Neoadjuvant chemoradiotherapy (nCRT)and subsequent radical resection have become the standard care of locally advanced rectal cancer (LARC).However,conventional radical surgery is associated with high intra-and postoperative morbidities,and a temporary or permanent stoma in some cases,impaired sexual and urinary function,and it eventually impair the quality of life.Rectum-preserving surgery is a novel concept in the era of nCRT,which will maximally benefit patients through the minimized injuries.This strategy has been increasingly utilized in LARC following nCRT.Nevertheless,it lacks high-level evidence of evidence-based medicine,and the long-term oncological safety remains to be determined by larger,multicenter,randomized clinical trials.The crucial aspect of rectum-preserving surgery is to accurately evaluate the status of primary tumor and metastatic lymph nodes,and thus to selective patients who could benefit from this strategy most.

Objective To observe the clinical efficacy of electroacupuncture at different frequencies in treating post-stroke depression. Methods A hundred patients with post-stroke depression were randomized into treatment group 1, treatment group 2, treatment group 3, and a control group, 25 in each group. The treatment groups were intervened by electroacupuncture, while 2 Hz was adopted in treatment group 1, 50 Hz in treatment group 2, and 100 Hz in treatment group 3. The control group was intervened by oral administration of Sertraline Hydrochloride tablets. The Function Independent Measure (FIM) and Hamilton Depression (HAMD) scale were adopted for observation before and after intervention, and the clinical efficacies were compared. Results The FIM and HAMD scores were significantly changed after intervention in the four groups (P<0.05). After treatment, the FIM and HAMD scores in treatment group 1 were significantly different from that in treatment group 2 and 3 (P<0.05). The FIM score in treatment group 1 was significantly different from that in the control group (P<0.05). The total effective rate was 96.0%in treatment group 1, versus 92.0%in treatment group 2, 82.0%in treatment group 3, and 84.0%in the control group. The total effective rate in treatment group 1 was significantly different from that in the control group (P<0.05). Conclusions Electroacupuncture at 2 Hz, 50 Hz, and 100 Hz all can improve the activities of daily living and depression degree in patients with post-stroke depression, while 2 Hz ranks the top in comparing the therapeutic efficacy.

OBJECTIVE To promote the communion with the department of nosocomial infection management and clinic.METHODS Set up the intranet to carry out the report of the nosocomial infection cases and shared with(information).RESULTS The intranet was hitted exceed 5000 times,collected 56 cards of the nosocomial infection cases reported through network in the two months.CONCLUSIONS Intranet is good for promoting the communion with the department of nosocomial infection management and clinic.

Objective To investigate the effects of combination of propofol and whole-body hypoxic preconditioning on lung ischemia-reperfusion(I/R)injury in rats and the mechansim involved.Methods Ninety male SD rats weighing 250-320 g,were randomly divided into 5 groups(n=18 each): sham operation group(group S),lung I/R group(group I/R),propofol preconditioning group(group P),whole-body hypoxic preconditioning group(group WBHP),and combination of propofol and whole-body hypoxic preconditioning group(group PW).The animals were anesthetized with intraperitoneal 3% pentobarbital 30 mg/kg,tracheostomized and mechanically ventilated.Lung I/R injury was produced by occlusion of hilum of the left lung for 45 min followed by reperfusion.Propofol was continuously infused iv at 30 mg·kg-1·h-1 30 min before ischemia in group P.In group WBHP,5 times of WBHP were performed before ischemia.In group PW,propofol was infused iv at 30 mg· kg-1·h- 1 and 5 times of WBHP were performed 30 min before ischemia.Six rats from each group were killed at 30 min,1 h,and 4 h of reperfusion(T1-3).The lungs were then removed for determination of the contents of TNF-α,IL-1,IL6 and MDA,and activities of SOD.The W/D lung weight ratio was calculated.Results Compared with group S,the contents of TNF-α,IL-1,IL-6 and MDA and W/D ratio were significantly increased at T1-3,and SOD activity was significantly decreased at T1-3 in the other four groups(P＜0.05).The contents of TNF-α,IL-1,IL-6 and MDA and W/D ratio were significantly lower at T1-3 ,and SOD activity was significantly higher at T1-3 in group P,WBHP and PW than in group I/R(P ＜ 0.05).The contents of TNF-α and IL-6 and W/D ratio at T2,3 and contents of IL-1 and MDA at T3 were significantly lower,and SOD activity was significantly higher at T2,3 in group PW than in group P and WBHP(P＜0.05).There was no significant difference in the parameters metioned above between group P and WBHP(P＞0.05).Conclusion The combination of propofol and WBHP can protect the lungs from I/R injury,the efficacy is better than that of either of them alone,and it may be related to the enhancement in the inhibiton of inflammatory reaction and improvement in the antioxidant effect.

