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One patient with recurrent attacks of pancreatitis and pancreatic head mass had a long history of recurrent abdominal pain, abdominal distension, nausea and vomiting, and no significant alleviations were observed under non-surgical treatment in many hospitals. After the diagnosis and treatment by the multidisciplinary team of gastroenterology, hepatobiliary and pancreatic surgery, oncology, pathology, radiology and other departments of Third Xiangya Hospital of Central South University, the patient underwent pancreaticoduodenectomy to completely remove the painful lesion, without leaving histological basis for canceration caused by chronic inflammation. The safety of the surgery was greatly improved and no obvious complications were observed.
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<p><b>OBJECTIVE</b>Combined the optical principle with automatic control technology and computer real-time image detection technology to develop a non-contact system for noninvasive esophageal varices pressure measurement.</p><p><b>METHODS</b>The system included the adjustable air pump, laser device, image collection and analysis program. The feasibility and accuracy of the system were verified by in vitro experiments.</p><p><b>RESULTS</b>The bionic vascular pressure measured by this system had good correlation and repeatability with the actual pressure.</p><p><b>CONCLUSIONS</b>This system is accurate, feasible and has good application prospects.</p>
Subject(s)
Blood Pressure Determination , Esophageal and Gastric Varices , Image Processing, Computer-Assisted , Lasers , SoftwareABSTRACT
OBJECTIVE@#To compare endoscopic variceal ligation (EVL) with propranolol for prophylaxis of first variceal bleeding.@*METHODS@#We chose 168 patients with cirrhosis and esophageal varices in our hospital and allocated them to EVL and propranolol groups. Treatment effectiveness and safety in the 2 groups were observed.@*RESULTS@#he parameters of two groups were similar before therapy. Follow-up period was 8-36 months. Variceal bleeding occurred in 24 (28.6%) of the EVL group and in 20 (23.9%) of the propranolol group (P>0.05). Overall mortality and death related to bleeding were similar (21.4% vs 17.9%; 7.1% vs 6.0%, P>0.05). Adverse events related to EVL were 43 (3 of them life-threatening) compared to 16 in the propranolol group (51.19% vs 19.05%, P<0.05).@*CONCLUSION@#Propranolol may be the better choice in prophylaxis of variceal bleeding with similar effects and lower adverse events than with EVL.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Endoscopy, Gastrointestinal , Methods , Esophageal and Gastric Varices , Drug Therapy , General Surgery , Therapeutics , Gastrointestinal Hemorrhage , Ligation , Methods , Liver Cirrhosis , Propranolol , Therapeutic UsesABSTRACT
ObjectiveTo explore the effects of splenectomy on hepatic fibrosis and on the expression of PDGF-B in the liver and PDGF-BB in the serum of rats with hepatic fibrosis. MethodsBy hypodermic injection CCl4, we established 65 rat models with hepatic fibrosis, splenectomies were performed in the three groups at different phases: before hypodermic injection CCl4 (A group), five weeks after hypodermic injection CCl4 (B group), and ten weeks hypodermic injection CCl4 (C group). The control groups were established at the same time, with samples of the livers and serum of the rats taken in different phases. The expressions of PDGF in the liver were detected by immunohistochemistry technique and the degree of hepatic fibrosis was detected by HE staining. The serum levels of PDGF-BB were analyzed by ELISA technique. ResultsAbsorbance values of PDGF-B in the experimental group were significantly lower than the control groups (P＜0. 05). Serum levels of PDGF-BB of the rats after splenectomy were significantly lower than those in the control groups (P＜0.05). HE and Masson's staining showed that the progression of Hepatic fibrosis was slow in the A group. Hepatic pathologic state was significantly relieved in the B group and the inflammation and fibrosis was relieved in the C group. Conclusion Earlier period splenectomy could delay the proceeding of experimental hepatic fibrosis. After splenectomy the decline in the level of PDGF may be one of the mechanisms causing the delay.
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OBJECTIVE@#To treat superficial hemangioma in children according to the local blood flow.@*METHODS@#A total of 98 children with superficial hemangiomas admitted to our hospital from January 2005 to June 2009, and their clinical data were analyzed.@*RESULTS@#According to the local blood flow velocity, 98 children were treated with injections or injection plus surgical treatment, respectively. Ninety-four children (95.9%) were cured.@*CONCLUSION@#Injection therapy is effective for children with superficial hemangioma, but we should arrange individualized treatment according to the local blood flow in children.
