温州医科大学学报
 
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2019 Vol. 49, No. 11
Published: 2019-11-25
 
 
781 The reversing effect of c(RGDyk) modified Nano-micelles on the docetaxel-resistance of glioma
WU Qilong, CAI Jinhua, XU Helin, LI Hui, ZHAO Yingzheng, CHEN Bin
DOI: 10.3969/j.issn.2095-9400.2019.11.001

Objective:  To prepare c(RGDyk) cyclic peptide modified Nano-micelles encapsulating docetaxel (DTX) and to evaluate its ability to reverse the resistance of U87 glioma cells against DTX. Methods: Using Poloxamer 188 (PL-188) as raw material, after carboxylation of succinic anhydride, the c(RGDyk) cyclic peptide was bonded to synthesize c(RGDyk)-PL-188 targeting material and its structure was confirmed by 1H-NMR and FT-IR. c(RGDyk)-PL-188 was used as the coating material; the Nano-micelles encapsulating DTX [c(RGDyk)DTX-NPs] were prepared by Nano coprecipitation method and the prescription was optimized. Transmission electron microscope (TEM), differential scanning calorimetry (DSC) and dynamic dialysis method were used to characterize the morphology, drug crystal form and drug release behavior of c(RGDyk)DTX-NPs in vitro. CCK8 cellular viability assay in vitro, cellular uptake and U87 cells spheroids growth inhibition test were applied to evaluate the reversal effect of c(RGDyk)DTX-NPs on human glioma U87 cells resistance to DTX. Results: 1H-NMR and FT-IR showed that c(RGDyk)-PL-188 was successfully synthesized, which could be spontaneously assembled into micelles with mean particle diameter of (115.6±0.2) nm. When the mass ratio of c(RGDyk)-PL-188/DTX is 10:1, drug loading content and drug loading efficiency for DTX-loaded micelles were high up to 7.88%±0.02% and 85.5%±2.78%, respectively. DTX-loaded micelles had a mean diameter of (159.2±0.2) nm and zeta potential of (-16.8±0.8) mV, exhibiting the spherical shape determined by TEM. In vitro DTX release showed that c(RGDyk)DTX-NPs exhibited sustained-release behavior and the cumulative release of DTX was only 78% within 24 hours. Cellular uptake indicated that c(RGDyk)-NPs could specifically target drug-resistant human glioma U87 cells, which significantly increased the intracellular fluorescence distribution of fluorescent probe ICG, and its targetability was inhibited by free c(RGDyk) solution. Compared with DTX solution and DTX-NPs, c(RGDyk)DTX-NPs had the stronger cytotoxicity to drug-resistant human glioma U87 cells. The study of U87 human glioma cells spheroids model in vitro showed that c(RGDyk)DTX-NPs could penetrate into the deep part of the tumor spheroids more effectively and inhibit the growth of the tumor spheroids. Conclusion: DTX is efficiently encapsulated in c(RGDyk) cyclic peptide modified Nano-micelles with high drug loading content and drug loading efficiency,  specifically targeting U87 human glioma cells and reversing their resistance against docetaxel
2019 Vol. 49 (11): 781-790 [Abstract] ( 781 ) HTML (1 KB)  PDF (1674 KB)  ( 815 )
791 The effect of regulated EphA1/EphrinA1 signaling axis on endothelial progenitor cells to promote their angiogenesis potency in hepatocellular carcinoma
YU Haitao, GUO Pengyi, XIE Xiaozai, CHEN Gang
DOI: 10.3969/j.issn.2095-9400.2019.11.002
