1.Clinical analysis of early postoperative oral enteral nutrition on immune function for colorectal cancer patients
Gaojian CAO ; Wenjing YE ; Tingting JI ; Ruiyao ZHOU ; Zhenfeng HUANG
Chinese Journal of Primary Medicine and Pharmacy 2016;23(12):1772-1775
Objective To investigate clinical effects of early postoperative oral enteral nutrition on immune function for colorectal cancer patients,to provide a reference for clinical treatment.Methods We selected 90 colorec-tal cancer surgery patients from January 2012 to April 2015,and they were divided into two groups by random number method.50 cases in the study group were given early oral enteral nutrition,and 40 patients in the control group were given postoperative parenteral nutrition.Before and after treatment,the quality of life,complications,immunology indi-cators,nutrition indicators were compared in two groups.Results In the observation group,the postoperative fever, exhaust time,hospital stay,hospital costs,quality of life scores were (54.29 ±5.76)h,(57.89 ±5.95)h,(10.48 ± 1.63)d,(41 432.85 ±2 165.46)RMB,(79.23 ±5.17)points,which were significantly lower than those in the con-trol group,the differences were statistically significant (t =8.69,P =0.00;t =8.61,P =0.00;t =9.49,P =0.00;t =5.54,P =0.00;t =4.16,P =0.01);7d after the treatment,the IgA,IgG,IgM,CD +4 ,CD +4 /CD +8 in observation group were (1.92 ±0.49)g/L,(11.31 ±2.24)g/L,(0.99 ±0.21)g/L,(41.21 ±5.51)%,(1.72 ±0.32),which were better than those in the control group,the differences were statistically significant (t =2.05,P =0.04;t =2.11, P =0.04;t =2.12,P =0.04;t =3.64,P =0.01;t =2.23,P =0.03).In observation group,postoperative 7d Hb, TRF,ALB,PAB were (113.28 ±13.36)g/L,(3.02 ±0.39)mg/L,(38.97 ±3.15)g/L,(333.15 ±18.35)mg/L, which were better than those in the control group,the differences were statistically significant (t =3.45,P =0.01;t =2.18,P =0.03;t =2.32,P =0.04;t =3.21,P =0.01).7d after operation,the CRP level of observation group was(7.29 ±2.05)mg/L,which was significantly lower than that of the control group,the difference was statistically sig-nificant (t =4.22,P =0.01 ).The incidence rate of postoperative complications in the observation group was 26.00%,that of the control group was 40.00%,the difference was statistically significant (χ2 =4.52,P =0.01). Conclusion Early oral enteral nutrition in patients with colorectal cancer will help to improve immune function, nutritional support,reduce the inflammatory response,which will help postoperative recovery.
2.Experimental study on arsenic trioxide and fluorouracin, gemcitabine effects on human pancreatic carcinoma cell lines PC-3
Gaojian CAO ; Ruiyao ZHOU ; Zhenfeng HUANG ; Qiang LI ; Shengzhang LIN
Chinese Journal of Primary Medicine and Pharmacy 2010;17(z1):1-2
Objective To study the effects of arsenic trioxide ( As2 O3 ) on inhibiting the proliferation of pancreatic carcinoma cell lines. Methods The inhibiting rate of As2O3 and Fluorouracin(5-Fu) ,Gemcitabine(GEM) on pancreatic carcinoma cell lines PC-3 were detected by using CCK-8 assay. Results As compared with 5-Fu、GEM,the inhibiting rate of As2O3 was the highest one( P < 0.01 or P < 0.05). Conclusion As2O3 can inhibit pancreatic carcinoma cell lines PC-3 effectively in vitro. The effects of As2O3 on inhibiting the proliferation of pancreatic carcinoma cell lines was stronger than 5-Fu and GEM. This is possibly due to the extensive and unique anticancer mechanism of As2O3.
3.Nonoperative management strategy to prevent the conversion of mild into severe acute pancreatitis
Qingfan PU ; Ruifang REN ; Gaojian CAO ; Yu CAI ; Kai JIN
Chinese Journal of General Surgery 2000;0(11):-
Objective To discuss the nonoperative management strategy to prevent the conversion of acute pancreatitis to the severe form.Methods In recent 4 years,286 patients with mild acute pancreatitis admitted to our hospital were divided into control group and treatment observation group;routine conservative management was performed in control group,and the strategy of improving pancreatic microcirculation and preventing cell Ca~2+ overload and inhibiting pancreatic protease was added to the treatment observation group.Results Among the 144 patients with mild acute pancreatitis in control group,conversion to severe acute pancreatitis occurred in 20 patients,and 14 of the 20 patients with severe acute pancreatitis developed systemic complications.Among the 142 cases in treatment observation group,the conversion of mild to severe acute pancreatitis occurred in 8 patients,and 2 of the 8 patients developed systemic complications.Serum C-reactive protein levels and Balthazar CT severity index were significantly decreased at each time point in treatment observation group compared to control group.Conclusions In addition to routine management,improving pancreatic microcirculation,preventing cell Ca~2+ overload and inhibiting pancreatic protease might serve as a benificial strategy for preventing the progression of mild acute pancreatitis to the severe form.
