Prevention of common bile duct injury during laparoscopic cholecystectomy

BACKGROUND: Since the widespread adoption of laparoscopic cholecystectomy (LC) in the late 1980s, a rise in common bile duct (CBD) injury has been reported. We analyzed the factors contributing to a record of zero CBD injuries in 10 000 consecutive LCs. METHODS: The retrospective investigation included 10 000 patients who underwent LC from July 1992 to June 2007. LC was performed by 4 teams of surgeons. The chief main surgeon of each team has had over 10 years of experience in hepatobiliary surgery. Calot's triangle was carefully dissected, and the relationship of the cystic duct to the CBD and common hepatic duct was clearly identified. A clip was applied to the cystic duct at the neck of the gallbladder and the duct was incised with scissors proximal to the clip. The cystic artery was dissected by the same method. Then, the gallbladder was dissected from its liver bed. A drain was routinely left at the gallbladder bed for 1-2 days postoperatively. RESULTS: No CBD injuries occurred in 10 000 consecutive LCs, and there were 16 duct leaks (0.16%). Among these there were 10 Luschka duct leaks (0.1%) and 6 cystic duct leaks (0.06%). Four hundred thirty cases were converted to open cholecystectomy (OC), giving a conversion rate of 4.3%. After a mean follow-up of 17.5 months (range 6-24 months), no postoperative death due to LC occurred, and good results were observed in 95% of the patients. CONCLUSIONS: In our 10 000 LCs with zero CBD injuries, the techniques used and practices at our department have been successful. Surgeon's expertise in biliary surgery, preoperative imaging, precise operative procedures, and conversion from LC to OC when needed are important measures to prevent CBD injuries.

Modified arterialization of orthotopic liver transplantation in a mouse model

BACKGROUND: With the establishment of genetically modified and gene knock-out models, the mouse has become an important animal model for liver transplantation. We examined hepatic rearterialization after liver transplantation in a mouse model. METHODS: Orthotopic liver transplantation was performed in 70 mice and sham-operation was performed in a control group of 40 mice. Based on the 'two-cuff' method, a continuous suture approach was applied to the suprahepatic inferior vena cava and a cuff approach to the portal vein and the infrahepatic inferior vena cava. A biliary stent was inserted into the bile duct. The hepatic artery was reconstructed with end-to-side anastomosis. The survival rate of recipients was monitored at 24 hours, one week, and one month after the operation. Liver function and morphology were evaluated one month postoperatively. RESULTS: Postoperative survival rates were 94.3% at 24 hours, 91.4% at one week, and 85.7% at one month. No significant difference was seen between the experimental and control groups in liver function. The hepatic tissue preserved normal structure. CONCLUSION: Owing to its high survival rate and stability, this surgical approach is ideal for establishing an orthotopic liver transplantation mouse model with hepatic artery reconstruction. (Hepatobiliary Pancreat Dis Jut 2010; 9: 264-268)

Curcumin reduces inflammatory reactions following transient cerebral ischemia/reperfusion injury

Inflammatory reactions are important pathophysiological mechanisms of ischemic brain injury. The present study analyzed the anti-inflammatory characteristics of curcumin via myeloperoxidase activity and nitric oxide content after 2-hour ischemia/24-hour reperfusion in Sprague Dawley rats. In addition, expressions of nuclear factor kappa B, tumor necrosis factor-α and interleukin-lβ protein were measured. Curcumin significantly reduced myeloperoxidase and nitric oxide synthase activities and suppressed expressions of nuclear factor kappa B, tumor necrosis factor-α, and interleukin-lβ in ischemia/reperfusion brain tissue. Results suggested that the neuroprotective effect of curcumin following cerebral ischemia/reperfusion injury could be associated with inhibition of inflammatory reactions.

Expression and significance of EGFR,C-erbB_2 and PCNA in primary breast carcinoma tissues

To study the expression of EGFR,C-erbB2 and PCNA in primary breast carcinoma tissues and the value of them in preducting the recurrence of primary breast carcinoma.Methods The expression of EGFR,C-erbB2,PCNA in 57 benign and malignant breast paraffin-embedded specimens was detected by using immunohistochemical assay and compared.Results The positive rate of EGFR,C-erbB2,PCNA was increased significantly in malignant breast tissues as compared with benign breast tissues.The positive intensity of PCNA,C-erbB2 was increased significantly is tissues of recurrent breast carcinoma as compared with tissues of no recurrent breast carcninoma.Conclusion The expression of EGFR,C-erbB2 and PCNA may indicate the active proliferation activity of carcinoma cells.The detection of the overexpression of PCNA and C-erbB2 can predict the recurrence of breast carcinoma and is beneficial to the choose of the treatments.3 refs,4 tabs.

