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Objective:To explore the reasons of the proximal migration of pancreatic stents and the endoscopic management.Methods:From April 2007 to January 2015, of all 967 patients with biliopancreatic diseases implanted with pancreatic duct plastic stents at the First Affiliated Hospital of Nanchang University, proximal migration occurred in 10 cases. Migrated rates and endoscopic retrieval methods of pancreatic straight stents and single pigtail stents were compared.Results:Pancreatic straight stents showed a higher migration rate than those single pigtail ones [3.23% (7/217) VS 0.40% (3/750)]. For 3 migrated single pigtail pancreatic stents: 2 were directly removed with biopsy forceps. Another failed in retrieval, and the same stent then was implanted. There was no discomfort after the operation. For 7 migrated pancreatic straight stents: 2 were pulled out of duodenum papilla incision under wire-guided balloon and basket. Five others were pulled out of papilla under wire-guided balloon, and then the stents were removed by a snare.Conclusion:Pancreatic straight stents are more likely to migrate compared with single pigtail stents. Migrated pancreatic straight stents can be removed with wire-guided balloon or basket and snare, while migrated single pigtail stents can be directly retrieved with biopsy forceps.
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Objective To evaluate the safety of anesthesia endoscopic retrograde cholangio pancreatography (ERCP) under general anesthesia.Methods From January 1st,2008 to June 30th,2016,patients underwent ERCP under general anesthesia were enrolled as anesthesia group and from January 1st,2005 to December 31st,2007,patients accepted ERCP without anesthesia were enrolled as control group.Chi-square test was performed to analyze disease composition,conditions during operation,success rate of operation and complications in these two groups.Results A total of 14 724 patients with ERCP under general anesthesia and 2 102 patients received ERCP without anesthesia were enrolled.In 14 724 patients with ERCP under general anesthesia,1 799 cases had malignant biliary and pancreatic diseases and 12 925 cases with biliary and pancreatic diseases.During the operation,transient hypoxemia occurred in 441 cases (3.00％) and relieved by increasing oxygen flow,lower anesthetic dose or lifting lower jaw.The success rate of ERCP in the anesthesia group (98.41 ％,14 490/14 724) was higher than that in the control group (97.34％,2 046/2 102),and the difference was statistically significant (x2 =11.500,P=0.001).The incidence rate of post-ERCP pancreatitis in the anesthesia group was 2.35％ (346/14 724),which was lower than that in the control group (3.85％,81/2 102),and the difference was statistically significant (x2 =16.813,P＜0.01).Conclusion ERCP under general anesthesia is safe,which could increase the success rate of operation and reduce the incidence rate of post-ERCP pancreatitis.
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Objective To explore the normal values for two-dimension solid state high resolution anorectal manometry (HRAM) in healthy adult volunteers.Methods The healthy adult volunteers were recruited by advertisement and underwent solid state HRAM in the left lateral position.Anorectal pressures and rectal sensation were recorded and analyzed.Results (1) A total of 126 Chinese healthy adult volunteers (male:50 cases (39.7％);age:(37.5 ± 14.2) years old) were recruited in this study.(2)Mean anal resting pressure (MERP) was (71.8 ± 17.3) mmHg (1 mmHg =0.133 kPa).Maximum anal resting pressure (MARP) was (79.3 ± 17.8) mmHg,Maximum anal squeeze pressure (MSP) was (178.7 ± 52.8) mmHg.Anal high pressure zone (HPZ) length was (3.4 ± 0.6) cm.During simulated evacuation,residual anal pressure (RAP) was (63.8 ±20.5) mmHg,and anal relaxation rate (ARR) was (37.0 ± 11.5) ％.Rectal threshold volume for first sensation (FST),desire to defecate (DDT),urgency to defecate (UDT) and maximum discomfort (MDT) was (47.4 ±10.0) ml,(84.5 ±18.2) ml,(125.8 ± 28.5) ml,and (175.5 ±36.1) ml,respectively.(3) Compared with female subjects,male subjects had higher MSP [(211.0 ± 50.7) mmHg vs (157.5 ± 42.5) mmHg],RAP [(71.6 ± 18.1) mmHg vs (58.8 ± 20.5) mmHg]and rectal MDT[(187.0 ±36.4) mmHg vs (168.0 ±34.1)mmHg],but lower ARR [(32.1 ±8.0)％ vs (40.2 ±12.3)％],all P＜0.01.(4) MERP,MARP,MSP and rectal MDT were higher in young group (≤ 40 years old),all P ＜ 0.05.Conclusions These observations provide normal values for two-dimension solid state HRAM,which have significant difference between genders and different age groups.
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Objective To evaluate the safety of endoscopic retrograde cholangiopancreatography (ERCP) for elder patients (age more than or equal to 80 years).Methods Data of 464 patients (age ≥ 80 years) who underwent ERCP procedures from June 2008 to June 2014 in the First Affiliated Hospital of Nanchang University were compared with those of patients less than or equal to 60 years old,randomly chosen at 1∶4,for comorbidity,feature of disease distribution,intraoperative situation and postoperative complications of ERCP.Results The comorbidity rates of coronary heart disease,hypertension,chronic pulmonary disease and type 2 diabetes in observation group were significantly higher than those in the control group(P＜0.05),but there was no significant difference between two groups regarding to the comorbidity rate of arrhythmia(P =0.111).The main feature of disease distribution in two groups was choledocholithiasis,but the rate of malignant tumor in observation group was higher than that in the control group(P＜0.05).The success rate of ERCP showed no significant difference in two groups (98.92％ VS 99.35％,P=0.358).There was no significant difference between the two groups in the complication rates of acute pancreatitis (4.96％ VS 3.18％,P =0.064),infection (0.43％ VS 0.54％,P =1.000) and hemorrhage (1.08％ VS 0.59％,P=0.259).However the rate of perforation in observation group was lower than that in the control group (0.43％ VS 0.05％,P =0.043).Conclusion ERCP is safe and effective for elder patients.
