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AIM To investigate the role of sphincter of Boyden in bile excretion and its regulating factors.METHODS Perfusion manometry, choledocho-cineradiography, reaction of the sphincter of Boyden toendogenous cholecystokinin (CCK) and immunohistochemical quantitative analysis were performed in 16dogs to study the motility and morphology of the sphincter of Boyden in experimental (postcholecystectomy)group ( n = 8) and the control group (n = 8).RESULTS The bile duct surrounded by SB was a low-pressure lumen (10.0 ± 2.0 mmHg), in which thepressure was significantly different (P<0.01, t = 6. 195) from the basal pressure of the high-pressure area ofsphincter of Oddi (SO), its basal pressure (SOBP) was 16.9±0.5 mmHg. The SB was an enlarged ampulladuring bile excretion interval, and showed active contraction during bile excretion. Intrinsic CCK could causediastole of SO, but does not affect the systole and diastole of SB. After cholecystectomy, spastic contractionpersisted in SB, which could not be relieved by intrinsic CCK. The sensitivity to CCK of SO was decreased,and the evacuation time of media prolonged (27.0±3.4 min vs precholecystectomy 17.l±0.9min P<0.01,t =7.961). In immunohistochemistry analysis, the contents of a-actin, myosin in the SB of experimentalgroup showed no increase. Under electronic microscope, the main changes were 3D structuraldisarrangement of the cell framework, distortion of the microfilaments, swelling and aggregation ofmitochondria at the nuclear side.CONCLUSION The excretion of bile can be divided into two types, physiological bile excretion with a drivemainly caused by the contraction of SB, and the other, functional bile excretion with a drive mainly causedby the contraction of gallbladder. It seems that the function of SB was controlled by vagus, whereas SO wasmore sensitive to the intrinsic CCK, The intact gallbladder is an elemental factor of functional coordinationof SB and SO.
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胆管胰管内导管内乳头状黏液瘤内镜逆行胰胆管造影诊治特点
胆管导管内乳头状黏液瘤(intraductal papillary mucinous tumor of the bile ducts,BPMT)和胰管导管内乳头状黏液瘤(intraductal papillary mucinous tumor of the pancrease,IPMT)临床少见[1-3],不易早期诊断.解放军第四〇一医院经内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)诊治BPMT和IPMT患者各2例,发现两病有共同的特点.本研究拟结合文献进行分析,探讨其规律.
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ObjecUve To iovestigate the role of hepatitis C virus (HCV) in the malignant transformation of bile duct celle. Tissues from 6Chinese patients and 6 American patients wtiJl cholengienarcinoma were studied.Mammals RNA was extracted from the selected tumor areas eq formalin-fixed, paraffin embedded sections,followed by reverse transcription double polymerase chain reaction (RT-PCR) and Southern blotting.Results Positive and negative strand HCV RNAsequences were detected in seven out of tweive patients witn choiangiocarcinorna. A high positive rate was found in Chinese patients (83%) as compared to US patients (38%).Coaclualon Our finding suggests HCV may play a role in the malignent transformation of bile duct cells.
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胆道冲洗治疗阻塞性新生儿肝炎
新生儿阻塞性黄疸,临床分为肝内淤滞性黄疸及肝外梗阻性黄疸.作者认为对新生儿持续性黄疸、白便、及血胆红质动态曲线观察增高者,应及早探查手术.临床实践证实,经内科治疗无明显效果的阻塞性新生儿肝炎,经胆道冲洗扩容治疗后,皆获得良好效果.
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先天性胆总管囊肿合并肝内胆管扩张的诊断与治疗
先天性胆总管囊肿合并肝内胆管扩张,为先天性胆道发育异常的疾病,临床报道不多.1971年Yoshiki报道35例先天性胆总管囊肿,9例合并肝内胆管囊性扩张.1973年K101z胆管囊肿分型时将本病列为第Ⅱ型.1978年Todani将本病列为第ⅣA型.由于既往对本病认识不够,有时不能及时诊断,有些患儿治疗效果较差.为了引起对本病的注意及提高治疗效果,简要报道如下.
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小儿外科性黄疸81例手术治疗分析
小儿外科性黄疸,多为梗阻所致.梗阻时间越长,肝功能损害就越严重.晚期由于胆汁淤积造成肝实质的损害,产生肝硬化.
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Hypohydrotic ectodermal dysplasia revisited
INTRODUCTIONCaroli's disease is the other name for congeni-tal nonobstructive dilatation of large intrahepatic bile ducts[1]. This rare entity was firstly described by Caroli et al[2]. This disease may be multifocal and diffuse or may be localized to a lobe or seg-ment of liver. Most cases are associated with con-genital hepatic fibrosis. Medullary sponge kidney may be associated with this disease. We present a case of Caroli's disease diagnosed on ultrasound and confirmed by scintigraphy.