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1.
目的：探讨内镜下0ddi括约肌切开取石术（endoscopic sphincterotomy,EST）联合腹腔镜胆囊切除术（1apanroscopic cholecystectomy,LC）治疗胆囊结石合并继发性胆管结石的疗效。方法：对21例胆囊结石合并继发性胆管结石患者先行EST术,再行LC术。结果：21例均完成EST和LC术,其中1例患者LC术后经胆道造影见胆总管结石残留,再次行EST术。结论：EST联合LC治疗胆囊结石合并继发性胆管结石是一种安全有效的微创治疗模式。  相似文献   

2.
目的：探讨腹腔镜胆囊切除术与开放胆囊切除术治疗胆囊结石的临床疗效。方法：选择2010年1月至2013年7月收治的胆囊结石患者共90例作为研究对象,按照治疗方式将其分为腹腔镜胆囊切除术（LC）组和开腹胆囊切除术（OC）组,比较两组患者疗效。结果：LC组手术时间、术中出血量、抗生素使用时间、胃肠功能恢复时间以及住院时间等围手术期指标均明显优于OC组（P〈0．05）;LC组并发症发生率为0．1％,OC组并发症的发生率3％,LC组并发症的发生率明显低于OC组（P〈0．05）。结论：腹腔镜胆囊切除术治疗胆囊结石术中出血少,术后恢复快,住院时间短,是一种安全可靠的治疗方式。  相似文献   

3.
Objective: This study was aimed at evaluating and comparing the quality of life in patients who underwent laparo-scopic and open cholecystectomy for chronic cholecystolithiasis. Methods: The study included 25 patients with laparoscopic cholecystectomy (LC group) and 26 with open cholecystectomy (OC group). The quality of life was measured with the Gastrointestinal Quality of Life Index (GLQI) preoperatively, thereafter regularly at 2, 5, 10 and 16 weeks after the operation. Results: The mean preoperative overall GLQI scores were 112.5 and 110.3 in LC and OC group respectively (P>0.05). In the LC group, the mean overall GLQI score reduced slightly to 110.0 two weeks after the operation (P>0.05). The LC group showed significant improvement in overall score and in the aspects of symptomatology, emotional and physiological status from 5 to 16 weeks postoperatively. In the OC group, the GLQI score reduced to 102.0 two weeks after surgery (P<0.05). Significant reductions were shown in the aspects of symptomatology, physiological and social status. The GLQI scores returned to the preoperative level of 115.6 ten weeks after the operation (P>0.05). The patients experienced significant improvements of GLQI sixteen weeks after OC operation (P<0.01-0.05). Within the 10 postoperative weeks, the LC group had significantly higher GLQI scores than the OC group (P<0.05). Conclusions: LC can improve the quality of life postoperatively better and more rapidly than OC. The assessment of quality of life assessment is a valid method for measuring the effects of surgical treatment.  相似文献   

4.
Objective: This study was aimed at evaluating and comparing the quality of life in patients who underwent laparo-scopic and open cholecystectomy for chronic cholecystolithiasis. Methods: The study included 25 patients with laparoscopic cholecystectomy (LC group) and 26 with open cholecystectomy (OC group). The quality of life was measured with the Gastrointestinal Quality of Life Index (GLQI) preoperatively, thereafter regularly at 2, 5, 10 and 16 weeks after the operation. Results: The mean preoperative overall GLQI scores were 112.5 and 110.3 in LC and OC group respectively (P>0.05). In the LC group, the mean overall GLQI score reduced slightly to 110.0 two weeks after the operation (P>0.05). The LC group showed significant improvement in overall score and in the aspects of symptomatology, emotional and physiological status from 5 to 16 weeks postoperatively. In the OC group, the GLQI score reduced to 102.0 two weeks after surgery (P<0.05). Significant reductions were shown in the aspects of symptomatology, physiological and social status. The GLQI scores returned to the preoperative level of 115.6 ten weeks after the operation (P>0.05). The patients experienced significant improvements of GLQI sixteen weeks after OC operation (P<0.01-0.05). Within the 10 postoperative weeks, the LC group had significantly higher GLQI scores than the OC group (P<0.05). Conclusions: LC can improve the quality of life postoperatively better and more rapidly than OC. The assessment of quality of life assessment is a valid method for measuring the effects of surgical treatment.  相似文献   