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OBJECTIVE:To establish a method for the content determination of eudesmin in Zanthoxylum simulans. METH-ODS:HPLC was performed on the column of Kromasil C18 with mobile phase of acetonitrile-water(56:44,V/V)at flow rate of 1.0 ml/L,detection wavelength was 221 nm,column temperature was 25 ℃. RESULTS:The linear of eudesmin was 0.208-2.08 μg (r=0.999 8);RSDs of precision,reproducibility and stability tests were lower than 2.0%;recovery was 96.18%-103.04%(RSD=2.58,n=6). CONCLUSIONS:The method is simple and good reproducibility,and can be used for the content determination of eu-desmin in Z. simulans.
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Objective To study the safety and efficacy of endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilation (EPBD) in the treatment for extrahepatic bile duct stones.Methods A total of 164 patients underwent endoscopic treatment for extrahepatic bile duct stones.Seventy eight underwent EST and EPBD (the EST + EPBD group),86 others underwent EST only (the EST group).The complication rate,complete stone clearance rate and gravel incidence rate were compared between the two groups.Results Hyperamylasemia occurred in 3 cases,mild acute pancreatitis in 2 cases of the EST and EPBD group,while hyperamylasemia occurred in 5 cases,mild acute pancreatitis in 3 and hemorrhage in 2 of the EST group.There were no severe complications like severe acute pancreatitis or intestinal perforation.The complication rate of the EST + EPBD group ( 6.4％,5/78 ) was slightly lower than that of the EST group ( 11.6％,10/86),(x2 =1.340,P =0.288),so was gravel incidence (33.3％ vs.60.5％,x2 =12.073,P =0.001 ).While complete stone clearance rate of this group was obviously higher than that of the EST group (100.0％ vs.93.0％ ),(x2 =5.649,P=0.030).Conclusion EST combined with EPBD is safe and effective for extrahepatic bile duct stone removal,especially for large stones or poor duodenal papilla.
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<p><b>OBJECTIVE</b>To study the effect of classic ancient prescription Kaixin San (KXS) on learning and memory abilities in chronic stress depression model rats and its possible mechanisms.</p><p><b>METHOD</b>Rats were randomly assigned to six groups: the control group, the model group, the positive drug group (fluoxetine 10 mg x kg(-1)) and KXS groups (1000, 500, 250, 125 mg x kg(-1)). KXS were orally administrated to CMS rats for 21 days. The anti-depression activity of KXS was assessed using the sucrose consumption and the open-field test. The protecting effect for learning and memory abilities was assessed using the Morris water maze (MWM) test. Furthermore, the levels of monoamine neurotransmitters, acetylcholine (Ach) and acetyl cholinesterase (AchE) in the total brain and brain-derived neurotrophic factor (BDNF) protein in the hippocampus were determined.</p><p><b>RESULT</b>The behavior test showed that KXS significantly increased the sucrose consumption and total distance in the open-field test and notably reduce the incubation period of location and navigation in the MWM test. It could also help increase the number of times passing through the platform, the swimming distance and time in quadrant of original platform, the levels of serotonin (5-HT) and dopamine (DA) , noradrenergic (NE), Ach, BDNF protein and reduce the level of AchE in the CMS-induced rats.</p><p><b>CONCLUSION</b>KXS can ameliorate the CMS-induced depression behavior in rats and improved their learning and memory abilities, which may be related to the increase in monoamine neurotransmitters, Ach and BDNF levels.</p>
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Animals , Humans , Male , Rats , Chronic Disease , Psychology , Therapeutics , Depression , Drug Therapy , Psychology , Disease Models, Animal , Drugs, Chinese Herbal , Learning , Maze Learning , Memory , Rats, Sprague-DawleyABSTRACT
Objective To study the effect of non steroidal anti inflammatory drug(NSAID) on apoptosis of hepatocellular carcinoma (HCC)cell lines(SMMC7721) and explore its anti tumor mechanism. Methods HCC line SMMC7721 was treated with different concentration of indomethacin(IN). Apoptosis was identified by terminal deoxynucleotidyl transferase mediated dUTP biotin nick end labeling(TUNEL)method. The expression of cyclooxygenase (COX) 2,p53,p27 kipl , C myc protein and Fas antigen was identified by immunocytochemical SP staining method. Results ①The apoptosis index was (2.4?1.4)%,(4.2? 1.5)% ,(8.0?3.2)%,(14.3?5.1)%,(14.9?4.3)% and (19.0?6.1)%( P0.05 ). Conclusion IN could induce apoptosis of HCC cell line in vitro by down regulating the expression of COX 2 and up regulating the expression of p27 kipl , p53 and c myc.