MM： Persistent cholestasis is a rare complication of severe trauma or infections. Little is known about the possible pathomechanisms and the clinical course.METHODS： Secondary sclerosing cholangitis was diagnosed in...MM： Persistent cholestasis is a rare complication of severe trauma or infections. Little is known about the possible pathomechanisms and the clinical course.METHODS： Secondary sclerosing cholangitis was diagnosed in five patients with persistent jaundice after severe trauma （one burn injury, three accidents, one power current injury）. Medical charts were retrospectively reviewed with regard to possible trigger mechanisms for cholestasis, and the clinical course was recorded.RESULTS： Diagnosis of secondary sclerosing cholangitis was based in all patients on the primary sclerosing cholangitis （PSC）-Iike destruction of the intrahepatic bile ducts at cholangiography after exclusion of PSC. In four patients, arterial hypotension with subsequent ischemia may have caused the bile duct damage, whereas in the case of power current injury direct thermal damage was assumed to be the trigger mechanism. The course of secondary liver fibrosis was rapidly progressive and proceeded to liver cirrhosis in all four patients with a follow-up 〉2 years. Therapeutic possibilities were limited.CONCLUSION： Posttraumatic sderosing cholangitis is a rare but rapidly progressive disease, probably caused by ischemia of the intrahepatic bile ducts via the peribiliary capillary plexus due to arterial hypotension.Gastroenterologists should be aware of this disease in patients with persistent cholestasis after severe trauma.展开更多
Objectives To explore the feasibility, safety and efficacy of transmyocardial stent to treat acute myocardial infarction. Methods 24 Chinese mini swines have been divided into 2 groups randomly：group myocardial infar...Objectives To explore the feasibility, safety and efficacy of transmyocardial stent to treat acute myocardial infarction. Methods 24 Chinese mini swines have been divided into 2 groups randomly：group myocardial infarction （group MI n1 = 14） and group transmyocardial stent（group ST n2 = 10）. In group MI, acute myocardial infarction animal model has been established by the ligation of the left descending coronary artery. In group ST, after the establishment of the model, 3 transmyocardial stents were implanted. 4 weeks later, echocardiography and pathological analysis have been done. Results The density of blood vessel in group ST is 6.47 ± 0.60/HP which is significandy higher than the group MI. At the same time, left ventricular ejection fraction and regional wall motion score index （WMSI） in group ST are ameliorated significandy compared with group MI. Conclusion It is feasible and safe to implant transmyocardial stents in acute myocardial infarction model. Although the channel can＇ t remain patent in long term, the prolonged stimulation can cause moderate-serious inflammatory reaction and proficient angiogenesis.展开更多
文摘MM： Persistent cholestasis is a rare complication of severe trauma or infections. Little is known about the possible pathomechanisms and the clinical course.METHODS： Secondary sclerosing cholangitis was diagnosed in five patients with persistent jaundice after severe trauma （one burn injury, three accidents, one power current injury）. Medical charts were retrospectively reviewed with regard to possible trigger mechanisms for cholestasis, and the clinical course was recorded.RESULTS： Diagnosis of secondary sclerosing cholangitis was based in all patients on the primary sclerosing cholangitis （PSC）-Iike destruction of the intrahepatic bile ducts at cholangiography after exclusion of PSC. In four patients, arterial hypotension with subsequent ischemia may have caused the bile duct damage, whereas in the case of power current injury direct thermal damage was assumed to be the trigger mechanism. The course of secondary liver fibrosis was rapidly progressive and proceeded to liver cirrhosis in all four patients with a follow-up 〉2 years. Therapeutic possibilities were limited.CONCLUSION： Posttraumatic sderosing cholangitis is a rare but rapidly progressive disease, probably caused by ischemia of the intrahepatic bile ducts via the peribiliary capillary plexus due to arterial hypotension.Gastroenterologists should be aware of this disease in patients with persistent cholestasis after severe trauma.
文摘Objectives To explore the feasibility, safety and efficacy of transmyocardial stent to treat acute myocardial infarction. Methods 24 Chinese mini swines have been divided into 2 groups randomly：group myocardial infarction （group MI n1 = 14） and group transmyocardial stent（group ST n2 = 10）. In group MI, acute myocardial infarction animal model has been established by the ligation of the left descending coronary artery. In group ST, after the establishment of the model, 3 transmyocardial stents were implanted. 4 weeks later, echocardiography and pathological analysis have been done. Results The density of blood vessel in group ST is 6.47 ± 0.60/HP which is significandy higher than the group MI. At the same time, left ventricular ejection fraction and regional wall motion score index （WMSI） in group ST are ameliorated significandy compared with group MI. Conclusion It is feasible and safe to implant transmyocardial stents in acute myocardial infarction model. Although the channel can＇ t remain patent in long term, the prolonged stimulation can cause moderate-serious inflammatory reaction and proficient angiogenesis.
