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Introducción: La coledocolitiasis es una enfermedad en la cual el conducto biliar común está ocupado por cálculos. La colangiopancreatografía retrógrada endoscópica juega un papel importante en el tratamiento, al conseguir el aclaramiento de la vía biliar principal y restaurar el paso normal de la bilis. Objetivo: Presentar un paciente con la COVID-19 y colangitis aguda por coledocolitiasis múltiple, que se le realizó colangiopancreatografía retrógrada endoscópica. Caso clínico: Mujer de 58 años, antecedentes de cálculos en vesícula biliar, que ingresó en estado de shock séptico por posible colangitis aguda y síntomas respiratorios leves, con prueba positiva para la COVID-19. Por ultrasonido abdominal se le diagnosticó coledocolitiasis y se le realizó colangiopancreatografìa retrógrada endoscópica, se visualizaron múltiples cálculos en colédoco. Se logró el drenaje exitoso de la vía biliar principal, sin complicaciones y evolución favorable. Conclusión: La terapéutica realizada fue una buena opción, en el contexto clínico, de una paciente con la COVID-19 y colangitis aguda por litiasis coledociana.
Introduction: Choledocholithiasis is a disease in which the common bile duct is occupied by stones. Endoscopic retrograde cholangiopancreatography plays an important role in the treatment where the normal passage of bile is restored. Objective: To present a patient with COVID-19 and acute cholangitis due to multiple choledocholithiasis, who underwent endoscopic retrograde cholangiopancreatography. Clinical case: A 58-year-old woman, with a history of gallbladder stones, who was admitted in a state of septic shock due to possible acute cholangitis and mild respiratory symptoms, with a positive test for COVID-19. Choledocholithiasis was diagnosed by abdominal ultrasound and endoscopic retrograde cholangiopancreatography was performed, showing multiple stones in the common bile duct. Successful drainage of the main bile duct was achieved, without complications and favorable evolution. Conclusion: The treatment performed was a good option, in the clinical context, of a patient with COVID-19 and acute cholangitis due to common bile duct stones.
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Neoadjuvant radiotherapy and chemotherapy combined with surgery is the standard treatment for patients with locally advanced esophageal cancer, which has been widely applied in clinical practice. Clinical efficacy has also been recognized by clinicians. However, even after the completion of neoadjuvant radiotherapy and subsequent surgical treatment, some patients still have local regional recurrence or distant metastasis in a short period of time. Among them, distant metastasis has become the main failure mode of patients undergoing surgery after neoadjuvant radiotherapy and chemotherapy, indicating that this treatment remains to be further improved. Based on the experience of patients with rectal cancer benefiting from total neoadjuvant therapy, the feasibility and implementation of total neoadjuvant therapy for locally advanced esophageal cancer were discussed in this article.
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Objective:To investigate the effects of 40 Hz and 70 Hz frequency flash stimulation on the ability of learning memory and autonomous exploratory in young rats.Methods:Twenty-seven SPF grade male SD rats aged 19-21 days were divided into control group (Ctr group), 40 Hz group and 70 Hz group with 9 in each group according to the random number table.The rats in Ctr group were not given flash stimulation, while rats in the 40 Hz and 70 Hz group were received 40 Hz, 70 Hz flash stimulation (1.5 h/d for 39 days), respectively.The Morris water maze experiment was used to assess the learning and memory ability of rats, and the open field experiment was used to evaluate the ability of autonomous exploratory of rats.Nissl staining was used to assess the morphology of Nissl bodies in the hippocampus CA1 region of the rats.The local field potentials (LFPs) collected from the primary visual cortex (V1 area) region by electrophysiological experiments was used to verify the synchronization of flash evoked neural oscillations.SPSS 23.0 software was used for statistical analysis.The repeated measures ANOVA and one-way ANOVA were used to analyze normal distribution measurement data, and LSD and Tamhane tests were used for further pairwise comparison.The Kruskal-Wallis test was used for non-normal distribution measurement data.Results:(1) The flash stimulation of 40 Hz and 70 Hz both can effectively caused synchronization of neural oscillations in the primary visual cortex of healthy young rats.