目的:探讨急性胆源性胰腺炎(ABP)患者行腹腔镜胆囊切除手术时机选择。方法:选择2014年3月—2017年1月收治的96例ABP患者,其中47例在行腹腔镜胆囊切除术与胆总管探查术之前行保守治疗,49例直接行腹腔镜胆囊切除术与胆总管探查术(对照组)...目的:探讨急性胆源性胰腺炎(ABP)患者行腹腔镜胆囊切除手术时机选择。方法:选择2014年3月—2017年1月收治的96例ABP患者,其中47例在行腹腔镜胆囊切除术与胆总管探查术之前行保守治疗,49例直接行腹腔镜胆囊切除术与胆总管探查术(对照组)。比较两组患者的相关临床指标。结果:与对照组比较,观察组的术后镇痛药使用例数(19例vs.9例)、平均手术时间(1.9 h vs.1.6 h)、平均术后胃肠蠕动恢复时间(2.6 d vs.1.9 d)、术后切口感染例数(7例vs.1例)、中转开腹手术例数(6例vs.1例)、平均术后引流量(56.9 mL vs.32.4 mL)与平均术后住院时间(6.2 d vs.4.5 d)均明显减少,治疗总有效率(81.6%vs.95.7%)明显升高(均P<0.05)。随访期9~39个月,两组均无ABP复发。结论:ABP先行积极保守治疗,待胰腺炎缓解后,再行腹腔镜胆囊切除,具有安全可行的特点,推荐临床应用。展开更多
BACKGROUND: The pancreas has a strong regeneration potential in mammals. Previous studies suggested that pancreas regeneration is correlated with proliferation and differentiation of pancreatic stem cells, but the fie...BACKGROUND: The pancreas has a strong regeneration potential in mammals. Previous studies suggested that pancreas regeneration is correlated with proliferation and differentiation of pancreatic stem cells, but the field of pancreatic stem cells is still in its infancy. This study was undertaken to detect the expression of pancreas/duodenal homeobox-1 (PDX-1) and proliferation of pancreatic duct epithelial cells in remnant pancreas during regeneration after partial pancreatectomy in rats, and characterize the source of pancreatic stem cells. METHODS: Partial pancreatectomy (90%) was performed on four- to five-week-old Sprague-Dawley rats, and duct epithelial cells and acinar cells were detected by immunohistochemical staining and scored using the 5-bromo-2-deoxyuridine (BrdU) labelling index at various time points. Western blotting and reverse transcriptase-polymerase chain reaction (RT-PCR) were used to assess the expression of PDX-1 protein and mRNA, respectively. RESULTS: At 24 hours after partial pancreatectomy, proliferation started in the main, large and small duct cells, and persisted in small duct cells to day 5. The experimental and control groups were significantly different (P<0.001). BrdU-positive acinar cells were greatly increased and reached a peak on day 5. PDX-1 protein was only faintly detectable in pancreatic ductal cells on day I after partial pancreatectomy. On days 2 and 3, a 2-3 fold increase in PDX-1 protein was observed, corresponding to the characteristic 42 kD protein in Western blotting. The operated and sham-operated groups also differed significantly (P<0.05). PDX-1 protein expression on days 5 and 7 after operation did not differ from that of the control group. RT-PCR revealed that PDX-1 mRNA expression did not significantly differ between the operated group and the sham-operated group at various time points. CONCLUSIONS: Pancreatic stem cells in pancreatic ductal epithelial cells are involved in the regeneration of remnant pancreas and the expression of PDX-1 in ductal cells is due 展开更多
目的评价胰管支架置入术预防高危患者内镜逆行胰胆管造影术后胰腺炎（PEP）的作用。方法通过计算机文献检索Cochrane图书馆（1970-2015.8）、Pub Med（1966-2015.8）、EMBASE（1966-2015.8）和中国生物医学文献资料库（1978-2015.8）,...目的评价胰管支架置入术预防高危患者内镜逆行胰胆管造影术后胰腺炎（PEP）的作用。方法通过计算机文献检索Cochrane图书馆（1970-2015.8）、Pub Med（1966-2015.8）、EMBASE（1966-2015.8）和中国生物医学文献资料库（1978-2015.8）,查找胰管支架置入术预防PEP的随机对照试验及其参考文献。由2名研究者独立选择实验、提取资料和评估方法学质量,采用Cochrane协作网提供的Rev Man 5.3软件进行统计分析。结果共纳入23篇文献,包括2556例患者。Meta分析结果显示：与对照组比较,使用胰管支架可以有效预防高危患者发生PEP（RR=0.34,95%CI：0.27～0.43,P〈0.00001）,并可有效减轻PEP的严重程度（RR=0.18,95%CI：0.08～0.42,P〈0.0001）。结论胰管支架能够预防高危患者PEP的发生,并可以减轻PEP的严重程度。展开更多
