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Objective To investigate the causes,diagnosis and treatment of postoperative acute cholecystitis. Methods Clinical data of 9 cases with postoperaive acute cholecystitis were analyzed retrospectively. Results7 cases was confirmed by ultrasonography, 1 case was confirmed by CT, and 1 case died of gallbladder perforation, no operative mortality in emergency cholecystectomy. Conclusion The prevalent etiology is biliary stasis. Early diagnosis and treatment is the key point to decrease the death rate.
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Objective To investigate and evaluate the changes of T lymphocytes and red cell immunity of peripheral blood in patients with primary hepatocyte carcinoma (PHCC) after radiofrequency ablation(RFA) treatment. Methods The pre- and post- RFA(3d,7d,14d) peripheral blood T lymphocyte subsets(T3,T4,T8,T4/T8) and red cell immunity (RBC C3 receptor flower and RBC-immuocomplex formation rate) were investigated in 120 patients with PHCC treated by RFA. Results On 7d, 14d after RFA, T3, T4 lymphocytes and T4/T8 were higher than those on preoperative day significantly(P
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Objective To study the mechanism of SW480 cell line death caused by transfection of retroviral vector-G1CEACDNa.Methods Plasmid G1CEACDNa was transferred into the SW480 cell line using liposomes method. RT-PCR was performed to examin the expression of CD gene indrectly.The cell growth curve was measured by means of cell counting. When the CD+SW480 cells were exposed to 5-FC (1mmol/L), the growth inhibition rate and the "bystander effect" were detected by MTT method.The ultrastructure was observed by electron microscope.Apoptosis was verified by flow cytometer .Results The product of RT-PCR showed a band at 1.5kb on the photo of electrophoresis. The growth of CD+ SW480 cells was inhibited 24h after administrating 5-FC,and the inhibition rates at 72h,96h,120h were 30.0%,50.0% and 80.0%,respectively.Apoptosis cells in different phases and apoptotic bodies in the field of electron microscope were observed. Meanwhile ,a few cells showed necrosis.Flow cytometer verified that a few cells appearred apoptosis 48h after exposed to 5-FC (1mmol/L), the apoptosis rate and the necrosis rate at 72h,96h were 20.2%,30.7% and 19.6%,21.1% respectively.Conclusions The death mechanism of SW480 cells transfected with G1CEACDNa followed by 5-FC treatment includes both necrosis and apoptosis.Apoptosis is possibly the bystander effect.
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Objective To investigate the changes of the levels of TNF and IL 8 in blood and in gastric mucosa and their mRNA expression after liver ischemia reperfusion (I/R). Methods 130 rats were randomly divided into 3 groups: (1) sham operation group(control group, n=10);(2)liver ischemia reperfusion group (n=60), including ischemia for 20min and 40min, and reperfusion for 1h, 24h and 72h respectively; (3) liver I/R rats treated with famotidine group (n=60). ALT and AST were detected after operation, pathomorphological changes of gastric mucosa were studied by light microscope and transmission electronic microscope, the concentrations of TNF and IL 8 in blood and gastric mucosa were measured by radioimmunoassay (RIA), TNF mRNA and IL 8 mRNA were detected by in situ hybridization. Results After liver I/R,inflammatory damage appeared in gastric mucosa, TNF and IL 8 concertrations increased significantly(P
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Objective To investigate the effect of thermochemotherapy with 5 fluorocytosine(5 FC) on human colorectal carcinoma cell lines SW480 transfected with carcinoembryonic antigen (CEA) tissue specific cytosine deaminase (CD) in vitro.Methods Recombinant retroviral vector G1CEACDNa, in which CD gene was controlled under the CEA promoter, was introduced through liposome technique to the human colorectal carcinoma cell line SW480, and then the cells were selectively cultured in G418. The proliferated colonies were treated with the combined therapy of 5 FC and hyperthermia at a 43℃ over 30 min for 3 times. RT PCR was performed to analyze the expression of CD gene in target cells after thermochemotherapy. Results The CD gene expressed steadily in the target cells after 3 times of hyperthermic treatment. After the transfection of CD gene, SW480 CEACD cells were more sensitive to 5 FC than their parental cells (P
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Objective To investigate the diagnosis and treatment of cystic adenoid tumor of the pancreas. Methods Retrospective analysis was made on the clinical data of 11 cases of pancreatic cystic neoplasms confirmed by operation and pathology at our hospital from 1978 to 1998. Results Cystic adenoid tumor of the pancreas is more likely to occur in young females with middle age, clinical presentations were as follows: a long-term persistent mass and distending pain in the epigastrium. Utrasounography, CT and ERCP could contribute to the diagnosis. Of the 11 cases, pancreaticoduodenectomy was performed in 2, distal pancreatectomy and splenectomy in 6, local excision of the mass in 2, and loop type cystojejunostomy in 1. The rete of resection was 90.9%. Of them, 1 case died of abdominal abscess and septicemia postoperatively. All the 10 cases who survived postoperatively were followed up. Among the 10 cases, 1 case of pancreatic cystoadenoma died of cardiac infarction 3 months after operation, and 1 case of cystoadenocarcinoma died of metastasis 51 months after tumor excision. The other 8 cases still alived well now. Conclusions Cystic tumor of the pancreas should be suspected when young or middle aged female patients have a long term big mass in epigastrium or left upper quadrant. Ultrasonography and CT scan are helpful in the diagnosis of the tumor including cystoademoma and cystoadenocarcinoma, Although the volume of the tumors may be very big, they often have a intact capsure,so easy to excise. The excision of the total tumor and some arounding pancreatic tissue is the first choice of the treatment for cystic tumor of the pancreas, and the curative effectiveness is satisfctory.
