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1.
Ann Surg ; 2019 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-30672792

RESUMO

OBJECTIVE: The aim of the study was to analyze the outcomes of patients who have undergone laparoscopic pancreaticoduodenectomy (LPD) in China. SUMMARY BACKGROUND DATA: LPD is being increasingly used worldwide, but an extensive, detailed, systematic, multicenter analysis of the procedure has not been performed. METHODS: We retrospectively reviewed 1029 consecutive patients who had undergone LPD between January 2010 and August 2016 in China. Univariate and multivariate analyses of patient demographics, changes in outcome over time, technical learning curves, and the relationship between hospital or surgeon volume and patient outcomes were performed. RESULTS: Among the 1029 patients, 61 (5.93%) required conversion to laparotomy. The median operation time (OT) was 441.34 minutes, and the major complications occurred in 511 patients (49.66%). There were 21 deaths (2.43%) within 30 days, and a total of 61 (5.93%) within 90 days. Discounting the effects of the early learning phase, critical parameters improved significantly with surgeons' experience with the procedure. Univariate and multivariate analyses revealed that the pancreatic anastomosis technique, preoperative biliary drainage method, and total bilirubin were linked to several outcome measures, including OT, estimated intraoperative blood loss, and mortality. Multicenter analyses of the learning curve revealed 3 phases, with proficiency thresholds at 40 and 104 cases. Higher hospital, department, and surgeon volume, as well as surgeon experience with minimally invasive surgery, were associated with a lower risk of surgical failure. CONCLUSIONS: LPD is technically safe and feasible, with acceptable rates of morbidity and mortality. Nonetheless, long learning curves, low-volume hospitals, and surgical inexperience are associated with higher rates of complications and mortality.

2.
Zhongguo Yi Liao Qi Xie Za Zhi ; 42(6): 431-433, 2018 Nov 30.
Artigo em Chinês | MEDLINE | ID: mdl-30560623

RESUMO

OBJECTIVE: The study presents an experiment platform to perform ventilation and develop the control strategy for ventilator. METHODS: The software designed by LabVEIW displays and saves data in ventilation support through connecting with data acquisition device and signal processing circuit, which is improved by control strategy in order to achieve the more scientific ventilation. RESULTS: The experiment platform realizes the ventilation support and is close to the data outputted from ventilator. CONCLUSIONS: The platform provides values for ventilation control strategy in development phase.


Assuntos
Processamento de Sinais Assistido por Computador , Software , Ventiladores Mecânicos , Humanos , Pulmão , Respiração
3.
Surg Endosc ; 32(10): 4271-4276, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29616339

RESUMO

BACKGROUND: Due to higher technical requirements, laparoscopic major hepatectomy (LMH) for primary hepatolithiasis have been limited to a few institutions. This retrospective study was performed to evaluate the therapeutic safety, and perioperative and long-term outcomes of LMH versus open major hepatectomy (OMH) for hepatolithiasis. METHODS: From January 2012 to December 2016, 61 patients with hepatolithiasis who underwent major hepatectomy were enrolled, including 29 LMH and 32 OMH. The perioperative outcomes and postoperative complications, as well as long-term outcomes, including the stone clearance and recurrence rate, were evaluated. RESULTS: There was no difference of surgical procedures between the two groups. The mean operation time was (262 ± 83) min in the LMH group and (214 ± 66) min in the OMH group (p = 0.05). There is no difference of intra-operative bleeding (310 ± 233) ml versus (421 ± 359) ml (p = 0.05). In the LMH group, there were shorter time to postoperative oral intake ((1.1 ± 0.6) days versus (3.1 ± 1.8) days, p = 0.01) and shorter hospital stay [(7.2 ± 2.3) days versus (11.8 ± 5.5) days, p = 0.03] than the open group. The LMH group had comparable stone clearance rate with the OMH group during the initial surgery (82.8% vs. 84.4%, p = 0.86). CONCLUSIONS: LMH could be an effective and safe treatment for selected patients with hepatolithiasis, with an advantage over OMH in the field of less intra-operative blood loss, less intra-operative transfusion, less overall complications, and faster postoperative recovery.