Role of Lactobacillus in the prevention of Clostridium difficile- associated diarrhea： a meta-analysis of randomized controlled trials

Background Clostridium difficile-associated diarrhea （CDAD） is a major public health problem because of significant morbidity and mortality, and many clinicians pay attention to Lactobacillus as a potentially effective treatment. The purpose of this meta-analysis was to evaluate the efficacy of Lactobacillus in the prevention of CDAD.

Safety and efficacy of polymer-free paclitaxel-eluting microporous stent in real-world practice： 1-year follow-up of the SERY-I registry

Background Polymer coating on coronary stents induces vascular inflammatory response, reduces re-endothelialization, and affects long-term outcome after percutaneous coronary intervention （PCI）. The SERY-1 registry aimed to determine whether a novel polymer-free paclitaxel-eluting microporous Yinyi stent could improve 1-year outcome after index procedure in real-world clinical practice. Methods Clinical and angiographic data and follow-up outcome were collected in 1045 patients who underwent PCI with implantation of 〉1 Yinyi stents between June 2008 and August 2009 at 27 medical centers. The primary endpoint was the cumulative rate of composite major adverse cardiac events （MACE） and the secondary endpoint was the incidence of stent thrombosis at 1 year. Results Overall, 1376 lesions were treated successfully with 1713 Yinyi stents, and 1019 （98.7%） patients received dual antiplatelet therapy for at least 12 months. During 1-year follow-up, 8 patients （0.78%） had cardiac death, 6 （0.58%） suffered non-fatal myocardial infarction, and 46 （4.46%） underwent repeat PCI due to recurrence of angina, resulting in 1-year MACE-free survival of 94.09%. Stent thrombosis occurred in 10 （0.97%） patients, and the rate of Academic Research Consortium （ARC） definite or probable stent thrombosis was 0.78%. Conclusions Polymer-free paclitaxel-eluting microporous Yinyi stent is effective and safe for interventional treatment of coronary artery disease in real-world clinical practice, without recourse to carrier polymer. Potential long-term clinical advantages of this stent deserve further investigation.

A prospective study to evaluate the efficacy of an intracardiac electrogram-based atrioventricular and interventricular intervals optimization method in cardiac resynchronization therapy

Background Cardiac resynchronization therapy （CRT） with biventricular pacing improves cardiac function,functional capacity and quality of life in selected patients with heart failure.The current study aimed to evaluate the efficacy of the intracardiac electrogram （IEGM）-based optimization method,QuickOptTM,in Chinese patients treated with CRT.Methods Aortic time velocity integrals （AVTI） achieved at the sensed atrioventricular （AV）,paced AV and interventricular （VV） interval settings recommended by both QuickOptTM and standard echocardiographic optimization were measured in 101 patients.Consistency and the strength of the relationship between the two timing cycle optimization methods were assessed by intra-class correlation coefficient （ICC）.Results The ICC showed good agreement and correlation with what the AVTI achieved at the optimal sensed AV （ICC=0.9683 （0.9535-0.9785））,paced AV （ICC=0.9642 （0.9475-0.9757）） and VV （ICC=0.9730 （0.9602-0.9817）） interval settings determined by the two optimization methods.The average time required by echocardiographic optimization and by QuickOptTM were （78.32±32.40） minutes and （1.98±1.64） minutes respectively （P 〈0.0001）.Conclusion The QuickOptTM algorithm provides a quicker,simpler and reliable alternative to the standard method for timing cycle optimization.（ClinicaITrial.gov Reference Number：NCT00918294）

Renal denervation for ＂resistant ventricular tachycardia＂： a potential treatment option？

To the editor： Recent evidence shows that renal sympathetic denervation can perform a promising role in attenuating the over-activity of sympathetic nerve system and treat related diseases A 42 years old male patient suffering from 7 years history of paroxysmal palpitation was referred to our center.

Effect of catalpol on senile plaques and spatial learning and memory ability in amyloid-β protein precursor/presenilin 1 double transgenic mice

Objective To investigate whether catalpol affects senile plaque formation and spatial learning and memory ability in the amyloid-βprotein precursor/presenilin 1(APP/PS1)double transgenic mice.

Characteristics of lung function in preterm infants with varying degress of bronchopulmonary dysplasia

Objective To explore the characteristics of lung function in preterm infants with varying degrees of bronchopulmonary dysplasia (BPD) .Methods There were407 infants (278 males and 129 females) were recruited from Shenzhen Children’Hospital between January

A study of inhibitory effect of ulinastatin on hyper-permeability of endothelium induced by TNF-α

Objective To investigate the influence of Ulinastatin(UTI)on the hyper-permeahility of vascular endothelial cells induced by tumor necrosis factor alpha(TNF-α).Methods Inflammation model was induced by TNF-αin human umbilical vein endothelial cell line(EA.hy926).The experiment was designed into 4 groups:normal group,TNF-αgroup,UTI group and TNF-αwith

