Explore the protective effects of the bone marrow mesenchymal stem cells on severe acute pancreatitis in rats / 中华急诊医学杂志

Objective To investigate effects of bone marrow mesenchymal stem cells (MSC) on severe acute pancreatitis (SAP) in rats.Methods A total of 60 rats were randomly divided into normal group (n =10),the model of SAP group (n =10),the transplantation of the MSC group (n =20),the combination of the MSC and the granulocyte colony-stimulating factor (G-CSF) group (n =20).The conversion rate of MSC was detected by using immunofluorescence methods,and the level of amylase in serum was assayed by using biochemical methods.Simultaneously,the level of interleukin-6 (IL-6) in serum was determined by using enzyme linked immunosorbent assay (ELISA).Results The conversion rates of the MSC increased,and consequently,the levels of amylases and interleukin-6 in serum were reduced (P ＜ 0.05).When a small amount of the G-CSF was added to MSC,the therapeutic effects of the two different kinds of cells were synergistically strengthened.In the contrary,when a large number of the G-CSF was added to MSC,the antagonism resulted between these two different kinds of cells gives rise to harmful effects on SAP.Conclusions The bone marrow mesenchymal stem cells have therapeutic effects on SAP.When the number of the bone marrow mesenchymal stem cells increases,the protective effects are enhanced.

Research on bone marrow mesenchymal stem cells in the treatment of severe acute pancreatitis / 中华肝胆外科杂志

Objective To investigate the mechanism of acute inflammatory response and tissue repair when rats accepted transplanted bone marrow mesenchymal stem cells (MSC) in severe acute pancreatitis (SAP).Methods A total of 40 rats were randomly divided into 4 groups which included the normal group (n=10),the model severe acute pancreatitis group (n=10),the transplanted bone marrow mesenchymal stem cells group (n =10),and the combination of bone marrow mesenchymal stem cells and granulocyte colony-stimulating factor (G-CSF) group (n=10).To cure the acute severe pancreatic injury caused by SAP,rats were injected with EDU-labeled MSCs and granulocyte colonystimulating factor (Gr-CSF).The conversion rate of MSCs to pancreatic cells or MSCs to endothelial cells was detected to assess the role of MSCs in tissue regeneration and repair.The expression of amylase,interleukin-6 (IL-6),and interleukin-10 (IL-10) in serum was detected to assess the role of MSCs in an acute inflammatory response.Results The concentrations of amylase and IL-6 were reduced and the concentration of IL-10 was increased in MSC and MSC+G-CSF groups after the onset of SAP.Flow cytometry showed a small amount of MSCs converting to endothelial or pancreatic cells,but the conversion rate was relatively low.Conclusions MSCs can play an important role in the antipre-release of inflammatory mediators,reducing acute immune response to control the acute inflammatory response in SAP.Moreover,MSCs can repair a damaged pancreas by converting into both pancreatic and endothelial cells.

Protective effects of bone marrow mesenchymal stem cells transplantation and mobilization for severe acute pancreatitis with acute renal injury / 中华消化外科杂志

