AIM： To study the role of macrophage inflammatory protein （HIP）-2 in liver resection-induced acceleration of tumor growth in a mouse model of hepatic metastasis. METHODS： After a 50% hepatectomy, 1×10^5 CT26....AIM： To study the role of macrophage inflammatory protein （HIP）-2 in liver resection-induced acceleration of tumor growth in a mouse model of hepatic metastasis. METHODS： After a 50% hepatectomy, 1×10^5 CT26.WT cells were implanted into the left liver lobe of syngeneic balb/c mice （PHx）. Additional animals were treated with a monoclonal antibody （HAB452） neutralizing HIP-2 （PHx＋mAB）. Non-resected and non-mAB-treated mice （Con） served as controls. After 7 d, tumor angiogenesis and microcirculation as well as cell proliferation, tumor growth, and CXCR-2 expression were analyzed using in- travital fluorescence microscopy, histology, immunohisto- chemistry, and flow cytometry. RESULTS： Partial hepatectomy increased （P〈0.05）the expression of the HIP-2 receptor CXCR-2 on tumor cells when compared with non-resected controls, and markedly accelerated （P〈 0.05） angiogenesis and metastatic tumor growth. Neutralization of HIP-2 by HAB452 treatment significantly （P〈 0.05） depressed CXCR-2 expression. Further, the blockade of MIP-2 reduced the angiogenic response （P〈 0.05） and inhibited tumor growth （P〈 0.05）. Of interest, liver resection-induced hepatocyte proliferation was not effected by anti-HIP-2 treatment. CONCLUSION： HIP-2 significantly contributes to liver resection-induced acceleration of colorectal CT26.WT hepatic metastasis growth.展开更多
Frailty is a state of late life decline and vulnerability, typified by physical weakness and decreased physiologic reserve. The epidemiology and pathophysiology of frailty share features with those of cardiovascular d...Frailty is a state of late life decline and vulnerability, typified by physical weakness and decreased physiologic reserve. The epidemiology and pathophysiology of frailty share features with those of cardiovascular disease. Gait speed can be used as a measure of frailty and is a powerful predictor of mortality. Advancing age is a potent risk factor for cardiovascular disease and has been associated with an increased risk of adverse outcomes. Older adults comprise approximately half of cardiac surgery patients, and account for nearly 80% of the major complications and deaths following surgery. The ability of traditional risk models to predict mortality and major morbidity in older patients being considered for cardiac surgery may improve if frailty, as measured by gait speed, is included in their assessment. It is possible that in the future frailty assessment may assist in choosing among therapies （e.g., surgical vs. percutaneous aortic valve replacement for patients with aortic stenosis）.展开更多
AIM:To investigate the role of anal cushions in hemorrhoidectomy and its effect on anal continence of the patients.METHODS:Seventy-six consecutive patients(33 men and 43 women) with a mean age of 44 years were include...AIM:To investigate the role of anal cushions in hemorrhoidectomy and its effect on anal continence of the patients.METHODS:Seventy-six consecutive patients(33 men and 43 women) with a mean age of 44 years were included.They underwent Milligan-Morgan hemorrhoidectomy because of symptomatic third-and fourth-degree hemorrhoids and failure in conservative treatment for years.Wexner score was recorded and liquid continence test was performed for each patient before and two months after operation using the techniques described in our previous work.The speed-constant rectal lavage apparatus was prepared in our laboratory.The device could output a pulsed and speed-constant saline stream with a high pressure,which is capable of overcoming any rectal resistance change.The patients were divided into three groups,group A(< 900 mL),group B(900-1200 mL) and group C(> 1200 mL) according to the results of the preoperative liquid continence test.RESULTS:All the patients completed the study.The average number of hemorrhoidal masses excised was 2.4.Most patients presented with hemorrhoidal symptoms for more than one year,including a mean duration of incontinence of 5.2 years.The most common symptoms before surgery were anal bleeding(n = 55),prolapsed lesion(n = 34),anal pain(n = 12) and constipation(n = 17).There were grade Ⅲ hemorrhoids in 39(51.3%) patients,and grade Ⅳ in 37(48.7%) patients according to Goligher classification.Five patients had experienced hemorrhoid surgery at least once.Compared with postoperative results,the retained volume in the preoperative liquid continence test was higher in 40 patients,lower in 27 patients,and similar in the other 9 patients.The overall preoperative retained volume in the liquid continence test was 1130.61 ± 78.35 mL,and postoperative volume was slightly decreased(991.27 ± 42.77 mL),but there was no significant difference(P = 0.057).Difference was significant in the test value before and after hemorrhoidectomy in group A(858.24 ± 32.01 mL vs 574.18 ± 60.28 mL,P = 0.011),but no obvious difference was noted in group B or group C.There was no significant difference in Wexner score before and after operation(1.68 ± 0.13 vs 2.10 ± 0.17,P = 0.064).By further stratified analysis,there was significant difference before and 2 months after operation in group A(2.71 ± 0.30 vs 3.58 ± 0.40,P = 0.003).In contrast,there were no significant differences in group B or group C(1.89 ± 0.15 vs 2.11 ± 0.19,P = 0.179;0.98 ± 0.11 vs 1.34 ± 0.19,P = 0.123).CONCLUSION:There is no difference in the continence status of patients before and after Milligan-Morgan hemorrhoidectomy.However,patients with preoperative compromised continence may have further deterioration of their continence,hence Milligan-Morgan hemorrhoidectomy should be avoided in such patients.展开更多
