OBJECTIVETo observe the antiulcer effects of pomegranate tannins in animal models.

METHODGastric ulcer models were established by pylorus ligation, intragastric absolute ethanol, and water-immersion stress, respectively. The ulcer index, the contents of nitric oxide (NO) and malondialdehyde (MDA), the activities of glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD) from gastric mucosa of rats, the gastric juice volume, free acidity, total acidity,total acid output, the pepsin activity, the amount of adherent mucus and free mucus were measured, respectively.

RESULTPomegranate tannins (500, 150, 50 mg x kg(-1)) significantly inhibited ulcerative formation induced by both water immersion stress and pylorus ligation, obviously decreased the gastric mucosa damages induced by intragastric absolute ethanol, in dose-dependent manner. Pomegranate tannins significantly inhibited absolute alcohol-induced elevation of MDA as well as decreasing of NO level, and activities of both SOD and GHS-PX from gastric mucosa. Pomegranate tannins significantly increased the secretion of adherent mucus and free mucus, but did not affect elevation of the free acidity, total acidity, and total acid output, gastric juice volume, gastric pepsin activity induced by pylorus ligation.

CONCLUSIONPomegranate tannins play a protective role against gastric ulcer. Its antiulcer effect is related to increasing secretion of adherent mucus and free mucus from the stomach wall, which may inhibit generation of oxygen-derived free radicals, and decrease the consumption of GSH-PX and SOD, and maintain content of NO at normal level.

Animals ; Anti-Ulcer Agents ; therapeutic use ; Disease Models, Animal ; Ethanol ; adverse effects ; Female ; Gastric Juice ; drug effects ; Male ; Mice ; Nitric Oxide ; adverse effects ; Plant Extracts ; therapeutic use ; Punicaceae ; chemistry ; Pylorus ; Rats ; Rats, Sprague-Dawley ; Stomach Ulcer ; chemically induced ; drug therapy ; Tannins ; therapeutic use

Objective To explore the application value of cone-shaped gastric tube combined with cervical end-to-end anastomosis in thoracoscopic and laparoscopic esophagectomy for esophageal cancer.Methods The retrospective and descriptive study was conducted.The clinical data of 122 patients with esophageal cancer who were admitted to West China Hospital of Sichuan University from December 2016 to December 2017 were collected.There were 89 males and 33 females,aged (61±8)years,with a range from 48 to 81 years.McKeowntype three-incision esophagectomy was performed,and the cone-shaped gastric tube was pulled up to esophagus in left neck for hand-sewn end-to-end anastomosis after the dissection of esophagus and stomach under total thoracoscopy and laparoscopy.Observation indicators:(1) surgical treatment situations;(2) postoperative complications;(3) follow-up.Follow-up using outpatient examination was performed to detect postoperative gastroesophageal reflux,anastomotic stenosis and evaluate anastomotic width at 1,3,6 months and one year postoperatively up to December 2018.Measurement data with normal distribution were represented by Mean±SD.Measurement data with skewed distribution were described by M (P25,P75) or M (range).Count data were expressed by absolute number.Results (1) Surgical treatment situations:122 patients underwent laparocopic McKeown-type three-incision esophagectomy successfully,using cone-shaped gastric tube combined with cervical hand-sewn end-to-end anastomosis as digestive tract reconstruction,with no intraoperative conversion to open surgery.The operation time,cervical anastomosis time,and volume of intraoperative blood loss were (229 ± 49) minutes,(27± 1) minutes,and 50 mL (40 mL,60 mL),respectively.There were 6-8 stations of lymph node dissected,and the number of lymph node dissected were 19 (15,25).Duration of postoperative hospital stay was 10 days (9 days,11 days) in the 122 patients.(2) Postoperative complications:31 of 122 patients had postoperative complications.The primary complications:3 patients with anastomotic fistula were cured by conservative treatment including enteral nutrition through placement of nutritional tube under gastroscope,closed thoracic drainage and anti-infection;6 cases with severe thoracic gastric dilation were cured after gastrointestinal decompression.The secondary complications of 22 patients included 8 cases with hoarseness caused by recurrent laryngeal never injury,5 with arrhythmia,9 with pulmonary infection.They were cured after symptomatic and supportive treatment.No chylothorax occured,and there was no perioperative death.(3) Follow-up:all the 122 patients were followed up for 10-24 months,with a median time of 19 months.During the follow-up,7 cases with anastomotic stenosis including 4 scoring less than grade 2 and 3 scoring more than grade 3 were relieved after dilation through gastroscope.There were 33 of 122 patients without any reflux symptoms,and 89 with reflux symptoms,among which 52 were scored 1,25 were scored 2 and 12 were scored 3.The width of gastroesophageal anastomosis measured by barium radiography at 1 month after operation was (1.2±0.4) cm.Conclusion Coneshaped gastric tube combined with cervical end-to-end anastomosis in digestive tract reconstruction of thoracoscopic and laparoscopic esophagectomy can reduce the incidence of postoperative anastomotic complications and thoracic gastric dilation,and nasogastric tube placement could be abandoned,which demonstrates good safety and universality.