The report deals with autopsies of 30 hospitalized patients with clinical manifestations of severe viral hepatitis (SVH), who died of hepatic failure. Their age ranged from 8-57 years with an average of 27.9. There were 23 males, and 7 females in the group. The duration of the disease varied with different' , individuals, ranging from 1-96 months. Before onset of SVH, 73.3% of the cases had been afflicted with acute hepatitis or CAH. The clinical' course, therefore, was quite different from that .of fulminat variant.The pathological changes in the livers could be classified into 4 different types: subacute necrotic hepatitis (type Ⅰ ), necro-proliferative hepatitis (type Ⅱ), precirrhotic hepatitis (type Ⅲ), and cirrhotic hepatitis (type Ⅳ). Each of the 4types could be delineated with its own morphological features. However, overlaps in between two successional types (e.g. between type Ⅰ -Ⅱ, etc.) existed/morphology. These facts make it reasonable to postulate that each of the 4 types might represent a different stage in the progress of SVH.

The report dealt with the pathological changes in the extrahepatic organs from 30 autopsied cases with clinical manifestations of severe viral hepatitis (SAH) . The main findings were epitomized as follows.(1 ) Brain edema with herniation of tonsil cerebelli in 24 (71%) cases among the 27 whose brains were examined. (2) Bilateral pulmonary edema in 20 (43%) cases among the 28 whose lungs were examined. 45% cases of pulmonary edema were complicated by bronchopneumonia, 10% by fungal infection, and 15% by pulmonary hemorrhage. ( 3 ) Cardiac hypertrophy in ( 43% ) cases among the 28 whose hearts were examined. (4) Biliary nephrosis in 22 (92%) cases among the 24 whose kidneys wers examined. ( 5 ) All the 30 cases showed intestinal congestion and edema throughout the 3 laminae of intestinal wall. (6) of 30 cases, 8 (27%) showed esophageal varicosis. Early hepatic cirrhosis was established in half of the cases. (7) of 29 cases, 25 (85%) had ascitis with various amount of transudate ranging from 2000-8000 ml in adults and 300-1500ml in children. (8) of 30 cases, 4 (13%) had subacute phlegmonous colitis. (9) of 30 cases, 3 (10%) were complicated by the generalizad aspergillosis and/or candiasis involving the lungs, brain, heart, kidneys, intestines, et al.It was considered that the alterations in extrahepatic organs should aggravate the primary disease and thus be prone to increase its motality rate. Some of them, such as brain edema might be the direct cause of death. It was thought that two factors might be responsible for the initiation of extrahepatic alterations. ( 1 ) increase in intrahepatic resistance to the portal blood flow which is presumably due to reduction of hepatic microcirculatory beds, and ( 2 ) hypoxemia which is probably due to intrapulmonary vascular shunts in case of hepatic failure. These factors, once established, might in turn trigger off a sequence of pathological events.

Hepatic carcinomas were induced with the administration of diethyl-nitrosamine (DEN) in rats. The morphological changes of the liver tissues in the course of carcinogenesis could be divided into 3 successive stages: the nonspecific changes reacting to the drug toxicity, non-cancerous hyperplastic nodules of hepatocytes and ductular cystadenomatous lesions,and the lesions of genuine malignancy including hepatocellular carcinoma and cholangiocarcinoma.The ultrastructural alterations of hepatocellular carcinoma showed a complicate picture and were related to the differentiation of the tumor cells. In one case of cholangiocarcinoma, numerous cytoplasmic dense-core granules similar to the neurosecretary granules seen in apudoma were found in some of the tumor cells, which is postulated to be a special type of cholangiocarcinoma. On the basis of the results, Ihe histogenesis of the neoplasms after DEN administration is considered to originate from hyperplastic nodules of hepatic cells and ductular hyperplasia.

Objective To investigate the epidemic factors of schistosomiasis in wetlands in Sichuan Province, so as to provide scientific evidence for the prevention and control of schistosomiasis in wetlands. Methods The artificial and natural wetlands were selected from Sichuan Province, and the relevant data regarding wetlands were collected. Routine snail survey, investigation on human morbidity due to schistosomiasis, snail diffusion experiments, questionnaire survey, determination of water infectivity and retrospective survey were conducted. Results In Sichuan Province, the mean densities of living snails were 0.003 snails/0.1 m² and 2.033 snails/0.1 m² in the upper and lower reaches of the Meiwan Reservoir wetlands, 0.08 snails/0.1 m² in the Jinyan Lake of Guanghan City, 0.21 snails/0.1 m² in Muhe River of Guanghan City, and 0.02 snails/0.1 m² prior to the construction of Qiong-hai wetland park in Xichang City in 2015. Artificial simulation experiments showed that the largest distance of snail diffusion in water was 2 000 m. There were 8.80% (41/466) of subjects that lived neighboring wetlands, worked in wetlands and visited wet-lands having infested water contact behaviors. A total of 690 sentinel mice were assigned, and no Schistosoma japonicum infection was detected in the 677 mice dissected. Retrospective survey showed that the construction of the Meiwan Reservoir caused the spread of schistosomiasis in Dailing County, and snails were found in the ditches entering the Jinyan Lake and in Jinyan Lake areas 5 years following the construction of the Jinyan Lake in Guanghan City, with S. japonicum -infected snails detected in the ditches entering the Jinyan Lake. Conclusions O. hupensis snails are found in some wetlands in Sichuan Province. Protection of wetlands and snail control with environmental improvements are recommended for the prevention of snail importation in natural wetlands, while in artificial wetlands, thorough snail control is recommended during the construction of the wetlands because of the likelihood of snail importation via water systems. In addition, both natural and artificial wetlands require long-term systematic surveillance of schistosomiasis.