Objective To observe the application effects of postoperative analgesia of ultrasound -guided transversus abdominis plane ( TAP) block in radical resection of colorectal cancer patients .Methods Fifty patients undergoing radical resection of colorectal cancer in our hospital within nearly two years were divided into two groups,according to number table mehtod ,25 cases in each group.Patients of group A were injected with 0.45%ropivacaine mesylate 20 mL in ultrasound-guided bilateral TAP after the end of surgery before extuba-tion;the patients of group B were injected with the same amount of normal saline in ultrasound -guided bilateral TAP block,Postoperative patient -controlled intravenous analgesia with sufentanil was provided to all patients . The VAS score of two groups after operation record the postoperative dosage of sufentanil in 24h,pressing times of analgesia pump ,the satisfaction of patients with postoperative analgesia and adverse reactions .Results The VAS score of group A(1.08 ±0.86),(1.60 ±0.71),(1.92 ±0.49),(2.28 ±0.61),(2.44 ±0.51)were lower than that of group B(1.88 ±0.73),(2.24 ±0.72),(2.68 ±0.56),(2.96 ±0.54),(3.24 ±0.44).The dos-age of sufentanil in group A(53.20 ±1.39)μg vs.group B(59.18 ±2.82)μg,pressing times of analgesia pump,group A(10.40 ±2.78)vs.group B(22.36 ±5.63),the satisfaction of patients with postoperative analge-sia,group A(9.12 ±0.78)vs.group B(7.52 ±0.77).There were 2 cases of postoperative nausea and vomiting in group B vs 8 cases in group A,The above -mentioned indexes difference had statistical significance except postoperative 4h score.The indicators of respiratory depression in the two groups did not occur .Conclusion The application of postoperative analgesia of ultrasound -guided transversus abdominis plane ( TAP) block in radical resection of colorectal cancer patients ,can reduce postoperative intravenous analgesic drug usage ,decrease the in-cidence of adverse reactions induced by opioid drugs ,and the analgesic effect is more effective with the positioning accuracy ,convenient operation ,less injury ,high safety and suitable for clinical application .

OBJECTIVETo observe the effects of conditioned medium from keloid fibroblasts under hypoxia on angiogenesis, and to investigate the role of hypoxic microenvironment in invasive growth of keloid.

METHODSPrimary keloid fibroblasts and human umbilical endothelial cells (HUVEC) were cultured as conventional method. Keloid fibroblasts were cultured either in a hypoxic incubator (2% O2) for 48 h or in a normoxic incubator (20% O2) as control. Then those cell culture mediums were collected and mixed with endothelial cell medium by the proportion of 1:1 as conditioned medium. The mRNA and secreted protein of pro-angiogenic factors such as vascular endothelial growth factor (VEGF), angiopoietin-1 (Ang-1) and periostin of keloid fibroblasts under hypoxia were detected by real time PCR and ELISA. The proliferation, migration and invasion, tube formation of HUVEC cultured with conditioned medium were evaluated by CCK-8 assay, Transwell assay and matrigel tube formation assay, respectively.

RESULTSHypoxia increased the expression of VEGF, Ang-1 and periostin in both mRNA (increased by 75%, 43% and 118% respectively, P < 0.05) and secreted protein (increased by 30.2%, 14.2% and 19.5% respectively, P < 0.05) levels; the proliferations of HUVEC in hypoxic conditioned medium in 1, 2 and 3 d were 0.67 +/- 0.07, 0.84 +/- 0.09 and 1.08 +/- 0.10 respectively, which were higher compared to those in control group (0.52 +/- 0.08, 0.72 +/- 0.10 and 0.91 + 0.14, P < 0.05); the numbers of migration, invasion and tube formation of HUVEC were (73.2 +/- 8.9), (56.3 +/- 12.5), (9.66 +/- 1.96) cells/HP, which were higher compared to those in control group [(59.0 +/- 8.0), 35.5 +/- 8.5), (6.5 +/- 1.87) cells/HP, P < 0.05].

CONCLUSIONSHypoxia increases the expression of pro-angiogenic factors of keloid fibroblasts, and its conditioned medium under hypoxia could promote angiogenesis. The results suggest hypoxic microenvironment may play a significant role in the invasive growth of keloid by inducing angiogenesis.

