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Objective: To investigate the safety and effect of laparoscopy for the treatment of biliary stricture after the biliary dilatation operation. Methods: The clinical data of 78 patients,including 27 males and 51 females aged (48.6±14.2)years(range:17 to 76 years),who presented biliary stricture after biliary dilatation operation from January 2017 to June 2021 in the Department of Minimally Invasive Hepatobiliary Surgery,Hunan Provincial People's Hospital,were retrospectively collected,with 38 cases in the laparoscopy group and 40 cases in the laparotomy group. Of the 78 patients,there were 67 cases of cholangiojejunostomy stricture and 11 cases of stricture of the high intrahepatic bile duct. Statistical methods such as t-test and χ2 test were carried out to compare perioperative clinical data and follow-up information between the two groups. Results: Less intraoperative blood loss((102.6±76.4)ml vs. (162.5±105.9) ml, t=-2.874,P=0.005),shorter postoperative stay length of stay((10.5±3.7)days vs. (14.5±6.4)days, t=-3.379,P=0.001) and shorter waiting time for postoperative anal exhaust((2.0±0.6)days vs. (2.5±0.9)days, t=-2.827,P=0.006) were found in the laparoscopy group than that in the laparotomy group,with statistically significant differences. While there was no statistically difference in the operative time((252.8±54.7)minutes vs. (257.4±68.6)minutes,t=-0.331,P=0.742). Postoperative review and follow-up did not show statistically significant differences between the two groups in the residual stone rate(5.3%(2/38) vs. 5.0%(2/40)) and the incidence of recurrent biliary stricture(5.3%(2/38) vs. 7.5%(3/40))(both P>0.05). Conclusion: Laparoscopy may be safe and effective in the treatment of biliary stricture after the biliary dilatation operation,with less trauma,faster recovery compared to laparotomy.
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To investigate the safety and feasibility of longitudinal transpancreatic U-sutures invaginated pancreatojejunostomy (Chen's pancreaticojejunostomy technique) in laparoscopic pancreaticoduodenectomy (LPD). Clinical data of 116 consecutive patients who underwent LPD using Chen's pancreaticojejunostomy technique in Hunan Provincial People's Hospital from May 2017 to December 2018 were retrospectively analyzed. Among these patients, 66 were males and 50 were females. The median age was 58 years old (32-84 yeas old). All 116 patients underwent pure laparoscopic whipple procedure with Child reconstruction method, using Chen's pancreaticojejunostomy technique. The intraoperative and postoperative data of patients were analyzed. All 116 patients underwent LPD successfully. The mean operative time was (260.3±33.5) minutes (200-620 minutes). The mean time of pancreaticojejunostomy was (18.2±7.6) minutes (14-35 minutes). The mean time of hepaticojejunostomy was (14.6±6.3) minutes (10-25 minutes). The mean time of gastrojejunostomy was (12.0±5.5) minutes (8-20 minutes). The mean estimated blood loss was (106.0±87.6) ml (20-800 ml). Postoperative complications were: 11.2%(13/116) of cases had postoperative pancreatic fistula (POPF), including 10.3% (12/116) of biochemical fistula and 0.9%(1/116) of grade B POPF, no grade C POPF occurred; 10.3%(12/116) had gastrojejunal anastomotic bleeding; 3.4%(4/116) had hepaticojejunal anastomotic fistula; 3.4%(4/116) had delayed gastric emptying; 4.3% (5/116) had localized abdominal infection; 12.1%(14/116) had pulmonary infection; postoperative mortality were 0(0/116) and 1.7%(2/116) within 30 days and 90 days, respectively. One patient died of massive abdominal bleeding secondary to Gastroduodenal artery pseudoaneurysm rupture, the other patient died of extensive tumor recurrence and metastasis after surgery. Chen's pancreaticojejunostomy technique is safe and feasible for LPD.It is an option especially for surgeons who have not completed the learning curve of LPD.
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OBJECTIVE: To explore the safety and feasibility of ICG fluorescence fusion technique in the treatment of liver neoplasms by laparoscopic anatomical right hepatectomy.METHODS: A retrospective study was conducted to enroll 108 patients with hepatic malignancies admitted to the Department of Hepatobiliary Surgery in the People's Hospital of Hunan Province from January 2016 to December 2018.The clinical data of the patients were collected.The patient's residual liver volume was calculated before surgery,and a liver function reserve test was performed to evaluate the patient's tolerance to laparoscopic right hepatectomy.According to whether indocyanine green fusion imaging technique was performed during intraoperative laparoscopic surgery,all patients were divided into two groups:fluorescent laparoscopic anatomical right hepatic group(experimental group)and non-fluorescent laparoscopic anatomical right hepatectomy group(control group).Intraoperative and postoperative clinical data of patients in both groups were compared and analyzed.Data were reported in the form of mean ± standard deviation for numerical variables and n(%)for categorical variables.RESULTS: There were 108 patients undergoing laparoscopic anatomical right hepatectomy,including 24 patients in the experimental group and 84 patients in the control group.Three patients stained failed in the experimental group,of which 1 patient failed for forward staining method and 2 patients failed for reverse staining method.Intraoperatively,compared with the control group,the operation time of the experimental group[(274.58±42.12)min vs.(303.99±54.67)min,(P0.05)]had no significant difference between the two groups.Postoperatively,there was no significant difference in hospitalization time,tumor diameter and the incidence of lung infection,hemorrhage and bile leakage between the two groups(P>0.05).CONCLUSION: ICG fluorescence imaging laparoscopic anatomical right hepatectomy is helpful for the confirmation of intraoperative hepatic plane,thus reducing the operation time and hepatic occlusion time.It can be used for the detection of intraoperative bile leakage.The development of ICG fluorescence fusion technology is conducive to the promotion of laparoscopic anatomical right hepatectomy.Under strict conditions,it can effectively improve the controllability and safety of laparoscopic anatomical right hepatectomy.
