The study aimed to retrospectively evaluate surgical treatment outcomes after delayed parotid gland and duct injuries. Nine patients subjected to parotid gland and duct injuries with l- to 3-month treatment delay were...The study aimed to retrospectively evaluate surgical treatment outcomes after delayed parotid gland and duct injuries. Nine patients subjected to parotid gland and duct injuries with l- to 3-month treatment delay were retrospectively evaluated with special reference of etiology, past medical history, and injury location. Conservative treatment, microsurgical anastomosis, and diversion of salivary flow or ligation were chosen for delayed parotid gland and duct injuries concerning to their site of injury, time of repair and procedures. Assistant treatment as pressure dressing was adopted thereafter. All patients experienced an uneventful recovery at the time of finalizing the study. Two patients received Stensen＇s duct ligation, 5 received microsurgical anastomosis and 2 accepted salivary flow diversion for 5 patients with sialoceles and 4 patients with fistulas, and no re-occurrence was found. Facial paralysis occurred after surgery in 4 patients, and 3 of them recovered after the nerve nutrition treatment. Our study suggested that appropriate surgical treatment is efficient for the re-establishment of the tissue function and facial aesthetic for delayed injury of the parotid and its duct.展开更多
Vanishing bile duct syndrome (VBDS) has been described in different pathologic conditions including infection, ischemia, adverse drug reactions, autoimmune diseases, allograft rejection, and humoral factors associated...Vanishing bile duct syndrome (VBDS) has been described in different pathologic conditions including infection, ischemia, adverse drug reactions, autoimmune diseases, allograft rejection, and humoral factors associated with malignancy. It is an acquired condition characterized by progressive destruction and loss of the intra-hepatic bile ducts leading to cholestasis. Prognosis is variable and partially dependent upon the etiology of bile duct injury. Irreversible bile duct loss leads to significant ductopenia, biliary cirrhosis, liver failure, and death. If biliary epithelial regeneration occurs, clinical recovery may occur over a period of months to years. VBDS has been described in a number of cases of patients with Hodgkin’s lymphoma (HL) where it is thought to be a paraneoplastic phenomenon. This case describes a 25-year-old man found on liver biopsy to have VBDS. Given poor response to medical treatment, the patient underwent transplant evaluation at that time and was found to have classical stage IIB HL. Early recognition of this underlying cause or association of VBDS, including laboratory screening, and physical exam for lymphadenopathy are paramount to identifying potential underlying VBDS-associated malignancy. Here we review the literature of HL-associated VBDS and report a case of diagnosed HL with biopsy proven VBDS.展开更多
AIM:This paper describes the procedure of detection of Helicobacter pylori(H.pylori)in bile specimens in patients suffering from benign diseases of biliary ducts(lithiasis with/without nonspecific cholangitis). METHOD...AIM:This paper describes the procedure of detection of Helicobacter pylori(H.pylori)in bile specimens in patients suffering from benign diseases of biliary ducts(lithiasis with/without nonspecific cholangitis). METHODS:The group of 72 patients entering the study consisted of 32 male and 40 female(45 % and 55 %, respectively).Bile was obtained during ERCP in 68 patients, and during cholecystectomy in 4 patients.A fast urease test (FUT)to determine the existence of H.pylori in gastric mucosa was carried out for all the patients during the endoscopic examination.The existence of genetic material of H.pylori was determined by detection of ure A gene by the method of nested PCR.The results of this reaction were shown by electrophoresis on 10 g·L^(-1)agarose gel in a band of 256 bp. RESULTS:The majority of the patients included in our study had biliary lithiasis without signs of cholangitis(48 patients, 67 %),whereas other patients were complicated by cholangitis(17 patients,24 %).Seven patients(9 %)had normal ERCP,forming thus the control group.In the group of patients with lithiasis 26 patients(24.2 %)had positive PCR of H.pylori in bile and among the patients with associated cholangitis positive PCR was detected in 9 patients(52.9 %).Among the seven patients with normal ERCP only one(14 %)had positive PCR of H.pylori.A high percentage of H.pylori infection of gastric mucosa