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Objective To investigate the excretion probability,clinical characteristics of gallstones with small common bile duct stone.Methods The clinical data of 216 patients were analyzed retrospectively.The relevant clinical characteristics of small common bile duct stone's excretion were analyzed.x2 and Pearson correlation coefficient were used to analyze correlation between small common bile duct stone's excretion and relevant clinical characteristics,multiple logistic regression analysis was performed to identify these excretion related factors.Results Univariate analysis showed that patients of age less than 50 years,female sex,abdominal pain relieved and liver function recovered rapidly in 3 days of treatment,normal or slightly dilated diameter of common bile duct,single or multiple stones located in one place,stones completely located in the common bile duct or completely within the sphincter were more likely to be discharged.Multivariate analysis indicated that rapid relief of abdominal pain,rapid recovery of liver function,single or multiple stones located in one place were independently correlated with small common bile duct stone's excretion.Conclusion Small stones in common bile duct have a high probability of spontaneous removal in patients with gallstones and small common bile duct stone.
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Aim To study the apoptotic inducing effects of deguelin on SH-SY5Y cells.Methods SH-SY5Y cells were treated with 0,0.625,1.25,2.5,5,10 and 20 μmol·L-1 deguelin for different time(24,48,72 h);cell viability was detected by CCK-8 assay.SH-SY5Y cells were treated with 0,8,20,50 μmol·L-1 deguelin for 24 h;light microscope and AO/EB double stained method were employed for observing the morphology and apoptotic morphology of treated cells.Apoptotic rate of treated cells was determined by flow cytometry.Cells were stained by DCFH-DA,and the whole reactive oxygen species(ROS)was determined by flow cytometry.Spectrophotometry was employed to determine the activation degree of caspase-3.Results Deguelin inhibited cell growth in a time-and dose-dependent manner,and the IC50 value of deguelin was(26.07±2.18),(18.33±0.94),(12.5±1.49)μmol·L-1 when treated with 24,48,72 h respectively.After treated with 8,20,50 μmol·L-1 deguelin for 24 h,cell apoptotic rate,ROS and activation rate of caspase-3 increased markedly(P<0.05),all of which performed a dose related effect.Conclusion Deguelin can inhibit SH-SY5Y cell proliferation and induce cell apoptosis,and the mechanism may be concerned with the elevated ROS and activated caspase-3.
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ObjectiveTo evaluate the influence of electrotome on permanent and temporary cardiac pacemaker in laparoscopic cholecystectomy ( LC),and the application of cardiac pacemaker to the cases of cholecystolithiasis combined with bradyarrhythmia.MethodsClinical data of 215 patients with permanent or temporary cardiac pacemaker who underwent were studied for the preoperative and postoperative variation of pacemaker function,and for the influence of electricity coagulation during the operation on cardiac pacemaker function.ResultsLC was successfully completed in all 215 patients.The function of cardiac pacemaker was not obviously interfered during the operation,and the parameters of cardiac pacemaker did not remarkably change after the operation.ConclusionCardiac pacemaker is slightly interfered when electrotome and electrocoagulation were used in LC; LC is feasible and safe for patients with bradyarrhythmia by placement of cardiac pacemaker.
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Objective To discuss how to improve judgement and technique for avoiding bile duct injury during laparoscopic cholecystectomy(LC).Methods The clinical data of 39 860 patients treated by LC between October 1992 and October 2005 were analyzed retrospectively.Bile duct injury occured in 46 patients.Results Bile duct repair and T-tube drainage was performed in 26 patients and bile duct end-to-end anastomosis and T-tube drainage was performed in 4 patients,with the T-tube indwelling time for 3~12 months.The Roux-en-Y cholangiojejunostomy was conducted in 11 patients,the ligation of accessory hepatic duct was conducted in 5 pauients,the re-operation for bile duct stenosis in 4 patients,and the re-operation for stenosis after cholangiojejunostomy,in 2 patients.Conclusions Intensive anatomic knowledge and skillful surgical performance can avoid or minimize the incidence of bile duct injury.Early detection and active repair of the bile duct injury for preventing acute inflammation is the most important measure to avoid repeated operations.
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Objective To investigate the relationships among clinical features, endoscopic characteristics and pathologic epithelial types of Barrett esophagus. Methods Magnification chromoendoscopy ( MCE) was performed in 2506 patients with gastroesophageal reflux disease ( GERD) and 106 patients with Barrett esophagus in our hospital during Feb,2003 -Feb,2004 were analyzed. The clinical features, endoscopic characteristics, pathologic epithelial types and their relationships were analyzed. Results The symptoms of gastro esophageal reflux disease ( GERD) were the main presentation of Barrett esophagus but 27 (25. 5% ) cases without such presentation. Four types of mueosal patterns, dot pattern, ridge or villous pattern and irregular/distorted pattern. were noted within the columnar mucosa using high magnification endos-copy: There were three epithelial types within the columnar lined esophagus: intestinal metaplasia (IM ) , cardiac and fundie types. Three epithelial types were noted in the methylene blue staining areas; ridged/vil-lous pattern and irregular/distorted pattern, all of them were in epithelial types of intestinal metaplasia. Conclusion Magnification chromoendoscopy helps to identify areas with IM, and having important significance in diagnosis and clinical follow up of Barrett esophagus.
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Objective To explore the management of unsuspected gallbladder carcinoma (UGC) discovered during laparoscopic cholecystectomy (LC). Methods From January 2000 to May 2007, 15 560 cases of LC were performed in our hospital, UGC was discovered in 28 of the cases. Clinical data of the 28 patients were analyzed retrospectively. Results Among the 28 cases of UGC, 12 were discovered intraoperatively, and 16 were diagnosed postoperatively.Radical cholecystectomy was performed on the 12 cases who were detected during the operation,and 5 of the 16 patients who were diagnosed after the operation.LC was carried out in the remaining 11 cases. Postoperative pathological examination showed TNM stageⅠin 3 cases, stageⅡin 23, and stage Ⅲ in 2. The patients were followed up for 7-66 months with a mean of 22 months. During the period, 19 patients died. The 1-, 3-, and 5-year survival rate of the 17 patients who received radical cholecystectomy were 76.5% (13/17), 23.5% (4/17), and 11.8% (2/17), respectively. Whereas, in the 11 patients who underwent LC, the 1-year survival rate was 45.4%; moreover, none of the 11 survived for more than 2 years. Conclusions For high-risk population, attention should be paid to UGC during operation. Most of the UGCs discovered during LC are early-stage carcinomas, which should be treated with standard radical cholecystectomy, but not LC.