Objective To investigate the protective effects of bone marrow mesenchymal stem cells transplantation (MSCT) and mobilization on severe acute pancreatitis (SAP) with acute renal injury.Methods A total of 240 SD rats were randomly divided into sham operation group ( n =48 ),model control group ( n =48 ),MSCT group ( n =48),bone marrow mesenchymal stem cells mobilization (MSCM) group ( n =48) and MSCT +MSCM group ( n =48 ) according to the random number table.Rat models of SAP were made by peritoneal injection of L-arginine.Rats in the MSCT group were injected with 1.2 ml of bone marrow mesenchymai stem cells via femoral vein at 6 hours after SAP model establishment; rats in the MSCM group were subcutaneously injected with 40 μg/kg of granulocyte-colony stimulating factor (G-CSF) at 3 days before SAP model establishment; rats in the MSCT + MSCM group were injected with 1.2 ml of MSC and 40 μg/kg of G-CSF simultaneously; rats in the sham operation group were injected with equal volume of normal saline.According to different time points after operation,rats in each group were subdivided into 12 h,24 h,48 h and 72 h groups (n =12).At each time points after operation,the mortality rate,pathological changes of renal tissue,expression of Bax protein,Bcl-2 protein and apoptosis indexes of renal tubular epithelium cells were observed.The contents of tumor necrotic factor-α (TNF-α),interleukin-6 (IL-6),blood urea nitrogen (BUN),creatinine (Cr),lactate dehydrogenase (LDH) and C-reactive protein (CRP) were determined.All data were analyzed by using SNK-q test,Fisher exact probability and analysis of variance.Results All rats in the sham operation group were survived.The numbers of rats in the model control group survived at postoperative 48 hours and 72 hours were 11 and 8,respectively.No rat died at postoperative 48 hours in the MSCT group,MSCM group and MSCT + MSCM group.The numbers of rats survived at postoperative 72 hours in the MSCT group,MSCM group and MSCT + MSCM group were 11,10 and 11,which were not significantly different from the number of survived rats in the model control group (P ＞0.05).The pathological injuries of renal tissues were relieved in the MSCT group,MSCM group and MSCT + MSCM group when compared with model control group.The expression of Bax protein,Bc1-2 protein,renal tubular epithelium cell apoptosis indexes at 12-72 hours were 12.80 + 1.78-20.30 + 2.40,4.34 + 1.20-3.03 ± 1.06,12.65％ ±2.31％-35.10％ ± 5.54％ in the model control group,9.68 ± 2.11-17.01 ± 2.54,5.57 ± 1.35-4.13 + 1.05,6.20％ ± 1.53％- 17.50％ ± 2.80％ in the MSCT group,10.05 ± 2.17-16.81 ± 2.55,5.49 ± 1.48-4.19 ±1.05,6.41％± 1.64％-17.14％±2.27％ in the MSCM group,8.33 ±2.06-14.03 ±2.27,6.60 ±2.11-5.63 ±1.52,5.80％ ± 1.52％-12.30％ ±2.43％ in the MSCT + MSCT group.There were significant differences in the expressions of Bax protein at 24 and 72 hours,Bcl-2 protein at 48 and 72 hours,renal tubular epithelium cell apoptosis index at 24,48 and 72 hours between the MSCT group,MSCM group and MSCT + MSCM group ( P ＜0.05 ),but no significant difference was found between the MSCT group and the MSCM group ( P ＞ 0.05 ).The contents of TNF-α,IL-6,BUN,Cr,LDH,CRP in the MSCT group,MSCM group and MSCT + MSCM group were decreased when compared with those in the model control group,and a significant decrease of the 6 factors was observed in the MSCT + MSCM group.There were significant difference in the content of TNF-α at 72 hours,IL-6,BUN and Cr at 48 and 72 hours,LDH at 24,48 and 72 hours and CRP at 72 hours between the MSCT group,MSCM group and MSCT + MSCM group (P ＜0.05),while no significant difference was observed between the MSCT group and the MSCM group (P ＞ 0.05).Conclusion MSCT and MSCM can significantly protect acute renal injury in the progress of SAP,the probable mechanisms are pathological regeneration,anti-inflammatory effect and apoptosis inhibition of mesenchymal stem cells.

Effects of dexamethasone and Salvia miltiorrhizae on the small intestine and immune organs of rats with severe acute pancreatitis.

To observe the protecting effects and mechanisms of Dexamethasone and Salviae miltiorrhizae on intestinal mucosa and immune organs (spleen, thymus and lymph node) in rats with severe acute pancreatitis (SAP). The rats were randomly divided into sham-operated, model control, Dexamethasone treated group and Salviae miltiorrhizae treated group. At 3, 6 and 12 h after operation, the mortality rate, pathological changes of intestinal mucosa and immune organs as well as the contents of serum PAF, IL-1 beta and sIL-2R were observed, respectively. The mortality rate and the contents of PAF (at 3 and 6 h), IL-1 beta (at all time points) and sIL-2R (at 3 and 6 h) as well as the pathological scores of thymus (at all time points) and spleen (at 3 h) in Dexamethasone treated group were significantly lower than those in model control groups (P < 0.05). The contents of PAF (at 3 and 12 h), IL-1 beta (at 6 and 12 h) and sIL-2R (at 3 and 6 h) as well as the pathological scores of thymus (at all time points) and spleen (at 3 and 12 h) in Salviae miltiorrhizae treated group were markedly lower than those in model control groups (P < 0.05). Since both Dexamethasone and Salvia miltiorrhizae can reduce the contents of serum PAF, sIL-2R and IL-1 beta, mitigate the pathological changes in the small intestine, spleen and thymus and reduce the mortality rate of SAP rats, they show good therapeutic effects on SAP rats.