Objective: To study the effect of regulated EphA1/EphrinA1 signaling pathways in endothelial progenitor cells (EPCs) on their cell biological behavior and promotion of angiogenesis potency in hepatocellular carcinoma. Methods: Different concentrations of doxycycline were used to regulate the EphA1 gene express in EPCs line EPCsEphA1/SiRNA-Tet in vitro and in vivo. Western blot was used to test the EphA1/EphrinA1 signaling pathway variation; CCK8 method, wound healing and cell invasion assay were used to test the changes in cell proliferation, migration and invasion ability; xenograft tumor growth curve and immunohistochemical staining of tumor microvascular were used to test their promote angiogenesis potency in hepatocellular carcinoma. T test was used to compare parameters between the groups. Results: In vitro assay it was showed that 10 μg/mL doxycycline could inhibit EphA1/EphrinA1 signaling pathway activity to the maximum extent. Compared with β-actin, the gray value of EphA1 and its ligand EphrinA1 protein expressions were 0.293±0.029 and 0.603±0.038 respectively, being statistically different (t=12.940, 4.864; P<0.001, 0.008) from Dox(-) group 0.943±0.041 and 0.960±0.062. The results of cell biological behavior showed that regulated EphA1 gene expression in EPCs had no effected on their proliferation ability. Compared with Dox(-) group, 10 μg/mL doxycycline regulation could inhibit EPCs’ motility and invasion ability (t=4.435, 2.467; P=0.002, 0.039) to the maximum extent. 100 μg/mL doxycycline induction in vitro could decrease to capacity EphA1 gene expression in EPCs in vivo. Compared with tumor volume (924.5±81.8) mm3 in Dox(-) group, the regulated group tumor volume (543.8±24.6) mm3 of nude mice was decreased at the end of sixth week (t=4.909, P=0.001) and compared with Dox(-) group (37.0±4.1), the microvascular density in regulated group 21.6±3.6 was significantly decreased (t=2.823, P=0.024). Conclusion: Different concentrations of doxycycline can precisely regulate the activity of EphA1/EphrinA1 signaling axis in EPCs in vitro and in vivo, thus controlling the promoted angiogenesis potency in hepatocellular carcinoma.
2019 Vol. 49 (11): 791-796 [Abstract] ( 820 ) HTML (1 KB)  PDF (1589 KB)  ( 743 )
797 Protective effect of paeonol on vascular endothelial cells damaged by hydrogen peroxide
PAN Da, HU Feihong, JIN Can, WEN Hao, MENG Weiyang, ZHU Lielie, CHEN Daqing
DOI: 10.3969/j.issn.2095-9400.2019.11.003
Objective: To investigate the protective effects and mechanism of paeonol (PAE) on vascular endothelial cells injured by tert-butyl hydroperoxide (TBHP). Methods: Human umbilical vein endothelial cells (HUVECs) were randomly divided into control group (only treated with 1640 medium), injured group (stimulated by TBHP), and PAE treatment group (pretreated with various dose of PAE followed by TBHP stimulation).CCK-8 method and lactate dehydrogenase (LDH) release assay were used to detect the proliferation of HUVECs in each group. Transwell assay was used to detect the migration ability of HUVECs. Flow cytometry and immunofluorescence staining of Cleaved-caspase 3 were used to detect the apoptosis rate of HUVECs in each group. Results: Compared with the control group, the cell survival rate and cell migration number of the model group were significantly decreased, and the apoptosis rate, LDH release rate and the expression of Cleaved-caspase 3 protein were significantly increased (P<0.05). Compared with injured group, the survival rate and cell migration number of the PAE treatment group gradually increased in a dose-dependent manner; moreover, the apoptosis rate, LDH release rate and the expression of Cleaved-caspase 3 protein decreased in a dose-dependent manner (P<0.05). Conclusion: Paeonol can inhibit the TBHP-induced HUVECs viability due to the increase in LDH release and apoptosis, up-regulate the expression of Cleaved-caspase 3, and exert its protective effect on vascular endothelial cells injured by TBHP in a dose-dependent manner.
