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With the continuous development of laparoscopic technology, the treatment of common bile duct stones has changed from the traditional open surgery to the current laparoscopic common bile duct exploration (LCBDE), which has the advantages of small trauma, fast recovery, less complications, short hospital stay and so on. LCBDE has two ways: through the common bile duct (LCD) and through the cystic duct (LTCBDE). LCD + T-tube drainage has a wide range of applications while the LCD + primary suture of bile duct eliminates T-tube and improves the quality of life of patients. LTCBDE has a certain range of applications, but has little trauma. The improvement of endoscopic technology and the application of new equipment also improve the efficiency and safety of operation. This article reviews the application progress of laparoscopic common bile duct exploration and lithotomy in the treatment of common bile duct stones.
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OBJECTIVE：To study “Qi-invigorating”effect and its possible mechanism of total saponins of Astragalus membranaceus on rats with Qi-deficiency ，and to provide reference for elucidating the material basis of “Qi-invigorating”effect of A. membranaceus . METHODS ：Forty male Wistar rats were randomly divided into normal group ，model group ，positive control group [Buzhong yiqi pills ，4.5 g/（kg·d）]，A. membranaceus total saponins high-dose and low-dose groups [ 252，28 g/（kg·d），by the amount of total saponins] according to body weight ，with 8 rats in each group. Except for normal group ，the model of Qi-deficiency was made in other groups by the method of “diet disorder+fatigue ”. At the same time ，administration groups were given relevant medicine intragastrically ，and normal group and model group were given constant volume of water，once a day ，for consecutive 21 days. After last administration ，the general situation of rats was observed ；the body weight ，spleen index and thymus index of rats were detected ；weight-bearing swimming time was recorded ；the levels of spleen T lymphocyte subsets CD 3 and CD 4，the levels of ATP and ADP in liver tissue ，serum levels of ALB ，RBC and HBG in blood as well as the serum levels of SOD，MDA，lactate，LDH，CK，IL-2，IL-12 and TNF-α were all detected. RESULTS：Compared with normal group ，body weight，thymus index ，spleen index ，weight-bearing swimming time ，the level of spleen T lymphocyte subsets CD 3，ATP，ADP， ALB，IL-2 and IL- 12 were decreased or shortened significantly in model group （P＜0.05 or P＜0.01）. The levels of MDA ， lactate，CK and TNF-α were increased significantly （P＜ 0.05）. Compared with model group ，body weight ，spleen index，weight-bearing swimming time ，the level of spleen T lymphocyte subsets CD 3 and the levels of ATP ，ADP，ALB， RBC and IL- 2 were increased significantly or prolonged（P＜0.05）；while the levels of MDA ，lactate，CK and TNF-α were decreased significantly in A. membranaceus total saponins high-dose group（P＜0.05 or P＜0.01）.Weight-bearing swimming time ，the levels of ATP ，ADP and IL- 2 in A. membranaceus total saponins low-dose group were increased significantly or prolonged （P＜0.05 or P＜0.01），while the levels of MDA ，lactate，CK and TNF-α were decreased significantly （P＜0.05 or P＜0.01）. Compared with positive control group ，spleen index ，spleen T lymphocyte subsets CD 3，weight-bearing swimming time and ATP level of A. membranaceus total saponins high-dose group were increased significantly or prolonged （P＜0.05 or P＜0.01），while MDA levels of A. membranaceus total saponins high-dose and low-dose groups were decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：A. membranaceus total saponins can reduce the body ’s accumulation of blood lactic acid ，the activity of CK ，the level of lipid peroxide and regulate immunity to tonify Qi ，delay fatigue and improve exercise ability.
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Intrahepatic cholangiocarcinoma (ICC) is a rare primary liver cancers. The pathogenesis is obscure and usually, it is asymptomatic in early stage, the diagnosis is made with difficulty. Most patients are in advanced stage upon diagnosis and have unresectable tumors.Strategies and indications for surgery are variable by different doctors. Standard, effective and individualized treatment strategies are lacking, with high malignancy, the tumor often shows unfavorable prognosis. In this review, we elucidate the cancer staging system, diagnostic algorithm, choice of surgical approaches and progress of nonsurgical treatment in conjunction with domestic and foreign literatures, so as to enhance the awareness of ICC and avoid misdiagnosis or underdiagnosis, eccessive or inadequate treatment in clinical work and confer benefit to patients.