(2) The results of repeated measures ANOVA analysis showed that there was no interaction effect of grouping and time in the escape latency of young rats in the Morris water maze positioning navigation phase( F=1.326, P>0.05 ). The escape latency had time main effect ( F=40.025, P<0.05), but no grouping main effect ( F=2.039, P>0.05). With the increase of learning days, the escape latency of young rats in each group decreased significantly.There was no interaction effect of grouping and time in the total distance of young rats ( F=2.029, P>0.079). It had time main effect ( F=32.052, P<0.05), but not grouping main effect ( F=2.390, P>0.05) on total distance.With the increase of learning days, the total distance of young rats in each group significantly shortened.On the 6th day of the Morris water maze experiment, there was no statistically significant difference among groups in terms of time in the target quadrant and the number of crossing platforms ( F=2.511, 0.802, both P>0.05). The results of the open field experiment showed that the total distance traveled in the center of young rats in each group was statistically significant ( H=8.935, P<0.05), the total distance traveled in the center in the 70 Hz group (3.80 (2.25, 6.93) m)was significantly longer than that in the 40 Hz group (0.80 (0.72, 1.46) m), P<0.05). The percentage of time spent in the center was statistically significant in the three groups ( H=11.050, P<0.05). Young rats in the 70 Hz group spent significantly higher percentage of time in the center(3.20(2.43, 8.30)) than those in the 40 Hz group (0.95 (0.37, 1.06 ), P<0.05 ). (3) Nissl staining results showed that Nissl bodies in the hippocampal CA1 area of young rats in Ctr, 40 Hz and 70 Hz group were all arranged neatly and tightly, no edema was found in the surrounding stroma, and no obvious inflammatory cell infiltration was found. Conclusion:70 Hz frequency flash stimulation may promote the ability of learning memory and autonomous exploratory of young rats.
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Objective:To investigate the application of scenario simulation teaching rounds in the residency training of teachers.Methods:A total of 56 faculty members in the surgical system were divided into the traditional method group and the scenario simulation group. The traditional method group adopted the training including multimedia centralized training, live rounds demonstration and observation, discussion and summary, while the scenario simulation group adopted the training including multimedia centralized training, scenario simulation demonstration and observation followed by step-by-step discussion and demonstration, review and summary. After the training, the training satisfaction questionnaires of the participants were collected. The participants were evaluated for teaching rounds before and after the training. The data were analyzed using Graphpad prism 7.Results:There were no significant differences between the two groups in terms of professional title, teaching years and gender ( P > 0.05). The average scores of teaching rounds before and after training in the scenario simulation group were (80.17±0.99) and (87.38±0.52). The average scores of teaching rounds before and after training in the traditional method group were (78.27±0.82) and (83.24±0.53). The teaching ability had improved after the teacher training in both groups, while the scenario simulation group performed significantly better than the traditional method group ( P < 0.05). The questionnaire survey showed that the satisfaction and training effect of the scenario simulation group were much higher than those of the traditional method group, and the difference was statistically significant ( P < 0.05). Conclusion:The scenario simulation teaching rounds training significantly improves the competency of teaching rounds of residential training teachers, as well as the scenario simulation capabilities of demonstration teachers and volunteers, which makes it worthy of further promotion in order to have a better performance on standardized residency training.
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In order to optimize the undergraduate teaching methods and improve students' comprehensive competitiveness, this study explored the scientific research training methods of medical laboratory undergraduates during medical internship. On the premise of ensuring that students carry out clinical practice according to the internship plan, the research group leads students to carry out scientific research training in their spare time. The scientific research training was divided into two stages. In the first stage, on the basis of informed consent and independent choice, the students in the control group were trained by self-regulated learning and teachers' question answering, while the students in the experimental group were trained by the way of centralized scientific research lectures and scientific research practice. In the second stage, all the students were in independent research and exploration under the guidance of teachers within 5 months. The results showed that in the process of independent research, the time of topic selection in the experimental group [(3.5±1.1) days] was significantly shorter than that in the control group [( 5.4 ± 1.9) days], and the time of topic design in the experimental group [(12.2±2.5) days] was significantly shorter than that in the control group [(14.6±3.1) days]. It shows that carrying out scientific research training in the medical internship stage of undergraduates is helpful to increase the efficiency of students' later independent research and accelerate the process of independent research.
