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Damage control surgery for severe pancreatic trauma

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Hepatobiliary & Pancreatic Diseases International 2007年第6期6卷 569-571页

作者： Wang, Ge-Fei li, You-Sheng li, jie-shou Nanjing Univ Sch Med Jinling Hosp Res Inst Gen Surg Nanjing 210002 Peoples R China

Pancreatic trauma as a challenge before and during explorative laparotomy is associated with multiple visceral injuries or critical conditions. Its optimal management remains *** current concept of damage control surg... 详细信息

关键词： Damage control surgery for severe pancreatic trauma

Outpatient versus inpatient laparoscopic cholecystectomy:a single center clinical analysis

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Hepatobiliary & Pancreatic Diseases International 2010年第1期9卷 60-64页

作者： Ji, Wu Ding, Kai li, ling-Tang Wang, Dan li, Ning li, jie-shou Nanjing Univ Sch Med Jinling Hosp Res Inst Gen Surg Nanjing 210002 Peoples R China

BACKGROUND: Outpatient laparoscopic cholecystectomy (OPLC) developed in the United States and other developed countries as one of the fast-track surgeries performed in ambulatory centers. However, this practice has not been installed as a routine practice in the major general hospitals and medical centers in China. We designed this case-control study to evaluate the feasibility, benefits, and safety of OPLC. METHODS: Two hundred patients who had received laparoscopic cholecystectomy for various benign gallbladder pathologies from April 2007 to December 2008 at Jinling Hospital of Nanjing University School of Medicine were classified into two groups: OPLC group (100 patients), and control group (100), who were designated for inpatient laparoscopic cholecystectomy (IPLC). Data were collected for age, gender, indications for surgery, American Society of Anesthesiology (ASA) class, operative time, blood loss during surgery, length of hospitalization, and intra- and post-operative complications. The expenses of surgery and in-hospital care were calculated and analyzed. The operative procedures and instrumentation were standardized for laparoscopic cholecystectomy, and the procedures were performed by two attending surgeons specialized in laparoscopic surgery. OPLC was selected according to the standard criteria developed by surgeons in our hospital after review. Reasons for conversion from laparoscopic to open cholecystectomy were recorded and documented. RESULTS: One hundred patients underwent IPLC following the selection criteria for the procedure, and 99% completed the procedure. The median operative time for IPLC was 24.0 minutes, blood loss was 16.2 ml, and the time for resuming liquid then soft diet was 10.7 hours and 22.0 hours, respectively. Only one patient had postoperative urinary infection. The mean hospital stay for IPLC was 58.2 hours, and the cost for surgery and hospitalization was 8770.5 RMB yuan on average. Followup showed that 90% of the patients were

关键词： laparoscopic cholecystectomy outpatient surgery fast-track surgery

Immunological protection of small bowel by simultaneously transplanted liver graft in pigs

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Hepatobiliary & Pancreatic Diseases International 2009年第4期8卷 363-369页

作者： Yin, Zhen-Yu li, Ning Wang, Xiao-Ming Ni, Xiao-Dong Jiang, Feng li, You-Sheng li, jie-shou Nanjing Univ Sch Med Jinling Hosp Inst Gen Surg Nanjing 210002 Peoples R China Xiamen Univ Zhongshan Hosp Dept Hepatobiliary Surg Xiamen 361004 Peoples R China

BACKGROUND: A simultaneously transplanted liver shields a bowel graft from immunologic attack in small animals, while the possible immuno-tolerance induced by the liver in liver and small bowel transplantation (LSBT) is uncertain in large animal models. To investigate the clinically suspected beneficial effect of the liver on small bowel allograft, we developed a new model of composite LSBT in the pig. METHODS: Seventy outbred long-white pigs were randomized into four groups. LSBT without immunosuppressive treatment (n=10, group A); LSBT with routine immunosuppressive treatment (n=10, group B); LSBT with a lower dose of immunosuppressive treatment (n=10, group C); and small bowel segment allotransplantation without immunosuppressive treatment (n=10, group D). RESULTS: There was no remarkable difference in survival time between groups A and D (10.33 vs. 12.89 days, P>0.05), but the initial time of acute rejection of the intestinal graft in group A was clearly delayed when compared to group D (8.22 vs. 4.33 days, P0.05), initial acute rejection time (25.40 vs. 22.13 days, P>0.05) or rejection score did not differ between groups B and C within one postoperative month. CONCLUSIONS: Compared to isolated segment small bowel allotransplantation, the intestinal graft in LSBT (group A) had a delayed initial time of acute rejection and a lower postoperative acute rejection score, and a lower dose of immunosuppressive treatment led to persistent graft immuno-tolerance in LSBT. Thus the simultaneously transplanted liver graft may reduce the risk of intestinal