4.
J Hazard Mater ; 348: 1-9, 2018 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-29353137

RESUMO

Cytotoxicity studies are important tools for the assessment of the toxicity of ionic liquids (ILs). In the present study, the cytotoxicity of eleven ILs against Spodoptera frugiperda 9 (Sf-9) cell lines were evaluated via 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays. The effect on cellular morphology, ultrastructural morphology, and nuclear morphology induced by 1-ethyl-3-methylimidazolium bromide ([C2mim][Br]) was studied via inverted light microscopy observation, acridine orange staining, and transmission electron microscope (TEM) analysis, respectively. The effect on cell DNA fragmentation, cell apoptosis and cell cycle induced by [C2mim][Br] was also investigated via DNA agarose gel electrophoresis and flow cytometry analysis, respectively. The results showed that the cytotoxic effect of ILs on Sf-9 cells was related to the IL structures, concentrations, and length of exposure. The morphological features of apoptosis induced by [C2mim][Br] such as cell shrinkage and convolution, apoptotic bodies, pyknosis, and karyorrhesis were observed. All these phenomena confirmed that Sf-9 cells exposed to [C2mim][Br] died via apoptosis. This study complements the current knowledge about the cytotoxic properties of ILs on insect cells and highlights the mechanism by which ILs kill these cells. Furthermore, it provides a basis for further studies on the future applications of ILs as insecticides.

5.
Molecules ; 22(9)2017 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-28892008

RESUMO

(1) Background: Ionic liquids (ILs) are considered "green" solvents and have been widely used in the extraction and separation field in recent years; (2) Methods: In this study, some common ILs and functionalized magnetic ionic liquids (MILs) were used as adjuvants for the solvent extraction of paclitaxel from Taxus x media (T. x media) using methanol solution. The extraction conditions of methanol concentration, IL type and amount, solid-liquid ratio, extraction temperature, and ultrasonic irradiation time were investigated in single factor experiments. Then, three factors of IL amount, solid-liquid ratio, and ultrasonic irradiation time were optimized by response surface methodology (RSM); (3) Results: The MIL [C4MIM]FeCl3Br was screened as the optimal adjuvant. Under the optimization conditions of 1.2% IL amount, 1:10.5 solid-liquid ratio, and 30 min ultrasonic irradiation time, the extraction yield reached 0.224 mg/g; and (4) Conclusions: Compared with the conventional solvent extraction, this ultrasonic assisted extraction (UAE) using methanol and MIL as adjuvants can significantly improve the extraction yield, reduce the use of methanol, and shorten the extraction time, which has the potentiality of being used in the extraction of some other important bioactive compounds from natural plant resources.


Assuntos
Antineoplásicos Fitogênicos/isolamento & purificação , Líquidos Iônicos/química , Extração Líquido-Líquido/métodos , Paclitaxel/isolamento & purificação , Taxus/química , Análise Fatorial , Concentração de Íons de Hidrogênio , Extração Líquido-Líquido/economia , Metanol/química , Extratos Vegetais/química , Solventes/química , Sonicação , Temperatura Ambiente , Fatores de Tempo
6.
BMC Genomics ; 18(1): 60, 2017 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-28068920

RESUMO

BACKGROUND: Fistular leaves frequently appear in Allium species, and previous developmental studies have proposed that the process of fistular leaf formation involves programmed cell death. However, molecular evidence for the role of programmed cell death in the formation of fistular leaf cavities has yet to be reported. RESULTS: In this study, we characterized the leaf transcriptomes of nine Allium species, including six fistular- and three solid-leaved species. In addition, we identified orthologous genes and estimated their Ka and Ks values, in order to ascertain their selective pattern. Phylogenetic analysis based on the transcriptomes revealed that A. tuberosum was the most ancestral among the nine species, and analysis of orthologous genes between A. tuberosum and the other eight species indicated that 149 genes were subject to positive selection; whereas >3000 had undergone purifying selection in each species. CONCLUSIONS: We found that many genes that are potentially related to programmed cell death either exhibited rapid diversification in fistular-leaved species, or were conserved in solid-leaved species in evolutionary history. These genes potentially involved in programmed cell death might play important roles in the formation of fistular leaf cavities in Allium, and the differing selection patterns in fistular- and solid-leaved species may be responsible for the evolution of fistular leaves.


