OBJECTIVE:To investigate the perioperative use of antibiotics in patients undergoing colorectal operations. METHODS:The medical records of 213 patients undergoing colorectal operations in 2006 were randomly selected from the gastrointestinal surgery department of our hospital and divided into type Ⅰ operation group and type Ⅱ operation group accord-ing to patients’ operation time and wound contamination.The kinds and medication duration of antibiotics used before,during and after operation were investigated,and the postoperative infections were analyzed.RESULTS:The preoperative preventive medication were all conducted within the first 1～3days,and the dosage schemes were unified with aminoglycosides and metronidazole topping the list.The antibiotics used during operation were all in single dose,with 3rd generation cephalosporins combined metronidazole predominantly used.Postoperative use of antibiotics was somewhat complicated:type Ⅰ operation patients were treated more often by 2 kinds of antibiotics concurrently for 3～7days and type Ⅱ operation patients were treated more often by 3 kinds of antibiotics concurrently for at least 6～7days.The incidence of postoperative infection was 3.4% in type Ⅰ operation patients as compared to 11.6% in type Ⅱ operation patients,showing significant differences between two groups.CONCLUSION:The perioperative application of antibiotics in patients undergoing colorectal operation was reasonable on the whole,with 3rd generation cephalosporins plus metronidazole predominantly used,but there were some problems in the postoperative medication.

Objective To study the antidepressant effect of total timosaponin(TT)and its mechanism.Methods The antidepressant effect of TT was examined by mice forced swimming test(FST),learned helplessness(LH)experiment,chronic mild stress(CMS)model,yohimbine induced lethality test and 5-HTP induced head-twitches test.Results TT(25 or 50 mg?kg-1,ig,qd?14 d)markedly shortened the immobility time in the FST,but didn't affect the autonomic activity.TT(12.5,25 or 50 mg?kg-1,ig,qd?14 d)significantly decreased the number of escape deficits in the LH mice.TT(25 or 50 mg?kg-1,ig,qd?21 d)markedly enhanced the locomotor activity and increased consumption of sucrose solution in CMS mice.TT(50 mg?kg-1,ig,qd?14 d)enhanced the mortality of mice after administration of yohimbine for 4 h,and distinctly increased the head-twitch number in the 5-HTP induced head-twitches test.Conclusion TT has antidepressant effects in various depression mouse models.Its mechanism may be related to the reinforcement of NE and 5-HT nerves system.

Objective: To evaluate the effect of pure titanium modified by bioadhesive RGD peptide on the early attachment, growth and proliferation of osteoblasts. Methods: The titanium samples were hydroxylated by alkali/hot water aging and sol-gel layer-by-layer deposition technique. Afterwards, the terminal -NH_2 group was introduced to the titanium surface by organosilane APTMS self-assembled monolayers and the functional group -NH_2 was further reacted with EDC/NHS by which RGD peptides was covalently immobilized to titanium. The efficiency of this bioreactive surface in promoting cell attachment and the competitive inhibition effect of RGD peptide with different concentrations were observed by calculating the amount of osteoblasts attached on the modified titanium. The growth and proliferation were observed by MTT method and scanning electronic microscopy. Results: The cell adhesion percentage of the RGD modified titanium group was much higher than that of the other groups. The RGD peptide solutions with higher concentration had stronger inhibitory impact on the cell adhesion onto the titanium surface. The cell growth, morphology and proliferation on the RGD peptide modified titanium were better than other groups. Conclusion: Bioadhesive peptide can be chemically grafted onto the titanium surface by means of self-assembled monolayers technique. The cells′ biological behaviors on the surface of RGD immobilized titanium are greatly improved in vitro.

In order to develop potent antidiabetic agents that have inhibitory effect to a-glucosidase, twelve β-acetamido ketone derivatives such as N-{[(substituted-4-oxo-thiochroman-3-yl)phenyl]-methyl}acetamide are designed and synthesized through one-pot Dakin-West reaction. Their chemical structures are confirmed by 1H NMR, 13C NMR, IR and HR-MS. In vitro α-glucosidase inhibition assays of compounds 4a-41 were carried out using glucose oxidase method. The result indicated that most of them possess inhibitory activity in vitro. Compound 4k showed the most potent inhibitory activity with 87.3% inhibition of α-glucosidase at the concentration of 5.39 mmol x L(-1). The structure-activity relationship of these β-acetamido ketone derivatives was discussed preliminarily. Moreover, the molecular docking method was used to study the interaction mode of compound 4k and α-glucosidase. Our results will be helpful for designing of α-glucosidase inhibitors in the future.