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Intrahepatic cholangiocarcinoma (ICC) is a rare primary liver cancers.The pathogenesis is obscure and usually,it is asymptomatic in early stage,the diagnosis is made with difficulty.Most patients are in advanced stage upon diagnosis and have unresectable tumors.Strategies and indications for surgery are variable by different doctors.Standard,effective and individualized treatment strategies are lacking,with high malignancy,the tumor often shows unfavorable prognosis.In this review,we elucidate the cancer staging system,diagnostic algorithm,choice of surgical approaches and progress of nonsurgical treatment in conjunction with domestic and foreign literatures,so as to enhance the awareness of ICC and avoid misdiagnosis or underdiagnosis,eccessive or inadequate treatment in clinical work and confer benefit to patients.
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Objective To explore the effect of omni-directional health education on self-management level and blood glucose control in patients with type 2 diabetes mellitus. Methods A total of 100 diabetic patients admitted to the department of neurology of Taizhou Central Hospital from January to December 2016 were randomly divided into an observation group and a control group, 50 cases in each group. All patients were given conventional medication according to their systemic conditions, the control group used conventional nursing care, while the observation group was supplemented with omni-directional health education (including diet control therapy, exercise therapy, blood glucose control, hypoglycemic drug use and observation, foot care, blood glucose self monitoring) on the basis of routine nursing;the course of treatment was 2 weeks in the two groups. The differences in self-management level and the effect of blood glucose control were compared between the two groups. Results On the return visits, the self-management scores were significantly higher in both groups than those before education (the control group was 35.2±9.2 vs. 30.1±5.2, the observation group was 78.6±11.5 vs. 29.8±5.4, all P < 0.05), fasting blood glucose [FBG (mmol/L): the control group was 8.8±2.5 vs. 14.8±2.9, the observation group was 6.1±1.6 vs. 15.1±2.7, both P < 0.05) and 2 hours postprandial blood glucose [2 h PBG (mmol/L): the control group was 12.5±3.4 vs. 22.5±3.8, the observation group was 9.1±2.2 vs. 21.9±3.6) were obviously lower than those before education (all P < 0.05), the degrees of improvement of the observation group were more significant than those of the control group [self management score: 78.6±11.5 vs. 35.2±9.2, FBG (mmol/L): 6.1±1.6 vs. 8.8±2.5, 2 hours PBG (mmol/L): 9.1±2.2 vs. 12.5±3.4, all P < 0.05]. Conclusion Omni-directional health education can improve the self-management level of diabetic patients, and the patient's blood glucose control is relatively better.
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Objective To study the reasons for conversion to laparotomy in laparoscopic pancreaticoduodenectomy (LPD).Methods Of the 74 patients who underwent LPD in Yi Jishan Hospital,Wan Nan Medical College from May 2012 to Dec 2016,7 patients were converted to laparotomy.The clinical and operative data of the 7 patients were reviewed.Results There were 6 males and 1 female.The age ranged was 51 to 66 years.The pathologies included tumor of pancreatic head in 5 patients,chronic inflammation of pancreas in 1 patient and duodenum papilla cancer in 1 patient.The reasons for conversion were:uncontrollable bleeding in 4 patients with superior mesenteric vein injury in 1 patient,portal vein injury in 1 patient and first jejunal vein injury in 2 patients,respectively.The bleeding was controlled successfully after laparotomy in all the 4 patients.The conversion in the remaining 3 patients were due to difficulty in the operative procedures which resulted from severe adhesions between the tumor and the major vessels.There were 2 patients who had invasion of the SMV by tumor.They underwent vascular resection after laparotomy.The remaining patient had chronic inflammation and the lesion was resected successfully after careful dissection.Of the 7 patients,1 patient developed pancreatic fistula,1 patient developed delayed gastric emptying and 1 patient developed both bile leakage and delayed gastric emptying.They were all treated conservatively.There was no peri-operative death in the study.Conclusion Uncontrollable bleeding and severe adhesions between the lesion and major vessels were the major reasons in LPD for conversion to laparotomy.
