Objective To investigate the safety and feasibility of laparoscopic surgery in the treatment of common bile duct stones after subtotal gastrectomy.Methods A retrospective analysis was performed for the clinical data of 46 patients with gallstones and common bile duct stones after subtotal gastrectomy who underwent surgical treatment in Luoyang Central Hospital Affiliated to Zhengzhou University from January 2010 to October 2016.Among these patients,25 underwent laparoscopic cholecystectomy + common bile duct exploration (laparoscopic group),and 21 underwent open cholecystectomy + common bile duct exploration (open group).The surgical conditions and postoperative complications were compared between the two groups.The t-test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.Results No patients died during the perioperative period and 2 patients (8.0％) in the laparoscopic group were converted to open surgery.There were significant differences between the laparoscopic group and the open group in time to ambulation after surgery (1.2 ± 0.6 d vs 2.4 ± 1.2 d,t =4.395,P ＜ 0.001),time to passage of gas by anus after surgery (1.8 ±0.5 d vs 2.8 ±0.8 d,t =5.168,P ＜0.001),and length of postoperative hospital stay (5.2 ± 1.1 d vs 7.5 ±2.3 d,t =4.439,P ＜ 0.001).There were no significant differences between the two groups in time of operation,intraoperative blood loss,hospital costs,T tube placement,and rate of residual stones (all P ＞ 0.05).After surgery,2 patients (8.0％) in the laparoscopic group and 3 (14.3％) in the open group experienced complications,and there was no significant difference between the two groups (P =0.495).Conclusion Laparoscopic surgery is safe and feasible in the treatment of common bile duct stones after subtotal gastrectomy and has the advantages of minimally invasive surgery.

Constriction, Pathologic ; diagnosis ; pathology ; therapy ; Humans ; Palate, Soft ; pathology ; Sleep Apnea, Obstructive ; diagnosis ; pathology ; therapy ; Tongue ; pathology ; Uvula ; pathology

Child, Preschool ; Foreign Bodies ; surgery ; Humans ; Intestines ; Laparoscopy ; methods

Epilepsy ; diagnosis ; drug therapy ; surgery ; Humans ; Magnetoencephalography ; Positron-Emission Tomography ; Stereotaxic Techniques ; Surgery, Computer-Assisted ; methods ; Treatment Failure

BackgroundAdenoid cystic carcinoma is a malignant tumor originating from lacrimal gland epithelium with high recurrence rate and mortality because of its invasiveness. Although surgery, radiotherapy and chemotherapy are used clinically,the curative effect is not enough satisfied. ObjectiveThis study was to provide an experimental basis for clinical application of 125 Ⅰ seeds interstitial brachytherapy. MethodsHuman ACC-2 cell links were transplanted subcutaneously in the back of 30 SPF BALB/C nude mice to establish the ACC model,and 25 of these mice with suitable sizes of tumor were selected and randomly divided into the G1 (0. 4 mCi 125 Ⅰ ), G2 (0. 6 mCi 125 Ⅰ ) ,G3(0. 8mCi 125 Ⅰ ) ,and G4( 1.0mCi 125 Ⅰ ) groups according to the different therapeutic radioactivity treatments,with 5 nude mice for each group,and a 125 Ⅰ seed without radioactivity was used in 5 mice as the control group. The dimensions of the tumors were measured at 2-day intervals and the inhibition rates of tumors were calculated. Nude mice were killed 14 days later by the broken neck method,and the amount of apoptosis and necrosis as well as the maximum effective radius of tumor to 125Ⅰseed were detected under the transmission electron microscope and routine pathological examination. ResultsFourteen day after operation, the dimension of tumors was (3713.19±243.23)mm3 in the G0 group;while in the G1 ,G2 ,G3 and G4 groups,the dimensions of tumors were (3113.35±316.54) mm3,(2635.85±261.21) mm3, (2538.37±312.16) mm3 and(1686.28±231.65) mm3,respectively, showing a significant decrease in comparison with the Go group( P＜0. 05 ). The tumor inhibitory rates in the G1 ,G2,G3 and G4 group were(20. 11±3.09)％, (36. 18±2.54)％ ,(40. 83±4. 17)％ ,and(66. 63±5.34)％ ,with an obvious elevation with the increase in the dose of 125 Ⅰ ( F=120. 240,P=0. 000). Correlative analysis showed that the intensity of radioactivity from 125Ⅰhad a positive correlation with tumor inhibitory rate (r =0. 653,P =0. 008 ). The maximum effective radius were ( 5.2 ±0.5 ) mm, ( 6.4 ±0. 7 ) mm, ( 7.4 ±0.4 ) mm, and ( 8.2 ±0. 5 ) mm in the G1 ,G2, G3 and G4 groups, with the considerable differences among them (F=29. 22, P=0. 000). Radioactivity of 125 Ⅰ exhibited positive correlation with the maximum effective radius ( r =0. 609, P =0. 004). Conclusions125 Ⅰseed implantation brachytherapy can inhibit the growth of the transplanted ACC in BALB/C nude mice by suppressing the proliferation of tumor cells. It is a safe ,feasible and effective method to treat adenoid cystic carcinoma.

