Objective To evaluate the therapeutic effect of combined splenorenal shunt and portaazygous devascularization on bleeding esophageal varices.Methods We summarized 120 cases suffering from esophageal variceal bleeding treated by splenorenal shunt plus portaazygods devascularization,from April,1978 to April,1997.Results The operative mortality was 4.2%,no short-term postoperative bleeding,and long-term postoperative bleeding rate was 9.5%,postoperative hepatic encephalopathy rate was 4.8%.Five,ten and fifteen years survival rate were 83.6%,64.5% and 54.5% respectively. The portal hemodynamics was observed by means of Doppler flowmeter,DSA,and intraoperative portal pressure measurement in some of the patients.Conclusion The result showed that combined shunt and portaazygous devacularization not only preserve the advantage of devacularization but also decrease the portal pressure and blood volume,alleviating portal hyperhemodynamics while preserve hepatopetal blood flow to some extent.

Objective To investigate the diagnosis and treatment of cystic adenoid tumor of the pancreas. Methods Retrospective analysis was made on the clinical data of 11 cases of pancreatic cystic neoplasms confirmed by operation and pathology at our hospital from 1978 to 1998. Results Cystic adenoid tumor of the pancreas is more likely to occur in young females with middle age, clinical presentations were as follows: a long-term persistent mass and distending pain in the epigastrium. Utrasounography, CT and ERCP could contribute to the diagnosis. Of the 11 cases, pancreaticoduodenectomy was performed in 2, distal pancreatectomy and splenectomy in 6, local excision of the mass in 2, and loop type cystojejunostomy in 1. The rete of resection was 90.9%. Of them, 1 case died of abdominal abscess and septicemia postoperatively. All the 10 cases who survived postoperatively were followed up. Among the 10 cases, 1 case of pancreatic cystoadenoma died of cardiac infarction 3 months after operation, and 1 case of cystoadenocarcinoma died of metastasis 51 months after tumor excision. The other 8 cases still alived well now. Conclusions Cystic tumor of the pancreas should be suspected when young or middle aged female patients have a long term big mass in epigastrium or left upper quadrant. Ultrasonography and CT scan are helpful in the diagnosis of the tumor including cystoademoma and cystoadenocarcinoma, Although the volume of the tumors may be very big, they often have a intact capsure,so easy to excise. The excision of the total tumor and some arounding pancreatic tissue is the first choice of the treatment for cystic tumor of the pancreas, and the curative effectiveness is satisfctory.

Purpose To investigate the clinicopathologic features of cervical adenoid basal cell carcinoma. Methods Clinical and pathological data were analyzed in 12 cases of cervical adenoid basal cell carcinoma and the relevant literatures were reviewed. Results The age of 12 cases of with cervical adenoid basal cell cancer patients ranged from 36~70 years ( mean:53. 3 years) , with a medi-an age of 51. 5 years. Amongst 12 patients who contained no gross definite lesion, 5 patients (41. 7%) had the symptoms of vaginal bleeding. 8 cases of patients underwent hysterectomy, while the other four received cervical conization. Cervical intraepithelial neopla-sia ( CIN) lesions were observed in all 12 cases. The tumor cells were small and uniform, with dark oval nuclei without conspicuous nucleoli and scanty cytoplasm. Tumor infiltrated into the stroma in nests and cords. Glandular differentiation within tumor nests were seen in 12 cases, including two cases of squamous cell differentiation accompanied by partial and minor interstitial edema. Peripheral palisading cells around tumor nests were also found. The infiltrating depth of tumor ranged from 0. 5~10 mm with the average 4. 12 mm. Cancer embolis were available in 2 cases with no lymph node metastasis. 10 cases followed up for 3~78 months with no recur-rence and metastasis, but 2 cases were lost. Conclusion Adenoid basal cell carcinoma is a rare uterine cervical tumor found in post-menopausal women, which are often accompanied with CIN. This tumor has a favorable prognosis and should be clearly separated from adenoid cystic carcinoma and other tumors which also have infiltrative growth pattern.