2019 Vol. 49 (11): 797-801,806 [Abstract] ( 779 ) HTML (1 KB)  PDF (1487 KB)  ( 885 )
802 The interference of severe lipid turbidity to sodium, potassium and chloride in serum tested by indirect ion selective electrode
NI Li, FANG Mao, ZHU Lidan, GE Haifeng, XU Xiaojie, DING Hongxiang
DOI: 10.3969/j.issn.2095-9400.2019.11.004
Objective: To study the interference of severe lipid turbidity to sodium, potassium and chloride in serum tested by indirect ion selective electrode method. Methods: According to EP7-A2 and EP9-A2, sodium, potassium and chloride in serum of 40 samples without lipid turbidity from inpatients admitted to the Second Affiliated Hospital of Wenzhou Medical University were measured by indirect ion selective electrode method (SIEMENS ADVIA 2400 automatic biochemical analyzer) and direct ion selective electrode method (Johnson VITROS 5600 dry chemical analyzer ). Another 40 samples with different lipid turbidity index from the same hospital were tested by the two methods. Samples of 3 different levels of sodium, potassium and chloride were collected for interference tests. Results: There were no obvious differences between the sodium, potassium and chloride in serum of 40 samples without lipid turbidity tested by indirect ion selective electrode method and those tested by direct ion selective electrode method (P>0.05). When triglyceride was greater than 35.3 mmol/L and turbidity index was greater than 965, interference test in vitro revealed that there was significant negative interference to sodium of 113 mmol/L in serum tested by indirect ion selective electrode method (bias>-2%). When triglyceride was greater than 28.4 mmol/L and turbidity index was greater than 710, there was significant negative interference to potassium of 5.8 mmol/L in serum tested by indirect ion selective electrode method (bias>-3%). When triglyceride was greater than 20 mmol/L and turbidity index was greater than 615, there was significant negative interference to chloride of 79.6 in serum tested by indirect ion selective electrode method (bias>-2.5%). Conclusion: There are negative interferences to sodium, potassium and chloride in serum with lipid turbidity tested by indirect ion selective electrode method. Sodium, potassium and chloride in serum with severe lipid turbidity should be measured by direct ion selective electrode method or measured by indirect ion selective electrode method after removing the lipid by high speed centrifugation.
2019 Vol. 49 (11): 802-806 [Abstract] ( 895 ) HTML (1 KB)  PDF (1262 KB)  ( 868 )
807 Association of RETN, LEPR and ADIPOQ polymorphisms with the risk of type 2 diabetes and lipid metabolism in Chinese Han population
ZHENG Wenwen, ZHANG Hang, ZHOU Xinhe, HONG Ying, ZHUANG Fei, WU Chenwei, CHEN Xia, HE Hanghui, SU Yue, ZHENG Chao
DOI: 10.3969/j.issn.2095-9400.2019.11.005
Objective: To investigate the association of resistin gene (RETN), leptin receptor gene (LEPR) and adiponectin gene (ADIPOQ) polymorphisms encoding adipokines with the risk of type 2 diabetes mellitus (T2DM) and the effect on lipid metabolism in Chinese Han population. Methods: A total of 526 T2DM patients and 344 nondiabetic controls were enrolled in our study. The single-nucleotide polymorphisms (SNPs) of RETN (rs1862513, rs3745367), LEPR (rs1137101, rs13306519, rs1805096) and ADIPOQ (rs1501299, rs2241766) were determined by the kompetitive allele specific PCR (KASP) technique. The association of RETN, LEPR and ADIPOQ polymorphisms with the risk of T2DM and the relationship between various SNP genotypes and lipid metabolism were applied by statistical methods. Results: The frequency of GG genotype and G variant allele of RETN rs1862513 in the T2DM group was higher than the control group, and the difference was statistically significant (42.0% vs. 30.0%, P=0.003; 65.0% vs. 57.1%, P=0.001, OR=1.397, 95%CI=1.140-1.712); Further analysis of the overall study population found that the frequency of RETN rs1862513 GG genotype in the T2DM group was visibly higher than the control group in the BMI<25 kg/m2 group after grouped by BMI (42.8% vs. 31.0%, P=0.015). Further analysis of the relationship between each genotype and lipid, RETN rs3745367 GG or AG genotype had lower high density lipoprotein cholesterol (HDL) level at BMI<25 kg/m2 (P=0.018); LEPR rs13306519 CC or CG genotype had lower HDL level at BMI≥25 kg/m2 (P=0.016). In the overall study population, ADIPOQ rs1501299 CC or AC genotype had higher triglyceride (TG) level than AA genotypes (P=0.044). Conclusion: RETN rs1862513 G allele may be associated with the risk of T2DM in Chinese Han population; ADIPOQ rs1501299 CC or AC genotype may be associated with high TG level, RETN rs3745367 GG or AG genotype in non-obesity and LEPR rs13306519 CC or CG genotype in obese people may be associated with low HDL level.
