【摘要】 目的 观察在不同剂量乙醇作用下大鼠下丘脑和脊髓神经细胞P物质的表达情况和扫描电子显微镜（SEM）下神经细胞的形态学变化，探讨乙醇作用下大鼠行为学改变的相关机制。 方法 通过福尔马林实验观察大鼠在不同剂量乙醇及时间作用下行为学的改变；采用免疫组织化学技术检测不同剂量乙醇作用下大鼠脊髓和下丘脑神经细胞中P物质的表达，通过扫描电子显微镜观察神经细胞的形态学变化。 结果 乙醇灌胃后0～2 h大鼠舔足次数有不同程度的变化，组间比较差异有统计学意义（Plt;0.05），灌胃2 h大鼠下丘脑和脊髓P物质表达程度与乙醇剂量有相关关系，扫描电子显微镜下各组大鼠的神经细胞形态学变化显著。 结论 急性乙醇中毒可引起大鼠对疼痛反应的变化，其程度与乙醇剂量和作用时间有关，大鼠下丘脑和脊髓神经细胞中P物质的表达强度与乙醇剂量和作用时间有关。【Abstract】 Objective To observe the expression of substance P(SP)in the hypothalamus and spinal cord nerve cells of rats with different concentrations of ethanol, and to observe the morphological changes of nerve cells by scanning electron microscopic(SEM) for elucidating the mechanism of ethological changes effected with ethanol. Methods Ethological changes were detected through the formalin test; SP expressions in the hypothalamus and the spinal cord were evaluated with immunohistochemistry technology, and the morphological changes of nerve cells were observed by SEM. Results The frequency of licking foot changed when the rats were gavaged with different concentrations of ethanol among zero to two hours, the difference between two groups was statistical signifcant (Plt;0.05). The expression level of SP and the morphological changes of nerve cells in hypothalamus and spinal cord had relationship with the ethanol concentration. Conclusions Acute alcoholism could cause pain dysfunction in rats. The frequency of licking foot of rats is correlated to the role of the time closely. The expression intensity of SP in the hypothalamus and the spinal cord nerve cells are correlated to the concentration of ethanol closely.
Objective To evaluate the clinical application value of the tauro ursodeoxycholic acid (TUDCA) for preventing the relapse of lithiasis after the gallbladder-protected lithotomy. Methods Totally 80 cholecyslithiasis patients in Chengdu General Military Hospital who met the demand of lithotomy in protecting gallbladder were divided into two groups by random permutations, with 40 patients in each. The calculus was removed by using the percutaneous ultrasonic lithotripsy in order to preserve the well-functioning gallbladder. The patients in the trial group were given TUDCA after surgery for two years, whereas the patients in the control group received the same nursing and diet therapies without medication. The thickness of gallbladder wall and the contraction function of gallbladder were checked two years after surgery, the statistics of the recurrence rate of liary calculus symptoms and cholecyslithiasis were conducted, and the comparison between those two groups was performed. Results All the operations of gallbladder-protected lithotomy were successful. There was significant difference between those two groups two years after surgery in terms of the thickness of gallbladder wall and the contraction function of gallbladder (Plt;0.05). The relapse of lithiasis was remarkably decreased in the trial group (Plt;0.05). Conclusion The application of TUDCA for patients with gallbladder-protected lithotomy can prevent the relapse of cholecyslithiasis.
Objective To observe the expression and localization of cellular homolog FLICE-like inhibitory protein (c-FLIP) in the procedure of benign biliary stricture formation and discuss the significances. Methods The method of in situ hybridization was used in anastomotic tissues from 15 dogs (experimental group) in 2, 3, 4, 5, 6 months after bile duct injury and 15 matching sham operation dogs (sham operation group) for analyzing the expression and localization of c-FLIP and calculating the average integrated optical density of each slice. Stain cells were counted under the magnification field (×400) and at least 5 fields per slice were examined. The cells stained red in the nuclei and (or) the cytoplasm were positive cells. The signals meant: Negative for cells no stained, weak positive for the cells with nuclei and (or) cytoplasm stained pink; b positive for the cells stained the bright red; while middle positive for the cells stained between the both. The image analysis software （Image pro plus 4.5） was applied in the gland tissue and interstitial tissue in each slice to calculate the average integrated optical density for the expression of c-FLIP. Results In the experimental group, there were all b positive expressions of c-FLIP in the interstitial tissue at all the time points, mainly expressed in the cytoplasm of fibroblast and very little or almost no expression in the glandular tissue. Positive expression of c-FLIP in the interstitial tissue was significantly ber than that of gland tissue (Plt;0.05); There were no significant differences among each time point in either the interstitial tissue or gland tissue (Pgt;0.05). In the sham operation group, there were all weak positive expressions of c-FLIP in the interstitial tissue and gland tissue at all the time points and was no significant difference (Pgt;0.05), no difference between each phase (Pgt;0.05). The expression of c-FLIP in the experimental group was significantly higher than that in the sham operation group in the interstitial tissue at all the time (Plt;0.05), while no significant that in the gland tissue (Pgt;0.05). Conclusion After bile duct injury, the expression of c-FLIP in anastomotic interstitial tissue is sustainable, by which the continuing obstruction effect to apoptosis may have a close relationship with the formation of biliary benign stricture.
