Résumé
Objective This study was conducted to build experimental model of orthotopic liver transplantation in rat(ROLT) with the character of acute rejection;and to study the effect of cytotoxic T lymphocyte antigen 4 immunoglobulin G(CTLA4-Ig) on prevention of rejection and the induction of immune tolerance of ROLT.(Methods Build model) of Wistar→SD ROLT(performed by the two cuff method) with character of acute rejection.Recipients were injected with CTLA4-Ig 75 ?g per ROLT into abdominal cavity after 2 days of operation.Contrast was made with no treatment group,the clinical characters,the liver function,the transplantated liver pathologic character and the concentrations of TNF-? in serum were observed and measured on postoperative day 7.In treatment group,all above observation were done on postoperative month 4.Above all,determination of the effect of CTLA4-Ig on preventing acute rejection and inducing tolerance in ROLT was observed.Results ①Recipients(no treatment group) died one by one within 6th～14th days;pathologic character of rejection in transplantation liver could be found;② In treatment group,on postoperative day 7 and month 4,no clinical rejection character and no pathologic character of rejection in transplantation liver were found and serum concentration of cytokins related to TNF-? found lower than that of contrast group(P
Résumé
Objective To evaluate the detection and localization of obscure lower gastrointestinal bleeding by using SPECT/CT and intraoperative endoscopy. Methods Twenty-six cases of patients with obscure lower gastrointestinal bleeding were analyzed retrospectively. Results The positive detection rate of SPECT/CT was 88.5%. All 26 patients (100%) were identified the bleeding source by using intraoperative endoscopy. No recurrence was found during 1-24 months follow-up. Conclusion SPECT/CT examination should be chosen firstly for patients with obscure lower gastrointestinal bleeding in order to localize the bleeding site roughly. Intraoperative endoscopy can localize the bleeding site accurately in patients who undergoes operation.
Résumé
Objective To compare the postoperative complications rate of total mesorectal excision(TME) performed by laparoscopic and conventional laparotomy method in treatment of rectal cancer.Methods The clinical data of patients with rectal cancer treated by laparoscopic surgery(n=42) or traditional laparotomy(n=50) were retrospectively analysed to analysis of the cause and occurrence rate of complications.(Results) The laparoscopic group had an advantage over the conventional laparotomy group in bowel movement recovery,earlier mobility and short hospital stay time.There was no difference in intraoperative injury,(anastomotic) leakage,sexual function preservation,long-term urinary dysfunction,and local recurrence or(incision) metastasis rates.Conclusions Laparoscopic TME treatment of rectal cancer had the same therapeutic effect as the conventional laparotomy procedure did,and has a better subjective outcome.