Hemodynamic changes and regulations of indomethacin have been studied in 64 patients with obstructive jaundice and 39 patients with simple gallstones (group C) Obstructive jaundice patients were divided into non indomethacin group (group A) and indomethacin group (group B) The results showed that stroke volum,cardiac output and cardiac index were significantly higher in group A than those in group C( P

Objective To study variant artery and treatment under video laparoscopic cholecystectomy(LC). Methods 521 patients who received selective cholecystectomy(male 159 patients and female 362 patients, aged 11 to 76 years),were operated on with video laparoscopy. Cystic artery was anatomized under general anesthesia and carbon dioxide pneumoperitoneum. Results Variant Cystic artery presented in 140 patients(26 .9% ). Cystic artery of 60 patients originated from anterior or posterior common bile duct, single cystic artery was in 3 patients, double cys- tic artery in 51 patients, cystic artery arose from celiac artery was in 6 patients, cystic body artery existed in 17 pa- tients and cystic artery originated from variant right hepatic artery in 3 patients. Conclusion Variant cystic artery is very common. Correct recognition, dissection and safe treatment are an important to prevent hemorrhage and bile duct injuries during laparoscopic cholcystectomy.

In this study,changes in immunity were observed in 120 patients undergoing laparoscopiccholecystectomy. It was found that postoperative levels of IgG,IgM,CD3+,CD4+,and CD8+ were significantly higher than that of preoperative and postpneumoperitoneal with CO2 (P

With the developments of digital medicine, Gd-EOB-DTPA enhanced magnetic resonance imaging, molecular imaging and optical/acoustic multi-modality imaging, the hepatopancreatobiliary surgery have entered the era of precise diagnosis and treatment.Bidimensional pattern of disease diagnosis and treatment is developing toward three-dimensional pattern, which make the diagnosis and treatment more comprehensive and clear.Morphological imaging is gradually developing towards molecular imaging.Ultimately, the goal of truly precise diagnosis and accurate treatment will be achieved.

Hepatolithiasis is a common disease in China with a high rate of residual stones up to 30％-90％ after surgery.Patients often require re-operation because the high rate of residual stones and stone recurrence.Because the calculi are deeply distributed in the liver,and the condition is often accompanied by anatomical variations,distortion and biliary strictures,traditional preoperative imaging examinations do not easily locate the lesioos precisely,making diaguosis and treatment difficult.In recent years,three-dimensional computed imaging and visual simulation have provided a novel preoperative diagnostie method for hepatolithiasis,and have offered a clearer radiologic basis for surgical planning.The value of digital medical technology in the diagnosis and treatment of hepatolithiasis is discussed in this article.

Objective To study the expression of proliferating cell nuclear antigen (PCNA) in the occurrence and development of hepatocellular carcinoma. Methods Sixty SD rats were randomly divided into control group and experimental group. 3′-Me-DAB was administrated into rats to establish the experimental model of hepatocarcinoma. The expressions of PCNA of different phases were detected by immunohistochemistry and the liver pathologic changes were observed by optical microscope. Results The process of canceration was divided into three stages: inflammation, proliferative fibrosis and hepatic carcinoma. The expression of PCNA firstly presented in the oval cells that located in the portal area at the stage of inflammation, and a part of PCNA were hyper-expressed in the portal area. The expression rate of PCNA in the middle phase of inflammatory stage was higher than that of any other phases but declined later. Yet, when it came to the stage of hepatic carcinoma, the rate increased again. Conclusion Under the experimental circumstance when liver cancer is caused by the carcinogenic agent, PCNA may be firstly expressed in the oval cells, and the dynamic expression of PCNA may be an indicator for the early diagnosis of hepatocarcinogenesis.

