AIM: To assess the use of dezocine combined with propofol for the anesthetization of patients undergoing indolent colonoscopy.METHODS: A cross-sectional survey of patients undergoing indolent colonoscopy in the Xinjia...AIM: To assess the use of dezocine combined with propofol for the anesthetization of patients undergoing indolent colonoscopy.METHODS: A cross-sectional survey of patients undergoing indolent colonoscopy in the Xinjiang people's Hospital was conducted from April 1 to April 30, 2015. The survey collected patient general information and anesthesia data, including overall medical experience and pain management. Thirty minutes after colonoscopy surgery, samples of venous blood were collected and the biochemical indicators of gastrointestinal function were analyzed. RESULTS: There were 98 female and 62 male respondents. Indolent colonoscopy was found to be more suitable for mid to older-aged patients. The necessary conditions for the diagnosis of digestive diseases were required in 65 of the 73 inpatients. Adverse reactions to the intraoperative process included two cases of body movement and two cases of respiratory depression. Gastrin and vasoactive intestinal peptide levels were slightly increased. However, somatostatin and endothelin levels were slightly decreased. CONCLUSION: This study revealed that dezocine combined with propofol can be successfully used for the anesthetization of indolent colonoscopy patients without pain and should be widely used.展开更多
AIM: To define the benefits of three-dimensional video-assisted thoracoscopic esophagectomy(3D-VATE)over 2D-VATE for esophageal cancer.METHODS: A total of 93 patients with esophageal cancer including 45 patients recei...AIM: To define the benefits of three-dimensional video-assisted thoracoscopic esophagectomy(3D-VATE)over 2D-VATE for esophageal cancer.METHODS: A total of 93 patients with esophageal cancer including 45 patients receiving 3D-VATE and48 receiving 2D-VATE were evaluated. Data related to patient and cancer characteristics, operating time,intraoperative bleeding, morbidity and mortality,postoperative inflammatory markers, Numerical Rating Scale for postoperative pain, Constant-Murley rating system for shoulder recovery and oxygenation index(OI) were collected. All medical records were retrieved from a prospectively maintained oncological database at our institution. A retrospective study was performed to compare the short-term surgical outcomes between the two groups.RESULTS: No significant differences were found between the two groups in either morbidity or mortality(P = 0.328). An enhanced surgical recovery was noted in the 3D group as indicated by shortened thoracoscopic operation time(3D vs 2D: 68 ± 13.79 min vs 83 ± 13min, P < 0.01), minor intraoperative blood loss(3D vs 2D: 68.2 ± 10.7 ml vs 89.8 ± 10.4 ml, P < 0.01),earlier chest tube removal(3D vs 2D: 2.67 ± 1.01 vs3.75 ± 1.15 d, P < 0.01), shorter length of hospital stay(3D vs 2D: 9.07 ± 2.00 vs 10.85 ± 3.40 d, P <0.01), lower in-hospital expenses(3D vs 2D: 74968.4± 9637.8 vs 86211.1 ± 8519.7 RMB, P < 0.01), lower pain intensity(P < 0.01) and faster recovery of the left shoulder function(P < 0.01). Better preservation of the pulmonary function was also found in the 3D group as the decline of the OI post operation was significantly lower than that of the 2D group(P < 0.01). Changes of postoperative inflammatory markers, including procalcitonin [postoperative days(PODs) 4 and 7: P <0.01], peripheral granulocytes(PODs 1, 4 and 7: P <0.01) and hypersensitive C-reactive protein(POD 4: P< 0.01) in 3D-VATE patients were less than those in the 2D group. Moreover, utilization of the 3D technique extended the dissection of the thoracic lymph nodes(P < 0.01), with better exposure of nodes in the left recurrent laryngeal nerve(P = 0.031).CONCLUSION: 3D-VATE could be a more viable technique over 2D-VATE in terms of short-term outcomes for patients with esophageal cancer.展开更多
