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Objective To investigate management strategy of minimally invasive surgery for common bile duct stones. Methods Three hundred and four cases of common bile duct stones were divided into 3 groups receiving respectively endoscopic papillary balloon delation plus laparoscopic cholecystectomy ( EPBD group, 35 cases ), endoscopic sphincterotomy plus LC ( EST group, 138 cases), and Laparoscopic common bile duct exploration plus LC (LCBDE group, 131 cases). Results There was no significant difference in treatment success rate, short-term complications and bile duct retained stones among these three group ( x2 = 1. 930, 0. 038, and 0. 427 respectively, P > 0. 05 ). There was significant difference among these three groups in operation time ( F = 17.941, P = 0. 000 ), and the operation time in LCBDE group was shorter than that in other two groups( EPBD-EST: P = 0. 122, EST-LCBDE:P = 0. 000, EPBD-LCBDE:P = 0. 020 ). There was significant difference among these three groups in postoperative hospital stay (F =24. 016,P =0. 000) ,and the postoperative hospital stay in EPBD group was shorter than that in other two groups ( EPBD-EST: P = 0. 000, EST-LCBDE : P = 0. 198, EPBD-LCBDE : P = 0. 000 ). In EPBD group,bile duct recurrent stones was found in 2 cases(6. 7% ) and cholangitis in 1 case(33% ) and no duodenal papilla stenosis was encountered; In LCBDE group, bile duct recurrent stones were found in 7 cases (6. 0% ), cholangitis in 3 cases ( 2. 6% ), and there was no duodenal papilla stenosis; In EST group, bile duct recurrent stones were complicated in 18 cases ( 15.8% ), duodenal papilla stenosis in 9 cases (7.9%), and cholangitis in 14 cases( 12. 3% ). There were significant differences among these three groups for these three complications( x2 = 6. 482, 9. 160, and 12. 020 respectively,P < 0. 05 ), and the rate of complications in EST group was higher than that in other two groups. Conclusion For common bile duct stones, EPBD is the first choice followed by LCBDE while EST is only indicated for very few cases.
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AIM: To study the change of myocardial ceramide during myocardial ischemia/reperfusion and the relationship between ceramide and apoptosis and oxidative stress. METHODS: After inducing myocardial ischemia/reperfusion (I/R) injury in mice with pituitrin (Pit), myocardial SOD activity and MDA content were measured. DNA agarose gel electrophoresis and fluorescent staining of DAPI were done to check up apoptosis. The content of myocardial ceramide (?g/kg) was measured through HPTLC and scan of thin plate. RESULTS: The myocardium of I/R model group had the phenomenon of DNA ladder. Apoptosis index and ceramide content in I/R model group were higher than those in normal control group (P
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Objective To study the anti-myocardial ischemia-reperfusion injury effect of Sini Decoction's active fraction(SNDAF).Methods Experimental animals were randomly individed into normal,model,Sini Decoction(SND),and SNDAF groups.Rat hearts were perfused by the Langendorff method.The model of myocardial ischemia-reperfusion injury was reproduced by adjusting the flow of perfused liquid.The perfused liquid of normal and model groups was KH buffer saturated by oxygen.The perfused liquid with SND or SNDAF was mixed with KH buffer.The coronary flow and contract power of myocardium at 0 min of ischemia and 1,5,10,20,30,40,and 50 min of reperfusion were tested,respectively.The incidence of reperfusion arrhythmias(IRA) in the first 1 minute of reperfusion was calculated.Mice were given drugs by ig for 3 d and then myocardial ischemia-reperfusion models were established by ip pituitrin(20 U/kg).ECG of mice was recorded at 0—80 min after ip administration. SOD activity,and the contents of MDA and LA in myocardium of mice were measured.Results Both SND and SNDAF could reinforce myocardial contract and reduce the IRA in the first minute of reperfusion.SND had better effect on IRA than that of SNDAF.SNDAF had better effect on myocardial contract than that of SND.SND and SNDAF could significantly drop ECG J point raise induced by ischemia,and increase SOD activity,and decrease contents of MDA and LA significantly in ischemia myocardium.There were no significant difference between SND and SNDAF.Conclusion SNDAF could improve oxidative injury and suppress(ischemia) of myocardium,reinforce myocardial contract,and reduce the incidence of arrhythmias during(myocardia) ischemia-reperfusion.
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AIM: To study the effects of Sini Decoction's effective component(SNDE) on myocardial apoptosis and ceramide content during myocardial ischemla/reperfusion. METHODS: The mice of Kunming species were randomly divided into 3 groups: control,myocardial ischemia/reperfusion and SNDE.After inducing myocardial ischemia/reperfusion injury of mice in vivo with pituitrin(Pit),myocardial SOD activity and MDA content were measured.DNA agarose gel electrophoresis and fluorescent stain of DAPI were done to check up apoptosis.The content of myocardial ceramide(?g/kg) was measured through HPTLC and scan of thin plate. RESULTS: The myocardium of model group has the phenomenon of DNA ladder.The apoptosis index and the ceramide content in model group were higher than those of control group(P
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AIM: To screen the differentially expressed genes among normal, ischemic and Sini decoction-treated myocardium using DNA microarray.METHODS: Kunming mice were randomly divided into control group, ischemic group and Sini decoction group. Total RNA was extracted from myocardium of each group. cDNA microarray chips containing 2 304 cDNAs were used to investigate the gene expression pattern of each group. RESULTS: Up-and down-regulated genes were 33 and 70 in ischemic group vs control group, respectively. Up-and down-regulated genes were 23 and 52 respectively in Sini decoction group vs ischemic group. CONCLUSIONS: The analysis of gene expression pattern of ischemic myocardium based on cDNA microarray can realize high-throughput screening of the genes. Further analysis of those obtained genes information will be helpful to understand the molecular mechanism of myocardial ischemia and the therapeutic mechanism of Sini decoction.