5.
Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure widely used to diagnose and treat conditions of biliary or pancreatic ductal system. The post-ERCP severe acute pancreatitis (SAP) accompanied with duodenum perforation is rare but serious, remaining a challenge in clinic. In this study we report two such cases. Two Chinese women were treated for clinical suspicion of bile duct obstruction and underwent ERCP after admission. Both developed duodenum perforation and SAP after ERCP, and were managed in the intensive care unit (ICU) and required an organ-failure support. The surgical intervention of the peri-pancreatic debridement with lumber-abdominal compound incisions and postoperative washing and drainage was performed, and the two patients recovered well. The therapeutic effect of the peri-pancreatic debridement with lumber-abdominal compound incisions combined with postoperative washing and drainage in the patients of severe post-ERCP-pancreatitis (PEP) and duodenum perforation is satisfactory.  相似文献   

6.
Objective: To study the relationship between cholecystolithiasis and polypoid gallbladder(PLG), 260 patients with polypoid gallbladder were investigated. The patients were divided into 2 groups: group A (PLG combined with cholecystolithiasis) and group B (without cholecystolithiasis). The clinical pathological characteristics were analyzed. The intestinal epithelium metaplasia and atypical hyperplasia of the gallbladder mucosa were observed under light microscope. Results: Intestinal epithelium metaplasia and atypical hyperplasia of gallbladder mucosa were found in 47 of the 260 cases. The pathological lesions included 16 gallbladder carcinoma, 11 adenomatosis polyp, 5 myoadenoma, 7 cholesterol polyp, 4 inflammatory polyp and 4 adenomatosis hyperplasia, which occurred in 26 and 21 patients in group A and group B, i. e. 44.0% and 10.3% respectively. The difference between group A and group B was statistically significant (P<0.01). Conclusion: Cholecystolithiasis and the succeeding inflammatory reaction is a risk-factor for the polypoid gallbladder to develop tumour. Project (No. 2002ZXO19) supported by the Zhejiang Province Health Bureau, China  相似文献   

7.
Objective:To evaluate the pharmacological effects of traditional Chinese medicine,bear bile capsule and Huangqi granule,on recurrent parotitis in children.Methods:In this prospective,controlled,and randomized study,a total of 151 young children were divided into three groups:Group A included massaging the children’s parotid region and melting vitamin C in their mouth daily;Group B included swallowing bear bile capsule and Huangqi granule daily;and Group C included massages and vitamin C as prescribed in Group A,and traditional Chinese medicine as prescribed in Group B.Children were treated individually for one month and then a follow-up study was conducted for 1 to 3.5 years.Analysis of variance(ANOVA) and Ridit analysis were employed for statistical analysis.Results:The recurrence rate decreased in every group,but was significantly more in Groups B and C when compared to Group A.The recurrences significantly decreased(P<0.01) in Group B and their recovery rate was as high as 63%,significantly better than those of the other groups(P<0.01).Conclusions:Huangqi and bear bile could be a novel clinical approach for treating recurrent parotitis in children.  相似文献   

8.
Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure widely used to diagnose and treat conditions of biliary or pancreatic ductal system. The post-ERCP severe acute pancreatitis (SAP) accompanied with duodenum perforation is rare but serious, remaining a challenge in clinic. In this study we report two such cases. Two Chinese women were treated for clinical suspicion of bile duct obstruction and underwent ERCP after admission. Both developed duodenum perforation and SAP after ERCP, and were ...  相似文献   

9.
Eighty-two patients with supraventricular tachycardia undergoing radiofrequency catheter ablation (RFCA) were studied to observe the inhibition effect of aspirin and ticlopidine on platelet aggregability (PAG) and thromboxane B2 (TXB2) of the blood samples. Patients were divided into aspirin group A, ticlopidine group B, aspirin + ticlopidine group C and control group D. PAG and TXB2 were increased clearly after RFCA in all groups (P<0.001). Treatment with aspirin or ticopidine before operation could reduce the platelet aggregability caused by RFCA and the joint effect of two drugs (change rate of group A: 52.51±12.51%; group B: 54.78±11.27%; group C: 30.51±10.59%; group D: 91.75±21.43%;P<0.05) was studied. The much decreased platelet aggregability after antiplatelet therapy was evidence of the potential benefit of the treatment in preventing thromboembolism after ablation. Pretreatment with aspirin and ticlopidine together is a good way to decrease palatelet aggregability after RFCA.  相似文献   

