Objective To study the relationship between angiopoietin and the angiogenesis of gastric carcinoma, and to investigate the inter-regulation effect between different vascular growth factors which exist in microenvironment of gastric carcinoma. Methods Literatures about angiopoietin and angiogenesis of gastric carcinoma were collected and reviewed. Results There is a relationship between the expression of angiopoietin in microcirculation and the angiogenesis of gastric carcinoma. Yet, it is still a disputable issue on the inter-regulation effect of different vascular growth factors. Conclusion Angiopoietin may play an important role in the processes of sprouting, development and apoptosis of the microvessel of gastric carcinoma.
Objective To evaluate the influence of the location of retinal vessel trunk on neuroretinal rim width of inferior and superior sectors of optic disc, and explore its role in the diagnosis of glaucomatous optic nerve lesion. Methods The photographs of ocular fundus from 459 patients with clear location of retinal vessel trunk, including large disc in 131, medium disc in 145, horizontally oval disc in 75, and small disc in 108 were evaluated. Independent-sample t test was used to compare the difference of the superior and inferior rim widths between the higher-vessel group and the lower-vessel group, and to compare the difference of superior and inferior vessel distances between the narrow-superior-rim-width group and the narrow inferior-rim-width group. Results In most of the patients, or the ones with large and small disc, the ratio of superior rim width to summation of superior and inferior rim widths in the higher-vessel group（0.467plusmn;0.051，0.445plusmn;0.040，0.508plusmn;0.056）were less than which in the lowervessel group（0.500plusmn;0.066，0.474plusmn;0.062，0.546plusmn;0.048）, and the differences were significant（P=0.000, 0.045, 0.018）; the ratio of superior vessel distance to summation of superior and inferior vessel distance in the narrow-superior-rim-width group（0.510plusmn;0.051，0.508plusmn;0.055，0.512plusmn;0.036）were less than which in the narrow-inferior-rim-width group（0.528plusmn;0.045，0.533plusmn;0.048，0.534plusmn;0.045）, and the differences were significant（P=0.000, 0.046, 0.022）. Conclusions The position of optic disc vessel trunk influences its superior and inferior rim width. The rim closer to vessel trunk position has narrower width than which comparatively far away from the position. In patients with large, medium, horizontally oval optic disc, glaucoma optic nerve lesion would be considered if the optic disc has the shape of narrower inferior rim, broader superior rim, and vessel location in the superior half of the disc. In the ones with small disc, the optic disc with the shape of narrower superior rim, broader inferior rim, and vessel location in the inferior half of the disc may suggest glaucoma optic nerve lesion. (Chin J Ocul Fundus Dis, 2007, 23: 118-121)
Objective To evaluate the clinical features, diagnosis, and outcome of the treatment of cytomegalovirus (CMV) retinitis, and the relationship between CMV retinitis and acquired immunodeficiency syndrome (AIDS). Methods A total of 95 eyes of 56 patients with cytomegalovirus retinitis and AIDS were studied. The fundus feature, visual acuity and CD4+ T-lymphocyte counts were analyzed and the follow-up periods ranged from 2 weeks to 18 months. Results Before the definitive diagnosis of CMV retinitis, the courses of AIDS were 4 to 26 months in all patients. In the initial examination, the granular form of CMV retinal lesion was noted in 55 eyes (57%) in which retinal lesion of 46 eyes was peripheral. The fulminant form of CMV retinitis of 25 eyes (26%) was found in the posterior pole and consisted of densely opaque retinal lesions with blotchy hemorrhage and vasculitis. The overlap between these two presentations was noted in 15 eyes. Papillitis was observed in 7 eyes of CMV retinitis in this series of patients. The visual acuity ranged from finger counting to 0.5. The patients with extensive CMV retinitis or CMV retinitis in the posterior pole got poorer vision. The CD4+ T-lymphocyte counts of 30 patients was 0-30 (mean, 15±9/μl), and the survival time ranged from 2 weeks to 18 months (mean, 6.4±3.3 months). The vision was improved and CD4+ T-lymphocyte counts was significantly higher in the group treated with ganciclovir, and progression of CMV retinitis occured and the vision decreased in the non-treated group. Conclusion CMV retinitis is the most common intraocular complication in patients with AIDS. Diagnosis of CMV retinitis is based on the characteristic of necrotizing retinitis which was typically associated with retinal hemorrhage and vasculitis. Ganciclovir is effective for the treatment of CMV retinitis. (Chin J Ocul Fundus Dis, 2002, 18: 89-91)