Cell Hypoxia ; Cells, Cultured ; Culture Media, Conditioned ; Fibroblasts ; Humans ; Keloid ; pathology ; Neovascularization, Pathologic

Objective To assess the safety and efficacy of an olive oil-based lipid emulsion for parenteral nutrition in patients after esophagectomy.Methods In the randomized controlled trial,60 patients undergoing esophagectomy were divided into study group(n=30,received olive oil-based lipid emulsion)and control group [n=30,received medium-chain triglyceride/long-chain triglyceride(MCT/LCT)emulsion].The parenteral nutrition Was provided for 7-10 postoperative days.The nutritional formulas were equivalent in nitrogen,calorie,osmotic pressure,and fluid volume.Peripheral venous blood tests were performed before operation and on the first and eighth postoperative days.All the patients were evaluated by nutritional status(weight,body mass index,nutritional risk screening,etc.),safety profiles[full blood test,electrolytes,aspartate aminotransferase(AST),alanine amiotransferase(ALT),total bilirubin and direct bilirubin,blood urea nitrogen(BUN),creatinine,blood glucose,etc.],and efficacy indicators(hemoglobin,albumin,total protein,etc.).Results The albumin and total protein levels returned to the normal ranges in beth groups 8 days after operation,although both levels were significantly higher in study group(P=0.000).Also,the difference of total protein levels between the eighth and first postoperative days Was significantly higher in the study group(P=0.002).In addition,the AST and BUN readings returned to normal ranges 8 days after operation in the study group, which were significantly lower than those in control group (P = 0.025, P = 0.013).No serious adverse events were reported in both groups.Other nutritional parameters, renal and hepatic safety profiels, vital signs, and hematology showed no significant difference between two groups.Conclusions Olive oil-based lipid emulsion is a safe and efficient lipid emulsion for parenteral nutrition in patients undergoing esophagectomy.Compared with MCT/LCT, it has less effect on AST and BUN.

Objective To build a bio-material artificial chest wall and discuss its feasibility and efficiency in reconstruction of huge bony defects of chest wall in mongrels in comparison with traditional "sandwich" procedure. Methods (1) The procine osteal and membranate tissues were treated with epoxy cross linking method and their surfaces were modified with amino acid solutions at various concen-trations and at different temperatures to obtain an artificial pleura and artificial ribs for construction of the artificial chest wall. (2) The huge bony defects (5 cm×5 cm) were created in chest wall of five Chinese mongrels. (3) Three mongrels in test group was repaired with artificial chest wall, while two mongrels in control group was repaired with traditional "sandwich" complex. A follow-up was carried out to observe reconstruction effect and rejection in both groups at 3,6 and 12 months after implantation. Results There was no death found during the perioperative period and at 12 month follow-up in test group, with abnormal contour of chest wall and good thoracic activity after reconstruction. In the meantime, there found no rejection, collapse in the repaired region or paradoxical respiration. The postoperative X-rays at 3,6,12 and 24 months showed a good integrity of the thorax, with no collapse, deformation or abnormal movement. Meanwhile, the follow-up of control group showed a normal contour but slight collapse, with no paradoxical respiration. The Chest X-ray examination revealed that the bone cement in" sandwich" complex was X ray opaque and showed mild abnormal movement with breathing. The common blood test and immune items showed no abnormal. Conclusions The bio-material artificial chest wall is a safe and effective reconstruction technique for bony defects of thoracic wall in mongrels, with no acute or chronic rejection.