BACKGROUND Anastomotic leakage(AL) is a severe complication associated with high morbidity and mortality after radical gastrectomy(RG) for gastric cancer(GC).We hypothesized that a novel abdominal negative pressure la...BACKGROUND Anastomotic leakage(AL) is a severe complication associated with high morbidity and mortality after radical gastrectomy(RG) for gastric cancer(GC).We hypothesized that a novel abdominal negative pressure lavage-drainage system(ANPLDS) can effectively reduce the failure-to-rescue(FTR) and the risk of reoperation, and it is a feasible management for AL.AIM To report our institution's experience with a novel ANPLDS for AL after RG for GC.METHODS The study enrolled 4173 patients who underwent R0 resection for GC at our institution between June 2009 and December 2016. ANPLDS was routinely used for patients with AL after January 2014. Characterization of patients who underwent R0 resection was compared between different study periods. AL rates and postoperative outcome among patients with AL were compared before and after the ANPLDS therapy. We used multivariate analyses to evaluate clinicopathological and perioperative factors for associations with AL and FTR after AL.RESULTS AL occurred in 83(83/4173, 2%) patients, leading to 7 deaths. The mean time of occurrence of AL was 5.6 days. The AL rate was similar before(2009-2013, period1) and after(2014-2016, period 2) the implementation of the ANPLDS therapy(1.7% vs 2.3%, P = 0.121). Age and malnourishment were independently associated with AL. The FTR rate and abdominal bleeding rate after AL occurred were respectively 8.4% and 9.6% for the entire period; however, compared with period 1, this significantly decreased during period 2(16.2% vs 2.2%, P = 0.041;18.9% vs 2.2%, P = 0.020, respectively). Moreover, the reoperation rate was also reduced in period 2, although this result was not statistically significant(13.5% vs2.2%, P = 0.084). Additionally, only ANPLDS therapy was an independent protective factor for FTR after AL(P = 0.04).CONCLUSION Our experience demonstrates that ANPLDS is a feasible management for AL after RG for GC.展开更多
AIM: To detect how BRCA-associated protein 1(BAP1) regulates cell migration in uveal melanoma(UM) cells. METHODS: Wound healing and transwell assays were performed to detect UM cell migration abilities. Protein chip, ...AIM: To detect how BRCA-associated protein 1(BAP1) regulates cell migration in uveal melanoma(UM) cells. METHODS: Wound healing and transwell assays were performed to detect UM cell migration abilities. Protein chip, immunoprecipitations and surface plasmon resonance analyses were applied to identify BAP1 protein partners. Western blot and calpain activity assays were used to test the expression and function of calpastatin(CAST). RESULTS: CAST protein was confirmed as a new BAP1 protein partner, and loss of BAP1 reduced the expression and function of CAST in UM cells. The overexpression of CAST rescued the cell migration phenotype caused by BAP1 loss.CONCLUSION: BAP1 interacts with CAST in UM cells, and CAST and its subsequent calpain pathway may mediate BAP1-related cell migration regulation.展开更多
BACKGROUND Syphilis is a chronic,classic sexually transmitted disease caused by Treponema pallidum,which can invade almost all organs of the body and produce various symptoms and signs.Although there are some cases of...BACKGROUND Syphilis is a chronic,classic sexually transmitted disease caused by Treponema pallidum,which can invade almost all organs of the body and produce various symptoms and signs.Although there are some cases of colorectal bleeding caused by syphilis,small intestinal bleeding caused by syphilis is still rare.CASE SUMMARY A 58-year-old man had experienced recurrent abdominal pain and melena for 3 years.Repeated gastroenteroscopy and computed tomography angiography examinations failed to find bleeding lesions.During the same admission,multiple intestinal ulcers were found by capsule endoscopy,and syphilis was also diagnosed.With a history of atrial fibrillation and chronic pancreatitis,he had undergone mitral valve replacement and tricuspid valvuloplasty for valvular heart disease.After anti-syphilis treatment,the melena and abdominal pain disappeared and his hemoglobin gradually increased.It is considered that gastrointestinal bleeding,chronic pancreatitis,atrial fibrillation,and heart valvular disease may have been caused by syphilis.CONCLUSION This case report found that syphilis can mimic systemic disease and cause intestinal bleeding.In addition,treatment of the disease requires both sexual partners to be treated.Finally,although syphilis is easy to treat,it is more important to consider that bleeding could be caused by syphilis.展开更多
