Objective To evaluate the changes of liver function after laparoscopic-assisted radical gastrectomy for gastric cancer and analyze related impact factors. Methods Patients with gastric cancer or colon cancer, who underwent radical gastrectomy or hemicolectomy between Jun 2008 and Jun 2010 in General Hospital of PLA, were included in this study. These patients were divided into open gastrectomy （OG group, n=43）, laparoscopic-assisted gastrectomy （LAG group, n=35）, and laparoscopic-assisted hemicolectomy （LAC group, n=23）. The serum AST, ALT, TB, and ALP levels of all patients enrolled on the preoperative day and post operative day （POD） 1, POD3, POD5, and POD7, and related impact factors were analyzed. Results Compared with the preoperative results, serum AST and ALT levels of patients increased until POD5 in both LAG and OG groups （P＜0.05）, and there was no changes in liver function after operation of patients in LAC group （P＞0.05）. In addition to that serum AST and ALT levels of patients in LAG group in POD1 were significantly higher than those in OG group （P=0.035 and P=0.041）， and that serum ALT level of patients in LAG group was significantly lower than that in OG group in POD3 （P=0.048）, serum AST and ALT levels of patients in two groups in the remaining time points were not statistically significant difference （P＞0.05）. The serum AST and ALT levels of patients in LAG group were significantly higher than those in LAC group during 5 d after operation （P＜0.05）.There was no significant changes of serum ALP and TB levels of patients in LAG and OG groups on the before and after operation （P＞0.05）. The increased serum ALT level of gastric cancer patients after operation related to body mass index （BMI, P=0.038）, operative time （P=0.011）, intraoperative hepatic injury （P=0.035）, and abnormal ligation of hepatic artery （P=0.048）, instead of the type of operation （OG vs.LAG, P＞0.05）. Conclusions Gastric cancer patients who underwent radical gastrectomy have transient liver dysfunction, which attributes mainly to direct liver manipulation or abnormal ligation of hepatic artery, but not CO2 pneumoperitoneum. Laparoscopic-assisted radical gastrectomy is feasible and safe to the patients without serious liver damage or other vital organs disorders.
Objective To investigate influence of genders on the activity of nuclear factor-kappa B (NF-κB) in lungs of endotoxemic rats. Methods Twenty female and 20 male Wistar rats were randomly divided into four groups as follow: female control group (n=10), male control group (n=10), male endotoxemic group (n=10), and female endotoxemic group (n=10). The endotoxemic rats model was made by injecting lipopolysaccharide (5 mg/kg) into the abdominal cavity. Tissue samples were collected from the lungs in different groups and electrophoresis mobility shift assay was used to measure the activity of NF-κB. The levels of serum TNF-α and estrogen were measured at the same time. Results There was no significant difference between the activities of NF-κB in male and female control groups (1.33±0.24 vs 1.47±0.40）, and there was also no significant difference between other items in these groups as well (Pgt;0.05). Yet, the activity of NF-κB (female: 12.10±2.89; male: 19.53±2.12) and the level of TNF-α 〔female: (4.10±0.72) ng/ml; male: (6.37±1.29) ng/ml〕 were significantly increased after injection of lipopolysaccharide (Plt;0.01), and the indices in female group were significantly lower than those in male group (Plt;0.01). Correlation analysis showed that there was a positive relation between the activity of NF-κB in lungs and the level of TNF-α (female: r=0.921 1, P=0.013; male: r=0.907 2, P=0.017), and there was a negative correlation between the activity of NF-κB and the level of estrogen (female: r=-0.887 5, P=0.017; male: r=0.872 3, P=0.022) in both male endotoxemic group and female endotoxemic group (Plt;0.05). Conclusion Gender may be one of the factors that influence the activity of NF-κB in the lungs of endotoxemic rats. While on the other hand, endogenous estrogen may protect the lungs of endotoxemic rats from injury by inhibiting the activity of NF-κB.
【Abstract】Objective To investigate the value of laparoscopy in the diagnosis and treatment of small bowel diseases.Methods Data of thirtythree cases of small bowel diseases receiving laparoscopy in this hospital from May 2000 to February 2004 were analyzed retrospectively. Results All cases underwent laparoscopy successfully and no complication was observed. The mean operative time was 65 min.The mean intraoperative blood loss was 30 ml. Postoperative pain was mild. Flatus and feces were passed about 32 hours after treatment and the mean postoperative hospital stay was 7 days. The pathologic examination showed: 18 benign and 6 lowgrade malignant stromal tumors, 5 Meckel’s diverticula and 4 NonHodgkin’s lymphomas. No recurrence occurred in 33 cases during the followup for 10 to 36 months.Conclusion Laparoscopy is a very useful and minimally invasive technique in the diagnosis and treatment of small bowel diseases. It is simple, safe, effective and worthy of be clinically applied.