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Gallstones is a common digestive system disease in China and has a complex pathogenesis. It is often considered that it is mediated by many factors in the genetic background, including biliary cholesterol supersaturation, intestinal cholesterol hyperabsorption, abnormal cholesterol nucleation in bile, dysfunction in gallbladder dynamics, and cholestasis. This article reviews the role of the above mechanisms in the association between diseases outside the gallbladder and gallstones. Based on current evidence, the above diseases may promote the formation of gallstones, and active intervention of the above diseases outside the gallbladder may help to expand new strategies for the prevention and treatment of gallstones.
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Objective To observe the therapeutic effect of Dioscorea opposita polysaccharide on gastric ulcer in rats,and to investigate the effects of Dioscorea opposita polysaccharide on level of epidermal growth factor ( EGF) in stomach tissues .Methods 50 rats were randomly divided into five groups [ A group ( normal control group ) , B group(model group),C group(Dioscorea opposita polysaccharide group ),D group(teprenone group)].The healing condition of gastric ulcer and EGF level were observed and compared .Results (1)The ulcer index of C group was obviously reduced compared with B group (P0.05).Conclusion Dioscorea opposita polysaccharide has protective effects for gastric mucosa .The mechanism of protection may be related to promote synthesis of EGF .
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Objective To increase the awareness of the incidence trend of ischemic colitis and improve the level of diagnosis and treatment.Methods From January 2004 to December 2013,the clinical data of 89 in patients with ischemic colitis were retrospectively analyzed.At the same period,100 patients diagnosed as chronic colitis were enrolled as control group.The laboratory findings of patients with ischemic colitis were compared with those of control group.Non normal distribution data were analysed by non parametric test.Results The annual person-times of patients with ischemic colitis and the percentages accounted in the whole hospital annual person-times increased year by year in recent 10 years,which was one person time and 0.01％ in 2004 increased to 41 person-times and 0.11％ in 2013.The average age of the 89 patients was (63.5±12.7) years,and the male to female ratio was 1∶2.18.The most common underlying disease in the 89 patients was hypertension,accounted for 43.8％.Thirty-eight patients had a history of abdominal surgery,and eighteen patients with appendectomy,accounted for 20.2％.Seventy-eight patients had abdominal pain and defecation desire.Seventy-four patients complained of hematochezia.Compared with control group,there was no statistically significant difference in fasting blood glucose,triglyceride,total cholesterol,blood platelet levels and prothrombin time (all P＞0.05).While the levels of C reactive protein and Ddimer were higher than those of control group (89.21 mg/L vs 61.29 mg/L,90.13 μg/L vs 59.39 μg/L; Z=-3.959,-4.377; both P＜0.05).The images of computed tomography (CT) indicated thickened bowel wall in lesion segment.The results of colonoscopy showed that in the left colon and rectum were the predilection sites,accounted for 93.88％ (138/147).The average hospital stay was (10.59 ± 5.97) days and t he recurrence rate was 3.37 ％ (3 / 89).The percentage of chronic cases was 2.25 ％ (2/89),and no death was reported.Conclusions The incidence of ischemic colitis significantly increased in recent years.Patients with abdominal pain and/or hematochezia should be considered,especially those over 60 years old.Receiving colonoscopy as earlier as possible was helpful for the diagnosis.
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Objective To explore how to improve the curative effects and reduce the complications of duodenoscopy in the treatment of bile duct diseases. Methods Clinical data of 292 cases of endoscopic sphincterotomy (EST) and 104 cases of endoscopic nose biliary drainage (ENBD, including 9 post-EST cases) from February 1995 to February 2003 were retrospectively reviewed. Results The success rate of EST was 92.1% (269/292). Among 272 cases of common bile duct calculus, stones were completely taken out in 235 cases (86.4%). Among 15 cases of intrahepatic duct calculus, stones were completely removed in 4 cases. Biliary duct foreign bodies were removed at once in 3 out of 5 cases. EST related complications were found in 16 cases (7 cases of acute pancreatitis, 5 cases of bleeding at the site of incision, 2 cases of severe cholangitis, 1 case of duodenal perforation and 1 case of instrumental break-off), with an incidence rate of 5.5% (16/292). Satisfactory outcomes were achieved in 92 cases receiving ENBD. No death occurred in the study. Conclusions Proper selection of patients and skillful performance of EST is the key to improve its curative effects and reduce its complications.
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Objective To clarify the factors influencing development of cholecystopathy in schis-tosomiasis portal hypertension. Methods The data of 116 schistosomiasis portal hypertension patients from 1998 to 2002 were retrospectively analyzed and compared with non-liver disease pa-lients. Results Of the incidence of cholecystitis, the schistosomiasis portal hypertension patients vs non-liver-disease were 87.9% (102/116) vs 36.6% (15/41) (P0. 05). Of the incidence of cholecystolithiasis, the schistosomiasis portal hypertension patients vs non-liver-disease were 38.8% (45/ 116) vs 19.5% (8/0.41) (P0. 05). Conclusion The incidences of cholecystolithiasis and cholecystitis are closely correlated with portal hypertension in schistosomiasis, and are not closely correlated with hypersplenism.