Objective To explore and summarize the application of minimally invasive technique to every stage of severe acute pancreatitis (SAP). Methods The treatment of 101 SAP patients admitted to our hospital between January 1995 and December 2008 were retrospectively analyzed. After calculi were removed by endoscopic retrograde cholangiopancreatograpy (ERCP) and endoscopic sphincterotomy (EST), endoscopic nasobiliary drainage (ENBD) were applied, then rhubarb liquid was perfused into gut with a nutrient canal and ultrasound-guided abdominal drainage tube were simultaneously placed at the early stage. Some patients received continuous renal replacement therapy (CRRT) at the same time. Laparoscopic cholecystectomy (LC) was performed at the subacute stage, and choledochoscope was introduced to remove parapancreatic necrotic tissues at the late stage of SAP.Results Of all the 101 cases treated by the method mentioned above, 75 cases received ERCP (or EST) and ENBD, and 31 cases underwent rhubarb liquid perfusion with a nutrient canal. Eight cases underwent continuous renal replacement therapy (CRRT). Forty-eight cases underwent LC and ultrasoundguided abdominal drainage. Thirtysix cases with infected peripancreatic tissue or abscess underwent debridement under choledochoscope 3 to 14 times at the later stage. Five cases died of multiple organ failure (MOF) and acute respiratory distress syndrome (ARDS). The hemobilia ocurred in 2 patients during choledochoscopy and was cured under direct visualization by electric coagulation. Intestinal fistula happened in 3 cases and cured by drainage. Pancreatic pseudocyst was latterly seen in 3 cases and treated by the anastomosis of cyst with jejunum through selective operation. After the hospitalization of 9-132 d (mean 24 d), 96 cases completely recovered. Conclusion Timely application of minimally invasive technique to every stage of SAP can avoid the defects of traditional operations, decrease the injury and interference to the maximum, and raise the cure rate.
Objective To summarize the experience of applying biliary balloon dilator to prevent rebleeding after operation for hepatolithiasis combined with hemobilia. Methods From 2003 to 2008, 11 patients were reoperated to stop from hemobilia by biliary balloon dilator’s application after operation for hepatolithiasis combined with hemobilia, and whose clinical data were collected and analyzed. Results In 11 cases, 7 were males and 4 were females. Eight cases were transferred from other hospitals. When intrahepatic duct bleeding was stopped, the biliary balloon dilator was placed at the right site under the guide of choledochoscope. Hemobilia occurred in 4 patients and biliary balloon dilator was opened to compress for 2 h, then decompress for 0.5 h alternately. In all of 4 patients, bleeding was stopped successfully, of which, 1 patient got hemobilia again 5 d after the first bleeding, and was also stopped by the same method. Conclusions After operation on hepatolithiasis combined hemobilia, rebleeding happens in some cases. Preset of biliary balloon dilator at the prebleeding site and opening it when rebleeding happens can get instant hemostasis, which may be a simple and effective treatment choice.
Objective To investigate the expressions of transforming growth factor (TGF) -α and -β1 after 90% portal branch ligation (PBL) in rats. Methods Ninety-six SD rats were randomly divided into sham operation group and portal vein branches ligation group. The weight of both ligated and unligated lobes of liver were measured on 0.5, 1, 3, 5, 7, 14, 21, and 28 d after operation. The morphological changes of the unligated liver lobes were observed by microscope. The expressions of proliferating cell nuclear antigen (PCNA), TGF-α, and TGF-β1 of the unligated liver lobes were detected by immunohistochemistry. Results After the ligation of 90% portal vein branches, hepatic lobe at the ligated side diminished progressively after ligation, whereas the lobes of the unligated side underwent compensatory regeneration. The ratio of unligated lobes weight to the whole liver increased slowly within 1 d, speeded up significantly during 1-5 d period, increased slowly on 5 d, and reached plateau phase on 7 d after operation. The expressions of PCNA protein markedly increased within 0.5-3 d (Plt;0.01), which reached the peak on 5 d and decreased slightly on 7 d after operation, but still higher than sham operation group level, and then gradually returned to the level of sham operation group lately. The expressions of TGF-α and TGF-β1 in the unligated liver lobes markedly increased on 0.5 d, and reached the peak on 3 d and 1 d respectively， and then gradually returned to the level of sham operation group in 7-28 d after operation. Conclusion Ligation of 90% portal branches can induce active regeneration of unligated liver lobes in rats, whose initiation and proliferation are involved in the expressions of TGF-α and TGF-β1 protein.
ObjectiveTo investigate clinical features and treatment of pancreatic metastasis from cardiac carcinoma.MethodsThe clinicopathological data of a patient with pancreatic metastasis from cardiac carcinoma in the General Hospital of Western Theater Command were retrospectively analyzed. The results of multi-disciplinary treatment (MDT) of this case were summarized.ResultsThe imaging findings of abdomen CT of this patient were that the solid occupying position of the head of pancreas was considered as a new organism. After discussing by the MDT and exclusing operative contraindications, the radical resection of cardiac cancer with pancreaticoduodenectomy and enlarged intraperitoneal lymph node dissection was performed under the general anesthesia. The operation was smooth and the bleeding was about 600 mL. The patient recovered well after the operation and had no serious complications. The patient was discharged on day 10 after the operation. The results of postoperative pathological diagnosis were the cardiac carcinoma with pancreatic head implantation metastasis (stage Ⅱ A, T3M0N0); obstructive jaundice, liver damage, extrahepatic and extrahepatic biliary dilatation. The patient received the intravenous infusion of the oxaliplatin pluse tigualone for 4 courses. The patient was generally in a good condition and had survived 5 months free tumor. The CA19-9 level was 45.6 U/mL (it was 449.60 U/mL before the operation).ConclusionsPancreatic metastasis from cardiac carcinoma is rare and need to be distinguished from primary pancreatic cancer. Survival time is short and prognosis is poor. Clinical symptoms are improved and survival time is prolonged after operation with postoperative chemotherapy.