Analysis of 32 patients with colon cancers co-existing with appendicitis / 局解手术学杂志

Objective To explore the reason of colon cancer with appendicitis and reduce the rate of misdiagnosis. Methods We car-ried out analysis retrospectively to analyze 1 094 hospitalized patients with colon cancer in the First Affiliated Hospital of Harbin Medical Uni-versity from January 2006 to March 2013. Results Among 1 094 colon cancer patients,31 patients who firstly diagnosed with acute appendi-citis received appendectomy,1 patient with appendiceal abscess received non-surgical treatment. Among 31 patients with acute appendicitis,6 patients were found to be with ileocecal tumors during surgeries;24 patients were diagnosed with colon cancer within one year;incision of 1 patient did not heal, with continuous drainage of brown liquid;the appendicitis of 1 patient who received non-surgical treatment was recur-rent. Conclusion As lack of typical symptoms,colon cancer is prone to misdiagnose and diagnose incorrectly when the cancer co-exists with appendicitis and symptoms of appendicitis were showed firstly. Therefore,clinicians should be vigilant for patients with appendicitis. In order to induce the rate of misdiagnosis,it is essential that requesting disease history carefully,timely and relevant inspection and appropriate ex-ploratory surgery for the patients with appendicitis.

Relationship between different death ways of pancreatic acinar cells and release of intracellular enzymes in acute pancreatitis / 中华胰腺病杂志

Objective To observe the apoptosis or oncosis of pancreatic acinar cells of different severity of acute pancreatitis (AP) and the release level of enzymes in vitro, and to investigate the relationship between them. Methods Two-step enzymatic digestion method was used to separate pancreatic acinar cells into 4 groups. 0. 1 μg/ml of the caerulein was added in the AP group. Caerulein and LPS (bacterial lipopolysaccharide, 10 mg/L) were added in LPS group. Caerulein and OCT (octreotide, 100 ng/ml) were added in OCT group. Medium was added in the control group. AO (acridine orange) and EB (ethidium bromide) double staining method was used to detect the incidence of apoptosis or oncosis of acinar cell. The release of intracellular enzyme was detected by measuring the concentrations of amylase and LDH in cell culture media by colorimetry method. Results The apoptosis index was 2.2 + 0.4, 6.4 ± 0.6, 4.6 + 0.4, 11.2 +1.2 in the control group, AP group, LPS group, OCT group; while the oncosis index was 3.0 +0.4, 17.2 ±1.6, 23.0 ± 2.2, 12.8 ± 1.4 in the control group, AP group, LPS group, OCT group; the release of LDH was (2180 ±240), (8060 ±930), (9460 +920), (6860 ±740) U/dl, the level of amylase was (1750 ± 190),(3820 ±460), (4420 ±480), (2260 ±260)U/L. All the values in the experiment groups were significantly higher than that in control group ( P ＜ 0.05 ). The oncosis index, LDH, amylase in LPS group was significantly higher than that in AP group ( P ＜ 0.05 ), but the apoptosis index in LPS group was significantly lower than that in AP group ( P ＜ 0.05 ). The apoptosis index in OCT group was significantly higher than that in AP group ( P ＜ 0. 05 ), but the oncosis index, LDH, amylase was significantly lower than that in AP group ( P ＜ 0. 05 ).Conclusions Induction of apoptosis and reduction of oncosis in AP pancreatic acinar cells can reduce the release of enzyme in acinar cells.

