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Objective:To analyze the causes of postoperative stricture of biliary-enteric anastomotic for congenital choledochal cysts.Methods:These 28 patients underwent salvage operation on an average 15 years (0.2-25 years) after initial surgeries at the Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital from Jan 2014 to Jun 2018.Results:In 26 patients the biliary-enteric anastomotic stenosis was benign, and in 2 the stricture was caused by cancerration. In 26 cases the Roux-en-Y hepaticojejunostomy was redone,among them 8 cases underwent concurrent hepatectomy for a better exposure of the intrahepatic bile duct. In 2 cases the anastomotic stenosis was found to be caused by canceration with extensive intraabdominal metastasis ,an external drainage was adopted. There were no inhospital deaths, and no serious complications. The postoperative follow-up time was 6-67 months. Two cancerated patients died within half a year, and the remaining patients had no long-term complications.Conclusions:Biliary-enteric anastomotic stenosis is one of the serious complications in postoperative patients for congenital choledochal cysts. Hence a wide, tension free biliary-enteric anastomosis performed by a experienced hand is necessary.
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Objective:To evaluate partial ventral hepatectomy in the treatment of patients with complicated iatrogenic high bile duct injury.Methods:The clinical data of 8 cases of complicated iatrogenic high bile duct injury treated with the assistance of hepatic ventral segmentectomy from Mar 2013 to May 2020 at Hunan Provincial People's Hospital was retrospectively analyzed.Results:Among the 8 patients, 5 patients underwent partial Ⅳb lobectomy, and 3 patients received partial Ⅳb and Ⅴ segmentectomy of the liver. All the operation was successful without death in hospital. One case developed subphrenic infection and seroperitoneum, which was healed by anti-infection treatment and abdominocentesis. The postoperative follow-up time was 5-90 months, and all of patients are doing well. There was no stenosis in intrahepatic bile duct by postoperative cholangiography or MRI.Conclusions:Quadrate lobe hepatectomy provides a wide view for the treatment of complicated iatrogenic high bile duct injury by fully opening the first porta hepatis and exposing the primary and secondary bile duct branch helping establish a wide patent tension free bile duct-jejunostomy.
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Objective To investigate the plasma total tau(T-tau)and phosphorylated protein tau(P-tau)protein in the diagnosis of Alzheimer's disease(AD).Methods 22 352 medical patients aged over 60 years in Beichen Area Community Service Center were involved in this survey.Random sampling principle was used for screening.Mini-mental state examination(MMSE)and activities of daily living assessment form(ADL)were conducted for the cognitive function and ability of daily score firstly.When the score below the standard,the Hamilton depression scale and Hachinski ischemic scale were re-used for diagnostic score.Related laboratory tests were conducted to exclude other central nervous system and other systems and material causes of dementia patients.Ultimately,105 cases of AD,diagnosed by the neurologist,and 42 cases of non central nervous system disease,non dementia non nervous system disease patients as the normal control group were involved.T-tau and P-tau levels in the two groups were determined by ELISA.Results the T-tau concentration in AD group(15.93+6.59)ng/L was higher than control group(14.10±6.32)ng/L,no significant difference was found (P ＞ 0.05).However,compared with control group (0.69 ± 0.24) ng/L,P-tau protein in AD group (1.26 ± 0.75)ng/L increased significantly(P＜0.05).Conclusion Plasma levels of phosphorylated tau protein might have diagnostic value for AD patients.
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Objective To study the effects of improved Wright-Giemsa staining. Methods 40 semen samples by both traditional and improved Wright-Giemsa staining.The morphological characteristics stained by two methods was ob-served. Results The defective rates of the middle and tail parts of sperm were 7.02%± 2.4%and 11.02%± 2.03%respec-tively in improved staining group;while those were 5.48%±2.8%and 8.05%±2.56%in traditional staining group. There was statistical significance between two staining methods (P < 0.05). There was no significant difference of normal sperm and sperm head between these two staining methods;however, improved staining method showed a much clearer nucleus and ac-rosome staining than that of traditional methods. Improved Wright-Giemsa staining is better for sperm, vaginal discharge and Trichomonas vaginalis. More importantly, axostyle and flagella were clearly stained with the improved method. Conclusion Improved Wright-Giemsa staining is simple and can be used in clinical diagnosis.