In order to explore the effect of binary tract pressure on Oddi's sphincter and the mechanism of development of high pressure of binary tract during acute obstructive and suppurative cholangitis (AOSC), house rab...In order to explore the effect of binary tract pressure on Oddi's sphincter and the mechanism of development of high pressure of binary tract during acute obstructive and suppurative cholangitis (AOSC), house rabbits were used to establish model of high binary pressure in acute binary duct caecus. It was observed that when the pressure of the acute binary tract was increased to 8 kpa,the electric activity of Oddi's sphincter was obviously enhanced, the pressure of Oddices sphincter increased remarkably (P <0. 05), and even constant spasm appeared with accompanying increase of discharge frequency of the right greater splanchnic nerves (P <0. 05) and progressive decrease of mean arterial pressure.However, when lidocaine of 0. 6 % was used to block the right celiac plexus, no above-mentioned reaction happened when the binary tract pressure was increased again. The results indicated that the acute binary tract obstruction might induce the contraction or spasm of Oddi's sphincter and bring about a vicious cycle. Its mechanism is related to splanchnic nerves reflection and it is one of important factors in the development of AOSC course.展开更多
AIM:The rote of the sphincter of Oddi(SO)in ethanol (ETOH)-induced pancreatitis is controversial.Our aim was to characterise the effect of E-I-OH on basal and stimulated SO motility. METHODS:SOs removed from white rab...AIM:The rote of the sphincter of Oddi(SO)in ethanol (ETOH)-induced pancreatitis is controversial.Our aim was to characterise the effect of E-I-OH on basal and stimulated SO motility. METHODS:SOs removed from white rabbits were placed in an organ bath(Krebs solution,pH7.4,37℃).The effects of 2 mL/L,4 mL/L,6 mL/L and 8 mL/L of ETOH on the contractile responses of the sphincter were determined. SOs were stimulated with either 0.1 μmol/L carbachol,1 μmol/L erythromycin or 0.1 μmol/L cholecystokinin(CCK). RESULTS:ETOH at a dose of 4 mL/L significantly decreased the baseline contractile amplitude from 11.98±0.05 mN to 11.19±0.07 mN.However,no significant changes in the contractile frequency were observed.ETOH(0.6%) significantly decreased both the baseline amplitude and the frequency compared to the control group(10.50±0.01 mN, 12.13±0.10 mN and 3.53±0.13 c/min,5.5±0.13 cycles(c)/min, respectively).Moreover,0.8% of ETOH resulted in complete relaxation of the SO.Carbachol(0.1 μmol/L)or erythromycin (1 μmol/L)stimulated the baseline amplitudes(by 82% and 75%,respectively)and the contractile frequencies (by 150% and 106%,respectively).In the carbachol or erythromydn-stimulated groups 2-6 mL/L of E-IOH significantly inhibited both the amplitude and the frequency.Interestingly, a 4-5 min administration of 6 mL/L ETOH suddenly and completely relaxed the SO.CCK(0.1 μmol/L)stimulated the baseline amplitude from 12.37±0.05 mN to 27.40±1.82 mN within 1.60±0.24 min.After this peak,the amplitude decreased to 17.17±0.22 mN and remained constant during the experiment.The frequency peaked at 12.8±0.2 c/min, after which the constant frequency was 9.43±0.24 c/min throughout the rest of the experiment.ETOH at a dose of 4 mL/L significantly decreased the amplitude from 16.13±0.23 mN to 14.93±0.19 mN.However,no significant changes in the contractile frequency were observed.ETOH at a dose of 6 mL/L inhibited both the amplitudes and the frequencies in the CCK-stimulated group,while 8 mL/L of ETOH completely relaxed the SO. CONCLUSION:ETOH strongly inhibits the basal,carbachol, erythromycin,and CCK-stimulated rabbit SO motility. Therefore,it is possible that during alcohol-intake the relaxed SO opens the way for pancreatic fluid to flow out into the duodenum in rabbits.This relaxation of the SO may protect the pancreas against alcohol-induced damage.展开更多
