【摘要】 目的 探讨胰腺癌早期诊断的要点及误诊因素。 方法 回顾性分析2009年7月8日收治的1例以腹胀、呕吐为主要表现的胰腺癌患者。 结果 患者经及时剖腹探查确诊为胰腺癌并行手术切除。 结论 胰腺癌起病隐匿，其早期误诊率高，进行胰腺癌的早期诊断、避免误诊是提高预后的重点和难点。【Abstract】 Objective To explore the main points of early diagnosis of pancreatic cancer and its misdiagnosis factors. Methods The clinical data of one patient with pancreatic cancer on the 8th July, 2009 was retrospectively analyzed. The chief complaints included abdominal distension and vomiting. Results By exploratory surgery in time,the patient was diagnosed as pancreatic cancer and underwent the resection. Conclusion The onset of pancreatic cancer is very insidious,usually with a high misdiagnosis rate. How to make the right early diagnosis and to avoid misdiagnosis are the focal points of improving the prognosis.
ObjectiveTo explore the safety and effectiveness of endoscopic treatment for biliary tract complications after liver transplantation.MethodsPatients who underwent endoscopic treatment for biliary tract complications after liver transplantation from January 2009 to December 2018 in West China Hospital were enrolled. Characteristics of patients, types of biliary tract complications, effectiveness of endoscopic treatment and endoscopic related complications were collected and analyzed.ResultsAmong the 57 patients with biliary tract complications, 37 patients had biliary stricture alone, 4 patients had bile leak alone, 15 patients had biliary stricture plus biliary stones or sludge, and 1 patient had biliary stricture combined with biliary leakage. A total of 112 treatments of endoscopic retrograde cholangiopancreatography (ERCP) were performed, among which 100 treatments were accomplished successfully (89.3%), including the improvement of bile duct stenosis, the cure of bile leak and the successful removal of common bile duct stones. The number of total ERCP related complications was 15 (13.4%), among which post ERCP pancreatitis was the most common (9.8%).ConclusionEndoscopic therapy can be considered as an initial treatment for biliary tract complications after liver transplantation as its safety and effectiveness.
Objective To evaluate the therapeutic effects of endoscopic treatment on biliary tract complications after liver transplantation. Methods The clinical data of 55 patients with biliary tract complications after liver transplantation undergoing endoscopic treatment from January 2006 to June 2009 were analyzed retrospectively. Results Ninety-eight times of endoscopic treatment were performed in 55 patients. There were 11 cases of biliary fistula, 4 cases of bile duct stricture with biliary fistula, 21 cases of bile duct stricture, 12 cases of bile duct stricture with biliary sludge or stones, 3 cases of biliary sludge or stones, 2 cases of angular distortion of the bile duct and papilla duodeni stenosis in 2 cases. Different procedures including biliary tract dilation, endoscopic nasobiliary drainage, endoscopic sphincterotomy, stone extraction technique and biliary stent placement were performed in different biliary tract complications. The endoscopic treatments were successful in 46 cases (83.6%). The procedure related complications were found in 13 times (13.3%). Conclusion Endoscopy may serve as the primary modality for treating biliary tract complications after liver transplantation with safety and effectiveness.
Astronauts who are exposed to weightless environment in long-term spaceflight might encounter bone density and mass loss for the mechanical stimulus is smaller than normal value. This study built a three dimensional model of human femur to simulate the remodeling process of human femur during bed rest experiment based on finite element analysis (FEA). The remodeling parameters of this finite element model was validated after comparing experimental and numerical results. Then, the remodeling process of human femur in weightless environment was simulated, and the remodeling function of time was derived. The loading magnitude and loading cycle on human femur during weightless environment were increased to simulate the exercise against bone loss. Simulation results showed that increasing loading magnitude is more effective in diminishing bone loss than increasing loading cycles, which demonstrated that exercise of certain intensity could help resist bone loss during long-term spaceflight. At the end, this study simulated the bone recovery process after spaceflight. It was found that the bone absorption rate is larger than bone formation rate. We advise that astronauts should take exercise during spaceflight to resist bone loss.