Humans ; Infant ; Job Syndrome ; diagnosis ; immunology ; therapy ; Male

Animals ; Antibodies, Monoclonal ; metabolism ; therapeutic use ; Biomarkers, Tumor ; metabolism ; Breast Neoplasms ; metabolism ; pathology ; therapy ; Drug Delivery Systems ; Epidermal Growth Factor ; immunology ; metabolism ; physiology ; Epithelial-Mesenchymal Transition ; GPI-Linked Proteins ; Humans ; Immunotherapy ; methods ; Intercellular Signaling Peptides and Proteins ; Membrane Glycoproteins ; immunology ; metabolism ; physiology ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasm Proteins ; immunology ; metabolism ; physiology

Objective To investigate the difference of clinical characteristics and treatment outcome between pituitary apoplexy with and without inducing factors. Methods The clinical characteristics and treatment outcome between 12 pituitary apoplexy with inducing factors and 30 pituitary apoplexy without ones. Results Compared with the patients of pituitary apoplexy without inducing factors, the patients of pituitary apoplexy with inducing factors more frequently occurred visual dysfunction(P=0.020) and visual field defection(P=0.046), and the diagnosis of pituitary apoplexy was also delayed in the latter (P=0.015). Conclusion Inducing factors of pituitary apoplexy often aggravated the apoplexy, delayed its diagnosis and treatment due to atypical clinical symptoms, and caused worse restoration of visual function. Headache patients with abrupt visual deterioration should be considered suffering from pituitary apoplexy.

Objective:To explore the mechanism of growth factor autocrine stimulation in human pituitary tumors. Method: Immunohistochemical analyses of EGF、TGF-αand EGFR were studied on paraffin-embeded sections of 30 pituitary tumors. Results: Expression of EGFR and its ligand EGF、TGF-αhas a variable stained cells intensity,density and type. EGFR and the ligands expressed in majority of pituitary tumors.Conclusion:The EGF autocrine stimulation exists in pituitary tumors,and tyrosine kinases inhibitors may be useful for pituitary tumors treatment.

Objective To discuss the value of holmium laser lithotripsy combined with choledochoscopy in the treatment of complicated common bile duct stones.Methods Under choledochoscopy,200 ?m fibre holmium laser lithotripsy of common bile duct stones was performed.The settings on the laser were 1.0 J and 10 Hz.The choledochoscope was used to access the common bile duct stones.The stones were fragmented and then extracted with irrigation or by using a basket. Results The stones were successfully removed in all the 17 cases.The duration of operation was 10~50 min(mean,20 min).Out of the 17 cases,there were 8 cases of primary closure of the common bile duct,6 cases of T-tube drainage, and 3 cases of stone removal via drainage passage.No bile duct bleeding or biliary leakage occurred after operation.Follow-up was conducted in 16 cases for 6~15 months(mean,10 months).B-ultrasonography or magnetic resonance cholangiopancreatography found no recurrent or residual stones,or bile duct stricture.Conclusions Holmium laser lithotripsy combined with choledochoscopy in the treatment of complicated common bile duct stones has advantages of minimal invasion,rapid recovery,satisfactory lithotripsy effects,simplicity of performance,and high reliability.