Objective To introduce a new anus preserving operation for low rectal cancer-ultralow anterior resection and colorectal/coloanal anastomosis by using supporting-bundling up method.Methods The clinical data of 310 patients who underwent anus preserving operation by supporting-bundling up method for low rectal cancer were retrospectively reviewed.Results The mean distance of tumor from the anal verge was 4.7?1.2cm;the TNM stage was stage Ⅰin 40 cases,stage Ⅱ30 cases,stage Ⅲ109 cases and stage Ⅳ 31 cases.the mean distance of the anastomosis from the anal verge was 2cm(1-4cm).the occurrence rate of postoperative anastomosis leak was 2.3%,the rate of excellent anal sphincter control was 82.25%.The 5-year local recurcence rate was 5.8%.Conclusions Ultralow anterior resection and colorectal/coloanal anastomosis by supporting-bundling up method may be one of the best anus preserving operations for low rectal cancer.It is a safe and feasible operation,and the long-term outcome is excellent.

ObjectiveTo observe the morphological changes of enteric nerve-interstitial cells of Cajal (ICC) network in rats with the bacterial peritonitis, and to investigate the main cause of gastrointestinal dysfunction and gastrointestinal failure with the bacterial peritonitis. Methods Sixty Wistar rats of both sexes were randomly divided into two groups. The model of the bacterial peritonitis was established.To record the frequency and amplitude of slow wave in myoelectricity of intestine in vivo to assess the function of the intestine motility. The proximal 10.0 cm segment of jejunum beginning 2 cm distal to the pylorus from each group was studied using c-Kit and vesicular acetylcholine transporter (VAChT)/ neuronal nitric oxide synthase (nNOS) immunohistochemical double-staining with whole-mount preparation technique and laser scanning confocal microscopy(CLSM). Results Compared the result of the bacterial peritonitis group with the normal group, it was found that the frequency and amplitude of slow wave in myoelectricity of intestine of the bacterial peritonitis group were slower and lower than the normal group, CLSM scanned ICC network showed that compared with the control group, the distributions and densities of ICC of intestine in the bacterial peritonitis group decreased significantly(P<0.01), the number of ICC synapse decreased, the cell junction between ICC and the ICC network was disrupted, and the fluorescence intension of cell decreased. CLSM scanned enteric nerve-ICC network indicated that compared with the control group, in the bacterial peritonitis group, the distributions and densities of cholinergic nerves (P<0.01)/ nitrergic nerves(P<0.01)and ICC(P<0.01)of intestine significantly decreased respectively, the cell junction between enteric nerve and enteric nerve -ICC network was disrupted, and the fluorescence intension of enteric nerve -ICC network decreased. The network of cholinergic/nitrergic nerve-ICC was disrupted. Conclusion The number of cholinergic nerves and nitrergic nerves were reduced, and the enteric nerve-ICC network was damaged in rats with bacterial peritonitis. Gastrointestinal motility dysfunction can be caused by the bacterial peritonitis.

Objective To evaluate the preoperative nutritional status of patients with colorectal carcinoma by using the nutritional risk screening 2002 (NRS2002) score and its prediction for postoperative outcomes.Methods Retrospectively evaluated the nutritional risk of 259 colorectal cancer patients with NRS2002 score in terms of different sexes,ages,tumor location,pathology and differentiation,Dukes stages.The relationship between different NRS2002 score and postoperative complications and hospital stay were also observed.Results NRS2002 score was applicable in 243 cases,≥ 3 scores of 80 cases,＜ 3 scores of 163 cases.Gender,histological differentiation and before surgery NRS2002 score unrelated (P ＞ 0.05).Ages,tumor location,and Dukes stages related NRS2002 score (P ＜ 0.01).No case of perioperative death,hospital stay 10-101 (21.6 ± 9.7) d.The incidence of complications in ≥ 3 scores patients was significantly higher than that in ＜ 3 scores patients [30.0％ (24/80) vs.17.2 ％ (28/163),P ＜ 0.05],hospital stay in ≥ 3 scores patients was significantly shorter than that in ＜ 3 scores patients[(20.5 ± 8.2) d vs.(23.9 ± 11.9) d,P＜ 0.05].Multiple Logistic regression analysis showed that gender,age,tumor location,histological differentiation,Dukes stages,surgical and colorectal cancer complications unrelated (P ＞ 0.05),NRS2002 score associated with colorectal cancer complications (P ＜ 0.05).Pearson correlation analysis showed that hospital stay correlated with NRS2002 score (P ＜ 0.01).Conclusions NRS2002 score is applicable in Chinese colorectal cancer patients.The youth and the elderly,the proximal part of colon,and Dukes D stage patients are more liable to develop preoperative nutritional risk than those of middle age,the distal part of colon,or other Dukes stages.≥ 3 scores predicts higher postoperative complications and longer hospital stay.Preoperative nutritional support is necessary in patients with ≥ 3 scores.

OBJECTIVETo study the influence of ligand structure on hydrolysis and solution stability of NAMI derivatives.

METHODNAMI type compound 1, trans- [RuCl4 (DMSO) (nica)] Na x 2DMSO (nica, nicotinamide) were prepared. Their hydrolytic mechanism, kinetics and stability were investigated by UV-Vis spectrophotometer.

RESULTSimilar to NAMI, compound 1 undergoes two well-separated steps chloro-hydrolysis (I chloro-hydrolysis and II chloro-hydrolysis) (step reaction) in pH 7.4 buffer solution; while dimethyl sulfoxide (DMSO) hydrolyze in pH 5.00 acetic buffer solution. The k(obs) and t1/2 for each hydrolytic reaction were determined.