Clinical study on cytomegalovirus infection after hematopoietic stem cell transplantation in 26patients with primary immunodeficiency diseases

Objective To explore the risk factors,and control measures of cytomegalovirus(CMV)infection after hematopoietic stem cell transplantation(HSCT)in children with primary immunodeficiency diseases(PID).Methods We retrospectively analyzed the results of 26 patients with PID-Wiskott-Aldrich syndrome(WAS,n=20),severe combined immunodeficiency(SCID,n=1),Xlinked chronic granulomatous disease(XCGD,n=2)and X-linked hyper-immunoglobulin M(Ig M)

Plasma level of brain-derived neurotrophic factor and the related analysis in depressive patients with suicide attempt

Objective To explore the association between brainderived neurotrophic factor(BDNF)and suicidal behavior through analyzing and detecting the alteration of plasma BDNF level in depressive patients with suicide attempt.Methods Using enzyme-linked immunosorbent analysis(ELISA)to test the plasma level of BDNF in 27suicidal depressed patients,33 non-suicidal depressed patients and 30 normal controls.Meanwhile,the Hamilton Depression Scale(HAMD)and

Clinical effect of different doses of atorvastatin on elderly acute coronary syndrome

Objective To observe the effect of different doses of atorvastatin in treating elderly acute coronary syndrome.Methods Totally 78 cases with acute coronary syndrome were randomly divided into two groups: low-dose atorvastatin group and high-dose atorvastatin group,39 cases

Study on the association between environmental chemical elements and fluorosis caused by coal-fire pollution

Objective To understand the distribution of chemical elements in soil,to investigate the differences between patients under different state of fluorosis and normal population after preventive measurement was implemented to get rid of some chemical elements and to

Construction of a recombinant plasmid pGEX-Sj26GST of Schistosoma japonicum and expression in Escherichia coli BL21( DE3)

Objective To construct and express a recombinant plasmid pGEX-Sj26GST of Schistosoma japonicum(Sj)in Escherichia coli(E.coli)BL21(DE3).Methods Total RNA was extracted from Sj adult worms by RNeasy Mini kit,26 kilodalton glutathione-S-transferases of Schistosoma japonicum(Sj26GST)antigen gene was amplified by real-time PCR(RT-PCR)from the total RNA,then cloned into a prokaryotic expression plasmid pGEX-1λT and transformed into E.coli BL21(DE3)to construct pGEX-Sj26GST;BL21(pGEX-

Change of plasma visfatin level in the population with different glucose tolerances

Objective To investigate the change of plasma visfatin level and the relationship of plasma visfatin level to body mass index (BMI) , waist hip ratio (WHR) , blood glucose, plasma insulin levels as well as other factors in the subjects with different glucose tolerances. Methods Fasting and glucose loading 2 h plasma visfatin levels were assayed by ELISA in patients with type 2

Expression of ICAT and Wnt signaling-related proteins in the monocytic differentiation of HL-60 cells induced by a new steroidal drug NSC67657

Objective To investigate the expression of mRNA and proteins ofβ-catenin,TCF-4(ICAT)and Wnt signaling pathway-related genes in the monocytic differentiation of acute myeloid leukemia HL-60 cells induced by a new steroidal drug NSC67657.Methods Wright’s staining andα-NBE staining were used to observe the differentiation of HL-60 cells after 5 days of

Protein O-linked mannose β1,2-N-acetylglucosaminyl transferase 1 gene is involved in the pathogenic process of Alzheimer ’s disease model mice

Objective To investigate the role of protein O-linked mannose β1,2-N-acetylglucosaminyl transferase 1(POMGnT1)in the pathogenic process of Alzheimer's disease(AD).Methods The expression of POMGnT1 gene was examined in AD model cells(N2a/amyloidprecursor protein(APP)695swe,n=3)and N2a/wt cells(n=3)using real-time PCR and Western blotting.This expression was also examined in AD model mice(APP/PS1,n=3)and wild-type mice(n=3)using immunofluorescence staining.Amyloid β-protein(Aβ)were examined in POMGnT1-gene-knockout mice(n=3)and wild-type mice(n=3)using immunochemistry.Results The expression of POMGnT1 gene decreased in mRNA and protein levels in N2a/APP695swe cells compared to N2a/wt cells(mRNA:0.80±0.02 vs 1.00,t=10.52,P<0.01;protein:0.50±0.02 vs 1.31±0.04,t=18.64,P<0.01).Immunofluorescence results showed the reduced expression of POMGnT1 protein in neurons of APP/PS1 mice.Immunochemistry results showed more Aβ deposits in POMGnT1-gene-knockout mice(2 months old:0.358±0.014 vs 0.048±0.001,t=22.58,P<0.01;1 year old:0.266±0.004 vs 0.229±0.003,t=7.771,P=0.002).Conclusion These findings suggest POMGnT1 gene may play an important role in the pathogenic process of AD.