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AIM To speculate the hypoglycemic mechanism for rats with type 2 diabetes by exploring the therapeutic effects of leaf aqueous extract from Cyclocarya paliurus on liver insulin receptor (InsR) and insulin receptor substrate 2 (IRS-2).METHODS The diabetic rat model was established through intraperitoneal injection of streptozotocin and fed with high-fat diet.The moleled rats were equally assigned into the control group and leaf aqueous extract from Cyclocarya paliurus group (extract group).After the test extract was orally administrated for four weeks,body weight,urine output,food intake,water intake and fasting blood-glucose (FBG) were measured,and the levels of serum insulin,InsR and IRS-2 mRNA in liver tissue were investigated in rats.RESULTS Compared with the control group,the extract group showed a reduction in urine output,food intake,water intake,FBG and insulin levels.Meanwhile,the rats' body weights in extract group were presented a trend to increase.The gene expressions of InsR and IRS-2 in liver tissue were up-regulated.Moreover,the insulin sensitivity was improved.CONCLUSION The leaf aqueous extract from Cyclocarya paliurus can reduce FBS,improve insulin sensitivity,which may be associated with the increase of InsR and IRS-2 gene expression in liver tissue.
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Objective To study the optimum determination conditions for lymphocytic proliferation by CCK-8 method in mice.Methods To study the different influence factors of spleen cell proliferation experiment stimulated by mitogen concanavalin A (ConA) or lipopolysaccharide (LPS),including cell preparation method,lymphocytic density,FBS and stimulating agent concentration in culture medium,and stimulating immediately or 24 h after preparing cell,with cross design or two factor completely randomized design.Results Spleen lymphocytic proliferation rate of preparation method by light suppression was higher than that of the light grind.The appropriate concentration of spleen cells was 5 × 106/mL.The proliferation rate has no significant difference after being stimulated for 48 or 72 h by ConA (2,5,or 1 0 μg/mL) or LPS (10,20,or 50 μg/mL) under 10％,15％,or 20％ FBS concentration in culture medium.The proliferation rate of stimulating immediately after preparing cell was higher than that of 24 h after preparing cell.Conclusion The optimum conditions of Balb/C mouse spleen cell proliferation assay stimulated by ConA and LPS are as follows:preparation of spleen cells with light pressure,spleen cell concentration of 5 × 106/mL,direct stimulation with 2-10 μg/mL ConA or 10-50 μg/mL LPS in the day of preparation.
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<p><b>OBJECTIVE</b>To discuss the application of right-inferior-posterior "artery first" approach in laparoscopic pancreaticoduodenectomy.</p><p><b>METHODS</b>Clinical data of 17 patients who underwent laparoscopic pancreaticoduodenectomy through right-inferior-posterior "artery first" approach in our department from February 2014 to April 2015 were retrospectively analyzed. The operation began at the inferior flexure of duodenum. After entering the Toldt's space, the left renal vein (LRV) was revealed and the root of superior mesenteric artery (SMA) was exposed just above the LRV. SMA was dissected along its trunk till the horizontal part of duodenum.</p><p><b>RESULTS</b>Of these 17 cases, adenocarcinoma of pancreatic head was observed in 5 cases, adenosquamous carcinoma in 2 cases, mucinous cycstic neoplasm in 1 case, adenocarcinoma of lower common bile duct in 4 cases, and duodenal papilla cancer in 5 cases. Fifteen cases were accomplished successfully with laparoscopy and 2 cases were converted to open approach. The average operating time was (320 ± 85) min and mean intraoperative blood loss was (305 ± 175) ml. The cutting margins were tumor negative in all the patients. The average number of harvested lymph node was 15.4 ± 6.5. Postoperative complication occurred in 5 cases. Two cases of bile leakage and 2 cases of pancreatic fistula were cured with conservative treatment. One case of delayed abdominal hemorrhage was resolved with reoperation.</p><p><b>CONCLUSION</b>Right-inferior-posterior "artery first" approach is safe and feasible in laparoscopic pancreaticoduodenectomy.</p>
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Humans , Adenocarcinoma , Duodenal Neoplasms , Duodenum , Laparoscopy , Mesenteric Artery, Superior , Operative Time , Pancreas , Pancreaticoduodenectomy , Postoperative Complications , Retrospective StudiesABSTRACT
