OBJECTIVETo explore different frequency electroacupuncture in acupuncture-drug compound anesthesia on analgesic effect and immune function in the pulmonary resection patients in order to recommend the best electroacupuncture frequency in acupuncture-drug compound anesthesia.

METHODSOne hundred and sixty-three patients scheduled for pneumonectomy were randomly divided into group A (n = 31), B (n = 34), C (n = 32), D (n = 34) and E (n = 32). Houxi (SI 3), Zhigou (TE 6), Neiguan (PC 6) and Hegu (LI 4) were selected in the five groups. Group A was treated with sham acupuncture by pasting needles without needle bodies at acupoints and electroacupuncture at the needle handle, and group B with 2 Hz electroacupuncture, and group C with 2 Hz/ 100 Hz electroacupuncture, and group D with 100 Hz electroacupuncture, and group E with 2 Hz/100 Hz transcetaneous acupoints electrical stimulation, and general anesthesia was produced in all the groups followed by 30 min electrical stimulation and the stimulation was lasted till the end of operation. The dosages of the anesthetics and the changes of surface antigen of leukomonocyte (CD3+ , CD4+ , CD8+ and CD4+/CD8+) and natural killer (NK) cell were observed at 1 day before surgery, intraoperative and 1 day after surgery.

RESULTSIn comparison with group A, the dosages of Propofol in group B and D were decreased, Fentanyl in group B, D and E were decreased. CD3+ and CD4+ in 5 groups increased at first and then decreased over time (all P < 0.01), and group E and C could inhibit the decrease of CD3+ and CD4+ in postoperation in comparison with that in the other three groups (all P < 0.05). CD8+ in 5 groups has no change in different times (all P > 0.05), and group E and D could inhibit the decrease of CD8+ in postoperation in comparison with that in the other three groups (all P < 0.05). CD4+/CD8+ in 5 groups has no change in different times (all P > 0.05), and group E and C could inhibit the decrease of CD4+/CD8+ in postoperation in comparison with that in the other three groups (all P < 0.05). NK cells of 5 groups were increased gradually in different times (all P < 0.01), with the similar regulation of NK cells (all P > 0.05).

CONCLUSIONAcupuncture-drug compound anesthesia with 2 Hz and 100 Hz electroacupuncture together with 2 Hz/100 Hz transcetaneous acupoints electrical stimulation have the best analgesic effect, and 2 Hz/100 Hz transcetaneous acupoints electrical stimulation and 2 Hz/100 Hz electroacupuncture have the best regulation of immune function. Acupuncture-drug compound anesthesia with 2 Hz/100 Hz transcetaneous acupoints electrical stimulation is recommended for that it can not only decrease the dosages of the anesthetics, but also significantly improve the immunosuppression in patients undergoing pneumonectomy.

Acupuncture Analgesia ; Adult ; Aged ; Anesthesia, General ; Anesthetics ; Electroacupuncture ; Female ; Humans ; Immune System ; immunology ; Killer Cells, Natural ; immunology ; Lung Diseases ; immunology ; surgery ; Male ; Middle Aged ; Pneumonectomy ; Young Adult

OBJECTIVETo compare the nutritional status between pancreaticojejunostomy(PJ) and pancreaticogastrostomy(PG) following pancreaticoduodenectomy.

METHODSA retrospective clinical analysis was performed on 37 patients undergoing pancreaticoduodenectomy(PD) for duodenal carcinoma and pancreatic non-epithelial tumor with PG(n=19) and PJ(n=18) in the First Hospital of Sun Yat-sen University from April 2006 to December 2010. All the patients had a needle catheter jejunostomy inserted at the conclusion of laparotomy. Postoperative early enteral nutrition and parenteral nutrition was performed for all the patients. Nutritional status of two groups was compared in body mass index (BMI), serum nutritional parameters such as albumin, transferrin and prealbumin before surgery and on 1, 3, and 6 months postoperatively.

