Objective To investigate the expressions of T helper cell 1 (Th1)-associated chemokine receptors CXCR3, CCR5 and T helper cell 2 (Th2)-associated chemokine receptor CCR3 in the spleen tissues of rats with cirrhosis and hypersplenism and probe into the balance between Th1/Th2 lymphocyte subsets.Methods Experimental study was adopted.Forty-six male SD rats were randomized into the hypersplenic group (n =36) and the control group (n =10).In the hypersplenic group, the rats were fed with 40％ CCl4 peanut oil solution (3.0 mL/kg, twice per week) and 15％ white spirit for 8 weeks to build the hypersplenic model.The rats in the control group received normal feeding.The animal models with cirrhosis and hypersplenism were confirmed by liver function test, routine blood test, HE staining and Masson staining after visual inspection.The expressions of chemokine receptors of CXCR3, CCR5 and CCR3 were detected by immunohistochemical staining and Western blot.Measurement data with normal distribution were presented as x ± s.Comparison between groups was done using the independent sample t test.Results Results of visual inspection: the rats in the hypersplenic group suffered from severe hair-shedding, metal fatigue and inappetence, with hair dimming and inactivity.There were rats dead successively 5 weeks after model establishment and 19 rats finally survived.The rats in the control group had color and gloss hair, with good appetite and spirits.They were active and sensitive to external stimulation.Changes of pathological morphology in liver: in the hypersplenic group, the fibers became denser and disordered, making normal structure of liver tissues destroyed.The hepatic lobules separated by fibrous bundle and proliferative hepatic cell mass were segmented and surrounded by thick fibrous,leading to the formation of pseudolobule.Disorganized hepatocytes suffused adipocytes, the nucleus of heterocysts enlarged or even multinucleated cells appeared.There was no change in the control group.Changes of pathological morphology in spleen: the rats in the hypersplenic group had slightly swelling spleen with the areas of red pulp increased and whit pulp disappeared gradually.Vascular endothelium became thicker and proliferated.Thickened central artery and fibrosis were depicted.Splenic sinusoid extended.There was no change of spleen tissues in the control group.Changes of liver function : the levels of ALT and AST of rats were (264 ± 111) U/L and (687 ± 299) U/L in the hypersplenic group,which were significantly different from (27 ± 8)U/L and (124 ± 20)U/L in the control group (t =5.64, 4.98,P ＜ 0.05).The level of total protein was (54 ± 8)g/L in the hypersplenic group, which was significantly different from (65 ± 3)g/L in the control group (t =-3.35, P ＜ 0.05).Changes of peripheral blood cell count: the white blood cell (WBC) count in the hypersplenic group was (23.9 ± 5.0) × 109/L, which was significantly different from (6.2 ± 2.4) × 109/L in the control group (t =3.50, P ＜ 0.05).The red blood cell count and platelet count in the hypersplenic group were (6.3 ±0.7) × 1012/L and (418 ± 124) × 109/L, which were significantly different from (8.0 ± 0.6) × 1012/L and (1 109 ± 161) × 109/L in the control group (t =-2.28,-4.92, P ＜ 0.05).Results of immunohistochemical staining: the cytomembrane and/or cytoplasm stained yellow, brown or sepia were defined as positive performance of CXCR3, CCR5 and CCR3.The absorbance A values of CXCR3 and CCR5 were (81.7 ±24.4) × 10-3 and (3.6 ± 1.3) × 10-3 in the hypersplenic group, which were significantly different from (19.2 ± 5.8) × 10-3 and (1.2 ± 0.4) × 10-3 in the control group (t =16.22, 9.09, P ＜ 0.05).The absorbance A value of CCR3 was (8.8 ±3.7) × 10-3 in the hypersplenic group and (7.9 ±2.8) × 10-3 in the control group, respectively, showing no significant difference between the 2 groups (t =0.87, P ＞ 0.05).The rates of positive cells of CXCR3 and CCR5 was 52％ ± 9％ and 19％ ± 5％ in the hypersplenic group, which were significantly different from 21％±5％ and 10％±3％ in the control group (t =17.31, 8.21, P ＜0.05).The rates of positive cells of CCR3 in the hypersplenic group and control group were 35％ ± 9％ and 33％ ± 14％, respectively, showing no significant difference between the 2 groups (t =0.43, P ＞ 0.05).Results of Western blot test : the relative expressions of CXCR3 and CCR5 were 2.45 ± 0.85 and 0.94 ± 0.48 in the hypersplenic group, which were significantly different from 1.31 ± 0.95 and 0.32 ± 0.26 in the control group (t =2.62, 2.91, P ＜ 0.05).The relative expression of CCR3 was 0.47 ± 0.27 in the hypersplenic group, which was significantly different from 0.92 ± 0.67 in the control group (t =-2.18, P ＜ 0.05).Conclusion The abnormal expression of chemokine receptors in the spleen tissues of rats with cirrhosis and hypersplenism induced by CCl4 suggests that functional imbalance of Th1/Th2 lymphocyte subsets may play an important role in the regulation of peripheral blood cytopenia.

