Objective To evaluate the therapeutic effect of combined splenorenal shunt and portaazygous devascularization on bleeding esophageal varices.Methods We summarized 120 cases suffering from esophageal variceal bleeding treated by splenorenal shunt plus portaazygods devascularization,from April,1978 to April,1997.Results The operative mortality was 4.2%,no short-term postoperative bleeding,and long-term postoperative bleeding rate was 9.5%,postoperative hepatic encephalopathy rate was 4.8%.Five,ten and fifteen years survival rate were 83.6%,64.5% and 54.5% respectively. The portal hemodynamics was observed by means of Doppler flowmeter,DSA,and intraoperative portal pressure measurement in some of the patients.Conclusion The result showed that combined shunt and portaazygous devacularization not only preserve the advantage of devacularization but also decrease the portal pressure and blood volume,alleviating portal hyperhemodynamics while preserve hepatopetal blood flow to some extent.

Objective To investigate the imaging features of pancreatic acinar cell carcinoma (PACC),and to assess the role of CT and MRI in the diagnosis of the disease.Methods CT and MRI data of 7 cases with PACC confirmed by surgery and pathology were reviewed retrospectively.Plan and dynamic contrast-enhanced CT were performed in 4 cases.MRI with T1 WI,T2 WI,and dy-namic contrast-enhanced series were performed in 3 cases.Results All of the PACC lesions were manifested as a single solitary mass.1 lesion was located in the pancreatic head,and the other 6 in the pancreatic body-tail.On plan CT,all of the 4 lesions ap-peared hypodense and 3 lesions had irregular more hypodense region in the lesions.On the contrast-enhanced CT,the tumor paren-chyma showed mild to moderate enhancement with non-enhanced hypodense region in the arterial phase,and lower enhancement than that of the surrounding normal pancreatic tissue in the portal and delayed phase.All of the 3 cases were heterogeneous hypointensity on T1 WI and hyperintensity on T2 WI.The manifestations of the tumors on contrast-enhanced MRI were similar with that on the contrast-enhanced CT.Dilation of the pancreatic duct was seen in 4 cases.Liver metastasis was seen in 1 case.Surrounding tissues were invaded in 4 cases.Conclusion CT and MRI can display the features of PACC and help to improve the diagnostic accuracy.

Purpose To investigate the clinicopathologic features of cervical adenoid basal cell carcinoma. Methods Clinical and pathological data were analyzed in 12 cases of cervical adenoid basal cell carcinoma and the relevant literatures were reviewed. Results The age of 12 cases of with cervical adenoid basal cell cancer patients ranged from 36~70 years ( mean:53. 3 years) , with a medi-an age of 51. 5 years. Amongst 12 patients who contained no gross definite lesion, 5 patients (41. 7%) had the symptoms of vaginal bleeding. 8 cases of patients underwent hysterectomy, while the other four received cervical conization. Cervical intraepithelial neopla-sia ( CIN) lesions were observed in all 12 cases. The tumor cells were small and uniform, with dark oval nuclei without conspicuous nucleoli and scanty cytoplasm. Tumor infiltrated into the stroma in nests and cords. Glandular differentiation within tumor nests were seen in 12 cases, including two cases of squamous cell differentiation accompanied by partial and minor interstitial edema. Peripheral palisading cells around tumor nests were also found. The infiltrating depth of tumor ranged from 0. 5~10 mm with the average 4. 12 mm. Cancer embolis were available in 2 cases with no lymph node metastasis. 10 cases followed up for 3~78 months with no recur-rence and metastasis, but 2 cases were lost. Conclusion Adenoid basal cell carcinoma is a rare uterine cervical tumor found in post-menopausal women, which are often accompanied with CIN. This tumor has a favorable prognosis and should be clearly separated from adenoid cystic carcinoma and other tumors which also have infiltrative growth pattern.

Objective To investigate the diagnosis and treatment of cystic adenoid tumor of the pancreas. Methods Retrospective analysis was made on the clinical data of 11 cases of pancreatic cystic neoplasms confirmed by operation and pathology at our hospital from 1978 to 1998. Results Cystic adenoid tumor of the pancreas is more likely to occur in young females with middle age, clinical presentations were as follows: a long-term persistent mass and distending pain in the epigastrium. Utrasounography, CT and ERCP could contribute to the diagnosis. Of the 11 cases, pancreaticoduodenectomy was performed in 2, distal pancreatectomy and splenectomy in 6, local excision of the mass in 2, and loop type cystojejunostomy in 1. The rete of resection was 90.9%. Of them, 1 case died of abdominal abscess and septicemia postoperatively. All the 10 cases who survived postoperatively were followed up. Among the 10 cases, 1 case of pancreatic cystoadenoma died of cardiac infarction 3 months after operation, and 1 case of cystoadenocarcinoma died of metastasis 51 months after tumor excision. The other 8 cases still alived well now. Conclusions Cystic tumor of the pancreas should be suspected when young or middle aged female patients have a long term big mass in epigastrium or left upper quadrant. Ultrasonography and CT scan are helpful in the diagnosis of the tumor including cystoademoma and cystoadenocarcinoma, Although the volume of the tumors may be very big, they often have a intact capsure,so easy to excise. The excision of the total tumor and some arounding pancreatic tissue is the first choice of the treatment for cystic tumor of the pancreas, and the curative effectiveness is satisfctory.