Objective:To explore the therapeutic effect of acupoint catgut embedding combined with gingerseparated moxibustion for sequelae of peripheral facial paralysis and whether surface electromyography(sEMG)can be an outcom...Objective:To explore the therapeutic effect of acupoint catgut embedding combined with gingerseparated moxibustion for sequelae of peripheral facial paralysis and whether surface electromyography(sEMG)can be an outcome to evaluate the effect of this disease.Methods:Thirty-five patients with sequelae of peripheral facial paralysis were treated with catgut embedding at the acupoints selected according to their individual symptoms and traditional Chinese medicine(TCM)differentiated syndromes.At the same time,the ginger-separated moxibustion was applied at Yifeng(翳风TE17)and Qianzheng(牵正EX-HN16)of the affected side.The catgut embedding was applied once every 15 days,one time of treatment is of one course,and a total of three courses were given.The moxibustion would be taken after 5 days of catgut embedding each time,once every other day,5 times as one course,a total of 3 courses are given.After treatment,the recovery of facial nerve functions was evaluated by House-Brackmann(H-B)facial nerve function evaluation grading system.Before and after treatment,the surface electromyography(sEMG)was used to detect the root-mean-square(RMS)of frontal muscles,cheek muscles,and orbicularis oris muscles to compare the RMS ratio of these muscles of affected side and healthy side.Results:After 3 courses of treatment,9 cases were cured,22 cases were effective,and 4 cases were ineffective.The total effective rate was 88.6%(31/35).After treatment,the RMS of frontal muscles,cheek muscles,and orbicularis oris muscles of the affected side were 31.56±4.25,34.13±4.28,and 7.46±1.53 respectively,significantly increased in comparing with 11.69±2.45,12.98±3.34,and 2.62±1.41 respectively before treatment(all P<0.05).After treatment,the RMS ratios of frontal muscles,cheek muscles,and orbicularis oris muscles of the affected side and healthy side were 0.73±0.09,0.71±0.11,and 0.68±0.08 respectively,greatly increased in comparing with 0.28±0.10,0.27±0.08,and 0.22±0.09 respectively before treatment(all P<0.05).Conclusion:Acupoint catgut embedding and ginger-separated moxibustion in combination can significantly improve the facial nerve functions,and sEMG used for evaluating the therapeutic effect can objectively reflect the effect of treatment.展开更多
Purpose:Early application of protease inhibitors through the intestinal lumen could increase survival following experimental shock by blocking the pancreatic digestive enzymes. Hence, it was hypothesized that two-rout...Purpose:Early application of protease inhibitors through the intestinal lumen could increase survival following experimental shock by blocking the pancreatic digestive enzymes. Hence, it was hypothesized that two-route injection (intraintestinal +intravenous) of ulinastatin (UTI), a broad-spectrum protease inhibitor, could better alleviate intestinal injury than single-route injection (either intravenous or intraintestinal).Methods:A sepsis model induced by lipopolysaccharide on rats was established. The rats were randomly divided into five groups: sham, sepsis, UTI intravenous injection (Uiv), UTI intraintestinal injection (Uii), and UTI intraintestinal +intravenous injection (Uii +Uiv) groups. The mucosal barrier function, enzyme-blocking effect, levels of systemic inflammatory cytokines, and 5-day survival rate were compared among groups. The small intestinal villus height (VH), crypt depth (CD), and two components of mucosal barrier (E-cadherin and mucin-2) were measured to evaluate the mucosal barrier function. The levels of trypsin and neutrophil elastase (NE) in the