BACKGROUND Robotic surgery is a cutting-edge minimally invasive technique that overcomes many shortcomings of laparoscopic techniques,yet few studies have evaluated the use of robotic surgery to treat Hirschsprung’s ...BACKGROUND Robotic surgery is a cutting-edge minimally invasive technique that overcomes many shortcomings of laparoscopic techniques,yet few studies have evaluated the use of robotic surgery to treat Hirschsprung’s disease(HSCR).AIM To analyze the feasibility and medium-term outcomes of robotic-assisted proctosigmoidectomy(RAPS)with sphincter-and nerve-sparing surgery in HSCR patients.METHODS From July 2015 to January 2022,156 rectosigmoid HSCR patients were enrolled in this multicenter prospective study.Their sphincters and nerves were spared by dissecting the rectum completely from the pelvic cavity outside the longitudinal muscle of the rectum and then performing transanal Soave pull-through procedures.Surgical outcomes and continence function were analyzed.RESULTS No conversions or intraoperative complications occurred.The median age at surgery was 9.50 months,and the length of the removed bowel was 15.50±5.23 cm.The total operation time,console time,and anal traction time were 155.22±16.77,58.01±7.71,and 45.28±8.15 min.There were 25 complications within 30 d and 48 post-30-d complications.For children aged≥4 years,the bowel function score(BFS)was 17.32±2.63,and 90.91%of patients showed moderate-to-good bowel function.The postoperative fecal continence(POFC)score was 10.95±1.04 at 4 years of age,11.48±0.72 at 5 years of age,and 11.94±0.81 at 6 years of age,showing a promising annual trend.There were no significant differences in postoperative complications,BFS,and POFC scores related to age at surgery being≤3 mo or>3 mo.CONCLUSION RAPS is a safe and effective alternative for treating HSCR in children of all ages;it offers the advantage of further minimizing damage to sphincters and perirectal nerves and thus providing better continence function.展开更多
[目的]了解芍药甙对家兔离体Oddi括约肌(sphincter of Oddi,SO)肌环收缩活动的影响。[方法]制备离体兔Oddi括约肌肌环标本,放置于平滑肌恒温灌流浴槽中,观察累积浓度芍药甙对乙酰胆碱(Ach)预收缩(乙酰胆碱组)的SO肌环的作用和芍药甙对...[目的]了解芍药甙对家兔离体Oddi括约肌(sphincter of Oddi,SO)肌环收缩活动的影响。[方法]制备离体兔Oddi括约肌肌环标本,放置于平滑肌恒温灌流浴槽中,观察累积浓度芍药甙对乙酰胆碱(Ach)预收缩(乙酰胆碱组)的SO肌环的作用和芍药甙对经无钙液(无钙液组)、无钙液加肝素(肝素组)预处理的SO肌环的作用。[结果]当芍药甙浓度累积达(12.5、25、50、100)μmol/L时,对Ach(10-6mol/L)预收缩的SO肌环产生剂量依赖性舒张作用(P<0.05)。经无钙液预处理后,芍药甙(100μmol/L)对SO肌环的舒张作用未被阻断;但经无钙液加肝素预处理后,该作用被明显抑制。[结论]芍药甙对Oddi括约肌具有舒张作用。其机制可能与阻断平滑肌细胞内质网上的三磷酸肌醇敏感的钙离子通道,抑制内钙的释放有关。展开更多
Gastroesophageal reflux disease (GERD) affects an estimated 20% of the population in the United States. About 10%-15% of patients with GERD develop Barrett’s esophagus, which can progress to adenocarcinoma, currently...Gastroesophageal reflux disease (GERD) affects an estimated 20% of the population in the United States. About 10%-15% of patients with GERD develop Barrett’s esophagus, which can progress to adenocarcinoma, currently the most prevalent type of esophageal cancer. The esophagus is normally lined by squamous mucosa, therefore, it is clear that for adenocarcinoma to develop, there must be a sequence of events that result in transformation of the normal squamous mucosa into columnar epithelium. This sequence begins with gastroesophageal reflux, and with continued injury metaplastic columnar epithelium develops. This article reviews the pathophysiology of Barrett’s esophagus and implications for its treatment. The effect of medical and surgical therapy of Barrett’s esophagus is compared.展开更多
