ObjectiveTo evaluate the efficacy of XiaochengqiMixture (XM) on promoting healing of colonic stoma. MethodsForty Wistar rats were divided into two groups randomly after colonectomy: experimental group (n=20) and control group (n=20). In early postoperatively stage rats were given gastric administration of XM in the experimental group and pure water in the control group. On day 3, 7, and 14 after establishment of animal models, laparotomy was performed in two groups of rats, respectively. Anastomotic stoma and surrounding tissues were harvested to detect the context of hydroxyproline and collagen fiber proportion by Masson dying. ResultsOn day 3 after establishment of animal models, hyperplastic collagen with small fiber was observed while no fasciculus was found. Hydroxyproline context and collagen fiber proportion of rats were higher in experimental group than those in control group (Plt;0.05). On day 7 after operation, many fasciculuses were found in two groups of rats, hydroxyproline context and collagen fiber proportion of rats were higher in experimental group than those in control group (Plt;0.01). On day 14 after operation, fasciculuses became bigger and more regular in arrangement, but there was no significant difference between the two groups (Pgt;0.05). ConclusionXM is capable of promoting healing of colonic stoma and might prevent the occurrence of anastomotic fistula.
目的 观察多西他赛三药及两药联合对胃癌根治术后辅助化学疗法(化疗)的疗效比较及不良反应。 方法 回顾性分析解放军总医院2006年1月-2011年12月42 例胃癌根治术后患者的临床资料,其中有22例、20例患者分别接受以多西他赛为基础的三药、两药联合辅助化疗。三药联合:多西他赛注射液+铂类+氟尿嘧啶/卡培他滨片/替吉奥;两药联合:多西他赛注射液+氟尿嘧啶/卡培他滨片/替加氟或多西他赛注射液+铂类;主要观察终点:无疾病生存期(DFS),次要观察终点:预后因素分析、复发转移情况、不良反应及亚组分析。 结果 两组中位DFS分别为9.530、7.170个月(P=0.646);性别、年龄、肿瘤浸润深度、脉管癌栓、淋巴结清扫范围是患者早期复发转移的不良预后因素,三药联合组肝转移率高于两药联合组(P=0.008);主要不良反应为恶心、呕吐、白细胞减少、腹泻、脱发、血小板减少等,多为1~2级,可耐受,三药联合组较两药联合组易出现不良反应(P=0.011),以恶心、呕吐为主。 结论 胃癌根治术后以多西他赛为基础的辅助化疗三药、两药联合对患者疗效及预后无明显差异,且两种辅助疗法不良反应基本可耐受。
Objective To investigate the effect and clinical significance of 3 d and 1 d bowel preparation method for colorectal carcinoma surgery on preoperative gut mucosal barrier function. Methods Plasma levels of D-lactate (D-LAC), diamine oxidase (DAO) and endotoxin (ET) were measured at 2 h before operation in 3 d bowel preparation group (50 cases) and 1 d bowel preparation group (50 cases), 25 cases of inguinal hernia were included as control group. D-LAC, DAO and ET were detected by using enzymatic spectrophotometric assay, spectrophotometric assay and limulus lysate test with azo chromogenic substrate, respectively. Results Preoperative plasma levels of D-LAC, DAO and ET in 3 d bowel preparation group were (10.25±1.43) mg/L, (5.82±0.80) U/ml and (10.11±1.41) ng/L respectively. In 1 d bowel preparation group the corresponding values were (10.19±1.35) mg/L, (5.80±0.81) U/ml and (9.82±1.35) ng/L respectively. There were no significant differences between 3 d and 1 d bowel preparation group (Pgt;0.05), compared with hernia group, 1 d and 3 d bowel preparation group were also no statistically significant differences (Pgt;0.05). Conclusions There are no significant preoperative gut mucosal barrier function damages in patients with 1 d and 3 d bowel preparation for colorectal carcinoma surgery, 1 d bowel preparation for colorectal carcinoma surgery can be performed in colorectal carcinoma patients, and 3 d bowel preparation can be used for certain special colorectal carcinoma patients.