The comparison made between two experimental models with obstructive jaundice, which were newly established reversible model and traditional bile duct ligation and internal drainage model, showed that the new model was superior to the traditional one. This study suggests that the new model would be an ideal model, which could replace the traditional one for studying obstructive jaundice.
To investigate the cause of septicemia in patients with obstructive jaundice,the correlationship between intra-biliary tract pressure(IBTP),portal veinous flow rate(PVFR)and interleukin-2(IL-2),soluble interleukin-2 receptor(sIL-2R),T lymphocyte subpopulation in patient with obstructive jaundice(Group A)has been studied.Group A was subdivided into A1,emergency operation group;A2,elective surgery group;A3,patient’s age over 60 years and A4,age under 60.Ninety patients with simple gallstone(Group B)were also tested as a contrast.The result showed that of all Group A,CD3+,CD4+,CD8+ before operation were much lower than those 10 days after operation(Plt;0.05 or Plt;0.01),while the postoperative sIL-2R was significantly higher than that of 10 days after operation(Plt;0.01),in Group A1,emergency surgery,the preoperative sIL-2R was much more higher than that in others of the jaundice group(Plt;0.01).Corralation analysis showed IBTP was negatively corralated to IL-2,CD3+,CD4+,CD8+,but it had positive correlation with sIL-2R(Plt;0.01).PVFR was positively correlated to IL-2(Plt;0.01).These indicate that obstructive jaundice with infection is closely related to the decreased host immunity.
Objective To observe therapeutical effect of recombinant human growth hormone (rhGH) on postoperative obstructive jaundice. Methods Fourtyeight patients were divided into two groups randomly: control group with 30 patients and rhGH group with 18 patients. After operation, subcutaneous injection of rhGH was administered 8 U/d for a week. At the same time, parenteral nutrition was given to both groups until the patients could eat and drink. Biochemistry examination, endotoxin, tumor necrosis factor, sIL-2R and nutritional status were all measured at following states: before operation 1, 7 and 14 days after operation. Results Body weights of rhGH group on the fourth day after operation and that of control group on the seventh day after operation increased, but the increasing tendency of rhGH group was more prominent than the control group. For blood sugar 7 days after operation, the level of rhGH group was higher than that of control group (P＜0.05). The level of serum albumin, transferrin, prealbumin in rhGH group was higher than that of control goup （P＜0.05）. Blood serum total bile acid,total cholesterol, low density lipoprotein,glutamicoxal acetic transaminase, transglutaminase, total bilirubin, endotoxin, tumor necrosis factor and sIL-2R were all decreased compared with control group (P＜0.01). However, no significant difference was observed in renal function and electrolute between the two groups.Conclusion An improvement of nutrition status and immunologic function can be observed in obstructive jaundice patients after the postoperative administration of rhGH.
ObjectiveTherapeutical effect of recombinant human growth hormone （rhGH) on obstructive jaundice and internal and external drainage was observed.MethodsNew Zealand white rabbits were randomly divided into groups below: obstructive jaundice internal drainage plus rhGH group, obstructive jaundice internal drainage plus NS group, obstructive jaundice external drainage plus NS group, and obstructive jaundice external drainage plus rhGH group. After the establishment of obstructive jaundice model, rhGH was used in the above groups. Subcutaneous injection of rhGH 0.2 IU/kg was given twice a day. Isovolume NS was used on the control groups. Full set of endotoxin, tumor necrosis factor, sIL2R and nutritional status were estimated before the model establishment, and 14 days after the model established, 14 days after internal and external drainage.ResultsFour days after internal and external drainage, body weight of therapy groups was increased compared with control groups (P＜0.05). Seven days and ten days after obstructive jaundice, blood sugar of therapy groups rised compared with control groups (P＜0.05). Albuminate, siderophilin and prealbumin of therapy groups were all observed an increase after 14 days after obstructive jaundice, and 14 days after internal and external drainage (P＜0.01). Blood total cholesterol, low density lipoprotein and omni bile acid of therapy groups after 14 days of obstructive jaundice were increased apparently (P＜0.05). Blood glutamicoxal acetic transaminase, transglutaminase, total bilirubin, blood uria nitrogen, creatinine and uric acid of therapy group after 14 obstructive jaundice days were increased (P＜0.05). Ca2+ of therapy groups 14 days after obstructive jaundice, 14 days after internal and external drainage rised as compared with control groups (P＜0.05). However, K+,Na+ of therapy groups 14 days after external drainage decreased (P＜0.05). An increasing tendency of sIL2R was observed in control groups 14 days after obstructive jaundice(P＜0.05) and ET,αTNF,sIL2R of control groups was decreased 14 days after internal and external drainage (P＜0.01).ConclusionAfter rhGH is used in obstructive jaundice and internal and external drainage, an improvement of nutritional status and immunological function can be observed.
ObjectiveTo study the diagnostic value of imaging examinations and their accuracy in evaluating the malignant obstructive jaundice and their resectability. MethodsThe clinical data of 674 malignant obstructive jaundice within 10 years were collected and analyzed.ResultsFor BUS, CT, PTC, ERCP and MRCP, the preoperative accuracy in malignant obstructive jaundice were 74.0%, 86.5%, 88.4%, 92.9% and 94.0%, while the ratio of actual removals in those who had been assessed removable preoperatively were 63.4%, 68.5%, 86.8%, 87.3% and 93.9%, respectively. Conclusion MRCP， PTC, CT and ERCP are better than BUS in the diagnosis of malignant obstructive jaundice (P＜0.05 vs. P＜0.01), while MRCP，ERCP and PTC are much better than BUS and CT in evaluating resectability (P＜0.01). Combination of two or more imaging examinations can improve the accuracy of preoperative diagnosis and assessing resectability.
Platelet aggregation test (PAgT), platelet adhesion test (PAdT), thromboplastic activity of factor Ⅷ (FⅧ∶c), antithrombin Ⅲ activity (AT-Ⅲ∶a), antithrombin Ⅲ antigen (AT-Ⅲ∶Ag), von willebrand factor (vWF) and fibrinogen (Fg) were measured in 33 patients with biliary tract diseases and 24 normal individuals. The results showed that there was no significant difference in PAgT, PAdT, AT-Ⅲ∶a and AT-Ⅲ∶Ag between the two groups (Ｐ＞0.05). Fg increased more significantly in biliary tract disease than in the controls (Ｐ＜0.01). FⅧ∶c increased more significantly in patients with obstructive jaundice than in that of nonjaundiced and the controls (Ｐ＜0.01). The levels of vWF increased higher and higher in the sequence of patients with no jaundice, obstructive jaundice due to benign diseases and obstructive jaundice due to malignancy(Ｐ＜0.01). In conclusion, Fg, FⅧ∶c and vWF increased in patients with biliary tract disease.