文摘In order to explore the effect of binary tract pressure on Oddi's sphincter and the mechanism of development of high pressure of binary tract during acute obstructive and suppurative cholangitis (AOSC), house rabbits were used to establish model of high binary pressure in acute binary duct caecus. It was observed that when the pressure of the acute binary tract was increased to 8 kpa,the electric activity of Oddi's sphincter was obviously enhanced, the pressure of Oddices sphincter increased remarkably (P <0. 05), and even constant spasm appeared with accompanying increase of discharge frequency of the right greater splanchnic nerves (P <0. 05) and progressive decrease of mean arterial pressure.However, when lidocaine of 0. 6 % was used to block the right celiac plexus, no above-mentioned reaction happened when the binary tract pressure was increased again. The results indicated that the acute binary tract obstruction might induce the contraction or spasm of Oddi's sphincter and bring about a vicious cycle. Its mechanism is related to splanchnic nerves reflection and it is one of important factors in the development of AOSC course.
基金Supported by The Wellcome Trust (Grant No.022618),and by the Hungarian Scientific Research Fund (D42188,T43066 and T042589)
文摘AIM:The rote of the sphincter of Oddi(SO)in ethanol (ETOH)-induced pancreatitis is controversial.Our aim was to characterise the effect of E-I-OH on basal and stimulated SO motility. METHODS:SOs removed from white rabbits were placed in an organ bath(Krebs solution,pH7.4,37℃).The effects of 2 mL/L,4 mL/L,6 mL/L and 8 mL/L of ETOH on the contractile responses of the sphincter were determined. SOs were stimulated with either 0.1 μmol/L carbachol,1 μmol/L erythromycin or 0.1 μmol/L cholecystokinin(CCK). RESULTS:ETOH at a dose of 4 mL/L significantly decreased the baseline contractile amplitude from 11.98±0.05 mN to 11.19±0.07 mN.However,no significant changes in the contractile frequency were observed.ETOH(0.6%) significantly decreased both the baseline amplitude and the frequency compared to the control group(10.50±0.01 mN, 12.13±0.10 mN and 3.53±0.13 c/min,5.5±0.13 cycles(c)/min, respectively).Moreover,0.8% of ETOH resulted in complete relaxation of the SO.Carbachol(0.1 μmol/L)or erythromycin (1 μmol/L)stimulated the baseline amplitudes(by 82% and 75%,respectively)and the contractile frequencies (by 150% and 106%,respectively).In the carbachol or erythromydn-stimulated groups 2-6 mL/L of E-IOH significantly inhibited both the amplitude and the frequency.Interestingly, a 4-5 min administration of 6 mL/L ETOH suddenly and completely relaxed the SO.CCK(0.1 μmol/L)stimulated the baseline amplitude from 12.37±0.05 mN to 27.40±1.82 mN within 1.60±0.24 min.After this peak,the amplitude decreased to 17.17±0.22 mN and remained constant during the experiment.The frequency peaked at 12.8±0.2 c/min, after which the constant frequency was 9.43±0.24 c/min throughout the rest of the experiment.ETOH at a dose of 4 mL/L significantly decreased the amplitude from 16.13±0.23 mN to 14.93±0.19 mN.However,no significant changes in the contractile frequency were observed.ETOH at a dose of 6 mL/L inhibited both the amplitudes and the frequencies in the CCK-stimulated group,while 8 mL/L of ETOH completely relaxed the SO. CONCLUSION:ETOH strongly inhibits the basal,carbachol, erythromycin,and CCK-stimulated rabbit SO motility. Therefore,it is possible that during alcohol-intake the relaxed SO opens the way for pancreatic fluid to flow out into the duodenum in rabbits.This relaxation of the SO may protect the pancreas against alcohol-induced damage.