关键词： liver transplantation small bowel transplantation porcine allotransplantation rejection immuno-tolerance

Effects of recombinant human growth hormone on enterocutaneous fistula patients

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World Journal of Gastroenterology 2008年第44期14卷 6858-6862页

作者： Guo-Sheng Gu Jian-An Ren Ning li jie-shou li The Research Institute of General Surgery Clinical School (Jinling Hospital) School of Medicine Nanjing University Nanjing 210002 Jiangsu Province China

AIM： To explore the effects of recombinant human growth hormone （rhGH） on intestinal mucosal epithelial cell proliferation and nutritional status in patients with enterocutaneous fistula. METHODS： Eight patients with enterocutaneous fistulas received recombinant human growth hormone （10 ug/d） for 7 d. Image analysis and immunohistochemical techniques were used to analyse the expression of proliferating cell nuclear antigen （PCNA） in intestinal mucosal epithelial cells in biopsy samples from the patients who had undergone an endoscopic biopsy through the fistula at day 0, 4 and 7. Body weights, nitrogen excretion, serum levels of total proteins, albumin, prealbumin, transferrin and fibronectin were measured at day 0, 4 and 7. RESULTS： Significant improvements occurred in the expression of PCNA in the intestinal mucosal epithelial cells at day 4 and 7 compared to day 0 （24.93 ± 3.41%, 30.46 ± 5.24% vs 12.92 ± 4.20%, p 〈 0.01）. These changes were accompanied by the significant improvement of villus height （500.54 ± 53.79 um, 459.03 ± 88.98um vs 210.94 ± 49.16 um, P 〈 0.01）, serum levels of total proteins （70.52 ± 5.13 g/L, 74.89 ± 5.16 g/L vs 63.51 ± 2.47 g/L, P 〈 0.01）, albumin （39.44 ± 1.18 g/L, 42.39 ± 1.68 g/L vs 35.74 ± 1.75 g/L, P 〈 0.01） and fibronectin （236.3 4- 16.5 mg/L, 275.8± 16.9 mg/L vs 172.5 ± 21.4 mg/L, P 〈 0.01） at day 4 and 7, and prealbumin （286.38 ± 65.61 mg/L vs 180.88 ± 48.28 mg/L, P 〈 0.05）, transferrin （2.61 ± 0.12 g/L vs 2.41 ±0.14 g/L, P 〈 0.05） at day 7. Nitrogen excretion was significantly decreased at day 7 （3.40 ± 1.65 g/d vs 7.25 ± 3.92 g/d, P 〈 0.05）. No change was observed in the body weight. CONCLUSION： Recombinant human growth hormone could promote intestinal mucosal epithelial cell proliferation and protein synthesis in patients with enterocutaneous fistula.

关键词： Recombinant human growth hormone Enterocutaneous fistula Intestinal Epithelial cell Proliferating cell nuclear antigen

1,25-dihydroxyvitamin D_3 regulates LPS-induced cytokine production and reduces mortality in rats

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World Journal of Gastroenterology 2008年第24期14卷 3897-3902页

作者： Xiao-Ping Qi Pei li Gang li Zhen Sun jie-shou li School of Medicine Nanjing University Department of GeneralSurgery Jinling Hospital 305 Zhongshandong Road Nanjing210002 Jiangsu Province China

