Plasma cortisols in 18 abdominal emergency patients and 20 planned-operation patients were examined. The result showed that cortisols in planned-operation patients were increased after their operations. On the other hand, plasma cortisols in emergency patients were higher in preoperative period than that in the postoperative period. There were no furher increase after operations. The changes of plasma cortisols between two kinds of patients were very different. This means that stress reactions in the patient with acute abdomen can be reduced by early operations.
ObjectiveTo study the curative effect and postoperative anorectal dynamics change of tissue-selecting therapy stapler (TST) and procedure for prolapse and hemorrhoids (PPH) respectively combined with mixed Milligan-Morgan and lauromacrgol injection in the treatment of Ⅲ–Ⅳ degree mixed hemorrhoid.MethodsClinical data of 158 patients with Ⅲ–Ⅳdegree mixed hemorrhoid who received operation in the Department of Colorectal and Anal Surgery, Chaoyang Central Hospital, from May 2016 to March 2018 were analyzed retrospectively, the observation group (TST+Milligan-Morgan+lauromacrgol injection, 80 cases) and control group (PPH+Milligan-Morgan+lauromacrgol injection, 78 cases). The clinical efficacy, adverse reactions, postoperative complications and recurrence of the two groups were observed, and the changes of anorectal dynamic indexes before and after operation were observed.ResultsPostoperative symptoms of mixed hemorrhoid prolapse could be alleviated by 100% in both the observation group and the control group, and the relief rate of hematochezia was 93.8% and 92.3%, respectively, and the effective rate of 1 year after surgery was 97.5% and 94.9%, respectively. Comparison between the two groups showed no statistical difference (P>0.05). The operative time, intraoperative blood loss, VAS pain score and hospital stay of the observation group were all better than those of the control group (P<0.05). In terms of postoperative massive hemorrhage and anastomotic stenosis, although the incidence rate of the control group was higher than that of the observation group (3.8% vs. 1.3% and 2.6% vs. 0.0%, respectively), there was no statistical significance in the two groups (P>0.05). Postoperative anal drop, stool urgency, postoperative urinary retention and postoperative stimulation of anal papilla hypertrophy and proliferation complications were significantly better in the observation group than in the control group (P<0.05). The difference of maximum anal systolic pressure (MASP) in the two groups of patients between before and after surgery and the comparison of MASP results between the two groups after surgery showed no statistical differences (P>0.05). The differences of resting anal sphincter pressure (RASP) and rectal sensory threshold volume (RSTV) between before and after operation were not statistically significant (P>0.05). The difference of rectal maximum threshold volume (RMTV) value and the comparison of RASP, RSTV and RMTV value between the two groups after surgery showed that the observation group were superior to the control group and the differences were statistically significant (P<0.05).ConclusionsTST or PPH combined with Milligan-Morgan and lauromacrgol injection both are effective and minimally invasive methods for the treatment of Ⅲ–Ⅳ degree mixed hemorrhoid. However, the observation group has shorter operative time and hospital stay, less intraoperative blood loss, and lower postoperative pain score. What is more important is that the postoperative complications are less and the anal function is protected to the maximum extent, and the quality of life of patients after operation is greatly improved.
ObjectiveTo systematically evaluate the clinical efficacy and adverse reactions of paclitaxel and carboplatin with or without bevacizumab in the treatment of non-small cell lung cancer (NSCLC).MethodsThe databases including PubMed, The Cochrane Library, EMbase, CNKI, Wanfang Data, VIP and CBM were searched from inception to October 2022 to collect randomized controlled trials of the clinical efficacy of paclitaxel and carboplatin with or without bevacizumab for the treatment of NSCLC. RevMan 5.4 software was used for meta-analysis.ResultsEight randomized controlled trials were enrolled, involving a total of 1 724 patients. Meta-analysis showed that for the treatment of NSCLC, the disease control rate, overall response rate, 1-year survival rate, and 2-year survival rate were higher in the trial group (paclitaxel and carboplatin combined with bevacizumab) than those in the control group (paclitaxel and carboplatin) (P<0.05); however, the incidences of the adverse reactions, such as leukopenia, hemorrhage, proteinuria and hypertension, etc, were higher in the trial group than those in the control group (P<0.05). There were no statistical differences between the trial group and the control group in the incidences of fatigue, thrombocytopenia, neutropenia or hyponatremia, etc (P>0.05). In addition, the median progression-free survival and overall survival were longer in the trial group than those in the control group.ConclusionFor the treatment of NSCLC, paclitaxel and carboplatin combined with bevacizumab is superior in terms of disease control, overall response and prolonging patient survival, etc, but will be associated with more adverse reactions.
To study of plasma lipoprotein cholesterol and effects of these changes on bile acids and cholesterol in bile during gallstone formation in rabbit model. This gallstone model was induced by high cholesterol diet (HCD). The rabbits were divided into five groups and there were ten animals in each group. The plasma highdensity lipoprotein cholesterol (HDL-C) and its subgroups (HDL2-C, HDL3-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), total cholesterol, triglyceride, phospholipid, bile acids and cholesterol of bile were investigated in different time. The results were as follow: ①As the time of feeding HCD passed by, the plasma total cholesterol, LDL-C and VLDL-C increased markedly (3-week group and 4-week group vs control group, Ｐ＜0.05). Though the plasma HDL-C and its subfractions HDL2-C and HDL3-C did not change significantly, the function of HDL in transporting plasma cholesterol decreased markedly (from 80.00% to merely 3.68%); ②Cholesterol in bile increased gradually and there were significant differences when 3-week group and 4-week group comparing with control group. The concentration of GDCA and GCA in bile changed slightly (Ｐ＞0.05). These results suggest that the changes of plasma lipoprotein cholesterol may affect the metabolism of cholesterol and bile acids and it may take an important role in the formation of gallstone.
Objective To observe the influence of resveratrol on superoxide dismutase (SOD), malondialdehyde (MDA), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) of intestinal mucosal ischemia-reperfusion injury protection in rats with severe acute pancreatitis (SAP). Methods Fifty-four rats were divided into three groups randomly: sham operation group (SO group), SAP model group (SAP group) and resveratrol-treated group (Res group). SAP model was made by injecting sodium taurocholate 50 mg/kg to pancreatic bile duct and resveratrol was given intravenously at 5 min after inducing SAP model. The rats were sacrificed at 3 h, 6 h and 12 h after inducing SAP model respectively by equal number. The levels of MDA, SOD, ICAM-1 and VCAM-1 and histological changes of small intestine were measured. Results The level of MDA in small intestine tissue in SAP group was significantly higher than that in SO group (P＜0.05), while the activity of SOD was significantly lower in the relevant tissues (P＜0.05). The expressions of ICAM-1 and VCAM-1 in SAP group were higher than those of SO group (P＜0.05). The activity of SOD in small intestine tissue in Res group was significantly higher than that in SAP group (P＜0.05); while the level of MDA was significantly lower in the relevant tissues (P＜0.05). The expressions of ICAM-1 and VCAM-1 in Res group were lower than those of SAP group (P＜0.05). Conclusions Oxygen free radicals are concerned with the process of pathological changes in intestinal mucosal ischemia-reperfusion in rats with SAP. Resveratrol might increase SOD activity and decrease MDA level to attenuate lipid peroxidation in small intestine of SAP, and reduce the expressions of ICAM-1 and VCAM-1 in intestine, thus diminish the damage of the intestine in SAP. And it acts as a protective effect to small intestinal ischemia-reperfusion injury.
