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find Author "李全生" 4 results
  • 腹腔镜胆囊切除术中胆囊管嵌顿结石的处理

    目的探讨腹腔镜胆囊切除术(LC)术中胆囊管嵌顿结石的处理方法。 方法回顾性分析2007年5月-2013年2月21例胆囊管嵌顿结石患者的临床资料。 结果18例患者成功在腹腔镜下完成手术,其余3例患者胆囊三角粘连致密、解剖不清,中转开腹后在术中超声探及胆囊管根部嵌顿结石,在超声引导下胆囊管切开取石,残端缝闭。 结论LC术中仔细解剖胆囊三角,“裸化”胆囊管可避免胆囊管结石漏诊,并能进行相应处理。

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  • 腹腔镜胆囊切除术后继发性胆总管结石的原因分析及处理

    目的探讨腹腔镜胆囊切除术(LC)后继发性胆总管结石的原因及处理方法。 方法回顾性分析2008年1月-2013年12月3 300例LC患者的临床资料。 结果所有患者术后随访半年,3 262例(98.75%)患者随访半年中未发现胆总管结石,38例(1.15%)患者出现继发胆总管结石。随访发现胆总管结石与未发现胆总管结石的患者在总胆红素水平[(15.3±3.8)、(17.8±5.4)μmol/L]、碱性磷酸酶水平[(75.9±19.4)、(84.4±23.1)U/L]、胆总管直径[(6.1±1.9)、(8.5±3.4)mm]、胆囊管直径[(1.9±0.5)、(3.5±1.4)mm]、合并有胆囊管结石比例(0.46%、13.20%)、胆囊结石为多发比例(58.7%、100.0%)方面比较差异有统计学意义(P<0.05)。 结论胆囊结石患者术前总胆红素及碱性磷酸酶水平偏高、胆总管较粗、胆囊管较粗、胆囊管结石、胆囊多发结石是LC术后继发性胆总管结石的高危因素,术中应谨慎操作以预防继发胆总管结石,术后证实的胆总管结石可行内镜逆行胰胆管造影以及内镜乳头括约肌切开术治疗。

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  • Experimental Study on the Mouse Model of Acute Necrotizing Pancreatitis Induced by Intraperitoneal Injection of Caerulein

    ObjectiveTo establish a mouse model of acute necrotizing pancreatitis.MethodsThirty-six male ICR mice were randomly divided into control group (n=6) and experimental group (n=30). Each of the animals in the experimental group received 7 intraperitoneal injections of caerulein (50 μg/kg body weight) in 0.9% NaCl at hourly intervals over 6 hours. The animals in the experimental group were killed at 9,18,24,48 and 72 hours respectively after the first caerulein injection. The control animals received the same volume of 0.9% NaCl without caerulein. The animals in the control group were killed at the 18th hour after the first intraperitoneal injection. The severity of acute necrotizing pancreatitis was evaluated in terms of amylase level, pancreatic weight/body weight and the histological changes. Variance analysis was employed in the processing of these data. ResultsBoth amylase level and pancreatic weight elevated 9 hours after the first caerulein injection, and correlated with the course of pancreatitis. The maximums of both alterations were observed at the same time point (18 hours after the first injection of caerulein). Prominent interstitial inflammation and acinar cell necrosis occurred at the 18th hour, and the histological score for pancreatitis reached a maximum (P<0.05). Conclusion Intraperitoneal injection of a large dosage of caerulein can induce acute necrotizing pancreatitis in ICR mice. This method is simple and noninvasive, and the model established thus is stable and reproducible.

    Release date:2016-08-28 04:43 Export PDF Favorites Scan
  • A preliminary study on metabonomics of amino acid and glucose in patients with gallbladder stones based on nuclear magnetic resonance

    Objective The method of metabonomics based on nuclear magnetic resonance (NMR) imaging was used to explore the difference in metabolites of serum and bile, and to analyze the metabolic variation related to the pathogenesis of gallbladder stones between normal people/liver transplantation donors and patients with gallbladder stones. Methods Prospectively collected the serum samples (17 cases) and bile samples (19 cases) in 19 patients with gallbladder stones who underwent surgery in West China Hospital form March 2016 to December 2016, as well as the serum samples of 10 healthy persons and the bile samples of 15 liver transplantation donors at the same time period. The differences of metabolites in the blood and bile in these 3 groups were compared by using 1H-NMR metabonomics technology and chemometric methods. Results The concentrations of valine, alanine, lysine, glutamine, glutamate, pyruvate, creatinine, choline, alpha-glucose, beta-glucose, tyrosine, histidine, and hypoxanthine in serum of patients with gallbladder stones decreased significantly, comparing with those of healthy people without gallbladder stones (P<0.05), while 1, 2-propanediol, acetoacetate, and lactate increased significantly in the serum of patients with gallbladder stones (P<0.05). The concentrations of taurine conjugated bile acids, glycine conjugated bile acids, choline, and phosphatidylcholine decreased significantly in the bile of patients with gallbladder stones when compared with those of liver transplantation donors (P<0.05), while cholesterol increased significantly in the bile of patients with gallbladder stones (P<0.05). Conclusions There are significant differences of the serum and bile metabolites between patients with gallbladder stones and healthy men without gallbladder stones/liver transplantation donors. 1H-NMR metabonomics is helpful to investigate the pathogenesis of gallbladder stones.

    Release date:2018-04-11 02:55 Export PDF Favorites Scan
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