Relationship between the oncosis of pancreatic acinar cells and activation of macrophage in rat model of acute pancreatitis / 中华消化外科杂志

Objective To study the relationship between the oncosis of pancreatic acinar cells and activa-tion of macrophage in rat model of acute pancreatitis (AP). Methods The pancreatic acinar cells were isolated by two-step enzyme digestion, and then they were divided into control group, AP group and test group. Pancreatic acinar cells were cultured with caerulein in AP group, with caerulein and endothelin in test group, and with culture medium in control group. The oncesis rate of the pancreatic acinar cells was detected after acridine orange and ethidium bromide fluorescent staining. The supernatant was collected to detect the release of amylase and lactate dehydrogenase (LDH). The macrophages were cultured with 1 ml of supematant for 6 hours, and then the protein level of tumor necrosis factor-α (TNF-α) was measured by ELISA. Results Few oncotic pancreatic acinar cells were observed in the control group, and the levels of amylase and LDH secreted by pancreatic acinar cells and TNF-α secreted by macrophage were (1175±165)kU/L, (846±118)U/L and (36±5)μg/L, respectively. Oncotic pancreatic acinar cells were observed in AP group, and the levels of amylase, LDH and TNF-α were (7130±680) kU/L, (4262±626) U/L and (155±18) μg/L, respectively, which were significantly higher than those in control group (t = 5.184, 4.277, 3.665, P < 0.05). The levels of amylase, LDH and TNF-α were even higher in test group, and they were (9240±1177) kU/L, (6937±893)U/L and (268±35)μg/L, respectively, which were significantly higher than those in AP group (t = 2.251, 2.825, 2.843, P < 0.05). Conclusions The release of amylase was changed as the oncosis of pancreatic acinar cells occurred. The secretion of TNF-α was along with the degree of oncosis of pancreatic acinar cells. The results of the study indicate that a relationship exists among the inflammatory response of macrophage, the release of contents of pancreatic acinar cells and the oncosis of the pancreatic acinar cells.

Nuclear factor-kappa B regulation on the expression of tumor necrosis factor-alpha mRNA in acute pancreatitis / 中华急诊医学杂志

Objective To explore the role of nuclear factor-kappa B(NF-?B)in regulating tumor necrosis factor-?(TNF-?)expression in acute pancreatitis (AP)in rats.Methods Sixty-four Wistar rats were randomly divided into two groups:the control group(n=32)and the AP group(n=32).Acute pancreatitis was induced by introperitoneal injection of caerulein,and the animals were killded at 12 hours,24 hours,36 hours,and 72 hours respectively.The activity of NF-?B and expression of TNF-? mRNA in the pancreas were determined by flow cytometry (FCM) method and semi-quantitave RT-PCR analysis,respectively,and the correlation coefficients were analyzed.Results The levels of activated NF-?B protein and TNF-?mRNA were all significantly higher in the AP group than those in the control group at any time point(P

Analysis of changes of the platelet count after splenectomy in patients with cirrhosis and portal hypertension / 中国现代普通外科进展

Objective:To investigate the clinical significance of changes of platelet count after splenectomy in patients with cirrhosis and portal hypertension.Methods:In this study,from January 2002 to January 2006,the platelet count and liver function in 153 splenomegaly and hypersplenism due to cirrhosis patients who had been carried out splenectomy were selected.The change tendency of platelet count was observed,the relationship of changes of platelet count and liver function was analysed,and compared with patients of spleen trauma.Results:Postoperative platelet count was higher than preoperatively in most patients with cirrhosis,the portion did not elevate,even decreased.The change tendency of platelet count was correlated with the liver function.The change in cirrhosis patients is not more than patients of spleen trauma.Conclusions:The reason of thrombocytopenia in patients with cirrhosis may be correlated with the change of liver function besides the splenomegaly.

Discussion on the training methods of laparoscopic techniques on general surgeons / 中华医学教育探索杂志

Minimally invasive surgery has been one of the main trend of surgical practice in 21 century,while the laparoscopic technique,as one of the product of high-tech,shows the minimally invasive surgery a more lactiferous prospect.However,with the popularity of laparoscopic technique,its high complications rate is gradually being highly regarded.By analyzing various causes comprehensively,we found that the complications rate had direct correlation with the operant level of the operator.Combining the successful experience of twice laparoscopic technique training courses,which were conducted by our department,this article will give rise to a discussion about the training of the general surgery doctor.