was observed(57 patients,79 %).It was also observed that its slightly higher positivity was in the patients with distinct bile pathology:81% FLIT positive patients in the group with choledocholithiasis alone and 76 % in the group with choledocholithiasis associated with cholangitis.Seventy-one percent of the patients with regular findings had positive FUT.CONCLUSION: The prevalence of H. pylori infection both in bile and in gastric mucosa in patients with benign diseases of biliary ducts does not show a statistically significant difference in relation to the prevalence of the same with the patients with normal ERCP. The existence of H. pylori infection possibly does not play a role in pathogenesis of benign biliary diseases.展开更多
An electrohydrodynamic （EHD） method, which is based on glow discharge plasma, is presented for flow control in an S-shaped duct. The research subject is an expanding channel with a constant width and a rectangular c...An electrohydrodynamic （EHD） method, which is based on glow discharge plasma, is presented for flow control in an S-shaped duct. The research subject is an expanding channel with a constant width and a rectangular cross section. An equivalent divergence angle and basic function are introduced to build the three-dimensional model. Subsequently, the plasma physical models are simplified as the effects of electrical body force and work （done by the force） on the fluid near the wall. With the aid of FLUENT software, the source terms of momentum and energy are added to the Navier-Stokes equation. Finally, the original performance of three models （A, B and C） is studied, in which model A demonstrates better performance. Then EHD control based on model A is discussed. The results show that the EHD method is an effective way of reducing flow loss and improving uniformity at the duct exit. The innovation in this study is the assessment of the EHD control effect on the flow in an S-shaped duct. Both the parametric modeling of the S-shaped duct and the simplified models of plasma provide valuable information for future research on aircraft inlet ducts.展开更多
Presence of Courvoisier's or double duct signs in a jaundiced patient is suggestive of malignant obstruction of the pancreaticobiliary ductal system.The oncologic impact of the simultaneous occurrence of these sig...Presence of Courvoisier's or double duct signs in a jaundiced patient is suggestive of malignant obstruction of the pancreaticobiliary ductal system.The oncologic impact of the simultaneous occurrence of these signs on the survival of patients with periampullary cancer is unknown.We report a case of obstructive jaundice secondary to an ampullary cancer demonstrating the Courvoisier's sign on clinical examination and a double duct sign on imaging.The patient underwent a pancreaticoduodenectomy which confirmed an ampullary adenocarcinoma.展开更多
Turbine noise would be one of the dominant noise sources especially in future UHBR (Ultra High Bypass-Ratio) aeroengine, but its currently far from being studied enough. Acoustic mode is crucial for duct propagation b...Turbine noise would be one of the dominant noise sources especially in future UHBR (Ultra High Bypass-Ratio) aeroengine, but its currently far from being studied enough. Acoustic mode is crucial for duct propagation but little study about the relation between serration and mode. Thus, taking axial single-turbine test bench NPU-Turb as object, the effect of Stator with Serrated Trailing-edge (Bionic S) and Rotor with Serrated Leading-edge (Bionic R) on duct acoustic modes of turbine turbulence interac-tion noise were studied in detail using DDES/AA hybrid model validated by acoustic experiment of NPU-Turb. Serval conclusions can be made here. First, for broadband noise, the effect of serrations on duct modes (increased or reduced of PWL<sub>mn</sub>) with the increasing frequency is more prominent. Second, the changing trend of ?PWL<sub>mn</sub> is something like Chinese character “人” with circumferential mode m and alternating with radial mode. Such distribution is more obvious at higher frequency. More theoretical and mechanistic research work needs to be carried out in depth in the future. .展开更多
