[Recognition of the membrane anatomy-based laparoscopic assisted right hemicolectomy]

Although it has become a consensus in the field of colorectal surgery to perform radical tumor treatment and functional protection under the minimally invasive concept, there exist many controversies during clinical practice, including the concept of embryonic development of abdominal organs and membrane anatomy, the principle of membrane anatomy related to right hemicolectomy, D3 resection, and identification of the inner boundary. In this paper, we analyzed recently reported literature with high-level evidence and clinical data from the author's hospital to recognize and review the membrane anatomy-based laparoscopic assisted right hemicolectomy for right colon cancer, emphasizing the importance of priority of surgical dissection planes, vascular orientation, and full understanding of the fascial space, and proposing that the surgical planes should be dissected in the parietal-prerenal fascial space, and the incision should be 1 cm from the descending and horizontal part of the duodenum. The surgery should be performed according to a standard procedure with strict quality control. To identify the resection range of D3 dissection, it is necessary to establish a clinical, imaging, and pathological evaluation model for multiple factors or to apply indocyanine green and nano-carbon lymphatic tracer intraoperatively to guide precise lymph node dissection. We expect more high-level evidence of evidence-based medicine to prove the inner boundary of laparoscopic assisted radical right colectomy and a more rigorous consensus to be established.

Effect of tramadol on perioperative immune function in patients undergoing gastric cancer surgeries

BACKGROUND

A prospective randomized controlled trial was designed to observe the effect of tramadol on T-lymphocyte subsets, activated T cell and natural killer (NK) cells of patients undergoing gastric cancer surgeries.

SUBJECTS AND METHODS

Thirty patients undergoing elective gastric cancer surgeries under general anesthesia were randomly divided into two groups. Before anesthesia induction, Group I did not receive any drugs and Group II received intramuscular tramadol 1 mg/kg. Peripheral venous blood samples were taken before anesthesia, 1 h after incision and postoperation. CD3(+), CD3(+) CD4(+), CD3(+) CD8(+), CD3(-)CD16(+) CD56(+) (NK) cells and CD3(+) human leukocyte antigen (HLA)-DR(+) (activated T cell) were measured by flow cytometer.

RESULTS

One hour after incision, CD3(+), CD3(+) CD4+, CD3(+) CD4(+)/CD3(+) CD8(+), CD3(-)CD16(+) CD56(+), and CD3(+) HLA-DR(+) cells in the experimental and control group were significantly decreased compared with their baselines (P < 0.05), while the values of Group I were lower than those of Group II (P < 0.05). After surgery, the values of Group I were lower than their baselines (P < 0.05). But the values of Group II had no significant difference compared with their baselines.

CONCLUSION

Tramadol can reduce the decrease of T-lymphocytes subsets and NK cells, thus improve the cellular immune function in the perioperation of gastric cancer.

Ag-decorated TiO₂ nanograss for 3D SERS-active substrate with visible light self-cleaning and reactivation

The production of SERS-active substrates which are uniform, sensitive, reproducibile and durable still remains an important issue. Here, we report a strategy for the fabrication of a large-area Ag-decorated TiO₂ nanograss SERS-active substrate by a simple solvothermal approach combined with Ag evaporation. The nanograss consists of dense rutile TiO₂ nanorods of about 5 nm in diameter and the decorated Ag nanoparticles are an average of 8 nm in diameter. The Ag protrusions and gaps between them contribute to three dimensional SERS "hot spots" which can be modulated by simply controlling the Ag evaporating parameters. The Ag-decorated TiO₂ substrate is highly efficient in detecting rhodamine 6G (R6G) and 4-aminothiophenol (4-ATP) molecules and has good homogeneity. An obvious red shift and even high enhancement of b₂ vibration mode were observed in detecting 4-ATP due to the effective charge transfer from the Ag atoms to sulfur atoms. The Ag-decorated TiO₂ substrate can be easily self-cleaned and reactivated by visible light irradiation without obvious degeneration of SERS signals. Our results demonstrate that the Ag-decorated TiO₂ substrate with high and homogeneous SERS activity has potential feasibility as a sensitive SERS probe.

