OBJECTIVETo explore the clinical effects of lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine ( Fuchunsan ) on the treatment of postburn hyperplastic scar.

METHODSSixty-three patients with hyperplastic scar after burn injury hospitalized from February 2012 to June 2014 in our department were treated with lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine (Fuchunsan). Patients were divided into early stage group (E, n = 35), middle stage group (M, n = 25), and late stage group ( L, n = 3) according to the formation time of scar, which was respectively 3 weeks to 3 months, longer than 3 months and less than or equal to 6 months, and 3 to 15 years in groups E, M, and L. The number of times of laser treatment of patients in each group was recorded. The degree of scar pain in patients of the three groups was assessed by the Numerical Rating Scale (NRS) before treatment and after treatment for 1, 2, and 3 times. The scar condition of patients in groups E and M was assessed by the Vancouver Scar Scale (VSS) before treatment and after treatment for 1, 3, and 5 times. Patients in group L did not receive VSS assessment but were evaluated by clinical observation only. Photos of scar in treating area were taken before treatment and after treatment for 3 and 5 times to evaluate the clinical effect. Data were processed with t test.

RESULTSPatients in groups E and M were treated with laser for (4.8 ± 1.1) and (7.7 ± 2.1) times respectively. In group L, the treatment was stopped in 2 patients after laser treatment for 5 times, and 1 patient received laser treatment for 12 times. The degree of pain in patients of groups E and M was alleviated significantly after treatment for one time, and the number of patients scoring 1-4 point(s) in NRS increased from 5 cases to 38 cases. After treatment for 2 and 3 times, the increase in the number of patients scoring 1-4 point (s) in NRS was on a small scale. Before treatment and after treatment for 1 time, VSS scores of patients in groups E and M were similar (with values respectively 0.641 and 0. 082, P values above 0. 05). After treatment for 3 and 5 times, VSS scores of patients in group E were respectively (9.2 ± 0.8) and (7.0 ± 1.1) points, which were significantly lower than those in group M [ (9.7 ± 1.0) and (8.2 ± 1.0) points, with values respectively -1.993 and -4.433 , P < 0.05 or P < 0.01]. After treatment for 3 times, the rate of improvement in appearance was respectively 88.6% (31/35) and 72.0% (18/25) in groups E and M, and it was respectively 100.0% (35/35) and 96.0% (24/25) after treatment for 5 times. No significant effect in appearance was found in the 3 patients in group L.

CONCLUSIONSEarly application of lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine (Fuchunsan) for the treatment of postburn hyperplastic scar is effective.

Burns ; Cicatrix ; etiology ; prevention & control ; Humans ; Lasers, Gas ; therapeutic use ; Medicine, Chinese Traditional ; Postoperative Care ; methods ; Postoperative Complications ; prevention & control ; Treatment Outcome

Objective To observe the effects of berberine on ICAM-1, VCAM-1 expression and inflammatory cells exudation in mice with viral pneumonia caused by influenza virus, and explore its anti-injury effect. Methods Totally 108 BALB/c mice were randomly divided into control group, model group, and berberine group. 25 μL 50 LD50 influenza virus, mouse lung-adapted strain, was intranasally inoculated to model group and berberine group. 1 h after infection, control and model group were intragastrically given 25 μL distilled water, berberine group was treated by intraperitoneal injection with berberine at a dose of 0.005 g/(kg·d) for 5 days, twice per day. On day 2, 4 and 6 after infection, immunocytochemical method was used to detect ICAM-1 and VCAM-1 expression, and sorting cell count of leukocytes in bronchoalveolar lavage fluid (BALF) were counted. Results The expression of ICAM-1 and VCAM-1 in model group increased obviously on day 2, 4, 6, and which in berberine group decreased compared with model group (P<0.01). WBC, mononuclear cell, eosinophile cell and neutrophil cell number in model group increased significantly. WBC and neutrophil cell number decreased in berberine group on day 6 (P<0.01), and the mononuclear cell number decreased on day 4 (P<0.01). Conclusion Berberine inhibited the expression of ICAM-1 and VCAM-1, and decreased the inflammatory cells exudation in lung of mice with viral pneumonia caused by influenza virus. Berberine has protective effect on inflammatory injury of lung tissue in mice with viral pneumonia caused by influenza virus.

1. 5 cm) sessile colorectal polyps referred for EMR. After submucosal injection of epinephrine, either en bloc or piecemeal snare polypectomy were performed. All resected specimens were retrieved for pathologic study. Follow-up colonoscopy was performed in all patients after EMR. Results All 157 polyps were removed completely. All lesions are larger than 1. 5cm, but 3 less than 1 cm on the submucosa of rectum. The largest one is 13 cm X 12 cm. No complication occurred. Histopathologic assessment of the resection specimens revealed the following: adenoma, 123; dysplasia, 80; mucosal carcinoma, 11; hyperplastic polyps, 20; rectal carcinoid, 3. Two patients who had rectal adenoma that was larger than 7cm recurrence happened at the resection site after 1 and 3 months follow-up respectively, than removed completely by hot biopsy forceps showed hyperplastic and villous adenoma on pathological study. No more residual tumor was detected for 6-12 months. Conclusion EMR with an intensive follow-up program is a safe and effective treatment for large sessile colorectal polyps and mucosal carcinoma.