Objective To explore the effect of adipose-derived stem cells (ADSCs) on inflammatory factors in rats with lipopolysaccharide (LPS)-induced acute lung injury (ALI) and the possible mechanism of anti-inflammatory. Methods Seventy male Sprague-Dawley (SD) rats were randomly divided into normal control group (n = 10), LPS model group (n = 30), and ADSCs intervention group (n = 30) by random number table. ALI model was reproduced by intraperitoneal injection of 8 mg/kg LPS, and the rats in ADSCs intervention group received tail vein injection of 300 μL ADSCs 30 minutes after the model reproduction, the samples of normal control group were harvested immediately without any intervention, and the specimens in remained two groups were taken at 6, 24, 72 hours respectively. Arterial partial pressure of oxygen (PaO2) and lactate level in femoral artery were determined. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum myeloperoxidase (MPO) and interleukin-10 (IL-10) in the blood of left ventricle. Lung wet/dry weight (W/D) ratio was detected by thoracotomy, and the pathological changes of lung tissue were observed under an optical microscope. Western Blot was used to detect the protein expression of nuclear factor-κB (NF-κB) in lung tissue of rats. Results Compared with the normal control group, the damage degree of lung tissue of LPS model group was significantly heavier from 6 hours, and lung W/D ratio, blood lactate, MPO, IL-10 and expression level of NF-κB in lung tissue were significantly increased respectively, while PaO2 was decreased significantly. Compared with LPS model group, the damage degree of lung tissue of ADSCs intervention group was significantly reduced from 6 hours, and lung W/D ratio, blood lactate, MPO, and NF-κB expression in lung tissue were significantly decreased, while PaO2 was increased significantly, and it became normal at 72 hours [lung W/D ratio: 5.33±0.29 vs. 5.77±0.42 at 6 hours, 5.14±0.46 vs. 5.43±0.38 at 72 hours; blood lactate (mmol/L): 3.6±1.0 vs. 5.7±1.1 at 6 hours, 3.1±1.0 vs. 3.8±1.2 at 72 hours; blood MPO (μg/L): 1.50±0.90 vs. 2.70±1.85 at 6 hours, 0.46±0.30 vs. 0.71±0.22 at 72 hours; NF-κB (gray value): 0.40±0.11 vs. 0.50±0.09 at 6 hours, 0.24±0.03 vs. 0.33±0.06; PaO2 (mmHg, 1 mmHg = 0.133 kPa): 78.0±4.1 vs. 74.5±3.2 at 6 hours, 89.3±9.4 vs. 81.9±3.4 at 72 hours; all P < 0.05]. The IL-10 level was significantly higher than that of LPS model group only at 24 hours (ng/L: 27.75±15.49 vs. 17.52±6.56, P < 0.05). Conclusion ADSCs can effectively relieve the inflammatory response of ALI induced by LPS, probably by inhibiting the expressions of NF-κB and blocking the release of inflammatory cytokines.

OBJECTIVETo determine lignan content in the vine stem of Schisandra chinensis during 12 months and provide the scientific basis for the development and utilization of the resources.

METHODAnalysis was carried out on an Eclipse XDB C18 column eluted with a mixture of methanol-acetonitrile-water (43: 28: 29) as the mobile phase. The flowrate was 1.0 mL x min(-1), and the detection wavelength was set at 250 nm. Schisandrin, deoxyschizandrin and schisandrin B were used as reference substance, and the external standard method was used.

RESULTThe content of three constituents in the vine stem varied under different months. Schisandrin's maximum is 2.3 mg x g(-1) in December, minimum is 1.4 mg x g(-1) in April. A Deoxyschizandrin's maximum is 0.8 mg x g(-1) in November, minimum is 0.4 mg x g(-1) in March; Schisandrin B's maximum is 3.0 mg x g(-1) in January, minimum is 1.1 mg x g(-1) in April.

