Objective:To evaluate the safety and efficacy of Delorme procedure for adults with full-thickness rectal prolapse.Methods:Clinical data of 17 adult patients suffering from full-thickness rectal prolapse undergoing Delorme procedure from June 2014 to May 2018 in Hangzhou Third Hospital were retrospectively analyzed. Patient characteristics, operative data, postoperative complications, recurrence of rectal prolapse, continence state and constipation state were evaluated.Results:Eleven patients were female, 6 patients were male with a mean age of (68 ± 9) years. Operations were successfully performed in these 17 cases. The operation time was (88 ± 16) minutes. The estimated blood loss during operation was (23 ± 9) ml. The postoperative time of hospital stay was (8 ± 1) d. Two complications in two patients were observed. There was no treatment related death. One recurrent case was observed during (16 ± 2) months follow-up. The preoperative and postoperative mean constipation score of five patients with fecal constipation were (23 ± 2) and (11 ± 3) respectively ( t = 9.51, P<0.01). The mean fecal incontinence score of six patients with fecal incontinence, before and after Delorme procedure, were (14 ± 2) and (6 ± 2) respectively ( t = 9.09, P<0.01). Conclusions:The Delorme procedure for adults with full-thickness rectal prolapse is a safe and effective surgery with less complications and low recurrence rate. The Delorme procedure may be one of the preferred option of perineal approach for adults with full-thickness rectal prolapse, but the long-term outcome of Delormer procedure and its effect on postoperative anal function need to be further studied.

Objective:To investigate the effects of total minimally invasive surgery (TMA) and mixed minimally invasive/open surgery (HMOA) on perioperative conditions and long-term efficacy of patients with rectal cancer.Methods:The clinical data of 240 patients with rectal cancer treated with minimally invasive surgery from January 2014 to August 2018 in Hangzhou Third People′s Hospital were retrospectively analyzed. Among them, 110 patients were treated with TMA (TMA group) and 130 patients were treated with HMOA (HMOA group). The relevant indexes of patients before and after surgery were collected and analyzed.Results:The operation time in TMA group was significantly longer than that in HMOA group: (312.5 ± 20.3) min vs. (210.8 ± 15.2) min, the length of hospital stay was significantly shorter than that in HMOA group: (4.0 ± 0.5) d vs. (6.8 ± 1.0) d, and there were statistical differences ( P<0.01); there were no statistical differences in low anterior resection and surgical procedures, ileostomy, open surgery, postoperative complications, reoperation, morphine dosage at 3 d after surgery and readmission between 2 groups ( P>0.05). Multivariate Cox analysis result showed that BMI ≥ 30 kg/m 2 ( OR=4.11, 95% CI 1.68 to 9.72, P<0.01), TMA ( OR=0.13, 95% CI 0.06 to 0.42, P<0.01), delayed bowel obstruction ( OR=13.6, 95% CI 1.59 to 110.56, P<0.05) and reoperation ( OR=15.32, 95% CI 5.52 to 42.56, P<0.01) were independent risk factors of prolonged hospital stay in patients with rectal cancer. The patients were followed up for 15 to 42 (29.5 ± 0.2) months, and there were no statistical differences in 3-year overall survival (OS) rate and 3-year disease-free survival (DFS) rate between HMOA group and TMA group (92.5% vs. 92.8% and 79.6% vs. 85.5%, HR=1.20 and 0.75, 95% CI 0.35 to 3.14 and 0.28 to 1.34, P=0.98 and 0.25). Conclusions:Patients with rectal cancer treated with TMA have the advantages of shorter hospital stay and shorter short-term effects compared with those treated with HMOA. However, the long-term effects of the two minimally invasive procedures are similar.

Objective:To study the anti-tumor efficacy of endostar microbubble combined with focused ultrasound radiation in colon cancer liver metastases.Method:29 mice with colon cancer liver metastasis were randomly divided into four groups. Group 1(8 mice), as the control group. Group 2(7 mice) were treated only with ultrasonic radiation. Group 3 (7 mice) treated with the ultrasonic radiation combined with SonoVue microbubbles without carrying any medicine. Group 4(7 mice), treated with the ultrasonic radiation combined with microbubbles carrying endostar. The mice were sacrificed and the tumor specimens were weighted on the 12 days after ultrasound radiation. Immunohistochemistry was used to assess CD34 expression within the metastatic tumor.Results:The tumor weight in group 4 (0.79±0.49)g was significantly lower than that in group 1 (2.67±0.61)g, group 2 (2.60±0.60)g and group 3 (1.74±0.33)g ( F=20.629, P<0.01). The liver metastatic tumor weight in group 4(0.55±0.16) g was much lower than that in group 1 (1.47±0.22)g, group 2(1.42±0.28) g and group 3 (0.95±0.27)g ( F=23.758, P<0.01). There was no obvious difference among the four groups in the number of nodules of metastatic tumor in liver ( F=0.167, P=0.918). The level of CD34 in group 4 were (8 037±1 708) , significantly lower than that in any other group, ( F=15.779, P<0.01). Conclusion:Endostar microbubble combined with focused ultrasound radiation decreases tumor angiogenesis in liver metastasis, and inhibits the growth of both primary and metastatic tumor.

