Since portal vein arterialization(PVA) was firstly introduced as a treatment in patients with portal hypertension due to liver cirrhosis, the concept of PVA has drawn much attention. In special situations, in hepatobiliary surgery, this procedure remains useful. However, PVA is unphysiological and there is much controversy on its use.This article reviews the current status of PVA in hepatic artery resection or injury, in acute liver failure and in liver transplantation, and suggests future directions in research in PVA.

0.05).(2) In the treatment group,19(70.37%) patients were cured,whose shoulder pain was relieved immediately,with the time for the complete recovery of joint function being 4.47 ? 3.08 days.In the control group,7 patients(53.85%) were cured,whose shoulder pain was relieved in 17.35 ? 6.22 days,with the time for the complete recovery of joint function being 26.13 ? 3.58 days.The differences between the two groups were significant(P

Objective To explore serratus anterior muscle transplantation for the repair of soft tissue defects in foot and ankle. Methods Seventeen patients consisted of 11 males and 6 females aging from 13 to 58 years with the mean age of 35.2 years. The anatomical parameters of serratus anterior of 17 cases were measured, the thickness of the muscle was (1.24?0.65) cm, and the diameter of origin point of the nutrient artery to the muscle was (1.4?0.6) mm. There were two veins arising from the muscle, the diameter of larger one was (2.5?0.8) mm. The length of vascular pedicle was (8.31?1.48) cm. 17 patients with soft tissue defect of foot and ankle were treated with free serratus anterior muscle transfer and split skin graft overlying the muscle. The primary lesions were soft tissue defect around the ankle and Pilon fracture in 5 cases, non-union of distal tibial fracture in 3, Achilles tendon and soft tissue defect in 3, metatarsal fracture and soft tissue defect in 4, and calcaneal fracture with soft tissue defect in 2. All of the patients suffered from infection or exposure of bone or applied plate, the area of soft tissue defect ranged from 4.5 cm?6 cm to 11 cm?13 cm. Results The average operative time was (6.5?1.2) hours. The complications included local hematoma in 2 cases, superficial infection in 2, winged scapula without function loss in 1,scar pain in 2, and numbness of lateral thoracic wall in 1. Furthermore, weakness and decreased shoulder mobility were noted in 3 patients comparing with the contralateral side, but the condition improved half year following the operation. The transferred muscle flap appeared thinner and less bulky , and healed intimately with the adjacent foot tissue, the patients resumed good function in walking. Conclusion The serratus anterior muscle flap is a good choice for treatment of soft tissue defects in foot and ankle.

Objective To detect the pain condition in patients with Parkinson's disease(PD) and explore the clinical significance.Methods From May 2007 to February 2008,pain was examined in 162 PD patients in Department of Neurology,West China Hospital,Sichuan University and in 135 healthy controls well matched for gender,age and education.Statistics analysis was employed according to gender,age,the form of morbility,early-onset PD or late-onset PD,duration and Hoehn-Yahr degree.Results The incidence of pain in PD patients(53.1%)was higher than that in the healthy controls(23.7%)(P

To study the telomerase expression in adrenal cortical tumors and its clinical signinificance. Telomerase expression was estimated in 8 cases of adrenal cortical carcinoma, 20 cases of adrenal cortical adenoma, 24 tissues adjacent to cancer, and 4 specimens of normal adrenal tissue by the PCR based telomeric repeat amplification protocol. Telomerase was found to be expressed positively in 7(87 5%) of 8 adrenal cortical carcinoma samples and 1(4 2%) of 24 tissues adjacent to tumor, while it was not expressed in all the 20 samples of adrenal cortical adenoma and normal adrenal tissue. The expression of telomerase in adrenal cortical tumors clearly demonstrated the malignant behavior of the tumor cells. Demonstration of telomerase expression appears to be a useful tool for the diagnosis of malignant adrenal cortical tumors.

