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Objective To compare the clinical efficacy of one-stage laparoscopic cholecystectomy (LC) plus laparoscopic common bile duct exploration (LCBDE) with primary suture (PS) versus two-stage endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST) followed by LC in treatment of cholecystolithiasis complicated with choledocholithiasis.Methods The clinical data of 171 patients with cholecystolithiasis complicated with choledocholithiasis,who underwent minimally invasive surgical treatment from January 2016 to December 2017,were retrospectively analyzed.Of these patients,90 underwent one-stage LC + LCBDE + PS (the one-stage group),and 81 underwent two-stage ERCP/EST followed by LC (the two-stage group).The main clinical variables between the two groups of patients were compared.Results The surgical success rates (94.4％ vs.95.1％),residual stone rates (3.3％ vs.4.9％) and incidences of postoperative complications (6.7％ vs.8.6％) showed no significant difference (all P ＞ 0.05) between the one-stage and two-stage groups.Compared with the two-stage group,the operative time was shorter (110.4 vs.135.7 min),the length of postoperative hospital stay was shorter (3.3 vs.7.1 d) and the total hospitalization cost was reduced (22 756.2 vs.31 429.3 yuan) in the one-stage group.The incidence of long-term complications (2.2％ vs.9.9％) in the one-stage group was also lower than that in the two-stage group (both P ＜ 0.05).Condusions Both one-stage LC + LCBDE + PS and two-stage ERCP/EST + LC are safe and effective in the treatment of cholecystolithiasis complicated with choledocholithiasis.One-stage LC + LCBDE + PS shows obvious advantages in hospitalization stay,hospitalization cost and in the preservation of function of the Oddi sphincter,and therefore should be the first choice in most cases.
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Objective To compare the clinical efficacy of one-stage laparoscopic cholecystectomy (LC) plus laparoscopic common bile duct exploration (LCBDE) with primary suture (PS) and two-staged endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST) followed by LC in treatment of cholecystolithiasis complicated with choledocholithiasis.Methods Of these patients,58 received one-staged LC + LCBDE + PS (the one-stage group),and 71 underwent two-staged ERCP/EST followed by LC (the two-stage group).Results The surgical success rate,residual stone rate,incidence of postoperative complications and operative time showed no significant difference (x2 =0.344,0.344,0.108,t =-0.240,all P ＞ 0.05) in both the one-staged and two-stage groups.Compared with the two-staged group,the hospital stay was shorter (4.1d vs.6.9d) and the total hospitalization cost was lower (23 126 yuan vs.32 982 yuan) in the one-staged group.Conclusion Both one-staged LC + LCBDE + PS and two-staged ERCP/EST + LC are safe and effective in the treatment of cholecystolithiasis complicated with choledocholithiasis on base for base basis.
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ObjectiveTo construct a protein interaction network based on high-throughput sequencing data of liver cancer-related non-coding RNAs, to perform a functional enrichment analysis, and to screen out circular RNAs (circRNAs) participating in the development and progression of liver cancer via the mechanism of competitive endogenous RNA (ceRNA). MethodsThe circRNA-miRNA-mRNA network was constructed using gene expression omnibus (GEO) data based on the ceRNA theory. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genome (KEGG) analyses were performed to identify circRNAs with potential ceRNA function and explore their functions. ResultsA total of 9 co-expressed circRNAs, 20 co-expressed miRNAs, and 153 co-expressed mRNAs were screened out from the GEO database, and the liver cancer-related circRNA-miRNA-mRNA network was successfully constructed. The GO analysis revealed 90 biological processes, which mainly involved 12 functional clusters including hepatocyte differentiation, phase-change regulation of cell cycle, and negative regulation of transcription factor activity. The KEGG analysis showed that the co-expressed circRNAs were also involved in the p53 and PI3K-Akt signaling pathways. ConclusionThis study provides new insights for circRNAs mediating the development and progression of liver cancer through the mechanism of ceRNA.
