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The iatrogenic cause of bile duct stone formation is mainly due to suture materials, especially silk sutures. In recent years, Prolene and Vicryl sutures have been widely used in biliary surgery, and bile duct stone formation related to sutures are seemingly becoming rare, as there has only been one report of bile duct stone formation caused by Prolene sutures in the literature. In the last few years we have had two cases of Prolene suture-related bile duct stone formation within our unit. We therefore suggest that Vicryl sutures should be used as the first choice in biliary surgery, in order to prevent the formation of iatrogenic bile duct stones
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Surgery is so far the most widely used and effective treatment of neoplastic diseases.However,residual tumour cells during surgery remain a major trigger of cancer recurrence and matastasis.Although intraoperative rapid pathological R0 resection can be achieved based on preoperative imageological examination,but for small satellite lesions and the naked eye can not find the error quickly and so often cause pathological presence of residual tumour cells.Thus,quick and accurate identification of residual cancer cells is crucial for prognosis of cancer patients.Indocyanine green (ICG) is a new type of fluorochrome that can stain tumours under the near-infrared fluorescence during surgery,the paper will be reviewed latest developments in the reagent for fluorescence in tumours.
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Objective To explore the therapeutic strategy and clinical value of intraoperative chole-dochoscopy and electrohydraulic lithotripsy for refractory intrahepatic bile duct stones.Methods Liver pa-renchyma,intrahepatic bile duct and bile duct stones were explored under direct vision and intraoperative choledochoscope in 1 1 cases of refractory intrahepatic bile duct stones.Electrohydraulic lithotripsy and lithot-omy were performed to remove the stones and protect the liver parenchyma.If the stones could not be re-moved once,a secondary lithotripsy and lithotomy was performed through the fistula tract.Results All re-fractory calculi were crushed after one or two procedures and the clearance rate were 100%.No complica-tions occurred.Ten patients were followed up from 1 to 3 years except one.Three cases revealed recurrent stone during follow-up due to withdrawal of ursodeoxycholic acid capsules in 1 to 2 years.Seven others showed no stone recurrence within follow-up time.Conclusion Intraoperative choledochoscopy and electro-hydraulic lithotripsy is an easy technique and can effectively protect the liver parenchyma.The life quality of patients can be improved with low surgical risk and postoperative complications.
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Objective By comparing the therapeutic effects of different nutrition support,to elementarily evaluate the protocol of nutrition support with ω-3 polyunsaturated fatty acids in patients undergoing hepatectomy.Methods Retrospective and comparative analysis was applied.From January 2009 to January 2011,82 patients undergoing liver resection were selected from Nanjing Drum Tower Hospital and divided into three groups according to different nutrition supporting protocol:total parenteral nutrition group (23,TPN for short),combined enteral nutrition group (30,EN for short),ω-3 PUFAs group (29).TPN group was given total parenteral nutrition.EN group was given both parenteral and enteral nutrition.ω-3 PUFAs group was given parenteral nutrition,enteral nutrition and ω-3 PUFAs.By comparing the general situation,the incidence of post-operation complications and index of liver function,the effect of different nutrition supporting plans could be comprehensively evaluated.Results (1) None patients from any groups had severe complications such as bile leakage and hemobilia.Slight complications included ascites and pleural effusion.No difference is of significance in statistics science.(2) Compared with TPN group,patients from EN and ω-3 PUFAs group had shorter defecating time and post-surgery hospital stay,the difference is of significance in statistics science (P =0.001,t =4.624; P =0.001,t =5.019).There was no significant difference between EN and ω-3 PUFAs group (P ＞ 0.05).(3) For patients received operation with major hepatectomy (≥4 segments),ALT in ω-3 PUFAs group was lower than EN group in the 3rd and 5th day after operation (P=0.024,t =2.432; P=0.042,t =2.144).(4) For patients with cirrhosis,TB in ω-3 PUFAs group was lower than EN group in the 3rd and 5th day after operation (P =0.032,t =2.202; P =0.035,t =2.183).Conclusions It is beneficial to use nutritional support in patients received hepatectomy.For patients received major hepatectomy and patients with cirrhosis,nutrition support with ω-3 PUFAs had better protective effects.
