and one patient (1.3%) was converted to open surgery because of intraoperative bleeding due to unexpected injury of ileocolic artery. The mean operative time was (152.8±42.1) min with a mean estimated blood loss of (70.4±43.5) ml. The mean time of first flatus was (49.3±22.9) h and mean liquid oral intake was (58.5±17.6) h. The postoperative complications appeared in 7 patients (9.2%), including one (1.3%) of pulmonary infection, one(1.3%) of urinary system infection, two (2.6%) of wound infection, two (2.6%) of inflammatory bowel obstruction and one (1.3%) of lymphatic fistula, and they were all cured with conservative treatments. The postoperative hospital stay was (7.8±5.4) d. The mean number of harvested lymph node was 34.2±10.9, among which 4.1±2.8 was positive.

CONCLUSIONSLaparoscopic radical right hemicolectomy using caudal-to-cranial approach is safe and feasible.