Assuntos
Allium/crescimento & desenvolvimento , Allium/genética , Perfilação da Expressão Gênica , Folhas de Planta/crescimento & desenvolvimento , Folhas de Planta/genética , Evolução Molecular , Anotação de Sequência Molecular , Filogenia
7.
Food Chem ; 217: 91-97, 2017 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-27664612

RESUMO

Salting-out extraction (SOE) based on lower molecular organic solvent and inorganic salt was considered as a good substitute for conventional polymers aqueous two-phase extraction (ATPE) used for the extraction of some bioactive compounds from natural plants resources. In this study, the ethanol/ammonium sulfate was screened as the optimal SOE system for the extraction and preliminary purification of allicin from garlic. Response surface methodology (RSM) was developed to optimize the major conditions. The maximum extraction efficiency of 94.17% was obtained at the optimized conditions for routine use: 23% (w/w) ethanol concentration and 24% (w/w) salt concentration, 31g/L loaded sample at 25°C with pH being not adjusted. The extraction efficiency had no obvious decrease after amplification of the extraction. This ethanol/ammonium sulfate SOE is much simpler, cheaper, and effective, which has the potentiality of scale-up production for the extraction and purification of other compounds from plant resources.


Assuntos
Sulfato de Amônio/química , Etanol/química , Alho , Cloreto de Sódio/química , Ácidos Sulfínicos/isolamento & purificação , Cromatografia Líquida de Alta Pressão/métodos , Alho/química , Extratos Vegetais/isolamento & purificação , Solventes/química , Água/química
8.
Appl Biochem Biotechnol ; 179(8): 1325-35, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27075456

RESUMO

In this study, enzyme-assisted three-phase partitioning (EATPP) was used to extract oil from flaxseed. The whole procedure is composed of two parts: the enzymolysis procedure in which the flaxseed was hydrolyzed using an enzyme solution (the influencing parameters such as the type and concentration of enzyme, temperature, and pH were optimized) and three-phase partitioning (TPP), which was conducted by adding salt and t-butanol to the crude flaxseed slurry, resulting in the extraction of flaxseed oil into alcohol-rich upper phase. The concentration of t-butanol, concentration of salt, and the temperature were optimized to maximize the extraction yield. Under optimized conditions of a 49.29 % t-butanol concentration, 30.43 % ammonium sulfate concentration, and 35 °C extraction temperature, a maximum extraction yield of 71.68 % was obtained. This simple and effective EATPP can be used to achieve high extraction yields and oil quality, and thus, it is potential for large-scale oil production.


Assuntos
Fracionamento Químico/métodos , Linho/química , Óleo de Semente do Linho/isolamento & purificação , Peptídeo Hidrolases/metabolismo , Poligalacturonase/metabolismo , Sulfato de Amônio/química , Cromatografia Gasosa-Espectrometria de Massas , Cinética , Temperatura Ambiente , terc-Butil Álcool/química
9.
Molecules ; 21(3): 262, 2016 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-26959002

RESUMO

BACKGROUND: Ionic liquids (ILs) are considered as green solvents, and widely applied for the extraction of various compounds. METHODS: The present research focuses on the extraction of flavonoids from Apocynum venetum L. leaves by ultrasound-assisted extraction (UAE). Several major influencing factors were optimized. Then, an aqueous biphasic system (ABS) was applied for further isolation of flavonoids. RESULTS: The flavonoids were mainly distributed in the top phase, while impurities were extracted to the bottom phase. The parameters influencing the extraction, namely type and concentration of salt, temperature, and pH, were studied in detail. Under optimized conditions (72.43% IL extract, 28.57% (NH4)2SO4, 25 °C temperature, pH 4.5), the preconcentration factor and extraction efficiency were found to be 3.78% and 93.35%, respectively. CONCLUSIONS: This simple and efficient methodology is expected to see great use in the extraction and isolation of pharmaceutically active components from medicinal plant resources.


