Objective To investigate the role of rehabilitation therapy both on nutritional status and intestinal adaptation of patients with short bowel syndrome (SBS). Methods The literatures about rehabilitation therapy for SBS were reviewed. Results Intestinal rehabilitation refers to the process of restoring enteral autonomy, in order to get rid of parenteral nutrition, usually by means of dietary, medical, and surgical treatment. Recent researches showed that medication and the use of specific nutrients and growth factors could stimulate intestinal absorption and might be useful in the medical management of SBS. Conclusion Intestinal rehabilitation is of benefit in the treatment of SBS and would play a greater role in the future.
Objective To investigate the effect of short-term administration of growth hormone (GH) on serum insulin-like growth factor-1 (IGF-1) level and nutritional status in patients after gastrointestinal operation, and evaluate whether postoperative application of GH rise the risk of tumor recurrence. Methods Forty-eight patients undergoing major gastrointestinal operation were randomly divided into two groups: GH group （n=24） and control group （n=24）. The two groups received isocaloric isonitrogenous nutrition with daily injection of either GH 0.15 U/kg or placebo for a period of day 3-9 postoperatively. Serum albumin, fibronectin, and IGF-1 were measured before operation as a baseline, and day 3 and 10 after operation using standard laboratory techniques. Nitrogen balance was measured daily from day 3 to day 9 after operation. Postoperative complications and adverse reaction were observed. All cancer patients received regular abdominal B-type ultrasonography and chest X-ray examination during 2 years of follow-up. Results Compared with control group, GH treatment did not influence serum IGF-1 and serum albumin level （Pgt;0.05）, but improved significantly the rise from day 3 to day 10 of serum fibronectin level 〔(22.8±5.8) mg/L vs.（9.6±3.6） mg/L， P＜0.05〕 and the cumulative nitrogen balance 〔（11.37±16.82） g vs.（－9.11±17.52） g， P＜0.01〕 postoperatively. There was no severe adverse effects and complications during GH treatment. The tumor-recurrence rates were not statistically different between two groups during follow-up. Conclusions Short-term administration of low-dose GH combined with early nutrition support can improve total nitrogen retention and protein metabolism, but not influence serum IGF-1 level after major abdominal surgery. Short-term administration of low-dose GH may not cause the tumor-recurrence.
To investigate the effect of BMSCs on the repair of digestive tract injury and its mechanisms.Methods Recent l iterature on the effect of BMSCs on the repair of digestive tract injury was reviewed. Results BMSCs had the potency of self-repl ication, prol iferation and multipotential differentiation, which played an important role in the repair of digestive tract injury. The probable mechanisms included: BMSCs’ abil ity of migrating to the injured tissue and inhibiting the host immune response; BMSCs’ dedifferentiation and redifferentiation; BMSCs’ direct differentiation into the epithel ial cellsor the stem cells of digestive tract; BMSCs’ fusion with the stem cells or the mature epithel ial cells of digestive tract; BMSCs’ participation in the reconstruction of injured microenvironment. Conclusion BMSCs participates in the repair of digestive tract injury and has a bright future in the treatment of digestive system disease.
