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Objective:To study the occurrence and disappearance of gallbladder polyps in patients who underwent multiple ultrasonographic examinations, and to determine the risk factors of formation of gallbladder polyps.Methods:From January 2014 to December 2017, relevant data on patients who underwent follow-up abdominal ultrasound examinations at the Health Screening Center of Xuanwu Hospital was retrospectively analyzed, and the dynamic changes of gallbladder polyps were assessed. A comparative analysis was then conducted between those who had gallbladder polyps (the gallbladder polyps group, n=1 149) and those who had no gallbladder polyps (the control group, n=18 243). The occurrence, changes and disappearance of gallbladder polyps shown on multiple untrasonographic examinations were compared. Results:The patterns of changes of gallbladder polyps showed that the proportions of patients with gallbladder polyps which were stable in size ( n=1 149, 52.1%) were greater than those who had new appearance of gallbladder polyps ( n=797, 36.2%), and these 2 groups of patients were having higher proportions than those who had disappearance of gallbladder polyps ( n=258, 11.7%). The largest proportion of gallbladder polyps were found in middle-aged people, and new polyps were mainly found in the age group of 30.0-59.0 years. The peak of gallbladder polyps incidence was after age 60. There were significant differences in age, male, blood glucose, total cholesterol, low density lipoprotein (LDL), and diastolic blood pressure between the study and the control groups (all P<0.05). Multivariate analysis showed that age ( OR=1.152), male ( OR=1.407) and LDL ( OR=1.656) were independent risk factors of gallbladder polyp formation. Conclusions:The annual incidence of gallbladder polyps was 9.7‰. Gallbladder polyps were more commonly found in middle age, and the incidence of gallbladder polyps was increasing. Gallbladder polyps could disappear. However, with increase in initial diameter of gallbladder polyps, the probability of disappearance decreased. Age, male gender and elevated LDL were independent risk factors of gallbladder polyps formation.
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Objective@#To explore the selection method and technology of laparoscopic surgery for gallbladder stones and common bile duct stones(GCBDS).@*Methods@#Data was collected from 318 in-patients of GCBDS at Department of General Surgery,Xuanwu Hospital of Capital Medical University from January 2013 to December 2017, and 298 in-patients acceptedlaparoscopic cholecystectomy(LC) and choledocholithotomy were recruited into final analysis.There were 138 males and 160 females,aged (60.4±18.6)years (range:25-89 years).Retrospective analysis was done on method distribution,effect and safety of laproscopic surgery.Comparisons of basic characters and therapeutic effects were performed betweenlaparoscopic common bile duct exploration (LCBDE) combined with primary closure and T tube drainage(TTD).@*Results@#Among therecruited in-patients,LC combined with common bile duct exploration was performed in 7 cases(2.3%, 7/298), LC combined with LCBDE was performed in 291 cases(97.7%,291/298).There were 133 cases (45.7%,133/291) who treated by LCBDE combined with TTD and 158 cases(54.3%,158/291) who treated by LCBDE combined with primary closure.In LCBDE combined with primary closure group,18 cases (11.4%,18/158)had intraoperative biliary manometry.All patients were followed up for 6 months at least and there no death.Postoperative complications rate was 10.0% (29/291).There were no significant differences in sex ratio,age,American Society of Anesthesiologists score,concomitant diseases and previous abdominal surgery history between LCBDE combined with primary closure and LCBDE combined with TTD group.Patients in LCBDE combined with primary closure group were accompanied with less acute cholangitis than TTD group (43.3% vs.76.7%; χ2=9.061, P=0.002).There were no significant differences in the diameter of common bile duct, the number of stones, hospitalization expenses and the incidence of complications between the two groups(all P>0.05).LCBDE combined with primary closure had shorter operation time ((134.2±28.3)minutes vs.(148.3±19.6)minutes; t=-1.830, P=0.011)and post-operative hospitalization time ((5.6±2.6)days vs. (7.2±2.4)days; t=-1.847,P=0.014).Bile duct leakage rate was higher in primary closure group(6.3% vs.0.8%, χ2=3.934, P=0.047) and TTD group had higher residual stones rate(6.8% vs.1.3%; χ2=6.008, P=0.014).@*Conclusion@#Strategy for treating GCBDS by laparoscopic surgery should be considered preoperative evaluation and intraoperative exploration to select appropriate minimally invasive surgical methods and techniques.
