Objective To compare the effects of quadratus lumborum block at the lateral supra-arcuate ligament(QLB-LSAL)versus subcostal transversus abdominis plane block(STAPB)on perioperative analgesia and postoperative inflammation in patients undergoing laparoscopic radical resection of colorectal cancer.Methods In this prospective randomized study,we recruited 102 patients undergoing laparoscopic colorectal cancer surgery between October 2022 and October 2024 under general anesthesia and randomly assigned them to two groups:QLB-LSAL(Group Q,n=51)and STAPB(Group S,n=51).Mean arterial pressure(MAP)and heart rate(HR)were recorded before anesthesia induction(T0),before surgical incision(T1),start of surgery(T2),during pneumoperitoneum establishment(T3),during peritoneal lavage(T4),at the end of surgery(T5),and upon leaving the operating room(T6).Intraoperative remifentanil consumption,time to first patient-controlled analgesia demand,and frequency of effective compression and rescue analgesia were recorded.Visual Analog Scale(VAS)scores at rest and during coughing were assessed at 24,48,and 72 hours postoperatively.Interleukin-6(IL-6)and systemic immune-inflammatory index(SII)at 1 day preoperatively,1,and 3 days postoperatively were recorded.Postoperative recovery indicators and adverse events were also recorded.Results Group Q demonstrated significantly lower MAP and HR compared with Group S from T3 to T6(P<0.05).Group Q had significantly lower intraoperative remifentanil consumption,significantly longer time to first analgesic pump demand,fewer effective pump compres-sion,and lower frequency for rescue analgesia requests(all P<0.05).VAS scores at rest and during coughing in Group Q were significantly lower at 24 h and 48 h postoperatively(P<0.05).As compared with preoperative levels,both IL-6 and SII increased at 1 and 3 days postoperatively,but magnitude of increase in Group Q was smaller than in Group S(P<0.05).In comparison to Group S,Group Q demonstrated significantly earlier ambulation,shorter hospital stay,and fewer adverse events(P<0.05).Conclusion QLB-LSAL is superior to STAPB in enhancing perioperative analgesia,attenuating inflammatory response,and accelerating postoperative rehabilitation in patients undergoing laparoscopic colorectal cancer resection.

Objective To compare the effects of quadratus lumborum block at the lateral supra-arcuate ligament(QLB-LSAL)versus subcostal transversus abdominis plane block(STAPB)on perioperative analgesia and postoperative inflammation in patients undergoing laparoscopic radical resection of colorectal cancer.Methods In this prospective randomized study,we recruited 102 patients undergoing laparoscopic colorectal cancer surgery between October 2022 and October 2024 under general anesthesia and randomly assigned them to two groups:QLB-LSAL(Group Q,n=51)and STAPB(Group S,n=51).Mean arterial pressure(MAP)and heart rate(HR)were recorded before anesthesia induction(T0),before surgical incision(T1),start of surgery(T2),during pneumoperitoneum establishment(T3),during peritoneal lavage(T4),at the end of surgery(T5),and upon leaving the operating room(T6).Intraoperative remifentanil consumption,time to first patient-controlled analgesia demand,and frequency of effective compression and rescue analgesia were recorded.Visual Analog Scale(VAS)scores at rest and during coughing were assessed at 24,48,and 72 hours postoperatively.Interleukin-6(IL-6)and systemic immune-inflammatory index(SII)at 1 day preoperatively,1,and 3 days postoperatively were recorded.Postoperative recovery indicators and adverse events were also recorded.Results Group Q demonstrated significantly lower MAP and HR compared with Group S from T3 to T6(P<0.05).Group Q had significantly lower intraoperative remifentanil consumption,significantly longer time to first analgesic pump demand,fewer effective pump compres-sion,and lower frequency for rescue analgesia requests(all P<0.05).VAS scores at rest and during coughing in Group Q were significantly lower at 24 h and 48 h postoperatively(P<0.05).As compared with preoperative levels,both IL-6 and SII increased at 1 and 3 days postoperatively,but magnitude of increase in Group Q was smaller than in Group S(P<0.05).In comparison to Group S,Group Q demonstrated significantly earlier ambulation,shorter hospital stay,and fewer adverse events(P<0.05).Conclusion QLB-LSAL is superior to STAPB in enhancing perioperative analgesia,attenuating inflammatory response,and accelerating postoperative rehabilitation in patients undergoing laparoscopic colorectal cancer resection.

