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Zou L.,Guangzhou University of Chinese Medicine | Xiong W.,Guangzhou University of Chinese Medicine | Mo D.,Hospital of Traditional Chinese Medicine of Zhongshan | Chen G.,Guangzhou University of Chinese Medicine | And 5 more authors.
Surgical Endoscopy and Other Interventional Techniques | Year: 2015

Background: Bursectomy is regarded as a standard surgical procedure during gastrectomy for serosa-positive gastric cancer in Japanese gastric cancer treatment guidelines (Japanese Gastric Cancer Association in Gastric Cancer 14:113–123, 2011). As a consequence, bursectomy is widely performed in open gastrectomy. However, laparoscopic gastrectomy with bursectomy is rare. Based on our previous experience of laparoscopic bursectomy in distal gastrectomy (Zou et al. in Oncol Lett 10:99–102, 2015), herein, we described the technique of totally laparoscopic radical total gastrectomy with complete bursectomy using an outside bursa omentalis approach. Methods: Firstly, the transverse mesocolon and distal gastric membrane were separated from right to left, and the right gastroepiploica vessels were ligated at root with No. 6 lymph nodes (LNs) dissection followed by the pancreas membrane dissection from pancreas head to pancreas tail. Secondly, the anterior plane of transverse mesocolon was dissected from left to right starting from the lower pole of spleen, and the membrane of pancreas tail was separated to combine the pancreas anterior plane with No. 4s, 10, 11d and 2 LNs dissection. Thirdly, the lesser omental was dissected from right to left with No. 5 and 12a LNs dissection, and the duodenum was transected. Then, the No. 7, 8, 9 and 11p LNs were dissected followed by No. 1 LNs dissection. Finally, a Roux-en-Y esophagojejunostomy was carried out intracorporeally with a linear cutter. Results: Thirty-two patients with advanced proximal gastric cancer underwent laparoscopic total gastrectomy with complete bursectomy using an approach outside bursa omentalis. One bowel obstruction and one pulmonary infection were recorded and cured with conservative measure. The mean operative time was 253.3 ± 31.3 min with a mean blood loss of 90.5 ± 23.1 ml. The mean length of stay was 10.6 ± 2.6 days. Conclusion: Laparoscopic radical total gastrectomy with complete bursectomy using an outside bursa omentalis approach is feasible and safe in experienced hands with favorable short outcome. Further studies were needed for its advanced application. © 2015 Springer Science+Business Media New York Source


Guo D.,Guangzhou University of Chinese Medicine | Cao X.-W.,Guangzhou University of Chinese Medicine | Liu J.-W.,Guangzhou University of Chinese Medicine | Niu W.,Guangzhou University of Chinese Medicine | And 6 more authors.
Trials | Year: 2015

Knee osteoarthritis is a major cause of disability in the aging population. Based on pathological, magnetic resonance imaging (MRI) and arthroscopy studies, progressive osteoarthritis involves all tissues of the joint and includes bone marrow lesions, synovial proliferation, fat pad inflammation, and high subchondral bone turnover. Recent research suggests that abnormal perfusion in bone marrow lesions, fat pads, and subchondral bone is associated with pain in knee osteoarthritis, and that dynamic contrast-enhanced MRI is a promising method for studying micro-perfusion alteration in knee osteoarthritis. Traditional Chinese Medicine approaches have been employed for thousands of years to relieve knee osteoarthritis pain. Among herbal medicines, the Jingui external lotion is the preferred and most commonly used method in China to reduce pain in patients with knee osteoarthritis; however, there is a lack of validated evidence for its effectiveness. The purpose of this study is to explore the effectiveness of Jingui external lotion for the management of painful knee osteoarthritis in a short-term study. In addition, we will assess micro-perfusion alteration in the patellar fat pad as well as the femur and tibia subchondral bone via dynamic contrast-enhanced MRI. Methods/design: This trial is a randomized, controlled study. A total of 168 patients will be randomized into the following two groups: 1) the Jingui external lotion group (treatment group); and 2) the placebo lotion group (control group). In both groups, lotion fumigation and external washing of the patients' knees will be administered twice a day for 14 consecutive days. Follow-up will be at regular intervals during a 4-week period with a visual analog scale to assess pain, and additional characterization with the Western Ontario and McMaster Universities Index score; rescue medication will be recorded as the extent and time pattern. In addition, micro-perfusion alteration in the patellar fat pad, femur and tibia subchondral bone will be assessed via dynamic contrast-enhanced MRI. Discussion: This study will provide clinical evidence of the efficacy of Jingui external lotion in treating knee osteoarthritis, and it will be the first randomized controlled trial to investigate micro-perfusion alteration of knee osteoarthritis with Traditional Chinese Medicine external lotion via dynamic contrast-enhanced MRI. Trial registration: ClinicalTrials.gov identifier: ChiCTR-TRC-14004727;31 May 2014. © Guo et al.; licensee BioMed Central. Source


Zou L.,Guangzhou University of Chinese Medicine | Xiong W.,Guangzhou University of Chinese Medicine | Mo D.,Hospital of Traditional Chinese Medicine of Zhongshan | He Y.,Guangzhou University of Chinese Medicine | And 4 more authors.
Annals of Surgical Oncology | Year: 2016

