Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy ; methods ; Child ; Child, Preschool ; Endoscopy ; Female ; Humans ; Larynx ; pathology ; Male ; Middle Aged ; Nasopharynx ; pathology ; Young Adult

Animals ; Animals, Newborn ; Hippocampus ; metabolism ; Hypoxia, Brain ; metabolism ; Ischemic Preconditioning ; methods ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; bcl-2-Associated X Protein ; metabolism

Adult ; Carcinoma, Small Cell ; pathology ; Female ; Humans ; Male ; Melanosis ; pathology ; Uterine Cervical Neoplasms ; pathology

Objective To investigate the application of high-frequency ultrasound in pre-operative evaluation of brachial artery elasticity in chronic renal failure patients planning arteriovenous fistula formation.Methods A total of 65 patients with chronic renal failure undergoing radial artery-cephalic vein fistula (chronic renal failure group) and 40 healthy adults (control group) were selected.The elastic modulus (EM) of brachial artery was calculated by ultrasound.All subjects were divided into 5 subgroups according to age (≥50 years),hypertension,diabetes and chronic glomerulonephritis.Patients in subgroup 0 (28 cases),subgroup 1 (22 cases),subgroup 2 (24 cases),subgroup 3 (20 cases),subgroup 4 (11 cases) had 0,1,2,3 and 4 risk factors respectively.Results The levels of systolic blood pressure,pulse pressure,serum creatinine,and the EM of brachial artery in chronic renal failure group were higher than those in control group:(20.65 ± 1.32) kPa vs.(16.38 ± 1.08) kPa,(8.64 ±0.51) kPa vs.(7.12 ±0.35) kPa,(637.3 ± 116.5) μ mol/L vs.(84.7 ±31.1) μmol/L,(132.96 ± 11.78) kPa vs.(102.16 ± 10.10) kPa,and there were significant differences (P ＜ 0.01 or ＜ 0.05).The single factor correlation analysis showed that age in control group,serum creatinine in chronic renal failure group and systolic blood pressure in two groups were significantly positively correlated with the EM of brachial artery(r =0.636,0.548,0.703; P ＜ 0.01).With the increase of risk factors,the EM of brachial artery increased gradually:(96.21 ±9.82),(104.45 ± 10.55),(114.87 ± 11.15),(127.26 ± 12.43),(143.54 ± 12.81) kPa in subgroup 0,subgroup 1,subgroup 2,subgroup 3,subgroup 4,and there were significant differences (F=17.43,P＜ 0.05).The EM of brachial artery increased significantly in subgroup 3 and 4 with multiple risk factors.Conclusions Brachial artery elasticity measured by high-frequency ultrasound can be used as an indicator of vascular function preoperative vascular assessment.Age,systolic blood pressure,pulse pressure and serum creatinine levels are the major risk factors for brachial artery elasticity.The coexistence of multiple risk factors of hypertension,diabetes or chronic nephritis could exacerbate the decrease of brachial artery elasticity.

Objective To evaluate the efficacy and safety of continuous suture by QuillTM SRS self-retaining suture for closing choledoch incision. Methods From January 2015 to October 2015, 66 patients with gall bladder calculi combined with common bile duct stones who received laparoscopic gallbladder excision, common bile duct explo-ration, laparoscopy choledochotomy, suture choledoch immediately were randomly divided into two groups, experi-mental group using QuillTM SRS self-retaining suture for closing choledoch incision and control group using tradi-tional absorbable suture for closing choledoch incision. Then observe the operation time, the risk of bile leakage oc-curred in the operation and the risk of bile leakage after operation. Results All patients successfully completed in laparoscopic surgery without laparotomy. Operation time, the risk of bile leakage occurred during operation in exper-imental group has statistically significant difference compared with control group ( < 0.05). The operation time and incidence of intraoperative bile leakage of the experimental group was less and lower than control group, while the risk of bile leakage after operation show no statistically difference ( >0.05). Conclusion Compared with interrupted suture by normal sutures, continuous suture by QuillTM SRS self-retaining suture for closing choledoch incision has the characteristics of shorter operation time and lower incidence of intraoperative and postoperative bile leakage. It is worthy of promoting.

