Objective To explore the causes and surgical management of acute gangrenous cholecvstitis(AGC)after endoscopic sphincterotomy(EST).Methods Clinical and pathological data of 1066 patients who underwent EST from June 2003 to January 2007 were analyzed retrospectively.ResultsAGC was complicated in 16 patients(16/1066,1.5%),who underwent emergency operations and no death occurred.During the follow-up period of 4 to 36 months,no infection or obstruction was found.Conclusion Difficuitv in EST manipulation and biliary obstrucion might play a leading role in AGC after EST,and early surgical intervention is effective.

Inhalation injury seriously threatens the survival and quality of life in burn and trauma patients. So far there is no breakthrough in the treatment of inhalation injury. A significant advance has been witnessed in the experimental study of the use of stem cells in the treatment of lung injury in recent years. In this paper, according to the results of our study in the systemic transplantation of bone marrow mesenchymal stem cells for the treatment of inhalation injury, the effect of mesenchymal stem cells on anti-inflammatory process and repair of lung tissues in inhalation injury, and its possible mechanisms are reviewed.
Humans ; Lung ; Lung Injury ; blood ; surgery ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; Quality of Life ; Smoke Inhalation Injury ; blood ; surgery ; Treatment Outcome ; Tumor Necrosis Factor-alpha ; blood

Objective To evaluate the enhancement effect of SLC(secondary lymphoid tissue chemokine)gene mediated by a repli- cation deficient recombinant adenovirus(Ad)on human pancreatic cancer in vitro and vivo and to investigate the mechanism of action of SLC.Methods Human pancreatic carcinoma cell line ASPC-1 was infected with Ad-SLC and Ad-CFG,and compared with phosphate buffered saline(PBS).MTT(3,-[4,5-dimethyhhiazol-2-yl]-2,5-diphenyhetrazolium bromide)assay was used to estimate the proliferation of ASPC-1 cells;tube formation assay and choriallantoic membrane assay were used to evaluate angiogenesis in vivo and in vitro.Xenografted nude mice with pancreatic cancer were established to observe in vivo tumour growth suppression.Microvessel density re- vealed by CD34 immunohistochemical staining was measured and TIL in tumor region was also evaluated.Results Growth and tube forma- tion of ASPC-1 cells infected with Ad-SLC were suppressed significantly compared with cells infected with Ad-CFG or ceils treated with PBS.Neovascularisation in the Ad-SLC group was less than that in the PBS and Ad-CFG groups,based on chorioallantoic mem- brane results.Volumes of pancreatic tumours in the Ad-SLC group were significantly smaller than those in the PBS and Ad-CFG groups at the end of the treatment period.Microvessel density in the Ad-SLC group was significantly lower than that in the Ad-CFG and PBS groups and TILs in tumor region in the Ad-SLC group was significantly risen much more than that in the Ad-CFG and PBS groups when the mice transferd the same number of TILs from spleen of health mice.Conclusions The SLC gene mediated by adenovirus is efficient for gene therapy for pancreatic carcinoma.Suppression of SLC on proliferation of vascular endothelium cells,attracting TIL to tumor region and angiogenesis may account for its effect.

Objective To observe the influence of Baicalin and Octreotide on lung injury of rat with severe acute pancreatitis(SAP) and discuss the therapeutic effect and mechanism of the two medicines on SAP.Methods The improved Aho(?)method was adopted to pre- pare SAP rat models via retrograde injection of 3.5% sodium taurocholate to the pancreatic duct.The 135 SAP rat models after being pre- pared were randomly divided into the model group,Baicalin treatment group and Octreotide treatment group with 45 rats in each group;an- other 45 were selected to be the sham operation group which only received abdomen opening surgery.The above - mentioned groups were then randomly divided into 3h,6h and 12h groups with 15 rats in each group.Observed respectively at 3h,6h and 12h after operation,the mortalities of all rat groups followed by batch execution of rats,and then observed the gross pathological and pathological changes of lung. The tissue microarrays technology was applied to prepare the lung tissue microarrays sections.The changes in Bax and bcl-2 protein ex- pression levels of lung tissue of each group were observed via immunohistochemical staining and meanwhile the TUNEL method was applied to observe the lung cell category and apoptotic index changes of lung tissue in each group.Results The 12h survival of model group was 66,67% while those of Baicalin treatment group and Octreotide treatment groups were both 100%,indicating a marked difference(P＜0.05).Comparison of lung pathological score disclosed:The model group and Baicalin treatment group obviously exceeded the sham oper- ation group at various time points(P＜0.01);at 6h and 12h the Baicalin treatment group was obviously less than the model group(P＜0.05)and the Oetreotide treatment group less than the model group(P＜0.01).Comparison of Bax protein of lung in each group dis- closed:The Baicalin treatment group and Octreotide treatment group obviously exceeded the sham operation group and model group at 3h (P＜0.05),meanwhile the Baicalin treatment group obviously exceeded the Octreotide treatment group(P＜0.01).Changes of lung bcl -2 protein expression level of all groups disclosed:The model group and Baicalin treatment group obviously exceeding the sham operation group(P＜0.01)as well as the Octreotide treatment group(P＜0.05)at different time points,the Baicalin treatment group was obviously less than the model group at 6h(P＜0.05).The peak of apoptosis occurred to the Baicalin treatment group at 6h,but statistics showed no obvious difference among all groups at different time points(P＞0.05).Conclusions(1)Both Baicalin and Octreotide have protecting effect on SAP lung injury and their therapeutic mechanism is possibly related to apoptosis.The application of tissue microarrays in SAP pathological examination can save manpower and material resources,cut down the experimental cost and improve the experimental efficien- cy,thus worth popularizing.