Recyclable magnetic photocatalysts of Fe2+/TiO2 hierarchical architecture with effective removal of Cr(VI) under UV light from water

We report the synthesis and photocatalytic removal of Cr(VI) from water of hierarchical micro/nanostructured Fe(2+)/TiO(2) tubes. The TiO(2) tubes fabricated by a facile solvothermal approach show a three-level hierarchical architecture assembled from dense nanosheets nearly vertically standing on the surface of TiO(2) microtube. The nanosheets with a thickness of about 20 nm are composed of numerous TiO(2) nanocrystals with size in the range of 15-20 nm. Ferrous ions are doped into the hierarchical architecture by a reduction route. The Fe(2+)/TiO(2) catalyst demonstrates an effective removal of Cr(VI) from water under UV light and the removal effectiveness reaches 99.3% at the initial Cr(VI) concentration of 10 mg L(-1). The ferrous ion in the catalyst serves not as the photo-electron trap but as an intermedium of a two-step reduction. The TiO(2) photoreduces the Fe(2+) ions to Fe atoms firstly, then the Fe atoms reduce the Cr(VI) to Cr(III), and the later is removed by adsorption. The hierarchical architecture of the catalyst serves as a reactor for the photocatalytic reaction of Cr(VI) ions and an effective absorbent for the removal of Cr(III) ions. The catalyst can be easily magnetically separated from the wastewater after photocatalytic reaction and recycled after acid treatment.

Enhanced electroluminescence from SiN-based multilayer structure by laser crystallization of ultrathin amorphous Si-rich SiN layers

Luminescent SiN-based multilayers were prepared in a plasma enhanced chemical vapor deposition system followed by subsequently laser crystallization of ultrathin amorphous Si-rich SiN sublayers. The cross-sectional TEM analysis reveals that grain size of Si nanocrystals embedded in the Si-rich SiN sublayers is independent of the laser fluence, while the grain density can be well controlled by the laser fluence. The devices containing the laser crystallized multilayers show a low turn-on voltage of 5 V and exhibit strong green light emission under both optical and electrical excitations. Moreover, the device after laser-irradiated at 554 mJ/cm(2) shows a significantly enhanced EL intensity as well as external quantum efficiency compared with the device without laser irradiation. The EL mechanism is suggested from the bipolar recombination of electron-hole pairs at Si nanocrystals. The improved performance of the devices was discussed.

[Characteristics of traditional Chinese medicine syndromes in both spontaneous and variant angina. An analysis of 21 cases]

An analysis of TCM syndromes is reported in 21 cases with both spontaneous and variant angina as compared with 147 cases with effort angina. The results showed that 3 characteristic features were present, which were as follows: the Biao-Shi syndrome of cold condensation was more than that of the control group in ratio of 42.86% to 3.40%; the Ben-Xu syndrome of Yang deficiency was more and that of Qi deficiency less than those in the control group, and they were in ratio of 33.33% to 6.12% and 33.33% to 72.11% respectively. An absolute reduction of blood supply resulted from coronary spontaneous spasm in both spontaneous and variant angina causes severe chest pain during attacks as a cold condensation type. Hyperfunction of parasympathetic nerves often occurring in coronary heart disease with Yang deficiency is liable to vasoconstriction of the large coronary arteries leading to episodes of both spontaneous and variant angina. The presence of less Qi deficiency type may be related to the less impairment of cardiac function resulted from the short course in these cases and only relatively mild state of an illness, even no marked lesion in coronary arteries in a part of patients with both spontaneous and variant angina. No significant difference in TCM syndromes occurred between spontaneous and variant angina. Both Yang and Yin deficiency, as the Ben-Xu syndromes, were more present in angina of cold condensation type.(ABSTRACT TRUNCATED AT 250 WORDS)

Increased beta-cell secretory capacity as mechanism for islet adaptation to nicotinic acid-induced insulin resistance

To determine whether prolonged nicotinic acid (NA) administration produces insulin resistance and, if so, how the normal pancreatic islet adapts to prolonged insulin resistance, we administered incremental doses of NA to 11 normal men for 2 wk, ending at 2 g/day. Insulin sensitivity was measured with Bergman's minimal model. Islet function was evaluated by measurement of acute insulin (AIR) and glucagon (AGR) responses to arginine at three glucose levels. Insulin resistance was demonstrated and quantified by a marked drop in the insulin sensitivity index (Sl) from 6.72 +/- 0.77 to 2.47 +/- 0.36 x 10(-5) min-1/pM (P less than .0001) and resulted in a doubling of basal immunoreactive insulin levels (from 75 +/- 7 to 157 +/- 21 pM, P less than .001) with no change in fasting glucose (5.5 +/- 0.1 vs. 5.7 +/- 0.1 mM). Proinsulin levels also increased (from 9 +/- 1 to 15 +/- 2 pM, P less than .005), but the ratio of proinsulin to immunoreactive insulin did not change (12.7 +/- 1.9 vs. 10.3 +/- 1.9%). beta-Cell changes were characterized by increases in the AIR to glucose (from 548 +/- 157 to 829 +/- 157 pM, P less than .005) and in the AIR to arginine at the fasting glucose level (from 431 +/- 54 to 788 +/- 164 pM, P less than .05). At the maximal hyperglycemia level the AIR to arginine represents beta-cell secretory capacity, and this increased with administration of NA (from 2062 +/- 267 to 2630 +/- 363 pM, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)