Objective To investigate the systemic stress responses after laparoscopic resection in colorectal cancer patients.Methods Sixty patients were randomized into the laparoscopic resection group (30 cases) and open resection group (30 cases) from October 2001 to September 2002 in our hospital.Analgesic dosages, recovery time of intestinal peristalsis, postoperative temperatures, C reactive protein(CRP), IL 6 and white blood cell (WBC) counts were recorded after operation. Results The changes of postoperative temperatures and WBC counts showed no significant difference between two groups.But in the laparoscopic resection group, the recovery time of intestinal peristalsis, postoperative analgesic dosages, CRP and IL 6 significantly decreased ( P

Objective To study the effect of hand-assisted laparoscopic anterior resection for rectal cancer(RC).Methods The clinical data of 28 cases of RC operated with hand-assisted laparoscopy were analyzed retrospectively. Results The operations in all the 28 cases were successfully performed, and no intra-or post-operative complications were observed.The number of resected lymph nodes and the resected margins from the tumor were sufficient.After operation,the patients felt less pain, recovered quicker and bowel movement recovered early;first postoperative flatus was appeared at 32 hours after operation;average postoperative hospital stay was 7 days.All the patients were followed-up for 8 to 19 months,and no trocar port tumor implantation or local recurrence occurred.Conclusions The results demonstrate that hand-assisted laparoscopic anterior resection in the treatment of RC have many advantages,such as safe,less trauma,the patients recover quicker,resection of the tumor more complete etc,so it can be used extensively.

Objective To investigate the clinical value of laparoscopic resection of gastric stromal tumors.Methods Thirty-two cases received this new type of operation.The tumors ranged in size from 1.5 to 5.5cm with a mean diameter of 2.6 cm.The operative methods included the full laparoscopic resection of(gastric) tumor and the hand-assisted laparoscopic resection of gastric tumor.Results All cases were(successfully) resected and no complications were observed.The mean operative time was 75min.The mean(intraoperative) blood loss was 50ml.Postoperative pain was slight.Postoperative flatus and feces were passed at a mean of 34 hours,and average postoperational hospital stay was 7.5days.Postoperative pathologic(examination) confirmed that 25 cases were benign GIST and 7 cases were of low-grade malignancy.No(recurrences) were observed at follow up of 8 to 30 months.Conclusions Laparoscopic resection of gastric(stromal) tumor is a technically simple,safe and effective procedure that could be widely used.

This study was to appraise safety and feasibility of laparoscopic approach and investigate the clinical effects of laparoscopic tension-free repair of esophageal hiatal hernia using mesh. From August 2006 to July 2009, 24 patients with esophageal hiatal hernia underwent laparoscopic repair. Twenty-three patients received laparoscopic tension-free repair using mesh, at the same time, Toupet or Dor partial fundoplication was performed. One patient was converted to open surgery. The average operating time was 90 min (70-210 min) and the blood loss was between 10-110 mL. There was no death. The mean postoperative hospital stay was 5 days (3-30 days). During a follow-up period of 12-20 months (mean 15 months), there was no recurrence of the hernia, and no complication with use of mesh. The present study suggested that laparoscopic approach was secure and minimally invasive operation for esophageal hiatal hernia and the use of mesh could reduce recurrence rate.

OBJECTIVETo compare therapeutic effects between unilateral decompression technique only and open decompression technique with fusion and internal fixation for the treatment of lumbar spinal stenosis.

METHODSFrom March 2008 to February 2011, 82 patients with lumbar spinal stenosis were treated with operations, and divided into two groups. There were 13 males and 19 females in group A, with a mean age of (56.31±4.31) years old. The patients in group A were treated with unilateral decompression via fenestration technique only, including 23 patients obtaining single level decompression and 9 patients obtaining two levels decompression. In group B, there were 18 males and 32 females, with a mean age of (57.53±4.28) years old. The patients in group B were treated with open decompressive technique with fusion and internal fixation, including 38 patients obtaining single level decompression and 12 patients obtaining two levels decompression. The VAS of back pain and leg pain, ODI were recorded before and after surgery to evaluate low back pain,leg pain and walking tolerance.

RESULTSAll the patients were followed up, and the duration ranged from 10.9 to 43.4 months,with a mean of 32.8 months. There were no differences in age, stenosis level, VAS of back and leg pain and ODI before surgery between two groups. Compared with the corresponding ones in group B, the operation time, blood loss, hospitalization time,recovery time of routine daily life and finacial expenditure of patients were all shorter or less in group A. There was no statistically difference in complications between two groups.

CONCLUSION"Unilateral decompression via fenestration technique" is a less invasive and more effective decompressive technique for degenerative spinal stenosis without posterior elements damage. It has advantages in operation time, blood loss, hospitalization time, recovery to daily life and financial expenditure. When controlling the operative indications strictly, the technique could be an important procedure for surgical treatment of degenerative spinal stenosis, especially in the elderly population.

