Double tube intraoperative lavagation on emergency one-stage surgery for left obstructing colorectal carcinomas

The purpose of this study was to analyzed the outcome in patients with acute obstruction of the left colonrectal cancer who was treated by double tube intraoperative levage methods.Methods Between 1999 and 2003,62 patients with acute obstruction for cancer underwent surgery.The patients were divided into two groups at random,31 patients were treated with double tube intraoperative lavage,resection,and primary anastomosis.31 patients were treated with traditional resection,and after 1～2 month,Ⅱ stage anastomosis.Results In double tube intraoperative lavage,No case occurred anastomotic leakage.The patients got a satisfactory recovery post-operatively.Conclusion It was concluded that one-satge emergency surgery for left obstrucing colonic cancers is safe with the regard of double tube intraoperative lavage methods.6 refs,1 tab.

Antibiotic usage in surgical critical patients

To study the antibiotic usage in surgical critical patients.Methods To record all antibiotic consumption by all patients admitted to Department of General Surgery,from Jan 1,2002 to Mar 31,2003.Results All patients received antibiotic therapy,and antibiotic therapy covered 79% of all patient-days,with β-lactams (especially cephalosporins and carbapenems) accounted for more than 50% of antibiotic consumption.Only 25% of empiric therapy was appropriate.The consumption of antibiotics against Gram-posive cocci and fungi significantly increased as patients stayed in ICU for more than 2 weeks.Conclusion Antibiotic therapy,especially with β-lactams,is common in surgical critical patients.The adequacy of empiric therapy remains to be improved.Gram-positive cocci and fungi are main pathogens of late onset nosocomial infection.7 refs,2 figs,3 tabs.

Complicate bile duct stricture and its surgical treatment

Objective To discuss the surgical procedure and choice of indication for complicated bile duct stricture. Methods A total of 357 cases of complicated bile duct stricture treated in our hospital between June 1984 and May 2001 were reviewed. Results Nine patients (2.5%) died of surgery and 348 were cured. Of the 348 patients, 281 (80. 9%) were Mowed up for 1 to 12 years, amongst which, 217 were followed up for 6 to 12 years and the long-term follow-up rate was 62. 4 %. Fourteen patients died during the follow-up period and the total death rate was 6.4%. The rate of excellent and good outcome was 83. 3 % . Conclusion Complicated bile duct stricture is difficult to treat with surgical management. Satisfactory outcome can only be achieved through selecting combined operations according to different conditions of the patients. 9 refs.

Clinical features and surgical treatment of retroperitoneal Castleman's disease with paraneoplastic pemphigus

To investigate the clinical characteristics and surgical treatment of retroperitoneal Castleman’s disease (CD) with paraneoplastic pemphigus (PNP).Methods The clinical symptoms,laboratory,histopathologic,CT findings and results of surgery in 7 patients were evaluated.Results All of 7 patients presented with PNP.Retroperitoneal tumors were found by CT examination and surgically removed.Castleman disease was confirmed by histopathology.Reoperation was performed to resect the recurrent tumor in one patient.The signs of PNP were dissolved completely or partially after operation.Conclusion Retroperitoneum CD with PNP are characteristic of distinctive clinical features.Surgical excision improves the mucocutanous manifestation of PNP.8 refs,1 fig.

Intrapuunonary expression of intercellular adhesion molecule-1 gene in rats with acute necrotizing pancreatitis

Objective To investigate intrapulmonary expression of ICAM - I mRNA and the relationship between the expression of ICAM - 1 and lung injury in ANP. Methods ANP was reproduced by retrograde injection of 3. 5 % sodium taurocholate. Animals were sacrified at 1,4,12 and 24 hours after induciton of ancreatitis. Intrapulmonary ICAM - I mRNA expression was assayed by reverse transcription - PCR. The following parameters were also measured:Serum amylase.histologic grading of lung injury and intrapulmonary myeloperoxidase (MPO). Results There was intrapulmonary overexpression of the ICAM -China Medical Abstracts (Surgery) 1 mRNA on the first hour and persisted up to 12 - 24 hours with the increase of serum amylase and intrapulmonary MPO and pancreatitis induction. Score of the lung injury correlated well with the expression of the ICAM- I mRNA and intrapulmonary MPO(r = 0.85,0. 85 and 0.96,all P【0.05).Conclusion The expression of ICAM- I mRNA and pulmonary leucocyte infiltratiorK / was related with lung injury

Establishment of combined liver-kidney transplantation model in rats

Objective To set up a model of the combined liver-kidney transplantation of orthotopic liver plus orthotopic left kidney. Methods In the donor operation, the liver and left kidney were flushed with a total of 10 - 12 ml of 4 ℃ sodium lactate Ringer’s injection throuth portal vein and aorta, respectively. During the recipients operation, except superior hepatic vena cava with suture,other blood vessels were reconstructed with cuff methods. A patch of aorta attached to the donor kideny was pruned into and oval form to facilitate operation so as to meet the equal-June 2003 Vol12 No2 diameter anastamosis. An underneath tunnel was made in the retro-peritoneum to pull out the ureter attached to the donor kidney to plant into the bladder. Results 35 combined liver-kidney transplant operations were carried out, in which the operation success rate in the last 20 cases was 90%. The average operation time was 2. 45 h. The longest survival time was over 5 months. Conclusion It is feasible that the model can be

Correlation between tumor necrosis factor a gene promoter polymorphisms and acute rejection following renal transplantation

Objective To study the significance of cytokine tumor necrosis factor α ( TNF -α) gene promoter 308 position polymorphisms in predicting acute graft rejection following renal transplantation. Methods In 35 preoperative recipients, TNF-α produced by peripheral blood cells was measured by enzyme-linked immmunosorbent assay, and their TNF- α gene promoter 308 position polymorphisms were determined by FOR restriction fragment length polymorphisms(PCR-RFLP). The assocication between TNF-α gene promoter polymorphisms and production of them was studied. Furthermore, the correlation between their polymorphisms and acute rejection in the first 3 months after renal transplantation was discussed. Results The recipients with A/A or A/G genotype in TNF-α promoter 308 position secreted more cytokine (624.96 ± 177.78) pg/ml and (544.32 ± 13.242)pg/ml than those with G/G(233.16 ± 25.37)pg/ml,P【0.01. When HLA-DR was mismatched, the recipients with high production of TNF - α genotype showed higher incidence

The mechanism by which pancreatic cancer cells acquire drug resistance against 5-FU and gemcitabine

Objective To investigate the mechanism by which pancreatic cancer cells (PCC) acquire durg resistance against 5 - FU and gemcitabine. Methods The cytotoxic effects of 5 - FU and gemcitabine on PCC (Panc - 1, Mia - Paca - 2 and Capan - 1) were assessed by using Sulforhodamine B and the expression of anti-apoptotic genes of the Bcl-XL and mcl-1 were analyzed by RNase protection assay and Western blot. Results 5 - Fu and gemcitabine effect cytotoxicity towards PCC. After repeated treatment with 5 - Fu, the IC50 values in Capan-1 cells increased by 2. 1 fold (P 【 0. 05 ). In case of gemcitabine, the IC50 in Capan-1 cells raised by 1. 8 fold (P 【 0. 05 ). RNase protection assay and Western blot analysis showed a negative correlation between Bcl-XL and mcl-1 expression and the sensitivity to 5 - FU and gemcitabine after 5 - FU and gemcitabine treatment. Conclusion Pancreatic cancer cell lines are generally more resistant to 5 - FU than gemcitabine. The expression of Bcl-XL and mcl-1 was upregulated