Assuntos
Apocynum/química , Flavonoides/isolamento & purificação , Cromatografia Líquida de Alta Pressão/métodos , Líquidos Iônicos , Extratos Vegetais/isolamento & purificação , Folhas de Planta/química , Plantas Medicinais/química , Solventes , Ultrassom , Água
10.
Exp Parasitol ; 164: 79-83, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26921717

RESUMO

The excretion frequencies of cecal and intestinal droppings of Chinese Lingnan yellow chickens were observed for 10 consecutive days. The chickens were then orally inoculated with a precocious line of Eimeria necatrix, and the oocysts present in the cecal and intestinal droppings were separately collected and monitored using the McMaster method. The results showed that the excretion frequency of cecal droppings was significantly lower than that of intestinal droppings, and the oocysts of E. necatrix were distributed primarily in the cecal droppings. This distribution affects the homogeneity of the second and third generation of oocysts ingested by the chickens and therefore affects the immune effect observed during E. necatrix immunization. To artificially strengthen the immunologic homogeneity against E. necatrix, a method of artificially strengthening the second immunization was applied, and the immune effect was evaluated based on oocyst excretion, body weight gain, fecal scores, intestinal lesion scores and survival percentages. The results showed that no significant intestinal damage was caused by immunization reactions in the chickens. In addition, the number of excreted oocysts in the immunized chicken groups could be significantly increased, and the immunologic homogeneity of the immunized chickens could be improved by artificially strengthening the second immunization, which could in turn improve the immune protective effect.


Assuntos
Galinhas/parasitologia , Coccidiose/veterinária , Eimeria/isolamento & purificação , Imunização/veterinária , Doenças das Aves Domésticas/parasitologia , Animais , Ceco/parasitologia , Coccidiose/imunologia , Coccidiose/parasitologia , Coccidiose/prevenção & controle , Eimeria/imunologia , Fezes/parasitologia , Imunização Secundária/veterinária , Intestinos/parasitologia , Intestinos/patologia , Oocistos , Doenças das Aves Domésticas/imunologia , Doenças das Aves Domésticas/prevenção & controle , Distribuição Aleatória
11.
Int J Clin Exp Med ; 8(9): 16167-74, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26629130

RESUMO

BACKGROUND: The importance of postoperative gastrointestinal function recovery is being increasingly recognized. In this multi-center randomized controlled study, we evaluated the efficacy and safety of Evodia hot compress (ECS) plus electro-acupuncture (EA) for patients who developed postoperative gastrointestinal tract dysfunction after abdominal surgery. METHODS: 1009 patients who developed postoperative gastrointestinal tract dysfunction after abdominal surgery were enrolled. All patients received conventional therapies for 7 days from the 1st postoperative day and were randomly assigned to receive coarse salt hot compress, Evodia hot compress or Evodia hot compress plus electro-acupuncture twice a day for 7 days. RESULTS: The mean time to first flatus and to first bowel sounds was comparable among the four groups (P>0.05). The control group had a significantly shorter time to defecation compared with patients receiving coarse salt hot compress, Evodia hot compress or Evodia hot compress plus electro-acupuncture (P<0.05). In patients undergoing open hepatectomy, the time to first defecation was the shortest in those who received Evodia hot compress plus electro-acupuncture (89.3±25.5 h), which was significantly different from that of controls(134±31.1 h), those who received coarse salt hot compress (106.7±36.4 h) and those who received Evodia hot compress (109.9±42.1 h) (P<0.05) in patients undergoingopen cholecystectomy, the time to first defecation was the shortest in those who received Evodia hot compress (73.1± 24.7), which was significantly different from that of controls (77.8±29.7), those who received coarse salt hot compress 90.5±30.2) and those who received Evodia hot compress plus electro-acupunctur (83.9±34.0). CONCLUSION: Evodia hot compress plus electro-acupuncture confers benefit in postoperative recovery of gastrointestinal function of patients who have undergone abdominal surgery and it is overall safe to use. TRIAL REGISTRATION: Chinese Clinical Trial RegistryChiCTR-TRC-09000527.

