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Etiology and surgical treatment of hilar bile duct stricture

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hepatobiliary & Pancreatic Diseases International 2003年第4期2卷 587-593页

作者： zhen-ping he Wen-Lin Hou ping Bie Jia-Hong Dong Shu-Guang Wang Ben-Li Han Jin-Xiu Cai Zhi-Hua Li ping Chen Kuan-Sheng Ma Shu-Guo zheng Institute of hepatobiliary Surgery Southwest Hospital Third Military Medical University Chongqing 400038 China. hezhenping@***

OBJECTIVE: To improve the surgical effects of hilar duct ***: The clinical data of 76 patients with hilar bile duct stricture treated at our hospital from1990 to 2000 were analyzed. The diagnosis was determined by triad signs of cholangitis, increase of ALPand γ-GGT levels, dilation of intrahepatic and extrahepatic bile ducts confirmed by ultrasonography(US), computed tomography (CT), percutaneous transhepatic cholangiography (PTC) or endoscopicretrograde cholangiopancreatography (ERCP). The location of stricture was divided according to theBismuth classification ***: Among the 76 patients, 46 (60.5%) suffered from injurious stricture, including 13% ofBismuth type Ⅰ, 39% of type Ⅱ, 19.4% of type Ⅲ, and 28.2% of type Ⅳ. Inflammatory stricture wasfound in 28 patients, locating in the left hepatic duct (LHD) 46.4% (13/28), the right hepatic duct(RHD) 35.7% (10/28), and the common hepatic duct (CHD) 17.9% (5/28), respectively. Thepercentages of patients with stricture due to Mirizzi’s syndrome, bile duct cyst, and sclerosingcholangitis were 9.2%, 3.9% and 2.6%, respectively. Bile duct repair procedures included biliaryreconstruction with pedicled umbilical vein graft for 9.2% of the patients, and proximalcholangiojejunostomy combined with LHD and RHD plasticity for 92.2% Seventy of the 76 patients werefollowed up for 2-10 years, and the excellent outcome rate was 94.7%.CONCLUSIONS: Injurious stricture is the major type of hilar bile duct stricture. Inflammatory strictureis mainly composed of RHD. Hilar bile duct stricture should be treated surgically according to variousetiological features and technical principles of biliary repair.

关键词： stricture bile duct operation repair

Clinical analysis of surgical treatment of portal hypertension

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World Journal of Gastroenterology 2005年第29期11卷 4552-4559页

作者： Xin-Bao Xu Jing-Xiu Cai Xi-Sheng Leng Jia-Hong Dong Ji-Ye Zhu zhen-ping he Fu-Shun Wang Ji-Run Peng Ben-Li Han Ru-Yu Du Department of hepatobiliary Surgery People's Hospital Peking University Beijing 100044 China Department of hepatobiliary Surgery Airforce General Hospital Beijing 100036 China Center of hepatobiliary Surgery Southwest Hospital The Third Military Medical University Chongqing 400038 China

AIM： To review the experience in surgery for 508 patients with portal hypertension and to explore the selection of reasonable operation under different conditions. METHODS： The data of 508 patients with portal hypertension treated surgically in 1991-2001 in our centers were analyzed. Of the 508 patients, 256 were treated with portaazygous devascularization （PAD）, 167 with portasystemic shunt （PSS）, 62 with selective shunt （SS）, 11 with combined portasystemic shunt and portaazygous devascularization （PSS＋PAD）, 9 with liver transplantation （LT）, 3 with union operation for hepatic carcinoma and portal hypertension （HCC＋PH）. RESULTS： In the 167 patients treated with PSS, free portal pressure （FPP） was significantly higher in the patients with a longer diameter of the anastomotic stoma than in those with a shorter diameter before the operation （P〈0.01）. After the operation, FPP in the former patients markedly decreased compared to the latter ones （P〈0.01）. The incidence rate of hemorrhage in patients treated with PAD, PSS, 55, PSS＋PAD, and HCC＋PH was 21.09% （54/256）, 13.77 （23/167）, 11.29 （7/62）, 36.36% （4/11）, and 100% （3/3）, respectively. The incidence rate of hepatic encephalopathy was 3.91% （10/256）, 9.58% （16/167）, 4.84% （3/62）, 9.09% （1/11）, and 100% （3/3）, respectively while the operative mortality was 5.49% （15/256）, 4.22% （7/167）, 4.84% （3/62）, 9.09% （1/11）, and 66.67% （2/3） respectively. The operative mortality of liver transplantation was 22.22% （2/9）. CONCLUSION： Five kinds of operation in surgical treatment of portal hypertension have their advantages and disadvantages. Therefore, the selection of operation should be based on the actual needs of the patients.

