胆囊

Objective:To study of earlier application of duodenoscopy in doubtful biliary tract injure after laparoscopic cholecystectomy.

目的 ：探讨腹腔镜胆囊切除术后怀疑胆道损伤早期十二指肠镜的应用。

Combination of duodenoscopy,laparoscopy and choledochoscopy is an effective and safe treatment with less trauma for cholecystolithiasis with choledocholithiasis,when indications and contraindications were controlled strictly.

严格掌握十二指肠镜、腹腔镜、胆道镜的适应证、禁忌证，三镜联合治疗胆囊结石并胆总管结石是一种创伤小、有效、安全且可靠的治疗模式。

Combination of duodenoscopy,laparoscopy and choledochoscopy is an effective and safe treatment with less trauma for cholecystolithiasis with choledocholithiasis,when indications and contraindications were controlled strictly.

严格掌握十二指肠镜、腹腔镜、胆道镜的适应证、禁忌证，三镜联合治疗胆囊结石并胆总管结石是一种创伤小、有效、安全且可靠的治疗模式。仁和代写代发医学论文：提供专业的医学论文写作指导，修改，翻译，发表服务。

The introduction combines traditional Chinese and Western medicine below the experience of enteritis of noxiousness of fine ailment of remedial Tibet mastiff, in order to offer reference. 1 hair sick condition and clinical expression ill dog are 2~4 month more age young dog, majority is come on suddenly, anorexia or abandon absolutely, mental depressed, systemic symptom worsens quickly, produce acuteness sex vomiting and diarrhoea, puke is first feed rotten, afterwards is yellow or olive bubble mucus and hematic type thing, have diarrhoea dung has the sticky stiff thing of grey yellow, turn after for rare dung of effluvial shape of embedded mucous membrane, then shows hematic dysentery, because ill dog is acuteness vomiting and diarrhoea are rapid dehydration, eyeball cave in, temperature is shown two-way and calorific,℃ of the 40~41 at the beginning of disease, 1~2d falls it is normal to come, after 3~4d answer elevatory, die very quickly next, 4~5d of course of diseases, the temperature when on one's deathbed drops more to normal temperature the following. Bottom of stomach of dog of die in one's bed of 2 analyse check has haemorrhage sex inflammation, show cardinal, small intestine mucous membrane falls off, alvine wall attenuates, there is gules mucus inside, mix inside large intestine have show wine blood excrement and urine, there are a lot of haemorrhage places on mucous membrane, haemorrhage of rectum mucous membrane is more, mesentery lymph node enlargement, sometimes afterwards sends intussusception, alvine tangent plane bleeds, cardiac muscle is loose, color becomes weak, cystic plentiful, liver is qualitative fragile and brittle. 3 diagnose 3.1 epidemiology to diagnose this ill much hair at young dog, rather dog of epidemic disease have an inoculation feels the most easily, be affected directly or affect secondhand, basically pass enteron infection, this disease all can happen all the year round, but with cold...

下面介绍中西医结合治疗藏獒细小病毒性肠炎的心得，以供参考。1发病情况和临床表现病犬多为2~4月龄幼犬，多数为忽然发病，食欲减退或废绝，精神沉郁，全身症状急剧恶化，发生剧烈性呕吐和腹泻，呕吐物先为食糜，继为黄色或黄绿色泡沫黏液和血样物，泻粪有灰黄色的黏稠物，后转为恶臭的内含黏膜状稀粪，继而呈血痢，由于病犬剧烈呕吐和腹泻迅速脱水，眼球下陷，体温呈双向发热，病初40~41℃，1~2d降至正常，3~4d后又复升高，然后很快死亡，病程4~5d，临死时体温多下降至常温以下。2剖检病死犬胃底部有出血性炎症，呈深红色，小肠黏膜脱落，肠壁变薄，内有红色黏液，大肠内混有呈暗红色血液粪便，黏膜上有许多出血点，直肠黏膜出血较多，肠系膜淋巴结肿大，有时继发肠套叠，肠切面出血，心肌松软，颜色变淡，胆囊充盈，肝质脆而易碎。3诊断3.1流行病学诊断本病多发于幼犬，未免疫接种犬最易感，直接感染或间接感染，主要通过消化道感染，该病一年四季均可发生，但以寒。。。