12.
Molecules ; 20(10): 17929-43, 2015 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-26437389

RESUMO

In this work, a two-step extraction methodology of ionic liquid-based ultrasonic-assisted extraction (IL-UAE) and ionic liquid-based aqueous two-phase system (IL-ATPS) was developed for the extraction and purification of secoisolariciresinol diglucoside (SDG) from flaxseed. In the IL-UAE step, several kinds of ILs were investigated as the extractants, to identify the IL that affords the optimum extraction yield. The extraction conditions such as IL concentration, ultrasonic irradiation time, and liquid-solid ratio were optimized using response surface methodology (RSM). In the IL-ATPS step, ATPS formed by adding kosmotropic salts to the IL extract was used for further separation and purification of SDG. The most influential parameters (type and concentration of salt, temperature, and pH) were investigated to obtain the optimum extraction efficiency. The maximum extraction efficiency was 93.35% under the optimal conditions of 45.86% (w/w) IL and 8.27% (w/w) Na2SO4 at 22 °C and pH 11.0. Thus, the combination of IL-UAE and IL-ATPS makes up a simple and effective methodology for the extraction and purification of SDG. This process is also expected to be highly useful for the extraction and purification of bioactive compounds from other important medicinal plants.


Assuntos
Butileno Glicóis/química , Butileno Glicóis/isolamento & purificação , Linho/química , Glucosídeos/química , Glucosídeos/isolamento & purificação , Extração Líquido-Líquido , Extratos Vegetais/química , Extratos Vegetais/isolamento & purificação , Ondas Ultrassônicas , Análise de Variância , Concentração de Íons de Hidrogênio , Extração Líquido-Líquido/métodos , Sais , Temperatura Ambiente
13.
Int J Clin Exp Pathol ; 8(3): 3257-61, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26045849

RESUMO

A 58-year-old male patient was admitted with right upper abdominal pain. Initial hematologic evaluation revealed mildly elevated serum carcinoembryonic antigen and carbohydrate antigen (CA) 19-9 tests, while an abdominal CT-scan showed a circumferential mass along the distal ascending colon and the right flexure of colon, simultaneously a liver lesion in segment 8 is considered metastases from colorectal. colonoscopic examination revealed a circumferential growth tumor in the right flexure of colon and the colonoscopy can not reach the proximal of the tumor. We performed a right hemihepatoectomy and a right hemicolectomy associated with loco-regional lymphadenectomy. Histological examination showed diffuse large B-cell lymphomas in resected right colon as well as liver tumors. The patient received six courses of chemotherapy with CHOP-based regimens. At 14-month follow-up before this report, the patient is still alive and free of disease.


Assuntos
Neoplasias do Colo/patologia , Neoplasias Hepáticas/patologia , Linfoma Difuso de Grandes Células B/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias do Colo/tratamento farmacológico , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Prednisolona/uso terapêutico , Vincristina/uso terapêutico
14.
Photodiagnosis Photodyn Ther ; 10(4): 583-90, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24284115

