ObjectiveTo analyze the cause of complications for patients with advanced malignant biliary obstruc-tion treated with percutaneous transhepatic implantation of biliary stent (PTBS) and summarize the experiences of comp-lications of the treatment. MethodThe complications of 59 patients firstly treated with percutaneous transhepatic cholangial drainage (PTCD) then with PTBS in 156 cases of advanced malignant biliary obstruction from January 2010 to January 2013 in this hospital were analyzed retrospectively. ResultsFifty-nine cases of complications were occurred in 156 cases of advanced malignant biliary obstruction, the incidence was 37.8%, including biliary infection in 26 cases, bile duct bleeding in 17 cases, liver failure in 5 cases, renal failure in 4 cases, acute pancreatitis in 4 cases, stent displa-cement in 2 cases, bile duct perforation in 1 case.Three cases died in 59 patients with complications, 56 cases were improved after symptomatic treatment. ConclusionPTCD combined with PTBS is a safe and effective treatment of advanced malignant biliary obstruction, the reasonable perioperative management is very important to reduce the occurrence of complications.
ObjectiveTo compare the analgesic effect of different treatment for herpes zoster neuralgia, and optimize herpetic neuralgia treatment. MethodsWe collected hospital inpatient data with herpes zoster by the First Military Medical Case Management System between January 1st, 2009 and December 20th, 2013. All the patients were divided into five groups according to different treatments. Patients in group A accepted valaciclovir capsules and doxepin hydrochloride tablets; patients in group B accepted valaciclovir capsules; patients in group C accepted valaciclovir capsule, nefopam hydrochloride tablets and doxepin hydrochloride tablets; patients in group D accepted valaciclovir capsules and nefopam hydrochloride tablets; patients in group E accepted valaciclovir capsules and non-steroidal anti-inflammatory drugs (including nimesulide capsules and ibuprofen sustained-release capsules). We collected such statistic data as sex, age, time of onset, time of pain disappearing after treatment. Then, we analyzed the difference among the groups on the time of pain disappearing. ResultsThere were 336 cases compliant with the standard in all the 898 cases of medical record data. The number of the patients was 72, 86, 66, 60 and 52; while the pain disappearing time after treatment was (5.94±2.54), (8.60±3.09), (5.77±1.85), (5.80±1.96) and (6.86±2.18) days, respectively in group A, B, C, D and E. Pain disappearing time after treatment of group B was significantly different from groups A, C, D, and E (P<0.05); group E was significantly different from groups A, C, and D (P<0.05); there was no significant difference between group A and groups C and D, and between group C and D (P>0.05). ConclusionThe combination of nefopam hydrochloride tablets, doxepin hydrochloride tablets, nimesulide capsules, and ibuprofen sustained-release capsules is effective in the treatment of herpes zoster neuralgia. The use of nefopam hydrochloride tablets with doxepin hydrochloride tablets is more effective than the combination of nimesulide capsules and ibuprofen sustained-release capsules. Doxepin hydrochloride tablets are not significantly different from nefopam hydrochloride tablets. Nefopam hydrochloride tablets and doxepin hydrochloride tablets are not associated with increased efficacy.
ObjectiveTo investigate the protective effect of Roux-en-Y gastric bypass surgery on early damage of renal tissue in type 2 diabetes mellitus rats, and explore the mechanism of the protective effects. MethodsDiabetes mellitus animal models were induced by intraperitoneal injection of streptozotocin (STZ, 35 mg /kg) and a high-fat diet.Diabetic rats were divided into three groups randomly (digital table method): diabetes control group (n=8), sham operation group (n=8), and Roux-en-Y gastric bypass group (n=14).Another 8 normal SD rats as the normal control group.The fasting blood glucose, serum total cholesterol (TC), triglyceride (TG), and free fatty acid (FFA) were measured before operation and in 8 weeks after operation; plasma BUN and Cr were measured respectively before operation and in 4 and 8 weeks after operation in each group rats, 24 h urine microalbumin and urine 8-hydroxydeoxyguanosine were measured respectively before operation and in 8 weeks after operation in each group rats.Renal pathological changes were observed and the indexes of kidney hypertrophy, the mean glomerular area (MGA), and the mean glomerular volume (MGV) were analyzed in 8 weeks after operation.The expressions of fibronectin, typeⅣcollagen (CoⅣ), transforming growth factor-β1 (TGF-β1), intercellular adhesion molecule-1(ICAM-1), nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4), and Bcl-2 protein in renal tissues were investigated by immunohistochemical staining. ResultsRoux-en-Y gastric bypass surgery could reduce the blood glucose, blood lipid, MGA, MGV, and the index of kidney hypertrophy of diabetic rats significantly (P < 0.05), improved renal pathological morphology and kidney function (P < 0.05), reduced the protein expressions of fibronectin and CoⅣ, decreased the protein expressions of TGF-β1, ICAM-1, and NOX4, and increased the protein expression of Bcl-2. ConclusionRoux-en-Y gastric bypass surgery can improve kidney function and the pathological damage of diabetes rats, its mechanism may be related to inhibition the protein expressions of TGF-β1, ICAM-1, and NOX4, and increase the protein expression of Bcl-2.
ObjectiveTo investigate the changes of amount of interstitial cells of Cajal (ICC) and expression of stem cell factor (SCF)/c-Kit in the process of cathartic colon induced by emodin in mice. MethodsA modified cathartic colon mouse model was established. Seventy-two healthy male Kunming (KM) mice were randomly divided into the blank control group and sustained drug delivery group.Morphological changes of colon in mice were observed; frozen section immunofluorescence was used to observed changes of amount of ICC; serum concentrations of SCF were examined by ELISA; Western blot was employed for observation of expression of SCF/c-Kit in colon. ResultsAfter the mice model were completed, the weight of mouse, length and diameter of entire colon were all reduced compared with the blank control group. The amount of ICC appeared to decline in the beginning of the first 6 weeks with emodin used, and significant decreased in 10-12 weeks. The serum concentrations of SCF first began to decline in 4 weeks with emodin used, and significantly decreased in 6 weeks, and continued at a low level after 8 weeks. The expression of c-Kit in colon began to decline in 4 weeks with emodin used and significantly reduced after 8 weeks. Conciusions The amount of ICC appear to slowly decline in the beginning of the first 12 weeks with emodin used, and significant decrease after 12 weeks.The serum concentrations of SCF and expression of c-Kit in colon have the dynamic changes in the meanwhile, and the changes of SCF are earlier than that of c-Kit. The trend of amount ofICC may have a certain relationship with changes of SCF and c-Kit.