To study the effect of intraperitoneal hyperthermic double distiled water and cis-diamminedichloro-platinum(DDP) perfusion to the peritoneal cancerous ascites,intraperitoneal injection of H22 cancer cells (2×107 tumor cell,each mouse) were performed in LACA mice. Five days after cancer cells injection, intraperitoneal perfusion of simple hypertherrnic (43℃) double distiled water(group Ⅰ) isotonic fluid (group Ⅱ ). DDP (group Ⅲ ), and hypertherrnic double distiles water perfusion combined with DDP (guoup Ⅳ ) were performed .The results showed that cancer cells in the peritoneal cavity of LACA mice were seriously damaged, the production of ascites was markedly inhibited and the survival days of LACA mice were prolonged in all groups . .The intraperitoneal hyperthermic double distilled water perfusion with DDP group showed more effective result as compared with the other groups,Only 1 peritoneal implanted dissemination was found after treatment in this group,Basing on the experimental from September 1991 through September 1993,intraperitoneal hyperthermic double distiled water perfusion with DDP was used to treat 32 advanced gastric cancer patients after radical gastrectomy with satisfactory results.
Objective Surgical repair for giant lower ventral hernia is facing challenge owing to enormous tissue defect and the critical structures of pubis and il iac vessels. To investigate the method and curative effect of intraperitoneal onlay mesh (IPOM) combined with Sublay for compound repair of giant lower ventral hernia. Methods Between November 2008 and August 2010, 26 patients with giant lower ventral hernia were treated. There were 15 males and 11 females with an averageage of 61 years (range, 36-85 years), including 11 cases of lower midl ine incisional hernia due to radical rectal procedures, 6 cases of Pfannenstiel incisional hernia due to radical uterectomy, and 9 cases of lower midl ine incisional hernia due to radical cystectomy. Of them, 11 patients underwent previous repair procedures. The mean time from hernia to admission was 8.5 years (range, 1-15 years). All hernias were defined as M3-4-5W3 according to classification criteria of Europe Hernia Society. The mean longest diameter was 17.5 cm (range, 13-21 cm) preoperatively. Before 2 weeks of operation, abdominal binder was tightened gradually until the contents of hernia sac were reduced totally, and then reconstruction of abdominal wall was performed with compound repair of IPOM and Sublay technique. Results All of compound repair procedures were performed successfully. The mean hernia size was 112.5 cm2 (range, 76.2-160.6 cm2); the mean polypropylene mesh size was 120.4 cm2 (range, 75.3-170.5 cm2); and the mean compound mesh size was 220.0 cm2 (range, 130.4-305.3 cm2). The mean operative time was 155.5 minutes (range, 105.0-195.0 minutes) and the mean postoperative hospital ization time were 12 days (range, 7-16 days). Incisions healed by first intention; 4 seromas (15.4%) and 3 chronic pains (11.5%) occurred and were cured after symptomatic treatment. All patients were followed up 3-24 months (mean, 14.5 months). No recurrence and any other discomforts related to repair procedure occurred. Conclusion Compound repair of IPOM and Sublay is a safe and efficient surgical procedure for giant lower ventral hernia, owing to its characteristics of adequate patch overlap and low recurrence rate. Perioperative management and operative technology play the key role in the success of repair procedure.
To evaluate the effect of intraperitoneal hyperthermo-chemotherapy (IPHC) on immunologic function of patients with gastrointestinal malignant tumor (GMT). The authors determined the serum T-lymphocyte subsets (T-LS) and interleukin-2 receptor (sIL-2R) of 32 patients with GMT after IPHC, and compared the two indexes with 20 healthy control group. Results: Before IPHC the serum CD＋3, CD＋4, CD＋8 and CD＋4/CD＋8 were higher and sIL-2R were lower than control group, after IPHC, CD＋3, CD＋4, CD＋8 and CD＋4/CD＋8 increased obviously (Ｐ＜0.01) and the serum sIL-2R decreased significantly (Ｐ＜0.01). Conclusion: The IPHC can improve the patients immunologic function.
ObjectiveTo compare two different ways to establish mouse model with acute lung injury (ALI) via intratracheal instillation or intraperitoneal injection of lipopolysaccharide (LPS). MethodsBALB/c mice received intraperitoneal/intratracheal administration of LPS or sham operation. Wet/dry lung weight ratio, protein concentration in bronchoalveolar lavage fluid (BALF), and lung tissue histology were examined at 0, 1, 2, 6, 12, 18, 24, 48 h after LPS administration. Tumor necrosis factor-α (TNF-α) in BALF and serum was assayed with ELISA method. ResultsLPS treatment significantly increased wet/dry lung weight ratio, BALF protein concentration and TNF-α concentration in serum and BALF. Lung tissue was damaged after LPS challenge. The mice received LPS intraperitoneal injection got a more significant lung edema than those received LPS intratracheal instillation. Inversely, LPS intratracheal instillation induced more severed microstructure destruction. ConclusionsALI animal model by LPS intratracheal instillation or intraperitoneal injection induces inflammation and tissue damage in lung. However, the degree of tissue damage or self-healing induced by two methods is different. Therefore the decision of which way to establish ALI model will depend on the study purpose.