intestine, serum, and vital organs were measured to determine the enzyme-blocking effect.Results:Compared with the single-route injection group (Uiv or Uii), the two-route injection (Uii +Uiv) group displayed: (1) significantly higher levels of VH, VH/CD, E-cadherin, and mucin-2;(2) decreased trypsin and NE levels in intestine, plasma, and vital organs;(3) reduced systemic inflammatory cytokine levels;and (4) improved survival of septic rats.Conclusion:Two-route UTI injection was superior to single-route injection in terms of alleviating intestinal injury, which might be explained by extensive blockade of proteases through different ways.展开更多
文摘AIM: To assess the use of dezocine combined with propofol for the anesthetization of patients undergoing indolent colonoscopy.METHODS: A cross-sectional survey of patients undergoing indolent colonoscopy in the Xinjiang people's Hospital was conducted from April 1 to April 30, 2015. The survey collected patient general information and anesthesia data, including overall medical experience and pain management. Thirty minutes after colonoscopy surgery, samples of venous blood were collected and the biochemical indicators of gastrointestinal function were analyzed. RESULTS: There were 98 female and 62 male respondents. Indolent colonoscopy was found to be more suitable for mid to older-aged patients. The necessary conditions for the diagnosis of digestive diseases were required in 65 of the 73 inpatients. Adverse reactions to the intraoperative process included two cases of body movement and two cases of respiratory depression. Gastrin and vasoactive intestinal peptide levels were slightly increased. However, somatostatin and endothelin levels were slightly decreased. CONCLUSION: This study revealed that dezocine combined with propofol can be successfully used for the anesthetization of indolent colonoscopy patients without pain and should be widely used.
文摘AIM: To define the benefits of three-dimensional video-assisted thoracoscopic esophagectomy(3D-VATE)over 2D-VATE for esophageal cancer.METHODS: A total of 93 patients with esophageal cancer including 45 patients receiving 3D-VATE and48 receiving 2D-VATE were evaluated. Data related to patient and cancer characteristics, operating time,intraoperative bleeding, morbidity and mortality,postoperative inflammatory markers, Numerical Rating Scale for postoperative pain, Constant-Murley rating system for shoulder recovery and oxygenation index(OI) were collected. All medical records were retrieved from a prospectively maintained oncological database at our institution. A retrospective study was performed to compare the short-term surgical outcomes between the two groups.RESULTS: No significant differences were found between the two groups in either morbidity or mortality(P = 0.328). An enhanced surgical recovery was noted in the 3D group as indicated by shortened thoracoscopic operation time(3D vs 2D: 68 ± 13.79 min vs 83 ± 13min, P < 0.01), minor intraoperative blood loss(3D vs 2D: 68.2 ± 10.7 ml vs 89.8 ± 10.4 ml, P < 0.01),earlier chest tube removal(3D vs 2D: 2.67 ± 1.01 vs3.75 ± 1.15 d, P < 0.01), shorter length of hospital stay(3D vs 2D: 9.07 ± 2.00 vs 10.85 ± 3.40 d, P <0.01), lower in-hospital expenses(3D vs 2D: 74968.4± 9637.8 vs 86211.1 ± 8519.7 RMB, P < 0.01), lower pain intensity(P < 0.01) and faster recovery of the left shoulder function(P < 0.01). Better preservation of the pulmonary function was also found in the 3D group as the decline of the OI post operation was significantly lower than that of the 2D group(P < 0.01). Changes of postoperative inflammatory markers, including procalcitonin [postoperative days(PODs) 4 and 7: P <0.01], peripheral granulocytes(PODs 1, 4 and 7: P <0.01) and hypersensitive C-reactive protein(POD 4: P< 0.01) in 3D-VATE patients were less than those in the 2D group. Moreover, utilization of the 3D technique extended the dissection of the thoracic lymph nodes(P < 0.01), with better exposure of nodes in the left recurrent laryngeal nerve(P = 0.031).CONCLUSION: 3D-VATE could be a more viable technique over 2D-VATE in terms of short-term outcomes for patients with esophageal cancer.
