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陈氏贯穿纵向“U”型胰肠吻合术的理论与实践 被引量:10
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作者 陈勇军 尹新民 +8 位作者 吴河水 袁玉峰 李德宇 闵军 杨智勇 李汉军 江斌 廖晓锋 张必翔 《中国实用外科杂志》 CAS CSCD 北大核心 2021年第6期668-672,共5页
华中科技大学同济医学院附属同济医院陈孝平院士在深入的理论和临床研究基础上,创建了一种贯穿纵向“U”型胰肠吻合术。该术式通过全层贯穿胰腺实质和肠壁的间断交锁“U”型缝合或者连续缝合,将胰腺断端的主胰管、副胰管、小叶导管引流... 华中科技大学同济医学院附属同济医院陈孝平院士在深入的理论和临床研究基础上,创建了一种贯穿纵向“U”型胰肠吻合术。该术式通过全层贯穿胰腺实质和肠壁的间断交锁“U”型缝合或者连续缝合,将胰腺断端的主胰管、副胰管、小叶导管引流的胰液全部引流入肠腔内无遗漏。经过多家大通量胰腺外科中心的大样本临床病例验证,该术式操作简便,能显著降低术后胰瘘和出血的发生率,在临床上得到了广泛应用,是一种能有效降低胰腺消化道重建术后胰瘘、出血等严重并发症发生率的吻合技术,适用于各种类型的胰腺残端。 展开更多
关键词 陈氏吻合术 胰肠吻合 近端胰腺切除术
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Endogenous danger signals trigger hepatic ischemia/reperfusion injury through toll-like receptor 4/nuclear factor-kappa B pathway 被引量:25
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作者 WANG Hui LI Zhuo-ya +4 位作者 wu he-shui WANG Yang JIANG Chun-fang ZHENG Qi-chang ZHANG Jin-xiang 《Chinese Medical Journal》 SCIE CAS CSCD 2007年第6期509-514,共6页
Background Restoration of blood flow to the ischemic liver lobes may paradoxically exacerbate tissue injury, which is called hepatic ischemia/reperfusion injury (IRI). Toll-like receptor 4 (TLR4), expressed on sev... Background Restoration of blood flow to the ischemic liver lobes may paradoxically exacerbate tissue injury, which is called hepatic ischemia/reperfusion injury (IRI). Toll-like receptor 4 (TLR4), expressed on several liver cell types, and the nuclear factor-kappa B (NF-KB) signaling pathway are crucial to mediating hepatic inflammatory response. Because IRI is essentially a kind of profound acute inflammatory reaction evoked by many kinds of danger signals, we investigated TLR4/NF-KB signaling pathway activation in a murine model of partial hepatic IRI. Methods Wild-type mice (WT, C3H/HeN) or TLR4 mutant mice (C3H/HeJ) were subjected to 45 minutes of partial hepatic ischemia followed by 1 hour, 3 hours of reperfusion. Sham group accepted the same procedure without the obstruction of blood supply. At the end of reperfusion, the compromise of liver function and the histological change of liver sections were measured as the severity of liver injury. The level of endotoxin in the portal vein was measured by limulus assay. NF-KB activation was determined by electrophoretic mobility shift assay (EMSA). The levels of tumor necrosis factor-a (TNF-a) and intedeukin-1β (IL-1β) in systemic blood after hepatic IRI were assessed by enzyme-linked immunosorbent assay (ELISA). Results The compromise of liver function and the morphological injuries in mutant mice were relieved more markedly than those in WT mice after partial hepatic IRI. NF-KB activation in WT mice was stronger than that in TLR4 mutant mice, and both were stronger than those in the sham operated mice (P〈0.01). Endotoxin in each group was undetectable. The levels of TNF-α and IL-1β in systemic blood were elevated in both strains, but lower in the sham operated group. These mediators were significantly decreased in TLR4 mutant mice compared with those in WT mice (P〈0.01). Conclusions The TLR4/NF-KB signaling pathway may mediate hepatic IRI triggered by endogenous danger signals. Inhibition of the TLR4/NF-KB pathway may be a potential therapeutic target for attenuating ischemia/reperfusion-induced tissue damage in some clinical settings. 展开更多
关键词 LIVER reperfusion injury toll-like receptor 4 ENDOTOXINS nuclear factor-kappa B
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