Objective To investigate the clinical effect of laparoscopic reverse papillary intubation through cystic duct and laparoscope combined with duodenoscope in the treatment of cholecystolithiasis and thining choledocholithiasis.Methods The retrospective cohort study was adopted.The clinical data of 192 patients with cholecystolithiasis and thining choledocholithiasis who were admitted to Chengdu Second People's Hospital between May 2012 to August 2015 were collected.The 96 patients who underwent laparoscopic reverse papillary intubation through cystic duct were allocated into the case group,and the other 96 who received surgery by laparoscope combined with duodeuoscope were allocated into the control group.All the patients underwent laparoscopic cholecystectomy (LC) according to routine approaches.The 96 patients in the case group received the placement of 4 Fr ureter catheter via cystic duct and placement of common bile duct inserted through the duodenal papilla under laparoscope,and then the duodenal papilla was resected using needle knife along the ureter catheter and stones were removed by basket lithotriptor and ball lithotriptor.The 96 patients in the control group received the intubation using the bow knife with zebra guidewire,and stones were removed by basket lithotriptor and ball lithotriptor.During the operations,it was observed whether there were residual stones by nasobiliary radiograph.The comparison was made between the 2 groups concerning (1) surgical situation:intubation and operation time.(2) Postoperative alanine transaminase (ALT),postoperative aspartate transaminase (AST),postoperative total bilirubin (TBil),postoperative blood amylase,postoperative lipase,complications and extubation time.(3) Situation of follow-up:follow-up was done by outpatient examination or telephone interview up to November 2015.The stones recurrence was detected by retrograde cholangiography through nasal bile duct,magnetic resonance cholangiopancreatography (MRCP) or ultrasonic examination.Measurement data with normal distribution were represented as x ± s.Comparison between groups was done by the t test.Count data were analyzed by the chi-square test.Results (1) Surgical situation:2 groups both underwent successful LC.Ureteral catheter in the case group was successfully imbedded through cystic duct,including 8 patients with being difficult to intubate.Five patients in the control group were failed in endoscopic sphincterotomy (EST) due to periamullary diverticula or other causes,and then EST was performed again by the duodenal papilla through ureteral catheter which was intubated through cystic duct.Operation time of the case group and control group was (89 ± 17) minutes and (105 ± 26) minutes,respectively,with a statistically significant difference between the 2 groups (t =5.05,P ＜ 0.05).(2) Postoperative situation:ALT,AST,TBil of the case group and control group were (163 ±54)U/L,(87 ±38)U/L,(43 ± 18)tmol/L and (147 ±49) U/L,(101 ± 26) U/L,(37 ± 17) μmol/L,respectively,showing no statistically significant differences (t =0.97,1.21,0.84,P ＞ 0.05).Postoperative blood amylase and lipase of the case group and control group were (151 ± 41) U/L,(198 ± 72) U/L and (395 ± 142) U/L,(549 ± 217) U/L,respectively,showing statistically significant differences (t =16.18,15.05,P ＜ 0.05).No pancreatitis was found in the case group while 6 patients in the control group complicated with mild pancreatitis were improved by symptomatic treatment of fasting,somatostatin administration and acid suppression,with no severe pancreatitis.No complications such as intestinal perforation,bile duct perforation and massive hemorrhage were detected in both groups after operation.No death occurred.The nasal bile duct in the patients without pancreatitis was removed at postoperative day 3.The nasal bile duct in the patients with pancreatitis was removed after the remission of abdominal pain and diet intake.In the case group,it was difficult to remove the nasal bile duct of 1 patient.Nasal bile duct radiograph showed that the bending section of nasal bile duct was mistakenly sutured by the absorbable thread at the lower margin of incision of junction of cystic ducts,and yet there was unobstructed biliary drainage.The nasal bile duct was removed and the patient was discharged from hospital at postoperative day 19.The abdominal drainage tubes were removed at postoperative day 3 to5 in both groups.(3) Of 192 patients,151 were followed up for a median time of 10 months (range,3-12 months).Patients had good recovery without recurrence of abdominal pain,jaundice and stones.Conclusion Laparoscopic reverse papillary intubation through cystic duct for the treatment of cholecystolithiasis and thining choledocholithiasis is safe and feasible,and it can also reduce incidence of pancreatitis after nasobiliary drainage.

Objective To detect the expression of VIP1R and VIP2R mRNA in gallbladder tissues of patients with gallbladder diseases. Methods The expression of VIP1R and VIP2R mRNA in gallbladder tissues were detected in 25 patients with gallstone, 8 patients with gallbladder polyps and 7 control liver transplantation donors by RT-PCR. Results The VIP2R mRNA level of the control group (1. 09 ?0. 58 ) was lower than that of the gallbladder polyps group (1.64?0.56 ),P

Objective To detect the changes of the brain white matter microstructure at the acute stage of posttraumatic stress disorder(PTSD)resulting from a single,extreme and long-lasting trauma.Methods DTI scans were performed on 1 7 survivors of coal mine disaster(PTSD group)and 1 7 cases of normal control(control group).The differences of the mean diffusivity(MD)values measured from the whole brain DTI between the two groups were analyzed based on tract based spatial statistics (TBSS).MD data were statistically compared between the two groups based on nonparametric random permutation test(RPT),and the brain areas of significant differences between the two groups were obtained.Results Compared with the control group,MD values were increased in the bilateral rostral corpus callosum body and left precorona radiata,and decreased in the bilateral superior and posterior corona ra-diate,posterior limb of the left internal capsule,left cerebral peduncle and left thalamic.The differences were statistically significant (P <0.01 TFCE-corrected).Conclusion TBSS is a comprehensive and accurate method for evaluate the changes of brain white mat-ter in PTSD cases.TBSS can provide an objective basis of the pathological brain neural structures imaging for early diagnosis and in-tervention of PTSD.

Adolescent ; Adult ; Child ; Child, Preschool ; Choristoma ; metabolism ; pathology ; surgery ; Encephalocele ; metabolism ; pathology ; surgery ; Female ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Infant ; Male ; Meningocele ; metabolism ; pathology ; surgery ; Middle Aged ; Mucin-1 ; metabolism ; Neuroglia ; metabolism ; pathology ; Nose Diseases ; metabolism ; pathology ; surgery ; S100 Proteins ; metabolism ; Vimentin ; metabolism ; Young Adult