ObjectiveTo summarize the research progress of near infra-red fluorescence imaging (NIRFI) in biliary tract surgery, and to provide protection for improvements of therapeutic effect and safety of biliary tract surgery.MethodThe relevant literatures about studies on NIRFI in the biliary tract surgery in recent years were reviewed.ResultsThe NIRFI had been preliminarily used in the surgical treatment of benign and malignant biliary diseases, and had shown its unique value in cholangiography. It provided a new method for effectively avoiding surgical complications, shortening operation time, reducing the rate of conversion to open surgery, evaluating blood supply of bile duct and improving the safety of operation.ConclusionsNIRFI has achieved notable successes in treatment of biliary tract diseases. With future application of fluorescence imaging in near infra-red Ⅱ window and new specific fluorescence targeting molecules, this technique will highlight its more important values in biliary surgery.
Objective To summarize the experience of single incision laparoscopic colorectal surgery and to discuss the operative techniques. Methods The clinical data of 21 cases who underwent single incision laparoscopic colorectal surgery in Shengjing Hospital from Jan. 2010 to Jun. 2011 were collected and analyzed. Results Of 21 cases underwent single incision laparoscopic surgery， right hemicolectomy performed in 5 cases， sigmoidectomy performed in 2 cases， rectal anterior resection performed in 9 cases， rectal abdominoperineal resection performed in 2 cases， total colectomy performed in 1 case， and colostomy performed in 2 cases. Twenty cases completed by single incision， but 1 case was added an extra 12 mm incision in order to dissect the lower segment of rectum. The operative time was （189±75） min （40-335min）；the postoperative hospitalization time was （11.5±3.4） d （7-16d）. There were no bleeding， anastomosis leakage or intestinal obstruction after operation， and no incision infection， rupture or hernia were founded. No recurrence was found within 6 months’ follow up after operation. Conclusions Under reasonable selection of indication， single incision laparoscopic colorectal surgery is safe and feasible， and it also has a satisfactory cosmetic effect and better minimally invasive effect.
Objective To discuss the changes of c-kit/scf mRNA and protein in guinea pig gallbladder fed on high cholesterol diet. Methods Twenty guinea pigs were divided into two equal groups of 10 each：the control group and lithogenic group. Normal diet and high cholesterol diet was given to each group respectively. The period of stone permeation was six weeks. RT-PCR and Western blot were used to determin the expressions of c-kit and scf mRNA and protein. Results RT-PCR results showed that the expressions of c-kit mRNA（t=6.985，P＜0.01） and scf mRNA （t=6.028， P＜0.01）decreased significantly in lithogenic group compared with the control group. Western blot results showed that the expressions of c-kit protein （t=10.256， P＜0.01） and scf protein （t=9.586， P＜0.01）decreased significantly in lithogenic group compared with the control group. Conclusions The expressions of c-kit/scf mRNA and protein decrease during the formation of cholesterol gallstones in guinea pigs fed on high cholesterol diet. Inhibition of c-kit/scf pathway may play a role in the formation of cholesterol gallstones.
ObjectiveTo compare clinical outcome between single-incision laparoscopic subtotal gastrectomy (SILSG) versus laparoscopy-assisted subtotal gastrectomy (LASG) in treatment of benign gastric ulcer and duodenal ulcer. MethodsClinical data of 37 patients with benign gastric ulcer or duodenal ulcer who underwent laparoscopic subtotal gastrectomy between Jan. 2008 and Feb. 2015 at Shengjing Hospital of China Medical University was collected retrospectively. Among them, 15 patients underwent SILSG and 22 patients underwent LASG. Demographic, intraoperative, and postoperative data was analyzed and compared between the 2 groups. ResultsThe operative time of SILSG group was significantly longer than that of LASG group (P < 0.050). However, the postoperative hospital stay was significantly shorter (P < 0.050), and the total patient scar assesment scale (PSAS) score was significantly lower (P < 0.050) in the SILSG group than those of LASG group. There was no significant difference between the 2 groups with respect to other variables (P > 0.050), such as conversion rate, intraoperative blood loss, postoperative exhaust time, incidence of complication, and visual analog scale score of pain. All patients received postoperative follow up, and the period ranged from 6 months to 25 months, with a median of 11 months. During the follow up period, no one suffered from incision hernia and recurrence of ulcer. ConclusionCompared with LASG, SILSG is a technically feasible procedure with better cosmesis and equivalent curability.
