Pre-and postoperative perfusion of thermochemotherapy was used in 25 cases of advanced malignant tumors of digestive tract.There were on significant changes in hepatic and renal functions after perfusions.The erythrocyte,leukocyte and platelet counts reduced in the second and third week after the beginningof perfusion,but rose up in the 4th week.A 2-year follow-up revealed that 23 patients were still alive without recurrence or metastases except 2cases died in the 6th and the 9th month after treatment.We claim that intraperitoneal thermochemotherapy is a simple and safe method. A prospective study is still necessaryin deciding the dose and course.
To evaluate effect of recombinant human growth hormone (rhGH) on immunologic function in patients with gastrointestinal malignant tumor (GIMT). Before and 3 weeks after surgical treatment and administration of rhGH, the amount of T lymphocyte subset (T-LS) and soluble interleukin 2 receptor (sIL-2R) level were measured in 12 patients with GIMT, which were compared with 20 cases of normal control and 18 cases of GIMT treated by surgery alone. Result: ①In all GIMT patients, the serum CD＋3, CD＋4 level and the ratio of CD＋4/CD＋8 were lower than normal control and the sIL2R level was much higher; ②After operation, the serum CD＋3, CD＋4 level and the ratio of CD＋4/CD＋8 of all patients increased, the serum sIL2R level decreased; ③In patients recieved rhGH, the serum CD＋3, CD＋4 level and the ratio of CD＋4/CD＋8 were much more increased and the serum sIL-2R level much more decreased than those of surgery alone group. Conclusion: rhGH can enhance the immunologic function of patients with GIMT.
【Abstract】Objective To introduce the current studies of the role of vascular endothelial growth factorC (VEGFC) and VEGFD in lymphangiogenesis and lymph node metastasis of gastrointestinal neoplasma. Methods The related literatures in recent 5 years were reviewed. Results The growth factors VEGFC and VEGFD enhance lymphangiogenic metastasis of gastrointestinal neoplasma with the property of angiogenesis and lymphangiogenesis. In gastric adenocarcinoma, VEGFC mRNA and tissue protein expression correlate with lymphatic invasion, lymph node metastasis, venous invasion and reduced 5year survival rates. The role of VEGFC in esophageal squamous cancer and colorectal cancer and VEGFD in colorectal cancer is not certain, with conflicting reports in the published literatures.Conclusion The VEGFC, VEGFD/VEGFR3 signal pathway may become the ideal target for inhibition of tumor proliferation and metastases, antilymphangiogenesis therapy may be a novel potential strategy in tumor biological therapy.
ObjectiveTo investigate effect of laparoscopic radical gastrectomy on gastrointestinal motility and gastrointestinal hormones in patients with gastric cancer. MethodsTwo hundred and eighty-nine patients who underwent laparoscopic radical gastrectomy from December 2013 to December 2015 were selected as observation group, 325 patients underwent laparotomy radical gastrectomy during the same period were selected as control group. The postoperative bowel sounds recovery time, the first anal exhaust time, and gastrin, motilin and vasoactive intestinal peptide levels in blood at 12 h before operation and at 24 h after operation were compared between these two groups. ResultsThe baselines had no significant differences between these two groups (P > 0.05). The postoperative bowel sounds recovery time and the first anal exhaust time in the observation group were significantly shorter than those in the control group (P < 0.05). Compared with the levels at 12 h before operation, the gastrin and motilin levels were significantly decreased and the vasoactive intestinal peptide level was significantly increased at 24 h after operation in these two groups (P < 0.05); Compared with the control group, the gastrin and motilin levels at 24 h after operation were significantly increased (P < 0.05) and the vasoactive intestinal peptide level was significantly decreased in the observation group (P < 0.05). ConclusionsPostoperative gastrointestinal motility recovery time in patients undergoing laparoscopic radical gastrectomy is significantly faster than that of laparotomy radical gastrectomy. There is a certain relation between gastrin, motilin or vasoactive intestinal peptide change and operation mode, it might be one of mechanisms of faster recovery of gastrointestinal motility after laparoscopic radical gastrectomy for gastric cancer.
