ObjectiveTo study the cell apoptosis and the dynamic expression and significance of apoptosis-related genes in graft veins. MethodsA rat experimental model of autogenous graft vein was established by transplanting the right external jugular vein to infrarenal abdominal aorta in 100 Wistar rats. TUNEL and immunohistochemistry were used to detect the apoptosis, the expression of apoptosis-related genes bcl-2 and bax in vascular smooth muscle cells (VSMCs) of graft veins. ResultsWithin the 8 weeks after transplantation, the apoptotic VSMCs in the graft veins were much more than those in the control group with the apoptotic rate reaching the peak〔（28.5±16.6）%〕 on the 2nd week and dropping to （8.1±2.8）% during the 4th to 8th week. There was statistical difference compared to the control group 〔(0.5±0.2)%, P＜0.01〕. From 1 to 2 weeks, the positive rate of bcl-2 was (22.1±5.4)% which was higher than that of the control group and the 4-8 week group (P＜0.01); from 1 to 6 weeks, the expression of bax was higher than that of the control group 〔(5.5±2.3)%〕 and the postoperative 8th week group 〔(8.2±2.9)%, P＜0.01〕.Conclusionbcl-2 and bax protein may be involved in the regulation of apoptosis of VSMCs. Apoptosis of VSMCs may be an important factor in graft remodeling and graft vein stenosis.
目的 探讨低位直肠癌双吻合器保肛手术后吻合口漏的预防。 方法 回顾性分析2000年5月至2005年5月我院肛肠外科行双吻合器保肛手术的78例低位直肠癌患者的资料。结果 所有病例应用双吻合器进行直肠闭合并吻合成功,术后切缘病理检查均未见癌细胞浸润,无吻合口漏及手术死亡。随访73例(93.6%),随访时间9~65个月，平均35个月。盆腔复发2例(2.6%),腹腔广泛转移1例(1.3%),肝脏转移7例(9.0%),吻合口局部复发1例（1.3%,术后11个月再次行Miles术）。结论 双吻合技术为低位直肠癌患者提供更多的保肛机会,使用得当可有效预防吻合口漏的发生。
Objective Platelet-rich plasma (PRP) can enhance the chondrocyte prol iferation and repair of cartilage defects. To explore the safety and efficacy of intra-knee-articular injection of PRP to treat knee articular cartilage degeneration by comparing with injecting sodium hyaluronate (SH). Methods Thirty consecutive patients (30 knees) with knee articular cartilage degeneration were selected between January 2010 and June 2010. According to different injections, 30 patients wererandomly divided into PRP group (test group, n=15) and SH group (control group, n=15). There was no significant difference in gender, age, body mass index, and Kellgren-Lawrence grade between 2 groups (P gt; 0.05). Test group received 3.5 mL of PRP intra-knee-articular injections while control group received 2 mL of SH during the same time period. Both treatments were administered in series of 3 intra-knee-articular injections at 3-week intervals. Then, adverse reactions were recorded. International Knee Documentation Committee (IKDC) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and Lequesne index were used for evaluation of treatment results. Results The patients of 2 groups were followed up 6 months. There were significant differences in IKDC score, WOMAC score, and Lequesne index between pre- and post-injection in 2 groups (P lt; 0.05); no significant difference was found between different time points (3, 4, and 6 months) in test group (P gt; 0.05), while significant differences were found between the postoperative 6th month and the postoperative 3rd and 4th months in control group (P lt; 0.05). There was no significant difference in IKDC score, WOMAC score, and Lequesne index between 2 groups within 4 months (P gt; 0.05), but the effectiveness of test group was significantly better than that of control group at 6 months after injection (P lt; 0.05). Adverse reactions occurred in 12 patients (31 injections) of test group and in 12 patients (30 injections) of control group. No significant difference in onset time, termination time, and duration of adverse reactions were found between 2 groups (P gt; 0.05). Conclusion Intra-knee-articular injection of PRP to treat knee articular cartilage degeneration is safe, which can alleviate symptoms of pain and swell ing and improve the qual ity of l ife of patients; however, further data of large samples and long-term follow-up are needed to confirm the safety and effectiveness.
ObjectiveTo investigate the efficacy and safety of laparoscopic cholecystectomy and common bile duct exploration(LCBDE) with biliary stent drainage or T tube drainage. MethodsThe clinical data of 68 cases of gallbladder and bile duct stones with the LCBDE by the same surgeon in our hospital from June 2008 to June 2013 were retrospectively analyzed. Twenty-two patients were treated with LCBDE and biliary stent drainage(stent drainage group), 46 patients were treated with LCBDE and T tube drainage(T tube drainage group). ResultsThe operation were successfully completed of 2 groups. The anal exhaust time, peritoneal drainage time, postoperative hospitalization time, and hospital expenses in stent drainage group were shorter or less than thoes T tube drainage group(P < 0.05). There were no significant difference in the operative time, postoperative bilirubin level, and incidences of postoperative complications between the two groups(P > 0.05). ConclusionsThe stent drainage and T tube drainage after LCBDE has its own indications. Laparoscopic common bile duct exploration and biliary stent drainage is superior to the laparo-scopic common bile duct exploration and T tube drainage.