2019 Vol. 49 (11): 807-813 [Abstract] ( 778 ) HTML (1 KB)  PDF (1237 KB)  ( 678 )
814 The role of AMPK/STAT1 pathway in the improvement of apoptosis of PC12 cells induced by hydrogen peroxide by alantolactone
XU Jianfei, WANG Yang, HU Xujun, WANG Hua, XU Zhaojun
DOI: 10.3969/j.issn.2095-9400.2019.11.006
Objective: To study the effect of alantolactone (ALA) on apoptosis of PC12 induced by hydrogen peroxide (H2O2). Methods: Cell proliferation was detected by MTT after treatment with different concentrations of ALA (1, 5, 10, 20, 50, and 100 μmol/L). After cells were pretreated with different concentrations of ALA (1 and 5 μmol/L) and then stimulated by H2O2, cell proliferation was detected by flow cytometry and MTT. The control group, H2O2 (100 μmol/L) group and H2O2 (100 μmol/L)+ALA (1 and 5 μmol/L) were established. Cell apoptosis was detected by flow cytometry, cell proliferation by MTT and phosphorylation of AMPK and STAT1 by Western blot. Phosphorylation of STAT1 was detected by Western blot after treatment with small interfering RNA (siRNA) of AMPK and ALA in PC12. Results: High concentration of ALA inhibited the proliferation of PC12 cells. Compared with the control group, the apoptosis of PC12 cells increased after stimulation by H2O2. Compared with H2O2 group, the apoptosis of PC12 cells in H2O2+ALA group decreased significantly in a dose-dependent manner. Silencing AMPK expression did not affect H2O2-induced phosphorylation of STAT1 in PC12 cells induced by H2O2. ALA was used to treat PC12 cells after silencing AMPK. Compared with siAMPK+H2O2 group, phosphorylation of STAT1 in ALA+siAMPK+H2O2 group showed no significant difference. Conclusion: ALA could regulate the phosphorylation of STAT1 in PC12 cells induced by H2O2 via activating AMPK and thus affect cell apoptosis.
2019 Vol. 49 (11): 814-818 [Abstract] ( 774 ) HTML (1 KB)  PDF (1669 KB)  ( 817 )
819 An fMRI study of network node changes in relapsing-remitting multiple sclerosis based on voxel centrality
LIU Chang’en, Du Xiaofeng
DOI: 10.3969/j.issn.2095-9400.2019.11.007
Objective: To explore the abnormal alteration of intrinsic functional hubs and their relationship with the clinical features in relapsing-remitting multiple sclerosis (RRMS) using degree centrality approach. Methods: A total of 26 RRMS and 27 status-matched healthy groups were recruited. RRMS patients underwent a physical examination using Expanded Disability Status Scale (EDSS) by an experienced neurologist. Degree centrality and functional connectivity methods were used to evaluate the features of abnormal intrinsic functional hubs. Pearson correlation analysis was conducted to investigate the relationship between clinical features and abnormal functional hubs. Receiver operating characteristic (ROC) curve was applied to calculate the sensitivity and specificity of those altered functional hubs in distinguishing the RRMS from the HGs. Results: The covered brain areas of degree centrality differences didn’t change with different thresholds of correlation coefficient r values. Compared with the HGs, the RRMS demonstrated significantly higher degree centrality values in multiple brain areas and lower degree centrality values in bilateral salience network and left cingulate gyrus. Decreased functional connectivity was found within the left-right salience network, and between the salience network and the cingulate gyrus. Disease duration of RRMS revealed a negative linear correlation with the degree centrality value in the left temporal pole (r=-0.483, P=0.020). EDSS revealed a positive linear correlation with the degree centrality value in the right superior parietal lobule (r=0.485, P=0.019), and a negative linear correlation with the degree centrality value in the right temporal pole (r=-0.430, P=0.041). ROC analysis showed good performance of these abnormal hubs in distinguishing the RRMS from the HGs (AUC=0.943, sensitivity was 96.3%, specificity was 88.5%). Conclusion: The functional deficits in the cingulate gyrus and temporal pole in RRMS could predict disease progression and disability status, which may expand our understanding of functional characteristics and provide a new insight into the pathophysiological mechanism of RRMS.