Objective To explore the causes and treatment of rebleeding after operation on portal hypertension patients. Methods The clinical data of 41 rebleeding cases underwent the operational between January 2000 and December 2009 in Peking Union Medical College Hospital were retrospectively analyzed. Results All 13 cases who got rebleeding after shunt operation received lienectomy, but for those who got rebleeding after lienectomy, 23 patients received Phemister or modified Phemister or expanded lienectomy and 5 patients received shunt operation. Surgical related complications occurred in 7 cases (17.1%) at 2 weeks after operation, including abdominal bleeding (3 cases), gastrointestinal bleeding (2 cases), and intractable ascites (2 cases). After the follow-up of 3-60 months (mean 39 months), all patients were still alive. During the follow-up, 3 cases of recurrent esophageal varices were observed and one of them got rebleeding.Conclusion The majority of rebleeding after lienectomy tend to be ascribed to the wrong operations chose, while bad operation skill often contribute to the rebleeding after shunt operation, suggesting ideal therapeutic effect for rebleeding can benefit from appropriate operation choose.
Objective To study the effects and mechanisms of major immune nutrients and to introduce the progresses of clinical applications about enteral immunonutrition. Methods The related literatures about the effects and clinical applications of enteral immunonutrition were reviewed. Results Infection rate can be reduced and the hospitalization can be shortened as a result of the improved nutritional status and immune competence of patients which can be enhanced by reasonable enteral immune nutrition. Most of the patients suffering from serious diseases can benefit from enteral immunonutrition, such as gastrointestinal cancers, post-transplantation complications, chronic liver disorders, acute pancreatitis and so on. However, as a new nutrition therapy, the clinical use of enteral immunonutrition in critically ill patients is still controversial. Conclusions Enteral immunonutrition plays an important role in the nutritional support of patients with serious diseases, such as gastrointestinal cancers, organ failures. However, much work remains to be done.
Objective To perform a systematic review on the safety (i.g. cardiovascular, mortality and gastrointestinal bleeding) of clopidogrel versus clopidogrel combined with proton pump inhibitors (PPIs) for the patients with coronary heart disease. Methods Such databases as The Cochrane Library, PubMed, EMbase, SSCI, VIP, CNKI, and CBM were searched from the date of their establishment to September 2010. The bibliographies of the retrieved articles were also checked. The data was extracted and evaluated by two reviewers independently. The RevMan 5.0 software was used for meta-analyses. Results A total of 29 studies were included. The results of meta-analyses showed that the use of clopidogrel combined with PPIs was associated with increasing the risk of cardiovascular events (RR=1.27, 95%CI 1.09 to 1.47), as well as myocardial infarction (RR=1.45, 95% CI 1.20 to 1.76), total mortality (RR=1.23, 95%CI 1.06 to 1.43), and rethrombosis (RR=1.37, 95%CI 1.01 to 1.86). However, there was no enough evidence to reach the conclusion that the combination use could benefit the situation of gastrointestinal bleeding (RR=0.84, 95%CI 0.47 to 1.50). Conclusion?Compared with clopidogrel, the combination use of clopidogrel and PPIs increases cardiovascular events, mortality, and the risks of myocardial infarction and rethrombosis. However, more clinical studies are required to assess the effect of reducing gastrointestinal bleeding.