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Objective To study the feasibility and efficacy of treatment of extrahepatic cholangiolithiasis using laparoscopic self-releasing J-tube drainage combined with primary suturing of common bile duct.Methods The clinical data of 172 patients with extrahepatic cholangiolithiasis who underwent operations from March 2013 to January 2015 were retrospectively studied.The patients were divided into two groups:the J-tube drainage group (n =82) and the T-tube drainage group (n =90).Surgical duration,intraoperative bleeding,postoperative hospital stay,treatment cycles,hospital costs,incidences of postoperative bile leakage and residual extrahepatic cholangiolithiasis were compared between the two groups.Results The length of postoperative hospital stay in the J-tube drainage group was (4.9 ± 1.2) days and in the T-tube drainage group was (8.0 ± 2.0) days.The treatment cycles in the J-tube drainage group were (4.9 ± 1.2) days while in the T-tube drainage group were (24.1 ± 3.2) days.The hospital costs in the J-tube drainage group were (12 817.1 ±3 167.1) yuan and the costs in the T-tube drainage group were (15 012.5 ±2 354.8) yuan.There were significant differences in hospital stay,treatment cycles and hospital costs between the two groups (all P ＜ 0.05).The surgical duration in the J-tube drainage group was (108.2 ± 10.2) minutes and the duration in the T-tube drainage group was (110.1 ± 13.1) minutes.The amount of intraoperative bleeding in the J-tube drainage group was (35.0 ± 20.0) ml and the amount in the T-tube drainage group was (42.0 ±30.0) ml.There were no significant differences in intraoperative bleeding and surgical duration between the two groups (all P ＞ 0.05).No significant differences were observed in the incidences of post-operative bile leakage and in residual extrahepatic cholangiolithiasis between the two groups (P ＞ 0.05).Conclusions Self-releasing J-tube drainage combined with laparoscopic primary suturing of common bile duct was safe and efficacious.It was minimally invasive in treating patients with extrahepatic cholangiolithiasis.
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To understand the genetic origin and variation of porcine epidemic diarrhea virus (PEDV) prevailing in Henan province,a total of 22 PEDV positive samples from suckling piglets with severe diarrhea were collected from 16 pig farms and amplified by RT-PCR.ORF3 genes were then cloned into pMD18-T vector and sequenced.The result of sequencing showed that the length of ORF3 genes all were 675 bp which encoded 224 amino acids.The strains in this study had eight amino acid substitutions when compared with CV777 strain.The nucleotide homologies of the 22 strains were 95.9％-100％ and amino acid homologies were 96.4％-100％.By comparing with those of European strain CV777 and vaccine strain truncated CV777,the nucleotide homologies were 97.1％-97.9％ and 94.8％-95.4％,respectively.Based on the phylogenetic relationship of ORF3 genes,the PEDV field strains and PEDV reference strains could be divided into two groups,and all the field strains identified in this study belong to group 2.It suggested that prevalent PEDV strains in this study seem to be closely related to Henan isolates in previous years,domestic strains,Janpanese strains,American strains as well as Korean strains but differ genetically from European strains or vaccine strains used in China.This experiment analyzed the ORF3 gene sequence features in prevailing of Henan region in recent years,which provides a new support of epidemiology study and protein function research of PEDV ORF3 gene.
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In order to develop a combined live vaccine that will be used to prevent against porcine parvovirus (PPV) and Pseudorabies virus (PRV) infection, the VP2 gene of PPV was inserted into the transfer vector plasmid pG to produce the recombinant plasmid pGVP2. The plasmid pGVP2 and the genome of PRV HB98 attenuated vaccine were transfected by using lipofectamine into swine testis cells for the homologous recombination. The recombinant virus rPRV-VP2 was purified by selection of green fluorescence plaques for five cycles. 6-week-old female Kunming mice were immunized intramuscularly with attenuated PRV parent HB98 strain, commercial inactivated vaccine against PPV, recombinant virus, DMEM culture solution. The injections were repeated with an equivalent dose after 2 weeks in all of the groups, and then challenged with the virulent PRV NY strain at 7 weeks after the first immunization. The recombinant virus rPRV-VP2 was successfully generated, and the recombinant virus could effectively elicite anti-PPV and PRV antibody and significant cellular immune response as indicated by anti-PPV ELISA and HI, PRV-neutralizing assay and flow cytometry. The challenge assay indicated that recombinant virus could protect the mice against the virulent PRV challenge. These results demonstrated that the recombinant virus can be a candidate recombinant vaccine strain for the prevention of PRV and PPV.
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Animals , Female , Mice , Antibodies, Viral , Allergy and Immunology , Antigens, Viral , Genetics , Allergy and Immunology , Capsid Proteins , Genetics , Allergy and Immunology , Gene Expression , Genetic Vectors , Genetics , Metabolism , Herpesvirus 1, Suid , Genetics , Metabolism , Parvovirus, Porcine , Genetics , Allergy and Immunology , Swine , Swine Diseases , Allergy and Immunology , Virology , Viral Vaccines , Genetics , Allergy and ImmunologyABSTRACT
Objective To investigate the clinical features,surgical treatment and prognosis of female breast cancer patients under 35 years.MethodsThe clinical data of 140 cases of female breast cancer patients in the young group ( ≤ 35 years) and 326 cases of female breast cancer patients in the control group ( 45 - 59years) undergoing surgical treatment from 2002 to 2009 in our hospital were analyzed retrospectively.All the data were analyzed with the statistical software of SPSS13.0.ResultsThe difference between the 2 groups had no statistical significance in tumor size or pathologic types( P ＞0.05).The axillary lymph node metastasis rate was obviously higher in the young group than in the control group ( P ＜ 0.05 ). Modified radical mastectomy and breast-conserving surgery were mainly performed.The proportion of patients in stage Ⅲ and Ⅳ in the young group was higher than that in the control group.The positive rate of ER and PR was lower while the positive rate of HER-2 was higher in the young group than those in the control group( P ＜ 0.05 ).ConclusionsBreast cancer in young women has the features of high clinical stage,high lymph node metastasis rate,low positive rate of ER and PR,high positive rate of HER-2,high recurrence rate and poor prognosis.The treatment principle of the diseaseis comprehensive therapies mainly based on surgical treatment.