Objective To investigate the imaging features of pancreatic acinar cell carcinoma (PACC),and to assess the role of CT and MRI in the diagnosis of the disease.Methods CT and MRI data of 7 cases with PACC confirmed by surgery and pathology were reviewed retrospectively.Plan and dynamic contrast-enhanced CT were performed in 4 cases.MRI with T1 WI,T2 WI,and dy-namic contrast-enhanced series were performed in 3 cases.Results All of the PACC lesions were manifested as a single solitary mass.1 lesion was located in the pancreatic head,and the other 6 in the pancreatic body-tail.On plan CT,all of the 4 lesions ap-peared hypodense and 3 lesions had irregular more hypodense region in the lesions.On the contrast-enhanced CT,the tumor paren-chyma showed mild to moderate enhancement with non-enhanced hypodense region in the arterial phase,and lower enhancement than that of the surrounding normal pancreatic tissue in the portal and delayed phase.All of the 3 cases were heterogeneous hypointensity on T1 WI and hyperintensity on T2 WI.The manifestations of the tumors on contrast-enhanced MRI were similar with that on the contrast-enhanced CT.Dilation of the pancreatic duct was seen in 4 cases.Liver metastasis was seen in 1 case.Surrounding tissues were invaded in 4 cases.Conclusion CT and MRI can display the features of PACC and help to improve the diagnostic accuracy.

OBJECTIVE: To summarize the effects of glial cell line-derived neurotrophic factor (GDNF) on ischemia damage to nerve tissue and discuss the possibility of GDNF in repair of spinal cord injury based on the development of microencapsulation technology.DATA SOURCES: A search of Medline from January 1996 to October 2000 was performed for the English articles related to GDNF, ischemia damage to nerve tissue, spinal cord injury and microencapsulation technology by using the key words "glial cell line-derived neurotrophic factor, ischemia damage to nerve tissue, spinal cord injury". Meanwhile, we retrieved Wangfang database for search of the related articles in Chinese by using the same keywords in Chinese.STUDY SELECTION: Articles including intervention group and control group were selected after first review, and those which were significantly non-randomized researches were excluded. Then, the full-texts of the enrolled articles were retrieved. Inclusion criteria: ①randomized controlled study; ②the experiment/clinical research including horizontal control group. Exclusion criteria: duplicated researches.DATA EXTRACTION: Totally 300 articles were selected but only 15 were in coincidence with conclusion criteria. 285 articles were excluded, 264 of them were duplicated and non-randomized researches, and 21 were review articles.DATA SYNTHESIS: GDNF can provide nutrition to dopamine nerve cell in rat's middle brain, so as to decrease dopamine nerve cell's death. Also GDNF can protect dopamine nerve cell in cerebral infarction rats from ischemic injury, inhibit the produce of nitrogen monoxide and reperfusion injury after ischemia. GDNF is an effective protective factor against ischemia damage. Microencapsulation technology has a bright future in treating endocrinopathic neural diseases, and GDNF can play a great role in the development of microencapsulation technology.CONCLUSION: GDNF is a protective factor against ischemia damage to nerve tissue, which can be enhanced by microencapsulation technology.There is a bright future for the research on GDNF in the clinical repair of spinal cord injury.

Objective To evaluate the clinical values of acoustic radiation force impulse(ARFI) elastography for liver fibrosis on hepatopath patients.Methods ARFI elastography was prospectively performed on 99 patients prepared to undergo hepatic surgery to get a shear wave velocity(Vs) which was the representative of liver stiffness.The fibrosis stages,inflammation grades and steatosis grades were evaluated histologically after surgery.Values of Vs were compared with the histological results.Results Values of Vs with fibrosis stage 0-4 was (1.14 ± 0.22) m/s,(1.30 ± 0.22) m/s,(1.36 ± 0.38) m/s,(1.47 ± 0.37)m/s and (1.87 ± 0.08) m/s,respectively.A significant difference was observed among them (P ＜0.001).There was a certain correlation between Vs and fibrosis stage(r =0.541,P ＜0.001).Vs was a significant predictor of stage ≥3 fibrosis with an area under the ROC curve of 0.812,sensitivity 73.2％ and specificity 81.4％ when 1.40 m/s was the cutoff value (P ＜ 0.001).Values of Vs with inflammation grade 0-3 was (1.17 ± 0.16)m/s,(1.43 ± 0.36) m/s,(1.59 ± 0.53) m/s and (1.89 ± 0.59) m/s,respectively,which were significantly different (P ＜ 0.001).A certain correlation was observed between Vs and inflammation grade(r =0.383,P ＜0.001).Values of Vs with steatosis grade 0-4 was (1.61 ±0.42) m/s,(1.47±0.58) m/s,(1.56 ± 0.71)m/s,1.13 m/s and (0.94 ± 0.95) m/s.Obvious difference didn't exist between Vs and steatosis grade (P =0.286).Obvious correlation wasn't observed between them,either (r =-0.177,P =0.080).Conclusions ARFI elastography has a certain value for the evaluation of liver fibrosis,while inflammation grade may affect its performance.

