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        west china medical publishers
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        find Author "李全生" 4 results
        • 腹腔鏡膽囊切除術中膽囊管嵌頓結石的處理

          目的探討腹腔鏡膽囊切除術(LC)術中膽囊管嵌頓結石的處理方法。 方法回顧性分析2007年5月-2013年2月21例膽囊管嵌頓結石患者的臨床資料。 結果18例患者成功在腹腔鏡下完成手術,其余3例患者膽囊三角粘連致密、解剖不清,中轉開腹后在術中超聲探及膽囊管根部嵌頓結石,在超聲引導下膽囊管切開取石,殘端縫閉。 結論LC術中仔細解剖膽囊三角,“裸化”膽囊管可避免膽囊管結石漏診,并能進行相應處理。

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        • 腹腔鏡膽囊切除術后繼發性膽總管結石的原因分析及處理

          目的探討腹腔鏡膽囊切除術(LC)后繼發性膽總管結石的原因及處理方法。 方法回顧性分析2008年1月-2013年12月3 300例LC患者的臨床資料。 結果所有患者術后隨訪半年,3 262例(98.75%)患者隨訪半年中未發現膽總管結石,38例(1.15%)患者出現繼發膽總管結石。隨訪發現膽總管結石與未發現膽總管結石的患者在總膽紅素水平[(15.3±3.8)、(17.8±5.4)μmol/L]、堿性磷酸酶水平[(75.9±19.4)、(84.4±23.1)U/L]、膽總管直徑[(6.1±1.9)、(8.5±3.4)mm]、膽囊管直徑[(1.9±0.5)、(3.5±1.4)mm]、合并有膽囊管結石比例(0.46%、13.20%)、膽囊結石為多發比例(58.7%、100.0%)方面比較差異有統計學意義(P<0.05)。 結論膽囊結石患者術前總膽紅素及堿性磷酸酶水平偏高、膽總管較粗、膽囊管較粗、膽囊管結石、膽囊多發結石是LC術后繼發性膽總管結石的高危因素,術中應謹慎操作以預防繼發膽總管結石,術后證實的膽總管結石可行內鏡逆行胰膽管造影以及內鏡乳頭括約肌切開術治療。

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        • Experimental Study on the Mouse Model of Acute Necrotizing Pancreatitis Induced by Intraperitoneal Injection of Caerulein

          ObjectiveTo establish a mouse model of acute necrotizing pancreatitis.MethodsThirty-six male ICR mice were randomly divided into control group (n=6) and experimental group (n=30). Each of the animals in the experimental group received 7 intraperitoneal injections of caerulein (50 μg/kg body weight) in 0.9% NaCl at hourly intervals over 6 hours. The animals in the experimental group were killed at 9,18,24,48 and 72 hours respectively after the first caerulein injection. The control animals received the same volume of 0.9% NaCl without caerulein. The animals in the control group were killed at the 18th hour after the first intraperitoneal injection. The severity of acute necrotizing pancreatitis was evaluated in terms of amylase level, pancreatic weight/body weight and the histological changes. Variance analysis was employed in the processing of these data. ResultsBoth amylase level and pancreatic weight elevated 9 hours after the first caerulein injection, and correlated with the course of pancreatitis. The maximums of both alterations were observed at the same time point (18 hours after the first injection of caerulein). Prominent interstitial inflammation and acinar cell necrosis occurred at the 18th hour, and the histological score for pancreatitis reached a maximum (P<0.05). Conclusion Intraperitoneal injection of a large dosage of caerulein can induce acute necrotizing pancreatitis in ICR mice. This method is simple and noninvasive, and the model established thus is stable and reproducible.

          Release date:2016-08-28 04:43 Export PDF Favorites Scan
        • A preliminary study on metabonomics of amino acid and glucose in patients with gallbladder stones based on nuclear magnetic resonance

          Objective The method of metabonomics based on nuclear magnetic resonance (NMR) imaging was used to explore the difference in metabolites of serum and bile, and to analyze the metabolic variation related to the pathogenesis of gallbladder stones between normal people/liver transplantation donors and patients with gallbladder stones. Methods Prospectively collected the serum samples (17 cases) and bile samples (19 cases) in 19 patients with gallbladder stones who underwent surgery in West China Hospital form March 2016 to December 2016, as well as the serum samples of 10 healthy persons and the bile samples of 15 liver transplantation donors at the same time period. The differences of metabolites in the blood and bile in these 3 groups were compared by using 1H-NMR metabonomics technology and chemometric methods. Results The concentrations of valine, alanine, lysine, glutamine, glutamate, pyruvate, creatinine, choline, alpha-glucose, beta-glucose, tyrosine, histidine, and hypoxanthine in serum of patients with gallbladder stones decreased significantly, comparing with those of healthy people without gallbladder stones (P<0.05), while 1, 2-propanediol, acetoacetate, and lactate increased significantly in the serum of patients with gallbladder stones (P<0.05). The concentrations of taurine conjugated bile acids, glycine conjugated bile acids, choline, and phosphatidylcholine decreased significantly in the bile of patients with gallbladder stones when compared with those of liver transplantation donors (P<0.05), while cholesterol increased significantly in the bile of patients with gallbladder stones (P<0.05). Conclusions There are significant differences of the serum and bile metabolites between patients with gallbladder stones and healthy men without gallbladder stones/liver transplantation donors. 1H-NMR metabonomics is helpful to investigate the pathogenesis of gallbladder stones.

          Release date:2018-04-11 02:55 Export PDF Favorites Scan
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