0.05),but the mortality of the patients undergoing anatomical resection was higher than that of the patients undergoing resection debridement(? 2=4.85,P

Objective To explore the surgical alternatives to severe liver injuries. Methods The data of 86 cases with severe liver injury treated surgically from January 1989 to December 2001 were summarized. There were 43 cases with grade Ⅲ injury, 32 with grade Ⅳ and 11 with grade Ⅴ. Eleven cases complicated by injuries on cardinal vein and posthepatic vein were all treated surgically. Results Of all, 66 cases (76.7%) were cured and 20 (23.3%) died. The post operative complication occurred in 23 cases (26.7%). Conclusions Correct surgical procedure for severe liver injury is crucial for a better curative effect. It is safe and effective to ligate one or two hepatic veins when the liver trauma is complicated by hepatic vein injuries.

Objective To explore the management methods for liver injury combined with posthepatic vein injuries in order to make an improvement in corresponding treatment. Methods Twenty-three cases with liver injury combined with posthepatic vein injuries were treated with the following 5 ways: repairing the hepatic vascular blockage step-by-step, pressing directly to exhibit the injured vessels for repair, ligating the injured hepatic veins, suturing the hepatic tissues and packing with gauze. Results Of all, 18 cases (78.3%) were cured and 5 (21.7%) died. Conclusions Rational preoperative emergent resuscitation and correct complex intraoperative management are key to the liver injury combined with posthepatic vein injuries.

Objective To study the characteristics and treatments of occlusive abdominal injuries during pregnancy. Methods The clinical data of 37 cases with occlusive abdominal injuries admitted in hospital from June 1993 to June 2003 were collected for study. Results All 37 cases received operative treatment, of which two cases complicated by enterorrhexis in the early pregnancy and one by retroperitoneal hematoma were managed using laparoscope. Laparotomy was performed in other 34 cases, of which eight received caesaren section because of placental abruption and enlarged uterus that impeded the management for intraabdominal organs. Of all, 33 cases (33/37,89%) were cured and four (4/37, 11%) died. The postoperative incidence of complications was 16% (6/37). The complications included abdominal cavity infection in two cases (5%), pulmonary infection in three (8%) and multiple organ failure in one (3%). Conclusion Besides obstetrics' diseases, we must keep alert about the injury of abdominal organs during the management of trauma. Accurate diagnosis and timely treatment will win time to save the lives of mother and infant.

Objective To explore the effect of hepatectomy or cholangiolithotomy on patients with hepatocholangic stones. Methods The clinical data of surgical treatment of 316 patients with hepatocholangic stones combined with bile duct stricture was retrospectively analyzed. The patients were divided into two groups:172 patients chiefly underwent hepatectomy,and the other 144 patients chiefly underwent cholangiolithotomy. Results The ratio of residual stones and reoperation in the hepatectomy group was significantly lower than those in the cholangiolithotomy group (P

Objective To discuss the diagnosis and treatment of pulmonary contusion. Methods A retrospective study was carried out in 132 cases of severe pulmonary contusion (injury severity score ≥20) from February 1993 to December 2003. Results Of all, 107 cases (81.1%)survived and 25 (18.9%)died. Conclusions Chest X-ray and CT are reliable for the diagnosis of pulmonary contusion. The important methods include keeping airway clear, progressively treating shock and reasonably applying ventilation, steroids as well as antibiotics. The early diagnosis and the prompt treatment of the associated injuries are key to higher cure rate.

Objective To evaluate the therapeutic effect of endoscopic treatment for acute biliary pancreatitis. Methods Thirty-six cases of acute biliary pancreatitis were treated in our hospital in recent 4 years. Tweent cases (group E) underwent emergency endoscopic retrograde cholongiopancreatography(ERCP),endoscopic sphincterotomy(EST) and endoscopic naso-biliary drainage (ENBD) within 24h of hospitalization; 16 cases (group C ) were treated conservatively or by operation. Results Successful rate of endoscopic management was 95.24%. There were no severe complications nor mortality in group E. The duration of symptoms and hospitalization in endoscopic group was significantly shorter than those in group C(P0.05). But the serum and urine amylase in group E were significantly lower than those in group C in the second day(P

Objective To investigate the role of miR-155 in diabetic nephropathy(DN)and its mecha-nism. Methods MiR-155 expression level in kidney was detected by real-time PCR and in situ hybridization. The target gene of miR-155 was predicted by bioinformatics and verified by Western Blot and double luciferase reporter activity. Western Blot was used to detect the related marker proteins of mesangial cells proliferation and mesangial matrix. Results (1)The expression of miR-155 increased in DN renal tissue and high glucose-stimulated renal cells.(2)MiR-155 was related to the regulation of Smad5 gene expression.(3)MiR-155 promoted the mesangial cells proliferation and increased extracellular matrix by down-regulating Smad5 expression. Conclusions MiR-155 can promote the mesangial cells proliferation and renal fibrosis by regulating Smad5 gene,providing a basis for further understanding the pathogenesis of DN.