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find Author "韩冰" 17 results
  • Gastric Function after Esophagectomy with Vagus Preserved

    ObjectiveTo study the gastric function of vagus-preserved patients after esophagectomy, and to evaluate the significance of keeping vagus and the value of gastric tube with vagal-sparing esophagectomy. MethodsWe retrospectively analyzed clinical data of 15 patients in West China Hospital between June 2012 and January 2014. They were divided into two groups. There were 8 patients with 6 males and 2 females with average age of 57 years ranging from 44 to 77 years, in a gastric pull-up group with vagal-sparing esophagectomy. There were 7 patients with 6 males and 1 female at average age of 60 years ranging from 50 to 70 years in a gastric tube group with vagal-sparing esophagectomy. We chose 8 patients with 7 males and 1 female at average age of 62 years ranging from 47 to 69 years as a control group with a classical esophagectomy and a gastric pull-up. Then we evaluated the function of the vagal nerves and gastric reservoir after vagal-sparing esophagectomy. ResultsAll 23 surgeries were successfully performed. In subjective symptom, diarrhea was rare in the vagal-sparing esophagectomy patients and statistically more common in patients with a standard esophagectomy. Dumping and early satisfaction situation were similar among 3 groups. The 60 minutes gastric emptying rate was much better in the vagal-sparing group than that in the control group. And the esophageal manometry of the vagal-sparing group was statistically hihger than that in the control group. The gastroscope showed that the incidence of reflux esophagitis in the vagal-sparing group was statistically lower than that of the control group. There was no statistic difference in weight in the vagus-preserved group before and after the surgery while the weight decreased statistically in the control group. ConclusionsFor both esophageal replacement and gastric tube, preserving the vagus can reduce the functional dyspepsia after esophagectomy.

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  • 肺隔离症一例

    Release date:2016-08-30 05:51 Export PDF Favorites Scan
  • RESEARCH ADVANCE AND CLINICAL APPLICATION OF MESENCHYMAL STEM CELLS

    Objective To review the advance in the experimental studies and evaluate the potential therapeutic application of the mesenchymal stem cells(MSCs). Methods The related articles published in China and theother countries during the recent years were extensively reviewed and analyzed. Results The MSCs were widely used in the cell-transplantation therapy and the tissue engineering because of their pluripotency of differentiation into various kinds of cells. They were also frequently used in the gene therapy because they could stably express the transfected objective genes. Because of their immunomodulatory function, the MSCs could also be used in the immunotherapy. Conclusion The MSCs are the stem cells, which have characteristics of renewing themselves, having multipotency, and being easy to undergo amplification in vitro.The MSCs are ideal target cells for the cell therapy, tissue engineering, gene therapy, and immunotherapy.

    Release date:2016-09-01 09:25 Export PDF Favorites Scan
  • The effects of FTY720 on retinal photoreceptor cells and microglial following light-induced degeneration in rat retina

    ObjectiveTo investigate the effects of FTY720 on retinal photoreceptor cells and microglial following light-induced degeneration in rat retina. Methods120 Sprague-Dawley rats were randomly divided into four groups including FTY720 group, solvent control group, model group and normal group. The rats of normal group were not intervened. The FTY720 group, solvent control group and model group establish retinal light injury mode. FTY720 was injected into abdominal cavity of the rats in FTY720 group 0.5 hours before light exposure. 50% dimethylsulfoxide was injected into abdominal cavity of the rats in solvent control group. The expressions of microglial cells in rat retinal were quantified using flow cytometry, the expressions of interleukin (IL)-1βwere examined by enzyme-linked immuno sorbent assay at 6 hours, 1 day, 3 days, 7 days after light exposure. The apoptosis of retinal photoreceptor cells were measured by terminal-deoxynucleoitidyl transferase mediated nick end labeling at 1 day after light exposure. The morphological change of retinal were viewed by haematoxylin and eosin staining at 7 days after light exposure. ResultsThe expressions of microgilal and IL-1βbegan to rise at 1 day after light exposure, reached at peak at 3 days and decreased at 7 days. The expressions of IL-1βand microglial in FTY720 group were significantly lower than solvent control group and model group, but higher than normal group (P < 0.05).One day after exposure to light, the apoptosis cell ratio in normal group, model group, solvent control group and FTY720 group were 0, (87.66±2.50)%, (86.00±2.44)%, (49.66±2.80)%. The apoptosis cell in FTY720 group were higher than normal group, lower than solvent control group and model group (P < 0.05). Seven days after exposure to light, the retinal in normal group was structured and the cell was arranged well, the cell in solvent control group and model group was irregular arrangement and the outer nuclear layer (ONL) was thin after light exposure. The thickness of the ONL in FTY720 group was significantly higher than solvent control group and model group, below normal group. ConclusionFTY720 can prevents retinal photoreceptor cells from apoptosis and inhibits activation of microglial.

