Abstract： Objective To investigate the effect of preoperative oral carbohydrate （CHO） administration on perioperative risks of patients with surgical thoracic oncology，and provide evidence for establishing new scientific preoperative fasting strategy.Methods?In this prospective study， from July to September 2010，32 out of 65 enrolled patients with surgical thoracic oncology in Department 1 of Thoracic Surgery，Cancer Hospital of Peking University， were randomly allocated to preoperative experiment group （fasting overnight and oral 12.5% dextrose 400 ml administration 2 h before anesthesia induction） or control group （fasting overnight and water deprivation from midnight）. Clinical data were collected including subjective evaluation of thirst and hunger measured by visual analogue scale （VAS）， blood glucose level（BGL），serum insulin level， homeostasis model assessment insulin resistance（HOMA-IR），postoperative length of hospital stay （LOS） and complications.Results?Sixteen patients were enrolled in each group. VAS scores of thirst and hunger of the preoperative experiment group at 1 h before anesthesia induction were significantly lower than those of the control group（24 vs. 49，24 vs. 62 ，P=0.000）. BGL（8.59±0.43 mmol/L vs. 5.59±0.43 mmol/L， P=0.000）， serum insulin level （24.33±1.80 mIU/ ml vs. 16.28±1.80 mIU/ml， P=0.004）and HOMA-IR（9.23±0.77 vs. 4.03±0.77，P=0.000）of the preoperative experiment group before anesthesia induction were significantly higher than those of the control group，and these three variables of the preoperative experiment group returned to baseline level soon after surgery. There was no statistical difference in postoperative LOS and complication rate between the two groups （P＞0.05）.Conclusion?Preoperative oral CHO treatment is safe for non-diabetic patients with surgical thoracic oncology， can alleviate their subjective discomfort，decrease insulin resistance， and ameliorate their perioperative stress and metabolism.
Objective To study the effect of local appl ication of different concentrations of nerve growth factor (NGF) on fracture heal ing, and to further search for the appropriate concentration gradient of NGF to promote fracture heal ing. Methods Seventy-five adult male Sprague Dawley rats, weighing (220.0 ± 2.5) g, were made the right tibia fracture model at 1 cm distal from the tibial tubercle and randomly divided into 5 groups (groups A, B, C, D, and E, n=15). Fractures were treated with 0.3 mL normal sal ine containing different concentration of NGF (0.006 48 × 10-2, 0.032 40 × 10-2, 0.162 00 ×10-2, and 0.810 00 × 10-2 μg/g) in groups A, B, C, and D, respectively, and the same amount of normal sal ine in group E. After2, 4, and 6 weeks, the specimens were harvested from 5 rats of each group to perform the biochemical test and histological observation. Before the rats were sacrificed, the arteriovenous blood was taken from the eye-ball to test the alkal ine phosphatase (ALP) activity. Results After 2, 4, and 6 weeks, the gross observation showed that the size and hardness of bone tissue and callus tissue growth gradually increased in groups A, B, C, and D, and group D was higher than groups A, B, C, and E. The X-ray films showed that the calcified area gradually increased in groups A, B, C, and D, and group D was higher than groups A, B, C, and E. The histological observation showed that the trabecular qual ity and maturity in group D were better than those in groups A, B, C, and E. Group D was significantly higher than groups A, B, C, and E (P lt; 0.05) in the gray values of callus tissue and the calcium content of callus tissue at 4 and 6 weeks, in the wet weight of callus tissue at 2 and 4 weeks, and in the ALP content of serum at 2 weeks. The trabecula surface index of osteoblast, the trabecular volume, and the trabecular width decreased as time in the order of groups A, B, C, and D, which were higher than those of group E; group D was the highest, showing significant differences when compared with the other groups (P lt; 0.05). Conclusion The local appl ication of NGF can promote fracture heal ing in rats. The high concentration gradient of NGF (0.810 00 × 10-2 μg/g) has an obvious promotion role on fracture heal ing.
Objective To investigate the effect of NGF on fracture heal ing, and to study the role of BMP-2 induced osteoblast. Methods Sixty cleaned male Kunming mice (aging 6-8 weeks and weighing 23-25 g) were made fracture models in the middle of femoral shaft and randomly divided into four groups (groups A, B, C and D, n=15). Fracture was treated with NGF/ normal sal ine, BMP-2, BMP-2 /NGF/normal sal ine, and normal sal ine in groups A, B, C and D, respectively. After 14, 21 and 28 days, the specimens were selected from 5 mice each group to do the biochemical and histological analysis. Beforethe mice were killed, the arteriovenous blood was taken from their eye-ball to test the ALP activity. Results After 14 days,21 days and 28 days, the gross observation showed that the size and hardness of bone tissue, and callus tissue growth increased in groups A, B and C order and were higher than those in group D; the X-ray films showed that the calcified area increased in groups A, B and C order and were higher than those in group D; the histological observation showed that the trabecular maturity increased in groups A, B and C order and were higher than those in group D. The osteoblast area, the gray degree value of the radiographs in callus tissue, the ALP contents of serum and callus tissue, calcium content of callus tissue and net weight of callus were higher in groups A, B and C than in group D. There were significant differences (P lt; 0.05) in osteoblast area and gray degree values of the radiographs at 14, 21 and 28 days; in ALP contents of serum at 14 days; in ALP contents of callus tissue at 14 days and 21 days; in calcium content of callus tissue at 21 days and 28 days among 4 groups. There were significant differences in net weight of callus between groups B, C and groups A, D at 14 days (P lt; 0.05). At 21 days and 28 days, the trabecular surface index of osteoblast, the average trabecular volume and the mean trabecular width decreased as time went on, having an increase order of groups A, B, C and was higher in groups A, B, C than in group D, showing significant differences among 4 groups (P lt; 0.05). Conclusion NGF promotes the heal ing of fractures. NGF possesses synergistic effect on ectopic bone formation induced by BMP-2.
Objective To investigate the method of single umbilical port laparoscopic cholecystectomy and its feasibility. Methods The clinical data of 46 patients receiving single port umbilical laparoscopic cholecystectomy in this hospital from December 2008 to February 2009 were analyzed retrospectively. Results Fourty-six cases were operated successfully with ordinary laparoscopic instruments by single umbilical port laparoscopic cholecystectomy, all without drainage placed. Operative time was from 40 to 130 min, average 52.3 min; bleeding was from 10 to 150 ml, average 40.6 ml. No complications, such as biliary leakage, hemorrhage, umbilical hernia and infection of incisional wound happened. Postoperative abdominal wall scar was not obvious, 1-4 d hospitalization, from 2 weeks to 3 months following-up without disconnecting of incision. Conclusions The single umbilical port laparoscopic cholecystectomy is safe and feasible, with little abdominal wall scar, but difficult to perform, so it can be applied in hospitals with related conditions as improvements of laparoscopic cholecystectomy.