Objective To study the diagnosis and treatment of primary hepatocellular carcinoma(HCC) complicated by intrabile duct obstruction.Methods From Aug.1994 to Feb.2000,the clinical data of 13 HCC patients with intrabile duct obstruction caused by tumor were reviewed.Results There was no operative mortality and all patients were followed up for one year.10 patients were still alive,and one died.Conclusion Jaundice caused by intrabile duct tumor was not a contraindication for hepatectomy.Hepatectomy could gain a longer postoperative survival term.

Objective:To study the role of tetrodotoxin-resistant(TTX-R)human sodium channel of hNa v1.8 mRNA in trigeminal neuralgia (TN). Methods:The samples of affected trigeminal division(inferior alveolar nerve) and non-affected division(lingual nerve) were surgically obtained from six idiopathic TN patients to whom the drug therapy was not effective.The expression of hNa v1.8 mRNA was assessed by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) with ?-actin as an internal control. A sample of great auricular nerve (from a patient who had to accept the combined radical neck dissection with glossectomy and hemimandibulectomy) and a sample of infraorbital nerve (from a patient who had to accept subtotal resection of maxilla) were used as the negative controls. Resoults:The relative amount of hNa v1.8 mRNA in the affected trigeminal divisions(1.233?0.324) was higher than that in the non-affected divisions(1.018?0.249), t=3.919,P=0.011. Conclusion:The higher expression of hNa v1.8 mRNA in the affected nerves of TN patients may play an important role in TN.

Objective　To evaluate the effect of palliative resection of advanced primary hepatocellular carcinoma (PHCC). Methods　98 patients with advanced PHCC were divided randomly into two groups in our hospital from March 1996 to Jan. 2000:(1) Therapy group (49 cases), dealt with palliative resection of liver cancer and implanted with a drug delivery system (DDS). (2) Control group (49 cases), only implanted with DDS. Results　In therapy group and control group, The decline rate of AFP was 60.0% and 31.7% respectively (P<0.05); and the survival rates of 0.5, 1, 3 　years after operation were 85.7% 　(42/49), 60.5%(23/38), 45.4%(10/22) and 　67.3%(33/49), 32.5%(13/40), 　10%(2/20) (P<0.05). Conclusions　Palliative resection of liver cancer can improve survival duration and life quality of patients with advanced HCC.

Objective To investigate the diagnosis and treatment of rectal carcinoid. Methods Clinical data of 16 patients of rectal carcinoids in our hospital from January 2000 to December 2009 were analyzed retrospectively. Related literatures were reviewed. Results Among the patients included, 11 cases(68.8%)suffered from hypogastralgia, 3 cases(18.8%)bloody stool, 3 cases(18.8%)defecation number increase. All the patients underwent enteroscopy. The average size in diameter of all the tumors was 8.8 mm. 81.3% of the tumors ≤10 mm in diameter. The average distance from tumor to anus was 6.8 cm and 87.5% of the tumors ≤8 cm in distance, Only 25% of all the cases were diagnosed preoperatively, most cases were diagnosed as other diseases and definitely diagnosed by postoperative pathology. 14 cases underwent operation as radical resection of rectal carcinoma, and 2 cases endoscopic removal. There was no operative death and postoperative five-year survival rate is 69.2%. Conclusions Preoperative diagnosis rectal carcinoid is difficult.Misdiagnosis rate is high. The key point of improving diagnosis of this disease is annal digital examination. Enteroscopy and pathology, operation is the first choice to treat rectal carcinoid.