Objective To explore the potential roles and mechanism of Wnt5a and its receptors in the pathogenesis of bronchiectasis. Methods From October 2017 to April 2018, outpatients with bronchiectasis who needed bronchoscopy were recruited in the Department of Respiratory and Critical Care Medicine of West China Hospital of Sichuan University. The control group was patients with pulmonary nodules less than 10 mm in diameter by health inspection. Patients who used antibiotics and/or glucocorticoids within the past 4 weeks or had other airway diseases were excluded. Serum and bronchial mucosa were collected for detection of Wnt5a by enzyme-linked immunosorbent assay and real-time polymerase chain reaction (PCR), respectively. The receptor of Wnt5a, Ror2, and the downstream pro-inflammatory cytokines, interleukin (IL)-1β and IL-6, were measured in the bronchial mucosa by real-time PCR. Results From October 2017 to April 2018, 32 outpatients with bronchiectasis were found but only 17 patients finished this study, and simultaneously 18 patients with pulmonary nodules were chosen as control. The level of serum Wnt5a in patients with bronchiectasis were significantly higher than that in the control group (P<0.05). Correlation analyses showed that serum Wnt5a level was positively correlated with the level of serum C reactive protein (r=0.806, P<0.05), but had no relation with the level of white blood cell count, blood neutrophil percentage, pulmonary function or bronchiectasis severe index. The mRNA levels of Wnt5a and its receptor Ror2 in bronchial mucosa of patients with bronchiectasis were significantly higher than those in the control group (P<0.001). The mRNA levels of IL-1β and IL-6 in bronchial mucosa of patients with bronchiectasis were higher than those in the control group (P<0.05). Conclusion Wnt5a may play crucial roles in the development of bronchiectasis through Wnt5a/Ror2 signaling pathways to regulate the release of pro-inflammatory cytokines including IL-1β and IL-6.
Objective To observe effects of enhanced recovery after surgery (ERAS) technique on stress indicators in patients undergoing laparoscopic rectal cancer surgery. Methods One hundred and twenty patients underwent laparoscopic rectal cancer surgery (Dixon) in the Xinqiao Hospital of the Third Military Medical University were included in this study and then were randomly divided into an ERAS group (n=60) and a conventional treatment group (n=60). The patients in the ERAS group were treated with an ERAS concept during the perioperative period. The patients in the conventional treatment group were treated with a traditional treatment concept during the perioperative period. The stress indicators including white blood cell count (WBC) and C-reactive protein (CRP) and interleukin (IL)-6 levels were compared in the two groups at admission, 1 h before operation, and 24 h, 48 h, and 72 h after operation. The first postoperative anal exhaust time, the first postoperative defecation time, the total hospitalization time, and readmission rate were also recorded after operation. Results ① The age, gender, tumor diameter, and TNM stage had no significant differences in these two groups (P>0.05). ② There were no significant differences in the WBC, CRP and IL-6 levels at admission and 1 h before operation between the two groups (P>0.05). The levels of CRP, IL-6, and WBC in the ERAS group were significantly lower than those in the conventional treatment group at 24 h, 48 h and 72 h after operation (P<0.05). ③ The first postoperative anal exhaust time, the first postoperative defecation time, and the total hospitalization time in the ERAS group were significantly shorter than those in the conventional treatment group (P<0.05). There was no significant difference in readmission rate between the two groups (P<0.05). Conclusion ERAS concept is helpful in reducing stress response and could promote earlier recovery of patients with rectal cancer.
ObjectiveTo understand the current evaluation methods and treatment progress of low anterior resection syndrome (LARS) after rectal cancer surgery.MethodThe recent literatures on the progress of LARS studies were reviewed.ResultsThe occurrence mechanism of LARS was closely related to the function state of anus before operation, the nerve and muscle injuries around the anus and rectum during the operation, as well as the new rectal volume and compliance. For this symptom group, there were various clinical evaluation methods, including the various quality of life score scales, fecal incontinence related scales, LARS score scale, anorectal pressure measurement, and imaging examination of anal sphincter, etc. The treatment included the anal lavage, comprehensive rehabilitation training, sacral nerve stimulation, traditional Chinese medicine therapy, and other treatment methods.ConclusionLARS might be prevented or alleviated through accurately preoperative evaluation, standardized and reasonable surgery and adjuvant therapy, and effective postoperative intervention.
Objective To explore effect of enhanced recovery after surgery (ERAS) on maintaining homeostasis of patient body and role of ERAS in alleviating stress response of physiological and psychological of patient and promoting recovery of patient from operative trauma as soon as possible. Method The related literatures published at home and abroad about the ERAS and its influence on the perioperative stress degree of patient were reviewed and analyzed. Results The ERAS was a new perioperative management mode established under the guidance of evidence-based medicine, whose core was to reduce the perioperative physiological and psychological stress level of the patient through a series of optimized measures, and to promote the postoperative rehabilitation. At the same time, the ERAS had been more and more widely accepted by the surgeons and patients because of its unique advantages, especially in shortening the hospital stay and reducing the operating costs. Conclusions Although concept of ERAS is not yet accepted by most clinicians, ERAS does provide a more optimal perioperative management strategy for patient, could obviously reduce perioperative stress level, improve patient outcome, accelerate postoperative recovery of patient, and provide benefit for patient underwent surgery.