Baicalin protects thymus of rats with severe acute pancreatitis.

To study the protective role of Baicalin on rats thymus with severe acute pancreatitis (SAP). The SAP rats were randomly assigned to the model control, Baicalin treated and Octreotide treated groups. Normal rats were assigned to the sham-operated group. The rat survival rates, pathological changes of thymus, apoptotic indexes and expression levels of NF-kappaB, Bax, Bcl-2, Caspase-3 and P-selectin of all groups were observed and recorded at 3, 6 and 12 h after operation, respectively. Rat survival rates were significantly higher in both Baicalin- and Octreotide-treated groups than those in the model control group at 12 h (P < 0.05). The thymus pathological score was significantly lower in Baicalin treated group than in control group at 3 and 12 h (P < 0.05). The expression of NF-kappaB, Bax and Bcl-2 in thymus tissue was negative in all groups. At 3 h after operation, the staining intensity, positive staining rate and intensity of Caspase-3 protein in the thymuses of the Baicalin treated group were significantly higher than those in the model control group (P < 0.01). At different time points after operation, no marked difference was observed in the staining intensity of P-selectin protein between the Baicalin treated group and the model control group (P > 0.05). At 6 h after operation, the positive staining rate and intensity of P-selectin protein in the Baicalin treated group was significantly lower than those in the model control group (P < 0.05). The apoptotic indexes were significantly higher in treated group than in model control group at 6 h (P < 0.05). Baicalin has a protective role on the thymus of SAP rats, and its effect of decreasing inflammatory mediators level in blood, inhibiting P-selectin expression and inducing apoptosis of thymocytes may involve in the mechanism of its protective role.

Combination of hemofiltration and peritoneal dialysis in the treatment of severe acute pancreatitis.

OBJECTIVE: Our aim was to study the therapeutic effects and the mechanism of combination of hemofiltration (HF) and peritoneal dialysis (PD) in the treatment of severe acute pancreatitis (SAP). METHODS: Fifty-one cases of SAP were randomly divided into the HF+PD group (treated group, 36 patients) and the non-HF+PD group (control group, 15 patients). Both groups were treated by the same traditional methods. The relief time of abdominal pain and abdominal distension, computed tomographic scores, acute physiology and chronic health enquiry II scores, length of stay, cost of hospitalization, operability, and recovery rate of the 2 groups were compared. The concentration of tumor necrosis factor-alpha, IL-6, and IL-8 in serum and ascites volumes was determined before and after treatment. RESULTS: : The mean time of abdominal pain relief, amelioration of abdominal distension, decrease of computed tomographic scores, acute physiology and chronic health enquiry II scores, the mean length of stay, and cost of hospitalization of the treated group were significantly shorter or less than those of the control group. The aforementioned inflammatory cytokines, detected at the end of 1 day and 2 days after HF+PD treatment, were decreased significantly compared with those observed in pretherapy and the control group. CONCLUSIONS: Inflammatory cytokines, which overproduced in SAP, can be eliminated effectively from the blood and the ascites by HF+PD treatment.