关键词： Portal hypertension Surgical operation Shunt

Preoperative selective portal vein embolization in two-step hepatectomy for hepatocellular carcinoma in injured livers: a preliminary report

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hepatobiliary & Pancreatic Diseases International 2003年第2期2卷 532-536页

作者： Wu Ji Wu-Hong Liu Kuan-Sheng Ma Xiang-Tian Wang zhen-ping he Jia-Hong Dong Jie-Shou Li Department of General Surgery Kunming General Hospital of Chengdu PLA Command Kunming 650032 China. jiwusky@***

OBJECTIVE: To study the effect of preoperative selective portal vein embolization (SPVE) in thetwo-step hepatectomy for patients with primary hepatocellular carcinoma (HCC) in injured ***: Twenty-six patients with HCC and cirrhosis who were not suitable for curative hepatectomywere treated by ultrasound-guided percutaneous transhepatic SPVE with a fine needle. The success rate,side-effects and complications of SPVE, serial changes of hepatic lobe volume and rate of two-step curativehepatectomy after SPVE were ***: SPVE was performed in 24 patients (92.3%). In patients whose right portal vein brancheswere embolized, the right hepatic volume decreased but the left hepatic volume increased gradually. Theratio of the right hepatic volume to the total hepatic volume decreased from 64.O% before SPVE to 60.8%after 1 week, 55.1% after 2 weeks and 52.7% after 3 weeks, respectively. The side-effects includeddifferent degree of pain in the liver quandrant (17 patients), lower fever (9), and nausea and vomiting(7). The levels of aspartate alanine transaminase (AST), alanine transaminase (ALT) and total bilirubin(TBIL) increased after SPVE, but returned to the preoperative levels in 1 week. After 2-4 weeks,two-step curative hepatectomy for HCC was performed in 13 patients (54.2%).CONCLUSIONS: Ultrasound-guided percutaneous transhepatic SPVE with a fine needle is feasible andsafe. It can extend the indications of curative hepatectomy for HCC in injured livers, and increase thesafety of two-step hepatectomy.

关键词： portal vein embolization two-step hepatectomy primary hepatocellular careinoma cirrhosis

Randomly Orthogonal (p, f)-factorizations in Graphs

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Acta Mathematicae Applicatae Sinica 2002年第3期18卷 489-494页

作者： Gui-zhen Liu, he-ping LongDepartment of Mathematics, Shandong University, Jinan 250100, ChinaDepartment of Mathematics, Shandong University at Weihai, Weihai 264209, China

Let G be a graph with vertex set V(G) and edge set E(G) and let g and f be two integer-valued functions defined on V(G) such that 2k-1≤g(x) ≤ f(x) for all x ∈ V(G). Let H be a subgraph of G with mk edges . In this paper it is proved that every (mg + m - 1,mf- m + 1)-graph G has (g, f)-factorizations randomly κ-orthogonal to H and shown that the result is best possible.

关键词： Graph (g f)-factorization randomly fc-orthogonal factorization

3D GIS与有限元模拟无缝耦合方法及其在隧道工程中的应用研究

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岩土力学 2017年第3期38卷 866-874,901页

作者：刘振平刘建何雨微贺怀建卞康中国科学院武汉岩土力学研究所岩土力学与工程国家重点实验室湖北武汉430071 湖北武穴长江公路大桥有限公司湖北武穴435400

为实现数值模拟获得的各种场数据与GIS空间信息的综合集成,有必要对GIS中融合有限元数值计算的方法开展研究。本文采用GRASS GIS、VTK等开源软件,通过Python语言建立了GIS与有限元模拟的复合系统开发框架,针对隧道开挖编写了3DGIS与有... 详细信息

为实现数值模拟获得的各种场数据与GIS空间信息的综合集成,有必要对GIS中融合有限元数值计算的方法开展研究。本文采用GRASS GIS、VTK等开源软件,通过Python语言建立了GIS与有限元模拟的复合系统开发框架,针对隧道开挖编写了3DGIS与有限元数值计算无缝耦合分析程序(3DPyGisTFEM)。给出了由中心线上多条轮廓线生成隧道模型的算法,提出了对各地层DEM与隧道模型进行剖切运算获得隧道开挖地质剖面的方法。引入Delaunay网格剖分算法,对GIS中TIN模型不断改良,获得了适合有限元模拟的地质剖面三角形网格。基于多个剖面计算结果,运用插值手段,形成研究区域场数据,结合GIS空间分析方法,对场数据分布规律进行综合分析,实现了GIS与有限元的无缝耦合。黄家寨隧道工程实例表明,相对坡度、隧道中心线缓冲区等因素,地表距隧道拱顶高差的空间分布特征与地表沉降规律相关性更强。

