Abscisic acid(ABA)is an important phytohormone regulating plant growth,development,and stress responses.It has an essential role in multiple physiological processes of plants,such as stomatal closure,cuticular wax acc...Abscisic acid(ABA)is an important phytohormone regulating plant growth,development,and stress responses.It has an essential role in multiple physiological processes of plants,such as stomatal closure,cuticular wax accumulation,leaf senescence,bud dormancy,seed germination,osmotic regulation,and growth inhibition among many others.Abscisic acid controls downstream responses to abiotic and biotic environmental changes through both transcriptional and posttranscriptional mechanisms.During the past 20 years,ABA biosynthesis and many of its signaling pathways have been well characterized.Here we review the dynamics of ABA metabolic pools and signaling that affects many of its physiological functions.展开更多
Surgical fraternity has not yet arrived at any consensus for adequate treatment of choledocholithiasis. Sequential treatment in the form of pre-operative endoscopic retrograde cholangio-pancreatography followed by lap...Surgical fraternity has not yet arrived at any consensus for adequate treatment of choledocholithiasis. Sequential treatment in the form of pre-operative endoscopic retrograde cholangio-pancreatography followed by laparoscopic cholecystectomy(LC) is considered as optimal treatment till date. With refinements in technique and expertise in field of minimal access surgery, many centres in the world have started offering one stage management of choledocholithiasis by LC with laparoscopic common bile duct exploration(LCBDE). Various modalities have been tried for entering into concurrent common bile duct(CBD) [transcystic(TC) vs transcholedochal(TD)], for confirming stone clearance(intraoperative cholangiogram vs choledochoscopy), and for closure of choledochotomy(T-tube vs biliary stent vs primary closure) during LCBDE. Both TC and TD approaches are safe and effective. TD stone extraction is involved with an increased risk of bile leaks and requires more expertise in intra-corporeal suturing and choledochoscopy. Choice depends on number of stones, size of stone, diameter of cystic duct and CBD. This review article was undertaken to evaluate the role of LCBDE for the management of choledocholithiasis.展开更多
Background:Laparoscopic common bile duct exploration(LCBDE)is one of the minimally invasive options for choledocholithiasis.Primary closure of the common bile duct(CBD)upon completion of laparoscopic choledochotomy is...Background:Laparoscopic common bile duct exploration(LCBDE)is one of the minimally invasive options for choledocholithiasis.Primary closure of the common bile duct(CBD)upon completion of laparoscopic choledochotomy is safe in selected patients.The present study aimed to evaluate the feasibility and safety of primary closure of CBD after LCBDE in patients aged 70 years or older.Methods:A total of 116 patients(51 males and 65 females)who suffered from choledocholithiasis and underwent primary closure of the CBD(without T-tube drainage)after LCBDE from January 2003 to December 2017 were recruited.They were classified into two groups according to age:group A(≥70 years,n=56),and group B(<70 years,n=60).The preoperative characteristics,intraoperative details,and postoperative outcomes of the two groups were evaluated.Results:The mean operative time was 172.02 min for group A and 169.92 min for group B(P=0.853).The mean hospital stay was 7.40 days for group A and 5.38 days for group B(P<0.001).Bile leakage occurred in two patients in group A and one in group B(3.57%vs 1.67%,P=0.952).There were no significant differences in the rates of postoperative complications and mortality between the two groups.At median follow-up time of 60 months,stone recurrence was detected in one patient in group A and two in group B(1.79%vs 3.33%,P=1.000).Stenosis of CBD was not observed in group A and slight stenosis in one patient in group B(0 vs 1.67%,P=1.000).Conclusion:Primary closure of the CBD upon completion of laparoscopic choledochotomy is safe and feasible in elderly patients≥70 years old.展开更多
基金supported by the Shanghai Center for Plant Stress Biology from the Chinese Academy of Sciences, the Strategic Priority Research Program of the Chinese Academy of Sciences (XDB27040107)the National Natural Science Foundation of China (31970293)the Shanghai Pujiang Program (18PJ1410900)
文摘Abscisic acid(ABA)is an important phytohormone regulating plant growth,development,and stress responses.It has an essential role in multiple physiological processes of plants,such as stomatal closure,cuticular wax accumulation,leaf senescence,bud dormancy,seed germination,osmotic regulation,and growth inhibition among many others.Abscisic acid controls downstream responses to abiotic and biotic environmental changes through both transcriptional and posttranscriptional mechanisms.During the past 20 years,ABA biosynthesis and many of its signaling pathways have been well characterized.Here we review the dynamics of ABA metabolic pools and signaling that affects many of its physiological functions.
文摘Surgical fraternity has not yet arrived at any consensus for adequate treatment of choledocholithiasis. Sequential treatment in the form of pre-operative endoscopic retrograde cholangio-pancreatography followed by laparoscopic cholecystectomy(LC) is considered as optimal treatment till date. With refinements in technique and expertise in field of minimal access surgery, many centres in the world have started offering one stage management of choledocholithiasis by LC with laparoscopic common bile duct exploration(LCBDE). Various modalities have been tried for entering into concurrent common bile duct(CBD) [transcystic(TC) vs transcholedochal(TD)], for confirming stone clearance(intraoperative cholangiogram vs choledochoscopy), and for closure of choledochotomy(T-tube vs biliary stent vs primary closure) during LCBDE. Both TC and TD approaches are safe and effective. TD stone extraction is involved with an increased risk of bile leaks and requires more expertise in intra-corporeal suturing and choledochoscopy. Choice depends on number of stones, size of stone, diameter of cystic duct and CBD. This review article was undertaken to evaluate the role of LCBDE for the management of choledocholithiasis.
文摘Background:Laparoscopic common bile duct exploration(LCBDE)is one of the minimally invasive options for choledocholithiasis.Primary closure of the common bile duct(CBD)upon completion of laparoscopic choledochotomy is safe in selected patients.The present study aimed to evaluate the feasibility and safety of primary closure of CBD after LCBDE in patients aged 70 years or older.Methods:A total of 116 patients(51 males and 65 females)who suffered from choledocholithiasis and underwent primary closure of the CBD(without T-tube drainage)after LCBDE from January 2003 to December 2017 were recruited.They were classified into two groups according to age:group A(≥70 years,n=56),and group B(<70 years,n=60).The preoperative characteristics,intraoperative details,and postoperative outcomes of the two groups were evaluated.Results:The mean operative time was 172.02 min for group A and 169.92 min for group B(P=0.853).The mean hospital stay was 7.40 days for group A and 5.38 days for group B(P<0.001).Bile leakage occurred in two patients in group A and one in group B(3.57%vs 1.67%,P=0.952).There were no significant differences in the rates of postoperative complications and mortality between the two groups.At median follow-up time of 60 months,stone recurrence was detected in one patient in group A and two in group B(1.79%vs 3.33%,P=1.000).Stenosis of CBD was not observed in group A and slight stenosis in one patient in group B(0 vs 1.67%,P=1.000).Conclusion:Primary closure of the CBD upon completion of laparoscopic choledochotomy is safe and feasible in elderly patients≥70 years old.
