ABSTRACT
Objective To explore the clinical effect of tumescent anaesthesia in laparoscopic cholecystectomy(LC). Methods We analyzed the data of 71 patients who underwent LC for gallbladder benign disease. Anesthesia swelling fluid was injected in 37 cases before the operation in the gallbladder triangle( group D)and another 34 cases received no injection(group C). SBP,DBP,HR and Spo2 were monitored at 4 min before gallbladder traction(T1),1 min(T2),6 min(T3)and 11 min after gallbladder traction(T4),and when the gallbladder was dissected from gallbladder bed completely(T5). The operation time,intraoperative blood loss,postoperative exhaust time,time of getting out of bed after the surgery and length of stay were recorded. The gallbladder rupture, vascular injury ,bile duct injury ,intestinal injury ,placement of drainage tube ,intra-abdominal hemorrhage , intraoperative use of atropine or ephedrine and nausea and vomiting 24 hours after the operation were recorded. Results In group C,SBP,DBP and HR were significantly decreased at T2-T4 when compared with those at T1, and were significantly lower when compared with those in group D(P < 0.05). There was no significant difference in oxygen saturation between the two groups(P > 0.05). There were shorter operation time and less intraoperative blood loss in group D when compared with those in group C and the difference was statistically significant (P <0.05). The anus exhaust time,time of getting out of bed after the surgery,length of stay,intraoperative intra-abdominal hemorrhage and nausea and vomiting in the two groups indicated no statistical significance (P > 0.05). Gallbladder damage,vascular injury,placement of drainage tube and the incidence of adverse event were less in group D than those in group C. Conclusion Swelling anesthesia in LC can shorten the operation time ,induce less postoperative complications and maintain blood circulation stability.
ABSTRACT
Objective:To construct I-Ad/IgG2b Fc baculovirus expression vector and express I-Ad/IgG2b Fc dimer fusion protein in Sf9 insect cells.Methods:I-Ad α,I-Ad β and IgG2b Fc gene sequences were amplified from BALB/c mouse lymphocytes by RT-PCR.I-Ad α and I-Ad β were connected with the leucine zipper sequence Fos and Jun respectively by overlapping PCR to form I-Ad α-Fos and I-Ad β-Jun.I-Ad α-Fos and IgG2b Fc fragments were ligated by restriction sites Xba I to form I-Ad α-Fos-IgG2b Fc recombination sequence.I-Ad α-Fos-IgG2b Fc and I-Ad β-Jun fragments were inserted to PPH and PP10,which were the downstream of the promoters in the plasmid pFastBacTMDual,to form pFastBacTMDual+[I-Ad/IgG2b Fc] recombinant plasmids.The constructed vector was identified by PCR,restriction endonuclease and sequencing.The recombinant plasmids pFastBacTMDual+[I-Ad/IgG2b Fc] was transferred into the DH10Bac competent cell to form recombinant baculovirus Bacmid+[I-Ad/IgG2b Fc].The recombinant baculovirus was transfected into Sf9 insect cells by liposome transfection reagent.After infected with Sf9 insect cells,the supernatant was collected and concentrated by PEG20000 to obtain I-Ad/IgG2b Fc dimer fusion protein.The fusion protein was detected by double-antibody sandwich ELISA and Western blot.Results:PCR,restriction enzyme digestion and sequencing confirmed that the recombinant vector pFastBacTMDual+[I-Ad/IgG2b Fc] had the correct sequence.The double antibody sandwich ELISA and Western blot showed that recombinant bacmid could successfully infect Sf9 insect cells,and the expressed fusion protein had the correct conformation.Conclusion:The pFastBacTMDual+[I-Ad/IgG2b Fc] baculovirus expression vector was successfully constructed and expressed in Sf9 insect cells,laying a foundation for the study of I-Ad-restricted T cells.
ABSTRACT
Objective To discuss the indication , feasibility and curative effect of endovascular treatment for vascular injuries. Methods 7 patients with vascular injuries were treated by endovascular treatment, including 1 cases of pseudoaneurysm ,2 arteriovenous fistula , 3 closed arteriorrhexis and 1 arterial stenosis after vascular operation . All of the patients were treated by twelve stent - grafts and one introcoil stent. Results All cases were technically successful during follow - up for about 3 to 30 months. The blood flow was rebuild and the diseased region was removed effectively after stent operations. There was no extremity ischemia , hemorrhage , engorgement , stent shift ,fragmentation, angiostegnosis and reinjury appeared in these cases during follow - up. Conclusion Endovascular intervention is a new therapeutic approach with advantages of safety , efectiveness and minimal invasiveness. Its long - term eficacy needs to be further evaluated.