RESUMO

OBJECTIVES: To investigate the efficacy and safety of low-concentration 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in the treatment of different severity of acne vulgaris and optimize the treatment regimen. METHODS: A self-controlled multicenter clinical trial was carried out in 15 centers throughout China. A total of 397 acne patients of grade II-IV received 3- or 4-session PDT treatment. 5% ALA gel was applied topically to acne lesions for 1h incubation. The lesions were irradiated by a LED light of 633 nm at dose levels of 96-120 J/cm(2). Clinical assessment was conducted before and after every treatment up to 8 weeks. RESULTS: The effective rate overall and of grade II, III and IV are 82.1%, 71.6%, 79.6% and 88.2%, respectively. The effective rate rises significantly proportionally to the severity of acne (P<0.01). No significant differences are found in the efficacy between patients received 3-session and 4-session PDT treatments (P>0.05). The count of inflammatory and non-inflammatory acne lesions gradually decrease after each treatment (P<0.01) and during the 8-week follow up (P<0.01 or P<0.05). Maximum efficacy is obtained at 8 weeks after the treatment completion. CONCLUSIONS: A low-dose topical ALA-PDT regimen using 5% ALA, 1h incubation and red light source of 3 treatment sessions is suggested as optimal scheme for the treatment of different severity of acne vulgaris in Chinese patients. Superior efficacy is found in severe cystic acne of grade IV with mild side effects.


Assuntos
Acne Vulgar/tratamento farmacológico , Acne Vulgar/patologia , Ácido Aminolevulínico/administração & dosagem , Fotoquimioterapia/métodos , Administração Tópica , China , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Fármacos Fotossensibilizantes/administração & dosagem , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
15.
Bioprocess Biosyst Eng ; 36(8): 1105-13, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23207826

RESUMO

An alcohol/salt aqueous two-phase system (ATPS) composed of 1-propanol and (NH4)2SO4 was employed to purify anthraquinones (AQs) extracted from Aloe vera L. The main influencing system parameters such as type of alcohol, type and concentration of salt, temperature and pH were investigated in detail. Under the optimal extraction conditions, AQs can be extracted into alcohol-rich phase with high extraction efficiency, meanwhile majority polysaccharides, proteins, mineral substances and other impurities were extracted into salt-rich phase. Partitioning of AQs is dependent on hydrophobic interaction, hydrogen bond interaction, and salting-out effect in ATPS. Temperature also played a great role in the partitioning. After ATPS extraction, alcohol can be recycled by evaporation; moreover, salt can be recycled by dilution crystallization method. Compared with other liquid-liquid extractions, this alcohol/salt system is much simpler, lower in cost with easier recovery of phase-forming components, which has the potential scale-up in down-processing of active ingredients in plant.


Assuntos
Aloe/metabolismo , Antraquinonas/isolamento & purificação , Álcoois/química , Antraquinonas/química , Cristalização , Emodina/química , Etanol/química , Ligações de Hidrogênio , Concentração de Íons de Hidrogênio , Interações Hidrofóbicas e Hidrofílicas , Extração Líquido-Líquido , Metanol/química , Extratos Vegetais/química , Sais/química , Temperatura Ambiente , Termodinâmica , Viscosidade
16.
Nat Prod Res ; 26(15): 1423-32, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22007923

RESUMO

Non-ionic surfactant-based aqueous two-phase system had been investigated to extract aloe anthraquinones. It had the advantage of using a single auxiliary chemical to induce phase separation above cloud point at a low concentration. Non-ionic surfactant Triton X-114 was chosen for its excellent phase-separating ability and low cloud point. The main factors affecting the cloud point extraction were discussed such as equilibrium temperature and time, concentrations of surfactant and inorganic electrolytes, pH, etc. Under the optimised conditions, the highest extraction yield 96.93% was obtained. The reverse extraction of anthraquinones from surfactant-rich phase was achieved with a recovery of 70.35% by adjusting pH. Compared with conventional purification methods, this CPE technique can be completed in one operation; besides, it is a low-cost method and an environment friendly one.