ObjectiveTo contrastive the clinical results of intraperitoneal sigmoid colostomy and extraperitoneal sigmoid colostomy in abdominal perineal resection.
MethodsThe clinical data of 172 patients who underwent abdominal perineal resection from March 2010 to March 2014 were retrospectively analyzed.Sixty cases were performed the intraperitoneal sigmoid colostomy (intraperitoneal group), seventy-six cases were performed the extraperitoneal sigmoid colostomy (extraperitoneal group), and thirty-six cases were performed the functional exercise after extraperitoneal sigmoid colostomy (functional exercise group). The operation situation, postoperative complications, and colostomy function of three groups of patients were compared.
Results①Operation situation: The colostomy location selection, operative time, intraoperative blood loss, and postoperative hospital stay of the three groups had no statistically significant differences (P > 0.05). The postoperative first exhaust and defecate time of the intraperitoneal group and the functional exercise group were obviously earlier than the extraperitoneal group, the difference had statistical significance (P < 0.05).②The postoperative complications: The postoperative complications rates of the extraperitoneal group and functional exercise group were lower than the intraperitoneal group, had statistically significant difference (P < 0.05), the functional exercise group was lower than the extraperitoneal group, the difference had statistical significance (P < 0.05).③The colostomy function:The patient' proportion that > 30 s of appeared time of defecation signals in the extraperitoneal group was significantly higher than the intraperitoneal group, and the functional exercise group was higher than that in the extraperitoneal group, the difference were statistically significant (P < 0.05). The patient' proportion that > 2 min of autonomous control of defecation to discharge feces time after the bowel signal appears in the extraperitoneal group was significantly higher than the intraperitoneal group, and the functional exercise group was higher than that in the extraperitoneal group, the difference were statistically significant (P < 0.05). Conciusions The intraperitoneal sigmoid colostomy has less colostomy related complications than extraperitoneal sigmoid colostomy in abdominal perineal resection. The control, and defecate ability are better. Postoperative function exercise can further reduce the colostomy complications and improve the function of colostomy.
Objective To explore the feasibility, safety, efficacy and mechanism of intraoperative regional chemotherapy of advanced gastric cancer.Methods The related literatures were reviewed and analyzed. Results Compared with systemic chemotherapy, intraoperative regional chemotherapy of advanced gastric cancer could increase blood drug concentration of cancerous tissue, reduce the systemic toxic side effects, increase survival rate and improve the quality of life. Conclusion Intraoperative regional chemotherapy, as an adjuvant treatment of advanced gastric cancer, has been gradually applied to clinic because of the definite curative effect, which is worth popularizing. However, it needs systemic researches and accumulation of cases.
Objective To study the medicine dynamics, distribution in tissue and abdominal cavity fluid concentration of 5-FU after giving intraperitoneal by using a gelatin carrier to be made 5-FU slowing-release microballoons. Methods 5-FU slowing-release microballoons medicine release speed, tissue distributing and the concentration in abdominal cavity fluid were measured by high performance liquid chromatography. Results 5-FU wrapped by gelatin were slowly released. The concentration in abdominal cavity fluid was obviously higher than that in tissue or in blood. Using established standard curve line, it was proved that in body area under curve (AUC) of 5-FU slowing-release microballoons group was obviously higher than that of simple 5-FU injection group, analyzed by 3p97 pharmacokinetic software management. Conclusion 5-FU enwrapped by gelatin can retain an effective anticancer activity concentration in abdominal cavity 7 days after giving intraperitoneal and it is distributed mostly in abdominal cavity.
Objective To compare three approaches of lipopolysaccharides ( LPS) administration for inducing acute lung injury ( ALI) in mice. Methods LPS ( 5 mg/kg) was intratracheally aerosol administered ( ITA group) , intratracheally instilled ( ITI group) , or intraperitoneally injected ( IPI group) to induce ALI in BLAB/ c mice. Evans Blue instead of LPS was intratracheally administered to observe the liquid distribution in the lungs. Two hours after LPS administration, the mice were sacrificed and the lungs were removed to determine wet-to-dry lung weight ratio ( W/D) , and the histological changes were evaluated by HE staining. Phosphorylation level of IκB-αand NF-κB p65 in lung tissue were investigated by Western blot. Transcription intensity of TNF-α and IL-1β mRNA in lung tissue were detected by real-time quantitative PCR. Results Evans Blue distributed more uniformly in the ITA group than the ITI group. The lung W/D ratio and histological changes score in three LPS administration groups were all significantly higher than the normal control group ( P lt;0. 01) , with the ITA group being the highest. The phosphorylation levels of IκB-αand NF-κB p65 were significantly higher in the ITA group than the ITI group ( P lt;0. 05) , and were significantly higher in the ITI group than the IPI group ( P lt; 0. 05) . Transcription intensity of TNF-αand IL-1βmRNA was significantly higher in the ITA group than the ITI group ( P lt;0. 05) , and were significantly higher in the ITI group than the IPI group ( P lt;0. 05) . Conclusion Being non-invasive and convenient,intratracheal LPS aerosol inhalation is an optimal method to induce ALI in mice because it induces more extensive and uniformly distributed injuries in lung.