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Objective To investigate the effects of different clipping time of first time using permanent aneurysm clips on common carotid artery wall in rabbitsMethods Sixty healthy male Japanese white rabbits were selected.The first time permanent aneurysm clips were used to clip common carotid artery for 30 min or 60 min respectively according to the random number method (n=30 in each group).Thirty segments of common carotid artery specimens clipped by aneurysm clips were collected respectively.Mean-Whitney U test was used to conduct the comparison of histopathological damage grade of vascular wall.Results The aneurysm clips were use to clip 30 min and 60 min caused vascular wall injury could observe the middle elastic plastic plate deformation and endothelial denudation.The vascular walls in the clipping 60 min group had local necrosis with inflammatory response,and even rupture of vascular wall.There were significant differences in overall damage degree of vascular wall (U=324.00,P=0.045) and severe injury rate (0%[0/30] vs.20.0%[6/30],P=0.031) between the clipping 30 min group and the clipping 60 min group (all P<0.05).Conclusion The vascular wall injury of using disposable permanent aneurysm clips for clipping 60 min was more severe than 30 min.Attention should be paid to shortening the time of carotid artery occlusion in operation.
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Objective To observe the therapeutic efficacy of Ganshuang granules in the treatment of hepatic fibrosis.Methods Sixty-eight patients with cirrhosis due to chronic hepatitis B (CHB)were divided into experimental group (n=34)and control group (n=34).Both groups received adefovir dipivoxil for 6 months,and the experimental group received Ganshuang granules additionally for 24 weeks.After treat-ment,the changes in hepatic fibrosis indices including hyaluronic acid (HA),laminin (LN),collagenⅣ(CⅣ),and precollagenⅢ(PCⅢ),as well as liver stiffness value were evaluated by paired t test.Results In the experimental group,the serum levels of HA,LN,CⅣ, and PCⅢwere significantly decreased by 37.5%,34.2%,35.4%,and 39.9%,respectively (t=2.238,2.151,2.148,and 2.198,P<0.05 for all),and the liver stiffness value was significantly cut by 40.6%(t=2.189,P<0.05).However,the control group showed no sig-nificant changes in these indices.Conclusion For patients with cirrhosis due to CHB,Ganshuang granules can effectively reduce serum mark-ers of hepatic fibrosis and liver stiffness value and have a good therapeutic efficacy in the treatment of hepatic fibrosis.
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BACKGROUND:Now, the bone marrow mesenchymal stem cel homing is thought to be mediated by adhesion molecules and chemokines, and this process involves bone marrow endothelial cel s, hematopoietic stem cel s, bone marrow microenvironment and its secreted or expressed molecules, in which, adhesion molecules may play an important role. OBJECTIVE:To explore the migrating and chemotactic mechanism of bone marrow mesenchymal stem cel s via acupoint injection into myocardial cel s by determining the expression of vascular cel adhesion molecule-1 and very late antigen-4. METHODS:Bone marrow mesenchymal stem cel s were cultured using adherent method, and the passage 3 cel s were used as seed cel s at a density of 1×1010/L. Sixty Sprague-Dawley rats were randomly divided into sham group, model group, myocardial injection group, and acupoint injection group, 15 rats in each group. The left coronary arteries of rats were ligated for establishing a model of myocardial infarction. At 72 hours after myocardial infarction, 0.3 mL bone mesenchymal stem cel s were transplanted into the Xinyu, Zhiyang, Tanzhong acupoints, respectively, in the acupoint injection group;while in the myocardial injection group, secondary thoracotomy was done, and 1.2 mL bone marrow mesenchymal stem cel s were equably transplanted into six sites in the feeding area of the left anterior descending artery and the surrounding myocardium. At 4 weeks after myocardial infarction, a multi-channel polygraph was adopted for detection of hemodynamic parameters, and the levels of serum vascular cel adhesion molecule-1 and very late antigen-4 were measured by ELISA. RESULTS AND CONCLUSION:The heart function of rats in the myocardial injection and acupoint injection groups were improved, and compared with the model group, the levels of serum vascular cel adhesion molecule-1 and very late antigen-4 were significantly higher in the myocardial injection and acupoint injection groups. However, there was no significant difference between the myocardial injection and acupoint injection groups. These findings suggest that vascular cel adhesion molecule-1 and very late antigen-4 may be one of the chemotactic mechanisms of bone mesenchymal stem cel s transplanted in myocardial infarction model rats by acupoint injection.
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AIM:To investigate the expression of transmembrane protein 16A(TMEM16A) in Fischer rat thy-roid follicular epithelial ( FRT) cells and its electrophysiologic properties .METHODS: The eukaryotic expression vector of pUB6/V5-TMEM16A was constructed and transfected into FRT cells by liposome-mediated transfection .In order to ob-tain the high efficiency of gene transfection and expression , the quantity and ratio of lipid/DNA complexes were optimized . The FRT cells stably expressing TMEM16A were gained by the selection with blasticidin and confirmed by the techniques of RT-PCR and immunofluorescence .The expression and location of TMEM 16A in the FRT cells were observed under an in-verted fluorescence microscope .TMEM16A protein was associated with calcium-dependent chloride current , as measured with halide-sensitive fluorescent protein and patch-clamp technique .RESULTS: The results of double digestion and se-quencing indicated that TMEM16A was cloned into pUB6/V5.The results of RT-PCR and immunofluorescence confirmed that TMEM16A was expressed in the FRT cells after transfection with TMEM16A.The classical calcium-activated chloride channel currents were recorded in the FRT cells stably expressing TMEM 16A by the technique of patch-clamp and halide-sensitive fluorescent protein YFP-H148Q/I152L.CONCLUSION:The protein expression of TMEM16A in the FRT cells was observed.TMEM16A is the molecular identity of calcium-activated chloride channels .