基金Supported by Scientific and Technological Innovation Joint Capital Projects of Fujian Province,No.2016Y9031Construction Project of Fujian Province Minimally Invasive Medical Center,No.[2017]171+2 种基金The Second Batch of Special Support Funds for Fujian Province Innovation and Entrepreneurship Talents,No.2016B013Youth Scientific Research Subject of Fujian Provincial Health and Family Planning Commission,No.2015-1-37QIHANG Funds of Fujian Medical University,No.2016QH025
文摘BACKGROUND Anastomotic leakage(AL) is a severe complication associated with high morbidity and mortality after radical gastrectomy(RG) for gastric cancer(GC).We hypothesized that a novel abdominal negative pressure lavage-drainage system(ANPLDS) can effectively reduce the failure-to-rescue(FTR) and the risk of reoperation, and it is a feasible management for AL.AIM To report our institution's experience with a novel ANPLDS for AL after RG for GC.METHODS The study enrolled 4173 patients who underwent R0 resection for GC at our institution between June 2009 and December 2016. ANPLDS was routinely used for patients with AL after January 2014. Characterization of patients who underwent R0 resection was compared between different study periods. AL rates and postoperative outcome among patients with AL were compared before and after the ANPLDS therapy. We used multivariate analyses to evaluate clinicopathological and perioperative factors for associations with AL and FTR after AL.RESULTS AL occurred in 83(83/4173, 2%) patients, leading to 7 deaths. The mean time of occurrence of AL was 5.6 days. The AL rate was similar before(2009-2013, period1) and after(2014-2016, period 2) the implementation of the ANPLDS therapy(1.7% vs 2.3%, P = 0.121). Age and malnourishment were independently associated with AL. The FTR rate and abdominal bleeding rate after AL occurred were respectively 8.4% and 9.6% for the entire period; however, compared with period 1, this significantly decreased during period 2(16.2% vs 2.2%, P = 0.041;18.9% vs 2.2%, P = 0.020, respectively). Moreover, the reoperation rate was also reduced in period 2, although this result was not statistically significant(13.5% vs2.2%, P = 0.084). Additionally, only ANPLDS therapy was an independent protective factor for FTR after AL(P = 0.04).CONCLUSION Our experience demonstrates that ANPLDS is a feasible management for AL after RG for GC.
基金Supported by the Science and Technology Commission of Shanghai (No.14411961800)
文摘AIM: To detect how BRCA-associated protein 1(BAP1) regulates cell migration in uveal melanoma(UM) cells. METHODS: Wound healing and transwell assays were performed to detect UM cell migration abilities. Protein chip, immunoprecipitations and surface plasmon resonance analyses were applied to identify BAP1 protein partners. Western blot and calpain activity assays were used to test the expression and function of calpastatin(CAST). RESULTS: CAST protein was confirmed as a new BAP1 protein partner, and loss of BAP1 reduced the expression and function of CAST in UM cells. The overexpression of CAST rescued the cell migration phenotype caused by BAP1 loss.CONCLUSION: BAP1 interacts with CAST in UM cells, and CAST and its subsequent calpain pathway may mediate BAP1-related cell migration regulation.
基金Supported by Science and Technology Innovation Joint Fund Project of Fujian Province,No.2018Y9116.
文摘BACKGROUND Syphilis is a chronic,classic sexually transmitted disease caused by Treponema pallidum,which can invade almost all organs of the body and produce various symptoms and signs.Although there are some cases of colorectal bleeding caused by syphilis,small intestinal bleeding caused by syphilis is still rare.CASE SUMMARY A 58-year-old man had experienced recurrent abdominal pain and melena for 3 years.Repeated gastroenteroscopy and computed tomography angiography examinations failed to find bleeding lesions.During the same admission,multiple intestinal ulcers were found by capsule endoscopy,and syphilis was also diagnosed.With a history of atrial fibrillation and chronic pancreatitis,he had undergone mitral valve replacement and tricuspid valvuloplasty for valvular heart disease.After anti-syphilis treatment,the melena and abdominal pain disappeared and his hemoglobin gradually increased.It is considered that gastrointestinal bleeding,chronic pancreatitis,atrial fibrillation,and heart valvular disease may have been caused by syphilis.CONCLUSION This case report found that syphilis can mimic systemic disease and cause intestinal bleeding.In addition,treatment of the disease requires both sexual partners to be treated.Finally,although syphilis is easy to treat,it is more important to consider that bleeding could be caused by syphilis.