Objective To evaluate the clinical application of immediate breast reconstruction with the pedicle transverse rectus abdominus myocutaneons(TRAM)flap.Methods Ten breast cancer patients underwent immediate breast reconstruction with the pedicle TRAM flap after mastectomy,among which 4 cases used single pediele TRAM and 6 cases used bipedical TRAM.Polypropypene mesh were applied on all cases of patients to repair the abdominal defect. Results All the breast reconstructions were successful.Complications included grafting flap infection in one case and skin necrosis on partial abdominal skin flap in one case.The reconstructed breasts had a very good shape in 8 cases,and good in 2 cases.No local recurrence and distant metastasis occurred in the patients during the follow-up time ranging from 3 to 15 months. Conclutions Immediate breast reconstruction with the pedicle TRAM flap is an ideal breast reconstruction method for those patients undergoing mastectomy not only because it reconstructs the defective breast but for its cosmetic effect on the abdominal wall.

Objective To establish the hyperinsulinemic-euglycemic clamp(HEC) technique in conscious rats, and to explore the effect of acute infusion of lipid on glucose infusion rate (GIR) in rats. Methods Ten SD rats were random-ly divided into two groups, 5 rats for each group. The right jugular vein and left carotid artery were catheterized and under-went a HEC with infusion of lipid (intralipid group) for 6 hours, and with continuing infusion of 5%glucose (control group). The plasma levels of free fatty acid(FFA) and GIR were measured by HEC method. Results The level of FFA concentration increased by 17.6-fold, and GIR was reduced by 27%in the intralipid group compared to those of control group (P＜0.001). Conclusion The rat model of HEC has been successfully established by intravenous intralipid infusion, which can be con-firmed by HEC technique.

Objective To investigate the changes in serum hyaluronic acid level at different periods of experimental piggyback liver transplantation and its significance. Methods Fifteen pairs of healthy pigs of both sexes weighing (28.3 + 5.0)kg undergoing liver transplantation were studied. The donor pigs were slightly smaller than the recipient pigs. The recipient pigs were premedicated with intramuscular ketamine 8mg kg-1 and atropine 0.02mg-kg-1 .Anesthesia was induced with propofol 2mg-kg-1 , fentanyl 0.002mg-kg-1 and vecuronium 0.1mg-kg-1 iv. After tracheal intubation the animals were mechanically ventilated. CVP line was placed via internal jugular vein. Carotid artery was cannulated for continuous BP monitoring. Anesthesia was maintained with iv propofol, fentanyl and vecuronium. Circulatory stability was maintained by infusion of crystalloid, colloid, plasma and whole blood of pig. Blood samples were taken from peripheral vein before operation (T0), pre-anhepatic phase (T1), anhepatic phase (T2) and neohepatic phase (T3) for determination of serum hyaluronic acid concentration by radioimmunoassay. At the same time liver function tests, ALT, AST, y-GT were also examined. Results The average time of liver transplantation was (343+74) min. SBP decreased by (23.51+5.87 ) mm Hg and DBF by (11.35+7.81) mm Hg after induction of anesthesia. Serurn hyaluronic acid level was 267ug-L-1 before operation (T0) and rose to 1743ug-L-1 at T1 , and 9530ug-L-1 at T2 (P

Objective To investigate the mRNA expression of secondary lymphoid tissue chemokine (SLC) in human gastric carcinoma. Method The study was designed to investigate semi-quantitatively the expression of SLC mRNA in gastric carcinoma and metastatic lymph nodes by reverse transcription-polymerase chain reaction.Result The expression of SLC mRNA in the gastric cancer tissues was markedly reduced compared with that in adjacent noncancer tissues. The average tumor/normal (T/N) ratio determined by RT-PCR was 0.43?0.08 in 29 patients.Metastatic lymph node/normal ratio was 0.63?0.07.Negative lymph node/normal ratio was 1.19?0.11. As a control,the mean G3PDH T/N ratio was 1.16?0.06,there was no correlation between SLC mRNA expression and clinicopathological characteristics in gastric cancer.ConclusionSLC mRNA expression is suppressed in the gastric tumours. SLC may play an important role in the early stage of carcinogenesis.

Objective To evaluate the clinical value of percutaneous transchepatic biliary internal external drainage (PTBIED) in treatment of malignant biliary obstruction.Methods Forty-three patients with malignant biliary obstruction,including 14 cases with hilary metastasis cancer 8 with carcinoma of gallbladder,8 with hilary biliary cancer,13 with pancreatic cancer were treated with PTBIED.Results The technical success rate was 90%.The serum total bilirubin almost fell to normal level in 40 patients.Four cases (9.3%) died within 1 month, twenty (46.5%) cases died within 6 months,thirteen (30.2%) cases are still alive 12 months later.The complications cases mild hemobilia (8 cases,18.6%),bacteriemia(10 cases,23.3%),retrograde infection(6 included,14.0%).Conclusion PTBIED is an effective and safe therapeutic method for palliation of malignant biliary obstruction.