Adult ; Aged ; Case-Control Studies ; Decompression, Surgical ; methods ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Spinal Fusion ; methods ; Spinal Stenosis ; surgery

OBJECTIVETo observe the effect of nourishing Yin, strengthening Qi and activating blood decoction on Fas/FasL in salivary glands of NOD mice with Sjogren's syndrome and their mRNA expression.

METHODThirty-two NOD mice were randomly divided into the model group, the traditional Chinese medicine group (TCM group, orally given 0.4 mL nourishing Yin, strengthening Qi and activating blood decoction as per 100 g x kg(-1) everyday), the hydroxychloroquine group (given 0.4 mL hydroxychloroquine as per 60 mg x kg(-1) everyday), the traditional Chinese medicine and western medicine group (TCM WM group, given nourishing Yin, Strengthening Qi and activating blood decoction 50 g x kg(-1) and hydroxychloroquine 60 mg x kg(-1), 0.4 mL everyday), with eight mice in each group. Eight Balb/C mice were selected as the normal control group (normal group). All of mice were killed after eight weeks, and their submaxillary glands were dissected. The expression levels of Fas/FasL were examined by immunohistochemical method, and the FasL mRNA was detected by RT-PCR.

RESULTThe expression levels of Fas/FasL in salivary glands of the model group were higher than that of other groups (P < 0.05). The expression level of FasL of the normal group was much lower than that in the hydroxychloroquine group (P < 0.05). The relative expression level of Fas mRNA in salivary glands of the model group was higher than that in other groups, but the control group was notably lower than other groups (P < 0.05). The expression level of FasL mRNA in salivary glands of the model group was higher than that in TCM and TCM WM groups (P < 0.05). But the expression level in TCM WM group was notably lower than the hydroxychloroquine group (P < 0.05).

CONCLUSIONThe nourishing Yin, strengthening Qi and activating blood decoction could down-regulate the expression level of Fas/FasL in salivary glands of NOD mice with Sjogren's syndrome and their mRNA expression, and had a better efficacy after being combined with hydroxychloroquine. The nourishing Yin, strengthening Qi and activating blood decoction might treat the Sjogren's Syndrome by reducing apoptosis which is regulated by Fas/FasL

Animals ; Fas Ligand Protein ; genetics ; Female ; Gene Expression Regulation ; Medicine, Chinese Traditional ; methods ; Mice ; Mice, Inbred NOD ; Qi ; RNA, Messenger ; genetics ; metabolism ; Salivary Glands ; metabolism ; Sjogren's Syndrome ; blood ; genetics ; therapy ; Yin-Yang ; fas Receptor ; genetics

OBJECTIVETo summarize the clinical characteristics of an infant with chronic myelogenous leukemia (CML) and the effects of imatinib on the case.

METHODThe clinical features of an infant with CML, who was treated with imatinib in the Norman Bethune International Peace Hospital at June 2009, were retrospectively analyzed and the reports in literature were reviewed. The 1-year-old boy suffered from recurrent low-degree fever and pallor. He had a moderate anemia, distended abdomen and marked splenomegaly. Bone marrow aspiration revealed CML in chronic phase)CP). The t (9; 22))q34; q11) could be detected and BCR-ABL (p210) was positive. The boy was diagnosed as CML-CP and treated with imatinib 100 mg per day. There were 10 related papers and more than 100 child CML patients were reported as retrieved from CNKI)from its establishment to August 2014) and Wanfang Database)from its establishment to August 2014) when "Child", " Chronic" and "Leukemia" were used as keywords. And there were 30 related papers including 400 cases from PubMed Database (from its establishment to August 2014) and one detailed report of an infant with CML was retrieved when "childhood" and "chronic myeloid leukemia" "imatinib" were used as keywords. The clinical effects of imatinib in infant CML cases were analyzed and summarized based on the literature.

RESULTThe boy obtained a complete hematologic response (CHR) at the 6th week of diagnosis, a complete cytogenetic response (CCyR) at the 3rd month and a complete molecular response)CMR) at the 12th month without side effect. This boy grows very well and after a 62-month follow-up, his disease was stable. According to the domestic literature, 5 children CML cases aged 6 -12 years were treated with imatinib without side effects and got complete hematologic response (CHR) after 2-month-therapy. The dose, metabolic characteristics and clinical observation of imatinib can be found in foreign literature and imatinib showed good response with good tolerance in children with CML. Imatinib is regarded as the first line drug for children CML. But it may affect the development of the children.

CONCLUSIONThe children with CML-CP had a good response to imatinib, but more experience in the treatment of children with CML with iniatinib is needed.

