OBJECTIVETo compare the number of harvested perisplenic hilar lymph nodes by laparoscopy-assisted total gastrectomy (LATG) and conventional open total gastrectomy (OTG) for advanced upper and middle gastric cancer.

METHODSThree hundred twelve patients with advanced gastric cancer treated in a single institution between Sept 2008 and Jan 2011 were included in this study. They were divided into two groups: the LATG group and OTG (D2) group. All the surgical operations were performed by one surgeon or under his supervision. The lymph node clearance outcomes of the patients treated by those two surgical procedures were analyzed.

RESULTSThe harvested lymph node numbers of the two groups were (29.57 ± 9.62) and (29.38 ± 11.22) respectively, statistically with no significant difference (P = 0.875). The numbers of lymph node dissected around the splenic area in the LATG group and OTG group (Section 10, 11 group) were (2.01 ± 1.34) and (1.33 ± 1.11), respectively, indicating a significant difference (P = 0.000). The numbers of lymph nodes dissected around the celiac region (Section 7, 8, 9, 11p and 12a(2) group) were (7.90 ± 3.41) and (7.22 ± 2.65), respectively, with a non-significant difference (P = 0.050). There were also no significant differences while comparing with the numbers of lymph nodes dissected in the cardiac area (group 1, 2), pyloric region (5, 6 group) and the greater and lesser omentum area (group 3 and 4) between the two groups (P = 0.605, P = 0.248, P = 0.262).

CONCLUSIONShort-term results of this study indicate that laparoscopy-assisted total gastrectomy (D2) is better than conventional open surgery in perisplenic hilar lymph node dissection.

Adult ; Aged ; Female ; Gastrectomy ; methods ; Humans ; Laparoscopy ; Lymph Node Excision ; methods ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Spleen ; Stomach ; Stomach Neoplasms ; pathology ; surgery

OBJECTIVETo compare the medial-to-lateral approach with the lateral-to-medial approach in laparoscopic right hemi-colectomy for right colon cancer.

METHODSA prospective randomized controlled trial was performed in the Fujian provincial tumor hospital between January 2007 and July 2009. Forty-eight cases with right colon cancer were randomly divided into two groups:medial-to-lateral laparoscopic right hemi-colectomy group(group M) and lateral-to-medial laparoscopic right hemi-colectomy group(group L). Primary outcome(operative time) and secondary outcomes (estimated blood loss, intra-operative complication, post-operative complication, number of lymph node retrieval, hospital stay) were compared between two groups.

RESULTSOperative time was(122.5+/-25.8) min in group M and (162.9+/-30.9) min in Group L (P=0.01). Estimated blood loss was(55.8+/-36.2) ml in group M and (104.6+/-58.2) ml in group L(P=0.01). There were no significant differences between the two groups in intra-operative complications(4.2% vs 8.3%, P=1.00), post-operative complications (8.3% vs 16.7%, P=0.66), number of lymph node retrieval (17.4+/-3.2 vs 17.8+/-3.4, P=0.67), and hospital stay[(7.8+/-2.2) d vs (8.0+/-3.6) d, P=0.81].

CONCLUSIONThe medial-to-lateral approach reduces operative time and blood loss in laparoscopic right hemi-colectomy as compared with the lateral-to-medial approach.

Adult ; Colectomy ; methods ; Colonic Neoplasms ; surgery ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Prospective Studies ; Treatment Outcome