CONCLUSIONThe collection seasons for the vine stem of S. chinensis are autumn and winter.

Chromatography, High Pressure Liquid ; Cyclooctanes ; chemistry ; Lignans ; chemistry ; Plant Stems ; chemistry ; Polycyclic Compounds ; chemistry ; Schisandra ; chemistry

Objective To investigate the effect of tail vein transplantation of human amniotic mesenchymal stem cells (hAMSCs) with different transforming growth factor (TGF)-β expressions on recovery of sciatic nerve function in peripheral nerve xenotransplantation mice.Methods The hAMSCs were isolated from amnion membranes by healthy mother donors and identified by fluorescence activated cell sorter.The up-regulated and down-regulated TGF-β lentiviral plasmids were constructed and transfected into the purified hAMSCs;hAMSCs with stable up-regulated or down-regulated TGF-β expression were constructed.The sciatic nerves of C57BL/6 mice were isolated and cut out,and sciatic nerves of SD rats were isolated and transplanted into the sciatic nerve defected C57BL/6 mice to construct peripheral nerve xeno-transplanted mice models;these mice models were divided into 4 groups (n=10)according to random number table:control group,hAMSCs treatment group,high-expressed TGF-βhAMSCs treatment group,and low-expressed TGF-β hAMSCs treatment group;one d before modeling,phosphate buffer saline (PBS) or hAMSCs re-suspension were drawn with a syringe and slowly pushed into the tail veins of mice for transplantation treatment;14 d after treatment,DigGait analysis system was used to evaluate the recovery of sciatic nerve function in each group of mice.Result Fourteen d after treatment,the sciatic nerve function index (SFI) of the high-expressed TGF-β hAMSCs treatment group (-25.820±0.286) was significantly higher than that of the low-expressed TGF-β hAMSCs treatment group (-33.413±0.920) and hAMSCs treatment group (-30.755±0.421,P＜0.05).Conclusion The tail vein transplantation of hAMSCs with TGF-β high expression can effectively improve the sciatic nerve function in peripheral nerve xenotransplantation mice,which may be a new breakthrough in the treatment of peripheral nerve defects.

OBJECTIVETo explore predictive factors associated with pathologic complete response (pCR) after neoadjuvant chemoradiotherapy for rectal cancer.

METHODSClinicopathological data of 163 patients with locally advanced rectal cancer who were treated with neoadjuvant chemoradiotherapy followed by radical surgical resection from January 2007 to May 2013 were analyzed retrospectively. Univariate analysis and multivariate logistic regression analysis were performed to analyze associated factors of pCR, including age, gender, body mass index (BMI), diabetes, anemia, tumor diameter, distance of the tumor from the anal verge, circumferential extent of the tumor, tumor pathological types, tumor differentiation, pre-chemoradiotherapy T stage, pre-chemoradiotherapy N stage, pre-chemoradiotherapy CEA level, pre-chemoradiotherapy CA199 level, per-operation CEA level, pre-operation CA199 level, radiation dose, chemotherapy modality, time interval from completion of chemoradiotherapy to surgery, etc.

RESULTSTwenty-nine patients(17.8%) achieved pCR after neoadjuvant chemoradiotherapy for rectal cancer. Univariate analysis showed circumferential extent of tumor(≥1/2 cycle)(P=0.018), tumor pathological types(adenocarcinoma)(P=0.036), tumor differentiation (moderate or high)(P=0.021) and pre-chemoradiotherapy CEA level(≤2.5 μg/L)(P=0.007) were significantly correlated with pCR after neoadjuvant chemoradiotherapy for rectal cancer. Logistic regression revealed that circumferential extent of tumor (≥1/2 cycle)(OR=2.901, P=0.020) and pre-chemoradiotherapy CEA level (≤2.5 μg/L)(OR=2.775, P=0.022) were independent predictive factors of pCR after neoadjuvant chemoradiotherapy for rectal cancer.

CONCLUSIONPatients with circumferential extent of tumor ≤1/2 and pre-chemoradiotherapy CEA level ≤2.5 μg/L are more likely to achieve pCR after neoadjuvant chemoradiotherapy for rectal cancer, and these two indices can be used to predict pCR after neoadjuvant chemoradiotherapy for rectal cancer.