Background: Due to the emphasis of oncologic principle, a medial-to-lateral approach for laparoscopic right hemicolectomy was recommended.1,2 This approach, however, is technically challenging and involves several limitations with overweight patients, whose mesocolon may be too thick for identification of the vessel landmarks. Moreover, it is difficult for inexperienced surgeons to enter the retroperitoneum space accurately. This report describes a caudal-to-cranial approach for laparoscopic radical extended right hemicolectomy. Methods: First, a “yellow-white borderline” between the right mesostenium and retroperitoneum in the right iliac fossa is dissected as the entry for separation of the fusion fascial space between the visceral and parietal peritoneum.3 The right Toldt’s fascia is dissected and expanded medial to the periphery of the superior mesenteric vein (SMV), cranial to the pancreas head, and lateral to the ascending colon. The posterior paries of ileocolic vessels (ICVs), right colic vessels (RCVs), and Henle’s trunk are exposed. Second, the mesocolon between the ICV and SMV is dissected safely, and the ICV, RCV, and right gastroepiploic vessels as well as the right branch of the middle colic vessel are divided and ligated easily because of the separated retroperitoneal space. The lymph nodes along the SMV are dissected using a caudal-to-cranial approach. Third, the greater omental is dissected for full mobilization of the mesocolon containing 10 cm of normal colon distal to the lesion followed by complete mobilization of the lateral attachments of the ascending colon. Results: In this study, 10 men and 8 women with hepatic flexure cancer underwent laparoscopic extended right hemicolectomy using a caudal-to-cranial approach. No conversion was recorded. The overall complication rate was 11.2 %, including one case of pulmonary infection and one case of urinary tract infection, both of which were cured with conservative measures. The mean age of the patients was 61.3 ± 12.7 years, and the mean body mass index was 22.1 ± 4.5 kg/m2. The mean operative time was 187.5 ± 47.7 min, and the mean blood loss was 100.4 ± 45.2 ml. The mean first time of flatus was 57.7 ± 26.3 h, and the time of fluid intake was 62.9 ± 29.2 h. The hospital stay was 8.5 ± 4.2 days. The mean number of lymph nodes retrieved was 37.3 ± 12.8. Conclusions: The initial results suggest that the reported approach may be a safe alternative to the conventional medial-to-lateral approach, especially for inexperienced surgeons. The main advantages of the current approach are easy access to the retroperitoneal space by protection of the ureter, safe dissection of lymph nodes along the SMV, and a potentially shortened learning curve. © 2016, Society of Surgical Oncology. Source


Lin X.,Hospital of Traditional Chinese Medicine of Zhongshan | Li J.,Guangdong Province Hospital of Integrated Traditional Chinese and Western Medicine | Pan J.,Guangzhou University of Chinese Medicine | Liu J.,Guangzhou University of Chinese Medicine | Guo D.,Guangzhou University of Chinese Medicine
Proceedings - 2012 IEEE International Conference on Bioinformatics and Biomedicine Workshops, BIBMW 2012 | Year: 2012

To evaluate the effects of abdominal acupuncture on malignant bone cancer patients' quality of life (QOL) during chemotherapy with Shenque qi distribution therapy, a randomized cross controlled trial was adopted. A total sample of 26 cases were randomly assigned to Group A and Group B for the treatment, as well as evaluated QOL(by EORTC QLQ-C30 V3.0 and Karnofsky scoring) before and after the chemotherapy; Chemotherapy was divided into two periods(the first chemotherapy period and the second one). Patients in group A accepted the scheme of therapeutic measures during the first chemotherapy and then received the plan of controlled measures during the second chemotherapy; and vice versa, patients in Group B accepted the plan of controlled measures during the first chemotherapy and then received the scheme of therapeutic measures during the second chemotherapy. The therapeutic measures were using abdominal acupuncture during routine chemotherapy, while controlled measures were receiving routine chemotherapy. Data from therapeutic measures and controlled measures were analyzed as the treatment group and control group respectively. During chemotherapy patients were affected in 5 dimensions of QOL which were the role, emotional, nausea, insomnia, loss of appetite. Abdominal acupuncture can help to improve 4 dimensions of QOL which are the emotional, fatigue, nausea, insomnia, and appetite, and have better results in Karnofsky scoring than the control group after chemotherapy. We assume under the guidance of Shenque qi distribution therapy, abdominal acupuncture therapy could help to promote healthy qi, smooth activity of qi, and keep patients under good condition and improve their QOL after chemotherapy. © 2012 IEEE. Source


Wu Z.Y.,Surgery Academy | Wang S.M.,Surgery Academy | Chen Z.H.,Hospital of Traditional Chinese Medicine of Zhongshan | Huv S.X.,Surgery Academy | And 7 more authors.
Cancer Biomarkers | Year: 2015

Background: Analysis using publicly available algorithms has found that high mobility group AT-hook 2 (HMGA2), a key transcriptional regulatory factor, is a potential target of microRNA-204 (miR-204). Some studies have shown that both miR-204 and HMGA2 are associated with cancer development. Objective: We examined the possible relationship between miR-204 and HMGA2 in the development of thyroid cancer. Methods: We assessed miR-204 expression in thyroid cancer specimens and cell lines using real-time polymerase chain reaction (PCR). Luciferase reporter assay was used to confirm the target associations. The effect of miR-204 on cell proliferation was confirmed with tetrazolium and colony formation assays. Gene and protein expression were examined using real-time PCR and western blotting, respectively. Results: MiR-204 was downregulated in the thyroid cancer specimens and cell lines, and targeted the 3′ untranslated region of HMGA2 directly. MiR-204 overexpression decreased cyclin D1 and Ki67 expression and increased P21 expression, which subsequently inhibited thyroid cancer cell proliferation. Conclusions: Our findings suggest that miR-204 plays a protective role by inhibiting thyroid cancer cell proliferation, and may identify new targets for anti-cancer treatment. © 2015 - IOS Press and the authors. Source

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