Objective:TO explore the effectiveness of splenic tissue autotransplantation in restoring host defense. Methods: Rabbits were divided into three groups,Sham Operation(SO), Splenic Autotransplantation(SA)and Total Splenectomy(TS), and dynamic changes in histology and immunology were observed for over 24 weeks. Results: Histologic study shows that the white pulps were poorly developed and central arterioles disappeared in the regenerated splenic tissue. The weight of regenerated spleens recovered six months later in SA was 11% of that in SO, and was significantly reduced comparing with the implanted weight( P ＜0.05). Tere were no significant difference in the number of T lymphocytes and the levels of serum lysozyme among the three groups. A poor antibody response by the rabbits of SA and TS as compared to those of SO was noted after the primary intravenous administration with sheep red blood cells. After the challenge with type 3 pneumococci intravenously, pneumococcal clearance from bloodstream in SA did not differ significantly from that in TS,but was marKedly delayed compared with that in SO(P＜0.01). Conclusion: The results indicate that the low quantity and poor quality of the regenerated spleens may contribute to the inferior immunoprotective ability of 1/3 splenic autotransplantation. Therefore, it implies that the regenerated spleens can not fully compensate the original one in im-munology, especially, host resistance to infection.

Objective: TO verify through animal experiment the validity of chemical cholecystectomy . Methods: The experimental objects seven healthy juvenile pigs,hardener was infused into the gallbladder,after infusion the samples were collected by pathoiogical examination , according to the different duration under anesthestize. Reslts:The mucous destructive and digestive process remained with one week, the inflammatory reacton in two weeks,the chronic inflatoy reaction compained a a great deal of granu lation tissue and scar formation occurred in 4th-8th week,10 weeks latter,the inflmmatory reaction reduced ,and scar tissue formed. Conclusion: Chemical cholecystectomy is safe and reliable in clinical.

Objective:To investigate gut barrier dysfunction and bacterial translocation (BT) in patients who underwent digestive tract reconstruction and to study the relationship between BT and acute systemic inflammatory state (SIRS). Method： Sixty patients who underwent selective digestive tract reconstruction were observed. Blood were collected before surgery and 1, 3, 5 days after surgery to detect plasma diamine oxidase(DAO) and bacterial DNA. PCR analysis was performed with β-Galactosidase gene of Eschenchia coli and 16SrRNA gene as target gene. The SIRS of all the patients were observed for 10 days. Result：All the PCR results before operation were negative, while there was positive in 14 patients after digestive tract reconstruction. There were 23 patients with SIRS after surgery, and 12 patients PCR result were positive among 23 patients with SIRS. 85.7% of the patients(12/14) with positive PCR result had SIRS, while 23.9% patients (11/46) with negative PCR result had SIRS (P<0.01).The positive PCR rate in SIRS was 52.2% (12/23), which was remarkably higher than that without SIRS(5.4%, 2/37, P<0.01).The levels of plasma DAO in patients with positive PCR result was significantly higher than those of the patients with negative PCR result (P<0.01). The levels of plasma DAO in patients with SIRS was significantly higher than those of patients without SIRS (P<0.01). Conclusion:The gut barrier dysfunction was closely related to BT, and BT was closely related to postoperative SIRS. PCR analysis can be used in early diagnosis of BT, the positive PCR result might be a useful early warning sign of postoperative SIRS.