2019 Vol. 49 (11): 819-825 [Abstract] ( 727 ) HTML (1 KB)  PDF (1492 KB)  ( 1033 )
826 Mechanism of Chinese medicine Fuzheng in reversing paclitaxel resistance in TLR4 over-expressed breast cancer
ZHANG Xiangjian, ZHANG Xinxin, MA Haiguang, HU Xiaoqing
DOI: 10.3969/j.issn.2095-9400.2019.11.008
Objective: To investigate the mechanism of Fuzheng Chinese medicine combined with paclitaxel against TLR4 over-expressing breast cancer, and to confirm the sensitization effect of traditional Chinese medicine combined with chemotherapy for TLR4 over-expressed breast cancer MDA-MB-231 so as to select specific tumor phenotype for combination of traditional Chinese and western medicine. The target provides drug intervention to provide basic data. Methods: MTT assay was used to detect the proliferation inhibition effect of Fuzheng Chinese medicine, paclitaxel and two drugs on breast cancer cell lines T47D and MDA-MB-231. The apoptosis rate was detected by flow cytometry. Expression of the apoptosis related protein and TLR4/NF-kB signaling pathway-associated proteins was detected by Western blotting technology. Results: Fuzheng Chinese medicine and paclitaxel had synergistic effect in the treatment of MDA-MB-231 cell line; Fuzheng Chinese medicine assisted paclitaxel to induce apoptosis of MDA-MB-231 cell line (P<0.05); combined with Chinese medicine and paclitaxel, MDA-MB-231 Cell line TLR4/NF-kB signaling pathway was inhibited (P<0.05). Conclusion: In MDA-MB-231 cell line, Fuzheng Chinese medicine can increase cell apoptosis by inhibiting TLR4/NF-kB signaling pathway, thereby increasing the cell proliferation inhibition effect of paclitaxel on MDA-MB-231 breast cancer cell line and reversing paclitaxel-resistance in breast cancer.
2019 Vol. 49 (11): 826-831 [Abstract] ( 816 ) HTML (1 KB)  PDF (2083 KB)  ( 704 )
832 Clinical observation of KushenGuihua Decoction combined with interventional chemotherapy for advanced colon cancer and its effect on expressions of CCSA2 and survivin
JIANG Yinghua
DOI: 10.3969/j.issn.2095-9400.2019.11.009
Objective: To investigate the clinical effect of KushenGuihua Decoction combined with interventional chemotherapy in the treatment of advanced colon cancer and its effect on the expression of colon cancer specific antigen 2 (CCSA2) and survivin as tumor markers. Methods: Sixty-two patients with colon cancer in our hospital were randomly divided as experimental group (n=31) and control group (n=31). Based on the treatment with interventional chemotherapy in both groups, the experimental group was given KushenOsmanthus Decoction for 8 weeks. The improvement in traditional Chinese medicine symptoms and changes of life quality scores were evaluated in two groups. Adverse reactions and survival rate of the patients were recorded. Meanwhile, the expression of CCSA2 and survivin in both groups was detected. Results: After treatment, the traditional Chinese medicine symptoms improved; the total effective rate and the life quality score in the experimental group were better than the control group (P<0.05). Moreover, the frequency of adverse reactions in the experimental group was lower than that in the control group (P<0.05) while the survival rate was much higher (P<0.05). The expression levels of CCSA2 and survivin in the experimental group were significantly decreased after treatment. Conclusion: KushenGuihua Decoction combined with interventional chemotherapy can effectively improve the symptoms of patients with advanced colon cancer and the life quality as well. Meanwhile, it can increase the survival rate but reduce the incidence of adverse reactions in patients and inhibit the expression of CCSA2 and survivin as tumor markers.
