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Objective To compare the effects between percutaneous transhepatic gallbladder drainage (PTGD) plus delayed laparoscopic cholecystectomy (LC) in comparison with emergency LC for elderly patients with acute cholecystitis.Methods From June 2011 to December 2014,the clinical data of elderly patients with acute cholecystitis receiving PTGD plus LC and emergency LC were retrospectively studied.Results In this study 38 patients received PTGD plus LC,59 patients received emergency LC.Patients in PTGD + LC group had longer operative time (67 ± 14) min and higher conversion rate (5 cases)than those in LC group (51 ± 13) min,1 case (t =5.741,x2 =5.057,P ＜ 0.05),but had quicker bowel function recovery time (24.5 ±6.4) h,shorter hospital stay (4.2 ± 1.8) d,less complications (3 cases)than those inLC group (27±5.2) h,(6.2±1.9) d,17 cases (t =2.11,t=5.165,x2 =6.18,P＜0.05).Conclusions Percutaneous transhepatic gallbladder drainage plus delayed cholecystectomy is safe for elderly patients with acute cholecystitis.
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Objective To analyze the risk factors of pulmonary embolism complications following laparoscopic bile duct exploration.Methods The data of 201 cases undergoing laparoscopic bile duct exploration from June 2002 to December 2014 were retrospectively analyzed.Fourteen risk factors of pulmonary cmbolism complications were evaluated by univariate analysis using no conditional binary Logistic regression.Results 23 patients developed pulmonary embolism complications (11.4％).Age (≥60y),Diabetes mellitus,coronary heart disease,history of cerebral infarction,preoperative shock,time of operation,ambulation after operation (≥3 d) were significant risk factors of pulmonary embolism complications (P ＜0.05).Multivariate Logistic regression analysis identified diabetes mellitus,coronary heart disease,history of cerebral infarction,time of operation,ambulation after operation (≥ 3 d) as independent risk factors of pulmonary embolism complications (P ＜ 0.05).Conclusions Diabetes mellitus,coronary heart disease,history of cerebral infarction,time of operation,ambulation after operation (≥ 3 d) are independent risk factors for pulmonary embolism complications following laparoscopic bile duct exploration.
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Objective To study the expression of P57kip2 and its clinical significance in hilar bile duct adenocarcinoma.Methods The expressions of P57kip2 in hilar bile duct adenocarcinoma tissues (37 cases) and normal bile duct tissues (32 cases) were determined by immunohistochemical SP methods.The relations between the expression levels of P57kip2 with clinicopathologic parameters were analyzed.Results The positive rate of P57kip2 was 43.2％ (16/37) in bile duct adenocarcinoma,while it was 87.5％ (28/32) in normal duct tissues (P ＜0.01).The expression level of P57kip2 in adenocarcinoma showed no significant association with gender,age or CA19-9 level (P ＞0.05),but they were significantly related with lymph node metastasis,invasion and degree of differentiation (P ＜ 0.05).Conclusions P57kip2 is associated with the occurrence and development of hilar bile duct adenocarcinoma.It may play an important role in invasion and metastasis of hilar bile duct adenocarcinoma.The P57 protein can be used as an index to diagnose hilar bile duct adenocarcinoma.
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Objective To study the clinical efficacy of splenectomy plus porta-azygous devascularization in the treatment of portal hypertension using either the hand-assisted laparascopic (HALS) or the laparoscopic approaches.Methods The clinical data of 30 cases of portal hypertension treated between January 2008 and June 2012 were enrolled in this study.16 patients underwent HALS and 14 patients underwent traditional laparoscopy approach.Results All the operations were successfully accomplished.The mean operation time of the HALS group was significantly shorter than the traditional laparoscopic group (270 min vs 350 min,P＜0.05).Intra-operative blood loss of the HALS group was significantly less than the traditional laparoscopic group (250 ml vs 370 ml,P＜0.05).The median overall costs were significantly lower in the HALS group (30000 RMB vs 35000 RMB,P＜0.05).There were no significant differences in the time to return to oral diet,the length of hospital stay,and the time to passage of flatus.The complication rates between the two groups were similar.Conclusion Hand-assisted laparoscopic surgery had the advantages over conventional laparoscopic surgery in minimal invasiveness,safety,and quicker postoperative recovery.