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Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Bleomycin , Glucocorticoids , Hemangioma , Therapeutics , Injections, Intralesional , Regional Blood Flow , Skin Neoplasms , TherapeuticsABSTRACT
OBJECTIVE@#To observe the effect of subfascial endoscopic perforator vein surgery (SEPS) in the treatment of chronic venous ulceration of the legs.@*METHODS@#Chronic venous ulceration for 91 patients with 102 limbs was treated by SEPS from January 2005 to July 2008. The effect of SEPS on chronic venous ulceration of the leg, the symptoms during and after the operation, and the durations of hospital treatment were analyzed.@*RESULTS@#The symptoms of the 102 legs conducted by SEPS operation, except the pigmentation, were obviously improved (P<0.01). Its cicatrisation rate, the recrudesce rate, and the cut infection rate were 93.1%, 1.96%, and 1.0%, respectively. The time of the operation was short and the hemorrhage was small during the surgery. The durations of hospitalization and the cicatrisation time of ulceration were (6.5+/-3.4) d and (12.2+/-13.7) d, respectively.@*CONCLUSION@#SEPS is simple and effective in treating chronic venous ulceration of the leg, and particularly effective for patients classified into C5 and C6 in clinical-etiological-anatomical-pathophysiology (CEAP).
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Angioscopy , Methods , Fasciotomy , Varicose Ulcer , General Surgery , Varicose Veins , General Surgery , Vascular Surgical Procedures , Venous Insufficiency , General SurgeryABSTRACT
A new device that allows noninvasive measurement of venous pressure has been invented in our laboratory and tested for its feasibility and validity. The device consists of four parts: 1. the air infusion system; 2. the pressure sensor gauge; 3. signal transducer and data processing system 4. the fixing apparatus. The correlation between noninvasive pressure and invasive pressure has been studied in vitro test on a saphenous vein model and in vitro test on dog's portal venous system. In vitro and vivo study, an excellent correlation between noninvasive pressure and invasive pressure was obtained(r = 0.99, P < 0.0005; r = 0.97, P < 0.005). These data suggest that the new device allows a noninvasive measurement of venous pressure especially for the large veins such as vena cava, venae pulmonales and esophageal varices.
Subject(s)
Animals , Dogs , Blood Pressure Determination , Equipment Design , In Vitro Techniques , Venous Pressure , PhysiologyABSTRACT
Objective To assess the effect of different treatment complex on portoazygous shunt in portal hypertensive patients. Methods Patients (115 cases) with esophageal varices were randomized to receive either endoscopic variceal ligation ( EVL) alone (54 cases ) , pericardial devascularization procedure (PDP) alone(30 cases) or a combination of EVL and PDP(31 cases) for variceal eradication. Esophageal vascular structures were examined with miniature ultrasonic probe and azygos blood flow (ABF) was measured with color Doppler ultrasonography. Results Esophageal varices were obliterated and collateral veins remained unchanged in patients treated by EVL, esophageal varices were diminished in size and collateral veins were obliterated by PDP and both esophageal varices and collateral veins were obliterated by the combination of EVL and PDP. EVL,PDP alone and a combination of the two modalities decreased ABF by 31% ,32% and 43% respectively. Conclusions The combination of EVL and PDP most effectively blocks esophageal collateral shunts.
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Objective This study aimed at assessing the long-term efficacy of EVL for esophageal variceal bleeding. Methods Long-term EVL was assessed in 263 patients with variceal bleeding,among them 71 were of Child- Pugh Class A,82 of Class B and 110 of Class C.EVL was repeated at two week intervals until varices were eradicated.Results Esophageal varices were eradicated in 91% of the 238 patients who survived for more than three months after 1 to 10 (average 4) successive ligations.Recurrent variceal bleeding occurred in 15% of the 263 patients and was markedly reduced after eradication of the varices.The overall cumulative survival rates at 1,3,and 5 years were 76%,62%,and 57%,respectively.The prognosis was influenced by Child- Pugh's risk grade.56 of the 263 patients died during the study period,and the major cause of death was liver failure.Conclusion EVL is effective for long-term control of esophageal variceal bleeding.Repeated EVL re- duces rebleeding rate and improves survival in patients who have bled from esophageal varices.
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Objective To study the role of VEGF in the development of portal hypertensive gastropathy(PHG). Methods Forty-four portal hepertensive patients were investigated according to with or without PHG. The degree and the location of PHG were recorded. The specimens were obtained to perform RT-PCR to measure VEGF mRNA. Results VEGF mRNA in severe (3.48?1.02) or moderate PHG (2.28?0.33) with portal hypertension was higher than that in control (1.40?0.23) and those (1.51?0.32) with portal hypertension without PHG( P