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<p><b>OBJECTIVE</b>To access the effect of wireless biofeedback therapy on bruxism.</p><p><b>METHODS</b>Ten voluntary bruxers (seven female and three male, mean age 26.1 years) were invited to participate in this clinical research. An electric resistance strain gauge was embedded in the position of canine of a maxillary splint for monitoring the abnormal clenching or grinding movement of teeth during sleep. The relevant details of bruxism events, including value of relative force, occurring time and duration were recorded and analyzed by the receiver device and monitoring program respectively. Meanwhile, for the purpose of nerve system and muscle relaxation, a watch-style device around the patient's wrist will vibrate to alert the patient of teeth grinding or clenching if the value of biting force and duration exceed the threshold. Total average episodes of bruxism and duration was observed during eight hours sleep, and was analyzed with one-way analysis of variance in SPSS 19.0 by the end of 6th week and three months following biofeedback therapy.</p><p><b>RESULTS</b>The average episodes of bruxism has declined dramatically from (9.8 ± 2.2) times to (3.0 ± 1.2) times during one night (P < 0.05), and the average duration of bruxism events was reduced from (20.7 ± 12.2) s to (10.0 ± 3.4) s (P < 0.05) after six weeks biofeedback therapy. By the end of three months, the average episodes declined to (2.9 ± 1.2) times (P < 0.05), and the average duration decline to (9.2 ± 2.9) s (P < 0.05) with contrast to preliminary night.</p><p><b>CONCLUSIONS</b>The pressure-based wireless biofeedback device is able to monitoring clenching and grinding of bruxism. The results suggest that biofeedback therapy may be an effective, novel and convenient measure for treatment of bruxism according to several months therapy.</p>
Subject(s)
Adult , Female , Humans , Male , Young Adult , Biofeedback, Psychology , Occlusal Splints , Sleep Bruxism , TherapeuticsABSTRACT
<p><b>OBJECTIVE</b>To investigate the regulatory mechanism of parathyroid hormone-related protein (PTHrP) in proliferation and differentiation of chondrocytes of condyle in fetal mouse.</p><p><b>METHODS</b>Chondrocytes of condyle in fetal mouse were separated and cultured in vitro, the influence of PTHrP on proliferation and differentiation was observed.</p><p><b>RESULTS</b>After two weeks' culture in 0.01 nmol/L, 0.1 nmol/L, 1 nmol/L, 10 nmol/L human PTHrP, there was significant difference in the number of cartilage nodule formed between experiment group and control group (P<0.05), and there was no significant difference in 0.01 nmol/L group (P>0.05). Alkaline phosphatase (ALP) activity was significantly intensified in experiment group and control group (P<0.05). Meanwhile, it was found that this function of promotion was lessened after anti-PTHR antibody used.</p><p><b>CONCLUSION</b>It can be seen that PTHrP, via its receptor, can promote proliferation and differentiation of chondrocytes of condyle, which resemble its modulation mechanism in epiphyseal growth plate cartilage intramembrane in mandibule.</p>
Subject(s)
Animals , Humans , Mice , Cell Differentiation , Chondrocytes , Growth Plate , Parathyroid Hormone-Related ProteinABSTRACT
<p><b>OBJECTIVE</b>An electric monitor of bruxism had been invented in order to evaluate the curative effect of cuspid occlusal upheaving splint and stabilization splint.</p><p><b>METHODS</b>20 patients with bruxism were randomly divided into two groups. A cuspid occlusal upheaving splint or a stabilization splint was fabricated respectively for patients. The vertical dimension for each splint was 0.5 mm lower than mandibular postural position. Sleeping time, bruxist time and times of bruxism were recorded with bruxism monitor that was invented for studying bruxing.</p><p><b>RESULTS</b>The bruxist time and the times of bruxism were decreased obviously in patients with cuspid occlusal upheaving splint, while no significant difference was shown before and after using the stabilization splint.</p><p><b>CONCLUSIONS</b>The bruxism monitor can automatically measure and record the data of bruxism with splint, which is valuable for clinic. The curative effect of cuspid occlusal upheaving splint is better than that of stabilization splint for treating bruxism.</p>