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ObjectiveThis study is aimed to investigate the association of human leukocyte antigen (HLA)-DRB1 with rheumatoid arthritis (RA) in Chinese Han population.MethodsA total of 281 Chinese Han patients with RA and 202 healthy controls were recruited.DNA was extracted from PBMC and HLA typing was performed by sequence based typing and PCR-Sequence Specific Primer.The frequency of HLADRB1 was compared between patients and controls using x2 test with continuity correction.ResultsThe susceptible HLA-DRB1 alleles were * 0101,* 0102,*0404,* 0405,and * 0410 which belonged to QRRAA.DRRAA and DERAA were protective alleles.At genotypic level,The association of S3P and S3D was detected.However,the protective effect of S3D was shown to be in a recessive mode.ConclusionOur results have shown that there are racial differences in RA susceptibility between Chinese Han population and Caucasians.
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Objective To investigate changes of learning ability and somatostatin (SS) changes after positive acceleration (+Gz) exposures. Mehtod Eighty male SD rats were randomly divided into 3groups: control group(Con), +6 Gz/3 min group ( +6 Gz), and +10 Gz/3 min group ( +10 Gz),8 rats in each group. Changes of learning ability in rats were observed at 0 d, 2 d, 4 d and 6 d after + Gz exposure. SS in hippocampus was measured by RIA at 0 d, 2 d and 4 d after + Gz exposures ( there were 8 rats every time, in each group). Result In Y-maze test,number of correct response decreased significantly (P ＜0.01 ), and total reaction time increased significantly(P ＜0.01 ) in +6Gz and +10 Gz groups as compared with control group; number of correct response and total reaction time in +10 Gz group changed significantly at 0 d(P ＜0.01 or P ＜0.05) as compared with +6Gz group. RIA showed that, content of SS in hippocampus declined at 0 d and 2 d(P ＜0.05 or P ＜0.01) in +6 Gz and + 10 Gz groups as compared with control group. Conclusion + Gz exposure could impair learning ability of rats, and inhibit expression of SS in hippocampus.
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BACKGROUND: At present, most researches on simulated weightlessness are confined to its effect on the artery. Therefore, the effect on the vein needs to be further studied.OBJECTIVE: To probe into the effect of simulated weightlessness on the ultrastructure of rabbit femoral vein and the remodeling of femoral vein.DESIGN: A completely randomized and controlled trial based on experimental animals.SETTING: Department of Aerospace and Aviation Medical Science, Fourth Military Medical University of Chinese PLA.MATERIALS: The experiment was completed in the Department of Aerospace and Aviation Medical Science, Fourth Military Medical University of Chinese PLA from December 2000 to December 2001. Altogether 24healthy male New Zealand rabbits, weighing 2.0-2.5 kg were obtained.INTERVENTIONS: The model of Head-Down Tilt( -20°) (HDT) simulated weightlessness was established in rabbits. A total of 24 healthy male New Zealand rabbits were randomly divided into control group, 10-day simulated weightlessness group and 21-day simulated weightlessness group, with 8rabbits in each group. The ultrastructure of the rabbit femoral vein was observed under transmission electron microscope.MAIN OUTCOME MEASURES: Changes and degeneration of endothelial cell, mitochondrion, internal elastic membrane, and smooth muscle.RESULTS: Cell organelles in endothelial cell of the femoral vein of HDT rabbits decreased, mitochondrion dissolved and disappeared, vacuolar degeneration in endothelial cell increased and phagolysosome in endothelial cell could be found. Internal elastic membrane became thinner and was broken. The smooth muscle layer became thinner and some smooth muscle cells became degenerated. Cell interstitial substance increased. There was significant difference in changes between 21-day and 10-day simulated weightlessness groups.CONCLUSION: The vascular remodeling of femoral vein occurs with atrophic changes during simulated weightlessness. The longer duration of simulated weightlessness is, the more obviously the structure of femoral vein changes.