Objective:To investigate the application value of single-port laparoscopic left lateral donor liver acquisition in pediatric living donor liver transplantation (PLDLT).Methods:The retrospective and descriptive study was conducted. The clinical data of the donor and recipient who were admitted to Beijing Friendship Hospital of Capital Medical University for PLDLT in January 2020 were collected. The donor was a male, aged 28 years with body mass as 62 kg, height as 174 cm and body mass index (BMI) as 20.5 kg/m 2. The recipient was the daughter of the donor, aged 1 year with body mass as 9 kg, height as 75 cm and BMI as 16.0 kg/m 2. The donor underwent single-port laparoscopic left lateral donor liver acquisition. The recipient underwent living donor liver trans-plantation by the same operation team. Observation indicators: (1) intraoperative conditions; (2) postoperative conditions; (3) follow-up. Results:(1) Intraoperative conditions. The donor under-went single-port laparoscopic left lateral donor liver acquisition successfully, with the single-port access system being placed through a transumbilical incision. The operation time, the warm ischemia time of the donor liver and volume of intraoperative blood loss were 240 minutes, 3 minutes and 40 mL, respectively, of the donor. The weight of the donor liver was 233.6 g, and the corrected graft-to-recipient body weight ratio was 2.60%. The recipient underwent living donor liver transplantation successfully. (2) Postoperative conditions. The donor began to take liquid diet at postoperative day 1, and results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyltransferase (GGT) and total bilirubin (TBil) of the donor was 239 U/L, 116 U/L, 53 U/L and 22.57 μmol/L. The donor began to take diet with high quality proteins at postoperative day 2, and to get for out-of-bed activities moderately. The donor′s peritoneal drainage fluid was light red at postoperative day 3, and no fluid accumulation was found in the operation area after abdominal B-ultrasound examination, so the peritoneal drainage tube was removed. The donor was discharged at postoperative day 4. The liver function of the recipient recovered to normal level 2 weeks after the operation. (3) Follow-up. The donor was followed up by outpatient examination 2 weeks after discharged, and results of laboratory examination showed that the ALT, AST, GGT and TBil was 44 U/L, 25 U/L, 53 U/L and 9.22 μmol/L, respectively. Neither the donor nor the recipient had complication ≥Ⅱ grade of the Clavien-Dino classification, such as biliary fistula and vascular complication during the 6 months after operation.Conclusion:Single-port laparoscopic left lateral donor liver acquisition can be used into the PLDLT.

OBJECTIVE: To analyze the effect of conjugated linoleic acid (CLA) on glucose and lipid metabolism in obese diabetic (db/db) mice. METHODS: db/db mice were randomized for treatment with saline or CLA mixture administered intragastrically. The changes in body weight, dietary intake, water intake, oral glucose tolerance, triglyceride and total cholesterol were recorded after the treatments. HE staining and oil red O staining were used to assess liver pathologies and fatty acid content. The expression levels of PPARα, PPARγ, CD36, CHREBP and SREBP-1c were detected using real-time PCR and Western blotting. HepG2 cells were treated with CLA and linoleic acid and the expressions of PPARα, ACC, P-ACC, and CD36 were detected; the level of acetyl-CoA in the cell supernatant was detected using ELISA. RESULTS: CLA treatment obviously reduced the dietary and water intake of db/db mice, effectively reduced the body weight and decreased serum triglyceride and cholesterol levels ( < 0.05). CLA significantly reduced fasting blood glucose, increased glucose tolerance, reduced the accumulation of lipid droplets in the liver and improved lipid metabolism in db/db mice. The mice showed significantly increased expression of PPARα ( < 0.05) and lowered CD36 expression ( < 0.001) in the liver after CLA treatment. Cellular experiments showed that CLA significantly up-regulated PPARα ( < 0.001) and P-ACC and decreased the expression of CD36 ( < 0.01). ELISA showed that acetyl-CoA was significantly up-regulated in the cells after CLA treatment ( < 0.01). CONCLUSIONS The mixture of two conjugated linoleic acid isomers can reduce fasting blood glucose, increase glucose tolerance and improve glycolipid metabolism in db/db mice by enhancing the expression of PPARα, increasing P-ACC and inhibiting CD36 expression.
Animals ; Diabetes Mellitus, Experimental ; Glucose ; Linoleic Acids, Conjugated ; Lipid Metabolism ; Liver ; Mice ; Triglycerides