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  • Security of progesterone drugs in breast cancer survivors

    Breast cancer is one of the most common malignant tumors in women. The systematic therapy of breast cancer may affect the endometrium and ovarian function, such as abnormal endometrial hyperplasia and abnormal uterine bleeding caused by ovulation disorders. If we do not consider the patients suffering from breast cancer, we can use progesterone drugs to stop bleeding, regulate menstruation, and protect the endometrium. But there is no consistent conclusion on the safety of progesterone drugs in breast cancer patients. This article reviews the security of progesterone drugs in breast cancer survivors from the perspective of basic and clinical research. At present, whether the use of progesterone drugs in breast cancer survivors increases the risk of disease may be related to the type, dosage, and method of use of progesterone drugs. At the same time, it is also related to the type of breast cancer the patient has. Based on the available data, it is safe to use natural progesterone or dydrogesterone for the short term in patients with breast cancer. More studies are needed to evaluate other approaches.

    Release date:2020-11-25 07:18 Export PDF Favorites Scan
  • ADVANCES IN GENE EXPRESSION OF BONE MARROW STROMAL CELLS

    Objective To review the advances in gene expression of marrow stromal cells(MSCs) in biological characteristic, differentiation, gene therapy, supporting hematopoiesis, inflammation reaction in wound repair.Methods The related articles in recent years were extensively reviewed.Results MSCs can express not only specific mRNA of mesodermal cells but also that of endodermal and ectodermal cell types on various differentiation conditions. When transfected or transducted, MSCs can steadily express many therapeutic transgenesin vitro or in vivo as well. Furthermore, they have the ability to support hematopoietic system and participate in the process of inflammation in wound repair.Conclusion MSCs are stem cells which have the characteristicof self renewing, multipotency and easy to expand in vitro. MSCs are ideal target cells for cell and gene therapies.

    Release date:2016-09-01 09:29 Export PDF Favorites Scan
  • Effect of Somatostatin Combined with Antibiotics on Serum Tumor Necrosis Factor-α and C-reactive Protein in Rabbits with Acute Cholecystitis

    ObjectiveTo explore the therapeutic effect and its possible mechanisms of somatostatin combined with antibiotics on acute cholecystitis through the detection of serum tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) in rabbits. MethodsForty-five rabbits were randomly averagely classified into three groups following the establishment of acute cholecystitis model: control group, blank group, and experimental group. The rabbits in control group received cefazolin sodium and metronidazoie by intravenous injection twice a day. The rabbits in experimental group got a hypodermic injection of somatostin (20 μg/kg) twice a day besides antibiotics, while these drugs were replaced by equal volume of normal saline for the rabbits in control group. The concentrations of serum TNFα and CRP were detected by enzyme-linked immunosorbent assay and histomorphological and electron microscopic changes of gallbladder in rabbits were observed on 3 d after administer. ResultsThe concentrations of serum TNF-α of rabbits in experimental group 〔(401.6±48.7) pg/ml〕 were significantly lower than those in control group 〔(767.3±67.4) pg/ml〕 and blank group 〔(806.7±61.2) pg/ml〕, P=0.000 and P=0.000, while the difference between the latter two groups was not significant (P=0.196). The concentrations of serum CRP of rabbits in experimental group 〔(16.2±1.1) mg/L〕 were significantly lower than those in control group 〔(55.4±1.2) mg/L〕 and blank group 〔(72.8±8.9) mg/L〕, P=0.000 and P=0.000, and which was higher in blank group compared with control group (P=0.018). The Histopathological results showed that gallbladder wall emerged mulifocality mucosal fluid necrosis, lamina propia hyperemia, bulk neutrophil infiltration and sequent alleviation of reaction in the rabbits of experimental group when compared with the rabbits of blank group and control group. Electron microscopic results demonstrated that the intercellular junction of gallbladder kept relative integrity and the swelling and vacuolar degeneration of mitochondria and endoplasmic reticulum obviously relieved. ConclusionsSomatostatin can significantly reduce the concentrations of serum TNF-α and CRP in the model of rabbits acute cholecystitis, which may protect the mucous membrane of gallbladder from the inflammation reaction.