Objectives:The time of Carotid intervention for recently symptomatic,severe carotid stenosis which cause a transient ischemic attack or minor stroke is still a controversial issue.Early studies showed that carotid endarterectomy (CEA) caused a high risk if performed within days follow an acute ischemic stroke.However,The National Stroke Strategy posted by UK Department of Health advocated that this situation should be regarded as an emergency procedure,and carotid intervention should ideally be performed within 48 hours.We designed this study to discuss the effect of urgent CEA on operative risk and benefit.Methods: we analyze 12 urgent CEA with primary closure performed during 1996 to 1998.All 12 patients were underwent CEA within 2 weeks,and 2 of them within 2 days.Operative risks and overall benefit from surgery were discussed in relation to the time from the last symptomatic event to CEA.Results: 2 urgent CEA performed in 2 days are recovery uneventful.1 of 12 patients,who underwent urgent CEA within 2 weeks,occurred restenosis after 3 months follow up.No 30-day perioperative recurrent TIA,stroke and death.Conclusions:CEA performed within 2 weeks is feasible and reliable procedure in preventing recurrent TIA and stroke after presenting manifestations.The future aim is to perform CEA within 48 hours after TIA or stroke symptoms.

Objective:To investigate the number of CD+68 cells in hepatocellular carcinoma (HCC),paraneoplastic tissues,cirrhosis tissues and normal liver tissues and their clinical significance.Methods:Surgical specimens from 60 cases of HCC,62 cases of cirrhosis and 23 cases of normal liver were investigated by immunohistochemical staining of CD+68with streptavidin-horseradish peroxidase detective system.Results:(1)The order of the mean number of CD+68cells in the tissues from the highest to the lowest was:paraneoplastic,cirrhosis,normal liver and HCC tissues(P〈0.01);(2)The number of CD+68cells in the tissues decreased successively with the decrease of HCC differentiation (P〈0.05);(3)There was no relationship between the number of CD+68cells in HCC and its clinical TNM stage;(4)The number of CD+68cells in the cases with metastasis within 15 months was significantly lower than that without metastasis (P〈0.05).Conclusion:The number of CD+68cells might be an important marker to estimate the immune status and a useful factor to predict the prognosis of HCC patients.

Objeetive:To study the expression of cell adhesion molecules on the lymphatic endothelial cells In the rectum cancer and peritumoral lymph nodes as well as their relationship with the diffusion of cancer cellS. Methods: In this Study the immunhistochemistry method was employed to observe the expression of CEA, ICAM-1 and CD31 on rectum cancer lymphatic endo-thelial cells. Results :The results demonstrated that CEA and lCAM-1 were highly expressed on the lynphatio endothelial cells in the peritumoral rectum tissues and lymph nodes. It was, howev-er,negative in normal lymphatic endothelial cells. CD31 was expressed on both lymphatic endothe-Ilal cells in the periturmral rectum tissues and lymph nodes and vessel endothelial cells of the normal human. Conelusion: The study suggests that there are relationships between the dis-semination of cancer cells and excession of CEA, lCAM-1 and CD31 in lymphatic endothelial cells.The CAE and ICAM-1 seem to induce stable adhesion between oancer cells and endothelial cells.

Objective: Gallbladder polyps are frequently discovered in the past decade. Ifthe polyps are oenign,without concomitant stone and the gallbladder has a good function, it is not an absolutely indication for cholecystectomy. For this reason percutaneous endoscopio polypectomy of the gallbladden polyps were developed and applied. Methods: Among those who underwent peroutaneous endosoopic polypectomy of the gallbladder, 85 patients with gallblaeder polyps were studied. Under the epidural anesthesia, cholecystoscope was introduced into the gallbladder. The polyps were coagulated by self-made miorowave ceagulator and then resected for histopathelogical evaluation. The preserved gallbladders were followed up to evaluate the effioacy of this minimally invasive therapy. Results: All precedures were eventful with mean operation time of 1h to 1. 5h. Sixty seven patients were followed-up for a mean of 5.5 yeah (2～9 years) and showed all patients to be symptom free and in 64 cases the gallbladder function was found to be well preserved without recurrence of polyps and occurrenca of gallstones on ultraSound. Conclusion: The procedure reposed is a reliable, simple,effective and minimally invasive technique to remove gallbledder polyps and to preserve gallbladder function for the patients who have the benign gallbladder polyps.