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Objective To explore the effect of acupoint injection of bone marrow mesenchymal stem cells (BMSCs)on hemodynamics of rat model with acute myocardial infarction(AMI). Methods Sixty Sprague-Dawley (SD)rats were randomly divided into sham group,model group,myocardium injection BMSCs group and acupoint injection BMSCs group(each n=15). The left anterior descending coronary artery(LAD)was ligated to establish a rat model of AMI. After the rat model was successfully established for 72 hours,0.2 ml BMSCs(1×1010/L)were transplanted by a micro-quantity syringe at 6 points in equal amount in the LAD blood-supply area and its periphery in the myocardial injection group,while in the acupoint injection group,0.3 ml BMSCs(1×1010/L)was transplanted at each of the following acupoints:Xinshu,Zhiyang and Tanzhong. Four weeks after AMI,polyethylene tubing was inserted into the right carotid artery to measure the hemodynamics,at the same time animals were sacrificed,and the heart was take out to calculate the heart mass index(HMI)and left ventricular mass index(LVMI). Results One, 3,5 and 4 rats were respectively dead in the sham group,model group,myocardium injection group,and acupoint injection group during the experimental period. Compared with the sham group,the left ventricular systolic pressure (LVSP,mm Hg,1 mm Hg=0.133 kPa),the maximum rate of increase of left ventricular pressure(+dp/dt max, mm Hg/s), the maximum rate of decrease of left ventricular pressure(-dp/dt max,mm Hg/s), the maximum logarithmic change rate of left ventricular pressure〔(dp/dt)?P-1max,s-1〕,HMI(mg/g),LVMI were significantly decreased,and left ventricular end-diastolic pressure(LVEDP,mm Hg),heart rate(HR,bpm)were obviously increased in model group(all P<0.05). Compared with the model group,the LVSP,+dp/dt max,-dp/dt max, (dp/dt)?P-1max, HMI,LVMI were significantly increased in myocardial injection group and acupoint injection group〔LVSP:130.38±14.96,124.36±14.36 vs. 114.36±12.71,+dp/dt max:4707.52±394.36,4597.14±411.05 vs. 3791.43±327.29,-dp/dt max:4075.11±317.89,3938.05±373.76 vs. 3116.32±275.04,(dp/dt)?P-1max:215.26±21.29,197.39±18.96 vs. 155.93±25.14〕,and the LVEDP and HR were significantly decreased(LVEDP:5.15±2.39,5.64±1.96 vs. 10.58±2.49,HR:400.50±42.58,395.55±44.62 vs. 414.51±35.75,all P<0.05). There were no significant differences in above indexes between myocardium injection group and acupoint injection group. Conclusion Acupoint injection of BMSCs can improve the heart function of rat model with AMI.
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Objective To investigate the effect of Bu Yang Huan Wu decoction(BYHWD,补阳还五汤) on the expression of basic fibroblast growth factor(bFGF) and its mechanism of anti-cerebral ischemia.Methods Eighty-five Sprague-Dawley rats(body weight 280-300 g) were randomly divided into five groups: normal control group(n=5),sham-operated group,model group(n=20),traditional BYHWD group and ultra-fine powder BYHWD group.Then the latter four groups were further divided into four subgroups of 1,3,5 and 7 days(each n=5).The cerebral ischemic rat model was made by occluding the middle cerebral artery(MCA) with a thread.The traditional decoction and ultra-fine powder decoction groups were ingested with the liquid medicine of BYHWD after 2 hours of the operation(2 ml per rat per day,according to the surface area,it was equivalent to three times the dosage of 70 kg adult(human)).All groups were executed at the 1,3,5 and 7 days after the operation.At the same time there were 5 rats as the normal control group.The brain tissue was taken for the preparation of specimens.The distribution and expression difference of bFGF in the ischemic brain tissues of rats in different groups had been investigated with immuohistochemistry technique.The contents of bFGF in the brain tissue were detected with enzyme linked immunosorbent assay(ELISA).Results The positive expression of bFGF at peri-infarct area after ischemia increased obviously,but at central-infarct area there was less such positive expression.There was no expression at contra-lateral side to the ischemic area.The expression of bFGF immune positive cell increased at 1 day,peaked at 3 days,and returned to baseline at 7 days.The positive cells of bFGF in tradition decoction and ultra-fine powder decoction groups were obviously more than those in the model group at 3,5 and 7 days(all P