Objective To investigate the dysfunction of gallbladder emptying in diabetic patients and its possible mechanism. Methods The postprandial gallbladder emptying function and the release of pancreatic polypeptide (PP), as well as the therapeutic effect of Cisapride on gallbladder contraction were observed in 50 diabetics without cholecystolithiasis and 15 normal controls. The distributions of nitric oxide synthase (NOS) and acetylcholinesterase (AChE) in the wall of surgical removal gallbladders of 7 diabetic patients with cholecystolithiasis were also studied by histochemistry method. Results (1) The function of gallbladder emptying was distinctly lower in diabetic patients with autonomic neuropathy (AN) than that of the healthy subjects and diabetic patients without AN (NAN). (2) The postprandial release of PP in AN group was significantly lower than those in NAN group and healthy subjects. (3) The gallbladder emptying function was improved after receiving Cisapride in patients with AN. (4) Both the amount and activity of NOS and AChE in the wall of gallbladders of diabetic patients were lower than that of the non-diabetic subjects. Conclusion The dysfunction of gallbladder emptying in diabetic patients is partly due to the impaired autonomic nerve. The administration of Cisapride will improve the gallbladder emptying function of diabetic patients with AN.

Objective To study the optimal laparoscopic procedure and its indication for remove of common bile duct stone. Methods Analysis was made on the clmical data of 124 cases of laparoscopic choledocholithotomy and T tube drainage in our center.Results 82 patients underwent the improved laparoscopic procedure, alternation to open operation in 4 cases (4.9%),and the mean operating time was (80?30) min. While 42 patients were operated with traditional laparoscopic method,changing to open operation in 6 cases (14.3%),and the mean operating time was (170?40) min . The improved method could shorten the operation time and reduce the open operation rate significantly than traditional method did (P

Objective To observe the effect of inferior vena cava filter (IVCF) on prevention of bone cement implantation syndrome (BCIS). Methods Ten sheep were divided into 2 even groups, BCIS and LVCF intervention ones. First IVCF was implanted into the inferior vena cava through cervical vena-right atrium pathway under fluoroscopic monitoring to observe the influence of IVCF on BCIS. Then BCIS was es-tablished in the same sheep by compressing 10 mL of bone cement into a sheep medullary canal after mutilation of the left femur. Arterial blood pressure, heart rate, central venous pressure (CVP) and blood gas were monitored, while an ultrasonic device was utilized to monitor fat embolisms in the right atriums of the sheep. Oil red staining was performed to detect fat embolisms in pulmonary arteries after the sheep were executed. Results In BCIS group, dotted uneven resonances were found in the right atrium and right ventricle when the medullary canal pressure was increased to 120 mm Hg, indicating embolisms in the right chambers. The dotted resonances were increased to ponderous, snowflake-like ones as the medullary canal pressure climbed up. At the same time, blood pressure and Pa02 dropped significantly, the systolic blood pressure dropped to (80±11) mm Hg and PaO<.2> to the minimum 25 minutes after cone cement implantation. The heart rate and CVP increased continuously. The blood gas assay indicated respiratory and metabolic acidosis. The oil red staining showed bulk fat embolus in pulmonary arteries. But in IVCF group, the similar resonances were not observed throughout the surgery and the medullary canal pressure climbed to 400 mm Hg, reaching the maximum of our pressure gage range. The blood pressure, PaO2, heart rate and CVP did not change much compared to those before implantation. The blood gas and pulmonary oil red staining showed few changes either. Conclusion IVCF implantation can prevent the genesis of BCIS.