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BACKGROUND:A variety of factors contribute to biliary injury that is difficult to be repaired. Stent implantation is extensively used for bile duct injury, but either scaffolds made by metal or plastics can lead to certain adverse reactions. OBJECTIVE:To explore the biological characteristics of a novel biodegradable scaffold and its repair effects on bile duct injury. METHODS:The biological characteristics of the novel biodegradable scaffold were detected by fresh bile, and its degradation was observed at different time points. Thirty Bama mini pigs were included and were randomly divided into observation group (n=15) and control group (n=15). After bile duct injury models were prepared, the control group was subjected to the bile duct interrupted suture, while the observation group was subjected to the novel biodegradable scaffold combined with omentum majus. The biological properties of the scaffolds were observed. Hepatic enzymes and serum total bilirubin levels were detected, as wel as hematoxylin-eosin staining, Masson staining and immunohistochemistry detection ofα-smooth muscle actin were performed. RESULTS AND CONCLUSION:Before and 1, 3 and 6 months after surgery, hepatic enzymes and total bilirubin of two groups were detected, and neither intra-group nor intergroup comparisons had significant differences (P>0.05). Hematoxylin-eosin staining and Masson staining revealed that inflammatory reactions and fiber hyperplasia at the anastomotic site in the observation group were lighter than those in the control group at different time points after surgery. Theα-smooth muscle actin-positive scores in both two groups were in a rise at 1 and 3 months after surgery, and peaked at the 3rd month, and then began to decline. Moreover, theα-smooth muscle actin-positive scores in the observation group were significantly lower than those in the control group at 3 and 6 months after surgery (P<0.05). These results show that the novel biodegradable scaffold has good biological characteristics and can obtain ideal repair effects in the bile duct injury.
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measured to compare the correlation between the changes of T lymphocyte subsets before and after operation and the change of platelet. Results Thirty-one patients were underwent laparoscopic splenectomy. The T lymphocyte subsets and CD3 + ,CD4 + and CD3 + / CD4 + in all patients showed an increase trend as the time prolonged after operation,and the differences were significant( F = 6. 91,3. 93,4. 18;P = 0. 023,0. 004,0. 011). While the ratio of CD3 + / CD8 + and CD3 + CD4 + / CD3 + CD8 + were decreased as time increased,and differences were statistically significant( F = 2. 59,3. 67;P = 0. 001,0. 002). They were related with platelet change after operation and correlation statistics analysis showed R values were 0. 332,0. 271,0. 345,- 0. 119,- 0. 164,and the P value were 0. 039,0. 021,0. 002,0. 017,0. 023. Conclusion ITP patients have the imbalance of T lymphocyte subsets,and splenectomy can improve the imbalance of T lymphocyte subsets in patients with ITP. T lymphocyte subsets may serve as a reference index to indicate the prognosis of the patients.
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Objective To investigate the efficacy and safety of laparoscopic splenectomy (LS) in the treatment of immune throm-bocytopenia(ITP) .Methods 230 cases of ITP were collected in this hospital from December 2011 to December 2012 and randomly divided into two groups with 115 cases in each group .Among them ,the control group was treated by the conventional treatment of open splenectomy(OS) ,while the observation group was treated by LS .The differences of the operative time ,hospitalization dura-tion ,intraoperative blood loss and platelet count ,clinical effects and the occurrence situation of adverse reactions were compared be-tween the two kinds of operation method .Results The operative time and the length of hospital stay in the observation group were significantly shortened compared with the control group (t=14 .706 ,t=13 .625 ,P<0 .05);intraoperative blood loss was significant-ly decreased(t=18 .238 ,P<0 .05) and the platelet count was significantly increased (t=17 .248 ,P<0 .05);the total effective rate of the observation group was 96 .52% ,which was significantly higher than 86 .09% of the control group ,(χ2 =9 .35 ,P<0 .05);the adverse reaction rate and the recurrence rate in the observation group were 6 .09% and 6 .96% respectively ,which were significantly lower than 10 .43% and 19 .13% in the control group(χ2 =8 .35 ,χ2 =8 .75 ,P<0 .05) .Conclusion LS for treating immune throm-bocytopenia has definite efficacy with high effective rate ,low adverse reactions and low recurrence rate .
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Objective To explore the instructive value of preoperative splenic artery CTA examination on Laparoscopic splenectomy (LS). Methods From January 2008 to February 2010,36 cases requiring Laparoscopic splenectomy (LS) were selected randomly and divided into two groups: CTA group and non-CTA group, 18 cases in each group. As for the CTA group,splenic artery CTA examination was performed before operation,to understand splenic artery and its branches anatomy type and track and then individualized surgical treatment was developed. As for the non-CTA group,a routine surgical procedure was performed. The indices before and during the operation were recorded and compared through χ2 test The operating time and the amount of bleeding in the two groups were compared using t-test Results There were no significant difference between the indices recorded by splenic artery CTA examination and those by laparoscopic splenectomy intraoperation ( P > 0. 05 ) . The operating time was (124. 32 ±21.43) mins in the CTA group, which was significantly shorter than that in the non-CTA group ((148.27 ±28. 36)mins) (P <0. 05). The amount of blood in the CTA group was significantly less than that in the non-CTA group( ( 80. 50 ± 16. 42) ml vs. (101. 35 ± 26.25 ) ml). Conclusions Splenic artery CTA can identify splenic artery and its branches anatomy type and track before LS,therefore guide the development of individualized surgical treatment It increases the safety of LS, reduces bleeding and shortens the operational time. It has an instrutive value to laparoscopic splenectomy.