TriVex system for the treatment of lower extremity varicose veins / 中华普通外科杂志

Objective To evaluate the TriVex system in the treatment of varicose veins of lower extremities,focusing on postoperative complications and management.Methods Clinical data of 108 patients (146 legs) of varicose veins of the lower extremity undergoing TriVex procedure were retrospectively analyzed.Deep veinons patency was verified in all patients by preoperative sonography.Above knee stripping of the great saphenous vein was done first when necessary.The below knee phlebectomy of the side branches was done with the new system (Trivex System/Smith and Nephew).Postoperative patients were followed-up,and results were evaluated.Results Procedure was successful in all cases.98 cases were followed up for 1 ～ 24 months.The mean operation time per leg was (34±8) minutes.Complications were as following:26 legs (17.8%) developed postoperative hematoma which was healed by conservative therapy including two cases in which the tension seroma,which was successfully managed by puncture aspiration.Transien skin numbness or paraesthesia developed in 13.0% (19/146).Subcutaneous induration in 11.6%(17/146) cases.Residual varicose and recurrence in 3.4% (5/146).Incision related complications developed in 4.8% (7/149) cases.Conclusion Transilluminated powered phlebectomy (TriVex) is a safe and effective cosmetic procedure for less invasive varicose vein surgery.

Influence of baicalin and octreotide on NF-kappaB and p-selectin expression in liver and kidney of rats with severe acute pancreatitis.

To observe the influence of Baicalin and Octreotide on liver and kidney of rats with severe acute pancreatitis (SAP) and discuss the related mechanism. SAP rats were randomly divided into model control, Baicalin treated and Octreotide treated group (n = 45). The same number of normal rats were included in sham-operated group (n = 45). In all groups, the mortality rate, pathological changes as well as expression levels of NF-kappaB p65 and P-selectin protein in liver and kidney were observed at 3, 6 and 12 h after operation. The survival rate of treated group was 100% at 12 h significantly higher than that of model control group (P < 0.05). The pathological changes of liver and kidney in treated groups were alleviated to different degrees, the NF-kappaB protein expression levels and pathological severity scores in liver and kidney of treated groups were significantly lower than those of model control group (P < 0.05 or P < 0.001). The hepatic P-selectin protein expression level in Baicalin treated group was significantly lower than that of model control group at 3 h (P < 0.01), and renal P-selectin expression level in Baicalin treated group at 3 and 6 h were significantly lower than those of model control group and Octreotide treated group (P < 0.01). (1) Early treatment with Baicalin or Octreotide have obvious protecting effects on liver and kidney injuries in SAP with their mechanisms associated to inhibiting NF-kappaB and P-selectin expression of liver and kidney. (2) Comparing the pharmacologic effects of Octreotide and Baicalin, we believe Baicalin as a new drug with its protecting effects on liver and kidney of SAP rats similar to Octreotide is worth further studying. (3) The advantages of tissue microarrays in pathological examination include time and energy saving and highly efficient. But the restriction of small diameter weakens the representation of tissues to various extents, which may lead to the deviation of analysis.

Influence of Salvia miltiorrhizae on the mesenteric lymph node of rats with severe acute pancreatitis or obstructive jaundice.

OBJECTIVE: To observe the effect of salvia miltiorrhizae injection on inflammatory mediator levels and mesenteric lymph nodes in severe acute pancreatitis (SAP) and obstructive jaundice (OJ) rats and explore the protective mechanism of salvia miltiorrhizae on the lymph nodes of these rats. METHODS: A total of 288 rats were used in SAP-associated and OJ-associated experiments. The rats were randomly divided into sham-operated group, model control group, and treated group. At various time points after operation, the pathological changes in mesenteric lymph nodes of rats in each group were observed, respectively. RESULTS: The pathological severity scores in lymph nodes of SAP rats in treated group were significantly lower than those in model control group (P < .05) while the pathological changes in lymph nodes of OJ rats in treated group also showed varying degrees of mitigation. CONCLUSION: Salvia miltiorrhizae can exert protective effects on the lymph nodes of SAP or OJ rats via a mechanism that is associated with reducing the contents of inflammatory mediators in blood.

Immediate breast reconstruction with the pedicle transverse rectus abdominus myocutaneous flap / 中华普通外科杂志

Objective To evaluate the clinical application of immediate breast reconstruction with the pedicle transverse rectus abdominus myocutaneons(TRAM)flap.Methods Ten breast cancer patients underwent immediate breast reconstruction with the pedicle TRAM flap after mastectomy,among which 4 cases used single pediele TRAM and 6 cases used bipedical TRAM.Polypropypene mesh were applied on all cases of patients to repair the abdominal defect. Results All the breast reconstructions were successful.Complications included grafting flap infection in one case and skin necrosis on partial abdominal skin flap in one case.The reconstructed breasts had a very good shape in 8 cases,and good in 2 cases.No local recurrence and distant metastasis occurred in the patients during the follow-up time ranging from 3 to 15 months. Conclutions Immediate breast reconstruction with the pedicle TRAM flap is an ideal breast reconstruction method for those patients undergoing mastectomy not only because it reconstructs the defective breast but for its cosmetic effect on the abdominal wall.

