1.Analysis of factors affecting preoperative Oddi sphincter function in patients with common bile duct stones
Haichuan CHEN ; Zhejin WANG ; Hongliang SONG
Chinese Journal of Hepatobiliary Surgery 2025;31(7):529-533
Objective:To analyze the factors affecting the laxity of Oddi sphincter in patients with common bile duct stones prior to common bile duct exploration.Methods:Clinical data of 101 patients with common bile duct stones undergoing common bile duct exploration at Wenzhou Central Hospital from January 2020 to June 2024 were retrospectively analyzed, including 38 males and 63 females, aged (68.6±13.3) years. All patients underwent common bile duct exploration with choledochoscopy. The size, shape, and patency of the papillary opening at the lower end of Oddi sphincter were observed to classify the sphincter function into Grades 1 to 4. The morphology of the papillary opening at the lower end of common bile duct was defined as narrowed, normal, oversized, and relaxed, respectively. Univariate and multivariate logistic regression analysis were conducted to identify the influencing factors of the laxity of Oddi sphincter.Results:Among the 101 patients, there were two cases (2.0%) classified as Grade 1 of Oddi sphincter function, 40 (39.6%) classified as Grade 2, 43 (42.6%) classified as Grade 3, and 16 (15.8%) classified as Grade 4. Under choledochoscopy, the Oddi sphincter function was classified into Grades 1 to 3 (stenosis, normal and oversized, included in the control group, n=85). Grade 4 was included in the laxity group ( n=16). The proportion of endoscopic retrograde cholangiopancreatography (ERCP) history, preoperative level of alanine aminotransferase, preoperative common bile duct diameter, preoperative maximum diameter of common bile duct stones, and preoperative bile duct gas accumulation in the laxity group were all higher than those in the control group (all P<0.05). Multivariate logistic regression analysis showed that patients with larger preoperative common bile duct diameter ( OR=12.993, 95% CI: 1.913-88.263), larger preoperative maximum diameter of common bile duct stones ( OR=6.238, 95% CI: 1.266-30.730), and a history of ERCP ( OR=8.119, 95% CI: 1.125-58.584) had a higher risk of preoperative Oddi sphincter laxity (all P<0.05). Conclusion:History of ERCP, diameter of common bile duct, and maximum diameter of common bile duct stones are risk factors for the laxity of Oddi sphincter prior to common bile duct exploration in patients with common bile duct stones.
2.Analysis of factors affecting preoperative Oddi sphincter function in patients with common bile duct stones
Haichuan CHEN ; Zhejin WANG ; Hongliang SONG
Chinese Journal of Hepatobiliary Surgery 2025;31(7):529-533
Objective:To analyze the factors affecting the laxity of Oddi sphincter in patients with common bile duct stones prior to common bile duct exploration.Methods:Clinical data of 101 patients with common bile duct stones undergoing common bile duct exploration at Wenzhou Central Hospital from January 2020 to June 2024 were retrospectively analyzed, including 38 males and 63 females, aged (68.6±13.3) years. All patients underwent common bile duct exploration with choledochoscopy. The size, shape, and patency of the papillary opening at the lower end of Oddi sphincter were observed to classify the sphincter function into Grades 1 to 4. The morphology of the papillary opening at the lower end of common bile duct was defined as narrowed, normal, oversized, and relaxed, respectively. Univariate and multivariate logistic regression analysis were conducted to identify the influencing factors of the laxity of Oddi sphincter.Results:Among the 101 patients, there were two cases (2.0%) classified as Grade 1 of Oddi sphincter function, 40 (39.6%) classified as Grade 2, 43 (42.6%) classified as Grade 3, and 16 (15.8%) classified as Grade 4. Under choledochoscopy, the Oddi sphincter function was classified into Grades 1 to 3 (stenosis, normal and oversized, included in the control group, n=85). Grade 4 was included in the laxity group ( n=16). The proportion of endoscopic retrograde cholangiopancreatography (ERCP) history, preoperative level of alanine aminotransferase, preoperative common bile duct diameter, preoperative maximum diameter of common bile duct stones, and preoperative bile duct gas accumulation in the laxity group were all higher than those in the control group (all P<0.05). Multivariate logistic regression analysis showed that patients with larger preoperative common bile duct diameter ( OR=12.993, 95% CI: 1.913-88.263), larger preoperative maximum diameter of common bile duct stones ( OR=6.238, 95% CI: 1.266-30.730), and a history of ERCP ( OR=8.119, 95% CI: 1.125-58.584) had a higher risk of preoperative Oddi sphincter laxity (all P<0.05). Conclusion:History of ERCP, diameter of common bile duct, and maximum diameter of common bile duct stones are risk factors for the laxity of Oddi sphincter prior to common bile duct exploration in patients with common bile duct stones.
3.Treatment and mechanism study of electromagnetic stimulation and vibrational massage for patients with ejaculatory incompetence.
Journal of Biomedical Engineering 2004;21(1):74-80
Studies on the effective methods and mechanism for the treatment of patients with functional ejaculatory incompetence were pursued on the basis of clinical practice. 90 patients with functional ejaculatory incompetence were treated by giving the electromagnetic stimulation to their pudendal nerve and the vibrational massage to their penis. Then the excitation conductive time and velocity of their pudendal nerve were simultaneously determined by the electro-neurophysiology technique. Of the 90 patients with functional ejaculatory incompetence, 69(76.7%) obtained cured effects, 19(21.1%) notable effects and 2(2.2%) improved effects. The total effective rate was 100%. The excitation conductive time and velocity of their pudendal nerve were both significantly different from those before treatment (P < 0.05). These suggest that it is practical to reach the ejaculatory threshold, trigger the ejaculatory reflex and complete the process of ejaculation because the nerve with improved excitational conductibility may release more acetylcholine from is endings after the electromagnetic stimulation to nerve and the vibrational massage to penis.
Adult
;
Ejaculation
;
Electric Stimulation Therapy
;
Humans
;
Male
;
Massage
;
Sexual Dysfunction, Physiological
;
therapy
;
Treatment Outcome
;
Vibration
4.Treating hypertensive intracerebral hemorrhage by pumping haematoma from vertebrae and skull with CT locating
Hong ZHANG ; Zhejin WANG ; Yizhan CAO ; Junqing WANG
Chinese Journal of Rehabilitation Theory and Practice 2003;9(11):690-691
ObjectiveTo investigate the effect of pumping haematoma from vertebrae and skull with CT locating to treat hypertensive intracerebral hemorrhage.MethodsThe cases were divided into 2 groups:the operation group(89 cases),in which patients were given the approach of pumping haematoma from vertebrae and skull on the basic of internal medical treatment, with the help of head CT locating, and the control group(71 cases),in which the internal medical treatment was used only. ResultsThe survival rate,the death rate,the complications and the nerve function recovery in the operation group after 20 days and 6 months were improved compared with that in the control group(P<0.01).ConclusionThe approach of pumping haematoma from vertebrae and skull is a safe,effective,practical and easy method in treating hypertensive intracerebral hemorrhage.


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