2019 Vol. 49 (11): 832-836 [Abstract] ( 737 ) HTML (1 KB)  PDF (1305 KB)  ( 775 )
837 The value of CT features in predicting the invasiveness of sub-centimeter lung adenocarcinoma presenting as pure ground-glass nodule
HUANG Dingpin, FU Gangze, CAI Mengting, ZHUANG Yuandi, CHEN Lifang, LIU Jinjin, XIA Tianyi, YANG Yunjun
DOI: 10.3969/j.issn.2095-9400.2019.11.010
Objective: To evaluate the value of CT features in predicting the invasiveness of sub-centimeter lung adenocarcinoma presenting as pure ground-glass nodule (pGGN). Methods: The imaging, pathological and clinical data of 124 cases (131 lesions) of lung adenocarcinoma proved by surgery and pathology of pGGN (≤1 cm) from January 2012 to December 2017 were retrospectively analyzed. All lesions were divided into pre-invasive group (87 lesions) and invasive group (44 lesions) according to histopathology. The size and density differences between the two groups were compared, as well as the location, lung-tumor interface, margin morphology, air bronchogram and vascular changes of the lesions between the pre-invasive lesion group and the invasive lesion group. The independent risk factors for evaluating the invasiveness of sub-centimeter pGGN were analyzed. And the cut-off point of size for differentiating pre-invasive lesions from invasive lesions were calculated. Results: There were statistical differences in size, marginal morphology and vascular changes between the two groups (P<0.05). ROC curve showed that the cut-off point of size in pre-invasive and invasive lesions was 8.5 mm. Multivariate logistic regression analysis showed that maximum diameter (≥8.5 mm), vascular abnormalities and spiculate or irregular margin morphology were independent risk factors for lesion invasiveness, with odds ratios (95%CI) of 2.277(1.006-5.152), 2.628(1.140-6.059) and 3.693(1.251-10.901), respectively. Conclusion: Maximum diameter (≥8.5 mm), vascular abnormalities and spiculate or irregular margin are independent risk factors for subcentimeter pGGN invasiveness.
2019 Vol. 49 (11): 837-841 [Abstract] ( 985 ) HTML (1 KB)  PDF (1302 KB)  ( 784 )
842 Different doses of simvastatin in the treatment of acute exacerbation chronic of obstructive pulmonary disease: a comparative study
CHI Qiong, ZNENG Jiyang, DAI Xinjian, ZHANG Baoyi, ZHANG Zhiyuan
DOI: 10.3969/j.issn.2095-9400.2019.11.011
Objective: To investigate the efficacy and safety of different doses of simvastatin in the treatment of patients with chronic obstructive pulmonary disease (COPD) at acute exacerbation stage. Methods: Totally 180 patients with acute exacerbation of COPD were randomly divided as the conventional simvastatin (40 mg/d)
treatment group (group A), the low-dose simvastatin (20 mg/d) treatment group (group B), and the conventional treatment control group (group C). The primary indicator was C-reactive protein (CRP) and the secondary indicators included interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), arterial blood gas, lung function, a 6-minute walk test (6MWD). Results: 180 patients entered the randomized group and three of them fell off. Compared with the situation before treatment, the above inflammation indicators, including CRP, IL-6 and TNF-α decreased significantly after treatment (P<0.01), and they were significantly lower in group A and group B (P<0.05) than group C, with group A the lowest (P<0.05). The arterial blood gas, lung function and 6MWD index of each group were improved (P<0.01), and no significant difference was found between the three groups after treatment (P>0.05). Conclusion: Simvastatin, especially the conventional doses of simvastatin, can inhibit patients with COPD from systemic inflammatory response at acute exacerbation stage.
2019 Vol. 49 (11): 842-845 [Abstract] ( 750 ) HTML (1 KB)  PDF (1215 KB)  ( 692 )
846 The effect of social cognition and interaction training on rehabilitation of schizophrenic in-patients
ZHANG Lijun, LIN Cuilyu, YE Xinwu, ZHOU Qiang
DOI: 10.3969/j.issn.2095-9400.2019.11.012
Objective: To explore how Social Cognition and Interaction Training acts on schizophrenic in-patients during rehabilitation. Methods: Fifty-eight out of 118 recruited schizophrenic patients received SCIT and antipsychotic therapy twice a week for nine weeks (SCIT group), while the rest received only antipsychotic therapy as the control group. Comparisons were made between the two groups in their social cognitive ability, including the total scores of Positive and Negative Syndrome Scale (PANSS), positive symptoms, negative symptoms, total Blame Bias (TBB), cue task and Social Disability Screening Schedule (SSPI) were compared in the dry prognosis. Results: Compared with the control group, the results showed positive symptoms have been significantly improved and social function improved with the trend level in the SCIT group after intervention. Mental symptoms (t=7.163, P<0.01), positive symptoms (t=19.154, P<0.01), negative symptoms (t=4.601, P<0.01) and social function (t=-8.990, P<0.01) have all significantly improved after intervention, compared with the results before intervention. Conclusion: SCIT is conducive to the rehabilitation of schizophrenic inpatients.
