Objective To investigate the safety of laparoscopic cholecystectomy(LC) under the use of cardiac pacemaker for the patients with cholelithiasis and serious cardiac arrhythmia.Methods The clinical data of 8 cases undergoing LC under the use of vvI cardiac pacemaker were analysed.Results All the 8 cases undergoing LC by cardiac pacemaker had successful results. There was no cardiac accident or complication of the pacemaker in perioperative period in this series, and the postoperative course was smooth . Conclusions LC is safe under the use of cardiac pacemaker, if the decompensation of heart is controlled and the anaesthesia and operation are estimated correctly.

Objective To evaluate the long term effects of laparoscopic surgery on duodenal ulcer with acute perforation. Methods From 1995, Twenty-five patients with duodenal ulcer perforation and diffused peritonitis were diagnosed definitely by TV laparoscopic technique, and the perforations were sutured and repaired by greater omentum under laparoscopy. Six cases of them were performed parietal cell vagotomy simultaneously. After operation the drain was put into abdominal cavity and H2 receptor blocking agent, proton pump inhibitor or plus antihelicabater pylori therapy were used. Results All operations of 25 cases were accomplished under laparoscopy. Whatever operative complications had not happened. Average operation times were 55 minutes. The total hospital days were 6 in average. Postoperative follow-up ranged from 0. 5 -3 years, no duodenal ulcer recurred. Conclusion The laparoscopy adopted in treating duodenal ulcer perforation is a procedure with minimal invasion and scarceness of postoperative complication; its clinical effectiveness is as good as laparotomized operation.

Objective To evaluate the value of endoscopic treatment for severe acute biliary pancreatitis (SABP). Methods A total of 36 patients with SABP, who received emergency operation were enrolled into this study. Among the patients, 16 received endoscopic naso-biliary drainage (ENBD) because of acute cholecystitis or cholecystolithiasis; 11 underwent endoscopic sphincterotomy (EST) and ENBD due to stenotic papillitis or choledocholithiasis; 4 were treated with EST using needle knife and ENBD due to difficulties in inserting bow knife and cannula catheter into the common bile duct; and 2 experienced the guide wire entering into the wirsung’s duct for over 3 times, when the cannula catheter was inserted into the common bile duct. Thus, the sphincter of Oddi was incised by bow knife to expose the opening of the cystic duct, and then ENBD was performed. Open surgery was performed in 3 cases because of failure of ENBD. In all the patients, systemic medical treatment was carried out after the operations.Results ENBD was completed in 33 cases, among which 29 (81%) patients were cured and 4 (11%) patients died. The operation failed in 3 cases. After the operation, 3 patients developed peripancreatic infection. No hemorrhage of the duodenum papilla, duodenal perforation, or cholangitis occurred in this series. The mean hospital stay was 22 d (15-75 d). 26 of the cured patients were followed up for 12-36 months (mean, 18 months), no recurrence of the symptoms of pancreatitis was found. Conclusions Endoscopic treatment combined with systemic medical therapy may reduce the course of disease and increase the cure rate for patients with SABP.

Objective To evaluate the efficacy of laparoscope, choledochoscope and duodenoscope in the treatment of extrahepatic bile duct stones. Methods The clinical data of 610 patients with extrahepatic bile duct stones who had received the treatment with laparoscope, choledochoscope and duodenoscope in our hospital from September 1997 to January 2007 were retrospectively analyzed. Patients with bile duct stones received ERCP or EST, and patients with cholecystolithiasis + choledocholithiasis underwent the treatment with laparoscope+ duodenoscope, or laparoscope + choledochoscope, or laparoscope + duodenoscope + choledochoscope. Results The operation was successful in 589 patients, with the successful rate of 96.6%. The duration of hospital stay was 7-28 days (mean, 13 days). No severe complications such as bile leakage, duodenal leakage, duodenal papilla bleeding, acute cholangitis occurred. Four hundred and eleven patients had been followed up for 1 to 3 years (mean, 13 months), and no bile duct stone recurrence or other complications occurred. Conclusions For patients with bile duct stones, the treatment with ERCP or EST is appropriate. Laparoscope + endoscopes in the treatment of cholecystolithiasis combined with choledocholithiasis is safe and effective.