Objective To investigate the dosimetric feasibility of volumetric modulated arc therapy (VMAT)with a simultaneous integrated boost(SIB-VMAT58.75 Gy)for preoperative chemoradiotherapy in patients with locally advanced rectal cancer(LARC),and to provide a basis for clinical practice.Methods Nine patients with stage Ⅱ-Ⅲ rectal cancer who underwent preoperative concurrent chemoradiotherapy were involved in the study,and two plans were performed for each patient:SIB-VMAT58.75 Gy and VMAT50.00 Gy. For the SIB-VMAT58.75 Gy plan,the prescribed dose was 58.75 Gy(2.35 Gy/fraction)for the local rectal tumor and positive lymph nodes(GTV 58.75 Gy),and 50 Gy(2 Gy/fraction)for the regions at high risk of harboring microscopic disease(pelvic lymphatic drainage area)(PTV 50Gy).For the VMAT50.00 Gy plan,the prescribed dose was 50 Gy(2 Gy/fraction)for the regions at high risk of harboring microscopic disease(pelvic lymphatic drainage area)without a boost. The conformity index(CI),homogeneity index (HI),and dose for target areas and organs at risk(OAR)were assessed according to the dose-volume histogram. The paired t-test or nonparametric rank test was used to compare the differences between the two plans. Results Both plans met the prescription goal for PTV dose coverage. There was no significant difference in CI for the PTV between the two plans(1.0±0.0 vs. 1.0±0.0,P>0.05).The SIB-VMAT58.75 Gy plan had a worse HI than the VMAT50.00 Gy plan(0.2± 0.2 vs. 0.1± 0.0,P<0.05).There was no significant difference in V10-V50of the small intestine,bladder,femoral heads,and pelvis between the two plans(P>0.05),but D 2 cm3of the small intestine was significantly higher in the SIB-VMAT58.75 Gy plan than in the VMAT50.00 Gy plan(P=0.038). Conclusions The SIB-VMAT58.75 Gy plan for LARC achieves required target volume dose coverage and OAR dose constraints,which is safe and feasible in terms of dosimetry,and its clinical efficacy and adverse effects need further evaluation.

OBJECTIVE:To systematically review the efficacy and safety of the Bushen huoxue lishi category TCM compound in the treatment of chronic prostatitis,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from VIP Database,Wanfang Database,CJFD and CBM,randomized controlled trials(RCT)about Bushen huoxue lishi category TCM com-pound preparation (test group) versus conventional Western medicine (control group) in the treatment of chronic prostatitis were collected. Meta-analysis was performed by Rev Man 5.3 software after data extraction and quality evaluation. RESULTS:Totally 22 RCTs were enrolled,involving 1 863 patients. Results of Meta-analysis showed the total effective rate [OR=4.46,95%CI(3.40, 5.84),P<0.001],total scores of chronic prostatitis symptoms[MD=-3.62,95%CI(-5.21,-2.04),P<0.001] and lecithin count [MD=7.58,95%CI(2.15,13.01),P=0.006] in test group were significantly higher than control group,prostatic fluid white blood cell count [MD=-1.68,95%CI(-3.26,-0.10),P=0.04] was significantly lower than control group,with significant differenc-es. CONCLUSIONS:Bushen huoxue lishi category TCM compound has good efficacy in the treatment of chronic prostatitis.

