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Objective To summarize the efficacy and feasibility of laparoscopic splenectomy combined with selective pericardial devascularization for cirrhotic portal hypertension.Methods From January 2015 to January 2017,the clinical data of 29 cases of cirrhotic portal hypertension treated by laparoscopic splenectomy combined with selective pericardial devascularization were analyzed retrospectively.Results Laparoscopic surgery was successful in all but one cases,who was converted to open surgery.Theoperation time was (235 ± 54) min,intraoperative blood loss was (384 ± 262) ml.The spleen fever syndrome and splenic vein thrombosis were found in 1,2 patients respectively after operation.No serious complications of abdominal hemorrhage,pancreatic fistula and intra-abdominal infection were found.The postoperative hospital stay was (9.6 ± 1.9) d,patients were followed up for 3-6 months,and 3 cases had portal vein thrombosis.The liver function was well maintained.Conclusion Laparoscopic splenectomy combined with selective pericardial devascularization for treatment of portal hypertension is with high success rate and lower incidence of postoperative complications.
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Objective To discuss the clinical effect of artificial pneumothorax combined with intercostal nerve block in alleviating chest pain occurring during and after percutaneous microwave ablation (MWA) for subpleural lung malignancy.Methods A total of 30 patients with subpleural lung malignancy were randomly and equally divided into group A (n=10),group B (n=10) and group C (n=10).The patients in group A received both artificial pneumothorax and intercostal nerve block before MWA.The patients in group B only received artificial pneumothorax before MWA,and the patients in group C only received intercostal nerve block before MWA.The degree of pain was evaluated by visual analogue scale (VAS) score during MWA,immediately after MWA and at 6 h,12 h and 24 h after WMA.The side effects after MWA were recorded.Results During MWA,no statistically significant differences in VAS scores existed between each other among the three groups (P=0.885).The VAS scores determined at 6 h,12 h and 24 h after MWA in group C were significantly increased (P=0.014,P=0.006 and P=0.006 respectively).No patient in group A and group B developed symptoms of chest tightness after artificial pneumothorax was performed.After treatment,a small amount of asymptomatic residual pneumothorax was still observed in 6 patients of group A and group B,which disappeared spontaneously in about one week.Another patient still showed massive pneumothorax even after thoracic gas suction,and the patient recovered after thoracic closed drainage for three days.No other serious complications related to artificial pneumothorax occurred.Conclusion Artificial pneumothorax combined with intercostal nerve block can effectively relieve the chest pain occurring during and after MWA in patients with subpleural lung malignancy,and clinically this technique is quite safe.(J Intervent Radiol,2017,26:269-273)
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ObjectiveTo investigate the effect of primary duct closure and T-tube drainage after laparoscopic common bile duct exploration, as well as the criteria for clinical application of primary duct closure. Methods A retrospective analysis was performed for the clinical data of patients with common bile duct stones who were treated in The First Hospital of Jilin University from July 2014 to July 2015, and 51 patients who met the inclusion criteria were enrolled. Among these patients, 26 underwent primary closure of the common bile duct and 25 underwent T-tube drainage. The change in total bilirubin after surgery, time to recovery of gastrointestinal function, volume of peritoneal drainage at 1 day after surgery, time of removal of peritoneal drainage tube, complications, length of postoperative hospital stay, and total hospital fee were analyzed and 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. ResultsThe length of postoperative hospital stay and total hospital fee showed significant differences between the two groups (t=-7.067, P＜0.001; t=-3.126, P=0.003). One patient in each group experienced a complication and was cured after treatment. ConclusionOn the basis of strict control of surgical indications, the primary closure of common bile duct after laparoscopic common bile duct exploration has the advantages of a short length of hospital stay, low hospital fee, and high quality of life, and is safe and feasible. Therefore, it holds promise for clinical application.
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Objective To investigate the effect of Bcl-2 gene expression on the proliferation and apoptosis of human pancreatic cancer SW1990 cells.Methods Bcl-2 short guide RNA (Bcl-2-sgRNA) was designed and synthesized,and it was combined with CRISPR-Cas 9.After confirmation by gene sequencing,it was transfected into human pancreatic cancer cell line SW1990,then the cells with stable Bcl-2 gene knock-out were selected,and wild type SW1990 cells were used as control.The cell growth curve was determined by CCK-8 method.The number of clone formation was measured.Flow cytometry was used to measure cell cycle and apoptosis.Results Human pancreatic cancer cell line SW1990 with Bcl-2 gene knock-out was successful constructed.Compared with wild type SW1990 cells,the growth of SW1990 cells with Bcl-2 gene knock-out was inhibited,the number of clone formation was significantly decreased [(160.7 ± 10.0) vs (285.3 ± 14.2)],the proportion of G1 cells was significandy increased [(84.51 ± 0.97) ％ vs (57.49 ± 1.08) ％],the proportion of S phase cells significantly decreased [(12.82 ± 0.99) ％ vs (27.56 ± 1.65) ％],and apoptosis rate was remarkably increased [(12.67 ± 0.59) ％ vs (0.37 ± 0.35) ％],and the difference between the two groups was statistically significant (P ＜ 0.01).Conclusions Knock-out of Bcl-2 gene can inhibit the growth of human pancreatic cancer cell line SW1990,decrease the ability of clone formation,block the cell in G1 phase and greatly increase cell apoptosis rate.
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Serum tartrate-resistant acid phosphatase-5b (TRAP-5b) is a marker reflecting bone absorption. The results showed that serum TRAP-5b level was higher in postmenopausal than that in premenopausal normal women (P