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 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 explore the protective effect of Salvia miltiorrhiza on small intestinal ischemia reperfusion injury during intestinal transplantation induced by cytokines in rats.Methods Sixty Sprague Dawley rats were randomly divided into sham operation group,model group and low,mid,high doze treatment group,the superior mesenteric artery was occluded and then released to simulate the model of small intestinal ischemia reperfusion during intestinal transplantation.Tumor necrosis factor-?,interleukin-1?,interleukin-8 both in the plasm and small intestinal tissue were evaluated by ELISA 2 hours after reperfusion,changes of pathology in intestinal mucosa were observed.Results TNF-?,IL-1?,IL-8 were significantly higer(P

Objective To study the short-term prognosis of laparoscopic splenectomy combined with lower esophagus transection in the treatment for hepatic cirrhosis induced portal hypertension.Methods The clinical data of 7 cases of portal hypertension treated by laparoscopic eplenectomy combined with lower esophagus transaction were retrospectively analysisd.Results Among of the patients,six cases were undertaken with total laparoscopic technique and only one case done with hand-assisted laparoscopic operation and one case turned to open surgery.Average operation time was 330 min and operation hemorrhage was 780 ml.None of cases died,bled or occurred pancreatical fistula.Mean time of bowel function recovery(70 h) and postoperative hospitalization(12.7 d).1 case complicated with hydrothorax recovered after conservative therapy.Conclusion Cincial short-term effects of patients treated with laparoscopic splenectomy combined with lower esophagus transection for hepatic cirrhosis induced portal hypertension is satisfied,so it is a safe and feasible way for future clinical practice if conducted by the skilled and competent surgeon.

Objective To investigate and analyze the severe complications and their surgical managements after endoscopic sphincterotomy(EST).Method 36 patients with complications after EST such as severe hemorrhage, perforation and severe pancreatitis were analyzed,of them there were 16 cases of hemorrhage, 11 case of perforation, 6 cases of hemorrhage combined with perforation and 3 cases of severe pancreatitis combined with perforation. Results 14 cases of merely hemorrhage patients, 11 cases of merely perforation patients, 1 case of perforation combined with severe pancreatitis patient and 3 case of perforation combined with hemorrhage patient were survived while 2 case of merely hemorrhage patient, 3 cases of perforation combined with hemorrhage patients and 2 case of perforation combined with severe pancreatitis patients died.Conclusions Hemorrhage is the most common complication of EST and most complications can be healed well through expectant treatment. Once severe complications occurred, prompt operations are the keys to lower the mortality.

Objective To investigate and analyze the diagnosis and treatment of gerontal large intestinal carcinoma patients complicating with intestinal obstruction.Methods The perioperative medical care and treatments of 94 cases of gerontal large intestinal carcinoma patients admit in our hospital were retrospectively analyzed.Results 85 cases (90.4%) of patients fully recovered and 9 cases(9.4%)died.Conclusions Thinking highly of the perioperitive medical care of gerontal large intestinal carcinoma complicating with intestinal obstruction and handling the postoperative complications effectively are the key point to lower the mortality and elevate the achievement ratio.

Objective To investigate the effect of transabdominal gastroesophageal stapling in management of variceal bleeding in portal hypertension with Hassabi operation and sum up our clinical experience.Methods Retrospective analysis of 48 cases with portal hypertension operated by transabdominal gastroesophageal stapling between May,1998 and Oct.2005.The elimination of oesophagus venous、the rebleeding rate、the operation mortality、the stricture and the fistula rate and the index that influences the liver function were maily observed.Results No case suffered rebleeding and hepatal encephalopathy during the hospitaligation of the patients.Esophageal varices disappeared or reduced in all cases.One case resulted from stricture and one case died of multiple organ failure.Conclusions Transabdominal extensive oesophagogastric devascularization combined with gastrooesophageal stapling is an effective and safe procedure for control of acute variceal haemorrhage with satisfactory short-term control,but the long-term effect needs to be long follow-up for the patients.

Objective To Investigate the expression of secondary lymphoid tissue chemokine (SLC) and its relationship with angiogenisis,pathological feature and prognosis of pancreatic cancer (PC).Methods SLC mRNA expression and microvessel density(MVD) were detected in 22 cases with PC with immunohistochemistry and reverse transcription-polymerase chain reaction(RT-PCR) respectively and compared with its clinical features.Results Mean MVD of PC was 57?12 and enhanced expression of SLC mRNA was detected in 17 cases(77%),The positive rate of SLC mRNA was significantly lower in cases of without metastasis and at early clinical stage(stage Ⅰ+Ⅱ)than that with metastasis and at advanced stage(stage Ⅲ+Ⅳ).MVD was significant higher in SLC mRNA-enhanced PC than in SLC mRNA reduced PC(P