OBJECTIVETo investigate the effects of intragastric administration of human interferon-α (hIFN-α)-transformed Bifidobacterium on immune functions of mice.

METHODSThe E.coli-Bifidobacterium shuttle expression vector containing hIFN-α gene was constructed and transformed into Bifidobacterium. The hIFN-α-transformed Bifidobacterium suspension (1010 /ml) was prepared after induction with 0.2% L-arabinose for hIFN-α expression and administered intragastrically in male Balb/C mice at the dose of 0.1 ml every other day for 2 weeks, with the mice receiving empty vector-transformed Bifidobacteria as the negative control and those having an equal volume of saline as the blank control. The percentages of mononuclear cell subsets in the thymus, spleen and blood were detected in the mice by flow cytometry, and the serum levels of IL-4, IL-12, IFN-γ and TNF-α were assayed using mouse cytokine FlowCytomix Kit.

RESULTSThe percentages of CD3⁺CD8⁺ and CD4⁺CD8⁺ cells in the thymus, CD3⁺CD4⁺, CD3⁺CD8⁺ and CD4⁺CD8⁺ cells in the spleen, and CD3⁺CD8⁺ cells in the blood all increased significantly in IFN group as compared with those in the negative and blank control groups (P<0.01 or 0.05). The serum level of IFN-γ also increased significantly (P<0.05) while IL-4 level remained unchanged in IFN group compared with those in the two groups.

CONCLUSIONIntragastric administration of hIFN-α-transformed Bifidobacterium promotes lymphocyte proliferation and maturation and increases the serum levels of Th1 cytokines in mice.

Animals ; Bifidobacterium ; Cell Proliferation ; Genetic Vectors ; Humans ; Interferon-alpha ; pharmacology ; Interferon-gamma ; blood ; Interleukin-12 ; blood ; Interleukin-4 ; blood ; Lymphocyte Activation ; drug effects ; Male ; Mice ; Mice, Inbred BALB C ; Recombinant Proteins ; pharmacology ; Spleen ; cytology ; Th1 Cells ; cytology ; Thymus Gland ; cytology ; Tumor Necrosis Factor-alpha ; blood

Objective To evaluate the therapeutic effect of transarterial chemoembolization (TACE) combined with CT-guided 125I seed implantation in treating hepatocellular carcinoma (HCC) complicated by portal vein tumor thrombus(PVTT), and to discuss the technical points. Methods A total of 48 HCC patients with PVTT were enrolled in this study. TACE combined with CT-guided 125I seed implantation was carried out in all 48 patients. Based on the sites of PVTT, the lesions were classified into type A (PVTT within main portal vein), type B(PVTT within level-1 portal branch) and type C(PVTT within level-2 or more distal portal branch). According to whether the 125I seeds were directly implanted into the PVTT or not, the patients were divided into direct in-tumor thrombus implantation group (group A) and around tumor thrombus implantation group (group B; the 125I seeds were implanted in the liver parenchyma or in tumor tissue around the tumor thrombus within 1.7 cm region). The tumor thrombus control rate(TTCR), the disease control rate(DCR), the time to progress(TTP) and the overall survival rate of patients(OS) were determined, and the results were compared among different types and groups. Results TACE combined with CT-guided 125I seed implantation was successfully accomplished in all 48 patients. The median OS of type A, B and C was 8, 11.5 and 15 months respectively(P=0.003);the TTCR of type A, B and C was 61.5%, 70.8%and 72.7%respectively(P=0.548); the DCR of type A, B and C was 69.2%, 75%and 81.8% respectively (P=0.483); the median TTP of type A, B and C was 4.5, 8 and 11 months respectively(P=0.030);the median TTP of intra-hepatic tumor of type A, B and C was 5, 9 and 9.5 months respectively(P=0.012). The median OS in group A and group B was 10 and 11.5 months respectively (P=0.239); the TTCR in group A and group B was 69.2% and 68.2%respectively(P=0.591); the DCR of intra-hepatic tumor in group A and group B was 73.1% and 77.3%respectively(P=0.502); the median TTP of tumor thrombus in group A and group B was 7 and 10 months respectively(P=0.276); and the median TTP of intra-hepatic tumor in group A and group B was 8 and 9.5 months respectively(P=0.089). Conclusion For the treatment of hepatocellular carcinoma complicated by portal vein tumor thrombus, TACE combined with CT-guided 125I seed implantation can effectively control the progress of both the tumor thrombus and the intra- hepatic tumor and prolong patient’s survival time. Implantation of 125I seeds into the portal vein tumor thrombus and implantation of 125I seeds into the liver parenchyma around the tumor thrombus have the same therapeutic results. (J Intervent Radiol, 2015, 24:488-493)