关键词：有限元法地理信息系统 Delaunay网格剖分算法无缝耦合隧道工程

构建3种低旋转轴点的前臂皮神经-浅静脉营养血管远端蒂复合瓣的解剖学实验

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中国临床康复 2005年第46期9卷 79-82,T0004页

作者：张发惠郑和平解放军南京军区福州总医院军区临床解剖学研究中心福建省福州市350025

目的:探讨前臂皮神经-浅静脉营养血管远端蒂复合瓣的构建,为临床手部损伤修复提供解剖学理论。方法:实验于2003-12/2004-12在南京军区福州总医院军区临床解剖学研究中心实验室完成。94侧动脉灌注红色乳胶成人上肢标本(由南京军区福州总... 详细信息

目的:探讨前臂皮神经-浅静脉营养血管远端蒂复合瓣的构建,为临床手部损伤修复提供解剖学理论。方法:实验于2003-12/2004-12在南京军区福州总医院军区临床解剖学研究中心实验室完成。94侧动脉灌注红色乳胶成人上肢标本(由南京军区福州总医院军区临床解剖学研究中心提供)。取90侧标本解剖观测前臂皮神经-浅静脉下1/3段营养血管的来源、分支、吻合及其与尺、桡骨血供关系:①前臂皮神经-浅静脉营养血管的来源、分支及吻合。②前臂皮神经-浅静脉营养血管与桡骨、尺骨骨膜血供的关系。另用4侧标本行远端蒂复合瓣摸拟手术设计。结果:取90侧成人上肢标本进入结果分析。前臂皮神经-浅静脉下1/3段为多源性供血,①前臂外侧皮神经-头静脉的营养血管来自桡动脉穿皮支6～11支,掌浅支穿皮支2～6支,桡骨茎突返支穿皮支一两支,鼻烟壶穿皮支一两支。桡动脉肌间隙骨皮穿支1～3支分布桡骨体部中下段的裸露区。②前臂内侧皮神经-贵要静脉的营养血管来自尺动脉穿皮支5～9支。骨间前动脉和骨间后动脉发骨皮穿支两三支与1～3支,分布尺骨中下段骨膜。③前臂后皮神经营养血管来自桡侧副动脉穿皮支2～6支,骨间后动脉尺侧骨穿皮支1～3支,桡侧骨穿皮支一两支,骨间前动脉腕背支穿皮支3～5支。骨间后动脉发肌骨膜6～8支,分布尺骨中上段背侧骨膜。上述穿皮支平均外径在0.5～0.8mm,发皮支、筋膜支、皮神经-浅静脉营养血管,形成皮神经-浅静脉血管链以及深、浅筋膜血管网。结论:前臂下1/3段的皮神经、浅静脉、骨膜、筋膜和皮肤的营养血管同源,可以设计3种皮神经-浅静脉营养血管远端蒂复合瓣,旋转轴点在腕关节平面,可用于手部创伤修复。

关键词：皮神/神经支配静脉外科皮瓣/血液供给

A promising approach for quantifying focal stroke modeling and assessing stroke progression:optical resolution photoacoustic microscopy photothrombosis

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Neural Regeneration Research 2025年第7期20卷 2029-2037页

作者： Xiao Liang Xingping Quan Xiaorui Geng Yujing Huang Yonghua Zhao Lei Xi zhen Yuan ping Wang Bin Liu Faculty of health Sciences University of MacaoMacao Special Administrative RegionChina Center for Cognitive and Brain Sciences University of MacaoMacao Special Administrative RegionChina Department of Biomedical Engineering Southern University of Science and TechnologyShenzhenGuangdong ProvinceChina State Key Laboratory of Quality Research in Chinese Medicine Institute of Chinese Medical SciencesUniversity of MacaoTaipaMacao Special Administrative RegionChina Department of Emergency Zhujiang HospitalSouthern Medical UniversityGuangzhouGuangdong ProvinceChina

To investigate the mechanisms underlying the onset and progression of ischemic stroke,some methods have been proposed that can simultaneously monitor and create embolisms in the animal cerebral ***,these methods often require complex systems and the effect of age on cerebral embolism has not been adequately studied,although ischemic stroke is strongly *** this study,we propose an optical-resolution photoacoustic microscopy-based visualized photothrombosis methodology to create and monitor ischemic stroke in mice simultaneously using a 532 nm pulsed *** observed the molding process in mice of different ages and presented age-dependent vascular embolism ***,we integrated optical coherence tomography angiography to investigate age-associated trends in cerebrovascular variability following a *** imaging data and quantitative analyses underscore the differential cerebrovascular responses to stroke in mice of different ages,thereby highlighting the technique's potential for evaluating cerebrovascular health and unraveling age-related mechanisms involved in ischemic strokes.

