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合并肥胖的胃食管反流病外科策略选择 被引量:3
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作者 朱乾坤 任海洋 +1 位作者 李小东 翟博 《世界华人消化杂志》 CAS 2020年第2期43-49,共7页
胃食管反流病(gastroesophageal reflux disease,GERD)和肥胖均已经成为影响全球健康的严重问题.对于合并肥胖的GERD患者的外科治疗策略选择仍是临床诊疗工作的难点,特别是肥胖加剧了GERD发生,而单纯的抗反流手术对肥胖病人疗效有限,目... 胃食管反流病(gastroesophageal reflux disease,GERD)和肥胖均已经成为影响全球健康的严重问题.对于合并肥胖的GERD患者的外科治疗策略选择仍是临床诊疗工作的难点,特别是肥胖加剧了GERD发生,而单纯的抗反流手术对肥胖病人疗效有限,目前减重手术是治疗这类患者的较好选择.Roux-en-Y胃旁路术是这类患者的最佳选择.对于术后复发患者的修正手术仍有待规范.另外,近年来不断兴起的新型抗反流减重手术,有望成为合并肥胖的GERD患者的有效替代治疗措施. 展开更多
关键词 胃食管反流病 肥胖 减重代谢手术 抗反流手术
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TLR4-HMGB1-, MyD88- and TRIF-dependent signaling in mouse intestinal ischemia/reperfusion injury 被引量:10
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作者 Jie Wang Gui-Zhen He +3 位作者 Yu-Kang Wang qian-kun zhu Wei Chen Tai Guo 《World Journal of Gastroenterology》 SCIE CAS 2015年第27期8314-8325,共12页
AIM: To characterize high-mobility group protein 1-toll-like receptor 4(HMGB1-TLR4) and downstream signaling pathways in intestinal ischemia/reperfusion(I/R) injury.METHODS: Forty specific-pathogen-free male C57BL/6 m... AIM: To characterize high-mobility group protein 1-toll-like receptor 4(HMGB1-TLR4) and downstream signaling pathways in intestinal ischemia/reperfusion(I/R) injury.METHODS: Forty specific-pathogen-free male C57BL/6 mice were randomly divided into five groups(n = 8 per group): sham, control, anti-HMGB1, anti-myeloid differentiation gene 88(My D88), and anti-translocatingchain-associating membrane protein(TRIF) antibody groups. Vehicle with the control Ig G antibody, antiHMGB1, anti-My D88, or anti-TRIF antibodies(all 1 mg/kg, 0.025%) were injected via the caudal vein 30 min prior to ischemia. After anesthetization, the abdominal wall was opened and the superior mesenteric artery was exposed, followed by 60 min mesenteric ischemia and then 60 min reperfusion. For the sham group, the abdominal wall was opened for 120 min without I/R. Levels of serum nuclear factor(NF)-κB p65, interleukin(IL)-6, and tumor necrosis factor(TNF)-α were measured, along with myeloperoxidase activity in the lung and liver. Inaddition,morphologic changes that occurred in the lung and intestinal tissues were evaluated. Levels of m RNA transcripts encoding HMGB1 and NF-κB were measured by real-time quantitative PCR, and levels of HMGB1 and NF-κB protein were measured by Western blot. Results were analyzed using one-way analysis of variance.RESULTS: Blocking HMGB 1, MyD 8 8, and TRIF expression by injecting anti-HMGB1, anti-My D88, or anti-TRIF antibodies prior to ischemia reduced the levels of inflammatory cytokines in serum; NF-κB p65: 104.64 ± 11.89, 228.53 ± 24.85, 145.00 ± 33.63, 191.12 ± 13.22, and 183.73 ± 10.81(P < 0.05); IL-6: 50.02 ± 6.33, 104.91 ± 31.18, 62.28 ± 6.73, 85.90 ± 17.37, and 78.14 ± 7.38(P < 0.05); TNF-α, 43.79 ± 4.18, 70.81 ± 6.97, 52.76 ± 5.71, 63.19 ± 5.47, and 59.70 ± 4.63(P < 0.05) for the sham, control, anti-HMGB1, anti-My D88, and anti-TRIF groups, respectively(all in pg/m L).Antibodies also alleviated tissue injury in the lung and small intestine compared with the control group in the mouse intestinal I/R model. The administration of antiHMGB1, anti-My D88, and anti-TRIF antibodies markedly reduced damage caused by I/R, for which anti-HMGB1 antibody had the most obvious effect.CONCLUSION: HMGB1 and its downstream signaling pathway play important roles in the mouse intestinal I/R injury, and the effect of the TRIF-dependent pathway is slightly greater. 展开更多
关键词 C57BL/6 MOUSE HIGH-MOBILITY group protein1 Intestinal ISCHEMIA-REPERFUSION injury MYELOID differentiationgene 88 Nuclear factor-κB translocatingchain-associating membrane protein
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如何安全的进行腹腔镜胆囊切除术?
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作者 任海洋 朱乾坤 翟博 《世界华人消化杂志》 CAS 2018年第35期2023-2028,共6页
腹腔镜胆囊切除术(laparoscopic cholecystectomy, LC)是现代微创外科的成功范式。当前已罕有愿意接受开放胆囊切除术的医生,乃至患者。在科学层面上LC已足够安全,但LC基数过于庞大,即便再低的并发症发生率也会是一组惊人的数字。 LC风... 腹腔镜胆囊切除术(laparoscopic cholecystectomy, LC)是现代微创外科的成功范式。当前已罕有愿意接受开放胆囊切除术的医生,乃至患者。在科学层面上LC已足够安全,但LC基数过于庞大,即便再低的并发症发生率也会是一组惊人的数字。 LC风险因素众多,而腹腔镜相关危险因素才是决策是否适合开展LC的关键。对不同类型的胆囊炎LC都较开放胆囊切除术具有微创优势,早期LC都值得考虑。探讨如何安全进行LC的问题,我们仍应强调恪守原则、注重细节、适时变通,考虑"延迟策略",意即在管道判别、管道离断等关键环节前都要容许反复辨别,能迟不早;组织游离过程中也要对扶镜助手有所等待迁就,及时调整,从而避免定式思维、重叠视野下的误判! 展开更多
关键词 胆囊切除术 腹腔镜 安全
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