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.

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 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

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.

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.

Objective To discuss the operative technique and curative effect of minor-incision cholecystectomy.Methods The clinical data of 672 patients with application of mini-cholecystectomy from June 2001 to June 2009 were analyzed.Perioperative management and operative technique were emphasized.Results Six hundred and fifty-two cases (97.0%) were cured with mini-cholecystectomy and 20 cases (3.0%) with incision lengthened.Operation time was (40.0?10.0) min.One case with hemorrhoea during operation was cured by interventional embolotherapy.Bile duct injury was found in 1 case during operation,and adopted suture with T tube.There were no infection of incisional wound or death in this study.Conclusion On the basis of skillful conventional cholecystectomy,by controlling indication and improving operative technique,it is an economical and safe way to perform minor-incision cholecystectomy.

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.

Objective To estimate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) level for early diagnosis of acute kidney injury (AKI) in patients with sepsis.Methods One hundred and twenty-six sepsis patients admitted to intensive care unit (ICU) in Baoshan Branch Hospital of Shuguang Hospital Affiliated to Shanghai University ofTraditional Chinese Medicine from June 2014 to December 2015 were enrolled, and they were divided into two groups according to whether complication of AKI was present. The levels of urinary NGAL in the two groups of septic patients were evaluated immediately and at 12, 24 and 48 hours after the definite diagnosis, and the levels were compared between the two groups; the receiver operating characteristic curve (ROC curve) was performed and the value of urinary NGAL level in early diagnosis of sepsis AKI was evaluated.Results There were 60 septic cases complicated with AKI (AKI group), with the prolongation of time after definite diagnosis, the urinary NGAL (g/L) levels were gradually increased at 12, 24 and 48 hours, the levels were significantly higher than those at the corresponding time points in the group without AKI [non AKI group (66 cases), 12 hours: 178.2±32.8 vs. 53.8±10.4, 24 hours: 228.4±24.6 vs. 54.1±9.0, 48 hours: 186.1±43.6 vs. 52.5±9.4, allP < 0.05]. The area under ROC curve (AUC) of urinary NGAL level at 24 hours after definite diagnosis and 95% confidence interval (CI) were 0.863 (0.766-0.929) and 0.686 (0.466-0.696), respectively, when the cutoff value of urinary NGAL was 65.9μg/L, the sensitivity was 81.9% and specificity 76.1%; when the cutoff value of urinary NGAL was 57.9μg/L, the sensitivity was 70.2% and the specificity 57.2%.Conclusion Urinary NGAL level can be used as a reference marker for the early diagnosis of sepsis concomitant AKI.