目的:通过比较不同模型建立方法,筛选制备高效、可靠的胆囊胆固醇结石动物模型。方法:将36只5周龄SPF级雄性ICR小鼠随机分为对照组、2%高脂组、1%胆固醇组,每组各12只。对照组采用普通颗粒饲料喂养,2%高脂组采用2%高脂饲料喂养,1%胆固...目的:通过比较不同模型建立方法,筛选制备高效、可靠的胆囊胆固醇结石动物模型。方法:将36只5周龄SPF级雄性ICR小鼠随机分为对照组、2%高脂组、1%胆固醇组,每组各12只。对照组采用普通颗粒饲料喂养,2%高脂组采用2%高脂饲料喂养,1%胆固醇组采用1%胆固醇饲料喂养。喂养16周,记录各组小鼠的死亡数量,计算存活率;观察并记录各组造模成功的小鼠数量及胆囊体积大小、胆汁的浑浊度、透光性等,计算小鼠成石率;ELISA法检测胆囊胆汁总胆固醇(total cholesterol,TC)、总胆汁酸(total bile acids,TBA)、磷脂(phospholipid,PL)及胆囊收缩素(cholecystokinin,CCK)的含量;HE染色观察小鼠胆囊、肝脏病理学变化。结果:对照组小鼠无死亡,胆囊大小正常,胆囊壁结构正常,胆汁澄清透亮,透光性好,胆囊内无沉淀;肝脏细胞排列整齐,结构完整。2%高脂组小鼠死亡1只,胆囊壁肌层变厚,浆膜结构及形态破坏,胆汁呈浑浊状态,透光性差,成石率为66.67%;肝脏细胞结构破坏严重,可见大量脂质空泡,肝脏存在明显的脂肪变性。1%胆固醇组小鼠死亡1只,胆囊体积明显增大,胆囊壁肌层毛糙、增厚,浆膜结构及形态破坏严重,胆汁呈褐色浑浊状态,透光性差,成石率约为83.33%;肝细胞排列紊乱,细胞结构破坏,肝脏出现小的脂质空泡。与对照组比较,2%高脂组和1%胆固醇组胆汁内TC含量升高,胆汁TBA、PL、CCK含量降低;与2%高脂组比较,1%胆固醇组胆汁TC、CCK含量降低,胆汁内TB、PL含量升高,差异均有统计学意义(P<0.01)。结论:1%胆固醇饲料喂养建立胆囊胆固醇结石动物模型效果最好,可作为胆囊胆固醇结石相关研究的备选模型。展开更多
Background:Whether the extra-hepatic bile duct(EHBD)should be routinely resected for gallbladder carcinoma(GBC)remains controversial.The current study aimed to determine the clinical impact of combined EHBD resection ...Background:Whether the extra-hepatic bile duct(EHBD)should be routinely resected for gallbladder carcinoma(GBC)remains controversial.The current study aimed to determine the clinical impact of combined EHBD resection during curative surgery for advanced GBC.Methods:In total,213 patients who underwent curative surgery for T2,T3 or T4 GBC were enrolled.The clinicopathological features were compared between the patients treated with EHBD resection and those without EHBD resection.Meanwhile,univariable and multivariable Cox-proportional hazards regression models were used to identify risk factors for overall survival(OS).Results:Among the 213 patients identified,87(40.8%)underwent combined EHBD resection.Compared with patients without EHBD resection,patients with EHBD resection suffered more post-operative complications(33.3%vs.21.4%,P=0.046).However,the median OS of the EHBD resection group was longer than that of the non-EHBD resection group(25 vs.11 months,P=0.008).Subgroup analyses were also performed according to tumor(T)category and lymph-node metastasis.The median OS was significantly longer in the EHBD resection group than in the non-EHBD resection group for patients with T3 lesion(15 vs.7 months,P=0.002),T4 lesion(11 vs.6 months,P=0.021)or lymph-node metastasis(12 vs.7 months,P<0.001).No survival benefit of EHBD resection was observed in GBC patients with T2 lesion or without lymph-node metastasis.T category,lymph-node metastasis,margin status,pre-operative CA19-9 level and EHBD resection were identified as independent prognostic factors for OS of patients with advanced GBC(all P values<0.05).Conclusions EHBD resection can independently affect the OS in advanced GBC.For GBC patients with T3 lesion,T4 lesion and lymph-node metastasis,combined EHBD resection is justified and may improve OS.展开更多