Application of Problem-based Learning Teaching Mode in General Surgery Practice / 中华医学教育探索杂志

Problem-based learning(PBL)teaching mode was applied in general surgery practice of the seven-year system externs.The externs were organized to analyze and discuss a real case,having grasped enough knowledge of relative diseases,and try to provide their advice about the diagnosis and treatment,and then their conclusions were verified by post-operational follow-up.PBL teaching mode can increase the students'study motivations and interests and the ability to resolve practical problems,master medical knowledge,train their clinical thinking and eventually pave a way to become qualified clinicians.

Cyst carcinoma after internal drainage operation for congenital choledocal cyst: a reports of 25 cases / 中国普通外科杂志

Objective To detective the carcinogenesis and operation principle of cyst canceration after internal drainage(ID) operation for congenital choledocal cyst (CCC).Methods The clinical data of 25 patients with cyst carcinoma after ID operation for CCC in the past 28 years were analysed retrospectively.Results The total canceration rate after internal drainage of CCC were 30.49%(25/82); after cystoduodenostomy was 35.29%(14/51),after cystojejunostomy was 22.58%(11/31), respectively. In the 25 cases, three of them were operated with Wipple operation , 4 with tumour resection plus biliary reconstrustion operation, 4 local resection with external drainage ,14 with external drainage only. Conclusions Internal drainage of CCC should be aborted becaus of the high canceration rate after the operation.

Change of Blood Parathyroid Hormone Level in Hypoparathyroidism Treated by pcDNA3.1?PTH / 中国医师杂志

Objective Measuring the concentration of PTH when pcDNA3.1?PTH was injected into the muscle of rabbits with hypoparathyroidism (HPT),studying the relationship between change of blood PTH and pcDNA3.1?PTH dosage.Methods Different dosages of pcDNA3.1?PTH(100?g/ml, 300?g/ml and 500?g/ml)containing human PTH gene were injected respectively into muscle of the experimental rabbits after parathyroidectomy in advance.Then the concentration of PTH in blood of rabbits was measured at following different times.Results PTH level began to increase from the first day,which reached in peak concentration at the seventh day after the injection of pcDNA3.1?PTH and persisting two months.Conclusion Human PTH gene was effective in therapying HPT rabbits,their best effective dosages were 300?g/ml and 500?g/ml respectively.

Exposure of recurrent laryngeal nerve in thyroid surgery:a report of 574 cases / 中国普通外科杂志

Objective To study the method and effect of exposure the recurrent laryngeal nerve(RLN) in preventing the damage of RLN in thyroid surgery. Methods One thousand and ten sides total and(or) subtotal thyroidectomies were operated on 574 cases with RLN exposure in our hospital in recent 9 years. Results The RLN injury rate was 0.3% in this series.Of them, permanent RLN injury occurred in 2 cases and temporary injury in 1. Conclusions The exposure of RLN can greatly decrease the nerve injure in thyroid surgery, especially in total lobectomy. The dissection of RLN must followed the principle of RLN exposure . RLN should be dissected around the inferior thyroid artery first, if the RLN is difficult to be found,then dissecting around the thyroid cartilage, or finding the cervical vagus inside of carotid sheath to find RLN should be done.

The clinical implication of exposure of recurrent laryngeal nerve in thyroid surgery / 中国普通外科杂志

Objective To study the methods and benefits of exposure of recurrent laryngeal nerve(RLN) in thyroid surgery Methods In this study, 2148 patients admitted in our hospital from July 1993 to July 2003 were divided randomly into two groups: RLN exposure group (936 cases) and RLN non exposure group (1212 cases) RLN was dissected around the inferior thyroid artery, thyroid cartilage, and cervical vagus Results Two cases (0 21%) suffered from RLN injury in exposure group and 5 cases (0 41%) suffered from RLN injury in non exposure group ( P