Purpose:To evaluate the effect of metallic stent in the treatment of malignant stricture in esophagus and cardia.Materials and Methods:Treated by metallic stent:14patients with malignant stricture in esophagus and cardia,13 males and 1 female aged ranged from 57 to 81,were discussed in this article.Among 12 patients,8 were proved as esophageal squamous carcinoma,4 as esophagus adenocarcinoma,and 1 was complicated with esophagotrachial fistula,l0 of the pa- tients could take fluid food and 4 only water.After catheterizing from mouth,the strictured portions dilated with hallon catheter,15 selfmade Z stents coveted with dacron and 1 strecker stent were in 13 and 1 patients respectively.Results:All stems were successfully placed.Patients could eat more easily after the operations.The esophogotrachial fistula was completely sealed.The average lifetime after the operation was 5.5 months.Conclusions:Metallic stent prosthesis is an effective method to treat malignant stricture in esophagus and cardia,and could elevate the life quality of patients sig- nifieantly.

Purpose:To study the angiographic characteristics and mechanism of shunt stenosis-occlusiion after TIPSS.Materials and methods:Eighty-nine portal venograms were obtained in 58 patients.Venograms analysis had been performed according to shape,position and degree of shunt stenosis.Results:Thirty-six shunt abnormaloties were found in the portal venograms of 58 patients,Shunt stenosis(diameter

Objective To inquire into the diagnosis and management of renal angiomyolipoma.Methods The 22 cases of RAML were studied restrospectively.Results The diagnosis accuracy was 54.5% for B ultrasound and 81.8% for CT,18 were diagnosed as RAML and 4 were misdiagnosed as renal cell carcinoma preoperatively,of which 3 were diagnosed as RAML based on intraoperative frozen section study.11 had been performed enuoleation,7 partial nephrectomy,3 nephrectomy and 1 radical nephrectomy. Conclusions CT is the first line imaging method for RAML.the cow fatty component,intratumor hemorrhage and small tumor are the main canse of misdiagnosis in RAML.careful analysis to clinical feature and imaging data,intraoperative frozen sect,ion study can avoid misdiagnosis.nephron sparing surgery is the best operative management.

Purpose: To evaluate the feasibility of interventional biopsy, the component of stenotic tissues of shunt tract and mechanism of shunt stenosis. Materials and Methods: The pathologic specimens of stenotis shunt tract were obtained in 10 patients with catherization endovascular biopsy clamp and atherectomy methods, then they were undergone routinely with HE stain and immunocytochemical stain, and observed procedures under microscope. Rusults: all of interventional biopsy were succeeded without complication. The microscopies, findcarge of stenotic tissue were primarily composed of fibrotic granulations and thrombi with inflammatory cells and exuberant foam cells derived from endothelial cells, smooth muscle cells and rhagiocrine cells. Conclusion: 1)The interventional biopsy is a safe and effective method. 2)The stenosis in parenchymal tract is related to thrombosis and tissue orangnization.

Objective To evaluate the efficacy of DSA-guided percutaneous transhepatic gallbladder catheter drainage (PTGCD) in treating aged patients with acute cholecystitis complicated by severe diseases. Methods The clinical data of 15 aged patients with acute cholecystitis or complicated by severe diseases, who were encountered at authors’ hospital in the past three years and were treated with PTGCD, were retrospectively analyzed. The clinical results were discussed. Results PTGCD was successfully accomplished with single procedure in all 15 patients. Abdominal pain was relieved within one to three days, and the abdominal symptoms and signs subsided or disappeared. Reexamination of routine blood test showed that the white blood cell count decreased to normal range in 1 - 2 weeks, and complete cure was achieved in some patients. Secondary surgery was carried out in some patients after the clinical condition was improved. During the follow-up period no complications occurred in all patients except one who developed biliary leakage after the catheter was retrieved two weeks after the treatment. Conclusion For the treatment of complicated acute cholecystitis in aged patients who are not suitable to receive surgery, DSA-guided percutaneous transhepatic gallbladder catheter drainage is an ideal therapeutic means as it can significantly relieve clinical symptoms.

Objective:To observe the effect of Kechuanning on Th cytokine expression in pediatric virus-induced asthma.Methods:120 cases of pediatric virus-induced asthma were randomly divided into Kechuanning group(treatment group,n =60,treated with Kechuanning) and Western medicine group(control group,n=60,treated with virazole).The change of Th1 cytokine IL-12 and Th2 cytokine IL-4 in blood serum were detected and analyzed.Results:Kechuanning could increase IL-12 but decrease IL-4 level in the patient's blood,therefore regulate Th cell subset,and the effect was more obvious than in control group.Conclusion:The mechanism of Kechuanning in curing pediatrics asthma induced by virus was related with increasing IL-12 and decreasing IL-4 level.

