单切口免钛夹腹腔镜胆囊切除术

Objective To explore the safety and feasibility of single-incision laparoscopic cholecystectomy without using titanium-clips. Methods Data of 1016 patients(group A) undergoing single-incision laparoscopic cholecystectomy without using titanium-clips were compared to that of 874 patients(group B)undergoing two-port laparoscopic cholecystectomy without using titanium-clips by t test and chi square test for operating time,operative hemorrhage,the length of postoperative hospital stay and postoperative pain.Results In group A,1001 cases were successfully operated on with single-incision laparoscopic cholecystectomy,with conversion to classic four-port laparoscopic cholecystectomy in 15 cases,while 874 cases in group B were operated on with two-port laparoscopic cholecystectomy.There were no bile leakage,biliary tract injury or death in both groups.There were no difference in operating time[(34.5 ±5.2) min vs (32.0±7.4)min,t=0.063,P=0.526],the length of postoperative hospital stay[(3.1±0.8)d vs(3.2±0.7)d,t=1.073,P=0.326]and operative hemorrhage[(56.5±17.8)ml vs (55.2±15.9)ml,t=0.812,P=0.425](P>0.05) between the two groups,but the postoperative pain was less severe in Group A than that in group B (P=0.000<0.05). Conclusions The single-incision laparoscopic cholecystectomy is feasible,safe,less traumatic and more cosmetic.     

前臂人工血管内瘘术后发生血清肿一例

患者男 ,38岁 ,左前臂桡动脉头静脉内瘘血液透析 5年 ,内瘘狭窄 3月 ,介入治疗失败并致内瘘闭塞 2d来诊手术。手术于左肘 ,间置 6mm× 7cmGore tex人工血管完成前臂肱动脉头静脉人工血管内瘘术。术中见人工血管“出汗”明显。术后 2 4h皮片引流出约 2 0 0 0ml清亮无色液体 ,术后4 8h引流自行停止。术后左肘局部渐隆起 ,不伴红肿 ,患者无寒战发热。术后 15d突发内瘘杂音震颤消失。急诊手术 ,经原手术入路撑开切口立见涌出浆液性液约 2 0ml(积液细菌培养阴性 )。内瘘解除压迫后恢复通畅。继续血液透析治疗。血液透析后左肘包块增大明显 ,需穿…     

单切口免钛夹腹腔镜胆囊切除术

Objective To explore the safety and feasibility of single-incision laparoscopic cholecystectomy without using titanium-clips. Methods Data of 1016 patients(group A) undergoing single-incision laparoscopic cholecystectomy without using titanium-clips were compared to that of 874 patients(group B)undergoing two-port laparoscopic cholecystectomy without using titanium-clips by t test and chi square test for operating time,operative hemorrhage,the length of postoperative hospital stay and postoperative pain.Results In group A,1001 cases were successfully operated on with single-incision laparoscopic cholecystectomy,with conversion to classic four-port laparoscopic cholecystectomy in 15 cases,while 874 cases in group B were operated on with two-port laparoscopic cholecystectomy.There were no bile leakage,biliary tract injury or death in both groups.There were no difference in operating time[(34.5 ±5.2) min vs (32.0±7.4)min,t=0.063,P=0.526],the length of postoperative hospital stay[(3.1±0.8)d vs(3.2±0.7)d,t=1.073,P=0.326]and operative hemorrhage[(56.5±17.8)ml vs (55.2±15.9)ml,t=0.812,P=0.425](P>0.05) between the two groups,but the postoperative pain was less severe in Group A than that in group B (P=0.000<0.05). Conclusions The single-incision laparoscopic cholecystectomy is feasible,safe,less traumatic and more cosmetic.     

单切口免钛夹腹腔镜胆囊切除术

目的 探讨单切口免钛夹腹腔镜胆囊切除术治疗胆囊良性疾病的可行性及安全性.方法 按患者意愿对1890例胆囊良性疾病患者中的1016例采用脐部单切口免钛夹腹腔镜胆囊切除术(单切口组),实际完成1001例,与同期完成的874例两孔法免钛夹腹腔镜胆囊切除术患者进行比较,采用t检验和x2比较两组的手术时间、术中出血量、术后恢复等情况.结果 单切口组1016例仅15例因胆囊壶腹部炎症严重改为传统的四孔法切除,其余1001例均顺利完成单切口下LC术.两孔法组完成腹腔镜胆囊切除术874例.两组均无胆漏、胆道损伤及手术死亡等严重的手术并发症.单切口组与两孔法组的手术时间无差异[(34.5±5.2)min与(32.0±7.4)min,t=0.063,P=0.526]、术中出血量无差异[(56.5±17.8) ml与(55.2±15.9)ml,t=0.812,P=0.425]、术后住院时间无差异[(3.1±0.8)d与(3.2±O.7)d,t=1.073,P=0.326],而单切口组切口疼痛轻于两孔法组(P=0.000).结论 单切口免钛夹腹腔镜胆囊切除术安全性好,创伤更小,更美观.[关健词]胆囊切除术,腹腔镜;单切口;钛夹     

细胞迁移机制的研究进展

细胞的迁移是一动态过程。为了研究的方便 ,目前把细胞的迁移过程机械的分成 4步[1] :①细胞前端伸出板状伪足 (lamillipodia) ;②细胞前端伪足和细胞外基质 (extracellularmatrix ,ECM )形成新的细胞黏着 ;③细胞体收缩 ;④细胞尾端和周围基质黏着解离 ,细胞向前运动。在迁移过程中 ,细胞内细胞骨架蛋白的动态组装、细胞和细胞外基质之间黏着的动态变化、周围基质的重塑等以及这些反应在迁移过程中的协调涉及复杂的信号调节。近来的研究认为黏着斑 (focaladhension) ,整合素 (integrin) ,黏着斑激酶 (focalad hensionkinase ,FAK) ,RHO…