Geometry sensitivity of magnetohydrodynamics （MHD） duct flow and some ab- normal phenomena deviating from the classical MHD laws were measured in an experimental investigation of the MHD effect of the flow channel i...Geometry sensitivity of magnetohydrodynamics （MHD） duct flow and some ab- normal phenomena deviating from the classical MHD laws were measured in an experimental investigation of the MHD effect of the flow channel inserter （FCI） duct flow. The results showed that the velocity distribution deviated from the M-type profile on the centre-plane of the cross section of the duct with small slots （in short ＂S-duct＂）. The electric potential difference in the duct wall was much lower than that given by the classical electromagnetic laws. The MHD pres- sure drop was much higher than that from the classical magneto-hydrodynamics theory. These results may help us find some new methods to reduce the MHD pressure drop, or explore other potential applications such as flow structure control.展开更多
BACKGROUND Gynaecologists should be aware of a rare obstructive Mullerian duct abnormality like Robert’s uterus and perform further surgery when necessary.CASE SUMMARY We report a 41-year-old mother of two children w...BACKGROUND Gynaecologists should be aware of a rare obstructive Mullerian duct abnormality like Robert’s uterus and perform further surgery when necessary.CASE SUMMARY We report a 41-year-old mother of two children with Robert’s uterus who was examined and treated by laparoscopy and hysteroscopy.Unlike the existing cases reported in the literature,this patient had a late onset of Robert’s uterus symptoms.Due to right tubal ectopic pregnancy 3 years previously,the patient was treated with right salpingectomy and left tubal ligation but suffered aggravated left lower abdominal pain.She was examined and treated by laparoscopy and hysteroscopy,and is completely asymptomatic at 5-year followup.CONCLUSION The typical obstructive Mullerian abnormality requires further surgery.Combined laparoscopy and hysteroscopy is an effective,minimally invasive technique with better recovery outcomes than traditional transabdominal procedures.展开更多
Introduction: In bile duct injuries (BDI), cholestasis and cholangitis can alter the fibrinolytic system by promoting an increase of extracellular matrix depositions which favor an imbalance between metalloproteinases...Introduction: In bile duct injuries (BDI), cholestasis and cholangitis can alter the fibrinolytic system by promoting an increase of extracellular matrix depositions which favor an imbalance between metalloproteinases (MMPs) and their tissue inhibitors (TIMPs). Materials and Methods: Levels of PAI-1, MMP-3, MMP-8, TIMP-1 and TIMP-2 in 35 patients with post-cholecystectomy BDI by complete biliary obstruction were measured and compared to a healthy control group. Sirius red staining and immune staining for MMP-3 and MMP-8 were also undertaken in liver biopsies. Results: Levels of PAI-1, TIMP-1, TIMP-2 and MMP-8 were higher in BDI than healthy controls: 15 ± 2 ng/mL vs 7.1 ± 2 ng/mL (p 0.024);539 ± 64 ng/mL vs 256 ± 13 ng/mL (p p p 2 vs. 22865.7 ± 3865 μm2 in healthy controls (p 2 vs. 30744.2 ± 5810.2 μm2 (p 2 vs. 116337.9 ± 24803.3 μm2 (p 0.55). These results suggest an imbalance between fibrogenic/fibrinolytic protein levels. Interestingly, expression of the fibrinolytic protein MMP-8 was increased in serum and liver biopsies in BDI. Conclusion: We found an imbalance of profibrogenic molecules which promote extracellular matrix deposition. The over-expression of fibrinolytic proteins such as MMP-8 could limit liver fibrosis, preventing hepatic dysfunction in post-cholecystectomy BDI.展开更多
基金This project was supported by the National Natural Science Foundation of China （No. 81372879, No. 81672666）.
文摘The study aimed to retrospectively evaluate surgical treatment outcomes after delayed parotid gland and duct injuries. Nine patients subjected to parotid gland and duct injuries with l- to 3-month treatment delay were retrospectively evaluated with special reference of etiology, past medical history, and injury location. Conservative treatment, microsurgical anastomosis, and diversion of salivary flow or ligation were chosen for delayed parotid gland and duct injuries concerning to their site of injury, time of repair and procedures. Assistant treatment as pressure dressing was adopted thereafter. All patients experienced an uneventful recovery at the time of finalizing the study. Two patients received Stensen＇s duct ligation, 5 received microsurgical anastomosis and 2 accepted salivary flow diversion for 5 patients with sialoceles and 4 patients with fistulas, and no re-occurrence was found. Facial paralysis occurred after surgery in 4 patients, and 3 of them recovered after the nerve nutrition treatment. Our study suggested that appropriate surgical treatment is efficient for the re-establishment of the tissue function and facial aesthetic for delayed injury of the parotid and its duct.