Protective effects of bone marrow mesenchymal stem cells transplantation Combined with bone marrow stem cells mobilization on liver cells in rats with severe acute pancreatitis / 中华急诊医学杂志

Objective To observe the protective effects of autologous bone marrow mesenchymal stem cells transplantation alone with bone marrow stem cells mobilization on liver cells in rats with severe acute paucreatitis in order to explore their mechanism. Method After the establishment of severe acute pancreatitis in rats made by intraperitoneal injection of L-arginine, 240 SD rats were randomly divided into sham-operated group (n = 48), model control group (n = 48), bone marrow mesenchymal stem cell transplanted (MSC) group (n = 48), granu-lacyte-colony stimulating factor treated (G-CSF) group (n = 48) and MSC + G-CSF (n = 48). The rats of MSC group were prepared by injection of 1.2 mL MSC into femoral vein 6 hours after SAP. The rats of G-CSF group were prepared by subcutaneous injection of G-CSF 40 μg/kg for 3 days before SAP. The rats of MSC + G-CSF group received MSC and G-CSF together. The rats of sham-operated group were injected with equal volume of nor-real saline. The rats in each group were sabdivided into 12 h, 24 h, 48 h and 72 h sub-groups (n = 12) according to the examinations in different intervals after operation. Of different subgroups, the morality rate, pathological changes, expression levels of Bax, Bcl-2 proteins and apoptosis indexes of livers were observed respectively. The contents of serum TNF-α,IL-6,ALT,AST,LDH and CRP were simultaneously determined to compare the difference among subgroups by variance analysis. Results Compared to the respective model group, the mortality rates of all treated 72 h subgroups showed no difference (P > 0.05), and no rats died before 48 h. The pathological injuries of liver cells were rather attenuated in rats of treated group than in rats of control group. The liver cell apoptosis in-dexes of 48 h and 72 h MSC + G-CSF subgroups were 107.1 ± 7.0, 110.3 ± 8.6, respectively; the expression of Bax in livers of 24 h,48 h and 72 h subgroups was 5.60±0.Z5, 5.69±0.22, 5.73±0.27, respectively;Bcl-2 protein of 48 h,72 h subgroups was 4.61±0.28, 4.43±0.28, respectively; compared with MSC and G-CSF subgroups the differences were significant (P < 0.05). The serum TNF-α, IL-6, ALT, AST, LDH and CRP de-creased obviously in 24 h/48 h treated subgroups in comparison with control group (P < 0.05). The MSC + G-CSF group showed more significant effects on those biomarkers than MSC or G-CSF alone after 48 hours (P < 0.05). Conclusions Autologous bone marrow mesenchymal stem cells transplantation alonewith bone marrow stem cells mobilization can significantly protect livers from severe damage during the course of severe acute panere-atitis, and the probable mechanisms are likely associated with the pathological regeneration, anti-inflammatory ef-fect and apoptosis inhibition of MSC.

Acute gangrenous cholecystitis after endoscopic sphincterotomy:a report of 16 cases / 中华消化内镜杂志

Objective To explore the causes and surgical management of acute gangrenous cholecvstitis(AGC)after endoscopic sphincterotomy(EST).Methods Clinical and pathological data of 1066 patients who underwent EST from June 2003 to January 2007 were analyzed retrospectively.ResultsAGC was complicated in 16 patients(16/1066,1.5%),who underwent emergency operations and no death occurred.During the follow-up period of 4 to 36 months,no infection or obstruction was found.Conclusion Difficuitv in EST manipulation and biliary obstrucion might play a leading role in AGC after EST,and early surgical intervention is effective.