Objective To summarize the surgical skills of the pancreaticoduodenectomy via mesenteric approach for the treatment of duodenal gastrointestinal stromal tumors (GISTs).Methods The clinical data of 1 patient with huge duodenal GIST combined with gastrointestinal hemorrhage and liver metastasis who was admitted to the Second Affiliated Hospital of Harbin Medical University in June 2014 were retrospectively analyzed.The patient had continuous bleeding before the operation.The results of computed tomography (CT) showed that there was a solid tumor below the liver and in front of the right kidney,with the size of 12.2 cm × 8.1 cm,inferior vena cava was squeezed by the tumor,a solid tumor was detected in the right lobe of liver,and the colon was suspiciously invaded by the tumor.The patient received pancreaticoduodenectomy,right hemicolectomy and right lobectomy of liver metastases.The patient was followed up by out patient examination and telephone interview up to August 2014.Results The operation time,volume of blood loss and volume of red blood cell (RBC) transfusion were 420 minutes,800 mL and 2 U,respectively,with a full recovery of patients.The duodenal GIST with metastasis tumor and necrosis located at the colon,pancreatis,liver and renal hilum was confirmed by pathological diagnosis.The life quality of the patient was good by follow-up at postoperative month 3.Conclusion In the pancreaticoduodenectomy via mesenteric approach,surgeons perform vigorously the method of mesenteric approach at the first stage of operation,it could maximally reduce the risk of operation and the volume of blood loss.

Objective To investigate the intra-splenic blood cell count of posthepatitic cirrhotic portal hypertension,and compare it with patients' peripheral blood cell count to explore the role the spleen plays in peripheral cytopenia often seen in posthepatitic cirrhotic portal hypertension.Methods A prospective study was made on 15 cases with post hepatitis B cirrhotic portal hypertension undergoing splenectomy.Intrasplenic blood was sampled from upper pole,hilus (central pole),and lower pole of the spleen respectively for blood cell count.Results were compared with that of preoperative peripheral blood.Results There were significant statistical differences in the WBC count between splenic blood and peripheral blood,(11.20 ± 4.73) × 109/L vs.(4.06 ± 1.75) × 109/L,t =5.05,P ＜ 0.05),and in PLT count,(182.45±66.57) × 109/L vs.(63.54 ±28.40) × 109/L,t =7.285,P ＜0.05.There was no differences in the RBC count,(3.55 ± 0.94) × 1012/L vs.(3.01 ± 0.62) × 1012/L,t =1.874,P ＞ 0.05.Positive correlations were found between splenic PLT count and peripheral PLT count (r =0.610,P ＜0.05).Conclusions In posthepatitic B cirrhotic portal hypertension patients the intra-megalosplenic PLT and WBC count are significantly higher than that in peripheral blood.Megalosplenic PLT count correlates positively with peripheral PLT count.

Tumor progression locus 2 (Tpl2) is a crucial three-stage kinase of the mitogen-activited protein kinase (MAPK) family,which plays an important role in MAPK pathway and other signaling pathways.In recent years,a large number of studies have found that aberrant expressing Tpl2 is involved in tumorigenesis and development of various cancers,and is expected to serve as a new biomarker and therapeutic target.Therefore,to reveal the mechanism of Tpl2 will provide a feasible theoretical basis and potential interventional target for the diagnosis and treatment of cancers.

It has been estimated that approximately 75% of the human genome is transcribed into RNA, 74% of which would be transcribed into non-coding RNA (ncRNA).The ncRNA can be divided into 2 major groups including small RNA and long non-coding RNA (lncRNA).There is increasing evidence that the dysregulation of lncRNA is closely associated with the occurrence and progression of many tumors.The lncRNA taurine up-regulated gene 1 (TUG1) is originally detected in a genomic screen for genes in response to taurine treatment of developing mouse retinal cells.According to research reports, dysregulation of TUG1 participates in the progression of a variety of tumors.Therefore, the regulatory effects of lncRNA TUG1 on tumorigenesis are summarized in this article.

Objective To evaluate the effectiveness and safety of percutaneous transhepatic balloon dilation for the removal of common bile duct stones.Methods 60 patients of common bile duct stone were divided into two groups:PTBD group (30 cases) and endoscopic sphicterotomy (EST) group (30 cases).Postoperatively biliary tract was drained for three days.Results All stones were removed in 28 patients (93％) in PTBD group and 29 cases (97％) in EST group.Early complications occurred in 13％ in PTBD patients and in 17％ in EST patients(x2 =0.35,x2 =0.13,P ＞0.05).There was no mortality in neither group.Long-term complications such as gallstone recurrence and cholangitis in PTBD group was significantly less than that in EST group (x2 =6.41,P ＜ 0.05).Conclusions The success rate of PTBD was similar to that of EST and while in PTBD the function of Oddi's sphincter was well reserved.PTBD procedure is a valuable alternative to EST in patients with bile duct stones,especially in patients who are not suitable for EST.