文摘Objective:To explore the therapeutic effect of acupoint catgut embedding combined with gingerseparated moxibustion for sequelae of peripheral facial paralysis and whether surface electromyography(sEMG)can be an outcome to evaluate the effect of this disease.Methods:Thirty-five patients with sequelae of peripheral facial paralysis were treated with catgut embedding at the acupoints selected according to their individual symptoms and traditional Chinese medicine(TCM)differentiated syndromes.At the same time,the ginger-separated moxibustion was applied at Yifeng(翳风TE17)and Qianzheng(牵正EX-HN16)of the affected side.The catgut embedding was applied once every 15 days,one time of treatment is of one course,and a total of three courses were given.The moxibustion would be taken after 5 days of catgut embedding each time,once every other day,5 times as one course,a total of 3 courses are given.After treatment,the recovery of facial nerve functions was evaluated by House-Brackmann(H-B)facial nerve function evaluation grading system.Before and after treatment,the surface electromyography(sEMG)was used to detect the root-mean-square(RMS)of frontal muscles,cheek muscles,and orbicularis oris muscles to compare the RMS ratio of these muscles of affected side and healthy side.Results:After 3 courses of treatment,9 cases were cured,22 cases were effective,and 4 cases were ineffective.The total effective rate was 88.6%(31/35).After treatment,the RMS of frontal muscles,cheek muscles,and orbicularis oris muscles of the affected side were 31.56±4.25,34.13±4.28,and 7.46±1.53 respectively,significantly increased in comparing with 11.69±2.45,12.98±3.34,and 2.62±1.41 respectively before treatment(all P<0.05).After treatment,the RMS ratios of frontal muscles,cheek muscles,and orbicularis oris muscles of the affected side and healthy side were 0.73±0.09,0.71±0.11,and 0.68±0.08 respectively,greatly increased in comparing with 0.28±0.10,0.27±0.08,and 0.22±0.09 respectively before treatment(all P<0.05).Conclusion:Acupoint catgut embedding and ginger-separated moxibustion in combination can significantly improve the facial nerve functions,and sEMG used for evaluating the therapeutic effect can objectively reflect the effect of treatment.
基金a grant from the National Natural Science Foundation of China (No.81701880).
文摘Purpose:Early application of protease inhibitors through the intestinal lumen could increase survival following experimental shock by blocking the pancreatic digestive enzymes. Hence, it was hypothesized that two-route injection (intraintestinal +intravenous) of ulinastatin (UTI), a broad-spectrum protease inhibitor, could better alleviate intestinal injury than single-route injection (either intravenous or intraintestinal).Methods:A sepsis model induced by lipopolysaccharide on rats was established. The rats were randomly divided into five groups: sham, sepsis, UTI intravenous injection (Uiv), UTI intraintestinal injection (Uii), and UTI intraintestinal +intravenous injection (Uii +Uiv) groups. The mucosal barrier function, enzyme-blocking effect, levels of systemic inflammatory cytokines, and 5-day survival rate were compared among groups. The small intestinal villus height (VH), crypt depth (CD), and two components of mucosal barrier (E-cadherin and mucin-2) were measured to evaluate the mucosal barrier function. The levels of trypsin and neutrophil elastase (NE) in the intestine, serum, and vital organs were measured to determine the enzyme-blocking effect.Results:Compared with the single-route injection group (Uiv or Uii), the two-route injection (Uii +Uiv) group displayed: (1) significantly higher levels of VH, VH/CD, E-cadherin, and mucin-2;(2) decreased trypsin and NE levels in intestine, plasma, and vital organs;(3) reduced systemic inflammatory cytokine levels;and (4) improved survival of septic rats.Conclusion:Two-route UTI injection was superior to single-route injection in terms of alleviating intestinal injury, which might be explained by extensive blockade of proteases through different ways.