10.
Objective: To investigate if intra-aortic balloon pump(IABP) is contraindicated without anticoagulation therapy. Methods: Some 153 IABP patients in the King Abdulaziz Cardiac Center(KSA) were randomly assigned into two groups. Anticoagulation group (Group A) consisted of 71 patients who were given heparin intravenously with target aPTT50–70 seconds. Non-anticoagulation group (Group B) consisted of 82 patients without intravenous heparin during balloon pumping. Hematological parameters including platelet count, D-dimer, Plasminogen activator inhibitor-1 (PAI-1) and fibrinogen degradation products (FDP) were checked respectively at the point of baseline, 24 hours, 48 hours and 24 hours post IABP counterpulsation. Clot deposits on balloon surface, vascular complications from IABP including bleeding and limb ischemia were recorded. Results: Platelet count and PAI-1 level decreased at 24 hours and 48 hours in both groups (P<0.05). D-dimer dimer and FDP level increased at 24 hours and 48 hours in both groups(P<0.05), but returned to the baseline level 24 hours post IABP removal (P>0.05). Three patients in Group A and 2 patients in Group B developed minor limb ischemia (P>0.05). No major limb ischemia in either group. Two patients in Group A suffered major bleeding and required blood transfusion or surgical intervention, whereas no patient had major bleeding in Group B. Eight patients had minor bleeding in Group A, but only 2 patients in Group B (P<0.05). No clot deposit developed on IABP surface in either group. Conclusion: IABP is safe without routine anticoagulation therapy. Selecting appropriate artery approach and early detection intervention are key methods for preventing complications.  相似文献   

11.
Pupils with emotional and behavioural difficulties (EBD) are often considered the most challenging group to manage within mainstream education. The challenges perceived by teachers may be due, in part, to negative attitudes towards this cohort of pupils, which may exacerbate feelings of inadequacy and impact negatively upon direct interactions with pupils. The current study comprised a combination of implicit (i.e. the Implicit Relational Assessment Procedure, IRAP) and explicit (The Opinions Relative to Mainstreaming Scale, ORMS) technologies to assess the attitudes of teachers (N = 25) and teachers in training (N = 20) towards pupils with EBD. When these attitudes proved to be negative (relative to typically developing pupils), the utility of a combined behaviour intervention (BI) and stress-management intervention (SMI), in conjunction with a series of pre and post measures, was examined. The IRAP results for teachers indicated that the SMI enhanced their implicit positivity towards pupils with EBD (EBD PUPIL) to a considerable extent (0.025-0.175), and this was greater than the impact recorded with the BI. The teachers in training showed implicit negativity towards EBD PUPIL (0.13) and this decreased, albeit marginally, at post-BI (0.05) and post-SMI (0.06). Significant differences were recorded in teachers’ general attitudes towards inclusion (p < 0.001) and efficacy (p < 0.008). Significant effects were recorded for teachers in training in relation to their attitudes towards having a child with EBD and having a previously excluded child with EBD in their classrooms (all ps < 0.001). For this latter group, reductions were also recorded in their levels of depression, anxiety and stress (p < 0.001) and there was an increase in their psychological flexibility (p < 0.001). The current results indicate that a range of positive implicit and explicit outcomes was associated with the current BI and SMI package in terms of fostering more effective inclusion of pupils with EBD in mainstream education.  相似文献   

12.
Objective: To explore the characteristics of NF-κB activation in the progress of pancreatitis, the relationship with expression of TNF-α in the inflammatory reaction, and prevent the exacerbation of pancreatitis by using NAC. Method: Forty-eight rats were divided into three groups: therapy (group C), pancreatitis (group B) and control (group A). NAC served as the inhibitor of NF-κB activation. In the time intervals of 1.5, 3.0, 6.0, 12.0 hour, NF-κB activation was detected with flow cytometry (FCM) and the expression of TNF-α mRNA and protein with in situ hybridization (ISH) and enzyme-linked immuno-sorbent assay (ELISA) respectively. Meanwhile, the level of lipase and amylase in the serum was assayed and the pathological change was evaluated. Result: NF-κB activation in the pancreatitis group was higher than that in the control group (P<0.01), peaked at 3 hours, and was depressed by the inhibitor of NF-κB, NAC. The expression of TNF-α as well as the level of lipase and amylase in the serum also rose synchronously with activation of NF-κB. In contrast to group A, it was significantly different (P<0.01) in group B. After using NAC in group C, all of these values were decreased and the inflammatory reaction in the pancreas abated evidently. The pathology changes of the pancreas were shown to be alleviated in group C. Conclusion: First, NF-κB activity is intensively initiated in the course of pancreatitis and shown to have closely relationship with the release of cytokines. Second, use of NAC markedly depressed NF-κB activation. TNF-α expression is down regulated by cytokines. It is suggested that NAC probably acts as a useful agent for treatment of pancreatitis by indirectly inhibiting activation of NF-κB.  相似文献   