ObjectiveTo investigate the effect of curcumin on the expression regulation of endogenousβ-glucoronidase (β-GD) induced by lipopolysaccharide (LPS).Methods① Human normal intrahepatic biliary epithelial cell line (HiBEpiC) cells in the logarithmic growth phase were divided into blank control group (0 h group) and 7 different stimulation time groups. The cell density was adjusted to 1×104/mL, and the cells were stimulated with 100 mg/mL LPS for 1, 3, 6, 18, and 24 hours respectively, including another two groups where the cells were cultured with LPS-free medium for 18 and 24 hours after LPS stimulation for 24 h. ② HiBEpiC cells in the logarithmic growth phase were divided into blank control group, LPS+low, medium, and high concentration curcumin group. The cell density was adjusted to 1×104/mL. In the blank control group, cells were not stimulated with any reagent; in the LPS group, cells were stimulated with 100 mg/mL LPS, in the other three groups, the cells were stimulated with 100 mg/mL LPS and simultaneously 20, 40, and 80 μmol/L curcumin, respectively, for 24 hours. The expressions of c-myc and endogenous β-GD were detected by Western blot method.Results① The expressions of endogenous β-GD and c-myc in HiBEpiC cells gradually increased with the prolongation of treatment time by LPS, and the expression levels of β-GD and c-myc at each time point group were significantly different from those in the 0 h group (P<0.05). ② There were significant difference between any two groups of the blank control group, LPS group, LPS+low concentration of curcumin group, LPS+medium concentration of curcumin group, and LPS+high concentration of curcumin group (P<0.05).ConclusionCurcumin is able to inhibit the increased expression of endogenous β-GD induced by LPS, possibly via inhibiting expression of c-myc.
目的 总结经脐单切口腹腔镜阑尾切除术的技术要点。方法 回顾性分析2012年1月至12月期间中国医科大学附属第四医院收治并行经脐单切口腹腔镜阑尾切除术的55例阑尾炎患者的临床资料。结果 54例患者手术均获成功，1例患者因腹膜后阑尾而中转为3孔法。手术时间为（40.6±12.3） min （35～90min），住院时间为（4.5±1.3） d （3～6d），住院费用为（1.2±0.3）万元（0.8～1.5万元），术后均无并发症发生。术后49例患者获访，随访时间为1～6个月，平均4.8个月。术后患者均恢复良好，脐部瘢痕不明显，美容效果较满意。结论 采用通用器械行经脐单切口腹腔镜阑尾切除术安全、可行，美容效果较佳。
ObjectiveTo summarize the procedure of transumbilical single incision laparoscopic surgery (SILS) with conventional laparoscopic instruments for different tumor diameter and different site of gastric stromal tumor. MethodThe clinical data, intraoperative procedure, and postoperative recovery of 34 patients with gastric stromal tumor from December 2009 to February 2014 in this hospital were analyzed retrospectively. ResultsThe transumbilical SILS was performed successfully in all the 34 patients.Among these patients, the wedge resection of stomach was perfor-med in 27 patients, distal subtotal gastrectomy was performed in 6 patients, distal subtotal gastrectomy complicated with multivisceral resection was performed in 1 patient.The pathology confirmed that the diameter of tumors was from 0.6 cm to 10.0 cm (average 3.4 cm).The resection margins were tumor free.The risk assessment showed that tumors with extremely low risk were in 9 cases, low risk were in 17 cases, intermediate risk were in 6 cases, high risk were in 2 cases.During surgery, 9 tumors were located on the fundus of stomach, 6 tumors on the gastric greater curvature, 7 tumors on the gastric lesser curvature, 2 tumors on the anterior and posterior wall of the stomach respectively, 3 tumors on the cardia below, 4 tumors on the gastric antrum, tumor invaded the surrounding organs in 1 case.There was no conversion to open or conventional laparoscopic surgery.no intraoperative or postoperative complications were experi-enced in all the patients except one was postoperative intraperitoneal bleeding and one was incision infection.All the patients were followed for an average of 25 months (range 3-49 months), there was no evident recurrence of disease. ConclusionsThe transumbilical SILS for gastric stromal tumor is a feasible and safe technique when performed by an experienced laparoscopic surgeon.The suitable procedure of SILS should be selected for gastric stromal tumor according their different size and location.