RESULTSThere were no significant differences between PG and PJ groups in operative time, blood loss, pancreatic fistula, perioperative death, or postoperative length of hospital stay. One month after surgery, there were no significant differences in BMI [(17.1±7.0) vs. (19.0±4.8) kg/m(2), P>0.05], albumin [(30.1±0.5) vs. (32.1±1.3) g/L, P>0.05], transferrin [(1.89±0.57) vs. (2.01±0.61) g/L, P>0.05] and prealbumin[(0.18±0.05) vs. (0.18±0.09) g/L, P>0.05]. These parameters were decreased at 1 month after surgery, and gradually recovered to baseline or higher than the preoperative levels at 6 months after surgery. However, the differences were still not statistically significant between two groups.

CONCLUSIONSThe influence of PJ and PG on the postoperative nutritional status are comparable.

Adult ; Aged ; Female ; Gastrostomy ; Humans ; Male ; Middle Aged ; Nutritional Status ; Pancreas ; surgery ; Pancreaticoduodenectomy ; Pancreaticojejunostomy ; Postoperative Period ; Retrospective Studies

Objective To investigate the efficacy and safety of photoselective vaporization treatment on benign prostatic hyperplasia(BPH)in the elderly over 70 years old.Methods From August 2004 to December 2005,a total of 126 patients with lower urinary tract symptoms secondary to BPH underwent photoselective vaporization of the prostate(PVP)with an 80 W quasicontinuous KTP laser.The patients aged between 70 and 96 years,(median 78.0),with 46 cases above 80 years. Prostatic volume was 24～86 ml,in an average of 47.0 ml,with 46 cases above 60 ml.Results The mean operative time was 46.8 min(range from 30 to 100 min).After operation,the catheter was pulled out in 69 cases within 24 hours and the patients generally urinated well.At three-months follow-up,the mean I-PSS decreased significantly from(25.0?3.7)to(16.3?2.0)(P＜0.01), while the Qmax increased from(5.8?2.7)ml/s to(16.3?4.8)ml/s(P＜0.01).Complications consisted of 4 cases of hematuria,6 urinary infection and 1 acute epididymitis.Conclusions The study indicates that PVP,a minimal invasive surgical procedure,is a safe and effective procedure for the treatment of BPH in the elderly.

AIM:To evaluate the effect of α2-macroglobulin(α2M) against X-ray induced obstacle on osteo-genic differentiation of human bone marrow mesenchymal stem cells(hBMMSCs). METHODS:hBMMSCs were cultured in vitro. The 4th generation of hBMMSCs was irradiated with 8 Gy X-ray,then induced osteogenic differentiation and trea-ted with different concentrations of α2M(0.5 and 1.0 g/L). The alkaline phosphatase(ALP) activity and the mRNA ex-pression of runt-related transcription factor-2 (RUNX2) were detected on day 7 after osteogenic induction. The protein ex-pression of osteoglycin (OGN) was evaluated by Western blot on day 14 after osteogenic induction. The formation of calci-um nodules was detected by alizarin red staining on day 21 after osteogenic induction. The activity of superoxide dismutase (SOD) and the protein expression of MnSOD of irradiated hBMMSCs with 8 Gy X-ray were determined at 24 h after α2M treatment. RESULTS:Compared with 8 Gy X-ray group,the activity of ALP,the mRNA expression of RUNX2,the pro-tein expression of OGN and MnSOD,as well as SOD activity were higher than those in the hBMMSCs treated with α2M at 0.5 and 1.0 g/L after 8 Gy X-ray irradiation,and the calcium nodules were also increased. CONCLUSION:α2M signifi-cantly improves the osteogenic differentiation ability,the SOD activity and MnSOD protein expression of hBMMSCs after ra-diation injury.

