Objective To explore the operative managements of ectopic gallbladder during laparoscopic cholecystectomy (LC).Methods Twenty one cases of ectopic gallbladder undergone LC in this hospital were analyzed regarding the perioperative management, principle, and technique of operation.Results There were 2 cases of situs transversus, 1 case with gallbladder under right posterior lobe of liver, 2 under left lateral lobe of liver and 16 in the liver. All 21 cases of ectopic gallbladder had undergone LC successfully, and no complications were found during and after operation. Conclusion Anatomic ectopia of gallbladder tosses a challenging problem to laparoscopic surgeon. It is safe for surgeons to recognise actual anatomical anomaly and to manage them appropriately.
【Abstract】Objective To study the effects of Chinese traditional medicine Sanqizonggan on bacterial translocation in rats with acute necrotizing pancreatitis (ANP).Methods The rat model of ANP was established by retrograde bilepancreatic duct injection of 5% sodium taurocholate. All rats were randomly divided into three groups: the shamoperation group(n=30), ANP group(n=30), and ANP+Chinese traditional medicine group (n=30). The serum amylase was detected at 0 h,12 h,24 h, and oneweek survival rate and pancreatic histological changes were observed in three groups, and the bacterial translocation from intestinal lumen was examined. Results The survival rate of the group treated with Chinese traditional medicine was significantly higher than that of the ANP group. The rate of bacterial translocation in the treated group significantly decreased. Conclusion The Chinese traditional medicine Sanqizonggan can promote gastrointestinal movement, protect intestinal mucosa and reduce bacterial translocation from intestinal lumen.
Objective To summarize the clinical therapeutic efficacy of emergent laparoscopic cholecystectomy （LC） and emergent open cholecystectomy （OC）. Methods One hundred and thirty-three patients with acute cholecystitis from March 2011 to June 2012 in this hospital were randomly divided into emergent LC （ELC） group and emergent OC （EOC） group. The examination and treatment before and after operation were the same. The clinical data before and during operation， postoperative complications， and recovery conditions were observed and compared. Results There was no obvious difference of the clinical data before operation between the ELC group and EOC group （P＞0.05）. Also， there were no significant differences of the operation time， biliary duct injury rate， postoperative bleeding rate， and reoperation rate in two groups （P＞0.05）. The time of postoperative anal exsufflation， time of out-of-bed activity， and postoperative hospital stay in the ELC group were significantly shorter than those in the EOC group （P＜0.05）， the poor incision healing rate in the ELC group was significantly lower than that in the EOC group （P＜0.05）， and the intraoperative blood loss in the ELC group was significantly less than that in the EOC group （P＜0.05）. Conclusions ELC as compared with EOC， are less intraoperative blood loss， less postoperative complications， more rapid recovery， and do not increase operation time. In a hospital with skilled LC technique， ELC is safe and feasible， has obvious advantages of minimal invasion.
Objective To investigate the mechanism of radix salviae miltiorrhizae (RSM) injection in treatment of pancreatitis through observing the changes of activity of nuclear factor-kappa B (NF-κB) in pancreas of rats with severe acute pancreatitis (SAP) and the influence of RSM injection upon NF-κB in pancreas tissue. Methods Seventy-five rats were randomly divided into 3 groups: normal control group, SAP group and RSM treatment group, which were injected with normal saline, normal saline or RSM in the peritoneal cavity, respectively. The model of SAP rats was made by injecting L-arginine into peritoneal cavity and by subcutaneous injection at the same time. The concentrations of amylase in plasma and in ascites were measured respectively, and the expression of NF-κB in pancreas tissues was determined by immunohistochemistry. Results The levels of amylase in plasm and ascites in SAP group and RSM treatment group increased significantly with the increased expression of NF-κB in pancreas tissue, but it was also found that both the level of amylase and the expression of NF-κB in RSM treatment group were significantly lower compared with those in SAP group, and the survival time of RSM treatment group was longer than SAP group with less pathological injury in the pancreas tissues. Conclusion RSM may be effective for the treatment of pancreatitis by degrading the expression of NF-κB.
