ABSTRACT
Objective:To study the optimal timing of laparoscopic cholecystectomy (LC) after percutaneous transhepatic gallbladder drainage (PTGBD) for grade Ⅱ-Ⅲ acute cholecystitis.Methods:A multicenter, single blind and randomized controlled study was conducted at Shanghai Fifth People's Hospital Affiliated to Fudan University, Shanghai Pudong Hospital, and Shanghai Minhang District Central Hospital from October 2018 to September 2021. Patients who underwent LC after PTGBD were divided 1∶1 into the early group and the late group. LC was performed 4-6 weeks after PTGBD in the early group and 7-8 weeks after PTGBD in the late group. Gender, age, AC grade, complications after PTGBD, body mass index, complications before LC, operation time of LC, intraoperative bleeding, total treatment cost, conversion rate to open surgery and complications after LC were compared between the two groups. The 36-Item Short Form Health Survey (SF-36) before and after LC was also compared.Results:Of 248 patients who were eligible for the study, there were 52 males and 196 females, with ages ranging from 18 to 89 years, and mean ±s.d. of (52.5 ± 20.2) years. There were 126 patients in the early group and 122 patients in the late group. There were no significant differences in gender, age, AC grade, body mass index and complications before LC between the two groups (all P>0.05). The preoperative score of SF-36 in the early group was significantly better than that in late group, and the complications of PTGBD in the late group were significantly higher than the early group (both P<0.05). The operation time and total treatment cost of the early group were significantly less than those of the late group (37.2±12.8 min vs. 48.5±19.7 min, 20 856±2 136 yuan vs. 2 2207±2 049 yuan) (both P<0.05). The intraoperative bleeding volume of LC in the early group was [ M( Q1, Q3)] 40 (40, 60) ml and the late group was [ M( Q1, Q3)] 35 (25, 40) ml. The difference was also significant ( P<0.05). There was no significant differences in the conversion rates to open surgery, complications and SF-36 scores after LC between the two groups (all P>0.05). Conclusion:LC should be performed 4-6 weeks after PTGBD for grade Ⅱ-Ⅲ acute cholecystitis. Although the amount of intraoperative bleeding was higher, the operation time was shorter, the burden on patients was reduced and there was more rapid recovery.
ABSTRACT
Objective To explore the expression and effects of RSp1 and ?-catenin in the intestinal epithelium with intestinal ischemia-reperfusion injury(IIRI)in of mouse.Methods Fifty healthy male kunming mice were randomly divided into control group(n=10)and experimental group(n=40).All mice in control group were only subjected to laparotomy,while the other mice underwent 20 minutes of intestinal mesenteric artery occlusion followed by 6 hours(group A),12 hours(group B),24 hours(group C)and 48 hours(group D)of reperfusion.RT-PCR was used to detect RSpo1 and ?-catenin in small intestine in intestinal ischemia-reperfusion groups and in control group.Results The villous heights of intestinal in experimental groups were significantly lower than that in control group(P
ABSTRACT
Reversed high-pressure liquid chromatography was applied in content determination of bufogenin in Liuying Pills. The sample was extracted with chloroform. Using the calibration curve method of external peak area for quantitation, ODS as chromatographic column, 60％ methanol as mobile phase, and detection wavelength at 298nm, the recovery reached 97.7％(CV=0.5％).