ObjectiveTo investigate the value of endoscopic sphincterotomy (EST) on treating sphincter of Oddi dysfunction (SOD). MethodsForty-two patients with SOD according to Rome Ⅱ diagnostic criteria were retrospectively summarized. Bile duct residual stone, tumor or biliopancreatic duct obstruction diseases were excluded by B ultrasound, CT, and MRCP examination. Total 42 patients underwent EST. ResultsEST was done successfully in 42 cases, success rate was 100%. Postoperative acute pancreatitis occurred in 5 patients (11.90%), which were cured by 3－7 d conservative treatment. There were no complications of severe acute pancreatitis, digestive tract perforation, hemorrhage, and cholangitis. Follow-up 12-45 months (mean 23.8 months), symptoms of abdominal pain in all cases were improved or relieved, the effective rate was 100%. There were 2 cases treated conservatively because of hyperlipemic pancreatitis. ConclusionEST has become the primary treatment procedure for SOD because of definite outcome, less suffering, safety, less complications, and reproducibility, which are concordant with the requirements of minimally invasive surgery.
ObjectiveTo investigate the synergistic antitumor effects of ionizing radiation and the cytosine deaminase (CD)/5-flurocytosine (5-FC) system therapy in human pancreatic cancer cell.MethodsThe expression vector containing CD was transfected into the human pancreatic cancer cell line PC3. The clones were picked out after G418 selection. The CD gene integration and expression were confirmed by the RT-PCR. The cytotoxicity to the cells with or without CD and (or) ionizing radiation under the treatment with 5-FC was measured by the MTT assay. The clonogenic assay was used to investigate the radiosensitizing effect of 5-FC on the PC3 cells transfected or untransfected with CD gene.ResultsThe CD gene was stably expressed in the PC3 cells transfected with CD gene. The cytotoxic effect of 5-FC was superior on the PC3 cells transfected than that of untransfected with CD gene (P<0.05) and which were enhanced in combination with the ionizing radiation (P<0.05). The CD/5-FC enhanced the radiosensitivity of PC3 cells transfected with CD gene (P<0.05). The change in the radiosensitivity was quantified by calculating the sensitization enhancement ratio (SER) at the clinically relevant dose of 2 Gy. The SER was 1.5 in the PC3 cells transfected with CD gene by giving ionizing radiation of 2 Gy.ConclusionsCD/5-FC system is a potenial radiosensitizer in PC3 cells transfected with CD gene. Ionizing radiation and CD/5-FC system is more effective for killing effect of PC3 cells than ionizing radiation or CD/5-FC system alone.
Umbrella review is a third study conducted through evidence synthesis method, based on the secondary studies including systematic reviews and meta-analyses. Although it has been widely used abroad, further understanding, recommendation and application of this type of method are still limited in China. We introduced the definition, objective, present application, the similarities and differences with systematic reviews or meta-analyses, indications, limitations, and research progress of umbrella review in the research area of traditional Chinese medicine (TCM), aiming to benefit future clinical research and treatment in practice.
【Abstract】ObjectiveTo study the therapeutic effects of indwelling catheters in patients with severe acute pancreatitis (SAP). MethodsThe clinical data of 113 patients with severe acute pancreatitis admitted to our hospital from Aug. 2002 to May 2004 were collected. The patients were divided into the indwelling catheter group (45 cases) and the control group (68 cases).The APACHEⅡscores and therapeutic results were compared. The drainage and intraabdominal pressure (IPA) were monitored. Results The APACHEⅡscores on day 2 and day 5 after therapy in indwelling catheter group were significantly decreased compared with the control group(P=0.000).The average hospital stay and cyst morbidity of the indwelling catheter group were significantly decreased compared with those of the control group(P=0.000). The mortality rate was lower in the indwelling catheter group, but there was no statistical difference between these two groups(Pgt;0.05). The IAP was positively correlative with the drainage volume, hospital day and APACHEⅡscores(r=0.552, r=0.748, r=0.923，P=0.000). ConclusionThe indwelling catheter is an important treatment in patients with SAP.
Objective To discuss the value of biliary stent in treatment of malignant biliary obstruction with different pathways of bile duct stent insertion. Methods Fourty-two cases of malignant biliary obstruction whose biliary stent insertions were through operation (n=18), PTCD (n=17) and ERCP (n=7) respectively were reviewed retrospectively. Results The bile duct stents were successfully inserted in all patients through the malignant obstruction and achieved internal biliary drainage. Compared with the level of the bilirubin before operation, it decreased about 100 μmol/L one week after the stent insertion in all patients. Compared with the levels of glutamic oxalacetic transaminase, glutamic pyruvic transaminase, alkaline phosphatase and glutamyltranspeptidase before operation, they decreased 1 week after the stent insertion （Plt;0.05). The median survival time was 22 weeks. The average survival time was (32.89±33.87) weeks. Two patients died in hospital after PTCD, and the mortality was 4.76%. Complications included 8 cases of cholangitis, 3 cases of bile duct hemorrhage and 2 cases of hepatic failure. Conclusion The bile duct stent insertions through operation, PTCD and ERCP are all effective in relieving the bile duct construction with malignant biliary obstruction. Each method should be chosed according to the systemic and local condition for every patient so as to improve the safety and efficiency, and to decrease the occurrence of complications.
ObjectiveSham acupuncture control is a commonly employed method to assess the specific effects of acupuncture in clinical trials. However, due to the absence of specific reporting standards, the reporting quality of sham acupuncture in these trials is low. In order to standardize the reporting of sham acupuncture and improve the reporting quality of sham acupuncture, our project team has developed SHam Acupuncture REporting guidelines and a checklist in clinical trials (SHARE). MethodsThe development process included four parts: we conducted literature research to form initial items of sham acupuncture reporting; two rounds of Delphi surveys were carried out to evaluate the reporting necessity of these initial items; two expert consensus meetings were held to further discuss and agree upon the Delphi results and approve the SHARE checklist; a pilot testing was conducted to assess the feasibility and practicality of the list and make necessary revisions to generate the final SHARE checklist. ResultsThe SHARE checklist consisted of 10 categories with 19 items. The requirements for reporting sham acupuncture primarily focused on sham acupuncture detailed information as well as relevant background factors. ConclusionThe SHARE serves as specialized reporting guidelines for sham acupuncture that offers clear guidance on comprehensive and concise reporting of sham acupuncture.