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Objective:To explore the ethical issues arising from stem cell research in China and propose countermeasures to regulate stem cell research.Methods:This article analyzed the ethical issues arising from stem cells in terms of regulatory systems, source channels, production processes, storage industries, and translational applications.Results:Combining the current ethical situation of stem cell research and the practical exploration of the authors' unit, we proposed countermeasures to address the ethical issues of stem cell research in five aspects, including forming a scientific and effective stem cell ethical regulatory system, building an open and transparent stem cell traceability mechanism, creating a GMP-compliant stem cell production platform, selecting a legal and compliant stem cell storage institution, and conducting ethical stem cell clinical research.Conclusions:It is of great practical significance to strengthen the ethical construction of stem cell research and regulate stem cell transformation research to promote the healthy development of the stem cell industry.
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OBJECTIVE@#To observe the effect of meridian sinew releasing technique on moxibustion sensation of heat-sensitive moxibustion in patients with knee osteoarthritis (KOA).@*METHODS@#A total of 60 patients with KOA were randomly divided into an observation group and a control group, 30 cases each group. In the observation group, on the basis of the meridian sinew releasing technique, moxibustion sensation exploration method was applied at Dubi (ST 35) area on the affected side. In the control group, moxibustion sensation exploration method was applied at Dubi (ST 35) area on the affected side. The meridian sinew releasing technique was performed for 20 min each time, the moxibustion sensation exploration method was performed for 60 min each time, once a day for 3 days. The excitation rate, latency, duration time and intensity value of moxibustion sensation of heat-sensitive moxibustion were recorded on the 1st, 2nd and 3rd days of exploration in the two groups.@*RESULTS@#The excitation rate on the 3rd day of exploration and total excitation rate in the observation group were higher than the control group (P<0.05). On the 1st, 2nd and 3rd days of exploration, the latency of moxibustion sensation of heat-sensitive moxibustion in the observation group was shorter than the control group (P<0.05), the duration time was longer than the control group (P<0.05), and the intensity value was higher than the control group (P<0.05).@*CONCLUSION@#Meridian sinew releasing technique could improve the excitation rate of moxibustion sensation of heat-sensitive moxibustion in patients with KOA, shorten the latency, prolong the duration time, and improve the intensity value.
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Humains , Gonarthrose/thérapie , Température élevée , Méridiens , Moxibustion , SensationRésumé
Objective:To evaluate laparoscopic choledocholithotomy in patients with cholecystolithiasis and normal sized common bile duct(CBD) with choledocholithiasis.Methods:The clinical data of 393 patients with cholecystolithiasis and choledocholithiasis treated by LC combined with LCBDE at the Department of General Surgery of Hefei Second People's Hospital from Mar 2014 to Jul 2021 were retrospectively analyzed.Results:There were 280 CBD calculi cases in which CBD diameter >8 mm which was included into CBD dilated group, and 113 cases of CBD calculi with normal diameter (5 mm≤CBD diameter ≤8 mm). There was no difference in operative time and postoperative complications in the small diameter group. During the follow-up period, 1 case in the dilated group experienced biliary tract stenosis and treated by stenting. There was no statistical significance in biliary tract stenosis in both groups ( P>0.05).Stone recurrence occurred in 3 cases (2.7%) in the normal diameter group, all of which were removed by ERCP lithotomy. Stone recurrence occurred in 8 cases (2.9%) in the CBD dilated group, 7 were removed by ERCP stone extraction and 1 refused further treatment. Conclusion:It is safe and feasible to perform LC+LCBDE in patients with cholecystolithiasis complicating normal sized CBD stones.