Objective:To observe the clinical effect of Buyang huanwu decoction combined with hyperbaric oxygen therapy on acute cerebral infarction (ACI) of qi deficiency and blood stasis type.Methods:A total of 78 patients with acute cerebral infarction of qi deficiency and blood stasis type admitted to the 901 Hospital of CPLA from June 2016 to May 2019 were selected as study objects and randomly divided into 3 groups according to random number table method: Traditional Chinese medicine (TCM) group, HBO group, and combination group ( n=26). The TCM group was treated with traditional Chinese medicine decoction on the basis of the conventional treatment of ACI; the HBO group was treated with HBO on the basis of conventional treatment of ACI; the combination group was treated with traditional Chinese medicine decoction and HBO on the basis of the conventional treatment of ACI. After 20 days of treatment, the National Institute of Health stroke scale (NIHSS) scores and TCM syndrome scores of the 3 groups were statistically analyzed according to their basic clinical characteristics. Results:There were no significantly statistical differences in terms of NIHSS score or TCM syndrome score before treatment among the 3 groups ( H=0.304, P=0.859; H=0.379, P=0.827). After treatment, the NIHSS score of the combination group was lower than those of the TCM group and the HBO group ( P’=0.033, P’=0.011). The difference of NIHSS score after treatment in the combination group was higher than those in the TCM group and the HBO group ( P’=0.025, P’=0.003). After treatment, the TCM syndrome score of the combination group was lower than those of the TCM group and the HBO group ( P’=0.016, P’=0.046). After treatment, the difference of TCM syndrome score in the combination group was higher than those in the TCM group and the HBO group ( P’=0.005, P’=0.023). The overall clinical efficacy of the combination group was better than those of the TCM group and the HBO group ( P’=0.045, P’=0.010)). Conclusion:Buyang Huanwu decoction combined with hyperbaric oxygen therapy has a synergistic effect in the treatment of ACI, which is worthy of clinical application.

Objective:To observe the clinical effect of Buyang huanwu decoction combined with hyperbaric oxygen therapy on acute cerebral infarction (ACI) of qi deficiency and blood stasis type.Methods:A total of 78 patients with acute cerebral infarction of qi deficiency and blood stasis type admitted to the 901 Hospital of CPLA from June 2016 to May 2019 were selected as study objects and randomly divided into 3 groups according to random number table method: Traditional Chinese medicine (TCM) group, HBO group, and combination group ( n=26). The TCM group was treated with traditional Chinese medicine decoction on the basis of the conventional treatment of ACI; the HBO group was treated with HBO on the basis of conventional treatment of ACI; the combination group was treated with traditional Chinese medicine decoction and HBO on the basis of the conventional treatment of ACI. After 20 days of treatment, the National Institute of Health stroke scale (NIHSS) scores and TCM syndrome scores of the 3 groups were statistically analyzed according to their basic clinical characteristics. Results:There were no significantly statistical differences in terms of NIHSS score or TCM syndrome score before treatment among the 3 groups ( H=0.304, P=0.859; H=0.379, P=0.827). After treatment, the NIHSS score of the combination group was lower than those of the TCM group and the HBO group ( P’=0.033, P’=0.011). The difference of NIHSS score after treatment in the combination group was higher than those in the TCM group and the HBO group ( P’=0.025, P’=0.003). After treatment, the TCM syndrome score of the combination group was lower than those of the TCM group and the HBO group ( P’=0.016, P’=0.046). After treatment, the difference of TCM syndrome score in the combination group was higher than those in the TCM group and the HBO group ( P’=0.005, P’=0.023). The overall clinical efficacy of the combination group was better than those of the TCM group and the HBO group ( P’=0.045, P’=0.010)). Conclusion:Buyang Huanwu decoction combined with hyperbaric oxygen therapy has a synergistic effect in the treatment of ACI, which is worthy of clinical application.