Objective To explore the protective effect of portal vein administration of propofol on hepatic ischemia reperfusion injury(HIRI) and its mechanism.Methods Thirty-two male rabbits were randomly allocated into four groups:Group A(sham operation group),the abdomen was only opened and closed;group B,the hepatic inflow was occluded for 30 min,and reperfused for 60 min;group C,the same managment as group B + propofol injected through jugular vein;group D,the treatment same as group B + propofol injected through portal vein.Drug injection was completed 20 min before hepatic inflow occlusion.Serum ALT and AST,and endothelin-1(ET-1) and nitric oxide(NO)in the hepatic tissue and blood,and the content of ATP in hepatic tissue were determined.Results The level of ET-1 in plasma and hepatic tissue was significantly increased in group B compared to group C and D(P

AIM:To investigate the activity change of voltage-dependent delayed rectifier potassium channel(Kv) on human airway smooth muscle cells(HASMCs) after transfection of Kv1.5 antisense oligonucleotides(AsOND),and to discuss the regulating mechanism of Kv1.5.METHODS: The mRNA and protein expressions of Kv1.5 in liposome-mediated Kv1.5 AsOND transfected HASMCs were measured with techniques of reverse transcriptase-polymerase chain reaction(RT-PCR) and Western blotting.Kv activities in transfected HASMCs were investigated with whole-cell patch clamp.RESULTS: After HASMC were transfected by liposome-mediated Kv1.5 AsOND,the mRNA and protein expressions of Kv1.5 were decreased,and Kv activity was inhibited,which made the cell membrane potential(Em) inclined to depolarization.CONCLUSION: Transfection of Kv1.5 AsOND made the function of Kv in HASMCs decreased.Kv1.5 may play a critical role in the regulation of Kv activity.

AIM: To investigate the regulatory effects of voltage-dependent delayed rectifier potassium channel (Kv) on the tension of normal and passively sensitized human airway smooth muscle (HASM). METHODS: By using blockers of potassium channels as tools, the tension of HASM and Kv gene mRNA and protein expressions in normal and asthmatics serum sensitized HASM cells were measured with techniques of reverse transcriptase/polymerase chain reaction (RT-PCR) and immunocytochemistry. RESULTS: (1) 4-aminopyridine (4-AP), the blocker of Kv, caused a concentration dependent constriction in normal HASM rings. The negative logarithm of the drug concentration causing 50% of maximal effect (pD_2) in normal group (2.09?0.09) was significantly different from that in the sensitized group (2.44?0.16, P0.05). (2) There were Kv1.2, Kv1.3 and Kv1.5 mRNA expressions in cultured HASM cells, but only Kv1.5 mRNA (P

The effects of protein kinase C (PKC) on the tension and the activity of voltage-dependent delayed rectifier potassium channel (K(y)) were examined in normal and passively sensitized human airway smooth muscle (HASM), by measuring tones and whole-cell patch clamp techniques, and the K(v) activities and membrane potential (E (m)) were also detected. The results showed that phorbol 12-myristate 13-acetate (PMA), a PKC activator, caused a concentration-dependent constriction in normal HASM rings. The constriction of the passively sensitized muscle in asthma serum group was significantly higher than that of the normal group (P<0.05), and the constrictions of both groups were completely abolished by PKC inhibitor Ro31-8220 and calcium channel inhibitor nifedipine. K(v) activities of HASM cells were significantly inhibited by PMA, and the E (m) became more positive, as compared with the DMSO (a PMA menstruum)-treated group (P<0.01). This effect could be blocked by Ro31-8220 (P<0.01). It was concluded that activation of PKC could increase the tones of HASM, which might be related to the reduced K(v) activity. In passively sensitized HASM rings, this effect was more notable.