AIM： To study the immunoregulatory effect of 1,25-dihydroxyvitamin-D3 Von dominant Thl response in rats. METHODS： Sixty adult Lewis rats were randomized into three groups. Rats in group 1 （n=25） were treated with 1,25-（OH）2D3 first and then challenged with LPS, rats in group 2 （n=25） were treated with vehicle first and then challenged with LPS. Ten animals in groups 1 and 2 were preserved for mortality observation. The remaining animals were injected （i.p） with endotoxin, 24 h after the last administration of 1,25-（OH）2D3 and vehicle. Rats in group 3 （n=10） were treated with 1,25-（OH）2D3 only. Serum IL-12, IFN-y, IL-2 and IL-4 levels were measured and target gene of 1,25-（OH）2D3 on Th cells was studied after 6 h. Gene abundance was verified by real-time quantitative PCR. RESULTS： No death occurred in rats pretreated with 1,25-（OH）2D3 after LPS injection. Death occurred 9 h after LPS injection in rats pretreated with the vehicle, and the number of deaths was 5 within 24 h, with a mortality rate of 50%. There was no change in the number of deaths within 96 h. Six hours after endotoxin stimulation, serum IL-12 and IFN-y levels decreased significantly in rats pretreated with 1,25-（OH）2D3 as compared with those in rats pretreated with the vehicle. The serum content of these two cytokines was very low in rats not challenged by endotoxin, and there was a significant difference as compared with the previous two groups. CONCLUSION： 1,25-（OH）2D3 attenuates injuryinduced by the lethal dose of 1PS, regulates Thl and Th2 cells at the transcription level, and dominantly responds to cytokine production in rats.

关键词： Endotoxin Cytokine 1,25-dihydroxy-vitamin-D3 Immunoregulation Mortality

Constraints on the generalized natural inflation after Planck 2018

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Chinese Physics C 2020年第9期44卷 231-238页

作者： Nan Zhang Ya-Bo Wu Jun-Wang Lu Chu-Wen Sun li-jie shou Hai-Zhou Xu Department of Physics Liaoning Normal UniversityDalian 116029China School of Physics and Electronics Qiannan Normal University for NationalitiesDuyun 558000China

Based on the dynamics of single scalar field slow-roll inflation and the theory of reheating,we investigate the generalized natural inflationary(GNI)*** introduce constraints on the scalar spectral index ns and the tensor-to scalar ratio r for theΛCDM+r model,according to the latest data from Planck 2018 TT,TE,EE+low E+lensing(P18)and BICEP2/Keck 2015 season(BK15),i.e.,with ns=0.9659±0.0044 at 68%confidence level(CL),and rlized and two-phase reheating are *** follows that the parameter m has significant effect on the model behavior.

关键词： early universe inflation model of inflation observational tests of inflation reheating

Mechanism of reduction of albumin expression induced by lipopolysaccharide in rat hepatocytes

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Chinese Medical Journal 2005年第20期118卷 1695-1702页

作者： WANG Xin-ying li Wei-qin LU Jun li Ning li jie-shou Research Institute of General Surgery Jinling Hospital Nanjing210002 China Department of Orthopaedics Zhongda Hospital Nanjing 210009China

