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Objective To observe the basic rhythm of myoelectrie activities of sphcter of Oddi (SO)and explore its biological significance.Methods Healthy adult rabbits(n=32)were randomized into 4 groups with 8 in each.The first group was for recording of myoelectric activities of SO after keeping fast for 18 hours.The second group was manipulated to observe the myoelectric activities of SO after food infusion through the stoma in stomach.The myoelectric activities of SO in the third group were monitored after the classical Nardi test was performed on these rabbits.The fourth group was used to observe the myoelectric activities of SO after the cholinergic receptors had been blocked.Using the double claw metal electrodes which were put into SO and duodenum through the plasma membrance,the myoelectric signal were recorded with RM6240 multi-channel physiologic recording and signal processing system and non-stop recording was conducted for 120-150 mins.Results 1)Spike Potentials of SO with the frequency was observed in rabbits that had been fasting.2)Myoelectronic activity of SO was observed in rabbits infused with 50 ml milk through stoma.3)After the administration of 1 mg morphine and 1 mg neostigmine i.v,the myoelectric activities of SO were noted as long-lasting persistent MASO.4)Administration of anisodamine 1 mg(i.v.)in the empty abdomen group dismissed SPSO and MASO.This state lasted for 120 min before SPSO gradually reconverted to the state of empty abdomen.Conclusion There are four patterns of myoelectric activities of SO,i.e,tensional waves under empty abdomen indicating a state in which the SO kept a basic tension level.Peristaltic waves under intake of food.Spastic waves under the stimulation of drugs and relaxant waves under the post-ganglionic block of cholinergic receptors were observed in the present study.Correspondingly,their mechanic locomotion is inferred as the basic tensional state to faciliate the deposition and condensation of bile,the peristalsis for the entry of bile into duodenum,the spasmus so that the bile can not be released into duodenum under pathological situation or the effect of drugs.the long lasting relaxant state after effective inhibition of post-ganglionic cholinergic receptors,respectively.The above results indicate that there are more than two states that is ON or OFF in SO and the concepts of contract and peristalsis of SO should be distinguished.
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Objective To explore the roles of B lymphocyte and plasma cell in liver allograft re-jection to find the evidences of humoral factor participating in the rejection. Methods Immunohisto-chemical inspection of C4d, CD20+ B lymphocytes and CD138+ plasma cells were performed in 34 liver biopsy specimens from 25 patients with hepatic injury and their preoperative specimens. Then we ob-served the variances of the above parameters in the liver biopsy specimens and the differences of them with different hepatic injuries. We further observed the relation of the presence of CD20+ B lympho-cytes and CD138+ plasma cells to C4d positivity. Meanwhile, we compared the difficulties of clinical therapy with different presences of CD20+ B lymphocytes and CD138+ plasma cells in the liver biopsy specimens. Results The positive ratios of CD20+B lymphocytes and CD138+ plasma cells were signif-icantly higher in the acute rejection group than in the non-rejection group(P<0. 05 and P<0. 01).The positive ratios of CD20+ B lymphocytes were markedly higher in the chronic rejection group than in the non-rejection group(P<0. 05). There was no difference in CD138+ plasma cells between the 2 groups. The degrees of hepatic injury could not influence the positive ratioes of CD138+ plasma, but the positive ratioes of CD20+ B lymphocytes in the heavy hepatic injury groups was higher than in the slight hepatic injury groups(P<0. 05). CD20+ B lymphocytes and CD138+ plasma cells presented fol-lowing C4d(P<0. 01 and P<0. 05). The effective power of steroid in the all-positive group was obvi-ously lower than in the all-negative group(P<0. 05). Conclusion Humoral immune may participate in some liver allograft rejection. It would be more favorable for observing and prewarning the humoral re-jection by finding CD20, CD138 and C4d by immunohistochemical staining in liver biopsy specimens with hepatic injury after liver transplantation. It would be helpful for choosing the therapeutic regi-mens of liver allograft rejection.
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Although weight loss is beneficial for obese patients with diabetes, current medical treatment for obesity is difficult. Bariatric surgery leads to substantial and durable weight reduction.Nearly 30% of patients who undergo bariatric surgery have type 2 diabetes.For many of them, diabetes resolves following bariatric surgery (83% to 93% for bypass procedures and 55% to 84% for restrictive procedures).This review discusses the effects of various bariatric procedures on type 2 diabetes mellitus and their possible mechanisms.
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Objective To evaluate the effect of laparoscopic adjustable gastric banding(LAGB) in patients with obesity and obesity-related comorbidities.Methods From Oct.2006 to Dec.2007,50 morbidly obese patients including 11 cases with type 2 diabetes,3 with hypertension,15 with hyperlipidemia,28 with fatty liver,1 with obstructive sleep-apnea syndrome and 2 cases with gallstones underwent LAGB.The mean follow-up period for these patients was 11.2 months.ranging from 6 to 18 months.The weight loss,obesity-related comorbidities,outcomes and complications were evaluated.Results Mean BMI decreased significantly from preoperative(39±6)kg/m2 to postoperative(31±4)kg/m2,(28±7)kg/m2 and(27±7)kg/m2 respectively at 9,12 and 18 months(P＜0.05).The mean excess weight loss at 9,12 and 18 months postoperatively was 30%±11%、42%±13%and 45%±13% respectively.At 12 and 18 months,respectively,20%and 44%of patients had＞50%excess weight loss.The obesity-related comorbidities resolved or improved in 66%～100%of the patients at 12 and 18 months postoperatively.Complications occurred in 4 cases,among them 3 cases were cured conservatively and in 1 case reoperation was performed. Conclusions Based on short-term follow-up results,LAGB is a safe,effective and feasible technique in the treatment of patients with morbid obesity and obesity-related comorbidities.
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Objective To investigate the short-term outcome of laparoscopic adjustable gastric banding (LAGB) for morbid obesity complicated with type 2 diabetes. Methods Eight morbidly obese patients with type 2 diabetes underwent LAGB from October 2006 to August 2007. The weight parameters, fasting (FBG) and 2-hour blood glucose (2hBG), medication for diabetes were assessed 1,3, 6 and 9 months after surgery. Results All of the patients lost weight, with a mean body mass index decreased from (38.7±7.5) kg/m2 before LAGB to (30.5±4.3) kg/m2 9 months after LAGB. The FBG and 2hBG were decreased significantly at month 6 and 9 after LAGB, with normal FBG and 2hBG in 4 patients. At month 9 after LAGB, 3 of 5 patients with insulin treatment before LAGB were changed to oral hypoglycemics, 1 was continuously administered with a reduced dose of insulin, and 4 patients stopped any medication. Conclusion LAGB is an effective procedure in the treatment of morbid obesity complicated with type 2 diabetes with a favorable short-term outcome.