Adult ; Aged ; Chemoradiotherapy ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Rectal Neoplasms ; therapy ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo establish a nomogram model to predict the peritoneal metastasis in colon cancer patients without distant metastasis by preoperative imaging examination.

METHODSClinicopathological data of colon cancer patients without distant metastasis by preoperative imaging examination who underwent surgery in our department between January 2000 and December 2014 were retrospectively analyzed. Predictors of peritoneal carcinomatosis were analyzed by univariate and Logistic multivariate analyses. Base on the independent predictors by multivariable analysis results, a nomogram model was formulated with further use of R software. The total score was calculated by the addition of each predictor score, indicating the corresponding risk of peritoneal metastasis. The score was greater in the nomogram, and the risk was higher in peritoneal implantation metastasis. A receiver operating characteristic(ROC) curve was then constructed to evaluate the predictive abilities of the various preoperative factors and nomogram.

RESULTSA total of 1 417 patients were defined as above and enrolled in the study. The median age was (60.5±13.3) years, 835 cases (58.9%) were male, and 132 cases (9.3%, 132/1417) were diagnosed with synchronous peritoneal carcinomatosis during operation. Univariate analysis showed that peritoneal metastasis was associated with age, incidence of abdominal pain, incidence of mucous bloody stool, CEA level, traversible rate, tumor diameter, ratio of infiltrating type cancer, differentiation, histological type, cT staging and cN staging (all P<0.05). Logistic multivariate analysis revealed that younger age (OR:0.974, 95%CI: 0.958 to 0.990, P=0.001), later clinical T stage (OR: 2.949, 95%CI: 1.588 to 5.476, P=0.001), lesion not traversible(OR: 0.519, 95%CI: 0.314 to 0.858, P=0.011), infiltrative gross type (OR: 1.812, 95%CI: 1.099 to 2.987, P=0.020), larger tumor (OR: 1.044, 95%CI: 0.998 to 1.093, P=0.061), higher preoperative serum CEA level(OR:1.004,95%CI: 1.001 to 1.007, P=0.007) and histopathologic type of mucinous or signet ring cell adenocarcinoma (OR:1.642, 95%CI: 1.009 to 2.673, P=0.046) were independent risk factors. The nomogram model was further established based on above 7 independent risk factors, whose total score was 350 and area under the ROC curve was 0.753(P=0.000).

CONCLUSIONThe nomogram model can be helpful to screen the colon cancer patients with high risk of peritoneal metastasis and to avoid unnecessary laparotomy for colon cancer patients without distant metastasis by preoperative imaging examination.

OBJECTIVETo explore the risk factors of anal function after transabdominal intersphincteric resection(ISR) for low rectal cancer.

METHODSClinical and follow-up data of 96 patients with low rectal cancer who underwent transabdominal ISR in our department from January 2005 to December 2012 were analyzed retrospectively. The Wexner scoring scale was used to evaluate the anal function and the risk factors of anal function were analyzed by the Cox proportional hazard model.

RESULTSNinety-six patients completed Wexner scoring scale with mean follow-up of 32.7 months. Eighty-three cases(86.5%) presented good continence with a Wexner score less than 10. There was negative correlation between Wexner score and follow-up duration (Pearson coefficient, -0.078, P=0.003). Univariate analysis suggested the distance less than 5 cm from tumor to anal verge(P=0.043), height less than 2 cm from anastomosis to anal verge (P=0.001) and neoadjuvant chemoradiotherapy(P=0.001) were the risk factors. Multivariate analysis revealed that distance less than 2 cm from anastomosis to anal verge(P=0.020) and neoadjuvant chemoradiotherapy(P=0.001) were independent risk factors for fecal incontinence.

CONCLUSIONSMost patients have good continence after transabdominal ISR. A distance of less than 2 cm from anastomosis to anal verge and neoadjuvant chemoradiotherapy are independent risk factors for poor anal function after transabdominal ISR.

Anal Canal ; physiopathology ; Fecal Incontinence ; Humans ; Rectal Neoplasms ; physiopathology ; surgery ; Retrospective Studies ; Risk Factors