Twenty - three cases of hypospadiaswere treated by primary cystomucoso - ure-throplasty。Twenty cases had the success inthe first operation with the success rate of86.9%。The external urethral orifice was re-constructed to the coronary groove in 17 cas-es ,and to the glans in 6 cases。The early re-sults were satisfactory。This operative tech-nique had the advantages of convenient forobtaining the materials, reasonable physiolog-ical needs, high success rate, satisfactory ex-ternal feature, and useful in various type of hypospadias.
Objective To investigate the correlation between the plasma endothelin (ET) and gastric mucosal pathology.MethodsIn this experiment,seven dogs who experienced common bileduct ligation were in experiment group, the other three dogs who underwent shamoperation were control group. By using specific radio immunological method, the plasma ET levels were determined in dogs before and after 1,4,7 d. The total bilirubin levels were determined before and after 1,4,7 d after operation by using carbazotic acid method.The gastric mucosa,7 d after operation, was cut into slices and was examined under the electron microscope and the light microscope.Results In the experiment group,the levels of ET and total bilirubin rose continually and were higher than those in control group. Vascular congestion and oedema were seen in gastric mucosa of common bileduct ligated dogs. Under the electron microscope, we could see the dilated blood capillary and sludging of blood,the intenstitial mucusa cells oedema. Conclusion The increase of plasma ET might lead to impairment of mucosal microcirculation,which might be one of the pathogens that could induce the gastric mucosal damages in common bileduct ligated dogs.
This experimental study was aimed at observing the influence of bile salt and lactulose on intestinal mucosa of obstructive jaundiced rat. Twenty adult Wistar rate were divided into four groups (five rats for each group): sham operation, common bile duct ligation (CBDL), CBDL plus sodium deoxycholate feeding and CBDL plus lactulose feeding. The results showed that the intestinal mucosa of rats with obstructive jaundice took on marked edema, markedly decreased activities of adenosine triphosphatase, alkaline phosphatase and succinic dehydrogenase and intensified acid phosphatase activity. However, the intestinal mucosa of the rats, treated with bile salt or lactulose as compared with that of the obstructive jaundiced rats showed both pathological and histochemical improvement.
Modified Goligher’s highly selective vagotomy (HSV) for 217 cases of duodenal ulcers is reported. In this series they were: duodenal ulcer (100 cases), combined gastric and duodenal ulcers (79 cases) and complicated perforating, bleeding or stenosed ulcers (38 cases). In the complicated duodenal ulcer, HSV was usually carried out with suturing bleeding point, perforated ulcer or with pyloroplasty. With a follow-up of 3~20 years, the recurrence rate werelt;2% and 85.7% of cases had excellent or good results as Visick classification. Considerations relevant to the HSV technic are deemed worthy of emphasis; complete resection of gastric branches of anterior and posterior vagal trunks and preservation of the first limb of the "Crow’s foot", extended dissection of the distal 5-7cm of the esophagus and division of the distal 8-10cm of the bundle of the gastroepiploic vessels in order to deprive the whole parietal cell mass of its vagal supply. In 4 patients, recurrence were easily controlled with remedies or operation for gastric retention by rational type. The authors suggest that the modified HSV plus mucusdeprived antrectomy be the rational surgical choice for duodenal ulcer.
Objective To investigate the effect of cholecystectomy on the induction of large intestine cancer and its mechanism. Methods After cholecystectomy, the large intestine neoplasm in mice was induced with dimethylhydrazine(DMH).The histogenesis and growth pattern of large intestine cancer were observed.The Sphase fraction (SPF) of epithelium cells in large intestine mucosa was determined using flow cytometry. Before and after operation, the feces of mice were collected to determine the cholic acid (CA), chenodeoxycholic acid (CDCA), deoxycholic acid (DCA) and lithocholic acid (LCA) concentration by highperformance liquid chromatography. Results The average number of large intestine neoplasms per mouse,percentage of large intestine adenomas in examined mice and SPF of experimental group were significantly higher than those of control group (P＜0.05). The fecal LCA concentration in postcholecystectomy was significantly higher than that in precholecystectomy and in sham operation group (P=0.00). Conclusion The large intestine neoplasm of mice induced by DMH is increased and the proliferation of epithelium cell in large intestine mucosa is increased after cholecystectomy. This suggests that cholecystectomy has promoting effect on induction of large intestine neoplasm in mice. The gut may deal with the increased secondary bile acid(LCA) concentration postcholecystectomy.