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ObjectiveTo discuss the diagnosis method and management of Gallbladder polypoeid lesions (GPL).MethodA ten-year (2002-2011) retrospective reviews of all patients result underwent in ultrosenography (US) was conducted.ResultsTotal 591 peatients with GPL detected on US were identified,349 patients (59.1％) were women,the age ranges 20 to 93 years.395 patients had abdominal symtoms,of which 39.9％ patients had a single polyp and 9.8％ had gallstones.The specifisity of the diagnosis of GPL in US was 92.5 ％.Laparascopic cholecystectomy (LC) is the treatment of 136 chosen cases.In cases suspicious of malignancy,it is advisable to do cholecystectomy.ConclusionsMost small GPL are benign and remain static for years.Age more than 50 years old and size of polyp more than 10 mm are the two main important risk factors predicting malignancy in GPL.Other risk factors include concurrent gallstones,solitary polyp,and symptomatic polyp.LC is the treatment of unless since the suspicion of malignancy is high.
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Objective To discuss the standard diagnosis and treatment for thyroid nodule.Methods 2 581 patients with thyroid nodule from 2005 to 2009 were studied.Common methods of examination and treatment were analyzed to avoid over-examination and over-treatment.Results 90%of the patients underwent ultrasound examination with a 92.9%sensitivity and 44.3%specificity when there were two or more risk characters.All patients underwent certain kinds of surgery according to their clinical conditions.The recurrence rate was 4%two and half years after lateral thyroid adenectomy or thyroid surgery without excision of thyroid isthmus.Conclusions There are many approaches to thyroid nodule examination and treatment,in which ultrasound is recommended for preoperative examination because of its higher sensitivity,specificity and lower cost,and surgery is still the most useful and effective treatment.Choosing the proper method for thyroid nodule diagnosis and treatment is the key point to avoid over-examination and over-treatment.
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Objective To discuss diagnosis and surgical treatment for chronic lymphocytic thyroiditis (CLT). Methods Records of 70 patients who were diagnosed as CLT from 2005 to 2009 were retrospectively reviewed. They were divided into two groups according to pathological results. Results There were 6 patients of CLT accompanying with papillary carcinoma. The rest 64 patients were diagnosed as CLT accompanying with benign nodules. All cases were confirmed by pathology and treated with operation. Conclusions Coexistence of nodules which can not be excluded from carcinoma is the main reason for surgical treatment in case of CLT. CLT patients especially for those associated with single nodule and/or microcalcification inside nodules should be given surgical treatment. The operative method depends on pathological results during operation.
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Objective To investigate the protective effects of G CSF on lungs of rats with acute cholangitis and changes in blood TNF and TXA 2/PGI 2 by treating the rats with G CSF. Methods Seventy two Wistar rats were randomized into the control, infected and treated groups. We established the model of cholangitis in the rats with injection of E. coli 25922 into the bile duct. The animals in the treated group were pretreated with G CSF 500 ng/day bid) for 5 days before the E. coli injection. The levels of blood TNF and TXA 2/PGI 2 were measured at the 3rd, 6th and 12th h after the injection. Meanwhile, the morphological changes in lungs of the rats were observed. Results The morphological changes in lungs were milder and levels of blood TNF and TXA 2/PGI 2 were significantly lower in the treated group than in the infected one (P
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Objective To summarize the pathogenesis and diagnosis experience of the ophthalmopathy in Graves' disease. Methods The summarize paper made on eviewing correlative documents. Results ①The endocrine ophthalopathy occupies about 25 percent in the Graves' disease patient. The clinical manifestation is infiltrating exophthalmic tissues, bulbar conjunctiva edema, ophthalmus muscles spasm and anopsia. ②It is a special auto immune disease. Thyrotrophin receptor antibody(TRAb) infiltrates the thyroid gland and internal orbital tissues to cause lymph cells infiltration and inflammatory reaction that can change the visual organ structure. The internal orbital IgA content also rise. ③Antithyroid drug, hormones and postorbital irradiation can be used to treat this disease, but total thyroidectomy can decrease the TRAb concentration in blood which has prominent therapeutic effect. Conclusions Graves disease is an auto immune disease, foe treatment of endocrine ophthalmopathy, total tyroidectomy is necessary as early as possible.