Objective To explore body image(BI),prosthesis satisfaction and quality of life(QOL)of amputees from Wenchuan earthquake and the relationship among them to provide evidence for the intervention.Methods A total of 21 amputees accepted a survey regarding QOL,BI,and satisfaction with prosthesis.The scale of SF-36 was used to assess QOL.Amputees Bodily Image Scale(ABIS)was;used to assess BI.A self-design questionnaire wag used to evaluate the prosthesis satisfaction of amputees.Results The scores of SF-36,ABIS,and prosthesis satisfaction wag 41.90 ±15.00,64.58 ±10.60,and 59.52±11.06,respectively.The ABIS scores in women(65.07 ±12.10)were hisher than that in men(63.20 ±5.0)(P＜0.05).There was a positive correlation between score of QOL and prosthesis satisfaction,but a negative correlation between QOL and BI.The negative correlations were also observed between BI and Vitality,BI and mental health.Prosthesis satisfaction had positive correla tions with education level.QOL and mental health.Conclusion The body image disturbance(BID)and dissatis faction with prosthesis may cause negative influences on the amputees'quality of life.Relevant intervention should be provided of amputees handling their prostheses and body images correctly and raising QOL.

OBJECTIVE: To summarize the effects of glial cell line-derived neurotrophic factor (GDNF) on ischemia damage to nerve tissue and discuss the possibility of GDNF in repair of spinal cord injury based on the development of microencapsulation technology.DATA SOURCES: A search of Medline from January 1996 to October 2000 was performed for the English articles related to GDNF, ischemia damage to nerve tissue, spinal cord injury and microencapsulation technology by using the key words "glial cell line-derived neurotrophic factor, ischemia damage to nerve tissue, spinal cord injury". Meanwhile, we retrieved Wangfang database for search of the related articles in Chinese by using the same keywords in Chinese.STUDY SELECTION: Articles including intervention group and control group were selected after first review, and those which were significantly non-randomized researches were excluded. Then, the full-texts of the enrolled articles were retrieved. Inclusion criteria: ①randomized controlled study; ②the experiment/clinical research including horizontal control group. Exclusion criteria: duplicated researches.DATA EXTRACTION: Totally 300 articles were selected but only 15 were in coincidence with conclusion criteria. 285 articles were excluded, 264 of them were duplicated and non-randomized researches, and 21 were review articles.DATA SYNTHESIS: GDNF can provide nutrition to dopamine nerve cell in rat's middle brain, so as to decrease dopamine nerve cell's death. Also GDNF can protect dopamine nerve cell in cerebral infarction rats from ischemic injury, inhibit the produce of nitrogen monoxide and reperfusion injury after ischemia. GDNF is an effective protective factor against ischemia damage. Microencapsulation technology has a bright future in treating endocrinopathic neural diseases, and GDNF can play a great role in the development of microencapsulation technology.CONCLUSION: GDNF is a protective factor against ischemia damage to nerve tissue, which can be enhanced by microencapsulation technology.There is a bright future for the research on GDNF in the clinical repair of spinal cord injury.

