Total laparoscopic splenectomy combined with pericardial devascularization has become an important surgical treatment for portal hypertension patients. Compared with the traditional open surgery, laparoscopic surgery has multiple advantages including precise operation, small trauma and quick recovery. Accurate preoperative evaluation, precise surgical operation and delicate perioperative management are still important parts in perioperative management of laparoscopic surgery. Preoperative reasonable and accurate individualized assessment, strict control surgical indications and contraindications are the important basis to ensure the perioperative surgery to be safe and rational; standardized and individualized surgical operation is the key for accurate vascular disconnection, reducing intraoperative bleeding and perioperative complications; the concept of fast-track surgery is conducive to the rapid recovery of patients with portal hypertension and reduce the operation related complications. Anticoagulant therapy is a safe and effective treatment to reduce portal vein thrombosis. It is an important task to strengthen the cooperation among different disciplines for the treatment of portal hypertension in the future.

AIM: To investigate the effect of neferine (Nef) on human gastric carcinoma cell line with multidrug resistance (MDR). METHODS: The cytotoxic effect of vincristine (VCR) was evaluated by MTT assay. The cell apoptosis induced by VCR was determined by flow cytometry, and the expression of P-glycoprotein (P-gp) and multidrug-resistance-associated protein (MRP) in cells was examined by immunofluorescence flow cytometry. RESULTS: MTT assay showed that Nef at the concentration of 5 ?mol?L~(-1) to 10 ?mol?L~(-1) have no cytotoxicity to parent human gastric carcinoma cell line (SGC7901) and its VCR-resistant variant cell line (SGC7901/VCR). The IC_(50) value of VCR to SGC7901 cell line was 0.06 mg?L~(-1)and that of to SGC7901/VCR cell line was 2.32 mg?L~(-1), which indicated SGC7901/VCR cell line were 39 times more resistant to VCR in comparison with the parent SGC7901 cell line. After treatment with Nef at the concentrations of 2.5, 5 and 10 ?mol?L~(-1), the IC_(50) value of VCR to SGC7901/VCR cell line decreased to 0.34, 0.12 and 0.05 mg?L~(-1), respectively and those increased by 6.8-, 18.1- and 43.8- fold in the chemosensitivity, respectively. Flow cytometry showed that SGC7901/VCR cells were resistant to apoptosis induced by VCR. After 24 h treatment with Nef (2.5, 5 and 10 ?mol?L~(-1)) and VCR, the apoptosis of SGC7901/VCR cells increased, which indicated Nef could abolish resistance of SGC7901/VCR cells to VCR-induced apoptosis. Furthermore, the action of Nef was more potent than verapamil. The expression of P-glycoprotein and multidrug resistance associated protein was strongly positive in SGC7901/VCR cells, and the expression level of P-gp and MRP in SGC701/VCR cells was significantly down-regulated at 24 h after treatment with Nef (10 ?mol?L~(-1)). CONCLUSIONS: Nef can reverse MDR in multidrug-resistant human gastric carcinoma SGC7901/VCR cell line. Its mechanism might be associated with down-regulation of expression of P-gp and MRP in SGC7901/VCR cells.

Due to lack of the practical technique to measure the biomechanical properties of the ocular cornea in vivo, clinical ophthalmologists have some difficulties in understanding the deformation mechanism of the cornea under the action of physiological intraocular pressures. Using Young's theory analysis of the corneal deformation during applanation tonometry, the relation between the elasticity moduli of the cornea and the applanated corneal area and the measured and true intraocular pressures can be obtained. A new applanation technique has been developed for measuring the biomechanical properties of the ocular cornea tissue in vivo, which can simultaneously acquire the data of the applanation area and displacement of the corneal deformation as well as the exerted applanation force on the cornea. Experimental results on a rabbit's eyeball demonstrated that the present technique could be used to measure the elasticity moduli and creep properties of the ocular cornea nondestructively in vivo.
Animals ; Biomechanical Phenomena ; Cornea ; Elastic Modulus ; Intraocular Pressure ; Muscles ; Rabbits ; Tonometry, Ocular

Objective To analyse the clinical features,imaging characteristics diversity of deep cerebral veins thrombosis (DCVT).Methods From 2004 to 2013,6 patients diagnosed as DCVT were recorded and a retrospective review of the cases were undertaken for the purpose of this analysis.Results Among the 6 patients with DCVT,4 were male and 2 were female,aged from 28 to 69 years old.The disease duration of 4 cases ranged from 2 to 7 days,remnants were 20 days and 3 months respectively.The first symptoms of 4 cases were headache,1 was feeblemindedness,and the other was hemiplegia.The secondary symptoms were disturbance of consciousness,apathy,diplopia and non-infectious fever.Non-contrast computed tomography showed low signal in the bilateral thalamus in four patients,high signal in the transverse sinus and straight sinus in one patient and high signal in torcular in one patient.Abnormal signal was found in bilateral thalamus on magnetic resonance imaging in all patients and some of them had abnormal signal in the mesencephalon or basal ganglia.The patients were definitely diagnosed as DCVT by magnetic resonance venography (MRV) or digital subtraction angiography (DSA).Among them,2 patients were confirmed by brain biopsy.Four patients were followed up with good outcome and 2 were lost to follow-up.Conclusions The clinical manifestations of DCVT are not specific.For acute-onset DCVT patients,the first symptoms are always headache and vomiting,while the main symptoms are declined cognition and slow reaction for chronic-onset ones.Along with the progress,the main symptoms of DCVT are disturbance of consciousness,psychiatric symptoms and intracranial hypertension.Changes in the bilateral thalamus and basal ganglia are especially main characteristics which are easily misdiagnosed as brain tumor according to the images.DCVT can be definitely diagnosed by no signal of deep cerebral veins on MRV or DSA.