Objective:To determine whether chewing gum during the postoperative period facilitates the recovery of bowel function in patients after radical cystectomy with ileum urinary diversion.Methods:In the study,60 patients who underwent radical cystectomy followed by ileum urinary diversions during Nov.2014 and Nov.2015 in Department of Urology of Peking University First Hospital were randomized into three groups:gum chewing group,placebo group treated with the abdomen physical therapy machine and control group treated with ordinary method.Time to flatus,time to bowel movement,incidence of postoperative distension of the abdomen and abdominal pain,and gut related complications (such as ileus,intestinal fistula,and volrulus)of all the patients were recorded and analysed.Results:In gum chewing group,the median time to flatus was 57 hours (49 -72 hours),and the median time to bowel movement was 95 hours (88 -109 hours),which were significantly shortened compared with the other two groups of patients (82 hours,109 hours in placebo group and 81 hours,108 hours in control group, respectively).No significant difference of the median time to flatus and to bowel movement was observed between placebo group and control group.There were no significant differences in the incidence of post-operative distension of the abdomen and abdominal pain,and gut related complications among the three groups.Conclusion:Chewing gum had stimulatory effect on bowel function recovery after cystectomy fol-lowed by ileum urinary diversion.Chewing gum was safe and simple,and could be routinely used for postoperative treatment after cystectomy and ileum urinary diversion.

Objective To evaluate the number of lymph node harvested during radical resection of invasive rectal carcinoma(stage Ⅰ toⅢ).Methods From January 2000 to June 2008,the pathological data of colorectal carcinoma patients who were operated on were retrospectively reviewed.Exclusion criteria included recurrent colorectal tumor,Tis tumor,R1 or R2 resection,tumor resection transanally or endoscopically,synchronous diseases affecting the surgical procedure for the reetal cancer(familial adenomatous polyposis.synchronous coloreetal carcinoma)and rectal cancer receiving perioperative neoadiuvant chemoradiation.Statistical analysis was performed using Mann-Whitney Test and Chi-Square Test (SPSS 15.0).Results were expressed as mean±SEM.Results A total of 2282 patients were identified.including 1216 cases in the rectal carcinoma group and 1066 cases in the colon carcinoma group.There were no significant difference in gender(719/1216 vs.593/1066,P=0.092)and overall TNM stage (P=0.067)between the two groups.But patients of rectal cancer were younger(58.6±0.4 vs.62.0±0.4.P=0.000).The lymph node retrieval in the rectal carcinoma group was significantly less than that of colon carcinoma group(9.4±0.1 vs.10.5±0.1,P=0.000).There were significantly less rectal cancer patients with a 1ymph node harvest equal to or more than 12 nodes(P=0.000).Patients in the low rectal cancer group(≤7 cm from the anal verge.n=834)had less lymph nodes harvested than the mid-high rectal cancer group(＞7 am and≤15 cm from the anal verge.n=382)(9.2±0.1 vs.9.9±0.2,P=0.009).Conclusion The lymph node harvest in the rectal carcinoma group was significantly less than that in the colon carcinoma group.A new standard may be necessary to define the adequate number of lymph nodes for rectal cancer.

Objective To explore the clinicopathologic factors impacting recurrence and survival in rectal cancer patients after radical resection.Methods Clinicopathologic data of 1 166 patients with rectal cancer in Changhai Hospital,were recruited between 2005 and 2010.Kaplan-Meier analysis and the logrank test were used to evaluate the effects of the pathology on patients' survival.Cox regression model was used to assess independent factors associated with clinical prognosis.Results The 1,3,5-year overall survival rates were 94.3％,81.2％ and 76.5％,median survival time was 53 months.328 patients had recurrence and metastases,with a median recurrence time of 18 months.The independent prognostic factors for overall survival time were CEA,CA19-9,tumor distance to dentate line,surgical modality,radical operation,tumor invasion,tumor differentiation,lymph node metastasis and postoperative treatment.Surgical treatment,radical operation or not,tumor invasion and lymph node metastasis were statistically significant associated with tumor recurrence and metastases.Conclusions The important factors inffuencing the prognosis of rectal cancer patients were CEA,CA19-9,tumor distance to dentate line,surgical modality,radial operation,tumor in vasion,tumor differentiation,lymph node metastasis,and post operative treatment.