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Introducción. La colelitiasis tiene una prevalencia del 15 % y el 21 % tendrá coledocolitiasis al momento de la colecistectomía, con 50 % de probabilidad de presentar complicaciones asociadas. Desde el advenimiento de la colecistectomía laparoscópica, el abordaje de la coledocolitiasis ha sido endoscópico, usualmente en un tiempo diferente al vesicular, sin embargo, los avances en laparoscopia han permitido explorar la vía biliar común por la misma vía, pudiendo realizar ambos procedimientos en el mismo tiempo de forma segura. Métodos. Se realizó una búsqueda de la literatura existente con relación al enfoque para el manejo de la colecisto-coledocolitasis en un paso comparado con dos pasos. Resultados. Existe evidencia que demuestra mayor efectividad del abordaje en dos pasos, con CPRE y posterior colecistectomía laparoscópica, sobre el abordaje en un paso, especialmente en la tasa de fuga biliar y de cálculos retenidos. El enfoque en un paso con exploración de vías biliares y colecistectomía laparoscópica en el mismo tiempo es seguro, con alta tasa de éxito, baja incidencia de complicaciones, menor estancia hospitalaria y costos. Conclusión. El abordaje laparoscópico en un solo paso es un procedimiento seguro y eficaz para el manejo de la colecisto-coledocolitiasis, con el beneficio de estancia hospitalaria menor, sin embargo, se requieren habilidades técnicas avanzadas en cirugía laparoscópica. En nuestro medio ya existe una infraestructura para el manejo híbrido con CPRE y colecistectomía laparoscópica, pudiéndose realizar ambos en el mismo tiempo, para reducir estancia y costos.
Introduction. Cholelithiasis has a prevalence of 15%, and 21% will have choledocholithiasis at the time of cholecystectomy, with a 50% probability of presenting associated complications. Since the advent of laparoscopic cholecystectomy, the approach to choledocholithiasis has been endoscopic, normative at a different time than the gallbladder; however, advances in laparoscopy have made it possible to explore the common bile duct by the same route, being able to perform both procedures in a single time safely. Methods. A search of the existing literature was performed regarding the one-step approach compared to the two-step approach for the management of cholelithiasis and choledocholithiasis. Results. There is evidence that demonstrates greater effectiveness of the two-step approach with ERCP and subsequent laparoscopic cholecystectomy over the one-step approach, especially in the rate of bile leak and the incidence of retained stones. The one-step approach with bile duct exploration and laparoscopic cholecystectomy at the same time is safe, with a high success rate, low incidence of complications, shorter hospital stay, and lower costs. Conclusion. The one-step laparoscopic approach is a safe and effective procedure for the management cholelithiasis and concomitant choledocholithiasis, with the benefit of a shorter hospital stay; however, advanced technical skills in laparoscopic surgery are required. In our environment there is already an infrastructure for hybrid management with ERCP and laparoscopic cholecystectomy, both of which can be performed at the same time to reduce hospital stay and costs.
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Humains , Conduits biliaires , Lithiase biliaire , Lithiase cholédocienne , Cholécystectomie , Cholangiopancréatographie rétrograde endoscopique , LaparoscopieRésumé
Objetivo: describir las conductas y los escenarios de riesgo que adolescentes y sus padres relatan de sus experiencias cotidianas. Metodología: se realizó una investigación cualitativa con enfoque fenomenológico hermenéutico que posibilitó acceder a los relatos de los participantes a través de siete entrevistas semiestructuradas con adolescentes y siete con padres. Los resultados muestran relatos sobre el riesgo en torno a la sexualidad y el consumo de sustancias psicoactivas en escenarios donde se relacionan con otros. Como conclusión se encuentra que hay una delgada línea entre la exploración y la práctica de riesgo y que los adolescentes, sujetos con capacidad de conciencia, pueden vivir las experiencias como una u otra de acuerdo con la presencia y el uso de los recursos con los que cuentan.