【Abstract】Objective To investigate the expression of PCNA in gastric cancer and its relationship with telomerase activity of peritoneal washings and peritoneal dissemination, and to compare the efficacy of telomerase activity and cytology of peritoneal washings for prediction of peritoneal metastasis of gastric cancer. MethodsTelomeric repeated amplification protocol (TRAP)enzymelinked immunosorbent assay (ELISA) was performed to measure the telomerase activity of peritoneal washings collected from 60 patients with gastric cancer. Exfoliate cytologic analysis of the corresponding samples was used for comparison.Expression of PCNA was measured with immunohistochemical staining.Their relationship with clinicopathologic features were evaluated. ResultsThe positive rate of telomerase activity in peritoneal washing collected from patients with gastric cancer was 41.7%,which well related to serosal invasion, histology types, depth of infiltration and peritoneal metastasis of gastric cancer. The positive rate of telomerase activity increased with the increased depth of infiltration and serosal involvement areas (P＜0.05).The positive rate of exfoliative cytology was 25.0%, which was obviously high in the group with macroscopic peritoneal metastasis (the group of P1-3). The positive rate of exfoliative cytology also increased with the increased depth of infiltration and serosal involvement areas (P＜0.05). Although the positive rate of telomerase activity in peritoneal washing collected from patients with gastric cancer was not significantly higher than that of exfoliative cytology in general, it was significantly higher than that of exfoliative cytology in the group of pT4, P1-3 and undifferentiated type.The PCNA proliferation index (PI) of positive telomerase activity group was significantly higher than that of negative. The PCNA PI was significantly higher in the group of P1-3 and serosal invasion thanthat of P0 and without serosal invasion. ConclusionTo detect telomerase activity in peritoneal washings and to detect tumor cells by cytologic method are useful to predict subclinical metastasis to the peritoneum in patients with gastric cancer,but telomerase activity is more sensitive than the other one.Telomerase activity is well related to proliferating activity of gastric cancer,which was the very important reason of peritoneal metastasis and serosal invasion.
目的探讨哈乐预防腹部手术后尿潴留的临床价值。方法哈乐组于拔尿管前1 d开始用哈乐0.2 mg，1次/d，3～5 d； 对照组未予特殊药物治疗。比较2组的尿潴留发生率、尿路感染发生率、住院时间和副作用。结果哈乐组未发生尿潴留，对照组尿潴留发生率为28%，差异有统计学意义(P＜0.05)。哈乐组无一例发生尿路感染，对照组有5例（20%），2组间差异无统计学意义（Pgt;0.05）。哈乐组术后平均住院时间为（10.7±3.3） d，对照组为（11.6±3.0) d，2组间差异亦无统计学意义（Pgt;0.05）。 结论哈乐可明显减少尿潴留的发生率，是预防腹部手术后尿潴留的有效药物。
目的探讨急性下肢深静脉血栓形成的治疗方法。 方法对我院1999年2月至2002年8月收治的20例急性下肢深静脉血栓形成患者的临床资料进行回顾性分析，并结合文献加以讨论。 结果采用手术取栓配合超声消融及区域性溶栓的综合治疗方法，20例中1例死亡，1例股浅静脉小段狭窄，1例遗留深静脉瓣膜功能不全，其余均获满意疗效，术后症状消失，肢体肿胀明显改善。结论手术取栓配合超声消融等微创技术是治疗急性下肢深静脉血栓形成的最佳选择。
Objective To assess the effectiveness and the safety of clinical use of growth hormone (GH) in burn patients. Method Search were applied to the following electronic databases: Chinese Bio-medicine Database (CBM), MEDLINE, EMBASE and Cochrane Library. Language was restricted in Chinese and English. Data were extracted and evaluated by the two reviewers independently of each other. Applied RevMan 4.1 for statistical analyse. Results Nine trials involving 732 patients were included. The combined results showed that GH can shorten wound healing time [weighted mean difference (WMD) = -11.25, 95%CI (-14.84 to -7.66), Plt;0.000 01], donor site healing times [WMD= -1.87, 95%CI (-2.28 to -1.47), P＜0.000 01), and length of hospital stay [WMD= -8.10, 95%CI (-10.40 to -5.79), P＜0.000 01]. There was no statistical significance on resting energy expenditure [WMD= -0.04, 95%CI ( -0.08 to 0.00), P=0.06], mortality [odds ratio (OR) =1.15, 95%CI (0.15 to 8.53), P=0.9], sepsis [OR=1.08, 95%CI (0.50 to 2.34), P=0.8] and ventilatory support required [OR=1.51, 95%CI (0.72 to 3.16), P=0.3]. Nevertheless, the plasma levels of glucose [standardized mean difference (SMD) =0.98, 95%CI (0.54 to1.42), P＜0.000 01] and insulin [SMD=0.86, 95%CI (0.43 to1.30), P=0.000 1] were increased in GH groups. Conclusions GH for burn patients is effective and safe if blood glucose can be controlled well.