Objective To observe the long-term effect of combined intestine/auxiliary liver transplantation in rat.Methods Male Lewis rats were used. Total small bowel and 60 % liver were transplanted en bloc with an aortic segment that contained the celiac axis and superior mesenteric artery ensuring the blood supply to the graft. The end-to-side anastomosis was made between donor infrahepatic vena cava (IHVC) and recipient IHVC. The recipient small bowel was resected and the intestine continuity was restored. Sham control (laporotomy only) and transplantation groups were included. Ten rats in each group were followed-up for 18 months and then sacrificed. Liver function tests, terminal deoxynuleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate (dUTP) nick end labeling (TUNEL) staining and proliferating cell nuclear antigen (PCNA) staining of liver tissue were evaluated.Results Sixteen rats survived over the operation. There were no significant differences in liver function tests between the sham control group and transplantation group. The grafted liver was hypertrophic and native liver did not regenerate 18 months following transplantation with an increased liver/body weight ratio. TUNEL-staining showed no significant differences among grafted liver, native liver of the recipient rat in transplantation group and the liver of the rat in control group. PCNA-staining revealed that the native liver in transplantation group had a lower proportion of TUNEL-positive hepatocytes. Conclusion This experimental study confirmed the long-term consequences of combined intestine-auxiliary liver transplantation, and the results suggest that liver/body weight ratio can be increased.

Objective To investigate the diagnosis and treatment of patients with benign tumor of duodenum(BTD). Methods Clinico-pathological data of 24 patients with BTD treated by surgery in our department in recent 21 years were analyzed retrospectively. Among the 24 cases, 18 cases underwent local resection, 4 segmental duodenectomy, 1 subtotal gastrectomy and 1 pylorus-preserving pancreatoduodenectomy. Results Abdominal pain, digestive tract hemorrhage and duodenal obstruction were the common clinical manifestations of BTD. The correct diagnostic rates of air barium double contrast radiography and duodenoscopy were 82.4% and 93.3% respectively. The result of surgical treatment was satisfactory, except 1 patient who died of acute myocardial infarction 6 days after the operation. Of the 24 patients, the pathological examination showed as follows 8 had a villous adenoma, 6 gastrointestinal stromal tumor, 5 Brunner′s gland adenoma, 2 leiomyoma, 2 multiple adenomas in familial adenomatous polyposis, 1 hemangioma. Conclusions Air barium double contrast radiography and duodenoscopy are mainsteps for the diagnosis of BTD. The best treatment is surgical resection.

Objective:To investigate the expression of costimulatory molecule B7-1 and B7-2 by warm ischemia/reperfusion(I/R)injury in rat liver and the meaning of immunology.Methods:Male Wistar rats were randomly divided into 3 groups:A(ischemia 30 mins,referfusion 24h),B(ischemia 60 mins,referfusion 24h),C(sham operation group).A model of hepatic warm I/R in rats was established according to the method of Ohmorid.The expression of B7-1 and B7-2 mRNA was analyzed by real-time reverse transcription polymerase chain reaction(RT-PCR).Results:Compared with the sham operation group,the expression of B7-1 and B7-2 mRNA increased significantly in the rats undergoing I/R procedure(P

Objective To evaluate the clinical significance of measuring angel of lesser pancreas(ALP) by ultrasound in diagnosis of neoplasm in the head of pancreas.Methods ALP was measured by ultrasound in 41 cases of pancreatic neoplasm,and in 52 normal cases as contrast.All of the cases were divided into three groups: group A,32 cases which were proven having mass in the head of pancreas by ultrasound; group B,9 cases which were discovered mass in the head of pancreas by CT or MRI,but not diagnosed by ultrasound; group C,52 cases as contract without presence of any mass in the head of pancreas.Results The mean value of ALP in group A,group B and group C was 83??9?,78??9?,and 43??5?, respectively.The angel in group A and group B was significantly wider than that in group C (P60?.Conclusions The widing of ALP by ultrasound is a sensitive sign for mass in the head of pancreas.

Objective: To set up the animal model of precancerous lesion of rats' pancreatic acinar cellular cancer,and to learn estrogen's effect on this lesion's biological feature and K-ras gene mutation. Methods: male Wistar rats were injected Azaser-ine 30mg/kg(ip). Some rats received Estradiol-17 P Valerate(0.18mg/100g/2weeks, im) .4 months later, rats'pancreas were autopsied and K-ras gene mutation were detected by PCR-SSCP method. Results : The incidence of AACN were very high. The incidence of K-ras gene mutation was 42.1% in rats without estrogen and 25.6% with estrogen. Conclusion: Azaserine could induce precancerous lesion of rats' pancreatic acinar cancer successfully, K-ras gene mutation was early change during this process Estrogen could inhibit this precancerous lesion's happen and development to some degree.