Objective To evaluate the clinical values of acoustic radiation force impulse(ARFI) elastography for liver fibrosis on hepatopath patients.Methods ARFI elastography was prospectively performed on 99 patients prepared to undergo hepatic surgery to get a shear wave velocity(Vs) which was the representative of liver stiffness.The fibrosis stages,inflammation grades and steatosis grades were evaluated histologically after surgery.Values of Vs were compared with the histological results.Results Values of Vs with fibrosis stage 0-4 was (1.14 ± 0.22) m/s,(1.30 ± 0.22) m/s,(1.36 ± 0.38) m/s,(1.47 ± 0.37)m/s and (1.87 ± 0.08) m/s,respectively.A significant difference was observed among them (P ＜0.001).There was a certain correlation between Vs and fibrosis stage(r =0.541,P ＜0.001).Vs was a significant predictor of stage ≥3 fibrosis with an area under the ROC curve of 0.812,sensitivity 73.2％ and specificity 81.4％ when 1.40 m/s was the cutoff value (P ＜ 0.001).Values of Vs with inflammation grade 0-3 was (1.17 ± 0.16)m/s,(1.43 ± 0.36) m/s,(1.59 ± 0.53) m/s and (1.89 ± 0.59) m/s,respectively,which were significantly different (P ＜ 0.001).A certain correlation was observed between Vs and inflammation grade(r =0.383,P ＜0.001).Values of Vs with steatosis grade 0-4 was (1.61 ±0.42) m/s,(1.47±0.58) m/s,(1.56 ± 0.71)m/s,1.13 m/s and (0.94 ± 0.95) m/s.Obvious difference didn't exist between Vs and steatosis grade (P =0.286).Obvious correlation wasn't observed between them,either (r =-0.177,P =0.080).Conclusions ARFI elastography has a certain value for the evaluation of liver fibrosis,while inflammation grade may affect its performance.

At present, zebrafish has played an increasingly important role in models for human development and diseases and several areas of life sciences.As a newly laboratory animal resource, standardization research has become the technical bottleneck to be solved and an inevitable trend.In this review, we summarized the research history and character-istics of zebrafish and the status of quality standardization.We also discussed the main problem facing by the standardiza-tion research of zebrafish as a newly laboratory animal.We hope that the data can provide useful reference for the develop-ment of zebrafish quality standardization research.

Objective: To observe the impact of vareniline tartrate on vascular endothelial function and inlfammatory factor releasing in acute coronary syndrome (ACS) patients with nicotine dependence after smoking withdrawal treatment.
Methods: We recruited the in-hospital ACS patients who were smoking ≥10 cigarettes/day for more than 10 years with at least moderate nicotine dependence, and randomly divided them into 2 groups: Varenicline group, the patients received oral medication for 2 weeks and Self withdrawal group, the patients without medication assistance.n=52 in each group. All patients received (10-30) min daily mission and consulting for quit smoking for 2 weeks. The basic information was recorded and blood levels of NO, IL-6 and ET-1 were compared before and after withdrawal treatment.
Results: Compared with they were before, after 2 weeks withdrawal treatment, in Varenicline group, blood levels of ET-1 decreased as (33.950 ± 1.439) ng/L vs (170.198 ± 12.602) ng/L and IL-6 decreased as (0.103 ± 0.020) ng/L vs (0.307 ± 0.051) ng/L; in Self withdrawal group, ET-1 decreased as (60.795 ±7 .036) ng/L vs (170.511 ± 12.374) ng/L, all P<0.05; while NO levels were similar,P>0.05. After treatment, ET-1 level in Varenicline group (33.950 ± 1.439) ng/L was lower than Self withdrawal group (60.795 ± 7.036) ng/L and IL-6 level in Varenicline group (0.103 ± 0.020) ng/L was also lower than Self withdrawal group (0.258 ± 0.042) ng/L, allP<0.05; while NO levels were similar between 2 groups,P>0.05.
Conclusion: Compared with self withdrawal, varenicline tartrate may effectively inhibit inlfammatory factor releasing in ACS patients with nicotine dependence, and therefore improve the vascular endothelial function.

Objective:To observe the effect of ketogenic diet on the growth of human colon cancer cells in nude mice and to de-termine its possible mechanisms. Methods:A total of 24 male BALB/C nude mice were injected subcutaneously with the tumor cells of the colon cancer cell line HCT116. These animals were randomized into two feeding groups. One group was fed with a ketogenic diet (KD group;n=12), and the other group was given a standard diet (SD group;n=12) ad libitum. Experiments were completed upon at-taining a target tumor volume of 600 mm3 to 700 mm3. The two diets were compared based on body weight, serum glucose, ketone body, insulin, tumor growth, and survival time, which is the interval between tumor cell injection and attainment of target tumor vol-ume. Results:The tumor growth was significantly more delayed in the KD group than in the SD group. Tumors in the KD and SD groups reached the target tumor volume at 33.8 ± 6.7 days and 24.8 ± 3.1 days, respectively. The ketone body in the KD group was ele-vated with a slight reduction in serum insulin, and the difference in serum glucose in the two groups was insignificant. Importantly, the KD group had significantly larger necrotic areas and less vessel density than the SD group. Conclusion:The application of an unre-stricted ketogenic diet delayed tumor growth in a mouse xenograft model. Further studies are needed to address the mechanism of this diet intervention and its effect on other tumor-relevant functions, such as invasive growth and metastasis.