Objective To investigate the effect of hyperbaric oxygen (HBO) on malignant biological behavior of ovarian cancer SKOV3 cells and its related mechanism.Methods After the culture of human ovarian cancer cell line SKOV3 was completed,the effects of HBO on the proliferation,apoptosis and tumorigenicity of SKOV3 cells were respectively detected by CCK-8,flow cytometry and Western blotting in the HBO group and the control group,and the effects of HBO on PTEN/PI3K/AKT pathway activation were detected by Western blotting.After PTEN was knocked down,the effects of HBO on the proliferation and apoptosis of SKOV3 cells were detected by the above methods.The inhibition of HBO on the growth of ovarian cancer-bearing mice and the expression of related proteins were detected by tumor-bearing experiment in mice.Results Proliferation of SKOV3 cells in the HBO group was significantly decreased,while apoptosis was significantly improved (P ＜ O.05).In the HBO group,the expression of Bcl-2 was decreased,while the expression of Bax and caspase-3 were increased (P ＜ 0.05).HBO could significantly increase the expression of PTEN protein,and at the same time decrease the expressions of p-PI3K and p-AKT proteins in ovarian cancer SKOV3 cells (P ＜0.05 or P ＜0.01).In addition,the expression of HIF-1 in SKOV3 cells was decreased in the HBO group,however,after knock-down of PTEN,the inhibitory effect of HBO on the expression of HIV-1 in SKOV3 cells was significantly weakened (P ＜ 0.05).The proliferation and apoptosis of SKOV3 cells in the hyperbaric oxygen + si-PTEN group were significantly inhibited (all P ＜ 0.05).Compared with the control group,the tumor size and body mass of mice in the HBO group were significantly decreased (all P ＜ 0.05).The expression levels of HIF-1,p-PI3K,p-AKT and Bcl-2 proteins in the ovarian cancer tissues were decreased,while the expression levels of PTEN,caspase-3 and Bax were increased (all P ＜ 0.05).Conclusion HBO treatment could significantly inhibit malignant biological behavior of ovarian cancer SKOV3 cells,the mechanism of which might be related with the improvement of the hypoxic environment of cells through the regulation of PTEN/PI3K/AKT pathway.

Objective To investigate the effect of hyperbaric oxygen (HBO) on malignant biological behavior of ovarian cancer SKOV3 cells and its related mechanism.Methods After the culture of human ovarian cancer cell line SKOV3 was completed,the effects of HBO on the proliferation,apoptosis and tumorigenicity of SKOV3 cells were respectively detected by CCK-8,flow cytometry and Western blotting in the HBO group and the control group,and the effects of HBO on PTEN/PI3K/AKT pathway activation were detected by Western blotting.After PTEN was knocked down,the effects of HBO on the proliferation and apoptosis of SKOV3 cells were detected by the above methods.The inhibition of HBO on the growth of ovarian cancer-bearing mice and the expression of related proteins were detected by tumor-bearing experiment in mice.Results Proliferation of SKOV3 cells in the HBO group was significantly decreased,while apoptosis was significantly improved (P ＜ O.05).In the HBO group,the expression of Bcl-2 was decreased,while the expression of Bax and caspase-3 were increased (P ＜ 0.05).HBO could significantly increase the expression of PTEN protein,and at the same time decrease the expressions of p-PI3K and p-AKT proteins in ovarian cancer SKOV3 cells (P ＜0.05 or P ＜0.01).In addition,the expression of HIF-1 in SKOV3 cells was decreased in the HBO group,however,after knock-down of PTEN,the inhibitory effect of HBO on the expression of HIV-1 in SKOV3 cells was significantly weakened (P ＜ 0.05).The proliferation and apoptosis of SKOV3 cells in the hyperbaric oxygen + si-PTEN group were significantly inhibited (all P ＜ 0.05).Compared with the control group,the tumor size and body mass of mice in the HBO group were significantly decreased (all P ＜ 0.05).The expression levels of HIF-1,p-PI3K,p-AKT and Bcl-2 proteins in the ovarian cancer tissues were decreased,while the expression levels of PTEN,caspase-3 and Bax were increased (all P ＜ 0.05).Conclusion HBO treatment could significantly inhibit malignant biological behavior of ovarian cancer SKOV3 cells,the mechanism of which might be related with the improvement of the hypoxic environment of cells through the regulation of PTEN/PI3K/AKT pathway.

OBJECTIVETo explore the impact of neutrophil gelatinase-associated lipocalin (NGAL) knockdown by NGAL siRNA encapsulated with urocanic acid-modified chitosan nanoparticles (UAC) on the proliferation, migration and apoptosis of human colon cancer cells.

