简介：AIM:Toinvestigatewhetherthesimultaneoustreatmentwithhumangrowthhormone(hGH)abolishesthenegativeeffectsofeverolimusonanastomotichealing.METHODS:Forty-eightmaleSprague-Dawley-ratswererandomizedtothreegroupsof16animalseach(Ⅰ:vehicle;Ⅱ:everolimus3mg/kgpo;Ⅲ:everolimus3mg/kgpo+hGH2.5mg/kgsc).AnimalswerepretreatedwithhGHand/oreverolimusdailyforsevendays.Thenastandardanastomosiswascreatedinthedescendingcolonandtreatmentwascontinuedforanothersevendays.Theanastomosiswasresectedintotoandtheburstingpressurewasassessedasamechanicalparameterofintestinalhealing.Moreover,biochemical(Hydroxyproline,PCNA,MPO,MMP-2andMMP-9)andhistological(celldensity,angiogenesis,amountofgranulationtissue)parametersofintestinalhealingwereassessed.RESULTS:AnastomoticburstingpressurewassignificantlyreducedbyeverolimusandasimultaneoustreatmentwithhGHresultedinconsiderablyhighervalues(Ⅰ:134±19mmHg,Ⅱ:85±25mmHg,Ⅲ:114±25mmHg;P<0.05,ⅠvsⅡ;P=0.09,ⅠvsⅢandⅡvsⅢ)HydroxyprolineconcentrationwassignificantlyincreasedbyhGHcomparedtoeverolimusalone(Ⅰ:14.9±2.5μg/mg,Ⅱ:8.9±3.6μg/mg,Ⅲ:11.9±2.8μg/mg;P<0.05,?ⅠvsⅡ/ⅢandⅡvsⅢ).ThenumberofMPO-positivecellswasreducedsignificantlybyhGHcomparedtoeverolimusalone(Ⅰ:10±1n/mm~2,Ⅱ:15±3n/mm~2,Ⅲ:9±2n/mm~2;P<0.05,ⅠvsⅡandⅡvsⅢ),whilethenumberofPCNA-positivecellswereincreasedbyhGH(Ⅰ:28±3/mm~2,Ⅱ:12±3/mm~2,Ⅲ:26±12/mm~2;P<0.05,?Ⅰ?vsⅡandⅡvsⅢ).Correspondingtothesebiochemicalfindings,HEhistologyrevealedsignificantlyincreasedamountofgranulationtissueinhGH-treatedanimals.CONCLUSION:InhibitionofintestinalwoundhealingbyeverolimusispartiallyneutralizedbysimultaeoustreatmentwithhGH.BothinflammationaswellascollagendepositionisinfluencedbyhGH.

简介：AIM:Toevaluateshort-termoutcomesfollowingintraoperativebiliarylavageforhepatolithiasis.METHODS:Atotalof932patientswhowereadmittedtotheWestChinaMedicalCenterofSichuanUniversitybetweenJanuary2010andJanuary2014andunderwentbileductexplorationandlithotomywereretrospectivelyincludedinourstudy.Thepatientsweredividedintothelavagegroupandthecontrolgroup.Relatedpre-,intra-,andpostoperativefactorswererecorded,analyzed,andcomparedbetweenthetwogroupsinordertoverifytheeffectsofbiliarylavageontheshort-termoutcomeofpatientswithhepatolithiasis.RESULTS:Amongstthepatientswhowereincluded,678patientswithhepatolithiasiswereincludedinthelavagegroup,andtheother254patientswereenrolledinthecontrolgroup.Dataanalysesrevealedthatpreoperativebaselineandrelatedintraoperativevariableswerenotsignificantlydifferent.However,patientswhounderwentintraoperativebiliarylavagehadprolongedpostoperativehospitalstays(6.67dvs7.82d,P=0.024),higherhospitalizationfees(RMB28437.1vsRMB32264.2,P=0.043),higherpositiveratesofbacterialculturesfromblood(13.3%vs25.8%,P=0.001)andbile(23.6%vs40.7%,P=0.001)samples,andincreasedusageofadvancedantibiotics(26.3%vs38.2%,P=0.001).Inaddition,inthelavagegroup,morepatientshadfever(>37.5℃,81.4%vs91.1%,P=0.001)andhyperthermia(>38.5℃,39.7%vs54.9%,P=0.001),andhigherwhitebloodcellcountswithin7daftertheoperationcomparedtothecontrolgroup.CONCLUSION:Intraoperativebiliarylavagemightincreasetheriskofpostoperativeinfection,whilenotsignificantlyincreasinggallstoneremovalrate.

简介：AIMTodeterminewhetherthenumberofexaminedlymphnodes(LNs)iscorrelatedwiththeoverallsurvivalofgallbladdercarcinoma(GBC)patients.METHODSPatientswerecollectedfromtheSurveillanceEpidemiologyandEndResultsdatabase(2004-2013)andcategorizedbythenumberofLNsintosixgroups:1LN,2LNs,3LNs,4LNs,5LNs,and≥6LNs.SurvivalcurvesforoverallsurvivalwereplottedwithaKaplan-Meieranalysis.Thelog-ranktestwasusedforunivariatecomparisons.RESULTSInacohortof893patients,themediannumberofexaminedLNswastwofortheentirecohort.Thesurvivalforthe1LNgroupwassignificantlypoorerthanthoseofthestageⅠandⅡdiseasegroupsandfortheentirecohort.BydichotomizingthenumberofLNsfrom1to6,wefoundthattheminimumnumberofLNsthatshouldbeexaminedwasfourforstageⅠ,fourorfiveforstageⅡ,andsixforstageⅢAdisease.Therefore,fortheentirecohort,thenumberofexaminedLNsshouldbeatleastsix,whichisexactlyconsistentwiththeAmericanJointCommitteeonCancercriteria.CONCLUSIONTheexaminationofhighernumbersofLNsisassociatedwithimprovedsurvivalafterresectionsurgeryforN0GBC.TheguidelinesforGBCsurgery,whichrecommendthatsixLNsbeexaminedatleast,arestatisticallyvalidandshouldbeappliedinclinicalpracticewidely.