Objectives To investigate the effect of the combined treatment with probiotics and lactulose of gastrointestinal function and postoperative infection after open cardiac surgery. Methods We retrospectively analyzed the clinical data of 264 patients underwent cardiopulmonary bypass in our hospital between August 2013 and June 2014. There were 129 males and 135 females at the mean age of 53.06±10.97 years. We divided those patients into a treatment group and a control group. In the treatment group, there were 58 males and 63 females at the mean age of 52.29±14.31 years. They took probiotics and lactulose from the first day to the seventh day after operation. In the control group, there were 71 males and 72 females at the mean age of 52.29±14.31 years. They didn’t take probiotics or lactulose after the surgery. Procalcitonin (PCT) and lipopolysaccharides (LPS) concentrations were measured before operation, at 24 hours postoperatively, at 72 hours and on the seventh day. We recorded the condition of postoperative infection, gastrointestinal disorders and relative informations. Results The PCT and LPS concentrations in the treatment group after 72 hours postoperatively were statistically lower than those of the control group (1.04±5.39 ng/ml vs. 3.51±4.28 ng/ml, P=0.04; 11.28±4.34 EU/ml vs. 21.59±7.34 EU/ml, P=0.03). The PCT and LPS concentrations in the treatment group were also statistically lower than those of the control group on the 7th day postoperatively (0.17±2.79 ng/ml vs. 1.98±4.62 ng/ml，P=0.04; 6.74±6.38 EU/ml vs. 15.96±4.61 EU/ml, P=0.01). The ICU stay time (43.25±14.36 h vs. 63.47±24.46 h, P=0.01) and postoperative hospital stay time (15.07±4.52 d vs. 21.08±6.49 d, P=0.02) were significantly less in the treatment group than those in the control group. The morbidity of infection and the morbidity of gastrointestinal disorders of the treatment group were statistically less than those of the control group (1.65% vs. 5.59%, P=0.00; 2.48% vs. 6.99%, P<0.001), and there was no statistical difference in mortality between the two groups (1.65% vs. 2.10%, P=0.12). Conclusions The combined treatment with probiotics and lactulose can improve the postoperative inflammatory reaction, gastrointestinal function, and reduce the morbidity of infection.
ObjectiveTo investigate the impact and mechanism of over-expression microRNA-92a (miR-92a) in clinicopathologic feature and prognosis of patients with colorectal cancer (CRC). MethodsThe expression levels of miR-92a and phosphatase and tensin homologue (PTEN) gene in 108 cases of colorectal cancer tissues were detected by using real-time fluorescent quantitative PCR (RT-PCR), and they were categorized as low or high in relation to the median value. Then the association between different levels of miR-92a gene expression and clinicopathologic feature and prognosis of CRC patients were evaluated. Moreover, the relationship between the expressions of miR-92a and PTEN gene were analyzed. ResultsHigh expression of miR-92a not only associated with lymph node metastasis (χ2=8.045, P=0.007), distant metastasis (χ2=5.708, P=0.030), and TNM staging (χ2=6.366, P=0.019) of CRC patients, but also related to the down-regulated of PTEN gene expression (χ2=21.333, P < 0.001). However, up-regulated miR-92a expression was negatively correlated with age, gender, tumor size, tumor location, depth of invasion and tumor differentiation. In addition, Kaplan-Meier survival curves showed that over-expression of miR-92a and low-expression of PTEN gene could potentially predict poor overall survival of CRC patients. ConclusionThe high expression of miR-92a can lead to a poor clinical prognosis of CRC patients through decreasing the expression level of PTEN gene.