METHODSNGAL siRNA was encapsulated by UAC and chitosan (CTS) respectively, and then was transfected into human colon cancer cell lines HT29. The NGAL mRNA was detected by real-time quantitative PCR (RT-QPCR). Relationships of NGAL gene silencing with the proliferation, migration and apoptosis of HT29 cell were analyzed.

RESULTSUnder the fluorescence microscope, the transfection efficiency of siRNA in UAC group was (37.52±7.17)%, which was significantly higher than (11.32±3.39)% in CTS group (t=6.102, P=0.005). Forty-eight hours after transfection, RT-QPCR examination showed that the level of NGAL mRNA expression was 0.350 in UAC group and 0.529 in CTS group with significant difference (t=-3.743, P=0.02), meanwhile both levels were significantly lower as compared to control group(F=163.538, P<0.001). Proliferation analysis revealed that after silencing NGAL gene, proliferation rate of UAC group and CTS group was slightly lower than control group, and no significant differences were found (F=9.520, P=0.438). However, migration assay demonstrated that the 24-hour migration rate of UAC group and CTS group was significantly lower than that of control group (F=6.756, P=0.029), meanwhile the migration rate of UAC group was slightly lower than that of CTS group [(77.90±7.14)% vs. (87.67±3.98)%, t=-1.704, P=0.164]. Apoptosis detection revealed that the apoptosis rate in UAC group was significantly higher than that in CTS group and the control group 2 days after transfection [(15.800±1.054)% vs. (12.900±0.656)%, (11.933±1.914)%, F=7.004, P=0.027].

CONCLUSIONSThe encapsulated ability and transfection efficiency of chitosan modified by urocanic acid elevate significantly. Silencing NGAL gene by UAC carrier can down-regulate the expression of NGAL mRNA in HT29 colon cell line, inhibit their migration and facilitate their apoptosis.

Objective To explore the effect of NGAL knockdown by NGAL siRNA encapsulated with urocanic acid-modified chitosan nanoparticles (UAC).MethodsNGAL siRNA encapsulated by UAC and chitosan (CTS) respectively, which were then used to transfect human colon cancer cell lines HT29.The expression level of NGAL protein were detected by Enzyme Linked Immunosorbent Assay(ELISA).ResultsThe ELISA study revealed that the expression level of NGAL protein in UAC group(average 0.583μg/L) was significantly lower than in CTS group (average 0.772μg/L) and control group(average 1.071μg/L) (P<0.05).ConclusionThe NGAL expression of mRNA and protein in HT29 cells could be down-regulated by siRNA encapsulated by UAC.

Objective To investigate the clinical efficacy of comprehensive hyperbaric oxygen (HBO) in the treatment of the patients with sudden hearing loss .Methods Totally, 80 patients with sudden hearing loss who were admitted into our hospital for treatment from June 2015 to March 2017 were selected as research subjects, and were divided into the observation group (n =40) and the control group (n =40), in accordance with the sequence of admission.The control group was given volume expansion to improve hemorheology , vasodilator to improve microcirculation, glucocorticoids, neurotrophic drugs and ginkgo biloba extract dripping pills, while the observation group received HBO in addition to the treatment received by the control group .One course of treatment for all patients in the 2 groups was 10 days, and following 3 courses of treatment, changes in hearing and clinical efficacy before and after treatment for the patients of the 2 groups were compared between the 2 groups.Results Following treatment for 3 courses for the observation group , 4 cases were cured, 21 cases were markedly effective , 10 cases were effective and 5 cases were ineffective, with a total effective rate of 87.5％, while for the control group, no cases were cured, 5 cases were markedly effective, 22 cases were effective and 13 cases were ineffective, with a total effective rate of 67.5％.Statistical significance could be seen, when comparisons were made between the observation group and the control group (P <0.05).Before treatment, there was no significant differences in full frequency hearing loss for the patients of 2 groups (P >0.05).After 2 courses of treatment, the value of low frequency hearing for the observation group increased more significantly, as compared with that of the control group [(37.39 ±5.77) vs (23.91 ±4.08) dB,P <0.05], however, there were no statistical differences in the increased values of high frequency hearing , when comparisons were made between the 2 groups (P >0.05).After 3 courses of treatment, the increased values of both low frequency and high frequency hearing for the patients of the observation group were all significantly better than those of the control group [ low frequency: (45.99 ±5.98) vs (36.79 ±5.72) dB; high frequency:(19.63 ±3.94) vs (9.70 ±2.17)dB, P <0.05].Conclusions Comprehensive HBO treatment could effectively improve the hearing level of the patients with full frequency sudden hearing loss , which was worth further clinical popularization .