Objective To investigate the clinical manifestations of early postoperative internal hernia. Methods Patients who were diagnosed with early postoperative small bowel obstruction(EPSBO)within 30 days after operation and underwent laparotomy between 1994 and 2006 were included for study.Clinical and radiological findings were analyzed. Results Totally 38 EPSBO patients were identined.among those,9 patients(23.7%)had an internal hera ag the cause of the howel obstruction.Other causes included intestinal adhesions in 27 patients(71.1%),gallstone ileus in 1 patient(2.6%)and stoma obstruction in 1 patient(2.6%).In the internal hernia group,6 cases were male and 3 cases were female witIl a mean age of 53.6 years.The mean time from the primary operation to symptom development was 7.8 d(range,2～17 d)and the mean time of conservative treatment Was 3.4 d(range,1～8 d).The main clinical features included:complete mechanical obstruction with symptoms rapidly progressing and early bowel strangulation.Specific radiologic abnormalities misht be identified,especially by contrast-enhanced CT.In this series,intestinal strangulation was found in 6 patients with bowel necrosis in 4 eases,necessitating howel resection in 5 patients.Wound infection developed in one cage and there was no perioperative death.Conclusion Internal hernia can occur early postoperatively and it bears a high risk of strangulation and bowel necrosis.Prompt operative intervention should be carried out in highly suspicious patients in order to avoid complications and achieve good outcome.

Objective To summarize the experience in diagnosis and therapy of familial adenomatous polyposis with desmoid tumour. Methods Clinical data of 6 patients with familial adenomatous polyposis and desmoid tumour from Jan 1989 to Jan 2005 were retrospectively analyzed. Results Five patients received proctocolectomy and 1 abdominoperineal resection. The most common symptom was progressive painless mass in abdomen. All patients were confirmed by image examination. Four received surgery, 2 were treated by medicine postoperatively and 1 got watchful therapy. Postoperative recurrence developed in two cases and one suffered from short bowel syndrome. All patients were alive at the follow-up. Conclusions FAP with desmoid tumour is not a rare condition and we should pay attention to diagnosis and manage this disease entity. A reasonable remedy was selected according to general state of health and location of desmoid tumour which can improve prognosis and quality of life.

Objective Few reports are seen on the methods of establishing the rabbit model of pancreatic cancer .This study was to compare the effect of Panc-1 cell suspension orthotopic implantation with that of VX-2 tissue orthotopic implantation in construc-ting the rabbit model of pancreatic cancer . Methods Using the random number table method , we divided 30 healthy rabbits into a tissue suspension group ( n=15) and a cell suspension group ( n=15) , VX-2 tissue suspension employed for in-situ implanting in the former group and panc-1 cell suspension utilized in the latter .Then we evaluated the two modeling methods by B-ultrasonography , 3.0T MRI, and CT. Results In the third week after modeling , transpla-ntive metastasis of lots of tumor tissues was observed in the duode-num, colon, appendix, and peritoneal wall in 5 rabbits of the tissue suspension group , but only in the greater omentum of 3 rabbits in the cell suspension group , with high signals of MR T 2 in the posterior gastric body .One case of duodenal metastasis was seen in the cell suspension group , with slightly high signals of MR LAVA in the posterior gastric body .The model of pancreatic cancer was successfully established in all the 15 rabbits of the tissue suspension group , but only in 3 of the cell suspension group .The success rate of tumor im-planting at 3 and 4 weeks was significantly higher in the former ( 46.66%and 100%) than in the latter group ( 6.67%and 20.00%) (P<0.05). Conclusion VX-2 tissue orthotopic implantation is a more feasible and convenient method than Panc -1 cell suspension orthotopic implantation for establishing the rabbit model of pancreatic cancer .

OBJECTIVE:To study the in vitro uptake of Resibufogenin(RBG)lactic acid glycolic acid copolymer-water solu-ble vitamin E (PLGA-TPGS) in human liver cancer HepG2 cells,mouse ascites-type lymphatic metastasis of tumor HCa-F cells, and the toxicity on HepG2 cells. METHODS:RCPTN loading RBG and coumarin-6(C6)were prepared. Fluorescent inverted mi-croscope was used to observe the in vitro uptake by RCPTN HepG2,HCa-F cells. It was divided into negative control group,blank PLGA-TPGS nanoparticles(EPTN)group,5-fluorouracil solution(FS)group,RBG solution(RS)group,RBG/PLGA nanoparti-cles(RPN)group and RPTN group. WST-1 was conducted to investigate the optical density at 450 nm wavelength of HepG2 cells after 24,48,72 h incubated by FS,RS,RPN and RPTN with different final concentrations (1.25,2.5,5,10,20 μg/mL);the cell viability (CV) and half inhibitory concentration (IC50) were calculated. RESULTS:RCPTN distributed around the nucleus of HepG2,HCa-F cells. CV was decreased by RBG concentration increased in RPN group and RPTN group,and decreased by time prolonged;compared with FS group,CV in RPTN group was decreased(P<0.05 or P<0.01). IC50 of HepG2 cells incubated by FS,RS,RPN and RPTN was decreased by time prolonged,ordered by RS>FS>RPN>RPTN;IC50 incubated by RPN and RPTN for 48,72 h was obviously less than that of FS and RS(P<0.05 or P<0.01). CONCLUSIONS:RPTN can deliver RBG in-to HepG2,HCa-F cells,showing inhibition effect on HepG2 cells which is stronger than RPN,RS and FS.