4.Effects of preoperative selective gastric arterial chemoembolization on the tumor vasculature in patients with gastric carcinoma
Suikang SUN ; Qingfan PU ; Lunan YAN ; Jibao PAN ; Gaojian CAO ; Wenzheng WU
Chinese Journal of General Surgery 1997;0(04):-
Objective To investigate the effects of preoperative selective gastric arterial chemoembolization on the tumor vasculature in patients with gastric carcinoma.Methods 40 patients with gastric cancer were divided into two groups :(1)gastric arterial influsion(GAI)group;and (2)gastric arterial chemoembolization(GAE)group.The peripheral vein plasma tumor necrosis factor(TNF ?) and thrombomodulin(TM)were determined before radiologic intervention(RI),and1d,3d after R1;and the gastric vein plasma TNF ? and TM were also determined during operation.The curative surgical resection of gastric cancer was performed between 7 and 10 days after treatment.Stomach histological alterations were observed postoperatively.Results Compared with GAI group ,the plasma TNF ? levels increased markedly at all the time points,and gastric vein plasma TM levels decreased siginificantly in GAE group (P
5.Application value of transanal endoscopic intersphincteric resection in sphincter preserva-tion for low rectal cancer
Gaojian CAO ; Ximo XU ; Hao ZHONG ; Zhenghao CAI ; Jun YOU ; Mingyang REN ; Liang KANG ; Bo FENG
Chinese Journal of Digestive Surgery 2024;23(6):836-844
Objective:To investigate the application value of transanal endoscopic intersphincteric resection (taE-ISR) in sphincter preservation for low rectal cancer.Methods:The pro-pensity score matching and retrospective cohort study was conducted. The clinicopathological data of 278 patients with low rectal cancer who were admitted to 5 medical centers, including Ruijin Hospital of Shanghai Jiaotong University School of Medicine et al, from January 2017 to December 2021 were collected. There were 178 males and 100 females, aged 58 (range, 49-64)years. Of 278 pati-ents, 147 cases undergoing taE-ISR were divided into the taE-ISR group, and 131 cases undergoing intersphincteric resection (ISR) were divided into the ISR group. Observation indicators:(1) propen-sity score matching and comparison of general data of patients between the two groups after matching; (2) comparison of intraoperative and postoperative conditions between the two groups; (3) long-term follow-up of the two groups; (4) analysis of risk factors affecting sphincter preservation for low rectal cancer. Propensity score matching was done by the 1∶1 nearest neighbor matching method, with a caliper value of 0.05. Propensity score matching analysis was done using the Matching package. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the Student′s t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Wilcoxon rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the Pearson chi-square test or Fisher exact probability. The Kaplan-Meier method was used to calculate survival rate and plot survival curve, and the Log-Rank test was used for survival analysis. Multivariate analysis was conducted using the Logistic regression model with the "glm2" package. The forest plot was used to show the risk factors affecting sphincter preservation for low rectal cancer. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of 278 patients, 180 cases were successfully matched, including 90 cases in the taE-ISR group and 90 cases in the ISR group, respectively. After propensity score matching, the elimination of distance between ischial tuberosities and distance from ischial tuberosity to the skin of buttocks confounding bias ensured comparability between the two groups. (2) Comparison of intraoperative and postoperative conditions between the two groups. Cases with positive distal margins, cases with specimen integrity, cases with sphincter preservation were 1, 88, 88 in the taE-ISR group and 8, 78, 74 in the ISR group, showing significant differences between the two groups ( P<0.05). (3) Long-term follow-up of the two groups. The median follow-up time was 4.3(range, 3.8-5.0)years of the taE-ISR group and 4.1(range, 3.4-4.7)years of the ISR group. The overall survival rate, disease-free survival rate and cumulative recurrence rate were 100.0%, 95.6% and 2.2% of the taE-ISR group, versus 98.9%, 87.8% and 10.0% of the ISR group, showing no significant difference in overall survival rate between the two groups ( χ2=0.97, P>0.05) and significant differences in disease-free survival rate and cumulative recurrence rate between the two groups ( χ2=4.05, 5.26, P<0.05). (4) Analysis of risk factors affecting sphincter preservation for low rectal cancer. Results of multivariate analysis showed that taE-ISR, distance from the tumor to the anus, and adjacent organ damage were independent factors affecting sphincter preservation for low rectal cancer ( odds ratio=0.86, 0.88, 1.35, 95% confidence interval as 0.79-0.93, 0.83-0.92, 1.04-1.74, P<0.05). In further analysis, there were significant differences in sphincter preservation and defecatory dysfunction between the 21 cases with neoadjuvant therapy in the taE-ISR group and the 19 cases with neoadjuvant therapy in the ISR group ( P<0.05). Conclusions:The taE-ISR is safe and feasible for patients with low rectal cancer. Compared with ISR, taE-ISR can significantly improve surgical quality, sphincter preservation rate and patient prognosis.