Background The severity of hypoalbuminemia has been shown to be related to morbidity and mortality in some critical illnesses, illustrating the need for better understanding of molecular mechanism of hypoalbuminemia. lipopolysaccharide （LPS） is a key mediator inducing hypoalbuminemia in sepsis and septic shock. The present study was designed to identify if the reduction of albumin expression is directly induced by LPS and modulated by activated extracellular signal-regulated protein kinase （ERK） and p38 mitogen-activated protein kinase （MAPK） in rat hepatocytes.Methods Primary rat hepatocytes were divided into five groups. In two of them, hepatocytes were treated with normal saline or 1 μg/ml LPS, then albumin mRNA expression was observed at 0, 2, 8, 12 and 24 hours after treatment. In another group, hepatocytes were pretreated with 100, 40 or 20 μmol/L of cycloheximide （CHX, an inhibitor of protein synthesis） for 30 minutes followed by 1 μg/ml LPS for 24 hours. Then the RNA was extracted from the cells for RT-PCR to detect the expression of albumin. The other two groups were administered 1μmol/L, 10 μmol/L and 50 μmol/L of SB203580 （p38 MAPK inhibitor） or PD98059 （ERK inhibitor） 30 minutes prior to 1μg/ml LPS treatment. After 24 hours of LPS treatment, the supernatant was collected and assayed for albumin concentrations. Data were analyzed by one-way analysis of variance, followed by the Newman-Keul test; a P〈0.05 was considered significant.Results There was no marked change in albumin mRNA expression in the control group during 2d-hours treatment with normal saline. The reduction did not occur until 24 hours after LPS treatment, and albumin mRNA decreased by 30% approximately compared to the control group at 24 hours （0.587 vs 0. 832, P = 0. 007 ）. CHX could inhibit the decline of albumin mRNA induced by LPS and the effect was correlated with the dose of CHX. The ERK inhibitor PD98059 caused a significant increase in LPS-induced albumin production at the three

关键词： lipopolysaccharide hepatocytes albumin hypoalbuminemia signal transduction

Endoscopic monitoring in small bowel transplantation

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World Journal of Gastroenterology 1997年第3期3卷 9-10页

作者： li You Sheng, li jie shou, li Ning, JIANG Zhi Wei, li Yuan Xin and li Xiao Hua

AIM To investigate the role of endoscopic monitoring in small bowel transplantation. METHODS This study consisted of two parts: the experimental study and clinical study. In the experimental study, white outbred pigs underwent segmental small bowel allotransplantation. The proximal and distal intestine were brought out as stomas (Thiry Vella loop). The grafts, treated with or without immunosuppression, were monitored by endoscopy via stomas. In the clinical study, a female patient with short bowel syndrome received whole small bowel allotransplantation. The graft was monitored by endoscopy via distal stoma. RESULTS The most common endoscopic findings of graft rejection following small bowel allotransplantation were mucosal erythema, erosion and ulceration. Diffuse ulceration with bleeding was seen in late phase of rejection. CONCLUSION Endoscopic monitoring is essential to small bowel transplantation.

关键词： small intestine/transplantation graft rejection endoscopy intestinal mucosa/pathology

Detection of bacterial DNA from cholesterol gallstones by nested primers polymerase chain reaction

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World Journal of Gastroenterology 1998年第3期4卷 54-57页

作者： WU Xiao Ting 1, XIAO Lu Jia 2, li Xing Quan 3 and li jie shou 1

AIM To search for bacterial DNA sequences in cholesterol gallstones with negative bacterial culture. METHODS DNA was extracted from cholesterol gallstones in gallbladders and nested primers polymerase chain reaction (NP PCR) was used to amplify bacterial gene fragments for identifying the existence of bacteria. The samples of bacterial DNA extracted from potentially causative or unrelated living bacteria were amplified in vitro as the standard markers and comparative 16S ribosomal RNA sequence analysis was made for bacterial identification. RESULTS The gallbladder gallstones of 30 patients were analyzed and bacterial DNA was found in 26 patients. Among them, gallstones with cholesterol content between 30%-69% were seen in 5 (5/5) patients, 70%-90% in 11 (11/14) patients, and more than 90% in 10 (10/11) patients. There was no difference either in cholesterol and water content of gallstones or in harboring bacterial DNA of gallstones. *** related DNA fragments appeared in the stones of 8 (26 67%) patients; propionibacteria type DNA in 7 (23 33%); and harbored bacterial gene fragments in 2 patients, similar to Streptococcus pyogenes . A more heterogeneous sequence collection was found in 7 (23 33%) patients, which could belong to multiple bacterial infections. Two (6 67%) patients had bacterial DNA with low molecular weight which might be related to some unidentified bacteria. CONCLUSION Most cholesterol gallstones harbor bacterial DNA. It is important to determine whether these microorganisms are innocent bystanders or active participants in cholesterol gallstone formation.

关键词： cholelithiasis/microbiology propionibacterium acnes staphylococcus aureus DNA, bacterial polymerase chain reaction