The objetive of this article is to describe the behaviors and risk scenarios that adolescents and their parents tell about their daily experiences. A qualitative research with a hermeneutical phenomenological approach was carried out that made it possible to access the participants' stories through seven semi-structured interviews with adolescents and other seven semi-structured interviews with their parents. The results show reports about the risk around sexuality and the consumption of psychoactive substances in contexts where they interact with people. As a conclusion, it is found that there is a little line between the exploration and the risk practice and the adolescents, subjects with the capacity for conscience, can live experiences as exploration or risk according to the presence and use of the resources they have
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Humains , Adolescent , Adulte , Facteurs de risque , Comportement sexuel/psychologie , Adolescent , Troubles liés à une substance/psychologie , Comportements à risque pour la santéRésumé
Background: The unprecedented increase in metal exposure has been aided by modern industrialization and anthropogenic activities. Cadmium and mercury are recognized as two of the most common heavy metals with destructive impacts on most organ systems. The present study was designed to investigate and improve existing literature on the possible deleterious effects of cadmium and mercury exposure. Methods: Adult Wistar rats were treated with cadmium chloride (5 mg/kg/day) and mercury chloride (4 mg/kg/day) for 14 days. Body, brain and cerebellar weights, motor deficits, antioxidant and lipid peroxidation activities as well as histological alterations to the cerebellum were evaluated at the end of the experiment. Results: Findings showed a significant reduction in body and brain weights, dysregulation of antioxidant enzymes activity and impaired locomotion and exploratory activity in treated rats. Also, an increase in lipid peroxidation and degeneration of Purkinje cells of the cerebellum was observed in treated rats. Conclusion: Overall, these results corroborate previous findings that cadmium and mercury induce deleterious effects on the cerebellum and central nervous system. In addition, this study helps to provide an anatomical perspective and information on the exact cerebellar changes induced by cadmium and mercury in Wistar rats.
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Humains , Mâle , Femelle , Syndromes neurotoxiques , Antioxydants , Cadmium , Maladies du cervelet , Enzymes , LocomotionRésumé
Objective:In order to explore the possibility of expanding the surgical indications of the ambulatory laparoscopic transcystic common bill duct exploration(LTCBDE).Methods:A retrospective case-control study analysis was performed on the clinical data of 585 patients who underwent laparoscopic transcystic common bill duct exploration in the Beijing Friendship Hospital Affiliated to Capital Medical University from January 2015 to December 2018, including 155 cases of the ambulatory LTCBDE (study group) and 430 cases of the overnight LTCBDE (control group). The propensity score was used to match the related variables, and 144 pairs were successfully matched. The two groups were compared in surgery-related indicators, such the preoperative tests, history of acute exacerbation in the last one month, history of upper abdominal surgery, concomitant diseases (high blood pressure, diabetes mellitus, coronary heart disease, cerebrovascular disease and respiratory diseases), american society of anesthesiology (ASA) score, intraoperative bleeding, operation time, total medical costs, unplanned readmission rate. Measurement data with normal distribution were expressed as mean±standard deviation( ± s), chi-square test was used for comparison between groups, and M( Q1, Q3) was used for measurement data with non-normal distribution. Fisher exact probability test and Wilcoxon rank-sum test were used for comparison between groups. Results:The indexes of aspartate aminotransferase (AST), alanine aminotransferase(ALT), total bilirubin, direct bilirubin (DBIL), alkaline phosphatase (ALP), gamma glutamyl transpeptidase (GGT), ASA score, intraoperative bleeding and total medical costs of the study group were 21.8(18.0, 31.0) U/L, 21.5(15.0, 42.5) U/L, 14.2(11.2, 18.6) umol/L, 2.6(2.1, 3.5) μmol/L, 91.0(73.3, 118.5) U/L, 44.5(22.0, 109.8) U/L, 2.0(2.0, 2.0) grade, 7.5(5.0, 10.0) mL, 9 659.0(8 704.8, 10 640.2) yuan respectively, and the control group were 26.0(17.7, 45.3) U/L, 29.5(16.0, 85.5) U/L, 17.2(13.0, 27.5) μmol/L, 3.8(2.4, 8.7) μmol/L, 105.0(81.0, 156.0) U/L, 86.5(25.0, 224.8) U/L, 2.0(2.0, 2.0) grade, 10.0(6.3, 20.0) mL, 14 366.6(11 766.4, 16 764.4) yuan, which the differences between the two groups were statistically significant ( P<0.05). In two groups of the surgery-related indicators, such as the history of acute exacerbation in the last one month, history of upper abdominal surgery, hypertension are significant statistical differences ( P<0.05). Then there were no significant differences in diabetes, coronary heart diseases, cerebrovascular disease, respiratory diseases, surgical time and unplanned readmission rate. Conclusion:The concomitant diseases may not be the absolute contraindications of the ambulatory LTCBDE. More patients can be treated with ambulatory LTCBDE in experienced centers if relevant outpatient assay and examinations can be further improved, risks of surgery and anesthesia can be fully evaluated, and surgical contraindications can be clearly excluded.