Emphysematous cholecystitis is a relatively rare variant but rapidly progressive and life threatening form of acute cholecystitis caused by gas-producing organisms. In contrast to acute cholecystitis, emphysematous cholecystitis occurs more commonly in elderly and diabetic patients, and is frequently associated with perforation and death, requiring emergent surgical intervention.

急性气肿性胆囊炎是急性胆囊炎的一种少见的形式，它是由产气性致病菌所感染，疾病进展快速，致死性高，与一般急性胆囊炎不同的是它较常发生於老年人及糖尿病患，也常导致胆囊穿孔及死亡而需紧急手术治疗。

Objective:To introduce a novel approach of laparoscopic cholecystectomy without epigastric scar.

目的：介绍一种在上腹部不留手术瘢痕的腹腔镜胆囊切除新术式。

Objective:To investigate the feasibility,safety and clinical value of laparoscopic cholecystectomy for the patients with epigastric operative history.

目的：探讨上腹部手术后患者行腹腔镜胆囊切除术（laparoscopic cholecystectomy，LC）的可行性和应用价值。

Objective:To investigate the feasibility,safety and clinical value of laparoscopic cholecystectomy for the patients with epigastric operative history.

目的：探讨有上腹部手术史患者行腹腔镜胆囊切除术（laparoscopic cholecystectomy，LC）的可行性、安全性及应用价值。

After finish the digestion, then flow back to the blood.also, during the period of liver and gallbladder concertrate in the hepatoenteral circulation,the bile acid can drain massively with the excrement.and more seriously after adding the fat feed stuff.if this condition go on, the fat cannot be absorbed in time and the energy will be wasted and cause some disease and etc.but after adding the appropriate exogenetic emulsifier,the question can be solved.

作为正常的机体，胆汁酸由肝脏分泌，进入肠道，在完成消化，回流入血液，又在肝脏和胆囊重新富集的肝肠循环的过程中，会经过粪便大量流失。在脂肪含量较高的饲料配方下，流失更为严重。日肝脏分泌量不足弥补流失量，会造成脂肪消化的阻滞，能量的浪费，且易诱发肝胆代谢紊乱等各种疾病。得不到消化吸收的油脂，在肠道内被噬油微生物降解，使噬油微生物类群大量增殖，打破原来肠道内微生态平衡，产生腹泻等菌群失调症，以上的问题，都是由于脂肪乳化作用不足和脂肪代谢失调造成的。在补充了合适本物种须求的外源性乳化剂后，问题可得到解决。

Results ①The most common lesions were the extragastric compressions caused by spleen, which accounted for 54.74%, followed by the enlarged gallblodder, hepatic cyst and carcinoma in the left lobe, left kidney, pancreatic cystic adenoma and pancreatic cyst.②The diagnostic accurancy of EUS was 100%, which was higher than that of USP.③Most of the lesions, benign or malignant, had normal structure of the gastric wall.④Splenomegaly only accounted for 38.46% in the lesions caused by the compression of spleen, which were slightly to moderately enlarged.⑤The location of the lesion was usually related to the organ which caused the extragastric compression.

结果 ①胃外压性隆起中脾脏压迫最多见，占54.74%，其余为肿大胆囊、肝右叶囊肿、肝左叶癌、左肾、胰腺囊腺瘤和胰腺囊肿；②EUS对胃外压性隆起的诊断正确率达100%，其对外压灶的完全显示率高于微超声探头；③良性胃外压灶及多数恶性肿瘤胃外压灶其所压胃壁结构均正常；④脾脏压胃者中脾肿大仅占38.46%，且均为轻、中度脾肿大；⑤胃隆起部位与外压灶的种类相关联。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。