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ObjectiveTo analysis the different types of bacteria in patients with a varying severity of acute cholangitis.Methods241 patients who presented with actue cholangitis between Jan 2008 to Oct 2011 to our hospital were retrospectively studied.These patients were divided into three groups according to the Tokyo Guideline.The bile specimens were obtained intraoperatively.The parameters were compared by SPSS 16.0 package program for statistical analysis.Results75.1 percent of the patients were positive for bacteria in the bile.There were 241 strains of bacterium which included 139 Gram-positive bacteria,99 Gram-negative bacteria and 6 strains of microzyme.Escherichia coli,Enterococcus faecalis,Enterococcus casseliflavus,Pseudomonas aeruginosa and Klebsiella species were the most frequently isolated bacteria.The positive rates for bacteria were significantly different between patients with mild and severe cholangitis (P＜0.05).There was no significant difference between patients with moderate and mild cholangits (P=0.141),or moderate and severe cholangitis (P=0.647).Gram-negative bacteria were more common than Gram- positive bacteria in patients with moderate and severe acute cholangitis (P＜0.05).In patients with moderate and severe acute cholangitis,there was more patients with multiple and mixed bacterial infection.ConclusionsEscherichia coli and Enterococcus species were more common in patients with acute cholangitis.The positive rate of bacteria in the bile in severe acute cholangitis was higher than that in mild acute cholangitis.In patients with moderate and severe cholangitis,Gram-negative bacterial infections and multiple and mixed bacterial infections were more common.
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In this paper is reported a new approach for the treatment of sarcoma--electroporation therapy. Electroporation can accelerate pharmacal molecules into cytoplasm by transient electromagnetic pulses. We have utilized the phenomenon of electroporation treating the S-180 sarcomas in the hind legs of the Kunming mice by intratumoral injection of anti-tumor agent at low dose. From the experiment, we learned that this approach can bring about remarkable effect. The technical procedure is easy to do and easy to control. Especially, it is useful in curing the flat tumor and has little untoward side effect. It deserves to be recommended as a new approach to treating the tumor in clinics.
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Animals , Mice , Antineoplastic Agents , Therapeutic Uses , Apoptosis , Cell Line, Tumor , Cyclophosphamide , Therapeutic Uses , Electrochemotherapy , Methods , Neoplasm Transplantation , Sarcoma 180 , Drug Therapy , PathologyABSTRACT
We chose Hela cells as research object and studied the cytotoxicity generated by cyclophosphamide, an antitumor drug, after cell electroporation by the use of electromagnetic pulses. Comparison between the electroporation group and the contrast group revealed the greatly enhanced cytotoxicity of the electroporation group, indicating that under some conditions electromagnetic pulses can enhance the cytotoxicity of antitumor drugs. The results of this study provide reliable evidences and a feasible approach for clinical treatment of tumor.
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Humans , Antineoplastic Agents , Pharmacology , Apoptosis , Cell Survival , Cyclophosphamide , Pharmacology , Drug Screening Assays, Antitumor , Electromagnetic Phenomena , Electroporation , Methods , HeLa CellsABSTRACT
This article reports the experiment studies on treating the S-180 sarcomas of KM mice with high-intensity electric pulse and antitumor drug (cyclophosphamide). The results showed that the experimental group of electric field combined with drug has the best effect on tumor, compared with the control group. In addition, electric field can inhibit the formation of vas Capillaries and decrease the supply of nutrition for tumor cell. In conclusion, electric field has inhibited the growth of tumor.