Objective To observe the clinical efficacy of self-prescribed Guchong Decoction combined with Ferroids for the treatment of iron deficiency anemia (IDA)patients with unconsolidation of thoroughfare and conception vessels. Methods A total of 70 IDA patients with unconsolidation of thoroughfare and conception vessels were randomized into treatment group and control group,35 cases in each group. The control group was given oral use of Ferroids, and the treatment group was treated with self-prescribed Guchong Decoction combined with Ferroids. One month constituted a treatment course,and both groups were treated for 2 courses. Before and after treatment,we compared the parameters of blood routine test for red blood cells(RBC),hemoglobin (HGB), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), MCH concentration (MCHC),white blood cells(WBC)and platelets,as well as reticulocytes(Ret)and iron metabolism indexes including serum iron(SI),serum ferritin(SF),and total iron-binding capacity(TIBC). The adverse reaction was monitored during the treatment. After treatment,both western medicine clinical efficacy and traditional Chinese medicine (TCM)syndrome clinical efficacy of the two groups were evaluated. A 3-month follow-up was carried out after treatment to evaluate the recurrence rate. Results(1)Drop-out occurred in one case from the treatment group and in 2 cases from the control group because of short-term medication suspension.(2)After treatment for 2 months, western medicine clinical cure rate of the treatment group was 82.4％ and that of the control group was 60.6％, and TCM syndrome clinical cure rate of the treatment group was 94.1％ and that of the control group was 51.5％,the difference being significant(P < 0.05 or P < 0.01).(3)The levels of RBC,HGB,Ret, MCV, MCH, MCHC, and WBC of the two groups were obviously increased after treatment (P < 0.01), and PLT level was markedly decreased (P < 0.01)as compared with those before treatment,but the inter-group differences after treatment were insignificant (P > 0.05). (4)After treatment,iron metabolism indexes of SF and SI of the two groups were significantly increased (P < 0.01), and TIBC of the treatment group was significantly decreased (P < 0.01). The treatment group had stronger effect on increasing SF and SI and on decreasing TIBC than the control group (P < 0.05 or P < 0.01). (5)The incidence of adverse reaction and the recurrence rate in the treatment group were lower than those of the control group,the difference being significant (P< 0.01). Conclusion Guchong Decoction combined with Ferroids is effective for the treatment of IDA with unconsolidation of thoroughfare and conception vessels through relieving symptoms rapidly, reducing gastrointestinal adverse reaction,and decreasing recurrent rate.

Objective To investigate the main components and antioxidant activity of the extract of corn silk.Methods The extraction of proteins was determined by the Kjeldahl method,total sugar was determined by the phenol-sulfuric acid assay,reducing sugar by 3,5-dinitrosalicylic acid (DNS) assay,respectively.Sodium dodecyl sulfate-polyacrylamide gel electrophoresis assay (SDS-PAGE) profile was used to show the composition of the protein of the extract of corn silk.The antioxidant activity of the extract of corn silk was evaluated by the ABTS · + radical scavenging rate and oxygen free radical absorption capacity.Results The contents of total sugar,reducing sugar and protein were 51.70％,10.43％ and 21.80％,respectively.SDS-PAGE profile showed that the extract of corn silk contained soluble protein,and its molecular weight was between 9.5 kD and 20 kD.The experimental results showed that the free radical scavenging rate of ABTS · + had reached 70.29％ when the extract concentration was 0.40 mg · mL-1 In the reaction system,the half inhibition rate (IC50) of ABTS free radical scavenging activity was 0.23 mg · mL-1.The total antioxidant activities evaluated by ORAC assay were 3.40 mmol Trolox equivalents · g-1,equivalent to 1/3 of absorption capacity of Vitamin C free radical.Conclusion The extract of corn silk has prominent antioxidant activity.

Tibetan medicine "Dida" isoccasionally misused due to its complex origins, which ultimately affects its clinical efficacy. The accurate name, origin, property, and efficacy of "Dida"are highly important for its further research and development. In the present study, by viewing the classic Tibetan medicine and modern literature, and combining the clinical practice of Tibetan medicine, the origins, properties and the clinic effects of "Dida" were defined. "Dida" originated from multiple plant species of Swertia, Gentianopsis, Halenia, Lomatogonium, Comastoma(Gentianaceae), Hedyotis (Saxifragaceae) and Erysimum (Cruciferae). The medicinal properties of "Dida" is mainly bitter and cold. It has been commonly used to treat febrile diseases and hepatic and gall diseases. This study suggested that the relevant herbalogical study, species identification and pharmacological effects of "Dida" should be taken based on the Tibetan medicine theories and clinical practice. Thus the medicine can be better used and ensure its safety and quality simultaneously.