基金Supported by National Institute of Health,NIH 5 T32 DK 7356-37(BN)
文摘Vanishing bile duct syndrome (VBDS) has been described in different pathologic conditions including infection, ischemia, adverse drug reactions, autoimmune diseases, allograft rejection, and humoral factors associated with malignancy. It is an acquired condition characterized by progressive destruction and loss of the intra-hepatic bile ducts leading to cholestasis. Prognosis is variable and partially dependent upon the etiology of bile duct injury. Irreversible bile duct loss leads to significant ductopenia, biliary cirrhosis, liver failure, and death. If biliary epithelial regeneration occurs, clinical recovery may occur over a period of months to years. VBDS has been described in a number of cases of patients with Hodgkin’s lymphoma (HL) where it is thought to be a paraneoplastic phenomenon. This case describes a 25-year-old man found on liver biopsy to have VBDS. Given poor response to medical treatment, the patient underwent transplant evaluation at that time and was found to have classical stage IIB HL. Early recognition of this underlying cause or association of VBDS, including laboratory screening, and physical exam for lymphadenopathy are paramount to identifying potential underlying VBDS-associated malignancy. Here we review the literature of HL-associated VBDS and report a case of diagnosed HL with biopsy proven VBDS.
基金Gastrointestinal Research Laboratory,Department of Medicine,University of Rostock,Germany
文摘AIM:This paper describes the procedure of detection of Helicobacter pylori(H.pylori)in bile specimens in patients suffering from benign diseases of biliary ducts(lithiasis with/without nonspecific cholangitis). METHODS:The group of 72 patients entering the study consisted of 32 male and 40 female(45 % and 55 %, respectively).Bile was obtained during ERCP in 68 patients, and during cholecystectomy in 4 patients.A fast urease test (FUT)to determine the existence of H.pylori in gastric mucosa was carried out for all the patients during the endoscopic examination.The existence of genetic material of H.pylori was determined by detection of ure A gene by the method of nested PCR.The results of this reaction were shown by electrophoresis on 10 g·L^(-1)agarose gel in a band of 256 bp. RESULTS:The majority of the patients included in our study had biliary lithiasis without signs of cholangitis(48 patients, 67 %),whereas other patients were complicated by cholangitis(17 patients,24 %).Seven patients(9 %)had normal ERCP,forming thus the control group.In the group of patients with lithiasis 26 patients(24.2 %)had positive PCR of H.pylori in bile and among the patients with associated cholangitis positive PCR was detected in 9 patients(52.9 %).Among the seven patients with normal ERCP only one(14 %)had positive PCR of H.pylori.A high percentage of H.pylori infection of gastric mucosa was observed(57 patients,79 %).It was also observed that its slightly higher positivity was in the patients with distinct bile pathology:81% FLIT positive patients in the group with choledocholithiasis alone and 76 % in the group with choledocholithiasis associated with cholangitis.Seventy-one percent of the patients with regular findings had positive FUT.CONCLUSION: The prevalence of H. pylori infection both in bile and in gastric mucosa in patients with benign diseases of biliary ducts does not show a statistically significant difference in relation to the prevalence of the same with the patients with normal ERCP. The existence of H. pylori infection possibly does not play a role in pathogenesis of benign biliary diseases.
文摘An electrohydrodynamic （EHD） method, which is based on glow discharge plasma, is presented for flow control in an S-shaped duct. The research subject is an expanding channel with a constant width and a rectangular cross section. An equivalent divergence angle and basic function are introduced to build the three-dimensional model. Subsequently, the plasma physical models are simplified as the effects of electrical body force and work （done by the force） on the fluid near the wall. With the aid of FLUENT software, the source terms of momentum and energy are added to the Navier-Stokes equation. Finally, the original performance of three models （A, B and C） is studied, in which model A demonstrates better performance. Then EHD control based on model A is discussed. The results show that the EHD method is an effective way of reducing flow loss and improving uniformity at the duct exit. The innovation in this study is the assessment of the EHD control effect on the flow in an S-shaped duct. Both the parametric modeling of the S-shaped duct and the simplified models of plasma provide valuable information for future research on aircraft inlet ducts.
文摘Presence of Courvoisier's or double duct signs in a jaundiced patient is suggestive of malignant obstruction of the pancreaticobiliary ductal system.The oncologic impact of the simultaneous occurrence of these signs on the survival of patients with periampullary cancer is unknown.We report a case of obstructive jaundice secondary to an ampullary cancer demonstrating the Courvoisier's sign on clinical examination and a double duct sign on imaging.The patient underwent a pancreaticoduodenectomy which confirmed an ampullary adenocarcinoma.