ObjectiveTo investigate healing of rat colonic anastomoses after early postoperative intraperitoneal chemotherapy (EPIC).MethodsFortyfive Wistar rats with colonic anastomoses were divided randomly into 3 groups (15 rats each). From postoperative 1 day to 5 day, rats were injected with normal saline (NS) to the peritoneal cavity with 20 ml/(kg·d) for the NS group; 5Fu with 20 mg/(kg·d) for the 5Fu group; 5Fu with 20 mg/(kg·d) and leucovorin with 10 mg/(kg·d) for the 5Fu+LV group. On the 7th postoperative day, rats were killed and the anastomoses were evaluated whether anastomotic complications (leakage or dehiscence) occurred, the anastomotic bursting pressure (ABP) and hydroxypoline content (HPC) were measured. ResultsIn the NS group, 1 rat had incision dehiscence, another one had anastomostic leakage with but no death. In the 5Fu+LV group, 2 rats showed anastomotic leakage and 1 death. On the 7th postoperative day, the ABP in NS, 5Fu and 5Fu+LV groups were (169.1±32.6) mm Hg, (116.8±25.5) mm Hg and (154.9±31.2) mm Hg respectively; the HPC was (1.54±0.28) μg/mg, (0.9±0.33) μg/mg and (1.24±0.29) μg/mg respectively. Both the ABP and HPC, in the NS group were much significantly higher than in 5Fu group (P＜0.01). Both the ABP and HPC in the 5Fu+LV group were significantly higher than which in the 5Fu group (P＜0.05).ConclusionEPIC with 5Fu significantly impairs healing of the colonic anastomosis. 5Fu combined with LV for EPIC might reduce this inhibition to the process of the anastomotic healing.
ObjectiveAdopting poly-L-lactic/glycolic acid (PLGA) and polyethylene glycol (PEG) as the material to fabricate PLGA/PEG electrospun polymer membrane by electrospinning technology. And to study its preventive effect on postoperative intraperitoneal adhesion of rat.MethodsPLGA and PEG were mixed at the ratio of 19∶1(M/M), then dissolved in organic solvent. The PLGA/PEG electrospun polymer membrane was prepared by electrospinning technology, and then the gross observation and scanning electron microscope observation were taken. Fifty-four Sprague Dawley rats (weighing, 180-200 g), were randomly divided into 3 groups. The rats in control group (n=6) were left intact. The rats in model group (n=24) and PLGA/PEG group (n=24) were treated with the method of mechanical injury of the cecal serosa in order to establish the intraperitoneal adhesion models; then the PLGA/PEG electrospun polymer membrane was used to cover the wound in PLGA/PEG group, but was not in the model group. The intraperitoneal adhesion in PLGA/PEG group and model group were observed at 3 days, 1 week, 2 weeks, and 8 weeks after operation, and the adhesion degree was assessed according to the self-generated standard. The degradation of PLGA/PEG electrospun polymer membrane was also observed in PLGA/PEG group. At each time point, the rats were harvested for histological observation. All the above indexes were compared with the control group.ResultsUsing the electrospinning technology, PLGA/PEG electrospun polymer membrane was prepared successfully. PLGA/PEG electrospun polymer membrane was white and opaque, with soft texture. Scanning electron microscopy observation showed that PLGA/PEG electrospun polymer membrane was mainly composed of disorderly staggered fibers, with microporous structure. All rats survived to the end of the experiment. Gross observation showed that PLGA/PEG electrospun polymer membrane gradually degraded after implantation in vivo, and the adhesion degree in PLGA/PEG group was significantly lower than that in model group (P<0.05), but it had not yet reached to the level of the control group (P<0.05). Histological observation showed that the proliferation of cecal fibrous connective tissue was slower in PLGA/PEG group than in model group, and adhesion severity significantly decreased, only with a small amount of inflammatory cell infiltration. Nevertheless, it was not up to the level of the control group.ConclusionPLGA/PEG electrospun polymer membrane can effectively prevent postoperative intraperitoneal adhesion of rat, and has good biodegradability.