Laparoscopic Splenectomy Combined with Lower Oesophagus Transection in the Treatment of Hepatic Cirrhosis Complicated with Portal Hypertension / 医学研究杂志

Objective To study the short-term prognosis of laparoscopic splenectomy combined with lower esophagus transection in the treatment for hepatic cirrhosis induced portal hypertension.Methods The clinical data of 7 cases of portal hypertension treated by laparoscopic eplenectomy combined with lower esophagus transaction were retrospectively analysisd.Results Among of the patients,six cases were undertaken with total laparoscopic technique and only one case done with hand-assisted laparoscopic operation and one case turned to open surgery.Average operation time was 330 min and operation hemorrhage was 780 ml.None of cases died,bled or occurred pancreatical fistula.Mean time of bowel function recovery(70 h) and postoperative hospitalization(12.7 d).1 case complicated with hydrothorax recovered after conservative therapy.Conclusion Cincial short-term effects of patients treated with laparoscopic splenectomy combined with lower esophagus transection for hepatic cirrhosis induced portal hypertension is satisfied,so it is a safe and feasible way for future clinical practice if conducted by the skilled and competent surgeon.

Clinical Significance of M K and VEGF Expression in Recurrent Gastric Carcinoma / 医学研究杂志

Objective To investigate the correlation between midkine(MK) and VEGF expression with angiogenesis and biological features in recurrent gastric carcinoma.Methods The expression of MK was examined using immunohistochemistry in 9 cases of gastric carcinoma and 9 cases of adjacent normal tissues.Microvessel density(MVD)was determined by VEGF immunohistochemical staining.Results Majority of recurrent gastric carcinoma tissues showed positive reaction to immunostaining,but no specific positivity was detected in adjacent normal tissue.Values of MVD and MK positive group(88.8%,79.75) was higher than those in the negative group(15.0%)(P

Protective Effects of Salvia Miltiorrhiza on Small Intestinal Ischemia Reperfusion Injury During Intestinal Transplantation Induced by Cytokines in Rats / 医学研究杂志

Objective To explore the protective effect of Salvia miltiorrhiza on small intestinal ischemia reperfusion injury during intestinal transplantation induced by cytokines in rats.Methods Sixty Sprague Dawley rats were randomly divided into sham operation group,model group and low,mid,high doze treatment group,the superior mesenteric artery was occluded and then released to simulate the model of small intestinal ischemia reperfusion during intestinal transplantation.Tumor necrosis factor-?,interleukin-1?,interleukin-8 both in the plasm and small intestinal tissue were evaluated by ELISA 2 hours after reperfusion,changes of pathology in intestinal mucosa were observed.Results TNF-?,IL-1?,IL-8 were significantly higer(P

Clinical Analysis of Thyroid Carcinoma(report of 146 casees) / 医学研究杂志

Objective To analyze incidence of thyroid carcinoma and to explore and conclude the principle of its diagnosis and treatment.Methods One hundred and forty six patients of thyroid carcinoma in our hospital were analyzed and discussed with literature.Results 101 cases were diagnosed as thyroid carcinoma by pathological diagnosis of fast frozen sections,the positive ratio is approximately 93.5%.totle resection of affected lobe and isthmus was performed on 35 cases,total resection of affected lobe and isthmus and majority of opposite lobe was done on 37 cases.The lymph node metastasis was found by postoperative pathological diagnosis with a rate of 32.5%.Conclusions Preoperative diagnose of thyroid carcinoma is rarely available,diagnosis of thyroid carcinoma by fast frozen sections is optimal.total resection of affected lobe and isthmus or total resection of affected lobe and isthmus and majority of opposite lobe are the main operation patterns.

Research of Early Using Glutamine-enriched Enteral Nutrition in Short Period on Patients with Gastric Neoplasms After Total Gastrictomy / 医学研究杂志

Objective To explore the effect on nutrient and immune function of glutamine-enriched enteral nutrition on patients after total gastrectomy. Methods 36 patients after total gastriecomy were randomly divided into EN(n=18) and GLN(n=18) group. Compared the index after total gastrectomy including nutrient status, immune function and lassitude degree in the 1st, 3rd, 7th day. Results GLN group showed more effective process than EN group in improving postoperative nutrient status, immune function, nitrogen balance and lassitude degree. All the indexes in GLN group changed significantly on the 7th day than that in EN group(P