Objective To compare the diagnostic value of X-ray film and MRI in the posterior ankle impingement syndrome (PAIS).Methods X-ray film and MRI data of 72 cases with posterior ankle pain were analyzed retrospectively.Passive plantar flexion test and diagnostic blocking were used as the diagnostic criteria.72 patients with posterior ankle pain were divided into PAIS group and non PAIS group.X-ray film and MRI findings in the PAIS group and non PAIS group were compared,and features which had differential diagnostic value were selected for calculating and comparing the efficacy of X-ray film and MRI in diagnosing or excluding PAIS.Results There was no significant difference for X-ray film findings such as os trigonum osteosclerosis(χ2 =2.947,P =0.086),os trigonum cystic changes(χ2 = 3.031,P =0.082)and posterior ankle soft tissue swelling(χ2 = 1.610,P =0.205 )between the PAIS group and the non PAIS group.There was significant difference for MRI features such as os trigonum or posterior talus bone marrow edema(χ2 =38.868,P =0.000 ),edema around os trigonum(χ2 =39.919,P =0.000 )and tenosynovitis of the flexor hallucis longus (χ2 =8.854,P =0.003)between the PAIS group and the non PAIS group.There was no significant difference for MRI features such as posterior ankle synovitis(χ2 =2.534,P =0.119)and posterior ankle ligament thickening(χ2 =1.515,P =0.218)between the PAIS group and the non PAIS group.Conclusion Using passive plantar flexion test and diagnostic blocking as the gold standard,the diagnostic efficacy of MRI on PAIS is obviously higher than that of X-ray film.MRI can significantly improve the diagnostic accuracy of PAIS,and avoid unnecessary diagnostic blocking.

We studied a family with Gorlin-Goltz syndrome. The novel mutations of our cases were located on the 21st exon of the PTCH1 gene (c.3450C>G). The father, who received a strategic 56-day vismodegib treatment for disease control, was the first patient with Gorlin syndrome treated with the hedgehog inhibitor in Taiwan. The lesions regressed gradually, with scar formation, and were subsequently removed via a wide excision. Further details are provided below.
Basal Cell Nevus Syndrome* ; Cicatrix ; Exons ; Fathers ; Hedgehogs ; Humans ; Taiwan

OBJECTIVETo verify the analgesic effect of acupuncture compound anesthesia in functionality nasal endoscopic sinus surgery (FNES).

METHODSNinety patients undergoing FNES were randomly divided into three groups. Group A was treated with routine local anesthesia, and group B and C were treated with electroacupuncture at Yintang (EX-HN 3) and Yingxiang (LI 20) for 30 min before local anesthesia. Group B received routine local anesthesia, and group C received decrement local anesthesia. The dosage of narcotic, modified fingers pain scores and postoperative satisfaction scores were observed in three groups.

RESULTSThe operative dosage of decicaine was (118.33 +/- 26.21) mg in group A, (100.83 +/- 4.56) mg in group B, and (71.33 +/- 8.90) mg in group C, with significant differences among the three groups (all P < 0.01), the lowest dosage was used in group C and the highest dosage in group A. The fingers pain scores of group B and C were both lower than that of group A (both P < 0.01), and the postoperative satisfaction scores of group B and C were both higher than that of group A (both P < 0.01).

CONCLUSIONAcupuncture compound anesthesia can effectively alleviate the pain, decrease the dosage of local anesthetic, lower the discomfortableness and be helpful for safety of the patients during sinus surgery.

Acupuncture Analgesia ; Adolescent ; Adult ; Anesthesia, Local ; Anesthetics, Local ; administration & dosage ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Pain ; drug therapy ; Pain Management ; Sinusitis ; surgery ; Young Adult

OBJECTIVETo explore the factors affecting the long-term survival of patients with curative resection of gastric cardia cancer.

METHODSThe data of 108 patients who underwent radical resection of gastric cardia cancer from Jul. 1994 to Dec. 2003 in our hospital were investigated retrospectively. The Kaplan-Meier method and long-rank test were used for bivariate comparisons of survival. Multivariate analysis was done by the Cox regression model (Backward Wald).