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0.05). RFA showed a marked short term therapeutic effect for patients with PHC.Conclusions After RFA treatment of patients with PHC,the serum levels of TNF and AFP decreased,and this suggests an augmentation of organism immune function. The serum levels of TNF and AFP can assist in the assessment of the therapeutic effect and prognosis of primary hepatic carcinoma.
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Objective To introduce how to improve the operation quality and clinical effect of pancreatoduodenectomy (PD). Methods The morbidity and mortality of 126 patients with pancreatic head cancer or peri ampullary cancer treated by PD of traditional Child method and modified Child method ( pancreatic stump closing style pancrea to jejunum anastomosis) in our department from 1973 to 2002 were analyzed retrospectively. Results In modified Child method group, the morbidity of pancreatic leakage and the mortality of the operation were 2.4% and 4.7% respectively, which were significantly lower than those in the traditional method group(P
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Objective To study the mechanism of 5 fluorouracil(5 FU) in the treatment of severe acute pancreatitis(SAP). Methods SD rats were randomly divided into three groups:acute pancreatitis group (AP group,n=12), 5 FU treatment group( 5 FU group,n=10),and control group (n=10). In 5 FU group,5 FU(1mg/100g) were injected immediately after AP was induced.12h after the AP was induced, blood samples were taken to determine nitric oxide(NO) and interleukin 6(IL 6). Results Compared with AP group,in 5 FU group, the survival rate increased,mean survival time prolonged,ascites volume decreased significantly,and the inflammatory mediators subsided. Conclusions NO and IL 6 may play an important role in the pathogenises of acute pancreatitis. The treatment effect of 5 FU for AP may through inhibit the inflammatory mediators.
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Objective To evaluate the therapeutic effect of combined splenorenal shunt and portaazygous devascularization on bleeding esophageal varices.Methods We summarized 120 cases suffering from esophageal variceal bleeding treated by splenorenal shunt plus portaazygods devascularization,from April,1978 to April,1997.Results The operative mortality was 4.2%,no short-term postoperative bleeding,and long-term postoperative bleeding rate was 9.5%,postoperative hepatic encephalopathy rate was 4.8%.Five,ten and fifteen years survival rate were 83.6%,64.5% and 54.5% respectively. The portal hemodynamics was observed by means of Doppler flowmeter,DSA,and intraoperative portal pressure measurement in some of the patients.Conclusion The result showed that combined shunt and portaazygous devacularization not only preserve the advantage of devacularization but also decrease the portal pressure and blood volume,alleviating portal hyperhemodynamics while preserve hepatopetal blood flow to some extent.
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Objective To compare prospectively the features and effects of combined operation(splenorenal shunt plus portal-azygous devascularization) and portal-azygous devascularization only(PCDV)on portal(hypertension)(PH).Methods We summarized 360 cases of PH admitted from 1984 to 2004.All patients were randomly divided into two groups,one was combined operative group(250 patients) and the other was PCDV group(110 patients).The therapeutic effects and changes of portal hemodynamics were studied with doppler flowmeter(DCFI),free portal pressure(FPP) and digital subtraction angiography(DSA) pre-and post-operatively,and were measured directly during the course of the procedure.Results(1)Postoperative bleeding:Of all the patients who underwent combined operation,no case of rebleeding occurred in the short period after operation,and the rebleeding rate was 8.0% in the long period of follow-up.In the patients who underwent PCDV,the rebleeding rate was 5.5% in the short period after operation,and 17.6% at long-term follow up(P0.05).(3)There was a significant decrease in the diameter of portal vein,and FPP postoperatively in the combined operation group compared to PCDV group.There was a significant decreases of PVF in the PCDV group.But the decrease of PVF in the two groups had no significant difference.Conclusions The combined procedure has merits of greater decrease of FPP,and alleviation of the condition of hyperdynamic blood flow in the portal vein.The clinical effect is also better than that of portal-azygous devascularization only.