13.
Objective: To assess the occurrence of stressful life events in the year before the initiation of systemic sclerosis. Methods: A consecutive series of 40 patients with systemic sclerosis (mean age (56.3~ 11.9) years, mean disease duration (4.3±3.1) years; 32 females and 8 males), including 28 with diffuse cutaneous scleroderma and 12 with limited cutaneous scleroderma, were evaluated. A control group of 40 healthy subjects free of systemic sclerosis also was included. Socioeconomic status was inves-tigated and Paykel's interview for recent life events (a semi-structured research interview covering 64 life events) was conducted. Results: Patients with systemic sclerosis showed higher percentages of lower education (72.5%) and working class (82.5%), and reported more stressful life events (P＜0.05), such as exits (P＜0.05), undesirable events (P＜0.01), and uncontrolled events (P＜0.001), when compared with the control. More events that had an objective negative impact (P＜0.001) were also reported in systemic sclerosis patients than in the control. These results are in accordance with a muitifactorial model of pathogenesis in systemic sclerosis. Conclusion: We reported a strong relationship between stressful life events and the initiation of systemic sclerosis. Our findings are consistent with current understanding of the extensive links of behavioral responses to stress with neurophysiological and biochemical processes.  相似文献   

14.
ＩＮＴＲＯＤＵＣＴＩＯＮＭｕｃｕｎｎｅｗａｓｔｈｅｆｉｒｓｔｔｏｕｓｅＥＲＣＰ (Ｅｎｄｏ ｓｃｏｐｉｃＲｅｔｒｏｇｒａｄｅＣｈｏｌａｎｇｉｏｐａｎｃｒｅａｔｏｇｒａｐｈｙ)ｉｎｔｈｅｄｉａｇｎｏｓｉｓｏｆｄｉｓｅａｓｅｓｏｆｂｉｌｅｄｕｃｔｓａｎｄｐａｎ ｃｒｅａｓｉｎ 1 968.Ｗｉｔｈｉｍｐｒｏｖｅｍｅｎｔｏｆｅｎｄｏｓｃｏｐｉｃｅｑｕｉｐｍｅｎｔ,ｔｈｅｔｅｃｈｎｉｑｕｅｗａｓｄｅｖｅｌｏｐｅｄｒａｐｉｄ ｌｙ.ＴｈｅｒｅａｒｅｆｅｗｒｅｐｏｒｔｓｉｎｔｈｅｗｏｒｌｄｏｎｔｈｅｕｓｅｏｆＥＲＣＰｆｏ…  相似文献   

15.
This study examined whether high performers performed better (a) under individual and group incentive pay than under hourly pay and (b) under individual incentive pay than under group incentive pay. Participants were 11 college students. An ABCDC within‐subject design was used in which A was hourly pay with individual feedback, B was individual incentives with individual feedback, C was individual incentives with individual and group feedback, and D was group incentives with individual and group feedback. Participants performed better under both individual and group incentive pay than under hourly pay (p<.01). They did not significantly decrease performance when switched from individual to group incentives, but increased their performance when switched back to individual incentives (p<.01). Individual incentive pay was rated as the most preferred and most satisfying of the three pay systems, and group incentive pay as the least preferred, least satisfying and most stressful. These data suggest that high performers perform better under individual than group incentive pay after exposure to both and are highly likely to prefer individual incentive pay.  相似文献   

16.
The aim of this study was to understand the characteristics of blood pressure(BP)variability in subjects with diabetic nephropathy(DN),and identify the probable predictors affecting BP variability.Fifty-one chronic kidney disease(CKD)-hypertensive patients without diabetes(NDN group)and sixty type 2 diabetic patients with overt DN(DN group)were enrolled in this study.The values of short-term BP variability were obtained from 24 h ambulatory BP monitoring(ABPM).Variance analysis or nonparametric analysis revealed that 24-h systolic BP variability and nighttime systolic BP variability of the DN group were significantly higher than those of the NDN group[(12.23±3.66)vs.(10.74±3.83)mmHg,P<0.05;(11.23±4.82)vs.(9.48±3.69)mmHg,P<0.05].Then the patients of the DN group were divided into two groups according to glycated hemoglobin(HbA1c)level:Group A(HbA1c<7%)and Group B(HbA1c≥7%),and the t-test showed that patients in Group B had larger 24-h diastolic,daytime diastolic,and nighttime systolic/diastolic BP variability compared with Group A.In the DN group,partial correlation analysis revealed that HbA1c exhibited a strong association with 24-h diastolic,daytime diastolic,nighttime systolic and diastolic BP variability(P<0.001,P<0.001,P<0.05,and P<0.001,respectively).Taken together,larger short-term BP variability was detected in hypertensive type 2 diabetic patients with overt nephropathy and renal insufficiency.It may imply that the optimal BP variability level could benefit from a better glycaemic control.  相似文献   

