目的探讨肠外和肠内营养支持在克罗恩病围手术期的应用价值。方法对我院1995～2001年经手术治疗的20例克罗恩病进行回顾性分析。结果经肠内及肠外营养支持后，该20例克罗恩病围手术期的各项营养指标均有不同程度改善，且无营养不良的并发症发生。结论营养支持是克罗恩病围手术期的重要治疗手段，适时合理地应用肠外和肠内营养，有助于提高该病的手术疗效。
目的探讨脾囊肿的诊断与治疗方法。方法对我院1995～2001年收治的9例脾囊肿患者的临床资料进行回顾性分析。结果9例脾囊肿患者均行手术治疗，行全脾切除7例，其中保留副脾1例，2例行脾片网膜囊内移植； 2例行囊肿及部分脾切除。本组均治愈，经随访11个月～10年，均未发现有与手术相关的并发症。结论脾囊肿少见； 诊断主要依靠B超及CT检查; 以手术治疗为主，可选择全脾切除、半脾或脾部分切除，尽可能行保脾手术。
【Abstract】Objective To study the regulatory ability of peroxisome proliferatoractivated receptor γ(PPARγ) ligands to the inflammatory response in human gallbladder epithelial cells. Methods Culture human gallbladder epithelial cells and identify them . Cells were treated for 24 hours with 0, 10 μmol/L, 20 μmol/L, 30 μmol/L, 50 μmol/L and 100 μmol/L of Ciglitazone during cellular growth peak(5th day), then stimulated them with hIL-1β 5 ng/ml for 2 hours and measured the concentration of IL-6、IL-8 and TNF-α in cellular supernatants by riadioimmunoassay. Results Contrasted with control group, the expression of IL-6 and IL-8 in each test group were inhibited （P＜0.001）. The IL-6 and IL-8 levels were gradually dropped and corelated with the dosage of Cigtitazone, and manifested dosagedependence (P＜0.001). The concentration of TNF-α could not be measured. Conclusion PPARγ ligands can inhibit the expression of IL-6 and IL-8 in human gallbladder epithelial cells and probably produce effect in the regulation of cholecystic inflammation.
ObjectiveTo compare the clinical recovery and immune response between laparoscopic-assisted and open D2 gastrectomy for advanced gastric cancer. MethodsThe clinical data of 53 patients with advanced gastric cancer from January 2012 to October 2013 were studied prospectively. According to random number table, patients were randomly divided into laparoscopic-assisted group(LA group, n=27) and open operation group(OO group, n=26). Operative time, blood loss, time to passage of flatus, time to resume soft diet, after bed time, postoperative hospital stay, and number of retrieved lymph nodes were compared respectively between the two groups. The changes in CD3, CD4+, CD8+, IgG, IgA, IgM, and CRP were examined respectively by using flow cytometry and immunoturbidimetric assays on the preoperative day 1, and on the postoperative day 1 and 7. ResultsThe operative time was longer significantly in LA group than that in OO group(P < 0.05). The mean blood loss, the first flatus time, after bed time, and postoperative hospital stay in the two groups were all different statistically(P < 0.05), and all were better in LA group. However, the mean number of retrieved lymph nodes and the time to resume soft diet were not significantly different in the two groups(P > 0.05). On the day 1 and 7 after operation, the CD3, CD4+, and CD8+ significantly decreased as compared with those preoperatively in two groups(P < 0.01, P < 0.05). On the day 1 after operation, the levels of IgG, IgA, and IgM significantly decreased as compared with those preoperatively in two groups(P < 0.05). Those immunoglobulin in LA group recovered to close to the level before surgery, but in OO group sustained lower level(P < 0.05). On the day 1 and 7 after operation, CRP level significantly increased as compared with those preoperatively in two groups(P < 0.01, P < 0.05). Those changes of above index were not significantly different between the LA group and OO group on the day 1 after operation(P > 0.05). All index recovered gradually in the two groups on the day 7 after operation and were better in LA group(P < 0.05, except IgA). ConclusionLaparoscopic radical gastrectomy for advanced gastric cancer resulted in a quicker clinical recovery and a lesser depression to the perioperative cellular and humoral immune function.
ObjectiveTo explore the suitable method for isolation and maintenance of primary cultures of human gallbladder epithelial cells (GECs) for establishing the basis of research works in physiological function of gallbladder and its related diseases.MethodsGECs were isolated with collagenase type Ⅳ and blunt separation.The dishes were coated with fibronectin, laminin and polyDlysine respectively.Additional 10 ng/ml epidermal growth factor was added to DMEM medium containing 20% fetal calf serum.The cells were studied under light and electron microscope to determine their shape and distribution.ResultsEach gallbladder yielded approximately (1-5)×107columnar epithelial cells,greater than 95% of which were viable by trypan blue exclusion.The cells grew vigorously within one week which was flat and multangular in shape. CK19 expressed positive.Electron microscope showed typical gallbladder epithelia with microvilli,tight junctions and mucus droplets.ConclusionCombination of collagenase type Ⅳ，mechanical blunt separation and twostep attachment is of great benefit for separating and harvesting GEC.Fibronectin coated culture dish and DMEM medium containing 20% calf serum and 10 ng/ml hEGF is of great benefit for culturing gallbladder epithelial cells.
【Abstract】ObjectiveThe growing gap between the number of patients waiting for transplantation and available organs has continued to be the number one issue facing the transplant community. The major limitation of adult-to-adult living donor liver transplantation (LDLT) is the adequacy of the graft size. But donor safety is the major concern in LDLT. Methods Two patients with end-stage liver disease were successfully performed adult-to-adult LDLT using dual grafts in our division. One patient’s donors are left lobe and left lobe from his two old sisters , respectively. The other graft are right lobe from his 56 years-old mother and left lobe splitting from a cadaveric organ donor (the other part of split-liver transplants from the the cadaveric organ donor offer to another adult donor ). Results Both recipients and three donors display good graft function and normal triangularshape regeneration of their liver grafts after liver transplantation. There was neither a mortality nor a serious complications in the donors. Conclusion The critical issue of LDLT is donor morbidity. Dual grafts from two living donors can help to alleviate the problem of small-for-size grafts and yet secure the safety of the donor. But the complicated surgical technique give a great challenge for liver transplant surgeons.