文摘目的:探讨急性胆源性胰腺炎(ABP)患者行腹腔镜胆囊切除手术时机选择。方法:选择2014年3月—2017年1月收治的96例ABP患者,其中47例在行腹腔镜胆囊切除术与胆总管探查术之前行保守治疗,49例直接行腹腔镜胆囊切除术与胆总管探查术(对照组)。比较两组患者的相关临床指标。结果:与对照组比较,观察组的术后镇痛药使用例数(19例vs.9例)、平均手术时间(1.9 h vs.1.6 h)、平均术后胃肠蠕动恢复时间(2.6 d vs.1.9 d)、术后切口感染例数(7例vs.1例)、中转开腹手术例数(6例vs.1例)、平均术后引流量(56.9 mL vs.32.4 mL)与平均术后住院时间(6.2 d vs.4.5 d)均明显减少,治疗总有效率(81.6%vs.95.7%)明显升高(均P<0.05)。随访期9~39个月,两组均无ABP复发。结论:ABP先行积极保守治疗,待胰腺炎缓解后,再行腹腔镜胆囊切除,具有安全可行的特点,推荐临床应用。
基金This study was supported by a grant from the National Natural Sciences Foundation of China (No. 30571817).
文摘BACKGROUND: The pancreas has a strong regeneration potential in mammals. Previous studies suggested that pancreas regeneration is correlated with proliferation and differentiation of pancreatic stem cells, but the field of pancreatic stem cells is still in its infancy. This study was undertaken to detect the expression of pancreas/duodenal homeobox-1 (PDX-1) and proliferation of pancreatic duct epithelial cells in remnant pancreas during regeneration after partial pancreatectomy in rats, and characterize the source of pancreatic stem cells. METHODS: Partial pancreatectomy (90%) was performed on four- to five-week-old Sprague-Dawley rats, and duct epithelial cells and acinar cells were detected by immunohistochemical staining and scored using the 5-bromo-2-deoxyuridine (BrdU) labelling index at various time points. Western blotting and reverse transcriptase-polymerase chain reaction (RT-PCR) were used to assess the expression of PDX-1 protein and mRNA, respectively. RESULTS: At 24 hours after partial pancreatectomy, proliferation started in the main, large and small duct cells, and persisted in small duct cells to day 5. The experimental and control groups were significantly different (P<0.001). BrdU-positive acinar cells were greatly increased and reached a peak on day 5. PDX-1 protein was only faintly detectable in pancreatic ductal cells on day I after partial pancreatectomy. On days 2 and 3, a 2-3 fold increase in PDX-1 protein was observed, corresponding to the characteristic 42 kD protein in Western blotting. The operated and sham-operated groups also differed significantly (P<0.05). PDX-1 protein expression on days 5 and 7 after operation did not differ from that of the control group. RT-PCR revealed that PDX-1 mRNA expression did not significantly differ between the operated group and the sham-operated group at various time points. CONCLUSIONS: Pancreatic stem cells in pancreatic ductal epithelial cells are involved in the regeneration of remnant pancreas and the expression of PDX-1 in ductal cells is due
文摘目的评价胰管支架置入术预防高危患者内镜逆行胰胆管造影术后胰腺炎（PEP）的作用。方法通过计算机文献检索Cochrane图书馆（1970-2015.8）、Pub Med（1966-2015.8）、EMBASE（1966-2015.8）和中国生物医学文献资料库（1978-2015.8）,查找胰管支架置入术预防PEP的随机对照试验及其参考文献。由2名研究者独立选择实验、提取资料和评估方法学质量,采用Cochrane协作网提供的Rev Man 5.3软件进行统计分析。结果共纳入23篇文献,包括2556例患者。Meta分析结果显示：与对照组比较,使用胰管支架可以有效预防高危患者发生PEP（RR=0.34,95%CI：0.27～0.43,P〈0.00001）,并可有效减轻PEP的严重程度（RR=0.18,95%CI：0.08～0.42,P〈0.0001）。结论胰管支架能够预防高危患者PEP的发生,并可以减轻PEP的严重程度。