17.
研究目的:探索不同肝功能指数对镇静药咪达唑仑的敏感性以及脑电双频谱指数(BIS)的预测意识消失的影响。创新要点:明确不同肝功能状态的患者对中枢抑制药的敏感性以及BIS预测意识消失概率发生的敏感性。指导临床医生根据患者的肝功能状态合理使用中枢抑制药以及正确利用BIS预测镇定深度。研究方法:选择意识消失作为研究终点,以50%患者意识消失时的咪唑安定的浓度以及BIS值作为观察指标。重要结论:终末期肝病患者对中枢镇静药咪唑安定更敏感,该类患者在BIS预测意识消失概率发生的敏感性存在差异。  相似文献   

18.
Study of the effect of dissolved oxygen and shear stress on rifamycin B fermentation with A. mediterranei XC 9–25 showed that rifamycin B fermentation with Amycolatoposis mediterranei XC 9–25 needs high dissolved oxygen and is not very sensitive to shearing stress. The scale-up of rifamycin B fermentation with A. mediterranei XC 9–25 from a shaking flask to a 15 L fermentor was realized by controlling the dissolved oxygen to above 25% of saturation in the fermentation process, and the potency of rifamycin B fermentation in the 15 L fermentor reached 10 g/L after 6-day batch fermentation. By continuously feeding glucose and ammonia in the fermentation process, the potency of rifamycin B fermentation in the 15 L fermentor reached 18.67 g/L, which was 86.65% higher than that of batch fermentation. Based on the scale-up principle of constantly aerated agitation power per unit volume, the scale-up of rifamycin B fed-batch fermentation with continuous feed from a 15 L fermentor to a 7 m3 fermentor and further to a 60 m3 fermentor was realized successfully. The potency of rifamycin B fermentation in the 7 m3 fermentor and in the 60 m3 fermentor reached 17.25 g/L and 19.11 g/L, respectively.  相似文献   

19.
Use and effects of liver specific antigen in orthotopic liver transplantations were researched in this study. Group I: syngeneic control (Wistar-to-Wistar); Group II: acute rejection (SD-to-Wistar); Group III: Thymic inoculation of SD rat LSA day 7 before transplantation. The observation of common situation and survival time, rejection grades, NF-κB activity of splenocytes and IL-2mRNA expression of grafted liver were used to analyze acute rejection severity and immune state of animals in different groups. The common situation of group I was very well after transplantation and no signs of rejection were found. Recipients of group II lost body weight progressively All dead within day 9 to day 13 posttransplantation; median survival time was 10.7 ±0.51 days. It was an optimal acute rejection control. As for group III, 5 out of 6 recipients survived for a long time and common situation was remarkably better than that of group II. Its rejection grades were significantly lower than that of group II(P<0.05). NF-κB activity was only detected in group I at day 5 and day 7 after transplantation, whereas high activity of NF-κB was detected at all time points in groupII and the low NF-κB activity detected in group III was significantly lower than that of group II (P<0.05). No IL-2mRNA expression was detected at any time point in group I, whereas high level expression was detected at all time points in group II and the low level expression only detected at day 3 in group III was significantly lower than that of group II (P<0.05). Conclusion: LSA is an important transplantation antigen which is involved directly in the immunorejection of liver transplantation. We report here for the first time that intrathymic inoculation of LSA can alleviate the rejection of liver allotransplantation; and that grafts can survive for a long time thereby, thus leading to a novel way to achieve liver transplantation immunotolerance. Project (NO. 011106206) supported by the Science and Technology Bureau of Zhejiang Province Foundation  相似文献   

20.
In this essay, we explore how the same theories and metaphors’ used historically to describe the frontier, are useful ways of thinking about both team teaching and English studies as an interdisciplinary field. Defining the frontier as both imprecise and liminal encourages the students, as well as the instructors, to work within an open space of all sorts of possibilities and no easily fixed answers. Such an approach illustrates the blurred line between written and visual texts and highlights how long the idea of the frontier has captivated US national consciousness, from early exploration narratives to film and TV.  相似文献   

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