1.Denervation and its effects on the colon
Xin GE ; Yinggang CHEN ; Xishan WANG
International Journal of Surgery 2013;40(11):776-780
Denervation is the abscission or destruction of the nerve,and when the endogenous and exogenous nerves distribited in the colon would be damaged,the colon would become a denervated one.That may be a result of surgical process or the symptom of disease such as Hirschsprung's disease.The denervated colon would have some changes in motility,absorption and secretion,thus the function of the colon would be affected.
2.Long-term survival of total laparoscopic radical distal gastrectomy with delta-shaped anastomosis.
Rui LUO ; Yinggang GE ; Xingye WU ; Jun ZHANG
Chinese Journal of Gastrointestinal Surgery 2016;19(5):549-552
OBJECTIVETo compare the long-term survival of total laparoscopic radical distal gastrectomy (TLDG) with delta-shaped anastomosis and laparoscopic assisted radical distal gastrectomy (LADG) with tubular anastomosis.
METHODSThe study retrospectively analyzed the clinical and pathologic data of 160 distal gastric cancer patients who underwent laparoscopic radical distal gastrectomy with Billroth I anastomosis at the First Affiliated Hospital of Chongqing Medical University from December 2012 to March 2015. All the patients were definitively diagnosed as primary gastric carcinoma before operation, and no evidences of invasion to adjacent organs, distant metastasis or enlarged fused lymph nodes around important vessels were discovered by image tests. Eighty-six patients underwent TLDG with delta-shaped anastomosis (delta-shaped anastomosis group, DSG) and 74 patients underwent LADG with tubular anastomosis (tubular anastomosis group, TAG) in two surgery teams who had different experience of gastroduodenostomy. All the patients agreed the operation and signed informed consent. All patients followed until October 2015 when the final cumulative survival rate was counted. Survival was analyzed by Kaplan-Meier method.
RESULTSThe baseline data were comparable and operations were successfully completed. Postoperative follow-up time of DSG was 7-32 months, follow-up rate was 91%(78/86), and 11 of whom died of the gastric cancer. The cumulative survival rate by the end of the follow-up was 82.8%. Postoperative follow-up time of TAG was 7-33 months, follow-up rate was 95%(70/74), 7 of whom died of the gastric cancer. The cumulative survival rate by the end of the follow-up was 81.7%. The intergroup difference of cumulative survival rate was not significant(χ(2)=1.210, P=0.271). No stage I patient died of gastric cancer in both groups. The cumulative survival rate by the end of the follow-up of stage II was 87.2% vs. 93.3%(DAG vs. TAG, χ(2)=0.426, P=0.514) ,and in stage III was 65.3% vs. 37.6%(DAG vs. TAG, χ(2)=0.718, P=0.397), and the differences were not significant.
CONCLUSIONThe TLDG with delta-shaped anastomosis and LADG with tubular anastomosis have similar long-term survival for distal gastric cancer treatment.
Anastomosis, Surgical ; Carcinoma ; surgery ; Gastrectomy ; methods ; Gastroenterostomy ; Humans ; Laparoscopy ; Lymph Nodes ; pathology ; Postoperative Period ; Reconstructive Surgical Procedures ; Retrospective Studies ; Stomach Neoplasms ; surgery
3.Practice of organ system integration education in the clerkship teaching of digestive system
Chinese Journal of Medical Education Research 2022;21(7):870-873
The integration education is organized around "an organ system" of the body, and integrates multiple medical disciplines orderly, which is the main trend of medical education reformation at home and abroad. Digestive diseases are diverse and complicated, so that it is of great significance to apply integration education mode in the clinical teaching of digestive system. Taking the clinical clerkship teaching of digestive system in The First Affiliated Hospital of Chongqing Medical University as an example, through reasonably integrating the course content, fully applying problem-based learning (PBL) method, taking multiple teaching methods, combing ideological and political education, and paying more attention to improving the teachers' training, the learning enthusiasm of students could be stimulated, their independent thinking ability and holistic medical view could be cultured, and the teaching effect would be effectively improved.