Diagnosis and Treatment of Gastroparasis Syndrome After Abdominal Operation / 医学研究杂志

Objective To explore the diagnosis and treatment of gastroparasis syndrome after abdominal operation. Methods Clinical data of 25 cases with gastroparasis syndrome after abdominal operation from Jan 1995 to June 2006 were analysed retrospectively. Results Gastrectomy and nongastrectomy amounted to 16 and 9 cases( portal-azygous vein disconnection in 4 cases, panceaticoduodenectomy in 1 case, partial small intestinectomy and adhesions lysis in 1 case, radical excision of colon carcinoma in 2 cases, choledocholithotomy in 1 case). Gastroparasis syndrome characterized by upper abdominal distension, nausea, vomiting after clipping the pipe or large quantity of gastric drainage after operations. Gastrointestinal series and gastroscopy confirmed functional delayed gastric emptying. All cases recoverd through non-operative therapy including fasting, continuous gastrointestinal decompression, total parenteral nutrition or enteral nutrition, adn administration of gastro-intestinal dynamic medicine. Conclusions Gastroparasis syndrome is the common complication after abdomianl operation, gastrointestinal series, gastroscopy are main diagnostic methods, conservative medication obtains good effect.

Diagnosis and Surgical Treatment of Chronic Lymphocytic Thyroiditis / 医学研究杂志

Objective To discuss the diagnosis and surgical management of Hashimoto's disease.Methods Clinical and pathological datas of 36 cases with Hashimoto's disease from 1995 to 2006 were studied retrospectively.Results 36 cases were all confirmed to be chronic lymphocytic thyroiditis by pathological examination,6 cases,5 cases and 3 cases were apartly accompanied by nodular goiter,thyroid adenoma and thyroid cancer among them;The clinical manifestations before operation included thyroid nodules in 29 cases,thyroid seriously enlarged in 5 cases,thyroid pain in 2 cases;Great partial/subtotal thyroidectomy in one or both part were taken in 23 benign cases,or together with isthmus excision,3 malignant case received total and subtoal thyroidectomy in either part with isthmus and homolateral neck dissection.Conclusions Surgery is actively to be advised when carcinoma under suspicion,thyroid enlarged with pressure symptoms or pain,medication is ineffective.The mode of operation should be selected according to intraoperative frozen section.A long-term substitute medication of thyroxin can help to obtain a good prognosis after operation.

Analysis of High-risk Factors of Iatrogenic Duodenal Injuries and Surgical Tactics of Treatnent According to Injuries Scaling / 医学研究杂志

Objective To sum up and discern the high risk factors of iatrogenic duodenl injuries and to evaluate the value of the treatment according to the new trauma scaling,so as to to facilitate and guide clinical research.Methods 21 patients with iatrogenic duodenal trauma hospitalized and From Jan.1985 to Oct.2005,in our hospital were collected and retrospectively reviewed,the duodenum organ iatrogenic injury scale was classified and developed depending on the clinical finding and referring to the injury scale by the American Association for the Surgery of Trauma(A.A.S.T.)in 1990.Results The iatrogenic duodenal injuries result from various surgery and endoscopic procedures,most from a sequelae to pertinent biliary operation and(or)iatrogenic technical errors of instrumention.High risk factors responsible for the iatrogenic injuries include inflammatory conglutination,biliary systems anomalies or anatomic variations,duodenal Vater's papilla with neoplasma or diverticulum,surgeohs with less experience or over self-confidence or some procedures with violence and specific correctable errors,and so on.According to the new grading scheme,the duodenal injuries of the 21 cases were classified as follows:grade I-5 cases,grade II-6 cases,grade III-5 cases,grade IV-3 cases,and grade V-2 cases.Among the patients,3 cases were treated by drainage.2 cases underwent simple repair.8 cases were treated with repair and drainage.8 cases underwent enterorrhaphy and drainage.Conclusions Knowledge about causal factors of such iatrogenic processes can play a crucial role in their prevention,correct diagnosis,and management.Having the iatrogenic duodenal scaling done well,appears to be an accurate and practical way to select an optimum and flexible treatment and improve the patients's prognosis.