关键词： age-dependent cerebral cortex ischemic stroke mouse model optical coherence tomography angiography photoacoustic microscopy photothrombosis vascular imaging

逍遥散合四磨汤加减对便秘型肠易激综合征肝郁气滞证脑-肠轴的影响

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中国实验方剂学杂志 2020年第22期26卷 53-58页

作者：郑和平张智彬魏先鹏唐学贵川北医学院第二临床医学院四川南充637001 川北医学院四川南充637001 川北医学院附属医院四川南充637001

目的:观察逍遥散合四磨汤加减治疗便秘型肠易激综合征(IBS-C)肝郁气滞证的临床疗效及对脑-肠轴的影响作用。方法:将144例患者采用随机按数字表法,按1∶1分为观察组和对照组各72例。对照组脱落、失访2例,剔除4例,完成66例;观察组脱落、失... 详细信息

目的:观察逍遥散合四磨汤加减治疗便秘型肠易激综合征(IBS-C)肝郁气滞证的临床疗效及对脑-肠轴的影响作用。方法:将144例患者采用随机按数字表法,按1∶1分为观察组和对照组各72例。对照组脱落、失访2例,剔除4例,完成66例;观察组脱落、失访2例,剔除5例,完成65例。对照组口服四磨汤口服液,20 mL/次,3次/d。观察组给予逍遥散合四磨汤加减内服,1剂/d。两组疗程均为连续治疗4周。进行治疗前后腹痛程度,肠易激综合征(IBS)症状严重程度量表(IBS-SSS),肠易激综合征生活质量(IBS-QOL),肝郁气滞证、汉密顿焦虑量表-14(HAMA-14)和汉密顿抑郁量表-17(HAMD-17)评分,记录每周的完全自主排便次数(CSBM),记录治疗后腹痛应答率、排便应答率和IBS-SSS缓解率;检测治疗前后血管活性肠肽(VIP),P物质(SP),神经肽Y(NPY),5-羟色胺(5-HT),生长抑素(SS)和降钙素相关基因肽(CGRP)水平;并进行安全性评价。结果:观察组腹痛程度,IBS-SSS和肝郁气滞证评分均低于对照组(P<0.01),CSBM次数多于对照组(P<0.01);观察组IBS-QOL评分高于对照组(P<0.01),HAMA-14和HAMD-17评分均低于对照组(P<0.01);观察组VIP,NPY,5-HT,SS和CGRP水平均低于对照组(P<0.01),SP水平高于对照组(P<0.01);观察组腹痛应答率、排便应答率和IBS-SSS缓解率分别为95.38%(62/65),93.85%(61/65)和90.77%(59/65),分别于高于对照组的83.33%(55/66),78.79%(52/66)和75.76%(50/66),比较差异均有统计学意义(P<0.05);观察组中医证候疗效优于对照组(Z=2.1034,P<0.05);研究过程患者均没有发生严重不良事件,未发现与中药相关不良反应。结论:逍遥散合四磨汤加减内服治疗IBS-C肝郁气滞证可显著改善IBS-C症状,并能减轻不良情绪,提高患者生活质量,还能调节多种脑肠肽因子,改善脑-肠轴紊乱情况,有着较好的临床疗效与安全性。

关键词：便秘型肠易激综合征肝郁气滞证逍遥散四磨汤脑-肠轴

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LED影视舞台专业灯具设计要点

演艺科技 2013年第12期 1-8,17页

作者：甄何平陈阔家北京星光影视设备科技股份有限公司北京100162

本文在分析影视舞台专业照明对LED灯具要求的基础上,从光学系统、散热系统和驱动控制系统三个方面分别介绍了柔光灯具、聚光灯具、成像灯具和天幕灯具的设计要点。

关键词：影视舞台灯具专业灯具设计 LED灯具柔光灯具聚光灯具成像灯具天幕灯具