Limit test of flavones in diterpene ginkgolides meglumine injection materials by UV-Vis and HPLC-DAD method was studied in this essay. The HPLC-DAD method has lower LOD (about 1% of the UV-Vis), that is, the sensitivity is higher than UV-Vis method. Through the analysis of the kinds of flavonoids ingredients in the samples by LC-MS, the three compounds with highest contents are kaempferol, quercetin and isorhamnetin. Kaempferol, quercetin and isorhamnetin were chosen as reference compounds for HPLC analysis, and the HPLC separation analysis was carried on an Agilent Eclipse plus C18 column (4.6 mm x 250 mm, 5 μm) with methanol and water containing 0.4% phosphoric acid (50: 50) as mobile phase, and the flow rate was 1.0 mL x min(-1). The detection wavelength was set at 360 nm. This method has good specificity, precision and reproducibility. The LODs of quercetin, kaempferide and isorhamnetin were 27.6, 22.3, 29.5 μg x L(-1). The average recovery was 87.9% (RSD 3.3%), 91.7% (RSD 3.1%), 88.3 (RSD 1.3%) for quercetin, kaempferide and isorhamnetin, respectively. Based on the 10 batches of sample results and sensitivity of different HPLC, the content of total flavonoids ingredients of diterpene ginkgolides meglumine injection materials was limited no more than 2 x 10(-5). This method is simple, quick and has good maneuverability, and could be used to the limit test of flavonoids in the diterpene ginkgolides meglumine injection materials.
Chromatography, High Pressure Liquid ; methods ; Diterpenes ; analysis ; Drugs, Chinese Herbal ; analysis ; Flavones ; analysis ; Ginkgolides ; analysis ; Limit of Detection ; Mass Spectrometry ; methods

Objective To study osteoporosis in patients receiving androgen deprivation therapy (ADT) with prostate cancer, and determine whether once-weekly oral alendronate can prevent bone loss in men receiving ADT. Methods One hundred and twelve men with nonmetastatic prostate cancer receiving ADT were divided into two groups from April 2007 to April 2008, 56 cases in each group. Group A took alendronate (70 rng once-weekly orally) and calcium supplement, group B received calcium supplement only. Bone mineral density (BMD) were measured both before and 6 months, 12 months after treatment for both groups. Results There were no statistically differences in age, persistence time of castration, prostate specific antigen level and adverse effect between two groups(P＞ 0.05). At baseline, 39.3%(44/112) of men had osteoporosis and 51.8%(58/112) had low bone mass. After 12 months treatment, in group A, BMD increased 3.7% (95% CI 2.80% to 4.60% ,P＜0.01 ) at the spine,0.7%(95% CI 0.10% to 1.40% ,P=0.031)at the total hip and 1.6% (95% CI0.40% to 2.80%,P =0.008) at the femoral neck. In group B decreased 1.4% (95% CI-2.70% to -0.03%, P = 0.045 ) at the spine, 0.7% (95% CI - 1.50% to -0.01%,P = 0.052) at the total hip and 0.7% (95% CI -1.50% to 0.10%, P = 0.081 ) at the femoral neck. The estimated changes in BMD were significantly different between two groups (P ＜ 0.01 ). Conclusions It suggests that ADT induce bone loss which should be treated in early stage. Bone loss that occurred with ADT is prevented and improved with once-weekly oral alendronate.

AIM: To investigate the feasibility and clinical effect of punctoplasty by using trabeculectomy punch combined with a novel RS tube for the treatment of punctal stenosis.METHODS: Totally 39 patients (39 eyes) with punctual stenosis were selected from October 2013 to October 2015 in the Second People`s Hospital of Foshan.All patients underwent punctoplasty by using trabeculectomy punch combined with a novel RS tube.These tubes were removed at 3mo after operation.A follow-up of 6mo was taken for final analysis.The fluorescein dye disappearance test score was recorded before the operation and at 1,3 and 6mo after the extubation.The curative effect of the operation at 6mo after the extubation was assess.RESULTS: Fluorescein dye disappearance test: the scores at 1,3 and 6mo after the extubation all decreased compared with the preoperative ones.The difference was statistically significant(P<0.05).At the last following up, 35 eyes (90%) were cured completely, 4 eyes (10%) were improved significantly, no patients recurred.Effective rate was 100%.No serious intraoperative and postoperative complications happened.CONCLUSION: Punctoplasty by using trabeculectomy punch combined with novel RS tubes is a safe and effective method for the punctul stenosis, which is easy to perform, with high success rate.

