Effects of herbal medicine Sijunzi decoction on rabbits after relieving intestinal obstruction

Construction of PVA/OHA-Gs@PTMC/PHA double-layer nanofiber flexible scaffold with antibacterial function for tension free rectal in-situ reconstruction

The effective prevention and treatment of anastomotic leakage after intestinal anastomosis for colorectal diseases is still a major clinical challenge. In order to assist intestinal anastomosis healing and avoid anastomotic leakage caused by high tension, low blood supply or infection, we designed a double-layer nanofiber intestinal anastomosis scaffold, which was composed of electrospun PTMC/PHA nanofibers as the main layer, and electrospun PVA/OHA-Gs nanofibers with antibacterial properties as the antibacterial surface layer. This double-layer scaffold has good toughness, its maximum tensile force value could reach 8 N, elongation could reach 400 %, and it has hydrophilic properties, and its contact angle was about 60°. On the basis of reducing anastomotic tension and isolating intestinal contents, this double-layer nanofiber anastomotic scaffold not only played an antibacterial effect in the short term after surgery to reduce inflammatory response, but also had the characteristics of multiple three-dimensional network structure like extracellular matrix which could promote tissue healing. The PVA/OHA-Gs@PTMC/PHA scaffold was implanted into a rabbit model simulating mechanical intestinal obstruction, and the results showed that the nanofibers of the scaffold could be degraded in vivo while maintaining a certain stability, that is, the overall structure of the PVA/OHA-Gs@PTMC/PHA scaffold would not shrink and deform due to degradation in a certain period of time. Therefore, the treatment with this scaffold showed better healing at the anastomotic site. Compared to the direct anastomosis group and pure PTMC scaffold group, the double-layer scaffold group promoted a faster return to normal anastomotic strength within 7 days. This PVA/OHA-Gs@PTMC/PHA double-layer nanofiber flexible scaffold appears to be a promising therapeutic strategy to prevent anastomotic leakage after intestinal anastomosis.

Meta-Analysis of Efficacy of Sijunzi Decoction Combined with Enteral Nutrition for the Treatment of Gastric Cancer

Objective: Whether to conduct Sijunzi decoction combined with enteral nutrition (SJZD/EN) in patients with gastric cancer (GC) remains controversial. This study was aimed to systematically analyze the efficacy and safety of SJZD/EN in patients with gastric cancer.Methods: We performed searches in PubMed, MEDLINE, EMBASE, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Wanfang database, and Chinese Biomedicine Literature Database (SinoMed) to identify relevant literature comparing SJZD/EN with conventional EN for GC patients. The analysis was carried out with RevMan 5.3.Results: A total of 10 randomized controlled trials (688 patients) were included. Meta-analysis showed a significantly shorter time to flatus (t/h) (MD, -9.45; 95% CI, -10.76 to -8.13; p < 0.00001), a shorter length of hospital stay (t/d) (MD, -5.22; 95% CI, -7.46 to -2.99; p < 0.00001), and a lower incidence of postoperative complications (%) (OR, 0.14; 95% CI, 0.03-0.64; p = 0.01) in the SJZD/EN group than the EN group. Compared with the EN, the SJZD/EN group had a higher level of albumin(g/L) (MD, 2.59; 95% CI, 1.90-3.28; p <  0.00001), prealbumin (mg/L) (MD, 36.81; 95% CI, 13.41-60.20; p = 0.002), transferrin (g/L) (MD, 0.19; 95% CI, 0.10-0.28; p < 0.0001), immunoglobulin G (g/L) (MD, 2.61; 95% CI, 2.12-3.09; p < 0.00001), immunoglobulin A (g/L) (MD, 0.38; 95% CI, 0.31-0.45, p < 0.00001), immunoglobulin M (g/L) (MD, 0.31; 95% CI, 0.22-0.41; p < 0.00001), CD3⁺ (%) (MD, 6.73; 95% CI, 3.48-9.98; p < 0.0001), CD4⁺ (%) (MD, 4.32; 95% CI, 3.30-5.33; p < 0.00001), and CD4⁺/CD8⁺ (MD, 0.20; 95% CI, 0.11-0.28; p < 0.00001).Conclusions: Sijunzi decoction combined with enteral nutrition appears to have efficacy and safety for gastric cancer.

Effect of Yikou-Sizi powder hot compress on gastrointestinal functional recovery in patients after abdominal surgery: Study protocol for a randomized controlled trial

BACKGROUND

Postoperative gastrointestinal dysfunction (PGD) is a common complication of patients who have undergone surgery. The clinical manifestations cause great discomfort to postoperative patients and can severely affect postoperative recovery. However, although various pharmacologic agents have been explored for several years, success has been limited. Because some commonly used drugs have caused adverse reactions and because abdominal surgery patients generally cannot consume food or medication during the perioperative period, we were prompted to try an external Chinese medicine treatment method. Yikou-Sizi powder hot compress is an efficient therapy in our hospital, but there is a lack of rigorous studies to certify the safety and effectiveness of its external use to improve gastrointestinal motility. This study aimed to introduce the clinical trial design and test the ability of Yikou-Sizi powder hot compress treatment to accelerate gastrointestinal functional recovery after abdominal surgery.

METHODS

This study is a randomized controlled clinical trial. The participants will undergo laparoscopic colorectal cancer surgery and laparoscopic total hysterectomy. The primary outcome measure will be the gastrointestinal functional evaluation index, including the time to first passage of flatus, first defecation, first normal bowel sounds, and first consumption of liquid/semigeneral diet foods. According to good clinical practice (GCP), we will evaluate the clinical efficacy and safety of Yikou-Sizi powder hot compress and objectively study the acting mechanism of ghrelin. This pilot trial will be a standard, scientific, and clinical study designed to evaluate the effect of Yikou-Sizi powder hot compress for the recovery of gastrointestinal function after surgery and determine its overall safety.

DISCUSSION

This is the first study to describe the use of Yikou-Sizi powder hot compress to accelerate the recovery of gastrointestinal function after abdominal surgery. The study is designed as a randomized, controlled, clinical, large sample size and pilot trial. Evaluation will consist of combining the primary outcome measures with secondary outcome measures to ensure the objectivity and scientific validity of the study. Due to the observational design and the limited follow-up period, it is not possible to evaluate to what extent the connection between the observed improvement and the interventions represents a causal relationship. Efficient comparison between groups will be analyzed by chi-square test.