目的 探讨胆囊残留病变的病因、诊断及治疗。 方法 对35例胆囊残留病变资料进行回顾性分析。 结果 所有病例术中均证实胆囊管残端gt;1.5 cm，5例胆囊管变异，3例单纯胆囊管残留过长，32例不同程度合并残留胆囊结石及肝内外胆管结石，34例术后近、远期效果佳，1例Oddi’s括约肌狭窄患者反复胆道逆行感染，行3次手术后痊愈。 结论 胆系的解剖变异、局部的炎症情况及术者的人为因素是胆囊残留病变发生的主要原因。术后复发多合并结石、炎症及狭窄等疾患，处理残留病变及并发症需选择合适的手术方式。
【Abstract】Objective To study the effects of nitric oxide (NO) on the growth and metastasis of tumor.Methods The literatures of recent years were reviewed.Results NO had double effects on the growth and metastasis of tumor. NO promoted the growth and metastasis by regulating the expression of tumor proliferation gene and inducing tumor angiogenesis. On the other hand, NO had antitumor effects by interfering with the metabolism of tumor cells, inducing the damage of DNA, forming high toxic free radical, inducing apoptosis of tumor cells and mediating the antitumor action of endothelial cells and macrophages.Conclusion Selective blockage or induction of synthesis of NO may be a new way for tumor therapy.
【Abstract】Objective To introduce the possible effect of endogenous angiogenesis inhibitive factors in the therapy of hepatocarcinoma. Methods Recent relevant literatures were reviewed. ResultsEndogenous angiogenesis inhibitive factors can suppress the growth of tumor blood vessels, which might head off the development and metastasis of hepatocarcinoma effectively. This might provide a new approach to the therapy of hepatocarcinoma. ConclusionRecent studies on endogenous angiogenesis inhibitive factors will be helpful in the prevention and treatment of hepatocarcinoma.
【摘要】目的探讨糖尿病合并肝脓肿的临床特点及外科治疗。方法回顾性分析22例糖尿病合并肝脓肿的临床资料。结果糖尿病合并肝脓肿多见于血糖控制不佳的中老年患者，其临床表现不典型，脓肿液化不完全，易合并多种疾患。用冲洗、烧灼、填塞手术治疗效果良好。结论冲洗、烧灼、填塞方法具有痛苦少、恢复快、一次性治愈的特点，适用于糖尿病合并的单发及多发肝脓肿。
【Abstract】Objective To investigate the expression of inducible nitric oxide synthase (iNOS) and p53 protein in hepatocellular carcinoma (HCC) and their relationship with angiogenesis. Methods Immunohistochemical method and image analysis technique were used to detect the expression of iNOS and p53 protein in tumor tissue sections of 59 HCC patients. Microvessel density (MVD) was counted by immunohistochemical staining with anti-CD34 antibody.Results ①The expression rates of iNOS and p53 were 81.4%(48/59), 64.4%(38/59) in HCC patients, respectively. The expression intensities of iNOS and p53 were 5 635±1 287, 3 352±873 in HCC patients, respectively. ②MVD was 32.5±2.73 in the tumor tissue of HCC patients. ③The expression of iNOS was correlated with the expression of p53 and MVD in HCC patients (P＜0.05); The expression of p53 was also correlated with the MVD in HCC patients (P＜0.05). Conclusion iNOS and p53 are highly expressed in HCC and may play a key role in angiogenesis of HCC.
ObjectiveTo explore the feasibility and curative effect of gastric pacing on postsurgical gastroparesis. MethodsThe indexes of gastric dynamic of applying gastric pacing to the experimental animal model of acute postsurgical gastroparesis was compared with that of injecting erythromycin (1 mg/kg).ResultsThe pressure of gastric antrum and the pressure gradient between gastric antrum and duodenum were respectively higher than basic pressure in the two experimental groups (P＜0.01); Except duodenal pressure, the indexs of gastric dynamic of pacing group were higher than that of erythromycin group (P＜0.05). The gastric emptying rate of pacing group 〔(66.37±7.21)%〕 was higher than erythromycin group 〔(49.92±9.27)%， (P＜0.01)〕. ConclusionHigherfrequency gastric pacing can improve the indexes of gastric dynamic and be applied to treat postsurgical gastroparesis, its effect may be better than erythromycin.
Objective To study the effects of glucose and lipid metabolism on gallstone formation. Methods Twenty five patients with gallstones and 25 normal volunteer controls were studied from January to April in 1998. The patients were well matched the control with sex and age (1∶1). In the study, Body Mass Index (BMI) and Waist-to-Hip circumference ratio (W/H) were measured. Blood glucose, glucosylated hemoglobin (HbA1C), insulin, C peptide and all parameters of lipids were detected at fasting state. The glucose,insulin, C peptide were detected again at 2-hour after taking 75g glucose orally.Results The result showed there was no difference on BMI and W/H between the patients and controls. HbA1C、mean fasting and 2hour glucose concentration were not in significantly different between the two groups (Pgt;0.05, Pgt;0.2, Pgt;0.1 respectively). There were 10 patients with abnormal glucose metabolism (7 with NIDDM, 3 with IGT), but only 4 controls were abnoumal (one with NIDDM, three with IGT). The difference was significant (Plt;0.05). Furthermore, the mean fasting and 2hour insulin concentration of gallstone group was higher than that of the control (Plt;0.02, Plt;0.05). And the gallstone group had a higher fasting C peptide concentration than control (Plt;0.05). There was no statistical difference on the parameters of plasma lipid between the tow groups. Conclusion The study suggests that diabetes mellious and hyperinsulinemia acted as an important role on gallstone formation.
Thisstudyisbasedonaretrospectivereviewof48patientswithechinococcosisofliverwithemphasisonthedifferentialdiagnosisandtheselectionofsurgery.Causesofmisdiagnosisandtheevaluationofavariousoperationsonthisdiseasewerediscussed.Results:Thecommonmisdiagnosiswasduetoobscurehistoryandsymptoms,errorsonimmunologicaltests,lackofspecificmanifestationonradiologicalexaminationandtheforemostsymptomsofcomplications.Theoperativewaysmustbechoseninaccordancewitheachindividualdisease.Theimprovementofoperativetechniquessuchas“tumorfree”operation,irrigationwithhypertonicsalinesolution,infillingwithgreateromentum,applicationofbiojellycanincreasethetherapeuticeffectofoperation.Conclusion:Thekeypointofdifferentialdiagnosisistorecognizetheatypicalcases.Rationalselectionofoperationsandimprovementofoperativetechniquesandmethodsarethecrucialtoincreasethetherapeuticeffectofthisdisease.