Objective To investigate the effects of highly selective vagotomy plus mucosal antrectomy (HSVMA) and highly selective vagotomy (HSV) alone on the functions of the gastric antrum. MethodsEighteen dogs and 48 patients with chronic duodenal ulcer were tested. The time of gastric emptying, antral myoelectric activity, antral pressure were measured 4-6 months after operation in 18 dogs which were randomized into the control, HSV and HSVMA groups. The gastric evacuation, frequency and amplitude of electrogastrography (EGG) were observed 4-6 months after operation in 48 patients who were randomly divided into HSV (20 patients) and HSVMA (28 patients) group, their preoperative values were considered as control group. ResultsIt was found by barium meal examinations that the shape of the stomach and duodenum was normal and gastric peristalsis was clearly visible in all the animals and patients of two postoperative groups. The beginning and ending time of gastric emptying were (5.0±0.06) min and (4.0±0.4) h respectively in the dogs of HSVMA group, which were similar to those of the dogs of control and HSV group (Pgt;0.05). The frequency of the antral myoelectric action potential was (3.11±0.65 ) cycles/min in the dogs of HSVMA group, the frequency of EGG was (3.25±0.75) cycles/min in the patients of HSVMA group, which were significantly lower than that of the dogs or patients of control and HSV group (P＜0.05). Injection of pentagastrin in dogs or taking meal in patients significantly increased the antral pressure or amplitude of EGG. Conclusion The motor function of the reconstructed antrum in the HSVMA group approaches the normal level despite a lower antral myoelectric frequency. It is believed that HSVMA will be a choice for the treatment of duodenal ulcer.
From march 199 to marxh 1994, 25 patients sustained acute gastroduodenal muncosal hemorrhage after liver surgery of 1519 cases in this hospital. Among all patients, 24 cases were primary liver carcinoma with hepatocirrhosis and one was cavernous hemangioma of the liver gt;all were treated by non-operative method, including nutritional support, liver function protection, blood transfusion and infusion to increase the blood volume and administration of hemostatic and antagonist of H2-receptor or H+/K+ATP enyme. Twenty one patients recovered and 4 deaths were cases of severe hepatocirrhosis. The result indicates that there is a direct relationship between acute gastroduodenal mucosal lesions and hepatic cirrhosis. The severer the degree of hepaticcirrhosis and the worse the general condition after surgery is the more severely the liver function impaired, there will be more chance of developing acute gastricmucosal erosion and bleeding.
Objective To summarize the role of inflammatory cytokines in the pathogenesis of acute pancreatitis (AP) and gut barrier dysfunction in recent years. Methods Literatures on cytokines and experimental pancreatitis as well as clinical pancreatitis were collected and reviewed. Results Tumor necrosis factor-α and other inflammatory cytokines were elevated significantly during pancreatitis in many tissues, especially in pancreas and alimentary tract, in a fashion independent of the animal model used. Anti-cytokine therapy could decrease the concentration of the cytokines in experimental animal. Conclusion Inflammatory cytokines are believed to be primarily responsible for the pathogenesis of acute pancreatitis and its associated distant organ dysfunction. Further study of the nature of these cytokines may provide a new approach to treating this disease.
Six dogs underwent high selective vagotomy and mucosal antrectomy (HSV+MA). The gross and histological change of dog’s stomach were observed at 4-6 months after operation. It was found that the reconstructed antrum healed well and there was no stasis and distension in the stomach .The appearance of the nerves in muscular layer of the antrum was normal. No serious gastritis and mucosal atrophy was observed. These results indicat that HSV+MA is a reasonable procedure for the treatment of duodenal ulcer.
Eighteen paticnts (17 females and 1 male ) with acguired preanal fistula were treated surgically. The ages ranged from 4 months to 12 years. Their locations were between the anorectum and the vestibulum (12 cases), the anorectum and the labia (2 cases), the anorectum and the vagina (3 cases), and the anorectum and the urethra (1 case). All of them were tueated by intraectal repair. The surgical procedures were briefly discused. The operation could be used in all types of acquired preanal fistula and has no danger of trauma to the anal sphincter and posterior vaginal wall. A long term follow-up study of 7 patients showed that there was a cure in 18 cases with normal function.