Objective To explore body image(BI),prosthesis satisfaction and quality of life(QOL)of amputees from Wenchuan earthquake and the relationship among them to provide evidence for the intervention.Methods A total of 21 amputees accepted a survey regarding QOL,BI,and satisfaction with prosthesis.The scale of SF-36 was used to assess QOL.Amputees Bodily Image Scale(ABIS)was;used to assess BI.A self-design questionnaire wag used to evaluate the prosthesis satisfaction of amputees.Results The scores of SF-36,ABIS,and prosthesis satisfaction wag 41.90 ±15.00,64.58 ±10.60,and 59.52±11.06,respectively.The ABIS scores in women(65.07 ±12.10)were hisher than that in men(63.20 ±5.0)(P＜0.05).There was a positive correlation between score of QOL and prosthesis satisfaction,but a negative correlation between QOL and BI.The negative correlations were also observed between BI and Vitality,BI and mental health.Prosthesis satisfaction had positive correla tions with education level.QOL and mental health.Conclusion The body image disturbance(BID)and dissatis faction with prosthesis may cause negative influences on the amputees'quality of life.Relevant intervention should be provided of amputees handling their prostheses and body images correctly and raising QOL.

Objective To establish a gata4 gene knockout zebrafish model of congenital heart disease, and construct transcription activator-like effector nuclease ( TALEN) vectors targeting gata4 gene.Method We construct TALEN vectors targeting zabrafish gata4 gene using unit assembly method and the in vitro-transcribed TALEN mRNAs were microinjected into one-cell stage zebrafish embryos.The efficiency of TALEN was identified by injected embryos, and mutations of zebrafish were screened and confirmed the different types through PCR and enzyme digestion.Results We successfully constructed correct targeting vectors by enzyme digestion and sequencing, and the gene knockout efficiency was 35.18%.We screened the mutant zebrafish and confirmed different types of gata4 gene mutations.Conclusions A gata4 knockout zebrafish model is successfully established, it can provide a good animal model for further research of congenital heart diseases.

Purpose To investigate the expression of polo-like kinase 1 (Plk1) and Cyclin B1, p21WAF1in cervical carcinoma, and to determine the relationship between the expression of the three proteins and tumor clinicopathological features. Methods The expres-sion of Plk1, Cyclin B1 and p21WAF1 was detected in 102 cases of cervical carcinoma, 20 cases of (cervical intraepithelial neoplasia, CIN) , and 20 cases of nomal cervical tissues by the technique of tissue chip and immunohistochemical staining of EliVision. Statistical analyses of the data were performed with SPSS 19. 0 software. Results The positive rates of Plk1 in cervical carcinoma and CIN were 70. 5%, 55. 0%, respectively, which were significantly higher than normal cervical tissues (10%) (P<0. 01);The positive rates of Cyclin B1 in cervical carcinoma and CIN were 52. 9% and 30. 0%, respectively, which were significantly higher than normal cervical tissues (10%)(P <0.01); The positive rates of p21WAF1 in cervical carcinoma and CIN were 23.5% and 10.0%, respectively, which were significantly higher than normal cervical tissues ( 0 ) ( P<0. 01 ) . There were no significant differences between cervical carcinoma and CIN in the positive rates of Plk1, Cyclin B1 and p21WAF1. The expression of Plk1 was associated with the depth of carci-noma invasion (P<0. 05), that of Cyclin B1 was associated with lymph node metastases and the depth of carcinoma invasion (P<0. 05)and that of p21WAF1 in cervical carcinoma was associated with histological grade (P<0. 05). In cervical carcinoma, the expres-sion of Plk1 was positively correlated with Cyclin B1 (rs =0. 297, P=0. 002) and negatively correlated with p21WAF1(rs = -0. 403, P<0. 001). Conclusion The expression of Plk1, Cyclin B1 and p21WAF1 is involved in the occurrence and development of cervical carcinoma, and the former two are also related with prognosis of cervical carcinoma. The combination of the three would provide a new target for clinical treatment.

At present, zebrafish has played an increasingly important role in models for human development and diseases and several areas of life sciences.As a newly laboratory animal resource, standardization research has become the technical bottleneck to be solved and an inevitable trend.In this review, we summarized the research history and character-istics of zebrafish and the status of quality standardization.We also discussed the main problem facing by the standardiza-tion research of zebrafish as a newly laboratory animal.We hope that the data can provide useful reference for the develop-ment of zebrafish quality standardization research.