BACKGROUND:Cigarette smoking can seriously damage the periodontal tissues and root, and the nicotine in tobacco accelerates the progression of periodontal diseases. OBJECTIVE: To investigate the effect of different doses of nicotine on the expression of cyclooxygenase-2 mRNA in the periodontal tissue during orthodontic tooth movement. METHODS: Totaly 110 Sprague-Dawley rats were randomly divided into blank control group (n=10), normal saline group (n=25), 0.5 mg/kg nicotine group (n=25), 0.75 mg/kg nicotine group (n=25), 1 mg/kg nicotine group (n=25). Rats in the normal saline groups were injected intraperitonealy with 0.1 mL normal saline, and those in the three nicotine groups were respectively injected with 0.5, 0.75, 1 mg/kg nicotine tartrate solution. Except the blank control group, the unilateral maxilary first molars of rats in the other four groups were exposed to 50 g force. At 1, 3, 5, 7, 14 days under force, the rats were sacrificed to take the maxilary tissues. Hematoxylin-eosin staining was used to observe the changes of periodontal tissues, immunohistochemical staining was employed to count positive cels, andin situ hybridization staining was adopted to detect the mean absorbance value of cyclooxygenase-2 in the periodontal tissues. RESULTTS AND CONCLUSION:The number of odontoclasts and the expression of cyclooxygenase-2 in the nicotine groups were higher than those in the non-nicotine groups. With the increasing dose of nicotine, the number of odontoclasts gradualy increased, and the difference was statisticaly significant (P < 0.05). At 7 days under force, the number of odontoclasts reached the peak. With the increasing dose of nicotine, the positive expression intensity of cyclooxygenase-2 was also increased, and the difference was statisticaly significant (P < 0.05). The expression of cyclooxygenase-2 reached peak at 5 days under force. These findings indicate that with the increasing dose of nicotine, the number of odontoclasts and the expression intensity of cyclooxygenase-2 are both increased at the same time point under force. During the orthodontic tooth movement, the intake of nicotine can damage the periodontal tissue, and the dose of nicotine can directly influence the severity of damage to the periodontal tissue.
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microRNAs (miRNAs)play important roles in recurrent hepatocellular carcinoma by regula-ting translation of target gene expression.Researches show that the abnormal expressions of miRNAs are closely related to the recurrent hepatocellular carcinoma,and the mechanisms include regulation of tumor angiogenesis and proliferation of tumor cells.miRNAs may be the most potential therapeutic targets for recurrent hepatocellu-lar carcinoma and have special advantages in prediction.
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BACKGROUND:Heat shock proteins have unique biological characteristics, and exploration of such proteins expressed in the myocardium under exercise stress has important value. OBJECTIVE:To investigate the studies about the expression of myocardial heat shock proteins under stress condition, and analyze the expression characteristics of myocardial heat shock proteins under different stress conditions. METHODA computer-based online retrieval was performed to find articles about the production, classification and function of heat shock proteins, as wel as the expression of myocardial heat shock proteins published from January 1991 to January 2014 in PubMed database and Wanfang databases. The key words were“heat shock protein;myocardium;exercise stress”in English and Chinese. Final y 48 relevant articles were summarized. RESULTS AND CONCLUSION:Heat shock proteins have the immune synergy effect. Researches show that, exercise training triggers the expression of myocardial heat shock protein. Acute exercise stress leads to a variety of physiological and biochemical changes, accordingly myocardial heat shock protein wil make the corresponding expression and protect myocardial cells. Low-intensity exercise can increase the expression level of heat shock protein 72, and inhibit cardiomyocyte apoptosis. High-intensity exercise reduces the expression of heat shock protein 72, which can not effectively inhibit cardiomyocyte apoptosis and is not conducive to the myocardial protective effect. The expression of heat shock protein under moderate-intensity exercise remains controversial. Exercise-induced expression of heat shock protein may have protection effect against damage induced by exercise, moderate exercise activities play an important role in enhancing myocardial function and preventing myocardial injury.