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At present, domestic scholars in China have conducted research on the implementation and process of doctor-patient joint decision-making, but they are facing difficulties in localization of decision-making theory, human resources of decision-making and transformation of decision-making results. Social work involved in doctor-patient joint decision-making can unlock channels of communication between doctors and patients, make full use of existing resources, and promote the physical and mental health of patients. From the perspective of social work, the involvement of doctor-patient joint decision-making will face the challenges of ambiguous decision-making authority, "non counterpart" social work talents, and the reluctance of doctors and patients to take responsibility for decision-making, makes it difficult for social workers to build a bridge of communication, cooperation, and trust in the intervention process. Therefore, this paper proposed to explore the platform of standardization, diversification and symmetry by establishing an "embedded" intervention process, a "patient-centered" multidisciplinary team, and a "Gong" communication model.
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Objective:To study the effect of internal drainage tube and T tube in laparoscopic common bile duct exploration.Methods:The data of 103 patients who underwent laparoscopic common bile duct exploration for the treatment of choledocholithiasis from January 2016 to April 2021 in Dongguan Kanghua Hospital were analyzed, including 50 males and 53 females, aged (50.3±17.2) years old, the age range was 15 to 90 years old. A total of 103 patients were randomly divided into T tube group ( n=60), who received laparoscopic cholecystectomy + choledocholithotomy and stone removal+ T tube drainage, and self-dropping stent group ( n=43), who received laparoscopic cholecystectomy + choledocholithotomy and stone removal + placed with self-dropping stent. The operation time, intraoperative blood loss, postoperative drainage, postoperative hospital stay and incidence of postoperative complications were compared between the two groups. Results:The operation time of self-dropping stent group was (107.2±26.1) min, intraoperative blood loss 10(5, 10) ml, and postoperative hospital stay (6.5±3.5) d, which were better than those of T tube group (143.5±52.7) min, 10(10, 20) ml, (8.8±3.8) d, the differences were statistically significant (both P<0.05). There were no significant difference in postoperative drainage volume and postoperative complications between the two groups (both P>0.05). Conclusion:The internal drainage tube in laparoscopic common bile duct exploration is a safe and reliable surgical method for the treatment of choledocholithiasis, which can significantly shorten the hospitalization time of patients.