Assuntos
Aloe/química , Antraquinonas/química , Tensoativos/química , Polietilenoglicóis/química
17.
Eur J Dermatol ; 21(5): 731-6, 2011 Sep-Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21742595

RESUMO

Mononuclear cell (MNC) infiltrate is one of the earliest pathological changes in systemic sclerosis (SSc) skin. However, little is known about the recruitment of these cells into skin lesions. Recently, the role of chemokines has been suggested in the pathogenesis of SSc. Here we studied the expressions and distributions of CC chemokine CCL20 and its receptor CCR6 in early SSc skin lesions and the difference in CCL20 expressions and ability to recruite MNCs of normal dermal fibroblast (NDF) and scleroderma dermal fibroblast (SSDF). We found that the expressions of CCL20 and its receptor CCR6 were obviously up-regulated in SSc in contrast to normal human skin. mRNA levels were significantly expressed in SSc lesional skins vs normal skin tissues. SSDF displayed increased constitutive expressions of CCL20 mRNA and protein. In addition, Th1 cytokines (TNF-α and IL-1ß) remarkably increased the expression of CCL20 in both NDF and SSDF in a dose- and time-dependent manner. Supernatants from SSDF showed stronger chemotactic activity to PBMCs than those from NDF. Thus our findings suggest that CCL20 released from cytokine-activated SSDF plays an important role in the induction of SSc by further recruiting more MNCs to the skin.


Assuntos
Quimiocina CCL20/metabolismo , Receptores CCR6/metabolismo , Escleroderma Sistêmico/metabolismo , Pele/metabolismo , Regulação para Cima/fisiologia , Células Cultivadas , Quimiotaxia/fisiologia , Relação Dose-Resposta a Droga , Feminino , Fibroblastos/metabolismo , Humanos , Interleucinas/metabolismo , Masculino , Fator de Necrose Tumoral alfa/metabolismo
18.
Zhonghua Wai Ke Za Zhi ; 47(2): 139-42, 2009 Jan 15.
Artigo em Chinês | MEDLINE | ID: mdl-19563012

RESUMO

OBJECTIVE: To discuss the value of a new technique of the binding pancreaticogastrostomy (BPG) in pancreaticoduodenectomy. METHODS: From May 2008 to October 2008, 15 patients were performed with BPG, included pancreatic head cancer in 7 cases, duodenal adenocarcinoma in 2 cases,mass-type chronic pancreatitis with pancreatolithiasis in 1 case, ampullary carcinoma in 1 case, gallbladder cancer in 1 case, islet cell tumor in 1 case and cholangiocarcinoma in 2 cases. The main procedures of BPG included: isolating remnant pancreas; slitting partial posterior wall of stomach and preplaced with seromuscular purse-string suture; cutting gastric anterior wall; performing pancreaticogastrostomy (binding of outer seromuscular and inner mucous layer of stomach). RESULTS: The procedures were successful in 15 patients. Postoperative complications included small amount of pleural effusion in 2 cases, delayed gastric emptying in 2 cases and bile leakage in 2 cases. All patients were cured in 2 weeks. No mortality and anastomosis leakage occurred. CONCLUSION: The application of BPG technique can prevent the anastomosis leakage and improve the safety for pancreaticoduodenectomy.


Assuntos
Pâncreas/cirurgia , Estômago/cirurgia , Adulto , Idoso , Anastomose Cirúrgica/métodos , Feminino , Fístula/etiologia , Fístula/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Pancreaticoduodenectomia/efeitos adversos , Complicações Pós-Operatórias/prevenção & controle , Estomas Cirúrgicos
19.
Zhonghua Wai Ke Za Zhi ; 47(23): 1764-6, 2009 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-20193541