文摘目的:通过比较不同模型建立方法,筛选制备高效、可靠的胆囊胆固醇结石动物模型。方法:将36只5周龄SPF级雄性ICR小鼠随机分为对照组、2%高脂组、1%胆固醇组,每组各12只。对照组采用普通颗粒饲料喂养,2%高脂组采用2%高脂饲料喂养,1%胆固醇组采用1%胆固醇饲料喂养。喂养16周,记录各组小鼠的死亡数量,计算存活率;观察并记录各组造模成功的小鼠数量及胆囊体积大小、胆汁的浑浊度、透光性等,计算小鼠成石率;ELISA法检测胆囊胆汁总胆固醇(total cholesterol,TC)、总胆汁酸(total bile acids,TBA)、磷脂(phospholipid,PL)及胆囊收缩素(cholecystokinin,CCK)的含量;HE染色观察小鼠胆囊、肝脏病理学变化。结果:对照组小鼠无死亡,胆囊大小正常,胆囊壁结构正常,胆汁澄清透亮,透光性好,胆囊内无沉淀;肝脏细胞排列整齐,结构完整。2%高脂组小鼠死亡1只,胆囊壁肌层变厚,浆膜结构及形态破坏,胆汁呈浑浊状态,透光性差,成石率为66.67%;肝脏细胞结构破坏严重,可见大量脂质空泡,肝脏存在明显的脂肪变性。1%胆固醇组小鼠死亡1只,胆囊体积明显增大,胆囊壁肌层毛糙、增厚,浆膜结构及形态破坏严重,胆汁呈褐色浑浊状态,透光性差,成石率约为83.33%;肝细胞排列紊乱,细胞结构破坏,肝脏出现小的脂质空泡。与对照组比较,2%高脂组和1%胆固醇组胆汁内TC含量升高,胆汁TBA、PL、CCK含量降低;与2%高脂组比较,1%胆固醇组胆汁TC、CCK含量降低,胆汁内TB、PL含量升高,差异均有统计学意义(P<0.01)。结论:1%胆固醇饲料喂养建立胆囊胆固醇结石动物模型效果最好,可作为胆囊胆固醇结石相关研究的备选模型。
基金supported by the grant from the Science&Technology Support Project of Sichuan Province(No.2018JY0019).
文摘Background:Whether the extra-hepatic bile duct(EHBD)should be routinely resected for gallbladder carcinoma(GBC)remains controversial.The current study aimed to determine the clinical impact of combined EHBD resection during curative surgery for advanced GBC.Methods:In total,213 patients who underwent curative surgery for T2,T3 or T4 GBC were enrolled.The clinicopathological features were compared between the patients treated with EHBD resection and those without EHBD resection.Meanwhile,univariable and multivariable Cox-proportional hazards regression models were used to identify risk factors for overall survival(OS).Results:Among the 213 patients identified,87(40.8%)underwent combined EHBD resection.Compared with patients without EHBD resection,patients with EHBD resection suffered more post-operative complications(33.3%vs.21.4%,P=0.046).However,the median OS of the EHBD resection group was longer than that of the non-EHBD resection group(25 vs.11 months,P=0.008).Subgroup analyses were also performed according to tumor(T)category and lymph-node metastasis.The median OS was significantly longer in the EHBD resection group than in the non-EHBD resection group for patients with T3 lesion(15 vs.7 months,P=0.002),T4 lesion(11 vs.6 months,P=0.021)or lymph-node metastasis(12 vs.7 months,P<0.001).No survival benefit of EHBD resection was observed in GBC patients with T2 lesion or without lymph-node metastasis.T category,lymph-node metastasis,margin status,pre-operative CA19-9 level and EHBD resection were identified as independent prognostic factors for OS of patients with advanced GBC(all P values<0.05).Conclusions EHBD resection can independently affect the OS in advanced GBC.For GBC patients with T3 lesion,T4 lesion and lymph-node metastasis,combined EHBD resection is justified and may improve OS.