Objective To study the three-dimensional (3D) reconstruction of pancreas based on the data of 64-row helical CT scanning and the effect of the dynamic simulation surgery of spleen.Methods The original scan data of spleen 64-slice helical CT were collected and the image program segmentation and automatic extraction were done with images of CT series by adaptive region growing algorithm.Then the image processing software was used to proceed with the 3D reorganization with the images which are segmented.Import reconstructed objectives to FreeForm Modeling System in the form of STL format were embellished and smoothed.GHOST SDK software of FreeForm Modeling System was utilized to develop various instruments needed by simulated surgeries.And the visualization of simulated surgery by PHANTOM software was studied before the splenectomy.Results By the adaptive region growing algorithm, the spleen image procedure could be calculated soon and efficiently, and the satisfactory spleen segmentation data were obtained.The clear picture structure of 3D- reorganization was a exact reproduction of spleen and the structures of vital organs and passages around;The simulated splenectomy was high simulated, vivid, exact and the operator could feel like a real surgery.Conclusions The research of 3D reorganization and visual artificial simulation surgery to spleen with the medical image process software and the FreeForm Modeling System can make surgeons know the 3D anatomical structure around spleen clearly before the surgery.And it is of great help to reduce the risk of surgery, decrease operative complications, and improve the effect of surgery.

Objective To investigate the location and ultrastructure of hepatic stem cells in adult rat. Methods Proliferation of hepatic oval cell of the rat was accomplished. Identification was made with immunohistochemistry with CK18, 19 and CD34 as markers. Ultrastructure of hepatic stem cells was observed with transmission electron microscope. Results The majority of hepatic oval cells were localized in the Hering channel, but some of them were distributed in the hepatic lobules. Electron microscopy revealed three types of oval cells. TypeⅠ cell was small, 7?m in size, with large nucleus but small amounts of cytoplasm and organelles. The cell was recognized as primitive oval cell. Type Ⅱ cell was larger, measuring 8?m in diameter, containing more cytoplasm and organelles. Type Ⅲ cells were larger than both of above cells, and they contained more organelles. Conclusion Hepatic oval cells in adult rat are localized in Hering channel, and they may be stem cells hepatocytes.

Objective To research the possibility of the rat mesenchymal stem cells (MSCs) to differentiate into hepatocyte-like with hepatocyte growth factor plus E growth factor in vitro. Methods (1) Bone marrow in the femurs of Wistar rat was collected by flushing under sterile condition. MSCs were separated and cultured according to the direct anchoring method, identified by using immunocytochemical methods and flow cytometry. After MSCs were induced by HGF (20mg/ml) and EGF (10mg/ml), mRNA expression level of AFP、Alb、CK-18 in the MSCs were detected by RT-PCR. In addition, ultrastructures in the cells induced were observed using electron microscope. Results Anchored MSCs is single or cell clone is developed. Cell is uniform in the configuration and converged long fusiform after 7-10 days. Cultured cells are certified to be MSCs in the immunocytochemistry and flow cytometry. Afer 21 days, cultured cells show Hepatocyte-like characters in the configuration. RT-PCR:On day 7 mRNA of AFP was detected; mRNA of Alb and CK-18 were detected at the beginning, then strengthen on 21 day. At the same time, induced cells in the electron microscope results coincided with hepatic cells. Conclusions MSCs can be isolated, cultured and expanded easily in vitro. MSCs induced by HGF plus EGF in vitro can differentiate into hepatocyte-like cells. As a result, it can provide a new therapeutic method for liver failure.

Digital medical technology pioneered the three dimensional (3D) era of the surgery.The 3D reconstruction and visualization technology made a breakthrough of the bottleneck of clinical diagnosis and therapy of the biliary surgery,and are widely used for the treatment of biliary disease such as hepatolithiasis and hilar cholangiocarcinoma,and achieved digital anatomy,procedural diagnosis and visualized surgery,just as provide a 3D Ⅹ-ray vision to surgeons.With the development of the digital medical technology and the wide application of 3D laparoscopy and robotic system,biliary tract surgery access to a 3D era.