    Release date:2016-09-08 10:41 Export PDF Favorites Scan
  • 非胸腔镜辅助Nuss手术治疗漏斗胸123例

    目的总结Nuss手术治疗漏斗胸及减少术中、术后并发症发生的临床经验。 方法回顾性分析2010年6月至2013年3月四川大学华西医院123例漏斗胸行Nuss手术治疗的临床资料,男101例,女22例;年龄3~32(15.0±5.1)岁;身高80~183(155.5±25.0)cm;体重15~71(44.4±13.3)kg。其中2例为Ravitch术后复发患者,其余患者均为初次手术。术前胸部CT示:Haller指数为4.1±1.4。 结果所有患者均顺利完成手术,手术时间35~155(74.3±25.4)min,术后住院时间3~16(4.2±1.6)d。其中26例患者需植入2根矫形板,其余患者均只需植入1根矫形板。CT示:术后Haller指数为2.6±0.6,与术前比较差异有统计学意义(P<0.05)。术后共发生并发症15例,发生率12.2%。其中气胸4例次,切口感染5例次,1例患者考虑为机体对矫形板材质过敏,伤口长期渗血、渗液,最终患者选择提前取出矫形板;2例患者有轻度脊柱侧弯,7例患者术后1~3个月内发生矫形板移位,需再次手术,重新放置矫形板。 结论Nuss手术安全、可靠,具有矫形效果佳、损伤小、恢复快等优点。

