目的探讨腹腔镜胆囊切除术(LC)致胆管损伤的预防措施。方法回顾性总结我院1999 年10 月至2005 年4月期间1 750例LC中,8例胆管损伤患者的损伤情况和特点。结果胆管横断伤4例，胆总管完全夹闭1例，胆总管3/4夹闭1例，电灼伤迟发性肝总管穿孔1例，肝总管撕裂伤1例。结论术中术者只要能遵循一定的手术程序,掌握LC的重要技术原则和技术要点,就能够很好地防止LC中胆管损伤的发生。
Objective To observe the effect of visible light on apoptosis of cultured human retinal pigment epithelium (RPE) cells. Methods Being the light source,500lx,(2 000±500)lx and (3 400±200)lx cold white light were used. The duration of exposure was 0,6,12 and 24 hours respectively. Apoptosis was detected by terminal deoxynucleotidyl transferase mediated dUTP nick end labelling, Annexin V-flunorescein isothiocyanate/Propidium iodium labelling and flow cytometry. Results Apoptosis and necrosis were found in cultured human RPE cells which were exposed to visible light.(1)A significant increase in apoptotic and necrotic percentages was consistent with a higher light intensity.(2)Apoptosis was the main response to shorter (6 h and 12 h) exposure duration,while necrosis was more pronounced correlated to the prolongation of post-exposure culture (P＜0.05),and the longer the post-exposure period was, the more apoptotic necrosis were seen.Thirty-six hours after exposure the necrotic percentages were more pronounced (P＜0.01). Conclusions Visible light (＞500 lx) increases the proportion of apoptosis and necrosis of human RPE cells in vitro.The extent is related to exposure intensity and duration. It demonstrates that the lower intensity and the shorter duration of exposure to light are, the more pronounced apoptotic percentages are observed,otherwise necrosis. (Chin J Ocul Fundus Dis, 2002, 18: 227-230)
Objective To systematically evaluate the effectiveness of aloe vera and its products (e.g. dressing for external use, and gel) for both acute (e.g. laceration, surgical incision, and burn) and chronic (e.g. infectious wound, and artery and venous ulceration) wounds. Methods With “aloe” and “wound” as the index words, such databases as Cochrane Library, PubMed, EMbase, CBM, CNKI and VIP were searched from the inception to April, 2012 to collect the randomized controlled trials (RCTs) about aloe vera or its products for treating acute and chronic wounds. Two authors independently screened literature, extracted data and assessed the risks of bias. Then meta-analysis was conducted using RevMan 5.0 software. Results A total of 15 RCTs involving 773 participants were included, and all studies were of low quality. There were 8 RCTs which evaluated aloe vera for treating acute wounds (burn, haemorrhoidectomy, and skin biopsy), and no RCT reported the incidence of infection. Compared with silver sulfadiazine, aloe vera products could increase the proportion of healing wounds for patients with burn (RR=1.28, 95%CI 1.03 to 1.60, P=0.03 ); compared with antibiotic cream, aloe vera products could reduce the average healing time for patients with burn (MD= ?12.90, 95%CI ?13.29 to ?12.51, Plt;0.000 01); compared with conventional therapy, aloe vera gel could increase the proportion of healed patients with acute surgical wounds (RR=16.33, 95%CI 3.46 to 77.15, P=0.000 4), and could increase the proportion of healed patients with pressure sores (RR=1.73, 95%CI 1.21 to 2.49, P=0.003). Conclusion The application of aloe vera topical agents and dressings is positively significant to both acute and chronic wounds. But this conclusion still needs to be supported by high quality trials.
Objective To observe the efficacy of vitreoretinal surgery in the treatment of early traumatized eyes with no light perception. Methods We performed vitreoretinal surgery on 17 eyes of early traumatized eyes with no light perception.The patients were followed up for 2～14 months. Results Retinal reattachment was achieved in 11 eyes after srugery.8 eyes got visual acuity better than light perception postoperatively.Visual acuities of 5 eyes were better than 0.05 and the best one reached to 0.2. Conclusion Timely vitreoretinal surgery is valuable to the early traumatized eyes with no light perception.Retinal reattachment is the most important thing for the treatment of this kind of cases. (Chin J Ocul Fundus Dis，2000，16：213-284)
Objective To observe the expression of proteins in light-injured retinal pigment epithelial (RPE) cells. Methods ARPE19 cells were exposed to the cool white light at the intensity of (2200plusmn;300) Lx for 6 hours to set up the light injured model. Cellular soluble proteins was extracted and analyzed by means of twodimensional electrophoresis to find out the changes of protein map of lightinjured RPE cells. Results Cellular soluble proteins had (390plusmn;10) spots on the map, in which 11 spots had obvious difference between the light injured group and the normal control group. In the lightinjured cells, the expressio of 8 proteins increased, 1 decreased, and 2 disappeared. Conclusion Twodimensional electrophoresis can find out the difference of expression of proteins in lightinjured and normal RPE cells.
Objective To assess the protective effect of recombinant human erythropoietin (EPO) on human retinal pigment epithelial (RPE) cells injured by light. Methods Cultured human RPE cells were exposed to light for 12 hours, and the culture was stopped 24 hours later. The 3(4,5dimethylthiazole2y1)2,5diphenyl tetrazolium bromide (MTT) cell viability assay and annexin V flunorescein isothiocyanate/propidium iodium labeling and flow cytometry were used to assess the effects of EPO with different concentration on the cellular viability and apoptosis of human RPE cells. The protective effect and mechanism of EPO on RPE cells injured by light was detected by adding AG490. Results EPO, especially with the concentration of 40 IU/ml, obviously increased the cellular viability of RPE cells and apparently decrease the cellular apoptosis induced by light injury. After adding AG490, the effects of EPO on cellular viability and apoptosis were inhibited. Conclusion It is suggested that EPO can protect the human RPE cells from lightinduced injures, and its protective mechanism works after the combination of EPO and its receptor.