The aim of this paper was to observe the efficacy of combination therapy of laparoscopic left hepatectomy and choledochoscopy for calculus of left intrahepatic duct.We retrospectively analyzed the clinical data of 76 patients with calculus of left intrahepatic duct who were admitted and diagnosed in this hospital between August 2014 and August 2015. Patients who received the laparotomy for treatment were enrolled into the control group (N.=32), and those who received the combination therapy of laparoscopic left hepatectomy and choledochoscopy were enrolled into the study group (N.=44). The surgical efficacy and the occurrence of surgery complications were compared between the two groups, and the recurrence of calculus was observed in follow-up after the operation.Comparison of the surgical duration showed no statistically significant difference between the two groups (P>0.05); bleeding amount, evacuation time and length of stay in the study group were less or shorter than those in the control group (P<0.05); the overall incidence rate of surgery complications in the study group was 9.10%, which was lower than the overall incidence rate of surgery complications, 43.75%, in the control group (P<0.05). No statistically significant differences were identified in the comparisons of the levels of albumin (ALB), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) at 1d before and 10d after operation, hospitalization expenses, and operation fee between the two groups (P>0.05). The average duration of follow-up after operation was 12 months, during which 2 patients in the control group were found with a calculus in a diameter of 0.4 cm in the left intrahepatic duct which was later removed using choledochoscopy followed by the extraction of T duct, and the conditions of patient were well-controlled; no recurrence of calculus was observed in the study group.Combination therapy of laparoscopic left hepatectomy and choledochoscopy is worth being promoted in clinical practice of treatment for calculus of intrahepatic duct with various advantages, such as significant effect, small trauma, high safety and reliability, rapid recovery after operation and few recurrences.
Objective:To explore the method,effect and feasibility of laparoscopic proximal gastrectomy.Methods:The clinical data of seven cases were analyzed retrospectivecy.Results:All cases were operated with laparoscopic method successfully.The mean operative time was 278min(237-356min).The mean blood loss was 120ml(60-300ml).Pathology results included 4 cases of low differential adenoma,2 cases of middle differential adenoma and 1 case of high differential adenoma.The mean distance from incision edge to the tumour was 5.9cm(3.5-8.5cm).The mean number of lymph nodes dissected was 14.2(7-21).Time of bowel pass was 34.2h(18-69h).Time of bedside movement was 42.7h(38-77h).Patients were encouraged to drink water 24h after operation,no vomitting was observed.The mean hospitalization was 8.4d(7-11d).No recurrence was observed during the 2-13 months follow-up.Conclusions:Laparoscopic proximal gastrectomy is a safe procedure and matches the results of open operation.It has the merits of less trauma and rapid recovery.
Objective To investigate clinical significance of serum antineutrophil cytoplasmic antibodies(ANCA) in active systemic lupus erythematosus(SLE). Methods Serum ANCA levels of 60 patients with SLE in active phase was measured by indirect immunofluorescence. Levels of anti-nuclear antibodies, anti-dsDNA antibodies, anti-ENA antibodies, antiphospholipid antibodies were also measured. Results The serum ANCA levels was not associated with the degree of SLE disease activity and the involvement of special organ. There were more patients with multisystemic damages in ANCA positive group than those in ANCA negative group. In the ANCA positive group, the incidences of autoantibodies positivity such as anti-dsDNA antibodies, anti-Sm antibodies, and antiphospholipid antibodies also increased. Conclusion In the SLE active phase, the positiveness of ANCA implicates complexity of the disease condition, but it is not correlated to the involvement of special oragn.
Definite the desulfurization fly ash and demonstrate its resources.The comprehensive utilization of desulfurization fly ash in domestic and overseas is indicated in brief,the talent utilization perspectives are elaborated .
Objective To observe the impact of growth hormone (GH) on expression of phosphoJAK2 (pJAK2) in pancreatic carcinoma cells and to discuss significance of pJAK2 in signaling.Methods (1)Pancreatic carcinoma cells (SW-1990,Cap-1,ASPC) during exponential growth stage were harvested and cultured in medium containing growth hormone(50 μg/L,100μg/L);After 24,48,72 hours,cells were counted using a Coulter Counter.(2)Athymic nude BALB/C mice were inoculated with SW-1990 cells,When tumors became palpable after inoculation.animals were randomized to receive GH(4 mg/kg.s.c.once daily for 2 weeks,n=21)versus saline control cytotoxic lymphocyte(CTL,n=7).(3)Human pancreatic carcinoma cell lines(SW-1990,Cap-1,Colo,Mia,Aspc,P3,Panc-1) were collected to detect the basal expression of pJAK2 with immol/lunoblots;After GH administration on special times(in vitro:5,10,15,30,45 min,1,2 h;in vivo:1,2,24 h),Cells were collected and Tumor tissues of the mice were rapidly incised respectively.All the specimen were frozen immol/lediately for subsequent Western blotting analysis,to ohserve the impact of GH on expression of pJAK2 in SW-1990 and inoculation tumor cells.Results The results revealed GH stimulated cell growth in vitro;On immol/lunoblots,positive expression of pJAK2 was observed on human pancreatic carcinoma cell lines(SW-1990、Cap-1、Colo、Mia、Aspc、P3、Panc-1).GH augmented rapidly tyrosine phosphorylation of this special proteins to the highest value on the 5th minute after GH administration in vitro and the values fluctuated later;No similar phenomena,however,were observed in vivo.Conclusion Positive expression of pJAK2 is observed on human pancreatic cancer ceils;Furthermore,GH augments rapidly tyrosine phosphorylation of these special proteins not in vivo but in vitro;and this discrepancy helps to explain why GH doesn't accelerate tumor growth in vivo.
Key words:
Growth hormone; Pancreatic carcinoma; pJAK2
Objective:To evaluate the feasibility and safety of total laparoscopic splenectomy plus esophagogastric devascularization in the treatment of portal hypertension.Methods:The patients suffering portal hypertension with the history of upper gastrointestinal tract hemorrhage underwent laparoscopic splenectomy plus esophagogastric devascularization from January 2005 to December 2007.The follow-up was from three months to three years,and the data was retrospectively analyzed.Results:The procedures were successful in all cases without conversion to open surgery.The mean operative time,blood loss in operation and postoperative hospitalization were 210min,340ml and 12d respectively.There was no mortality and serious postoperative complications.No bleeding event occured postoperatively.Conclusions:Total laparoscopic splenectomy plus esophagogastric devascularization is feasible,safe and less invasive in treatment of patients with portal hypertension,which is worth gereralized.
Objective To explore a new minimally invasive surgical treatment for common bile duct stones. Methods All 21 patients were diagnosed as choledocholithiasis by B ultrasound in our department from Dec. 2003 to March 2005.Under the guidance of laparoscopy,the calculus removed basket was inserted into common bile duct through cystic duct.Stone capture was accomplished by calculus removed basket,and then laparoscopic cholecysectomy was carried out.The total procedure was monitored fluoroscopically. Results All patients were operated on successfully.No patients were converted to “open” common duct exploration.T-tube was not needed.Fluoroscopic cholangiography revealed no residual stones.All patients were discharged from hospital 2 to 4 days after operation.No complications occurred. Conclusion Combined laparoscopy and calculus removed basket in the treatment of cholelith of common bile duct is an effective,efficient,simple and minimally invasive way.
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