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Objective:To investigate the clinical effect of laparoscopic common bile duct exploration through Micro-incision of cystic duct and its junction in for choledocholithiasis.Methods:The clinical data of 62 patients with cholecystolithiasis complicated with choledocholithiasis treated in the Department of hepatobiliary and pancreatic surgery of Huangshi Central Hospital, Edong Healthcare Group from January 2017 to December 2021 were analyzed retrospectively, and were divided into two groups according to different treatment schemes. Among them, 32 cases underwent laparoscopic cholecystectomy, common bile duct exploration and lithotomy (primary suture group), Laparoscopic choledocholithotomy and exploration + T-tube drainage (T-tube Drainage Group) 30 cases. The general data, operation time, intraoperative bleeding, postoperative exhaust time, first time out of bed, postoperative hospital stay, 24-hour postoperative pain score and the incidence of total complications were compared between the two groups.Results:The operation was successfully performed in both groups, there was no perioperative death.There was no significant difference in general data, operation time, intraoperative bleeding and the incidence of total complications between the two groups ( P> 0.05), the postoperative anal exhaust time, the first time out of bed and the postoperative hospital stay in the primary suture group were (20.3±5.8) h, (15.5±4.3) h and (4.5±1.7) d, respectively, which were significantly shorter than those in the T-tube drainage group (28.3±7.9) h, (22.8±6.7) h and (7.0±2.8) d( P<0.05); The hospitalization cost in the primary suture group was (18 725.9±855.8) yuan, which was significantly lower than that in the T-tube drainage group (23 450.7±975.4) yuan ( P< 0.05). The 24-hour pain score (2.7±0.9) scores in the primary suture group was significantly lower than that in the T-tube drainage group (3.8±1.2) scores ( P< 0.05). Conclusion:Laparoscopic common bile duct exploration through micro-incision of cystic duct and its junction is safe and effective, which can accelerate the rehabilitation of patients and reduce the cost of hospitalization, which is more in line with the concept of ERAS.
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Strengthening clinical research is an inevitable requirement for expediting the development of the medical and healthcare services, as well as enhancing the capability of the hospitals in China. On the basis of sufficient argumentation of the significance and the internal and external environment of developing clinical research according to structure-conduct-performance analysis model, Henan Cancer Hospital set the aim of transforming from clinical hospital to clinical research hospital. By constructing a high-level phase Ⅰ clinical trials center, establishing the department of clinical research management, promoting the collaborative innovation and cooperation among medical institutions, research institutions, and enterprises, and developing the accessory clinical trial management system, Henan Cancer Hospital has turned abundant patient resources into advantages of clinical research. The quality and quantity of clinical trials have been elevated significantly, which could provide strong impetus for hospital′s discipline construction and high-quality development.
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Objective To evaluate the safety and effectiveness of laparoscopic common bile duct exploration in the treatment of common bile duct stones. Methods A retrospective analysis was conducted for 158 patients with cholecystolithiasis and choledocholithiasis admitted to the Number One Hospital of Zhangjiakou from January 2015 to December 2019.The patients were assigned into three groups according to the diameters of cystic duct and common bile duct,degrees of abdominal infection and tissue edema,and operation method.Group A(16 cases):laparoscopic cholecystectomy,transcystic choledochoscopic exploration for stone removal;Group B(94 cases):laparoscopic cholecystectomy,common bile duct incision exploration combined with choledochoscopy for stone removal,T tube drainage;Group C(48 cases):laparoscopic cholecystectomy,common bile duct incision exploration combined with choledochoscopy for stone removal,primary closure of the common bile duct.The operation time,residual rate of stones,and complication(bleeding,bile leakage,and wound infection) rate were compared between groups. Results The operation time of groups A,B,and C was(95.1±14.7),(102.2±18.1),(110.1±16.4) minutes,respectively,which showed no statistical difference between each other(F=0.020,P=0.887).One case in group A had residual stones,while no residual stone appeared in groups B and C.The overall stone clearance rate was 99.4% and the overall complication rate was 1.9%.There was no perioperative death. Conclusion It is generally safe and effective to carry out laparoscopic cholecystectomy and common bile duct exploration for stone removal in suitable populations.
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Humains , Lithiase cholédocienne/chirurgie , Conduit cholédoque/chirurgie , Calculs biliaires/chirurgie , Laparoscopie/méthodes , Études rétrospectivesRésumé
The National Life Science Competition for College Students has been held for five times, which has become the largest and most influential life science competition in China. The competition is designed to follow principles of "interest-driven, scientific exploration, process evaluation and ability improvement". The holding of the competition has effectively improved the training quality of life science talents in colleges and universities. This paper summarized the development, organization and management of the competition as well as the organizational characteristics of the competition. It may serve as a guidance for colleges and universities to organize students to participate in the competition, and improve the fostering of talents in the field of life sciences in colleges and universities nationwide.
