ABSTRACT
Objective Analyze and compare the clinical data of patients with choledocholithiasis combined with benign biliary stricture and Oddi sphincter received laparoscopic percutaneous endoscopic dilation of duodenal papilla and endoscopic sphincterotomy, to explore the clinical experience and investigate the safety and superiority of laparoscopic papillary dilatation and the clinical value in extending the first phase suturing.. Methods From January 2016 to January 2017, 60 patients with choledocholithiasis combined with Oddi sphincter received laparoscopic nipple expansion (30 cases, Group L) and the others received endoscopic sphincterotomy (30 cases, Group E). All the patients clinical data was retrospectively compared and analyzed to explore the clinical experience. Results All operation were successfully performed with no perioperative deaths occurred.. By comparison of the clinical data before and after surgery, we learned that the changes of alanine aminotransferase (ALT), aspartate transaminase (AST), direct bilirubin and postoperative biliary tract bleeding has no statistically significant difference (P > 0.05), while the operation time, the changes of blood amylase and lipase, postoperative gastrointestinal symptoms, postoperative pancreatitis, gastrointestinal function recovery time has statistically significant differences (P < 0.05). There has one self-healing bile leakage case in Group L thanks to routine placement of abdominal drainage tube intraoperatively. The patients gastrointestinal function recovered quick and not suffered pancreatitis because of there's no incision of nipple sphincter. Conclusion Laparoscopic papillary dilation reflects its superiority for not increase postoperative liver function damage, DBIL abnormalities, residual stones, biliary tract bleeding and biliary stricture, while can effectively decrease the incidence of complications such as postoperative pancreatitis, bile reflux and gastrointestinal symptoms. It is safe and effective with less postoperative complications in appropriately application in treatment of fine diameter common bile duct stones with sphincter of Oddi stenosis.
ABSTRACT
Objective Analyze and compare the clinical data of patients with choledocholithiasis combined with benign biliary stricture and Oddi sphincter received laparoscopic percutaneous endoscopic dilation of duodenal papilla and endoscopic sphincterotomy, to explore the clinical experience and investigate the safety and superiority of laparoscopic papillary dilatation and the clinical value in extending the first phase suturing.. Methods From January 2016 to January 2017, 60 patients with choledocholithiasis combined with Oddi sphincter received laparoscopic nipple expansion (30 cases, Group L) and the others received endoscopic sphincterotomy (30 cases, Group E). All the patients clinical data was retrospectively compared and analyzed to explore the clinical experience. Results All operation were successfully performed with no perioperative deaths occurred.. By comparison of the clinical data before and after surgery, we learned that the changes of alanine aminotransferase (ALT), aspartate transaminase (AST), direct bilirubin and postoperative biliary tract bleeding has no statistically significant difference (P > 0.05), while the operation time, the changes of blood amylase and lipase, postoperative gastrointestinal symptoms, postoperative pancreatitis, gastrointestinal function recovery time has statistically significant differences (P < 0.05). There has one self-healing bile leakage case in Group L thanks to routine placement of abdominal drainage tube intraoperatively. The patients gastrointestinal function recovered quick and not suffered pancreatitis because of there's no incision of nipple sphincter. Conclusion Laparoscopic papillary dilation reflects its superiority for not increase postoperative liver function damage, DBIL abnormalities, residual stones, biliary tract bleeding and biliary stricture, while can effectively decrease the incidence of complications such as postoperative pancreatitis, bile reflux and gastrointestinal symptoms. It is safe and effective with less postoperative complications in appropriately application in treatment of fine diameter common bile duct stones with sphincter of Oddi stenosis.
ABSTRACT
Chaenomeles speciosa fruits were extracted using water. The extracts were precipitated with 20%~95% (φ) ethanol, respectively. The amount of total polysaccharide was measured with phenol-sulfuric acid method. A method using high-performance size-exclusion chromatography (HPSEC) equipped with multiangle laser-light-scattering photometry (MALLS) and differential refractometry (RI) was presented for determining the molecular weight and molecular weigh distribution. RAW264.7 macrophage were cultured and stimulated with the polysaccharides in vitro and the production of nitric oxide in the cells was determined by the Griess assay. The aim of the study is to determine the amount and the molecular weight of the polysaccharides from Chaenomeles speciosa fruits, and preliminary investigate the immunomodulatory activity, The study provided the basis datas for the further research of Chaenomeles speciosa fruits. , and provided a simple and system method for the research of natural polysaccharide. The ethanol fractional precipitation showed that the order of total polysaccharide content was 95%>80%>40% ≥60%>20%. The results indicated that most polysaccharide from Chaenomeles speciosa fruits might be precipitated when ethanol concentration was up to 95% (T) and the crude polysaccharide purity had risen from 35. 1% to 45. 0% when the concentration of ethanol increased from 20% to 95%. HPSEC-MALLS-RI system showed that all the polysaccharide samples had the similar compositions. They appeared three chromatographic peaks and the retention time were not apparently different. The Mw were 6. 570 X 10(4) g . mol-1 and 1. 393 X 10(4) g . mol-1 respectively, and one less than 10 000 which was failure to obtain accurate values. The molecular weight of the first two polysaccharide distribution index(Mw/Mn)were 1. 336 and 1. 639 respectively. The polysaccharide samples had not exhibited immunomodulatory activity assessed on the basis of nitric oxide production by RAW264. 7 macrophage cells in the experiment.