Objective Increasing evidence suggest that aberrant activation of PI3K/Akt is involved in many human cancers, and that inhibition of the PI3K/Akt pathway might be a promising strategy for cancer therapy. The study is to evaluate the effects of combined therapy of PI3K inhibitor (LY294002) and Ad-PTEN in athymic mice xenogeneic transplant model of human glioma and to reveal the possible mechanisms involved.Methods Twenty-four athymic mice were randomly divided into 4 groups (DMSO、Ad-vector plus DMSO、LY294002 alone and Ad-PTEN plus LY294002), and were treated, respectively. Athymic mice xenogeneic transplant model was established by inoculation (sc) with LN229 glioma cells. Body mass (BM) and diameter of tumor mass were measured. Furthermore, The protein expressions of PTEN、p-Akt、CyclinD1、Caspase-3、MMP-2、p-FAK in tumor tissues were analyzed with immunohistochemistry.Results The tumor-inhibiting rate of was significantly higher in Ad-PTEN plus LY294002 than in the LY294002 alone (92.46 vs 65.59%)( P <0.05).The protein expressions of PTEN and Caspase-3 were significantly higher, while PCNA、CyclinD1、bcl-2 and MMP-2、p-FAK was significantly lower in Ad-PTEN plus LY294002 group than in the other three groups ( P <0.05).Conclusions LY294002 plus Ad-PTEN achieve better outcome than either alone in treating glioma possibly through enhancement of the inhibitory action of PI3K/Akt pathway and Ad-PTEN pathway.

In case of accident, appropriate payment for the injured is important in the point of justice or even for the early social rehabilitation of the injured. To evaluate the exact status of the injured is the prerequisite for this. The physical status is converted to social or legal status using impairment or disability evaluation system. For this many different systems are used in Korea right now, that are several legislations such as 'Nation Compensation Law', or popular McBride and AMA(American Medical Association) guidelines. These guidelines are not similar in main idea or in detail items. Furthermore as these are from another country, these could not reflect our national status. Several national legislations are also far from appropriateness. There are many cases that showed different evaluation results depending on what guidelines are adopted. To overcome this irrational situation, many trials have been made to establish Korean guideline for the disability evaluation by different groups of specialists using different concepts. In this study the irrational status that showed different rating results depending on different guideline adopted were showed through several case works. With thorough review of the related materials, the pros and cons of the major systems in Korea were pointed out. Guideline suggested recently in Korea by different groups were also reviewed thoroughly. To know the points that must be considered in making new guideline, many specialists and business mans who are actively participating in compensation related works were questioned on the major topics. With the introduction of major concept in compensation medicine, author tried to present the plausible way for the improvement of our system. Author believe that this results would be helpful in making direction for the Korean guideline for the disability evaluation and contribute in settling down the social or legal dispute around the disability evaluation around us.
Commerce ; Compensation and Redress ; Disability Evaluation* ; Dissent and Disputes ; Jurisprudence ; Korea ; Rehabilitation ; Social Justice ; Specialization

OBJECTIVETo compare the incidence of postoperative long-term complications and quality of life between two digestive tract reconstruction techniques after total gastrectomy in order to provide evidence for clinical practice.

METHODSA systematic literature search was carried out to obtain studies of randomized controlled trials (RCTs) of reconstruction techniques including jejunal interposition and Roux-en-Y. Data extracted from RCTs for meta-analysis were independently assessed by two reviewers. A meta-analysis was performed by RevMan5.0 software.

RESULTSA total of 1628 gastric cancer cases undergoing total gastrectomy from 10 RCTs were eligible for inclusion, among whom 728 received jejunal interposition reconstruction and 954 Roux-en-Y anastomosis. As compared with Roux-en-Y anastomosis, jejunal interposition reconstruction significantly decreased the incidence of dumping syndrome (OR=0.19, 95%CI:0.11-0.34, P<0.01), increased the prognostic nutritional index (WMD=6.02, 95%CI:1.82-10.22, P<0.01), and improved the body weight postoperatively (WMD=-2.45, 95%CI:-3.81--1.71, P<0.01). Meanwhile, jejunal interposition reconstruction did not prolong operative time and hospital stay (both P>0.05).

CONCLUSIONJejunal interposition has better efficacy than Roux-en-Y in dumping syndrome and quality of life, and is a reasonable and effective digestive tract reconstruction for long-term survival of gastric cancer patients.

Anastomosis, Roux-en-Y ; Gastrectomy ; methods ; Humans ; Jejunum ; surgery ; Postoperative Complications ; Quality of Life ; Randomized Controlled Trials as Topic ; Stomach Neoplasms ; surgery