2019 Vol. 49 (11): 846-849 [Abstract] ( 871 ) HTML (1 KB)  PDF (1213 KB)  ( 683 )
850 Two treatment methods for cesarean scar pregnancy: a clinical analysis
DU Xiumei
DOI: 10.3969/j.issn.2095-9400.2019.11.013
Objective: To analyze the clinical effect and safety of trans-vaginal and laparoscopic treatment of cesarean scar pregnancy (CSP). Methods: 76 CSP patients treated in our hospital from January 2016 to December 2018 were divided as Transvaginal Operation Group (Group A) and Laparoscopic Operation Group (Group B), with 38 cases in each group. Group A underwent transvaginal hysterectomy and Group B underwent laparoscopic hysterectomy. The operation time, bleeding volume, hospital stay, first anal exhaust time, menstrual recovery time, recovery time of serum human chorionic gonadotropin (β-HCG), 24-hour visual analogue score (VAS) were compared between the two groups. The occurrence of bladder injury, vaginal bleeding, infection and other complications were recorded. Results: The operation time, bleeding volume and hospitalization time were significantly less (P<0.05) in Group A than in Group B. The first anal exhaust time and 24-hour VAS of group A were less than those of group B, the difference being statistically significant (P<0.05). There was no significant difference between the two groups (P>0.05) in menstrual recovery time, serum β-hCG recovery time as well as the occurrence of complications. Conclusion: Both transvaginal and laparoscopic approaches are effective and safe for CSP patients. However, transvaginal surgery has the advantages of less trauma and faster recovery.
2019 Vol. 49 (11): 850-852，,856 [Abstract] ( 846 ) HTML (1 KB)  PDF (1235 KB)  ( 701 )
853 Clinical application of non-pneumoperitoneum laparoscopic appendectomy in super senior patients
XU Maiyu, MA Zhongwu, CHEN Feng, CHEN Lei
DOI: 10.3969/j.issn.2095-9400.2019.11.014
Objective: To evaluate the value of non-pneumoperitoneum laparoscopic appendectomy (NLA) in super senior patients with acute appendicitis. Methods: The overall clinical data of 55 cases of appendicectomy (age≥80 years), which were consisted of 27 cases of NLA and 28 cases of open appendectomy (OA), were collected retrospectively. The operative time, intraoperative blood loss, postoperative pain level (6~24 h), postoperative intestinal function recovery time, postoperative hospital stay, complications and hospitalization cost were compared between the two groups. Results: Compared with the OA group, The NLA group had a obvious advantage in postoperative pain level (6~24 h), postoperative intestinal function recovery time and postoperative hospital stay, the difference was statistically significant (P<0.05). There was no significant difference in the operation time and intraoperative blood loss between the two groups. There was 1 case of incision infection in the NLA group (trocar for 1.0 cm), and 4 cases of incision infection in the OA group. The difference was not statistically significant. There were 4 cases and 5 cases in the NLA group and OA group. Postoperative pulmonary infection occurred in 4 patients and 5 patients in NLA group and OA group, respectively, and recovered after anti-inflammatory and aerosol therapy. The difference was not statistically significant. The overall hospitalization cost of the OA group was lower than that of the NLA group, and the difference was statistically significant (P<0.05). Conclusion: NLA is as safe and feasible for super senior patients with acute appendicitis. The units with mature laparoscopic techniques deserve to be popularized.
2019 Vol. 49 (11): 853-856 [Abstract] ( 765 ) HTML (1 KB)  PDF (1185 KB)  ( 736 )
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