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  • 1例股静脉至无名静脉金属异物的外科治疗

      患者,男,39岁。3年前因大面积烧伤在外院治疗,2年后经X线拍片见一金属导丝从右股静脉直到无名静脉(图1),遂切开右股静脉欲取出导丝,但见部分导丝已与静脉内膜黏合,无法取出,手术失败; 后再次经对侧股静脉入径,用抓捕器从无名静脉将导丝套住并向下行套至第二腰椎水平处即无法下行,考虑腰二椎体以下导丝已与下腔静脉黏合,再将抓捕器进入右股静脉也无法抓捕导丝,手术再次失败(图2)。后收治于第二炮兵总医院,决定采用导管套切分离摘取法,经术前准备后于全麻下行第3次手术。手术沿右股部原切口进入,瘢痕密集,分离困难。逐步显露出右股总及股深浅静脉并分别过带控制,沿右股总静脉触及硬条索样物,向下延及股浅静脉。切开右股总静脉,见导丝与股静脉后壁完全贴合,被光滑内膜覆盖(图3)。切开后壁内膜显露导丝,小心地将其自股浅静脉抽出,检查导丝完整,试牵引并不会被拉伸或折断(图4)。用6 F椎动脉造影管沿导丝插入,导丝由导管壁上的预开孔处引出并固定,此后小心地沿金属异物推进导管,至进入约5 cm处即无法前进; 换用10 F SteerEase输送导管以同法推进(图5),此过程中不断转动并前后移动导管,前进十分困难,操作达40 min后导管进入约30 cm至超过腰二水平,小心将导丝和导管向下同时牵引,将异物完整取出(图6)。患者术后恢复顺利,满意出院。拟服抗凝药3~6个月。  讨论  静脉内金属异物多是外伤或医源性所致,临床罕见,治疗困难。本例长条金属异物位于无名静脉和股静脉之间。以往手术和介入治疗未能成功的原因在于导丝在体内时间过长,已与血管融合一体。本例于第二炮兵总医院成功治疗的关键在于将导丝从血管融合体中游离出来。避免盲目暴力拉扯,否则会出现导致患者生命危险的大出血。宜选择直型且韧性好的导管,便于导管旋转进入且不会损伤周围静脉管壁。术中证实导丝无明显腐蚀表现,所以沿导丝同轴缓慢向上推进导管穿破下腔静脉的可能性不大。我们将导丝游离端穿入套管后从预先自制的侧壁孔引出,在固定导丝的前提下采用推进管鞘的方法 (图5)完成手术(应用杠杆原理), 这是我们在手术室而不是在导管室施行治疗的根本原因,如有条件在透视下缓慢插入导管会更安全。但是必须指出的是,如果在股部切口发现导丝游离端已经被腐蚀且很易折断时,我们则会中止该治疗方案,因为笔者曾手术取出留置体内的自无名静脉到肝内留存11年的塑料套管,极易折断,最终是分为数段后全部取出。若本例导丝随着置入时间的延长,亦达到此程度,显然不宜采用上述方法。本例手术成功的关键在于术前充分准备、可行的方案及术中精细的操作。在取出异物后,可能的大范围静脉内膜损伤,因而防止术后附壁血栓形成和肺栓塞至为重要,因而需予抗凝治疗。

    Release date:2016-09-08 11:05 Export PDF Favorites Scan
  • Study on The Effect of Endovascular Treatment Guided by Ultrasonography Combined with Portosystemic Shunts for Budd-Chiari Syndrome

    Objective To explore the effect of endovascular treatment guided by ultrasonography combined with portosystemic shunts on the patients with Budd-Chiari Syndrome (BCS).Methods The clinical data of 136 patients with BCS treated by balloon angioplasty and stent implantation guided by Doppler ultrasonography in our hospital from January 1995 to January 2011 were retrospectively analyzed.After balloon angioplasty,53 patients were treated by inferior vena cava (IVC) stent implantation and 31 patients with hepatic venous occlusion underwent portosystemic shunts (PSSs) at one week after endovascular treatment.The long-and short-term effects after treatment were studied.Results After endovascular procedures,the IVC pressure of patients significantly decreased (P<0.01),while IVC diameter, flow velocity in the lesion,and right atrial pressure of patients showed significant increase(P<0.01).Slight heart dysfunction appeared in 13 cases of patients.After shunting,acute pancreatitis occurred in 3 cases, and 1 patient died of upper gastrointestinal hemorrhage on the 10 d after PSSs.Doppler ultrasonography for IVC and shunt vessels showed:the swollen liver and spleen lessened on 3d after endovascular procedures.The swollen liver lessened 2-7cm (mean 5.5cm),swollen spleen lessened 3-8cm (mean 5.8cm), and the time of ascites disappearance was 3-60d (mean 14d).All the patients were followed up for 1 month to 15 years with an average of 3 years.Restenosis of the distal part of stent was found in 1 patient in 2 years after operation, hepatic vein occlusion occurred in 1 case in 1 year after treatment,hepatocellular carcinoma occurred in 1 patient in 3 years after stent implantation,and 1 patient died of C type hepatitis after 1 year,and 5 out of 6 cases of patients with infertility had babies after 1 year.All patients had no stent migration or occlusion of shunts and the symptoms of portal hypertension were obviously relieved.Conclusions Endovascular treatment guided by Doppler ultrasonography is a convenient,safe,and effective method for BCS.Portosystemic shunts are commended to patients with hepatic venous occlusions.The above mentioned methods provide a feasible and effective means for IVC stenosis and short segment occlusion with hepatic vein occlusion of BCS.

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