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BACKGROUND:As an important cytokine, interleukin-6 regulates immune responses in inflammation sites and has an autocrine/paracrine activity that stimulates osteoclast formation and bone resorption, which is related to bone remodeling during orthodontic tooth movement. OBJECTIVE:To investigate the effects of orthodontic force on the expression of interleukin-6 mRNA in the periodontal tissue of rats. METHODS:In situ hybridization was performed to measure the expression of interleukin-6 mRNA at 1, 3, 5, 7, 10 and 14 days after the application of orthodontic force on the maxil ary first molars of rats. RESULTS AND CONCLUSION:The expression of interleukin-6 mRNA was observed at a low level in the normal periodontal tissue of rats. After the application of force, the induction of interleukin-6 mRNA was observed to reach a maximum on day 3 and to decline thereafter. The expression of interleukin-6 mRNA can be evoked by orthodontic force but with a certain self-limiting. As a multifunctional cytokine, interleukin-6 plays a very important role in periodontal remodeling during orthodontic tooth movement.
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ObjectiveTo study the role of laparoscopic splenectomy (LS) using the anterior approach with sequential layered dissection. MethodsFrom December 2007 to July 2009, we performed 27 LS using the anterior approach with sequential layered dissection. The clinical data were retrospectively analyzed. ResultsThe range of splenic length was 8-20 cm. Accessory spleen was found in 6 patients (22.2%). The mean operative time was 125 mins. The mean intraoperative blood loss was 90 ml, and the mean postoperative stay was 5.5 days. ConclusionsLaparoscopic splenectomy using the anterior approach with sequential layered dissection could be carried out smoothly and rapidly. It reduced accidental injuries and shortened the operative time.
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BACKGROUND: Palatal implant could be an effective type of anchorage that can afford long-term stress, and bone thickness and bone density of the implant placement will affect the success of the implant stability. Presently, actinoscopy commonly used in stomatological clinic cannot provide the precise information of palatal bone thickness and bone mineral density such as toroidal slide plate photograph and skull lateral projection. OBJECTIVE: To measure the thickness and density of median palatine suture, and to provide the consultation for implant anchorage using spiral CT. DESIGN, TIME AND SETTING: A measurement study was performed at the Medical Imaging Center, First Affiliated Hospital of Xinjiang Medical University from July to December in 2008 PARTICIPANTS: The sample consisted of 194 cases undergoing 64 slice CT at the Medical Imaging Center of First Affiliated Hospital of Xinjiang Medical University, including the scope of the hard palate and maxillary dentition. They were aged from 18 to 50, and divided into three groups by age, 18-30-year-old group, 31-40-year-old group, and 41-50-year-old group. METHODS: Measurement of palatal raphe area first three-dimensional reconstruction of images at up to nasion plane centerline, whichever was determined as a reference surface plane, selection one point on incisor cervix in this line, to measurement of the available palatal bone height; sagittal views were selected at 6 mm dorsally from the incisive canal. The available bone height was defined as the distance from the palatal baseline (lower cortical border of the palate) to the nasal cavity (upper cortical border of the nasal cavity). Bone mineral density can also be measured at the same site, take the average of the cortical and cancellous bone. MAIN OUTCOME MEASURES: The palatal bone thickness and bone thickness density were measured at 6 mm dorsally from the incisive canal. RESULTS: Male in the palatal bone thickness and bone mineral density were significantly higher than female (P < 0.05); there were no significant difference between Han and Uygur (P>0.05). In different age's group of men and women, the palatal bone thickness and bone mineral density showed no statistical difference (P > 0.05). Age, palatal bone thickness and palatal bone mineral density had no significant correlation. CONCLUSION: Spiral CT can be used in different parts of mandible thickness and density measurement and analysis. The palate raphe can be implant as orthodontic anchorage if it measured exactly.