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Humains , Disciplines des sciences biologiques , Programme d'études , Qualité de vie , Étudiants , UniversitésRésumé
Aerobic methane oxidizing bacteria (methanotrophs) can use methane as carbon source and energy source, eliminating 10%-20% of global methane. Methanotrophs can also effectively synthesize valuable methane-derived products. This article introduced the methane oxidizing mechanism of methanotrophs, and summarized the practical application and research hotspots of methanotrophs in the field of methane emission reduction in the landfill, ventilation air methane mitigation in coal mines, valuable chemicals biosynthesis, as well as oil and gas reservoir exploration. Main factors influencing the pollutant removal and the biosynthesis efficiency in various applications were also discussed. Based on the study of large-scale cultivation of methanotrophs, some measures to benefit the application and promotion of aerobic methane oxidizing biotechnology were proposed. This includes investigating the effect of intermediate metabolites on methanotrophs activity and population structure, and exploiting economical and efficient alternative culture media and culture techniques.
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Biotechnologie , Carbone , Milieux de culture/composition chimique , Méthane/métabolisme , Methylococcaceae/métabolisme , OxydoréductionRésumé
La litiasis coledociana es una complicación poco frecuente asociada a la litiasis vesicular. Puede ser resuelta mediante colangiopancreatografía retrógrada endoscópica (CPRE) o en su defecto, una exploración de las vías biliares por abordaje convencional (cirugía abierta) o laparoscópico. Objetivos: Determinar la efectividad del abordaje laparoscópico versus el convencional en la exploración de las vías biliares como tratamiento de la litiasis coledociana. Métodos : Se realizó un estudio prospectivo y comparativo con una muestra de 31 pacientes con litiasis coledociana seleccionados de manera no aleatoria. Resultados : Ambos grupos fueron comparables en edad, sexo, frecuencia de litiasis vesicular y CPRE preoperatoria. El tiempo quirúrgico promedio fue 4,52 versus 3,49 horas para los abordajes laparoscópico y convencional respectivamente. En el grupo laparoscópico se usó tubo de Kehr en 21% de los pacientes y en 79 % sutura primaria. En el grupo convencional se usó tubo de Kehr en 29% de los pacientes y en 71 % sutura primaria. La fuga biliar fue la complicación más frecuente. La estancia hospitalaria fue 3,14 días en el grupo laparoscópico versus 5,23 días en el grupo convencional, sin diferencia estadísticamente significativa. Conclusión : No se logró demostrar una superioridad evidente de alguno de los grupos estudiados, sin embargo nuestros pacientes podrían beneficiarse de las ventajas del abordaje laparoscópico en términos de tener menor dolor postoperatorio y una reincorporación más rápida a sus actividades habituales. Estudios similares con mayor número de casos son necesarios para llegar a datos más concluyentes(AU)
Common bile duct (CBD) lithiasis are an unusual complication associated to gallbladder stones. It can be resolved by endoscopic retrograde cholangiopancreatography (ERCP) or, alternatively, a CBD exploration by conventional (open surgery) or laparoscopic approach.Objectives : To determine the effectiveness of laparoscopic approach versus conventional approach in CBD exploration as a treatment for choledochal lithiasis.Methods : A prospective and comparative study was carried out with a non-random intentionally selected sample consisting of 31 patients with CBD stones.Results : Both groups had no statistical differences regarding age, sex, frequency of gallbladder stones, and preoperatory ERCP. The average surgical time was 4.52 versus 3.49 hours for the laparoscopic and conventional approaches, respectively. In laparoscopic group, Kehr tube was used in 21% of patients and primary closure in 79%. In conventional group, Kehr tube was used in 29% of patients versus 71% of patients with primary closure. Biliary leak was the most frequent complication. Hospital stay was 3.14 days in the laparoscopic group versus 5.23 days in the conventional group, with no statistically significant difference.Conclusion : It was not possible to demonstrate an evident superiority of any of the groups studied, however our patients could benefit from the advantages of the laparoscopic approach in terms of less postoperative pain and faster return to their usual activities. Similar and larger studies are necessary to achieve stronger and conclusive data(AU)