This paper aims to explore the feasibility of building a finite element model of left atrial diverticulum (LAD) using reverse engineering software based on computed tomography (CT) images. The study was based on a three-dimensional cardiac CT images of a atrial fibrillation patient with LAD. The left atrium and LAD anatomical features were accurately reproduced by using Geomagic Studio 12 and Mimics 15 reverse engineering software. In addition, one left atrial model with LAD and one without LAD were created with ANSYS finite element analysis software, and the validity of the two models were verified. The results show that it is feasible to establish the LAD finite element model based on cardiac three-dimensional CT images using reverse engineering software. The results of this paper will lay a theoretical foundation for further hemodynamic analysis of LAD.
Acute pancreatitis is a common and critical disease in clinical practice, and clinical treatment has formed a multidisciplinary and collaborative model of traditional Chinese and Western medicine. However, its etiology and pathogenesis are complex and varied, and immune response is crucial in the occurrence and development of the disease. Therefore, based on the thinking of the pathological and physiological basis of immune response in the different stages of acute pancreatitis disease progression and related complications, and based on the biological characteristics and laws of the disease, this article summarizes a reasonable and phased implementation of Chinese and Western medicine collaborative management strategy, which is proposed to achieve optimal and precise treatment of the disease.
Objective Tissue engineered bone implanted with sensory nerve can effectively promote angiogenesis and repair of bone defects. To investigate the effects of calcitonin gene-related peptide (CGRP) on proliferation and migration of human umbilical vein endothelial cells (HUVECs) for further revealing the mechanism of tissue engineered bone implanted with sensory nerve promoting angiogenesis. Methods HUVECs were collected from human umbilical core, and identified through von Willebrand factor (vWF) and CD31 immunofluorescence. The HUVECs were treated with CGRP and were ivided into 6 groups according to CGRP concentration: group A (0 mol/L), group B (1 × 10—12 mol/L), group C (1 × 10—11 mol/L), group D (1 × 10—10 mol/L), group E (1 × 10—9 mol/L), and group F (1 × 10—8 mol/L). The expression of the CGRP1 receptor (CGRP1R) was observed in HUVECs by cell immunofluorescence. The growth rate of HUVECs was detected through AlarmarBlue at 1, 2, 3, 4, and 5 days. Transwell chamber was used to detect the abil ity of cell migration. ELISA assay was used to detect the vascular endothel ial growth factor (VEGF) secretion and the protein expression of focal adhesion kinase (FAK) was examined using Western blot. Results HUVECs were identified through morphology, vWF and CD31 immunofluorescence. HUVECs expressed CGRP1R. CGRP could stimulate HUVECs prol iferation in a time- and concentration-dependent manners; the cell growth rates of groups B-F were significantly higher than that of group A at all time (P lt; 0.05); group F had highest cell growth rate. The number of cell migration of group B-F was significantly higher than that of group A (P lt; 0.05), which increased more than 3 times. Groups B-F had higher amount of VEGF than group A (P lt; 0.05), and groups C and D had highest amount of VEGF. FAK expression of groups B-F was significantly increased at 3, 7, and 10 days after CGRP treatment when compared with group A (P lt; 0.05). Conclusion CGRP may enhance the proliferation and migration of HUVECs by increasing the secretion of VEGF and expression of FAK.
Objective To explore the effects of calcitonin gene-related peptide (CGRP) on the migration of bone marrow mesenchymal stem cells (BMSCs) and vascular endothel ial growth factor (VEGF) expression in vitro. Methods TheBMSCs were isolated from Sprague Dawley rats using whole bone marrow adherence method. At 1, 2, and 3 weeks after culture, the expressions of CGRP receptor (CGRPR) was detected by Western blot. The BMSCs were treated with CGRP at concentration 1 × 10-8 mol/L (experimental group) and did not treated (control group), and the efficacy of BMSCs migration was analyzed by Transwell chamber assay after 72 hours; at 1, 3, 5, and 7 days, the mRNA expressions of vascular cell adhesion molecule 1 (VCAM-1) were detected by real-time fluorescent quantitative PCR; the protein expressions of VEGF were examined using immunohistochemistry and Western blot. Results CGRPR expressed stably in the cultured BMSCs and reached the peak at 2 weeks. CGRP had a significantly enhanced role in promoting cell migration. The number of cell migration was (3.20 ± 1.77) cells/HP in experimental group and (1.11 ± 0.49) cells/HP in control group, showing significant difference (t=4.230, P=0.001). In experimental group, the expressions of VCAM-1 mRNA increased with time and reached the peak at 7 days. There were significant differences in the expressions of VCAM-1 mRNA between control group and experimental group at 3, 5, and 7 days (P lt; 0.05). Immunocytochemistry results showed positive DAB staining for VEGF at 5 and 7 days in experimental group. Western blot results showed that the protein expressions of VEGF increased significantly at 5 and 7 days in experimental group when compared with control group (P lt; 0.05), which was signfiantly higher at 5 days than at 7 days in experimental group (P lt; 0.05). Conclusion CGRP can promote the migration of BMSCs and stimulate the protein expression of VEGF, which may plays an important role in regulating bone metabol ism by increasing angiogenesis.