Objective To investigate the effects of intragastric administration of human interferon-α (hIFN-α)-transformed Bifidobacterium on immune functions of mice. Methods The E.coli-Bifidobacterium shuttle expression vector containing hIFN-αgene was constructed and transformed into Bifidobacterium. The hIFN-α-transformed Bifidobacterium suspension (1010/ml) was prepared after induction with 0.2%L-arabinose for hIFN-αexpression and administered intragastrically in male Balb/C mice at the dose of 0.1 ml every other day for 2 weeks, with the mice receiving empty vector-transformed Bifidobacteria as the negative control and those having an equal volume of saline as the blank control. The percentages of mononuclear cell subsets in the thymus, spleen and blood were detected in the mice by flow cytometry, and the serum levels of IL-4, IL-12, IFN-γand TNF-αwere assayed using mouse cytokine FlowCytomix Kit. Results The percentages of CD3+CD8+and CD4+CD8+cells in the thymus, CD3+CD4+, CD3+CD8+and CD4+CD8+cells in the spleen, and CD3+CD8+cells in the blood all increased significantly in IFN group as compared with those in the negative and blank control groups (P<0.01 or 0.05). The serum level of IFN-γalso increased significantly (P<0.05) while IL-4 level remained unchanged in IFN group compared with those in the two groups. Conclusion Intragastric administration of hIFN- α- transformed Bifidobacterium promotes lymphocyte proliferation and maturation and increases the serum levels of Th1 cytokines in mice.

Objective To investigate the effects of intragastric administration of human interferon-α (hIFN-α)-transformed Bifidobacterium on immune functions of mice. Methods The E.coli-Bifidobacterium shuttle expression vector containing hIFN-αgene was constructed and transformed into Bifidobacterium. The hIFN-α-transformed Bifidobacterium suspension (1010/ml) was prepared after induction with 0.2%L-arabinose for hIFN-αexpression and administered intragastrically in male Balb/C mice at the dose of 0.1 ml every other day for 2 weeks, with the mice receiving empty vector-transformed Bifidobacteria as the negative control and those having an equal volume of saline as the blank control. The percentages of mononuclear cell subsets in the thymus, spleen and blood were detected in the mice by flow cytometry, and the serum levels of IL-4, IL-12, IFN-γand TNF-αwere assayed using mouse cytokine FlowCytomix Kit. Results The percentages of CD3+CD8+and CD4+CD8+cells in the thymus, CD3+CD4+, CD3+CD8+and CD4+CD8+cells in the spleen, and CD3+CD8+cells in the blood all increased significantly in IFN group as compared with those in the negative and blank control groups (P<0.01 or 0.05). The serum level of IFN-γalso increased significantly (P<0.05) while IL-4 level remained unchanged in IFN group compared with those in the two groups. Conclusion Intragastric administration of hIFN- α- transformed Bifidobacterium promotes lymphocyte proliferation and maturation and increases the serum levels of Th1 cytokines in mice.