Anemia ; Antineoplastic Agents ; therapeutic use ; Fusion Proteins, bcr-abl ; Humans ; Imatinib Mesylate ; therapeutic use ; Infant ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; Male ; Remission Induction ; Retrospective Studies

Objective To investigate the infection following the lymphocytes deleted agent (ATG) and IL-2 receptor antagonists (Basilixinab and Daclizumab)-based induction therapy after renal trausplantation.Methods A retrospective analysis was carried out on 701 kidney transplant recipients between Jan. 1,2005 to Dec.31,2010.According to exclusive and inclusive criteria,finally 549 patients were evaluated,including 429 patients treated with ATG (ATG group) and 120 patients with anti-CD25 monoclonal antibodies (monoclonal antibodies group; 86 patients with Basiliximab,and 34 patients with Daclizumab).The incidence of acute rejection,infection rate,infection time,hospital stay,severe infection rate and mortality were analyzed.After operation,the patients received an immunosuppression therapy including Tacrolimus (cyclosporine A),Mycophenolate-Mofetil and prednisone to present rejection. Part of the patients were treated with ganciclovir and sulfamethoxazole sulfadiazine and trimethoprim for infection prevention.Results The acute rejection rate in ATG group and monoclonal antibodies group was 15.9％ (68/429) and 10.0％ (12/120),and there was no statistically significant difference (P＞0.05).The infection rate in ATG group was 11.9％ (51/429),including 13.7％ (7/51) with severe infection,and mortality was 7.8％(4/51).The infection rate was 15.0％ (18/120) in monoclonal antibodies group,including 11.1％ (2/18) with severe infection,and mortality was 5.6％ (1/18).There was no statistically significnat difference in infection rate,severe infection rate and mortality between two groups (P＞0.05).The hospital stay in ATG group and monoclonal antibodies group was 25.8 days and 19.1 days respectively (P＜0.05).Dead cases had not received regular anti-infection treatment,and the patients age was over 50 years.Conclusion The infection risk and mortality between these two induction therapies are identical,but hn comparison to the patients using ATG,the infection of patients using anti-CD25 monoclonal antibodies is easier to control.Anti-infection prophylaxis is important to reduce infection rate and decrease infectious mortality.

In this study, 120 patients with rheumatic heart disease undergoing valve replacement were randomly divided into the control group and the Qishen group, with 60 cases in each group. Before the operation, the control group was given routine heart and diuretic treatments and placebo of Qishen Yiqi dropping pills for seven days (0.5 g each time, three times a day); While the Qishen group was given Qishen Yiqi dropping pills for seven days (0.5 g each time after meal, three times a day) on the basis of the routine treatments. The right ventricular end-diastolic volume (RVEDV), end-systolic volume (RVESV), stroke volume (SV) and right ventricular ejection fraction (RVEF) were detected after the operation. The results showed that patients in the two groups showed significantly lower right ventricular end diastolic volume (RVEDV), right ventricular end systolic volume (RVESV) and stroke volume (SV) decreased than that before the operation, but with significantly higher Ejection fraction (RVEF) significantly than that before the operation. However, the Qishen group showed a significantly lower right heart function reduction than the control group, with the statistical significance in the differences (P < 0.05). This indicated that the pretreatment with Qishenyiqi Drop Pills showed a remarkable efficacy in the improvement of right ventricular function after valve replacement.
Aged ; Cardiac Valve Annuloplasty ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Heart Valve Diseases ; drug therapy ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Perioperative Care ; Ventricular Function, Right ; drug effects

Objective To evaluate the postoperative quality of life of donors in living donor renal transplantation patients.Methods One hundred and seventeen donors were involved in present study from 2006-2008.A crosssectional survey was performed with questionnaire research to all the donors who received living donor nephrectomy during this period.The questionnaire included sociodemographic characteristics,surgical complications,economic status,donors awareness status,family support,the health care,social welfare and daily exercise after surgery.The Chinese version of SF-36 was used as the measurement of quality of life.The statistic analyze include T test,analysis of variance and stepwise regression analysis.Results The donors' mental health status was better than the healthy population (P ＜ 0.05).The difference of quality of life and scores of other dimensions compared with the healthy population was not statistically significant (P ＞ 0.05).In univariate analysis,four kinds of fields such as age,education level,economic status and physical exercise were associated with quality of life.In further multivariate analysis,with exclusion of the interaction between various factors,the main factors for postoperative quality of life are the cultural,economic status and physical activity (P ＜ 0.05).Conclusions Social and psychological factor should be concerned in donor's preoperative screening.Good social psychological background,the necessary psychological intervention and postoperative follow-up maybe play an important role to improve the postoperative quality of life in living donor renal transplantation.