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Objective To study the indications,feasibility and efficacy of rigid choledochoscopy via biliary fistula tracts to remove bile duct stones.Methods A retrospective analysis was performed on the clinical data of 86 patients with bile duct stones treated with rigid choledochoscopy via biliary fistula tracts at our hospital between November 2011 and July 2016.Patients with bile duct stones were divided into the percutaneous transhepatic cholangio drainage (PTCD) group and the T tube tract group.There were 40 patients who underwent lithotomy using rigid choledochoscopy via the PTCD tract and 46 patients who underwent choledocholithotomy using rigid choledochoscopy via the T-tube tract.A comparison was conducted to compare the duration of the procedures,the amount of perioperative bleeding,the postoperative complication rates and residual stone rates between the two groups.Results In the PTCD group,the average operation time was (77.0 ± 36.5) min,the amount of perioperative bleeding was (26.5 ± 54.1) ml,and the postoperative complication rate was 37.5 ％ (15/40).Complete lithotomy in one-stage was successful in 33 patients,and in two-stages in 1 patient.The residual stone rate was 15.0％ (6/40).In the T tube tract group,the average operation time was (82.5 ± 44.1) min,the amount of perioperative bleeding was (14.8 ± 21.0) ml,and the postoperative complication rate was 32.6％ (15/46).Complete lithotomy in one-stage was successful in 34 patients,and two-stages in 2 patients.The residual stone rate was 21.7％ (10/46).There were no significant differences in the residual stone rates,complication rates and operation time between the two groups (P ＞ 0.05).The amount of operative bleeding was significantly better in the T tube tract group than the PTCD group,(P ＜ 0.05).Conclusions There was no significant differences in the clinical efficacy in the treatment of bile duct stones using choledochoscopy either via the PTCD tract or the T tube tract group.Both approaches can be used for bile duct stones.
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Pancreatic cancer is one malignancy with high aggressive and extremely poor prognosis,its incidence and mortality rates are increasing gradually in our country.Although surgical techniques and adjuvant drug therapy are improving,survival of patients with pancreatic cancer still has not been significantly improved.Long non-coding RNA are a class of non-coding transcripts longer than 200 nucleotides.Recent studies show long non-coding RNA is closely related to pancreatic cancer cells,apoptosis,metastasis and drug resistance.LncRNA plays an important role in the diagnosis,treatment and prognosis of pancreatic cancer.In this article we reviewed the role of long noncoding RNA and their significance in pancreatic carcinoma.
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Objective To evaluate the clinical effect of Kangai injection combined with transcatheter arterial chemoembolization (TACE) in the treatment of hepatic cancer.Methods We searched CBM,CNKI,WanFang and VIP,clinical studies of Kangai injection combined with TACE in the treatment of hepatic cancer were included and compared.The methodological quality of included studies was assessed and Meta analysis was performed by Rev Man 5.2 software.Results 9 studies involving 595 patients were included.Meta analysis results indicated that the difference of effective rate was significant [RR =1.32,95 ％ CI(1.10,1.58),P =0.003] ; The quality of life improvement rate also had significant difference[RR =1.85,95％ CI(1.42,2.41),P ＜ 0.000 01].Conclusion Kangai injection combined with TACE in the treatment of hepatic cancer can get extra benefits compared with TACE alone.It can improve the curative effect,significantly improve the quality of life.
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Induced pluripotent stem cell (iPS cell) opened a new way to stem cell research,iPS cells can differentiate into hepatocytes in vitro gradually,this breakthrough makes the iPS cells have become a promising clinical application source.During the process of iPS cells to hepatocytes,a variety of cytokines regulate gene expression by coordinating various liver cell growth signal to promote iPS cells into hepatocytes differentiation and maturation.This article summarizes the relevant cytokines and their role in iPS cells in hepatocytes differentiation.
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Objective To prospectively study the clinical significance of the MELD scoring system in surgical treatment of obstructive jaundice.Methods 112 patients with obstructive jaundice who were admitted into our hospital from January 2009 to December 2013 were divided into two groups:group A (Stage Ⅰ PTCD and stage Ⅱ open operation,n =53) and group B (1 stage open surgery,n =59).The amount of intraoperative bleeding blood loss,operation time,postoperative complications,duration of hospitalization,mortality rate,and the changes in liver function after surgery were compared between the two groups.Results The differences in the liver function index of the two groups on the same postoperative date were significantly different (P ＜ 0.05).The liver function of group A recovered faster than group B.Patients in group A with a MELD ＜ 10 points stayed in hospital significantly longer when compared with patients in group B.For patients in group A with MELD ＞ 10 points,the operation time,bleeding volume,postoperative complications and hospitalization were significantly less than the patients in group B (P ＜ 0.05).There were 3 patients (group B) who died with MELD ≥ 20 points after operation.Conclusions In patients with obstructive jaundice with a MELD score greater than 10 points,especially those with a score equal to or greater than 20,PTCD should be performed first to relieve biliary tract obstruction,followed by a stage Ⅱ open surgical operation after the liver function had improved.MELD had important clinical significance in the evaluation of operation risk in patients with obstructive jaundice.