4.Effects of open-lung strategy on cardiopulmonary function in frail elderly patients undergoing laparoscopic surgery
Xiangpeng ZHU ; Yinggang XIAO ; Chao LUO ; Yali GE ; Yang ZHANG ; Ju GAO
Chinese Journal of Anesthesiology 2022;42(12):1426-1431
Objective:To evaluate the effect of open-lung strategy (OLS) on cardiopulmonary function in frail elderly patients undergoing laparoscopic surgery.Methods:Eighty-four frail elderly patients aged 65-80 yr, with body mass index of 18.5-30.0 kg/m 2, of American Society of Anesthesiologists physical status Ⅱor Ⅲ, with preoperative Fried frailty phenotype scale score ≥3, undergoing elective laparoscopic radical rectal cancer or radical prostate cancer surgery under general anesthesia, were divided into 2 groups ( n=42 each) by the random number table method: OLS group and non-OLS group (NOLS group). The patients underwent recruitment maneuvers and individualized positive end-expiratory pressure (PEEP) in OLS group, while patients received fixed PEEP (5 cmH 2O) in NOLS group.At 10 min after endotracheal intubation (T 0, baseline value), immediately after the peak of recruitment maneuvers (T 1), 30 min (T 2) and 1 h (T 3) after individualized PEEP setting and 10 min before the end of surgery (T 4), cardiac function indexes were measured by transoesophageal echocardiography, optic nerve sheath diameter was measured, and the arterial blood gas analysis indexes and pulmonary function indexes were recorded.The levels of serum cardiac troponin T, creatine kinase-MB and precursor of type B natriuretic peptide were determined by chemiluminescence before surgery and at 1 and 2 days after surgery.The postoperative pulmonary complications within 7 days after surgery and postoperative outcomes were also recorded. Results:Eighty-one patients were finally enrolled, with 41 in NOLS group and 40 in OLS group.Compared with NOLS group, the left ventricular end diastolic area, left ventricular ejection fraction, stroke volume, ratio of early mitral flow velocity to early mitral annulus velocity, mitral annular plane systolic excursion, left ventricular global longitudinal strain, right ventricular end diastolic area, right ventricular fractional area change, tricuspid annular plane systolic excusion and right ventricular global longitudinal strain were significantly decreased at T 1, 2 ( P<0.05), and no significant change was found in the indices mentioned above at the remaining time points ( P>0.05), PaO 2, oxygenation index, and lung compliance were increased at T 1-4, PaCO 2 and alveolar arterial partial pressure difference of oxygen were decreased, the total incidence of pulmonary complications was reduced within 7 days after operation, and the duration of postanesthesia care unit stay, time to first out-of-bed activity and postoperative length of hospital stay were shortened ( P<0.05), and no significant change was found in optic nerve sheath diameter and concentrations of serum cardiac troponin T, creatine kinase-MB, and precursor of type B natriuretic peptide at each time point in OLS group ( P>0.05). Conclusions:OLS can improve lung function in frail elderly patients, which is helpful for patient prognosis without causing negative cardiac effects, and can be safely used for intraoperative airway management in frail elderly patients without obvious cardiac dysfunction.
5.Effect of berberine on morphine-induced activation of BV2 microglial cells
Shuai HAN ; Jianwen SHI ; Zi WANG ; Yinggang XIAO ; Yongxin LIANG ; Yali GE ; Ju GAO
Chinese Journal of Anesthesiology 2023;43(11):1360-1363
Objective:To evaluate the effect of berberine (BBR) on morphine-induced activation of BV2 microglial cells.Methods:The BV2 microglial cells were divided into 3 groups ( n=12 each) using a random number table method: control group (C group), morphine group (Mor group)and morphine+ BBR group (Mor+ BBR group). The Mor group was treated for 24 h with a final concentration of 200 μmol/L morphine, while C group was treated for 24 h with an equal volume of PBS buffer. Mor+ BBR group was first treated for 2 h with a final concentration of 20 μmol/L berberine, followed by treatment with a final concentration of 200 μmol/L morphine for another 24 h. The viability of BV2 microglial cells was determined using the CCK-8 assay, the concentrations of interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α) and IL-10 in supernatant were measured using enzyme-linked immunosorbent assay, and the expression of CD86 and NF-κB proteins in microglial cells was detected using Western blot. Results:Compared with group C, the BV2 microglial cell viability and concentrations of IL-1β and TNF-α were significantly increased, the concentrations of IL-10 were decreased, and the expression of CD86 and NF-κB in microglial cells was up-regulated in Mor group ( P<0.05). Compared with Mor group, the BV2 microglial cell viability and concentrations of IL-1β and TNF-α were significantly decreased, the concentrations of IL-10 were increased, and the expression of CD86 and NF-κB in microglial cells was down-regulated in Mor+ BBR group( P<0.05). Conclusions:BBR can inhibit morphine-induced activation of BV2 microglial cells.