Background and purpose:Glutamine is the major fuel for the enterocyte and major energy origin of intestinal mucosal cell which prevent gastrointestinal mucosal cell from atrophying.Although there were a lot of studies of how to protect the gastrointestinal mucosal in various stress,such as trauma,burn and complex operation,but the impact of how the glutamine affected the gastrointestinal mucosa in the period of chemotheraphy was rarely reported.Our aim was to investigate the protective effects of glutamine for the morphological and functional damage of gastrointestinal mucosa induced by introperitoneally fluorouracil(5-FU) in rats in order to find the ways to prevent the intestinal mucosa from damage in the period of chemotherapy.Methods:Forty Wistar rats were randomly divided into four groups:A:Blank control group,B:5-FU group,C:5-FU + Glycin group,D:5-FU + Glutamine group.The rats in group C were given Glycin,group D glutamine(0.35 g/kg each).Group B,group C and group D received 5-FU(100 mg/kg) injection intraperitoneally on the fourth day respectively to make the model of gastrointestinal barrier injury.The content of endotoxin in peripheral blood was measured in all groups after the rats were killed on the seventh day.The mesenteric lymph nodes(MLN) and liver were harvested for comparison of bacterial translocation incidence among the four groups.Ileum tissue was taken for pathologic examination including comparison of mucosal thickness,villus height and width and morphology change of ileum of each group.Results:The test showed that the weight and the height,the width,the thickness of the villus intestinal mucosa of group D were more than those of groupB and group C.The content of endotoxin in peripheral blood and the positive cases of bacterial translocation in MLN and liver of group D were less than group B and group C.The weight and the height,the width and the thickness of the villus intestinal mucosa of group A were more than those of group B,group C,and group D.The content of endotoxin in peripheral blood and the positive cases of bacterial translocation of MLN and liver of group A were less than group B,group C and group D.Conclusion:There were damage to the rat's gastrointestinal mucosa during the giving of 5-FU intraperitoneally.Glutamine could protect rat's gastrointestinal mucosa from damage during the giving of 5-FU intraperitoneally.Glycin could not protect rat's gastrointestinal mucosa against from damage during the giving of 5-FU intraperitoneally.

Objective To study the feasibility and clinical effect of trans umbilical single incision laparoscopic right hemicolectomy for right hemicolon carcinoma.Methods The clinical data of 35 patients with right hemicolon carcinoma were retrospectively analyzed,the 15 cases were received the trans umbilical single incision laparoscopic right hemicolectomy (single incision group) and 20 cases were received laparotomy right hemicolectomy (laparotomy group).The clinical indexes were compared between the 2 groups.Results The length of incision,intraoperative bleeding volume,passage of gas by anus time,feeding time,hospitalized time in single incision group were significantly better than those in laparotomy group [(5.5 ± 0.6) cm vs.(17.6 ± 2.2) cm,(84.0 ± 31.1) ml vs.(155.5 ± 43.1) ml,(2.00 ± 0.76) d vs.(3.75 ± 0.63) d,(5.3 ± 0.6) d vs.(6.5 ± 0.6) d,(9.3 ± 1.4) d vs.(13.5 ± 1.5) d],the operation time in single incision group was significantly longer than that in laparotomy group [(238.4 ± 19.3) min vs.(165.3 ± 25.8) min],there were statistical differences (P ＜ 0.05).There was no statistical difference in number of incision lymph node between the 2 groups (P ＞ 0.05).Postoperative complication in single incision group occurred in 2 cases,postoperative complication in laparotomy group occurred in 3 cases,there was no statistical difference (P ＞0.05).The follow-up time was 1-55 months,the median follow-up time was 28 months,local recurrence and distant metastasis were found in 2 cases in single incision group,and 4 cases was found in laparotomy group,there was no statistical difference (P ＞ 0.05).Conclusions Single incision laparoscopic right hemicolectomy for right hemicolon carcinoma is safe and feasible,which has the advantages of minimal trauma,aesthetic outlook,less bleeding,quick recovery and short hospitalization time,etc.It can be developed in the hospital which has some basis of laparoscopic surgery.

Lipase of 54/923 cases increased in viral hepatitis group with an abnormal rate of 5.85％.Lipase level of viral hepatitis patients gradually increased with the rising total bilirubin levels,and the difference was statistically significant (P ＜0.0l).Among 54 viral hepatitis cases with elevated lipase,11 died.The sustained abnormal rate of lipase (6/11) of the death group was statistically significant vs.4.65％ (2/43) of the survival group(P ＜0.01).Thus viral hepatitis could be concomitant with elevated lipase and elevated lipase might promote the progression of liver disease.The continuing rise of lipase is correlated with the severity and prognosis of the patients.