Objective:To investigate the prognosis of patients with liver metastasis or local recurrence after radical resection of rectal cancer,in order to provide reference for the further screening of high-risk patients for the precise therapeutic methods.Methods:The clinicopathological factor and follow-up data of 485 patients who underwent surgical treatment for rectal cancer from March 2005 to January 2016 were retrospectively analyzed.Including 75 liver metastasis and 32 local recurrence.The prognosis were compared between the patients with liver metastasis and with local recurrence.Results:The difference was statistically significant in CEA level,primary tumor position,surgical methods,tumor cell differentiation,tumor infiltration depth between liver metastasis and local recurrence after radical resection of rectal cancer (P＜0.05).The 1-,3-and 5-year overall survival rates were 76.6％,53.1％ and 18.8％ respectively of patients with liver metastasis,The 1-,3-and 5-year overall survival rates were 81.3％,62.5％ and 37.5％ respectively of patients with local recurrence,the difference was statistically significant(P＜0.05).Conclusion:There were different clinicopathological characteristics of patients between liver metastasis and local recurrence.The prognosis of patients with local recurrence was better than patients with liver metastasis.

Objective:Ultrasound guided by Mammotome spiral cut (MMT) system and the traditional bard needle aspiration biopsy in the diagnosis of nonpalpable breast lesions.Methods:Chooses January 2014 to 2016 January in our hospital were 113 cases of breast ultrasound,mammography found and nonpalpable breast lesions were retrospectively analyzed,a total of 167 breast lesions,of which 80 cases (120 lesions in ultrasound guided by MMT rotary cutting biopsy (MMT group),33 cases (47 lesions) take bard biopsy (Bard group),with postoperative pathological results as the gold standard,comparison of the two methods diagnostic value.Results:MMT group biopsy success rate of 100％ was significantly higher than that of Bard group 87.23％,the difference has statistical significance (P＜0.05);MMT method biopsy for differential diagnosis sensitivity of benign and malignant nonpalpable breast lesions is 96.67％,and the specificity was 97.78％,misdiagnosis rate was 3.33％,and the misdiagnosis rate was 2.22％;bard biopsy to identify diagnostic sensitivity of benign and malignant nonpalpable breast lesions was 83.33％,the specificity was 92.22％,misdiagnosis rate was 16.67％,misdiagnosis rate was 7.78％.MMT biopsy complication rate was 10％ significantly lower than the Bard group 30.30％,the difference was statistically significant (P ＜ 0.05).Conclusion:Ultrasound guided MMT biopsy needle puncture biopsy with Bard has a higher diagnostic value for breast nonpalpable lesions.

Objective:To investigate the open method(OC) and laparoscopic cholecystectomy (LC) after bile duct dilation incidence of contrast.Methods:collected from 2006 December to 2014 December in the department of hepatobiliary surgery requires 412 patients underwent cholecystectomypatients hospitalized with cholecystolithiasis,chronic cholecystitis,gallbladderpolyps,were randomly divided into LC group and OC group,LC group of 207 cases,205 cases in OC group,and were respectively treated with LC and OC.Start regular follow-up after a month,the comparison of 2 surgical operation time,blood loss and postoperative application of antibiotics time,anus exhaust time,eating time and hospitalization time.And to observe the two groups the incidence of patients after bile duct dilatation in follow-up after operation.Results:207 cases of LC patients were 89 patients had bile duct dilation,205 cases of OC patients were 41 patients had bile ductdilation,statistically significant differences between the two groups (P＜0.05).In group LC,the diameter of common bile duct in operation half months began to increase,the increase continued until 3 months after operation.After 3 months of little change in the diameter of common bile duct.The averagepreoperative bile duct diameter is 5.3 mm,after 6.1 mm,there was significant difference(P＜0.01).Conclusion:LC is a safe and reliable operation method,Identifying cause dilatation of common bile duct after LC operation and attention as soon as possible to give the corresponding prevention and treatment,further can reduce complications occur.