RESULTSSurvival status of the 108 patients was ascertained in Dec. 2004. Among them, 68 were Siewert type II and 40 were Siewert type III. Seventy-four patients had lymph node metastases (68.5%). The mean follow-up time was 37 months (95% CI: 29.3-44.7 months) and the middle follow-up time was 26.6 months (95% CI: 25.8-34.2 months). The 1-,3- and 5-year cumulative survival rates were 77.2%, 33.6% and 21.8%, respectively. According to the Kaplan-Meier and log-rank methods, splenectomy, lesion size, depth of tumor invasion and regional lymph node status were prognostic factors. Multivariate regression analysis indicated that only depth of tumor invasion (P=0.009) and lymph node metastases (P=0.001) were independent prognostic factors.

CONCLUSIONDepth of tumor invasion and lymph node metastases have negative effects on the survival of patients with gastric cardia cancer undergoing curative resection. Splenectomy may only be appropriate for patients with direct tumor invasion to the spleen and the extent of gastric resection does not influence survival in patients with curative gastric cardia cancer.

Adult ; Aged ; Aged, 80 and over ; Cardia ; pathology ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Regression Analysis ; Retrospective Studies ; Stomach Neoplasms ; pathology ; surgery

OBJECTIVETo investigate the related factors and prognosis of peritoneal dissemination and hepatic metastasis in gastric cancer, and the impact of palliative surgery on the prognosis.

METHODSThe clinicopathologic and follow-up data of the patients with gastric carcinoma treated in our hospital from Aug. 1994 to Jul. 2005 were analyzed retrospectively.

RESULTSThe clinicopathologic factors correlated with peritoneal dissemination included serosal penetration, whole stomach cancer, undifferentiated type, female and hepatic metastasis, while those correlated with hepatic metastasis included Borrmann IV, lymph node metastasis and peritoneal dissemination (P< 0.05). The postoperative one-year survival rate of the patients with hepatic metastasis (H group) were lower than that of the patients with peritoneal dissemination (P group)(P< 0.05). The one- year survival rate of the patients with peritoneal dissemination undergoing palliative resection was significantly higher than that of the patients undergoing by-pass operation or feeding neostomy, and exploratory laparotomy (P< 0.05), while there was no significant difference among the three groups of the patients with hepatic metastasis.

CONCLUSIONSThe short-term prognosis of the patients with hepatic metastasis is poorer than that of the patients with peritoneal dissemination. Palliative resection could improve the short-term survival rate of the patients with peritoneal dissemination, while it had no significant impact on the survival rate of the patients with hepatic metastasis.

Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; mortality ; secondary ; Male ; Middle Aged ; Neoplasm Metastasis ; Peritoneal Neoplasms ; mortality ; secondary ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; mortality ; pathology ; Survival Rate

BACKGROUNDDiabetes mellitus plays an important role in cancer prevalence and outcomes. The aim of this study was to evaluate the influence of DM on stages and outcomes among patients with colorectal cancer.

METHODSThe study enrolled 945 patients who were diagnosed as having colorectal carcinoma from August 1994 to December 2002. In the cohort, 26 patients were diagnosed as having DM. With a median follow-up of 45.8 months, differences in overall survival and disease-free survival between the diabetes and non-diabetes groups were analyzed.

RESULTSKaplan and Meier analysis showed that there were no significant differences between the two groups in overall survival rates at 3 years or 5 years. At 5 years, patients with DM, compared with patients without diabetes, experienced a significantly lower disease-free survival rate (34.2% diabetics vs. 55.1% non-diabetics; P = 0.025).

CONCLUSIONSDM was associated with an increased risk of recurrence in patients with colorectal cancer.

Adult ; Aged ; Colorectal Neoplasms ; mortality ; Diabetes Mellitus, Type 2 ; mortality ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged