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Objective:To compare the therapeutic effect of one-stage versus two-stage percutaneous transhepatic biliary fistulation lithotripsy in treatment of complex hepatolithiasis.Methods:A retrospective study was conducted on 145 patients with complex hepatolithiasis who were treated at the First Affiliated Hospital of Guangzhou Medical University between September 2013 and June 2018. There were 60 males and 85 females, aged 21 to 91 (56.5±14.1) years. According to the method of fistula establishment, patients were divided into the percutaneous transhepatic one-step biliary fistulation (PTOBF) group ( n=94) or the two-stage percutaneous transhepatic choledochoscopic lithotripsy (PTCSL) group ( n=51). The success rates of one-time puncture and fistula dilation, operation time of lithotripsy, operative conversion rate (PTCSL was converted to laparotomy and laparoscopic surgery), postoperative complications (including catheter dislodgement), residual stone rates and stone recurrence rates were compared between groups. Results:In the PTOBF group, operation time (105.8±43.6) min, success rate of one puncture 73.4% (69/94), and success rate of one fistula dilation 93.6% (88/94), the rate of operative conversion 0. All these results were significantly better than the corresponding results of the two-stage PTCSL group of (130.0±70.0) min, 54.9% (28/51), 68.6% (35/51), and 13.7%(7/51) respectively (all P<0.05). There were no significant differences in stone residual rate [17.0%(16/94) vs. 15.7% (8/51)] and stone recurrence rate [14.9%(14/94) vs. 17.6% (9/51)] between groups (both P>0.05). The postoperative complications rate was 7.4%(7/94) in PTOBF group, which was 39.2% (20/51) in two-stage PTCSL group (χ 2=22.02, P<0.001). The catheter dislodgement rate of PTOBF group was 2.1% (2/94), lower than that of two-stage PTCSL group 27.4% (14/51), the difference was statistically significant (χ 2=21.59, P<0.001). Conclusion:One-stage PTOBF and two-stage PTCSL were both safe and effective in treatment of complex hepatolithiasis. However, PTOBF had shorter operative times, lower catheter dislodgement and operative conversion rates than PTCSL.
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Objective To discuss the proliferation inhibition, apoptosis-inducing effects and the mechanism of dihydromyricetin on human liver cancer HepG2. Methods The effects of dihydromyricetin on cell death rate and proliferation in light of MTT test were examined and IC50 was calculated. The effects of dihydromyricetin on liver cancer HepG2 in different cell cycles were observed and analyzed in light of HE fluorescent staining method and Annexin V-PI flow cytometry (FCM). The protein expressions of p34cdc-2、CyclinB1、Bcl-2 and PARP which were related to the cell cycle and apoptosis before and after the use of dihydromyricetin were determined in light of Western blotting. Results The death rate of liver cancer HepG2 were increased with the increasing of dihydromyricetin concentration. The IC50 read (35.22 ± 1.56)μmol/L and displayed dose-response relationship. Dihydromyricetin had significant impacts on liver cancer HepG2 in different cell cycles, the proportion of G2/M cells rose dramatically and that of S cells lowered sharply and that of G0/G1 cell decreased exponentially.The difference was of statistical significance compared with the control group (P < 0.05). Conclusion Dihydromyricetin has distinct medical effects on inhibiting the growth and inducing the apoptosis of liver cancer HepG2. The mechanism is to activate Caspase-3,thus engaged in apoptosis in light of signal transduction of the mitochondrion.
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ObjectiveTo evaluate selectave blocking of hepatic artery tor hepatectomy in onder to reduce blood loss. MethodsPatients with liver cancer in right hepatic lobe were randomly divided into study group (n =25 ) and control group (n =31).Conventional posterior approach for liver tumor resection was applied.In study group,right hepatic artery was first freed and inflow was temporarily blocked before the right liver lobe was freed from its peripheral attachment.Then hepatectomy was performed under Pringle's manouver. Result in term of blood loss was compared with that in control group in which hepatectomy was performed under Pringle's. ResultsThere were no significant differences between two groups in age,sex,tumor size,liver cirrhosis,HBsAg,AFP and tumor emboli in portal vein.Blood loss in study group was significantty less (272 ± 113 ) ml than that in control group (547 ± 221) ml,the difference was statistically significant(t =-5.6,P ＜ 0.01).The length of hospital stay was significantly shorter than that in control group ( t =- 2.12,P ＜ 0.05 ). ConclusionsInitial hepatic artery blochade before liver freeing during the process of hepatectomy significantly reduced intraoperative in blood loss liver cancer patients.
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Objective To study the feasibility and effect of scarless endoscopic thyroidectomy(SET) and minimally invasive video-assisted surgery of the thyroid(MIVA) endoscopic technique. Methods SET: Incisions were made on the anterior part of the breast and mareolata,blunt dissection of the subcataneous planes of the neck and chest were administered .MIVA: Incisions were made 3cm above the thymus notch and the operation was video assisted in the thyroid adenoma extripation and subtotal thyroidectomy. The thyroid nodules were extirpated or subtotal thyroidectomy was performed. Results All 10 cases of the SET and 12 cases of the MIVA were successful performed and without complications. Conclusions For thyroid surgery,SET is a good cosmetic operation,MIVA is a minimal trauma and effective operation.