Ovarian cancer is characterized by insidious onset and poor prognosis, and among gynecological malignancies, its mortality rate ranks first, which poses a serious threat to women's health worldwide. In recent years, increasing evidence has suggested that modifiable lifestyle factors, particularly dietary factors, played important roles in the prognosis of ovarian cancer. As important nutrients, dietary fats and fatty acids can affect various vital physiological functions in human beings. However, the association of dietary fat and fatty acid intake with the prognosis of ovarian cancer remains unclear. Therefore, this review aims to analyze the existing epidemiological evidence between the two variables by searching the literature to provide dietary suggestions for ovarian cancer patients.

Objective To investigate the effect of folic acid intervention on plasma homocysteine (Hcy) metabolic changes and pulse wave velocity(PWV)in patients with type H hypertension. Methods Patients(hos-pitalized from March 2014 to December in our hospital)with H type hypertension were randomly divided into treat-ment group and control group randomly ,and were given routine antihypertensive drug therapy. Treatment group was given oral folic acid 0.8 mg,1 times a day,the control group was given placebo,1 times a day. All patient were treated for 12 months. Changes of plasma Hcy and PWV levels were observed. Results 432 patients(Han nationality)with type H hypertension were enrolled in this study with the age of 61.7 ± 13.6 years old and the ratio of men and women is 1.3:1. The most common diseases were coronary heart disease and type 2 diabetes mellitus. 2 groups were treated for a period of 12 months,with follow-up time from 6 to 10 months(average duration in 8 months). After treatment,the difference between plasma Hcy(Z=-7.63,P=0.000)and PWV(Z=-3.16,P=0.002)levels of the two groups were statistically significant. Conclusion Folic acid intervention can significantly reduce the level of plasma Hcy in patients with type H hypertension ,slow down the progression of atherosclerosis and reduce the risk factors of cardiovascular disease.

Dexmedetomidine,which is an α2 adrenergic receptor agonist with sedative,analgesic,anxiolytic and anti-sympathetic effects,has become a widely used drug in clinical anesthesia and intensive care unit(ICU).Compared with other drugs in the department of anesthesiology,dexmedetomidine has no obvious respiratory depression and no obvious hemodynamic changes,and can significantly reduce the dosage of sedative and analgesic drugs when combined with other anesthetics.In clinical applications,dexmedetomidine has been found to induce a sedative response that is associated with rapid arousal.Dexmedetomidine is traditionally thought to act through α2 adrenergic receptors to lower blood pressure,dilate blood vessels and lower heart rate,but it is unclear how it affects neural circuits in the brain.In recent years,there has been an increasing number of studies on the mechanism of action of dexmedetomidine,which has confirmed that the ventrolateral preoptic nucleus(VLPO),locus coeruleus(LC)and ventral tegmental area(VTA)of the hypothalamus are involved in the sedation mediated by dexmedetomidine,the dorsal root ganglion(DRG)and superior cervical ganglion(SCG)are involved in dexmedetomidine-mediated analgesia,and the hypothalamic preoptic area(PO)and hypothalamic paraventricular nucleus(PVN)are involved in the changes in body temperature and water-electrolyte balance mediated by dexmedetomidine,providing a new direction for understanding the mechanism of dexmedetomidine in the central nervous system.

Objective:To examine the safety and effectiveness of a novel stent assisted intestinal bypass for preventing anastomotic leakage in laparoscopic assisted radical resection of rectal cancer.Methods:The clinical data of 9 patients with rectal cancer who underwent laparoscopic radical resection and stent assisted intestinal bypass from September 2019 to June 2020 at the Department of Anus & Intestine Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University were retrospectively analyzed. There were 6 males and 3 females, aged (62.1±6.8) years (range: 53 to 75 years), underwent laparoscopic assisted radical resection of rectal cancer and stent assisted intestinal bypass. A degradable diverting stent was placed at the end of the ileum, and a drainage tube was placed at the proximal end of the stent to bypass the intestinal contents. After operation, the patients were given a diet with less residue. From the 14 th day after operation, abdomen X-ray films were taken every 5 to 7 days to observe the destination of the stent dynamically. When the stent was observed to be disintegrated into pieces, the drainage tube was clamped for 3 days to observe any side effects before the tube was removed. The operation time, the time of removing the bypass tube and the total hospital stay were recorded. Results:Laparoscopic assisted radical resection of rectal cancer and stent assisted intestinal bypass were successfully performed in all patients. The operation time was (230.4±48.0) minutes (range: 150 to 318 minutes), and the time of removing shunt tube was (28.8±4.6) days (range: 22 to 34 days). The duration of hospitalization was (21.0±8.6) days (range: 9 to 34 days). Postoperative pathological examination showed 7 cases of moderately differentiated adenocarcinoma, 1 case of moderately well differentiated adenocarcinoma and 1 case of mucinous adenocarcinoma. There were 2 cases of T1, 4 cases of T2 and 3 cases of T3. The number of lymph node dissection was 13.4±3.5 (range: 6 to 18), 3 cases were positive and 6 cases were negative. The post-operation follow-up time was 6 to 16 months, no anastomotic leakage or stenosis was found.Conclusion:Stent assisted intestinal bypass for the prevention of anastomotic leakage in laparoscopic assisted radical resection of rectal cancer is safe and feasible, and shows good short-term effect.