基金Supported by the National Health and Family Planning of China,No.201402007the National Natural Science Foundation of China,No.81873848 and No.82170528.
文摘BACKGROUND Robotic surgery is a cutting-edge minimally invasive technique that overcomes many shortcomings of laparoscopic techniques,yet few studies have evaluated the use of robotic surgery to treat Hirschsprung’s disease(HSCR).AIM To analyze the feasibility and medium-term outcomes of robotic-assisted proctosigmoidectomy(RAPS)with sphincter-and nerve-sparing surgery in HSCR patients.METHODS From July 2015 to January 2022,156 rectosigmoid HSCR patients were enrolled in this multicenter prospective study.Their sphincters and nerves were spared by dissecting the rectum completely from the pelvic cavity outside the longitudinal muscle of the rectum and then performing transanal Soave pull-through procedures.Surgical outcomes and continence function were analyzed.RESULTS No conversions or intraoperative complications occurred.The median age at surgery was 9.50 months,and the length of the removed bowel was 15.50±5.23 cm.The total operation time,console time,and anal traction time were 155.22±16.77,58.01±7.71,and 45.28±8.15 min.There were 25 complications within 30 d and 48 post-30-d complications.For children aged≥4 years,the bowel function score(BFS)was 17.32±2.63,and 90.91%of patients showed moderate-to-good bowel function.The postoperative fecal continence(POFC)score was 10.95±1.04 at 4 years of age,11.48±0.72 at 5 years of age,and 11.94±0.81 at 6 years of age,showing a promising annual trend.There were no significant differences in postoperative complications,BFS,and POFC scores related to age at surgery being≤3 mo or>3 mo.CONCLUSION RAPS is a safe and effective alternative for treating HSCR in children of all ages;it offers the advantage of further minimizing damage to sphincters and perirectal nerves and thus providing better continence function.
文摘[目的]了解芍药甙对家兔离体Oddi括约肌(sphincter of Oddi,SO)肌环收缩活动的影响。[方法]制备离体兔Oddi括约肌肌环标本,放置于平滑肌恒温灌流浴槽中,观察累积浓度芍药甙对乙酰胆碱(Ach)预收缩(乙酰胆碱组)的SO肌环的作用和芍药甙对经无钙液(无钙液组)、无钙液加肝素(肝素组)预处理的SO肌环的作用。[结果]当芍药甙浓度累积达(12.5、25、50、100)μmol/L时,对Ach(10-6mol/L)预收缩的SO肌环产生剂量依赖性舒张作用(P<0.05)。经无钙液预处理后,芍药甙(100μmol/L)对SO肌环的舒张作用未被阻断;但经无钙液加肝素预处理后,该作用被明显抑制。[结论]芍药甙对Oddi括约肌具有舒张作用。其机制可能与阻断平滑肌细胞内质网上的三磷酸肌醇敏感的钙离子通道,抑制内钙的释放有关。
文摘Gastroesophageal reflux disease (GERD) affects an estimated 20% of the population in the United States. About 10%-15% of patients with GERD develop Barrett’s esophagus, which can progress to adenocarcinoma, currently the most prevalent type of esophageal cancer. The esophagus is normally lined by squamous mucosa, therefore, it is clear that for adenocarcinoma to develop, there must be a sequence of events that result in transformation of the normal squamous mucosa into columnar epithelium. This sequence begins with gastroesophageal reflux, and with continued injury metaplastic columnar epithelium develops. This article reviews the pathophysiology of Barrett’s esophagus and implications for its treatment. The effect of medical and surgical therapy of Barrett’s esophagus is compared.
