Role of p75 neurotrophin receptor in neuronal apoptosis after cerebral ischemia / 国际脑血管病杂志

p75 neurotrophin receptor (p75 NTR) is a member of the tumor necrosis factor receptor superfamily, which interacts with tropomyosin receptor kinase (Trk) receptor or binds neurotrophic factors. It mediates a variety of complex signal transduction pathways, induces synaptic growth and affects cell survival. After acute cerebral ischemia, p75 NTR binds effector factors such as pro-nerve growth factor (proNGF) and sortilin, activating downstream apoptotic signal molecules and leading to neuronal death. Therefore, elucidating the pathways and molecular mechanisms of p75 NTR that mediate neuronal apoptosis in acute cerebral ischemia is of great significance for the development of new therapeutic drugs for acute cerebral ischemia.

Clinical analysis on safety of primary suture in laparoscopic choledocholithotomy / 重庆医学

Objective To explore the feasibility and safety of primary suture in laparoscopic common bile duct exploration(LCBDE) for treating choledocholithiasis.Methods The clinical data in 185 cases of choledocholithiasis underwent LCBDE in Sun Yat-sen Memorial Hospital from March 2010 to October 2015 were retrospectively analyzed.The patients were divided into 1aparoscopic common bile duct exploration and primary suture(LBEPS) group(117 cases) and T tube drainage group(68 cases) according to different processing modes of common bile duct incision.The operative time,intra-operative blood loss amount and postoperative complications were observed in the two groups.Results All operations were successfully performed in both two groups without converting to laparotomy.The operative time,intra-operative blood loss amounts and postoperative complications had no statistically significant differences between the LBEPS group and T tube drainage group(P>0.05).The postoperative hospital stay of the LBEPS group was significantly shorter than that of the T tube drainage group(P<0.01).There was no bile duct stricture or stone recurrence during the follow up period in the two groups.Conclusion Under strictly grasping the operation indication,selecting correct suture material and possessing practiced operating skills,primary suture of laparoscopic choledocholithiasis is safe and feasible,can avoid the risk of T tube placing related complications,has short postoperative hospitalization duration and increases postoperative living quality.

Treatment of Common Bile Duct or Common Hepatic Duct Transverse Injures in Cholecystectomy:Report of 5 Cases / 中国微创外科杂志

Objective To investigate the treatment of common bile duct or common hepatic duct transverse injures(CBDTI) in cholecystectomy.Methods From January 1993 to March 2008,3362 patients received cholecystectomy in our hospital,among them 5 developed CBDTI.We reviewed the clinic feature,management,and outcomes of these patients. Results Of the 5 patients,2 had common hepatic duct transverse injuries and 3 showed common bile transverse injuries.One of the five received postenterobiliary drainage and the other four underwent choledoch end-to-end anastomosis.No biliary leakage was found after the operation.One patient developed biliary stenosis and cholangitis after the end-to-end anastomosis and thus received postenterobiliary drainage.This case was followed up for 15 years,during which no abdominal pain,fever or jaundice occurred.The patient who underwent postenterobiliary drainage showed symptoms of cholangitis for 3 times whithin 2 months after the treatment;therefore,conservative therapy was carried out.Afterwards,the patient was cured and showed no abdominal pain,fever or jaundice during a 5-year follow-up.The other 3 patients who received end-to-end anastomosis were followed up for 1,2,or 4 years,no complications were noticed during the period.Conclusions Based on personal experience and the type of injury,surgeons may chose choledoch end-to-end anastomosis or postenterobiliary drainage to treat CBDTI.

Prognostic analysis of patients suffering from gallbladder carcinoma / 中国普通外科杂志

To study parameters influencing the prognosis of patients suffering from gallbladder carcinoma.MethodsA retrospective clinical analysis was made on 56 cases of gallbladder carcinoma, admitted to our hospital between 1995～2001.ResultsThere were 20 males and 36 femals. Thirty four patients(61%) complicated with gallstons.Abdominal pain(47/56,84%) and jaundice(23/56,41%) were the major complaints.Ultrasonography,CT scan and CA 19 9 measurement were helpful for preoperative diagnosis. Thirty cases(including 5 Nevin stage Ⅱ cases,3 stage Ⅲ cases,4 stage Ⅳ cases,and 18 stage Ⅴ cases) received radical or extended radical chelecystectomy, 11 cases with Nevin stage Ⅴ underwent palliative resection and 15 cases of Nevin stage Ⅴ were subjected to bypass procedure and/ or biopsy.The statistical analysis showed staging of Nevin,surgical procedure,gallstone,adjuvant radiotherapy and chemotherapy significantly affected the survival.Conclusions Early diagnosis, radical resection, active and comprehensive adjuvant radiotherapy with/or chemotherapy help to improve the prognosis of gallbladder carcinoma.