文摘Turbine noise would be one of the dominant noise sources especially in future UHBR (Ultra High Bypass-Ratio) aeroengine, but its currently far from being studied enough. Acoustic mode is crucial for duct propagation but little study about the relation between serration and mode. Thus, taking axial single-turbine test bench NPU-Turb as object, the effect of Stator with Serrated Trailing-edge (Bionic S) and Rotor with Serrated Leading-edge (Bionic R) on duct acoustic modes of turbine turbulence interac-tion noise were studied in detail using DDES/AA hybrid model validated by acoustic experiment of NPU-Turb. Serval conclusions can be made here. First, for broadband noise, the effect of serrations on duct modes (increased or reduced of PWL<sub>mn</sub>) with the increasing frequency is more prominent. Second, the changing trend of ?PWL<sub>mn</sub> is something like Chinese character “人” with circumferential mode m and alternating with radial mode. Such distribution is more obvious at higher frequency. More theoretical and mechanistic research work needs to be carried out in depth in the future. .
基金supported by National Natural Science Foundation of China (No.10775042)
文摘Geometry sensitivity of magnetohydrodynamics （MHD） duct flow and some ab- normal phenomena deviating from the classical MHD laws were measured in an experimental investigation of the MHD effect of the flow channel inserter （FCI） duct flow. The results showed that the velocity distribution deviated from the M-type profile on the centre-plane of the cross section of the duct with small slots （in short ＂S-duct＂）. The electric potential difference in the duct wall was much lower than that given by the classical electromagnetic laws. The MHD pres- sure drop was much higher than that from the classical magneto-hydrodynamics theory. These results may help us find some new methods to reduce the MHD pressure drop, or explore other potential applications such as flow structure control.
文摘BACKGROUND Gynaecologists should be aware of a rare obstructive Mullerian duct abnormality like Robert’s uterus and perform further surgery when necessary.CASE SUMMARY We report a 41-year-old mother of two children with Robert’s uterus who was examined and treated by laparoscopy and hysteroscopy.Unlike the existing cases reported in the literature,this patient had a late onset of Robert’s uterus symptoms.Due to right tubal ectopic pregnancy 3 years previously,the patient was treated with right salpingectomy and left tubal ligation but suffered aggravated left lower abdominal pain.She was examined and treated by laparoscopy and hysteroscopy,and is completely asymptomatic at 5-year followup.CONCLUSION The typical obstructive Mullerian abnormality requires further surgery.Combined laparoscopy and hysteroscopy is an effective,minimally invasive technique with better recovery outcomes than traditional transabdominal procedures.
文摘Introduction: In bile duct injuries (BDI), cholestasis and cholangitis can alter the fibrinolytic system by promoting an increase of extracellular matrix depositions which favor an imbalance between metalloproteinases (MMPs) and their tissue inhibitors (TIMPs). Materials and Methods: Levels of PAI-1, MMP-3, MMP-8, TIMP-1 and TIMP-2 in 35 patients with post-cholecystectomy BDI by complete biliary obstruction were measured and compared to a healthy control group. Sirius red staining and immune staining for MMP-3 and MMP-8 were also undertaken in liver biopsies. Results: Levels of PAI-1, TIMP-1, TIMP-2 and MMP-8 were higher in BDI than healthy controls: 15 ± 2 ng/mL vs 7.1 ± 2 ng/mL (p 0.024);539 ± 64 ng/mL vs 256 ± 13 ng/mL (p p p 2 vs. 22865.7 ± 3865 μm2 in healthy controls (p 2 vs. 30744.2 ± 5810.2 μm2 (p 2 vs. 116337.9 ± 24803.3 μm2 (p 0.55). These results suggest an imbalance between fibrogenic/fibrinolytic protein levels. Interestingly, expression of the fibrinolytic protein MMP-8 was increased in serum and liver biopsies in BDI. Conclusion: We found an imbalance of profibrogenic molecules which promote extracellular matrix deposition. The over-expression of fibrinolytic proteins such as MMP-8 could limit liver fibrosis, preventing hepatic dysfunction in post-cholecystectomy BDI.