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AIM: To detect the effect of Sini decoction on glutathione S-transferase (GST) mRNA expression in the ischemic myocardium. METHODS: Kunming mice were randomly divided into control group, ischemic group and Sini decoction group. Total RNA was extracted from the myocardium of mice in each group. The effect of Sini decoction on the expression of GST gene was detected by RT-PCR. RESULTS: The expression of GST mRNA in Sini decoction group was significantly up-regulated compared with the ischemic group and control group. CONCLUSION: Sini decoction can promote the expression of GST gene, which may be related to its protective effect on ischemic myocardium.
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AIM: To compare effects of SiNi-decoction and Vitamin E on vascular endothelial function of experimental atherosclerosis rabbits and their therapeutic action on atherosclerosis. METHODS: The model of experimental atherosclerosis rabbits fed with forage of high lipid was established and treated in groups randomly. At the end of the experiment, samples of aorta and blood were taken and the percentage of lipid plaque area of aortic endothelium ,lipid metabolism and vascular endothelial oxidative injury (SOD activity, MDA content, NO level, endothelin concentration) of each group were analyzed. RESULTS: In comparison with model group,the percentage of the lipid plaque area of aortic endothelium and endothelial oxidative injury (except for SOD of VitE group) of SiNi-high and mid-dose group and VitE group are reduced obviously (P
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AIM: To investigate the mechanisms of the anti-myocardial ischemia of Sini decoction at the level of proteome. METHODS: The total proteins of left ventricular muscle were separated with two-dimensional electrophoresis. The 2-DE images were analyzed with the PDQuest7 1 1 software package. The peptide mass fingerprinting(PMF) was made with MALDI-TOF-MS, then the identification and function of the protein was made via bioinformatics. RESULTS: Sini decoction could regulate the expression of 13 proteins in the ischemic myocardium. The proteins could allocated into five groups: energy metabolism-associated proteins, signal-associated proteins ,self-repair-associated proteins, anti-free radical injury-associated proteins and myocardial contractile-associated proteins. CONCLUSION: Sini decoction could prevent the myocardium from ischemia via regulating expression of different proteins.
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AIM: To investigate the influence of Sini decoction (SND) on the proliferation and apoptosis of rabbit abdominal aorta smooth muscle cells after ballon injury and discuss the effect of vascular smooth muscle cell's (VSMCs) proliferation and apoptosis in post-percutaneous coronary intervention (PCI) restenosis (RS) and the feasibility of SND preventing post-PCI RS. METHODS: The animal model of rabbit abdominal aorta ballon injury was set up and the therapertic group was treated with SND. The shape of proliferative and apoptotic cell were investigated by electron microscope. Immunohistochemistry staining was performed using ?-actin,PCNA and Cyclin E monoclonal antibodies. In situ Cell Death Detection Kit was used to identify apoptotic cells. Abdomial aorta angiography was operated in the 84th day subgroup and the stenosis degree was evalued by quantitative angiographic analysis. RESULTS: As compared with the control group, the therapeutic group displayed a lower proliferative percentage and a higher apoptosic percentage (P
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AIM: To investigate the effect of Sini decoction (SND)on the ultrastructure of small intestinal epithelial cells in rats with intestinal ischemia-reperfusion. METHODS: Thirty-two Sprague-Dawley rats of both sexes were randomly divided into 4 groups: (1) Control group in which sham operation was performed; (2) Model group in which intestinal I/R was produced by clamping super mesenteric artery(SMA) for 1 hour and declamping SMA for 3 hours; (3) SND1 group in which SD (0.6 g/200 g rat) was given via stomach tube 3 d before intestinal I/R; (4) SND2 group in which SD (1.2 g/200 g rat)was given via stomach tube 3 d before intestinal I/R. A strip of small intestine was taken from distal end of ileum for electron microscopic examination. The two-dimensional structural parameters and three-dimensional structural parameters of mitochondria were calculated. RESULTS: (1)Morphological changes of small intestine: In control group, epithelial cells were orderly arranged, with normal mitochondria and intestinal villi. In model group, the gaps between epithelial cells widened. There were a lot of apoptotic cells. Microvilli were short and swelled. Mitochondria were swelled obviously with broken ridges. Endoplasmatic reticulum was severely dilated. In SND1 and SND2 groups, microvilli and epithelial cells were orderly arranged relatively, mitochondria was slightly swelled. (2) Structural parameters of mitochondria: In model group, there were the least mitochondria and the swelling of mitochondria was severe. In SND1 and SND2 groups, the mitochondria was more than that of model group and the swelling were slight. CONCLUSION: Sini decoction can protect small intestine from ischemia-reperfusion injury without dose-dependent effect.