Objective To evaluate the surgical approaches for gastric carcinoma accompanied by portal hypertension ( PHT).Methods The clinical data of 22 patients with PHT undergoing operation during 5 years were retrospectively analyzed.The liver function was Child's A in 12 cases, Child's B in 10 cases.Total gastrectomy + pericardial devascularization was performed in 11 cases, distal subtotal gastrectomy in 9 cases, distal subtotal gastrectomy + splenectomy in one, distal subtotal gastrectomy + pericardial devascularization in one.12 cases with Child's A underwent D2 lymph node (LN) dissection and 10 cases with Child's B were treated with D1 LN dissection.Liver biopsy was taken in all patients.Results Postoperative complications developed in 50% and mortality rate was 9%.The rate of liver function deterioration in patients of Child A ungergoing D2 lymph node dissection was 42% , and that of patients with Child B was 70%.The rate of postoperatiave complications in patients with Child A ungergoing D2 lymph node dissection was 25% , while that of patients with Child B was 80%.There was no significant difference in liver function deterioration rate between Child A and Child B (P ＞ 0.05) , but the rate of postoperative complications in Child A is much lower than those in Child B(P ＜ 0.05).The complication rate in patients receiving PHT targeting measures was 77% ,much higher than 11% in those without concurrent treatment of PHT ( P ＜ 0.05 ).Conclusions Individualized surgical approache is crucial for treatment of gastric carcinoma accompanied by PHT.Surgical treatment should be on the basis of liver function and the severity of PHT.

OBJECTIVE: To observe the effects of salvianolate on rats with postoperative intestinal adhesion and to explore the prevention mechanism. METHODS: Forty SD male rats with intestinal adhesion were randomly divided into four groups: untreated group, low-dose salvianolate-treated group (12 mg/kg), medium-dose salvianolate-treated group (24 mg/kg) and high-dose salvianolate-treated group (48 mg/kg), with another ten SD male rats as normal control. Intraperitoneal injection of glucose was administered to the rats in the normal control group and the untreated group, and intraperitoneal injection of salvianolate was administered to the rats in the low-, medium- and high-dose salvianolate-treated groups. They were all treated for 8 days and once a day. On the eighth day after surgery the blood samples of each group were collected. Grades of intestinal adhesion were ranked by macroscopic observation. The adhesive tissues between viscera and belly wall were taken for pathological observation. The levels of interleukin-1beta (IL-1beta), interleukin-4 (IL-4) and tumor necrosis factor-alpha (TNF-alpha) were determined by enzyme linked immunosorbent assay. RESULTS: Salvianolate can significantly reduce the extent of postoperative intestinal adhesion, obviously decrease the levels of IL-1beta, TNF-alpha and inhibit the hyperplasy of fibrous connective tissue. However, there was no significant impact on the level of IL-4. CONCLUSION: Salvianolate can reduce the extent of postoperative intestinal adhesion, decrease the expression of IL-1beta and TNF-alpha and inhibit the hyperplasy of fibrous connective tissue. This may be the mechanism of salvianolate in preventing intestinal adhesion.