CONCLUSIONThe stability of compound 1 in acidic solution is much more stable than that of in neutral solution. Nicotinamide in place of imidazole can decrease chloro hydrolytic rate of NAMI derivatives obviously, while the influence on the DMSO hydrolytic process is not so remarkable.

Dimethyl Sulfoxide ; chemistry ; Drug Stability ; Hydrolysis ; Imidazoles ; chemistry ; Kinetics ; Ligands ; Niacinamide ; chemistry ; Ruthenium ; chemistry ; Solutions ; chemistry

OBJECTIVETo explore efficacy and safety of modified FOLFIRINOX (mFOLFIRINOX) regimen by dose attenuation in locally advanced pancreatic cancer (LAPC) and metastatic pancreatic cancer(MPC).

METHODSBetween April 2014 and October 2015, 35 patients with LAPC (n=18) or MPC (n=17) were treated with mFOLFIRINOX regimen (irinotecan 135 mg/m(2), oxaliplatin 68 mg/m(2), 5-FU 2 400 mg/m(2), no bolus of 5-FU, leucovorin 400 mg/m(2)) in the Second Affiliated Hospital of Zhejiang University School of Medicine. The primary end point was progression free survival. The second end points were overall survival, objective response rate, adverse effects, surgical resection rate for LAPC.

RESULTSAmong 35 patients, 6 patients (17.1%) who dropped out and received less than 2 cycles were excluded for response analysis. Among the other 29 patients, 9 patients had grade 3 or 4 adverse effects. No patients ceased treatment due to adverse effects. The 29 patients received 5 (2-13) cycles were evaluated by efficacy and found partial remission in 16 cases, stable disease in 10 cases, progression disease in 3 cases. Response rate was 55.2%. Nine patients with LAPC accomplished surgery after neoadjuvant treatment without perioperative complication and death, and 6 patients accepted R0 resection.

CONCLUSIONSThe mFOLFIRINOX regimen used in the study is well-tolerated in Chinese population with high treatment efficacy on patients with LAPC and MPC. Further investigation of efficacy and adverse effects on more advanced pancreatic cancer patients is necessary.

Antineoplastic Combined Chemotherapy Protocols ; Camptothecin ; administration & dosage ; analogs & derivatives ; Disease Progression ; Disease-Free Survival ; Fluorouracil ; administration & dosage ; Humans ; Leucovorin ; administration & dosage ; Neoadjuvant Therapy ; Organoplatinum Compounds ; administration & dosage ; Pancreatic Neoplasms ; drug therapy ; Tertiary Care Centers ; Treatment Outcome

Glial cell line-derived neurotrophic factor (GDNF) is an important functional protein derived from enteric glial cells. It plays an important role in the enteric nervous system, such as nutritional neurons, promoting synaptic remodeling and anti-inflammation. The role of GDNF in the progression of gastrointestinal diseases has received more attention gradually. This article reviewed GDNF and its ligands, related signaling pathway, correlation with intestinal homeostasis and clinical application.

Objective:To explore the role and the intervention effect of emodin in intestinal neuropathy in rats with severe acute pancreatitis (SAP) through the nucleotide binding oligomerization domain like receptor protein 3/cysteine containing aspartic acid protease-1 (NLRP3/Caspase-1) pathway.Methods:Forty male healthy SD rats aged 6-8 weeks with a weight of approximately 200g were randomly divided into control group, SAP model group, emodin treatment (EMO) group, and NLRP3 knockdown group. SAP were induced by retrograde injection of sodium deoxycholate into the pancreatic duct of rats and serum amylase of which were detected. The effective NLRP3 knockdown sequence was screened for NLRP3 knockdown animal experiments. Fluorescence quantitative polymerase chain reaction was used to detect the expression of NLRP3, Caspase-1, gasdermin-D (GSDMD), interleukin (IL)-1β, IL-18 and tumor necrosis factor-α(TNF-α) in the small intestine of each group. Immunofluorescence staining was used to detect the expression of glial fibrillary acidic protein (GFAP) in the small intestine of each group.Results:The amylase levels of the control group, SAP group, EMO group, and NLRP3 knockdown group were (277.73±24.92) U/L, (1018.57±282.89) U/L, (625.43±134.40) U/L, and (391.01±27.63) U/L, respectively. The SAP and EMO groups were significantly higher than the control group ( P<0.001), while the EMO and NLRP3 knockdown groups were significantly lower than the SAP group (all P<0.001). Compared with control group, the expression levels of NLRP3, Caspase-1, IL-1β, IL-18, TNF-α and GSDMD in SAP group were increased, with statistical significance (all P<0.001). Compared with SAP group, the NLRP3 knockdown group showed the expressionlevels of the above 6 genes were all decreased, and EMO group showed decreased gene expressing levels of NLRP3, IL-1β, IL-18 and TNF-α, with statistical significance (all P<0.05). The relative expression of GFAP in small intestine of control group, SAP group, EMO group and NLRP3 knockdown group were (1.00±0), (1.66±0.11), (1.13±0.02) and (1.13±0.02), respectively. Among them, the expression of GFAP in SAP group was increased compared with the control group; The expression of GFAP in EMO group and NLRP3 knockdown group was lower than that in model group, and the differences were statistically significant (all P<0.05). Conclusions:Emodin and knocking down NLRP3 can both promote the repair of SAP small intestine injury through the NLRP3/Caspase-1 signaling pathway, and thus play a protective role in the intestine.