The early histological myocardial ischemic changes in both experimental rabbitsand forensic caseworks of sudden death were demonstrated by the hematoxylin basicfuchsin-picric acid staining method.After the ligation of the coronary artery,therewere discrete patchy fuchsin-stained fibers which in contrast with the normal fibersof light-brown color.The number of fuchsin-stained fibers increased with the pro-longation of the intervals after ischemia.The results were not affected by the post-mortem autolysis.We consider that this method can be used as a routine test ofearly myocardial ischemia in both clinico-pathology and forensic pathology.

Proteolysis and amino acid metabolism in autolyzing rabbit left ventricular myocardium were studied. Tissue slices were incubated in a moist chamber at 37℃ from 15 min to 480 min. Their free acidic, neutral and basic amino acids and ammonia were determined by ion exchange chromatography. It was found thatmost of the free tissue amino acids in the course of autolys is increased significantlg, Increasing of alanine, lysine and histidine was noted at 15min of autolysis while the tissue glutamic acid content decreased,and the tissue ammonia content increased. The results suggest that the protcelysis was accelerated in early autolyzing heart muscles. It is helpful for the timing of death.

With the combined interruption of the superior mesenteric vein, the splenic artery and vein and the portal vein, we successfully separated the adhesion between the collum pancreatis and the portal vein which is difficult to separate in 8 cases During the separation, the portal vein was damaged in 2～5 parts, and the size of wounds of vein were of 2～6mm in length, but the amount of bleeding was small and the bleeding speed was slow All the wounds were easily repaired under direct vision We consider that the mothod of the combined interruption is safe and effective for the separation of the adhesion between the collum pancreatis and the portal vein, and is helpful to increasing the success rate of removing carcinoma of the head of pancreases The interruption is safe for 20～25 minutes under normothermia

Objective To study the clinical and X-ray findings of primary reticulocytic sarcoma of bone in order to improve its diagnosis and differential diagnosis.Methods X-ray representations of primary reticulocytic sarcoma of bone in 11 cases proved by operations and pathologies in combination with clinical manifestations were analyzed.Results The tumors located in tubular bone were 5 cases(45%),in vertebra,in costa and pelvis were 2 cases respectively.The main X-ray sign was osteolytic lesion.The soft tissue masses were seen in 7 cases and pathologic fracture in 1 case,only 2 cases appeared lightly periosteal reaction.Conclusion When the osteolytic lesions in company with soft tissue mass are showed on X-ray films,but the clinical symptoms of the disease are not as serious as those of other malignant bone tumors,the bone reticulocytic sarcoma should be considered,and the final diagnosis of the disease desponds on pathologic result.

Aim To investigate the effects of rosiglitazone(ROZ)combined with cisplatin(DDP)on the growth of transplanted lung adenocarcinoma in mice and the corresponding mechanism.Methods The human lung adenocarcinoma mode was established with A549 cell in nude mice.Twenty eight female Balb/c-nu mice with lung adenocarcinoma were randomly divided into seven groups.① control group;② low-dose DDP group(1 mg?kg-1);③ high-dose DDP group(4 mg?kg-1);④ low-dose ROZ group(10 mg?kg-1);⑤ high-dose ROZ group(30 mg?kg-1);⑥ low-dose DDP plus low-dose ROZ group;⑦ low-dose DDP plus high-dose ROZ group;all the mice were sacrificed at 48 h after the last injection.Subcutaneous tumor was subjected to histological examination.Expressions of PPAR?、PTEN and pAkt in tumor tissues were detected by immunohistochemistry.Results ① In every treatment group tumor growth was suppressed significantly.Intraperitoneal injection of low and high-dose DDP,low and high-dose ROZ,low-dose DDP plus low-dose ROZ and low-dose DDP plus high-dose ROZ group resulted in a significant inhibition of the growth of A549 cells in vivo compared with that of control group(P

AIM To study the effect of neferine on intracellular adriamycin(ADM) accumulation in MCF-7/Adr cell line. METHODS The cytotoxic effect was determined by MTT assay. The intracellular ADM concentration was assayed by HPLC. RESULTS Neferine(Nef) decreased the IC 50 of ADM to MCF-7/Adr cells but increased the intracellular concentration of ADM. CONCLUSION The mechanism of the MDR reversal effect of Nef is associated with the increase of the intracellular accumulation of anticancer drug.