Objective To investigate the effect of percutaneous transhepatic gallbladder drainage(PTGBD) on different American Society of Anesthesiologists(ASA) grading of laparoscopic cholecystectomy in patients with acute cholecystitis. Methods The 324 patients with acute cholecystitis undeigoing laparoscopic cholecystectomy who were hospitalized in Department of Hepatobiliary Surgery, Xianyang Central Hospital from March 2010 to December 2014 were enrolled in the retrospective analysis. According to the history of the patients with or without PTGBD before laparoscopic cholecystectomy, all patients were divided into 2 groups. One hundred and eighty four patients who underwent directly laparoscopic cholecystectomy were the control group, and the other 140 patients who underwent PTGBD + elective laparoscopic cholecystectomy were the study group. The rates of conversion to laparotomy, total days of hospitalization, hospitalization days after cholecystectomy incidence, postoperative complications incidence, postoperative drainage were compared between two groups. The difference of clinical data between the two groups were compared under different ASA classification. Measurement data were expressed as ((x)±s) and t-test were used for comparison between groups. Count data were compared by X2 test. Results The rate of intraoperative laparotomy was 23.6％(33/140) in the study group and 20.7％(38/184) in the control group; the mean length of hospital stay was (7.3 ±3.3) days in the study group and (6.8 ±2.3) days in the control group; the postoperative complication rate was 2.8％(4/140) in the study group and 0.5％(1/184) in the control group; the abdominal cavity drainage rate was 80.0％(112/140) in the study group and 73.9％(136/184) in the control group; intraoperative laparotomy rate, postoperative hospital stay, postoperative complications incidence, and abdominal cavity drainage rate between the two groups had no significant difference(P> 0.05). The total length of hospital stay was(17.6 ±4.4) days in the study group and(10.6 ±3.0) days in the control group, and there was a statistically significant difference between the two groups(P <0.001). According to the subgroup analysis by ASA classification, the two groups of ASA-I patients in the experimental group were significantly higher than the control group in the temperature, C reactive protein and the total number of days of hospitalization, and the difference was statistically significant(P< 0.05). The two groups of ASA-Ⅱ patients in the experimental group were significantly higher than those of the control group in age, white blood cell count, C reactive protein and total hospitalization days, and the difference was statistically significant(P<0.05). In ASA-Ⅲ patients, the rate of intraoperative laparotomy was 28.3％ (13/46) in the study group and 32.1％ (9/28) in the control group; the mean hospital stay after surgery was(10.8 ± 3.7) days in the study group and(11.2±4.8) days in the control group; The total length of hospital stay was (19.7 ±7.2) days in the study group and (16.8 ± 8.6) days in the control group; the rate of intraoperative laparotomy, the mean length of hospital stay and postoperative hospital stay in the two groups of ASA-Ⅲ patients had no statistically significant difference(P>0.05). Conclusions PTGBD has different effects on laparoscopic cholecystectomy in patients with different ASA grading of acute cholecystitis. PTGBD combined with laparoscopic cholecystectomy is a safe and effective method that can turn emergent operation intoselective operation. It is worthy of extensive application.

Objective To explore the clinical efficacy of laparoscopic improved ileal bypass (LIB)for treatment of type 2 diabetes mellitus(T2DM).Methods The clinical data of 52 patients who received LIB for T2DM at the Center Hospital Xianyang City,Southern Medical University,from May.2012 to Jul.2015 were retrospectively analyzed.On the basis of their body mass index (BMI),all cases were divided into two groups:group A (16 cases,BMI≥28 kg/m2) and group B(36 cases,BMI ＜28 kg/m2).LIB surgery were complete by laparoscopic ultrasound knife and the cutting anastomat etc.Before and during one year after surgery fasting blood glucose(FBG),fasting c-peptide,glycosylated hemoglobin (HbA1c) and BMI were detected to evaluate the outcome of T2DM.Count data and comparison of rates were analyzed by chi-square test.Measurement data with normal distribution were presented as ±s and analyzed by the t test.Repeated measurement data were analyzed by the repeated measuresanalysis of variance.Results All the 52 patients underwent successful LIB without perioperative death during the follow-up of 12 months.There were significant differences in FBG and HbA1c at admission and 12 months after surgery:group A (t=4.223,3.602,P＜0.05);group B (t=4.356,5.613,P＜0.05).With reference to the literature[1] curative effect evaluation standard,13 patients had complete remission,2 patients had partial remission and 1 patient had non-remission in group A,accounting for 81.25％,12.5％,and 6.25％ respectively.For 36 patients in group B,32 patients had complete remission,3 patients had partial remission and 1 patient had non-remission,accounting for 88.9％,8.3％,and 2.8％ respectively.Total treatment effectiveness was 96.2％ (50/52).No significant differences was found between group A and group B at 12 months after surgery (X2=0.053,P＞0.05).BMI at admission and 12 months after surgery had no significant differences in group A (t=1.581,P＞0.05),nor group B(t=2.124,P＞0.05).Conclusions LIB for T2DM improved the glucose metabolism significantly,with unconspicuous influence for BMI and was indications for the non-obese T2DM.Due to the poor weight loss,LIB choose carefully in obese patients with T2DM.The therapy has small trauma,fewer complications,simple operation skills and facilitated clinical promotion.