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We introduced the method of computer simulation in the studies of gravitational physiology. Based on work of Melchior (1994), we developed a mathematical model that can be used to stimulate cardiovascular responses to orthostatic stress (lower body negative pressure, LBNP). The model includes 7 sub-models: the redistribution of blood, the filling of left ventricle, left ventricle working, peripheral circulation, control of heart rate (HR), control of peripheral resistance and control of venous tone. Then we simulated the changes of blood pressure (BP) and heart rate during lower body negative pressure, and the results agreed well with the results of our human experiment. By using the developed model, we also simulated the effects of hypovolemia on the BP, HR and shock index during orthostatic stress. The simulation results indicate that the cardiovascular responses to orthostatic stress change significantly when the decrease of blood volume is more than 15% of the total blood volume. However, if the amount of the decrease of blood volume is less than 5% of the total blood volume, HR and BP could be maintained in normal range by the regulation of baroreflex during LBNP. Our simulation results suggest that hypovolemia may be the main cause of orthostatic intolerance induced by weightlessness.
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Adult , Humans , Male , Blood Pressure , Physiology , Cardiovascular Deconditioning , Physiology , Computer Simulation , Heart Rate , Physiology , Hypotension, Orthostatic , Hypovolemia , Lower Body Negative Pressure , Models, Cardiovascular , Ventricular Function, Left , Physiology , Weightlessness SimulationABSTRACT
Objective To explore the effects of acute mild and moderate hypoxia on human mood state.Method The mood states of 18 healthy male volunteers were evaluated by self-assessment questionnaires,profile of mood state (POMS) and state anxiety inventory (S-AI) after random exposure to simulated altitude of 300 m (control),2800m,3600 m and 4400 m for 1 h in a hypobaric chamber.Result The data at 300 m level were taken as the baseline control.The negative mood state factor points (tension,fatigue etc.) increased gradually as the altitude level increased while V (vigor-activity) points had a tendency to decrease (P<0.05 or P<0.01).No significant difference was found in the points of (D,A) even under exposure to 4400 m(P>0.05).At the early period of 2800 m exposure the tension points of POMS and S-AI scores were higher than those of control level (P<0.05) then dropped to baseline level when exposure to this altitude for 1 h.Conclusion Exposure to acute mild hypobaric hypoxia at 2800 m for 1 h has adverse effect on mood state of healthy person and the negative effect was further aggravated with the increment of altitude level.
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Objective The aim of this study was to determine whether psychomotor performance and visual reaction time were affected by acute exposure to mild or moderate hypoxia. Method Eighteen healthy male volunteers performed finger tapping, simple reaction time(SRT) and 4-choice reaction time(CRT) tests at simulated altitude of 300 m (control),2800 m, 3600 m and 4400 m for 1 h in a hypobaric chamber. Result SaO2 decreased from 98%(control) to 90%,82% and 74% respectively at the various altitudes. All the performance parameters showed no significant change after exposure to 2800 m for 1 h relative to ground level(P>0.05). However the mean reaction time of 4-CRT under 3600 m prolonged and performance decreased as compared with baseline value(P<0.05), and the performance decreased further under 4400 m(P<0.01). No significant difference was found in finger tapping and SRT even under exposure to 4400 m for 1 h.Furthermore, no decrease in correct rate were observed at any altitude (P>0.05). Conclusion The results from this study demonstrated that there were no measurable impairment of visual reaction time and psychomotor performance under exposure to an altitude of 2800 m for 1 h. However, adverse effects on psychomotor performance were observed under 3600 m and over.
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Aim To observe the expression of migration inhibitory factor (MIF) in the enteric neurons,and to explore the nervous regulation on MIF activity in experimental colitis.Methods Colitis was induced in sensitized rat and mouse by 2,4-dinitrochlorobenzene(DNCB)enema.MIF activity was measured both in the mesentery lymphocyte(by MTT)and in the enteric neurons(by immunofluorescence double staining).6-OHDA was intraperitonealy (ip) administered to mouse before DNCB treatment.Norepinephrine(NE) was added to lymphocyte culture in vitro during MIF preparation.Results The expression of MIF protein in enteric neuron was increased in DNCB-induced colitis in rat.ip 6-OHDA in colitis mouse(38～150 mg?kg-1) resulted in a further increase of MIF activity than ip vehicle in colitis mouse (P