The early loss of intraportally transplanted islets / 国际外科学杂志

The intraportal islet transplantation is the most hopeful method for the treatment of type 1 dia-betes mellitus. However about 70% of transplanted islets would be destroyed in the early two weeks after transplantation, only a few parts of them could engraft in liver and become functional. This results in the lower efficiency of islet transplantation. Here we review the reasons of this early islet loss and its preventive strategies.

Laparoscopic cholecystectomy combined with duodenoscopic procedures for selective common bile duct stones / 中国微创外科杂志

Objective To investigate the value of combined use of laparoscopic cholecystectomy (LC) and duodenoscopic procedures in the treatment of selective common bile duct stones. Methods We retrospectively analyzed clinical data of 32 cases of selective common bile duct diseases treated with laparoscopic cholecystectomy combined with endoscopic retrograde cholangiopancreatography (ERCP) from January 2002 to December 2003. Results Of 24 cases receiving ERCP before LC, 19 cases were found having common bile duct stones, 3 cases having stricture at the lower end of the common bile duct, and 2 cases normal. These cases underwent ERCP and endoscopic sphincterotomy (EST) following by LC. Of 8 cases receiving ERCP after LC, 4 cases were found having common bile duct stones, 3 cases having stricture at the lower end of the common bile duct, and 1 case normal. Except for 1 case of conversion to open surgery because of a failed stone removal, all the cases were cured with EST. Conclusions combined use of LC and ERCP is a highly useful approach in the treatment of selective common bile duct stones, which has broadened the utilization of minimally invasive treatment for bile duct diseases.

Differentiation of CEA and CEA-Related Substances by Western Blot Technique in Biliary and Gastric Diseases / 中国普外基础与临床杂志

Objective To eliminate the interference of CEA-related substances in CEA measurement and increase the specificity of CEA in the detection of malignant digestive diseases.Methods CEA level of peripheral blood and digestive juice(bile,gastric juice) from patients with benign or malignant digestive diseases was measured by ELISA,and semi-dry electrophoretic transfer method of Western blot technique to distinguish CEA and CEA-related substances.Results In malignant diseases,the CEA level of digestive juice was significantly higher than that in the blood,and there was no difference of CEA level in digestive juice and blood in benign diseases.Meanwhile,the CEA level of digestive juice and blood in malignant diseases were significantly higher than that in benign diseases.A specific band(molecular weight about 210?10~3) was detected in all malignant diseases except four cases whose CEA level was too low(less than 5 ?g/L),whereas no one of benign diseases had this specific band no matter how high or low the CEA level was.Conclusion The specificity of CEA detection in malignant digestive diseases can be improved by using digestive juice as sample and combining with Western blot technique.

The selection of endoscopic method for treatment of common bile duct stones / 中国普通外科杂志

Objective To explore the appropriate operative methods for the treatment of CBD(common bile duct) stone in endoscopic era.Methods We retrospectively analyzed the diagnosed and treated data of 309 patients with suspected CBD stones with ERCP,LC+ERCP and LECBD(laparoscopic exploration of the commonbile duct) from January 2004 to July 2008 in our hospital.Results A total of 216 patients receivedERCP,among them 97(44.9%) cases had CBD stone,and there was the trend that the number of patients who received ERCP reduced yearly.Among the 93 patients who received LECBD,71 cases were successful and 22 cases were converted to open operation.Of the 71 cases,transcystic duct CBD exploration was done in 11 cases,direct CBD exploration in 60 cases,and 6 cases had primary closure of CBD.The number of cases that received LECBD grew steadily with time.There was no difference in successful operative rate,intraoperative bleeding and residual calculi rate between ERCP+LC and LECBD group.The operative time,postoperative complications and length of hospital stay in LECBD.group were significantly lower than those in LC+ERCP group.Conclusions LECBD is better than LC+ERCP in the treatment of CBD stones,but in the endoscopic era,the selection of an individualized treatment approach is the best operative method for the management of CBD stone.

Diagnosis of Pancreatic Cancer by Detecting K-ras Gene Mutations / 中国医师杂志

Objective To detect plasma K-ras gene mutation by using CED-RFLP/PCR to diagnose pancreatic cancer. Methods CED-RFLP/PCR technique was used to detect K-ras gene mutation in the plasma specimens of pancreatic cancer patients, patients with benign pancreatic diseases and healthy subjects. Results In pancreatic cancer patients the positive rate of plasma K-ras gene mutation was 73%, without false positivity, and higher than that in the pancreatic juice and duodenal juice, but lower than that in the fine-needle aspirates. Plasma K-ras gene mutation was not found in patients with benign pancreatic disease and healthy subjects. Conclusion The detection of plasma K-ras gene mutation by CED-RFLP/PCR is simple and effective, and could avoid the faults of other detection methods. It is helpful for the diagnosis and identification of pancreatic cancer.