基金Supported by the grants of the Research Committee the Medical Faculty of the University of Saarland,No.HOMFOR-A/2003/1
文摘AIM： To study the role of macrophage inflammatory protein （HIP）-2 in liver resection-induced acceleration of tumor growth in a mouse model of hepatic metastasis. METHODS： After a 50% hepatectomy, 1×10^5 CT26.WT cells were implanted into the left liver lobe of syngeneic balb/c mice （PHx）. Additional animals were treated with a monoclonal antibody （HAB452） neutralizing HIP-2 （PHx＋mAB）. Non-resected and non-mAB-treated mice （Con） served as controls. After 7 d, tumor angiogenesis and microcirculation as well as cell proliferation, tumor growth, and CXCR-2 expression were analyzed using in- travital fluorescence microscopy, histology, immunohisto- chemistry, and flow cytometry. RESULTS： Partial hepatectomy increased （P〈0.05）the expression of the HIP-2 receptor CXCR-2 on tumor cells when compared with non-resected controls, and markedly accelerated （P〈 0.05） angiogenesis and metastatic tumor growth. Neutralization of HIP-2 by HAB452 treatment significantly （P〈 0.05） depressed CXCR-2 expression. Further, the blockade of MIP-2 reduced the angiogenic response （P〈 0.05） and inhibited tumor growth （P〈 0.05）. Of interest, liver resection-induced hepatocyte proliferation was not effected by anti-HIP-2 treatment. CONCLUSION： HIP-2 significantly contributes to liver resection-induced acceleration of colorectal CT26.WT hepatic metastasis growth.
文摘Frailty is a state of late life decline and vulnerability, typified by physical weakness and decreased physiologic reserve. The epidemiology and pathophysiology of frailty share features with those of cardiovascular disease. Gait speed can be used as a measure of frailty and is a powerful predictor of mortality. Advancing age is a potent risk factor for cardiovascular disease and has been associated with an increased risk of adverse outcomes. Older adults comprise approximately half of cardiac surgery patients, and account for nearly 80% of the major complications and deaths following surgery. The ability of traditional risk models to predict mortality and major morbidity in older patients being considered for cardiac surgery may improve if frailty, as measured by gait speed, is included in their assessment. It is possible that in the future frailty assessment may assist in choosing among therapies （e.g., surgical vs. percutaneous aortic valve replacement for patients with aortic stenosis）.
文摘AIM:To investigate the role of anal cushions in hemorrhoidectomy and its effect on anal continence of the patients.METHODS:Seventy-six consecutive patients(33 men and 43 women) with a mean age of 44 years were included.They underwent Milligan-Morgan hemorrhoidectomy because of symptomatic third-and fourth-degree hemorrhoids and failure in conservative treatment for years.Wexner score was recorded and liquid continence test was performed for each patient before and two months after operation using the techniques described in our previous work.The speed-constant rectal lavage apparatus was prepared in our laboratory.The device could output a pulsed and speed-constant saline stream with a high pressure,which is capable of overcoming any rectal resistance change.The patients were divided into three groups,group A(< 900 mL),group B(900-1200 mL) and group C(> 1200 mL) according to the results of the preoperative liquid continence test.RESULTS:All the patients completed the study.The average number of hemorrhoidal masses excised was 2.4.Most patients presented with hemorrhoidal symptoms for more than one year,including a mean duration of incontinence of 5.2 years.The most common symptoms before surgery were anal bleeding(n = 55),prolapsed lesion(n = 34),anal pain(n = 12) and constipation(n = 17).There were grade Ⅲ hemorrhoids in 39(51.3%) patients,and grade Ⅳ in 37(48.7%) patients according to Goligher classification.Five patients had experienced hemorrhoid surgery at least once.Compared with postoperative results,the retained volume in the preoperative liquid continence test was higher in 40 patients,lower in 27 patients,and similar in the other 9 patients.The overall preoperative retained volume in the liquid continence test was 1130.61 ± 78.35 mL,and postoperative volume was slightly decreased(991.27 ± 42.77 mL),but there was no significant difference(P = 0.057).Difference was significant in the test value before and after hemorrhoidectomy in group A(858.24 ± 32.01 mL vs 574.18 ± 60.28 mL,P = 0.011),but no obvious difference was noted in group B or group C.There was no significant difference in Wexner score before and after operation(1.68 ± 0.13 vs 2.10 ± 0.17,P = 0.064).By further stratified analysis,there was significant difference before and 2 months after operation in group A(2.71 ± 0.30 vs 3.58 ± 0.40,P = 0.003).In contrast,there were no significant differences in group B or group C(1.89 ± 0.15 vs 2.11 ± 0.19,P = 0.179;0.98 ± 0.11 vs 1.34 ± 0.19,P = 0.123).CONCLUSION:There is no difference in the continence status of patients before and after Milligan-Morgan hemorrhoidectomy.However,patients with preoperative compromised continence may have further deterioration of their continence,hence Milligan-Morgan hemorrhoidectomy should be avoided in such patients.