ObjectiveTo summarize the clinical features of pulmonary mucoepidermoid carcinoma (PMEC) and improve the level of the diagnosis and therapy.MethodsA case of PMEC was reported and related literatures were reviewed in PubMed, WanFang data and China National Knowledge Infrastructure.ResultsA 21-year-old female patient, complaining of cough and expectoration for 5 months, intermittent hemoptysis for 3 months and repeated fever more than 4 days, was hospitalized in March 2017. After admission, the patient was diagnosed as low-grade PMEC and received anti-infection, fibrobronchoscope sputum aspiration and alveolar lavage therapy. During the hospitalization, the anti-infection of the patients was not much effective, and the chest CT examination suggested space-occupying lesions in the middle lobe of the right lung. After the surgical removal of the right lung, the syndrome of the patient was improved. A total of 13 patients were reviewed, there was no obvious gender difference, and the median age was about 40 years old (most frequently occurred in younger adults with an average age less than 50 years). Frequent clinical manifestations were cough, fever and hemoptysis, which were often accompanied with atelectasis. Most of the patients could be improved after surgical resection, and a few need comprehensive treatment including radiotherapy, chemotherapy and targeted treatment, etc.ConclusionsPMEC is rare and the etiology is still unclear. The pathology is mainly low-grade. Majority of patients with PMEC could be cured after surgical resection.
Objective To observe the histopathological changes of tumor tissue after intraoperative regional chemotherapy of rectal cancer. Methods After the treatment of intraoperative regional chemotherapy with 5-FU (15 mg/kg)， the histopathological changes of tumor tissue were detected. Results Slight changes with cancer cells in all the cases accepted intraoperative regional chemotherapy were found under light microscope such as karyopyknosis, nuclear swelling, coagulation and necrosis of cytoplasm, hydropsia of intercellular substance, invasion of inflammatory cells, and 9/15 cases with slight inflammation of vessels were observed; While those changes were found in individual cells of the cases without regional chemotherapy. The more enlarged intercellular space of cancer cell was observed under electron microscope in the case with regional chemotherapy. Conclusion The intraoperative regional chemotherapy of rectal tumor can change the histopathological appearance of tumor tissue, that is significant in preventing cancer cells diffusing during operation and relapsing after operation.
ObjectiveTo evaluate the application value of three-dimensional visualization (3DV) technique in the reconstruction of complex abdominal incisional hernia. MethodsThe clinical data of the patients with complex abdominal incisional hernia admitted to the West China Hospital of Sichuan University from September 2021 to September 2022 were collected. The area of abdominal wall defects was analyzed by Medraw software and reconstructed using 3DV technique, then the classifying and partition of abdominal wall defects were performed, the hernia sac/ intraabdominal volume ratio was calculated, patch size was estimated, and intraabdominal pressure values at 24 h and 48 h after surgery as well as operation time, complications were recorded. ResultsA total of 48 patients with complex abdominal incisional hernia were enrolled, including 30 cases of midline abdominal incisional hernia and 18 cases of other sites. There were 13 cases of moderate hernia, 19 cases of large hernia, and 16 cases of huge hernia. The abdominal wall defect area measured by 3DV technique for the 48 patients was (92.11±60.25) cm2, the hernia sac / intraabdominal volume ratio was (7.7±5.2)%, and the actual defect area measured intraoperatively was (89.20±57.38) cm2. Pearson correlation analysis showed a positive correlation between the preoperative 3DV measurement and intraoperative measurement (r=0.959, P<0.001). The operation time was (73.5±8.2) min, postoperative anal exhaust time (31.66±15.32) h, intraabdominal pressures at 24 h and 48 h postoperatively were (13.50±2.12) mmHg and (11.39±1.42) mmHg, respectively. The patient’s hospitalization time was (7.12±1.21) d. Among the 48 patients, 7 cases (14.58%) experienced complications after surgery, recovered smoothly after conservative treatment and no unplanned reoperation was required. All patients were followed up for 18–32 months with a median time of 26 months, and no long-term hernia recurrence was observed. ConclusionFrom the analysis results of this study, it can be seen that the application of 3DV technique to evaluate complex abdominal wall defects can assist hernia surgeons to make a correct choice and has a better safety and effect.