ObjectiveTo investigate the etiology of pediatric pancreatitis and the effect of endoscopic retrograde cholangiopancreatography (ERCP) in it. MethodsPatients hospitalized for pancreatitis in West China Hospital of Sichuan University from Jan. 2008 to Jun. 2023 were included according to the inclusion and exclusion criteria. Totally, 241 cases (207 cases with acute pancreatitis and 34 with chronic pancreatitis) were included. Patients were divided into primary group (n=168) and recurrent group (n=73) according to their previous medical history. ResultsThe duration of hospitalization in the primary group was longer than that in the recurrent group [10.0 (7.0, 16.0) d vs. 7.5 (6.0, 11.8) d, P=0.012]. The proportion of acute pancreatitis in primary group (163/168, 97.0%) was higher than that in the recurrent group (44/73, 60.3%), P<0.001. There was no significant difference in the etiological component ratio between the primary and recurrent groups (χ2=7.504, P=0.347). However, in the primary group, the first etiology was biliary factors (38/163, 23.3%), and the second was biliary pancreatic anatomic abnormality (22/163, 13.5%). In the recurrence group, biliary pancreatic anatomic abnormality (13/44, 29.5%) was the first cause, and biliary factor (7/44, 15.9%) was the second cause. Among 207 cases with acute pancreatitis, there were 114 cases (55.1%) with clear etiology, including 45 cases (21.7%) of biliary factors, 35 cases (16.9%) of abnormal biliary pancreatic structure, 12 cases (5.8%) of traumatic factors, and 10 cases (4.8%) of drug-induced factors. In this study, 66 cases were treated with ERCP for pancreatitis, and a total of 103 ERCP operations were performed with cannulation success rate of 100%. Twenty-three cases (23/37, 62.2%) of acute pancreatitis resulted from biliary and biliary pancreatic structure abnormalities received ERCP. In biliary acute pancreatitis, the removal rate of choledocholithiasis in single ERCP operation was 80.0% (8/10). The clinical symptoms (abdominal pain, jaundice, and fever) of all cases were significantly improved after surgery, and no complications such as cholangitis, bleeding and perforation occurred. ConclusionsBiliary, congenital pancreatic anatomical abnormalities, drugs and trauma are the common causes of acute pancreatitis in children. ERCP is a safe and effective treatment for children with biliary pancreatitis, pancreatic anatomical abnormalities, and chronic pancreatitis.
Objective To explore the effects of celecoxib, a selective COX-2 inhibitor, on the expression of NHE1 and intracellular pH (pHi) of SGC-7901 human gastric carcinoma cells. Methods Human gastric carcinoma cell line SGC-7901 was used as research object. MTT method was used to detect the celecoxib's depressant effect on the proliferation of SGC-7901 cells after intervening with different concentrations of celecoxib (5, 12.5, 25, 50, 75, and 100 μmol/L) for different time. Western blot was applied to detect influence of different concentrations of celecoxib on NHE1 expression in SGC-7901 human gastric carcinoma cells. On this basis, pHi of SGC-7901 cells was tested by BCECF-AM immunofluorescence. Results Celecoxib could effectively inhibit the proliferation of SGC-7901 human gastric carcinoma cells. And within a certain concentration range, the inhibitory action on SGC-7901 cells increased with the increase of celecoxib concentration. It also increased with the extension of explosion time while at the same concentration (P<0.05). Different concentrations (except 5 μmol/L) of celecoxib could down-regulate the expression of NHE1 in SGC-7901 cells, which was concentration dependent (P<0.05). The pHi of SGC-7901 cells that were not intervened with celecoxib is alkaline. Compared the pHi of cells in control group, the pHi of SGC-7901 cells decreased significantly after intervening with different concentrations of celecoxib (except 5 μmol/L) for 24 h (P<0.05). And the decrease of pHi was also concentration dependent (P<0.05). Conclusion Celecoxib may inhibit the growth of SGC-7901 cells through down-regulating the expression of NHE1 and declining the pHi.
ObjectiveTo investigate the neural mechanisms of subjects with anisometropic amblyopia using event-related potential (ERP) technology.MethodsNineteen subjects diagnosed with anisometropic amblyopia were consecutively recruited from the outpatients of the West China Hospital of Sichuan University from June 2013 to February 2014, and twenty normal subjects were recruited as control subjects. All subjects were given different orientation Gabor stimuli with three spatial frequencies (1, 2, 8 cpd) and their ERP was recorded. The differences of P3b, including amplitude and latency, were compared between amblyopic eye and fellow or control eye.ResultsAmong the three groups of amblyopic eye and fellow or control eye, there was no statistically significant difference in accuracy or response time at three spatial frequencies (P>0.05), in latency or amplitude of P3b at low spatial frequencies (1, 2 cpd) ((P>0.05), or in amplitude of P3b at high spatial frequency (8 cpd) (P>0.05). P3b latency of amblyopic eye extended at high spatial frequency (8 cpd), compared to fellow or control eye. Amblyopic eye was most significantly weakened in Brodmann area 17 at the P3b wave of each spatial frequency (1, 2, 8 cpd), and there was most significantly weakened in high spatial frequency (8 cpd).ConclusionThe P3b latency of amblyopic eye extended at high spatial frequency suggests that the cognitive function of amblyopia is impaired, at an extent, in the late visual processing stage.