ObjectiveTo systematically review the effect of early moxibustion therapy on the recovery of gastrointestinal functioning after gastrointestinal surgery. MethodsWe searched The Cochrane Library, Web of Science, PubMed, EMbase, Ovid, EBSCO, CBM, CNKI, VIP and WanFang Data from inception to Jan. 2015, to collect randomized controlled trials (RCTs) and quasi-RCTs about early moxibustion therapy on the recovery of gastrointestinal functioning. Two reviewer independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was conducted using RevMan 5.3 and Stata 12.0 softwares. ResultsA total of nine RCTs and four quasi-RCTs involving 1444 patients were included. The results of meta-analysis indicated that, the early moxibustion therapy group was significantly superior to the control group in total effective rate (OR=1.26, 95%CI 1.17 to 1.36, P<0.00001), the time to first bowel motion (MD=-11.79, 95%CI -13.79 to -9.78, P<0.00001), the time to first flatus (MD=-15.13, 95%CI -17.40 to -12.85, P<0.00001) and the time to first passage of feces (MD=-34.93, 95%CI -59.33 to -10.53, P=0.005). ConclusionCurrent evidence shows that early moxibustion therapy after gastrointestinal surgery is beneficial for promoting the recovery of gastrointestinal functioning. In addition, due to the low methodological quality of included studies, larger sample, high-quality RCTs are needed to prove the above conclusion.
Objective To evaluate the short-term clinical efficacy and safety of 10-Hydroxy-camptothecin （10- HCPT ） chemotherapy on gastrointestinal carcinoma. Methods We searched electronic database including CNKI （ 1995 - 2005 ）, MEDLINE （ 1995 - 2005 ） and The Cochrane Library （ Issue 1, 2005 ）. More related research data were odtained by cantacting with researchers. Randomized controlled trials of gastrointestinal carcinoma chemotherapy comparing only or including 10-HCPT chemotherapy with normal chemotherapy on efficacy rate, digestive and hematology system toxicity were included. Data related to the clinical outcome were extracted by two reviewers independently. Statistical analysis was performed by using RevMan4. 2.2. Results Twenty-five trials including 1 881 patients met the inclusion criteria. The results of meta-analysis were hsted as follows： 10-HCPT could significantly improve the short-term chemotherapy efficacy for colorectal cancer （ RR. 1.62, 95% CI 1.37 to 1.92） and gastric cancer （RR 1.48, 95% CI 1.18 to 1.85）in chemotherapy curative efficacy in short-term. 10-HCPT induced severe toxicity of lower digestive system（RR. 0.96,95% CI 0.62 to 1.50 ） without statistical significance, while severe toxicity of hematology system was significantly higher than that of control with RR 1.27,95% CI 1.02 to 1.58. Conclusions Current evidence suggests that 10-HCPT can improve hematology system short-term chemotherapy efficacy for gastrointestinal carcinoma and increase the incidence of severe toxicity. Further research is needed to value its influence on the prognosis of gastrointestinal carcinoma.
ObjectiveTo investigate the prevalence of the nutritional risks, the relationship between application of nutritional support and the clinical outcome of patients with gastrointestinal major surgery in the Frist People's Hospital of Shuangliu. MethodsGastrointestinal major surgery patients in Department of General Surgery in the Frist People's Hospital of Shuangliu from March 2010 to March 2014 were consecutively enrolled. Patients who provided informed consent were screened by NRS 2002, tracking nutrition support status and analysis the relationship between nutrition support and clinical outcome. In this study, the clinical outcome index included postoperative complications and hospitalization time. ResultsThere were totally 130 cases enrolled, 112 cases completed assessment by NRS 2002. The prevalence of nutritional risk was 75.9%(85/112), there were totally 57 patients(50.9%) received nutrition support, and all for parenteral nutrition. The prevalence of postoperative complication was 46.4%(52/112). The prevalence of postoperative complication in patients who had nutritional risk and received nutritional support was 41.7%(15/36), whereas, in patients who had nutritional risk but not received nutritional support was 73.5%(36/49), there was statistically significant difference between the 2 groups(P=0.002). In patients who not had nutritional risk, the postoperative complication rate was only 3.7%(1/27). ConclusionsBecause of noninvasive and easy to operate, NRS 2002 are adpted to hospitalized patients with gastrointestinal major surgery. Because of the specific of disease metabolism, the higher nutritional risk occurres in patients with gastrointestinal major surgery, appropriate nutritional support for this kinds of patients can reduce the incidence of postoperative complication, and improve the prognosis.