Objective To investigate the etiology and treatment of iatrogenic ureteral injury(IUI) and bladder injury(IBI). Methods Forty-seven patients(7 males, 40 females) with ureteral and bladder inju-ries caused as a result of any medical procedures were reviewed from 1996 to 2007. Obstetrics and gynecolog-ical, urological,general surgical procedures were involved in 38, 6, and 4 of the injuries respectively. Re-sults Sixteen cases of IUI were found during operation, including 14 cases of entire ureteral laceration, 4 cases of partial ureteral laceration. Thirteen cases received ureteral anastomosis, one case received uretero-neopyelostomy. One case of ureteral perforations during ureteroscopic procedure was indweUed of double-J after the operation was terminated immediately. Three cases received nephrectomy. Four cases of lower ure-teric suture ligation and three cases of ureterovaginal fistula were detected at 3 days～ one week of postopera-tion. These 7 cases were received ureteroneocystomy during 2 weeks after the initial surgical procedure. Nineteen cases of IBI were found during operation, the length of cystic wound was ranging from 1 cm to 3 cm. 17 cases underwent repairing, 2 eases of bladder perforation which caused by endourologic or TVT procedure received catheterization for 1 week. Five cases of vesicovaginal fistula which were found during one week--one month of post-operation, were received fistula resection and bladder repairing 3 months after of initial operation. Forty-seven cases were follow-up ranging from 5 months to 11 years after the second opera-tion,mean time were 47 months. All cases were recovered. Conclusions Intraoperative findings and effec-tive treatments can achieve good therapeutic effects and avoid injury during secondary operation. Correct treatment of urinary fistula can promote cure rate.

Objective To evalute the feasibility of treatment for rabbit model with hepatic cirrhosis by transplantation of autologous bone marrow-derived stem cells via the hepatic artery and evaluate the effect of hepatocyte growth-promoting factors (pHGF) in the treatment of stem cells transplantation to liver cirrhosis.To provide empirical study foundation for future clinical application.Methods Chronic hepatic cirrhosis models of rabbits were developed by subcutaneous injection with 50% CCl4 0.2 ml/kg.Twenty-five model rabbits were randomly divided into three experimental groups,stem cells transplant group (10),stem ceils transplant + pHGF group (10) and control group (5).Autologous bone marrow was harvested from tibia of each rabbit,and stem cells were disassociated using density gradient centrifugation and transplanted into liver via the hepatic artery under fluoroscopic guidance.In the stem cells transplant + pHGF group,the hepatocyte growth-promoting factor was given via intravenous injection with 2 mg/kg every other day for 20 days.Liver function tests were monitored at 4,8,12 weeks intervals and histopathologic examinations were performed at 12 weeks following transplantation.The data were analyzed using analysis of variance Results Following transplantation of stem cells,the liver function of rabbits improved gradually.Twelve weeks after transplantation,the activity of ALT and AST decreased from (73.0±10,6)U/L and(152.4± 22.8) U/L to (48.0±1.0)U/L and(86.7±2.1)U/L respectively; and the level of ALB and PTA increased from (27.5 ±1.8)g/L and 28.3% to (33.2 +0.5)g/L and 44.1% respectively.The changes did not have statistically significant difference when compared to the control group(P >0.05).However,in the stern cellstransplant + pHGF group,the activity of ALT and AST decreased to (43.3±0.6)U/L and (78.7±4.0)U/L respectively and the level of ALB and PTA increased to (35.7 ±0.4)g/L and 50.5% respectively.The difference was statistically significant when compared to the control group(F=47.38,23.52,52.27,174.45,P < 0.05).In pathohistology,the degeneration and necrosis of hepatic cells and the degree of fibrous hyperplasia in stem cells transplant group were less obvious than that of the control group.Hepatic pseudo-lobules persisted.The improvement of liver architecture in the stem cells transplant + pHGF group was more evident than that in stem cells transplant only group.In addition,there were more hepatic CD34 <'+> cells within liver tissue in the stem cells trasplant group when compared to the control group,and the most hepatic CD34<'+> cells were seen in the stem cells transplant + pHGF group.Conclusion Autologous bone marrow stem cells transplanted via the hepatic artery for the rabbit hepatic cirrhosis model is an effective method to treat hepatic cirrhosis.The hepatoeyte growth-promoting factor can help to enhance the results of treatment.

Objective To investigate a modified technique of pancreaticojejunostomy in pancreaticoduodenectomy ( PD ).Methods The clinical data of 72 patients of PD using the modified technique of duct-to-mucosa pancreaticojejunostomy for treatment of benign or malignant tumor of pancreas or duodenum was retrospectively analyzed.Results There were no operative deaths; 2 of the 72 patients (2.78%) had postoperative pancreatic fistula. 63 patients were followed up. Of the 63 cases, the digestion and absorption functions of gastrointestine were normal in 60 patients and they were well nourished,but 3 patients suffered from chronic steatorrhea and malnutrition.Conclusions The modified duct-to-mucosa pancreaticojejunostomy is a simple and safe technique. With this technique, the rate of pancreatic fistula or leakage is relatively low and the function of the remnant pancreatic is well preserved.

Objective To explore the clinical application value of transcatheter arterial chemoembolization (TACE) combined with CT-guided percutaneous acetic acid injection (PAI) in treatment of huge hepatocellular carcinoma (HCC). Methods Forty-three patients with huge HCC were randomly divided into two group. Twenty-one patients in group A underwent routine one course for TACE (three times), and the interval of TACEs was one month. Twenty-two patients in group B underwent TACE combined with PAI, and CT-guided PAI was performed once a week since 2-3 weeks after first TACE, and one course included 6-9 times of PAI. Postoperative follow-up was conducted (including AFP, the size of tumor, etc.). One course of treatment was repeated in case of tumor recurred. Results At the 1st month after treatment, no statistical difference was found of AFP positive rate between two groups. Statistical difference of total effective rate was found between two groups (38.10% vs 77.27%). The 1-, 2- and 3-year survival rate In group A was 47.62%, 23.81% and 9.52%, respectively, while in group B was 81.82%, 54.55% and 36.36%, respectively, and significant differences were found between the two groups for the same period. Conclusion TACE combined with PAI is safe and more effective than TACE alone in the treatment of huge HCC.