RESUMO

OBJECTIVE: To explore the feasibility and safety of type II binding pancreaticogastrostomy (BPG) in pancreaticoduodenectomy and mid-segmentectomy of pancreas. METHODS: From November 2008 to May 2009, 26 patients underwent pancreaticoduodenectomy and mid-segmentectomy of pancreas with type II BPG reconstruction, including 13 cases of pancreatic head cancer, 3 cases of duodenal adenocarcinoma, 2 cases of ampullary carcinoma, 4 cases of cholangiocarcinoma, 1 case of bile duct cell severe atypical hyperplasia, and 1 case of stomach cancer. The process of type II BPG was described as the following: after pancreas remnant was mobilized for 2-3 cm, a piece of sero-muscular layer at the posterior gastric wall was excised and then a sero-muscular depth purse-suturing with 3-0 prolene was pre-placed (outer purse-string). Incising anterior gastric wall or opening part of the closed distal gastric stump, the mucosa layer at the sero-muscular defect was incised and then purse-suture at the mucosal tube was pre-placed (inner purse-string). Through the two pre-placed purse-strings, the pancreas remnant was pulled into the gastric lumen and then posterior gastric wall was pushed backward to keep it closely in contact with the retro-peritoneal wall. Thereafter, the outer purse-string was tied (outer binding) and then the inner purse-string was tied (inner binding). RESULTS: All cases underwent BPG of type II. The operative time ranged from 3 to 5.5 hours. The postoperative hospital stay ranged from 6 to 48 days. Postoperative complications included 1 case of ascites, 2 cases of delayed gastric emptying and 1 case of intra-abdominal bleeding. All cases with complications were cured after nonsurgical treatment. No mortality or pancreatic leakage occurred. CONCLUSIONS: Pancreaticogastrostomy is good for accommodating a large pancreas stump. Binding technique is very helpful in minimizing the leak rate of pancreaticogastrostomy. While type I BPG is safe and easy to perform, type II is even safer and easier to be done.


Assuntos
Anastomose Cirúrgica/métodos , Pâncreas/cirurgia , Estômago/cirurgia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Pancreaticoduodenectomia , Resultado do Tratamento
20.
Zhonghua Wai Ke Za Zhi ; 46(24): 1892-4, 2008 Dec 15.
Artigo em Chinês | MEDLINE | ID: mdl-19134380

RESUMO

OBJECTIVE: To summarize the reasons for bile duct injury (BDI) after laparoscopic cholecystectomy (LC), and to determine the effect of multiple treatment after BDI. METHODS: A retrospective cohort study was performed. The medical records of 110 patients diagnosed with BDI after LC from October 1993 to November 2007, in ten large hospitals in Guangdong of China, were reviewed. RESULTS: Among 110 patients with BDI, 58 cases (52.7%) were local patients, whereas 52 cases (47.3%) were transferred from outside hospitals. Reasons for BDI following LC were: (1) Lack of experience of the LC operator (48.2%); (2) LC performed during acute cholecystitis (20.0%); (3) The structure of Calot triangle was unclear (15.5%); (4) Variable anatomical position (11.8%); (5) Intra-operation bleeding (4.5%). The commonest sites of injury were the choledochus and common hepatic duct (76.4%). Following BDI, endoscopic stenting or operative repair was performed in 106 patients. The overall success rate was 95.3% (101/106), with a mortality rate was 0.9% (1/106). Cholangitis occurred in 3.8% (4/106) cases. Choledocho-enterostomy operation was performed in almost 60.0% (63/106) cases, and the success rate was 93.7% (59/63). Endoscopic stenting or operative repair was performed immediately following BDI in 23.6% (25/106) patients, the success rate was 100%; and within 30 days in 63.2% (67/106) patients. Eighty-eight out of 106 patients who underwent repair were successful following the first operative procedure. CONCLUSIONS: Factors such as an un-experienced operator and unclear anatomical position were causes of BDI following LC. Early operative repair should be regarded as the treatment of choice, in patients diagnosed with BDI. Early refer to an experienced hepatobiliary operator ensures a high success rate.


Assuntos
Ductos Biliares/lesões , Colecistectomia Laparoscópica , Complicações Intraoperatórias , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ductos Biliares/cirurgia , Colecistectomia Laparoscópica/efeitos adversos , Feminino , Humanos , Doença Iatrogênica , Complicações Intraoperatórias/diagnóstico , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
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