Objective To investigate the extent and the relevant factors for local lymph node metastasis of gallbladder carcinoma. Methods Clinicopathologic features of 34 patients with gallbladder carcinoma who underwent radical resection were analyzed retrospectively. Results The overall lymph node metastasis rate was 68%(23/34), with 0(0/3) in T 1 stage, 43%(3/7) in T 2, 85%(11/13) in T 3, and 82%(9/11) in T 4. The metastasis rate was 29%(10/34) in gallbladder lymph nodes, 44%(15/34) in pericholedochal, 18%(6/34) in hepatic hilum, 24%(8/34) alongside proper hepatic artery, 21%(7/34) in periportal vein, 38%(13/34) in retropancreaticoduodenal, and 4/6 in paraaortic region. Conclusions Lymph node metastasis was determined by the depth of invasion of the primary tumor. The extent of surgical dissection was made according to the exploration and result of intraoperative biopsy.

Objective To study the relationship between graft injury and expression of redox factor-1 in early period after liver transplantation in rats. Methods One hundred and fifty adult male Wistar rats were randomly divided into three groups: liver transplant group, sham surgery group and control group. Animals were sacrificed in each group at different time points: 3,6,9, 12,24 hour after liver transplantation. The changes and significance of the expression of Ref-1 were explored by immunohistochemistry, serology and histopathology. Results Compared with sham surgery group and control group, the expression of Ref-1 protein in transplant group was higher than that in other two groups in early period after liver transplantation ( P ＜ 0. 05 ). In pathology there were lots of inflammation cells infiltration around the portal veins, and cell damage of hepatic tissue, while that in sham surgery and control group was comparatively slight. Serum ALT and AST values reached the peak at 6 ～ 12 h, and decreaced significantly after 12 h ( P ＜ 0. 05 ). Conclusions Graft injury after liver transplantation during early period reaches peak at 6 hour and then decreased. Hepatic ischemic reperfusion injury promotes Ref-1 expression, which in turn compensates for programme cell death induced by the injury.

In recent years,liver transplantation donor shortage as one of world medical problems is paid more attention by domestic and overseas scholars.In view of that,heterotopic auxiliary liver transplantation emerges which transplants the whole or some parts of a donor liver outside the original liver position on the condition that some parts or the whole of the original liver were retained.As for the liver transplantation with poor conditions on portal vein,reconstruction of portal vein has become an aporia.Based on this,some scholars put forward the theory——arterialization of portal vein(PVA),namely a method to increase arterial blood supply or replace portal vein blood perfusion of liver by establishing some pathes among artery and portal vein or its branches.The research background and current situation of heterotopic auxiliary liver transplantation with portal vein arterialization,the transplanting position of donor liver,vessel reconstruction,dynamics mechanism after reconstruction and liver regene-ration are summarized in this review.

Objective To evaluate the effect of esophagofundostomy combined with devascularization for the treatment of portal hypertension.Methods From February 2009 to August 2013,30 cases (research group) underwent esophagofundostomy combined with devascularization,while 56 cases (control group) were treated by devascularization only.Splenectomy was performed in all patients.Results There was no perioperative mortality in either group.The difference of postoperative serum bilirubin,albumin and blood platelet was not statistically significant (t =1.13、0.23、1.53,all P ＞ 0.05) ; The incidence of hepatic encephalopathy in research group and control group was 3％ and 11％,respectively,three years mortality was 14％ and 24％,respectively (x2 =0.61、1.22,all P ＞0.05).The rebleeding rate in research group was lower than control group,there was a significant difference (x2 =4.61,P ＜ 0.05).Research group was superior to control group in improving esophageal-gastric varices and there was a significant difference (P ＜ 0.05).Conclusions Compared with devascularization,esophagofundostomy combined with devascularization is more effective in reducing esophageal-gastric varices and prevention of rebleeding.

Basic surgical skills tralning which belongs to the basic course of surgery, is clini-cal basis for the medical students. The teaching practice of basic surgical skills tralning was explored by the Affiliated Hospital of Inner Mongolia Medical University, the theoretical teaching was combined with skills tralning practice, three kinds of means which contalned the model, animal tissues and or-gans in vitro and animal experiment were used to carry out systemic and standardized tralning. Finally, the basic surgical skills of postgraduate in surgery were improved, and the expected alm of teaching was achieved.