ObjectiveTo evaluate the clinical efficacy of surgical intervention combined with endoscopic ultrasound-guided transluminal drainage in the treatment of infected pancreatic necrosis (IPN). MethodsA retrospective, historical control study was conducted. A total of 98 patients with acute pancreatitis (AP) complicated with IPN who met the inclusion and exclusion criteria and were admitted to the Third People’s Hospital of Chengdu from June 2016 to January 2023 were selected as the research objects. The endoscopic ultrasound-guided transluminal drainage was carried out in our hospital in June 2020. In this study, patients treated before May 2020 were divided into the non-EUS group (52 cases), and patients treated after June 2020 were divided into the EUS group (46 cases). The baseline data, surgical intervention, length of hospital stay, length of intensive care unit (ICU) stay, infection time, incidence of multiple organ dysfunction syndrome (MODS), survival situation, short-term and long-term complications, and other indicators were compared between the two groups. ResultsThe number of percutaneous catheter drainage (PCD, 1.0 vs. 1.0), the number of PCD drainage tube (1.0 vs. 2.0), the number of retroperitoneal debridement drainage (1.0 vs. 2.0), the total length of hospital stay (42.0 d vs. 45.5 d), the length of ICU stay (11.0 d vs. 14.0 d), the length of infection time (10.5 d vs. 18.5 d), the incidences of MODS [43.5% (20/46) vs. 67.3% (35/52)] and residual infection [28.3% (13/46) vs.48.1% (25/52)] in the EUS group were shorter (or lower) than those in the non-EUS group (P<0.05); but there were no significant differences in the number of endoscopic pancreatic stent implantation, the number of laparotomy, the number of laparoscopic surgery, and the incidences of abdominal bleeding, gastrointestinal fistula, gastrointestinal obstruction, chronic pancreatic fistula, chronic pancreatitis and incisional hernia between the two groups (P>0.05). ConclusionFor patients with AP complicated with IPN, surgical intervention combined with endoscopic ultrasound-guided transluminal drainage can reduce the number of PCD and drainage tube, shorten the total length of hospital stay, the length of ICU stay and infection, as well as reduce the incidences of MODS and residual infection.
ObjectiveTo evaluate the therapic efficacy for severe acute pancreatitis (SAP) during different periods. MethodsAccording to internalized standard, 234 patients with SAP admitted to this hospital from January 1986 to October 2009 were included, which were divided into two stages based on the time of admitting to this hospital. The first stage named prior operation group was from January 1986 to August 1998 (n=117), the second stage named individual treatment group was from September 1998 to October 2009 (n=117). There was comparability in demography and clinic between two groups. The prior operation group primarily underwent laparotomy and medication, and the individual treatment group underwent multiple combined therapies. These indexes were compared between two groups: hospital stay, cure rate, and mortality; the incidences of pancreatic pseudocyst, pancreatic and peripancreatic abscess, pancreatic encephalopathy, cardiac insufficiency, acute renal failure (ARF), acute respiratory distress syndrome (ARDS), and shock. The efficacies for early treatment, ascites, biliary pancreatitis, and pancreatic and peripancreatic complications were compared two groups by stratified analysis. ResultsCompared with the prior operation group, the hospital stay was shorter (Plt;0.05), cure rate was higher (Plt;0.001), and mortality was lower in the individual treatment group (Plt;0.001). During the treatments, the incidences of pancreatic pseudocyst, pancreatic and peripancreatic abscess, pancreatic encephalopathy, cardiac insufficiency, ARF, ARDS, and shock in the individual treatment group were lower than those in the prior operation group (Plt;0.05). According to the stratified analysis, the efficacies for early treatment, ascites, biliary pancreatitis, and pancreatic and peripancreatic complications in the individual treatment group were better than those in the prior operation group (Plt;0.001). ConclusionIn recent years, the change of therapeutic mode significantly improves the treatment efficacy for SAP.