腹腔镜下胆总管探查取石术21例分析

目的 探讨腹腔镜下胆总管探查取石术(LCBDE)的优点、方法、适应证及术后胆总管引流的必要条件.方法 运用腹腔镜下胆总管切开,专用胆石钳取石和/或在胆道镜直视下取石,回顾性分析胆总管结石患者行腹腔镜胆总管切开取石术的术式及特点.结果 21例患者均在腹腔镜下成功完成胆总管切开取石术,无中转开腹,平均手术时间145min,平均出血75mL,平均住院6d.3例患者术后出现轻微胆漏,保守治疗4d后痊愈;5例发现残余结石,均使用胆道镜或逆行胰胆管切开取石术(EST)取尽结石.其余患者无严重并发症发生.结论 腹腔镜下胆总管切开取石术具有微创、安全的优点,在严格把握手术适应证和熟练掌握腔镜基本功的前提下,是值得推广的临床治疗胆总管结石的手术方式.     

Sealing of anodized magnesium alloy AZ31 with MgAl layered double hydroxides layers

In this work, anodized magnesium alloy AZ31 with and without boiling water sealing was pre-prepared, and then MgAl-layered double hydroxide (LDH) films were fabricated on it through hydrothermal chemical conversion of the pre-prepared anodic layer. The morphology, structure, and composition of the films were characterized by XRD, SEM, EDS, FT-IR, XPS and GDOES. It was found that the porosity of the films was reduced after in situ fabrication of the LDHs. The effects of boiling water sealing treatment on the anodized substrate were also discussed. Moreover, the polarization curve, EIS, and immersion tests showed that LDHs fabricated on the anodized substrate with boiling water sealing treatment exhibited a significant long period of protection for the substrate.

In this work anodized magnesium alloy AZ31 with and without boiling water sealing was pre-prepared, and then MgAl-layered double hydroxide (LDH) films were fabricated on it through hydrothermal chemical conversion of the pre-prepared anodic layer.     

Role for engagement of β‐arrestin2 by the transactivated EGFR in agonist‐specific regulation of δ receptor activation of ERK1/2

Background and Purpose

β‐Arrestins function as signal transducers linking GPCRs to ERK1/2 signalling either by scaffolding members of ERK1/2s cascades or by transactivating receptor tyrosine kinases through Src‐mediated release of transactivating factor. Recruitment of β‐arrestins to the activated GPCRs is required for ERK1/2 activation. Our previous studies showed that δ receptors activate ERK1/2 through a β‐arrestin‐dependent mechanism without inducing β‐arrestin binding to the δ receptors. However, the precise mechanisms involved remain to be established.

Experimental Approach

ERK1/2 activation by δ receptor ligands was assessed using HEK293 cells in vitro and male Sprague Dawley rats in vivo. Immunoprecipitation, immunoblotting, siRNA transfection, intracerebroventricular injection and immunohistochemistry were used to elucidate the underlying mechanism.

Key Results

We identified a new signalling pathway in which recruitment of β‐arrestin2 to the EGFR rather than δ receptor was required for its role in δ receptor‐mediated ERK1/2 activation in response to H‐Tyr–Tic–Phe–Phe–OH (TIPP) or morphine stimulation. Stimulation of the δ receptor with ligands leads to the phosphorylation of PKCδ, which acts upstream of EGFR transactivation and is needed for the release of the EGFR‐activating factor, whereas β‐arrestin2 was found to act downstream of the EGFR transactivation. Moreover, we demonstrated that coupling of the PKCδ/EGFR/β‐arrestin2 transactivation pathway to δ receptor‐mediated ERK1/2 activation was ligand‐specific and the Ser³⁶³ of δ receptors was crucial for ligand‐specific implementation of this ERK1/2 activation pathway.

Conclusions and Implications

The δ receptor‐mediated activation of ERK1/2 is via ligand‐specific transactivation of EGFR. This study adds new insights into the mechanism by which δ receptors activate ERK1/2.

Abbreviations

DPDPE

[D‐Pen2, D‐Pen5] enkephalin

HB‐EGF

heparin‐binding EGF‐like growth factor

IGFR

insulin‐like growth factor receptor

NG108‐15

cell mouse neuroblastoma x rat glioma hybrid cell

RTK

receptor tyrosine kinase

TIPP

H‐Tyr‐Tic‐Phe‐Phe‐OH

     

MT1-MMP collagenolytic activity is regulated through association with tetraspanin CD151 in primary endothelial cells

MT1-MMP plays a key role in endothelial function, as underscored by the angiogenic defects found in MT1-MMP deficient mice. We have studied the molecular interactions that underlie the functional regulation of MT1-MMP. At lateral endothelial cell junctions, MT1-MMP colocalizes with tetraspanin CD151 (Tspan 24) and its associated partner alpha3beta1 integrin. Biochemical and FRET analyses show that MT1-MMP, through its hemopexin domain, associates tightly with CD151, thus forming alpha3beta1 integrin/CD151/MT1-MMP ternary complexes. siRNA knockdown of HUVEC CD151 expression enhanced MT1-MMP-mediated activation of MMP2, and the same activation was seen in ex vivo lung endothelial cells isolated from CD151-deficient mice. However, analysis of collagen degradation in these experimental models revealed a diminished MT1-MMP enzymatic activity in confined areas around the cell periphery. CD151 knockdown affected both MT1-MMP subcellular localization and its inclusion into detergent-resistant membrane domains, and prevented biochemical association of the metalloproteinase with the integrin alpha3beta1. These data provide evidence for a novel regulatory role of tetraspanin microdomains on the collagenolytic activity of MT1-MMP and indicate that CD151 is a key regulator of MT1-MMP in endothelial homeostasis.     

Anatomical Variations in Stylopharyngeus Muscle Insertions Suggest Interindividual and Left/Right Differences in Pharyngeal Clearance Function of Elderly Patients: A Cadaveric Study

The stylopharyngeus plays a critical role in the clearance of the piriform recess. We dissected 78 sides of the pharynx from 55 donated cadavers and observed histology of another seven sides of the pharynx from seven cadavers. The stylopharyngeus consistently comprised (1) a descending muscle bundle surrounding the piriform recess and (2) an additional short sheet inserting into the tonsillar bed. Histologically, the former bundle connected to a thick fascia providing the lateral glossoepiglottic fold, extending along the submucosa of the piriform recess, and covering the thyroid cartilage, whereas the latter sheet intermingled with other pharyngeal wall muscles at and near the tonsillar bed. Notably, in 44.4% of female specimens, the additional sheet occupied a greater proportion in cross section than the descending muscle bundle. Given the different directions, the additional sheet seemed to check clearance function of the descending bundle for the piriform recess. Thus, particularly in women, interindividual differences in pharyngeal clearance were likely to depend on whether the additional sheet is strong or weak. Chin down in combination with tilting and rotating the head may represent effective exercises of the stylopharyngeus that could compensate for the disadvantages of additional insertion.