Objective:To examine the safety and effectiveness of a novel stent assisted intestinal bypass for preventing anastomotic leakage in laparoscopic assisted radical resection of rectal cancer.Methods:The clinical data of 9 patients with rectal cancer who underwent laparoscopic radical resection and stent assisted intestinal bypass from September 2019 to June 2020 at the Department of Anus & Intestine Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University were retrospectively analyzed. There were 6 males and 3 females, aged (62.1±6.8) years (range: 53 to 75 years), underwent laparoscopic assisted radical resection of rectal cancer and stent assisted intestinal bypass. A degradable diverting stent was placed at the end of the ileum, and a drainage tube was placed at the proximal end of the stent to bypass the intestinal contents. After operation, the patients were given a diet with less residue. From the 14 th day after operation, abdomen X-ray films were taken every 5 to 7 days to observe the destination of the stent dynamically. When the stent was observed to be disintegrated into pieces, the drainage tube was clamped for 3 days to observe any side effects before the tube was removed. The operation time, the time of removing the bypass tube and the total hospital stay were recorded. Results:Laparoscopic assisted radical resection of rectal cancer and stent assisted intestinal bypass were successfully performed in all patients. The operation time was (230.4±48.0) minutes (range: 150 to 318 minutes), and the time of removing shunt tube was (28.8±4.6) days (range: 22 to 34 days). The duration of hospitalization was (21.0±8.6) days (range: 9 to 34 days). Postoperative pathological examination showed 7 cases of moderately differentiated adenocarcinoma, 1 case of moderately well differentiated adenocarcinoma and 1 case of mucinous adenocarcinoma. There were 2 cases of T1, 4 cases of T2 and 3 cases of T3. The number of lymph node dissection was 13.4±3.5 (range: 6 to 18), 3 cases were positive and 6 cases were negative. The post-operation follow-up time was 6 to 16 months, no anastomotic leakage or stenosis was found.Conclusion:Stent assisted intestinal bypass for the prevention of anastomotic leakage in laparoscopic assisted radical resection of rectal cancer is safe and feasible, and shows good short-term effect.

Objective:To analyze the pathological types, tissue sources and clinical features of malignant pleural effusion.Methods:Cell masses were collected from 105 cases of malignant pleural effusion diagnosed by immunohistochemical examination after liquid-based cytology between May 2017 and October 2019 in Qidong People's Hospital, China. The pathological, morphological, immunohistochemical and clinical characteristics of the cell masses were analyzed.Results:Immunohistochemistry results showed that pleural effusion malignant cells were from lung adenocarcinoma tissue in 94 (89.52%) cases because they were positive for thyroid transcription factor-1, Napsin A and carcinoembryonic antigen, from small cell lung cancer tissue in one (0.95%) case because they were positive for neural cell adhesion molecule 1 and synaptophysin,from lung squamous cell carcinoma tissue in 2 (1.90%) cases because they were positive for cytokeratin 5/6 and P40, from ovarian adenocarcinoma tissue in 1 (0.95%) case because they were positive for CA125, from breast adenocarcinoma tissue in 4 (3.81%) cases because they were positive for estrogen receptor, progesterone receptor and gross cystic disease fluid protein 15, from the gastrointestinal tract adenocarcinoma tissue in 2 (1.90%) case because they were positive for caudal-type homeobox 2, and from the pancreatic adenocarcinoma tissue in 1 (0.95%) case because they were positive for cancer antigen 19-9 (CA199).Conclusion:Lung adenocarcinoma is the most common cause of malignant pleural effusion. Lung adenocarcinoma cells are positive for thyroid transcription factor-1, Napsin A and carcinoembryonic antigen. The combined use of the three markers can help the diagnosis of lung adenocarcinoma. In addition, lung adenocarcinoma should be differentiated from other types of lung cancer and the tumors from other regions.