ObjectiveTo evaluate the influencing factors and explore a better method of making rat model of type 2 diabetes by high fat and sugar diet and streptozotocin(STZ) injection. MethodsSixty SPF grade of 6 weeks male SD rats were fed with high fat and glucose diet by 4 weeks and then randomly divided into 3 groups, the control group rats(n=20) were injected citric acid by 50 mg/kg and fed with normal diet, and the diabetes mellitus group rats were further divided into 2 subgroups by the different doses of STZ:the rats of diabetes mellitus model group 1(n=20) were injected by 50 mg/kg, while the rats of diabetes mellitus model group 2(n=20) were injected by 35 mg/kg. The diabetes mellitus model group rats were fed with high fat and glucose diet continually. The fasting blood glucose(FBG) were measured on day 3, 7, 10, and 14, respectively. The success model rate(blood glucose > 16.7 mmol/L after 14 days) and the mortality rate were calculated. Meanwhile fasting serum insulin level(FSI), total serum cholesterol(TC), and triglyceride(TG) were measured. ResultsCompared with the control group, the levels of FBG, FSI, TC, and TG were increased significantly in the diabetes mellitus model group 1 and 2(P < 0.05). And insulin sensitivity was worsen markedly(P < 0.05). But the diabetes mellitus model group 2 had higher success rate of making model(85% vs. 75%) and lower mortality(0 vs. 25%), P < 0.05. ConclusionRat model of type 2 diabetes induced by 4 weeks of high fat and sugar feeding and 35 mg/kg STZ injection has high morbidity, strongly security, and stable features.
ObjectiveTo compare clinical efficacy of totally laparoscopic gastrectomy (TLG) and conventional laparoscopy-assisted gastrectomy (LAG) and to explore safety and feasibility of total laparoscopic anastomosis in laparoscopic gastrectomy. MethodThe clinical data of 64 patients who received TLG and another 70 patients who received conventional LAG in our department from January 2013 to March 2014 were retrospectively analyzed. ResultsAll procedures were completed successfully. There were no significant differences in the time of anastomosis〔(73.8±10.3) min versus (72.7±8.9) min, t=0.693, P=0.489〕 and the number of dissected lymph nodes (32.4±9.7 versus 33.6±9.6, t=-0.700, P=0.485) between the patients underwent TLG and the patients underwent LAG. However there were obvious differences in the blood loss〔(275.0±66.3) mL versus (364.3±75.7) mL, t=-7.419, P=0.000〕, the incision length〔(3.0±0.8) cm versus (7.3±1.7) cm, t=-19.354, P=0.000〕, the time to fluid diet〔(4.9±0.8) d versus (6.0±0.7) d, t=-8.750, P=0.000〕 and the time to flatus 〔(2.8±0.8) d versus (3.9±0.8) d, t=-8.388, P=0.000〕, the off-bed time〔(1.3±0.5) d versus (3.4±1.2) d, t=-14.118, P=0.000〕, and the hospital stay〔(9.8±1.2) d versus (13.0±1.5) d, t=-17.471, P=0.000〕 between the patients underwent TLG and the patients underwent LAG. Meanwhile it was found that the postoperative pain score〔On day 1 postoperatively: (3.4±0.8) points versus (6.2±1.3) points, t=-15.509, P=0.000; on day 3 postoperatively: (1.7±0.6) points versus (4.0±0.8) points, t=-18.799, P=0.000〕 and the dosage of pain killers (1.7±0.7 versus 4.0±2.1, t=-8.912, P=0.000) in the patients underwent TLG were significantly lower than those in the patients underwent LAG. One patient developed anastomotic leakage and 3 patients developed anastomotic stenosis in the patients underwent LAG, the complication rate related to the anastomosis was 5.7% (4/70). While there were no complications related to the anastomosis in including anastomotic leakage, stenosis, and bleeding in the patients underwent TLG. ConclusionsTotal laparoscopic anastomosis is safe and feasible in laparoscopic gastrectomy for gastric cancer. Compared with small incision-assisted anastomosis, totally laparoscopic anastomosis is associated with minimal trauma, less blood, quicker postoperative recovery, shorter time, slighter pain and satisfactory short-term efficacy.
ObjectiveTo summarize experience of laparoscopy combined with choledochoscopy common bile duct exploration for patients with schistosomiasis liver cirrhosis with common bile duct stones. MethodThe clinical data of 45 patients with schistosomiasis liver cirrhosis combined with common bile duct stones (liver function Child-Pugh grade A and B) admitted in this hospital from September 2012 to September 2015 were analyzed retrospectively. ResultsTwenty cases were successfully treated by laparoscopy combined with choledochoscopy (laparoscope group), 25 cases were treated by conventional open common bile duct exploration (laparotomy group). Two cases were converted to laparotomy due to bleeding during laparoscopic operation. The mean operation time, intraoperative bleeding, postopera-tive hospitalization time, and postoperative total complications rate had no significant differences between these two groups (P>0.05). There were 2 cases of pulmonary infection and 1 case of incision infection in the laparoscope group, and 1 case of grade A bile leakage and 1 case of pulmonary infection in the laparotomy group, there was no common bile duct stone residual in these two groups. ConclusionAlthough laparoscopic surgery is more difficult for schistosomiasis liver cirrhosis combined with common bile duct stones patients, it is safe and feasible. Appropriate perioperative management and precise laparoscopic and choledochoscopic operation are key to success of operation.