Objective To investigate the effect of ischemia/reperfusion(I/R) on tumor metastasis in a experimental mouse model of hematogenous metastasis after I/R; we also quantitated expression of matrix metalloproteinases-9 (MMP-9) during I/R.Methods An experimental mouse model of metastasis after partial hepatic I/R was designed to determine the effects of I/R on tumor metastasis to liver.Tumor loads were valued 7 days after operation.In addition,tissue analysis for alanine transaminase,aspartate transaminase (AST) and matrix metalloproteinases and 8 h reperfusion were performed.Results After 2 h hepatic reperfusion,ALT and AST in I 45 min group were higher than the sham group and I 30 min group (P ＜0.05).ALT and AST in the sham group were both a little higher than the normal.ALT and AST in the I 45 min group and I 30 min group at 8 h were both higher than those at 2 h reperfusion(P ＜0.05).The tumor load (valued by Hepatic replacement area) and the expression of MMP-9 in ischemic lobe in I 45 min group were greater than that after 30 min group and sham group.(P =0.013,P =0.007).There was no statistical difference on tumor load between the right lobe of sham operated mice and the right lobe (non-ischemic lobe) of mice subjected to I/R(P =0.089).Mouse survival were compared among the groups.Mice in Sham group lived longer than I 30 min group (P =0.041).And there were no statistical significance between I 45 min group and I 30 min group (P =0.055).MMP-9 expression in I 45 min group was higher than I 30 min group(P ＜ 0.001).Conclusion Hepatic I/R promotes liver hematogenic metastasis of hepatocellular carcinoma in mice through induction of MMP-9 expression.

Objective:To investigate the expression of lysozyme in ampullary carcinoma, and its relation with invasion, metastasis and prognosis. Methods: 36 cases were analyzed with immunohistochemistry of lysozyme. Results: The lysozyme-positive rate in patients with lymph node metastasis (30%) was significantly lower than that in patients without metastasis (71%), while that in patients with advanced cancer invading the pancreas (35%), was significantly lower than that in patients with cancer without invasion of the pancreas. The Survival rate of lysozyme-positive patients (66.7%) was significantly higher than that of lysozyme-negative patients (14.3%). Conclusion: The expression of lysozyme in carcinoma of ampulla is associated with invasion, metastasis and prognosis. Lysozyme is important in typing of cancer of ampulla.

Objective:To evaluate the value of gastrointestinal endoscopy in patients with hepatic cell cancer.Methods:A retrospective analysis was made on 316 patients with hepatic cell cancer undergoing gastrointestinal endoscopy preoperatively from 1992 to 1998.Results:2 cases were accompanied with gastric cancer,62 cases with esophagogastric varices,58 cases with gastric or duodenal ulcer,218 cases with gastritis,Of them 30 cases with portal hypertension gastropathy,24 cases were normal.Conclusion:Hepatic cell cancer is usually accompanied with upper gastrointestinal lesions,It should be paied attention to treat perioperatively.

Objective: To explore the effect of CO 2 pneumoperitoneum in laparoscopic surgery on the cardiovascular function of the geriatric cholelithiasis.Methods:Sixty aged patients undergone laparoscopic surgery were selected.During various stage of CO 2 insufflation,the heart rate(HR),blood pressure,oxygen saturation ,electrocardiogram(ECG),and myocardial enzymes were dected,and the clinical values of these changes were analyzed.Results: when CO 2 pneumoperitoneum established ,the HR and blood pressure were increased obviously .The incidence of arrhythmia was 36% and the incidence of changes of ST segment was 30%,10 minutes after pneumoperitoneum eliminated,these changes were restored. The myocardial enzymes and the oxygon saturation of blood had no distinct changes. Conclusion: The procedure of CO 2 pneumoperitoneum caused temporany changes of the HR ,SBP/DSP and ECG.The laparoscopic surgery is effective and safe for geriatric cholelithiasis.It suggests that the dynamic monitoring of electrocardiogram is necessary,especially for those with abnormal heart function.

Objective:To investigate the role of oxygen free radicals in renal dysfunction in rats with obstructive jaundice and the protective effect of Salvia Miltiorrhiae(SM) on renal mitochondria.Methods:The 54 Wistar rats were randomly divided into three groups:sham-operation control group(group A,n=18),obstructive jaundice group(group B,n=18),SM-treated group(group C,n=18).The model of obstructive jaundice in rats was established by common bile duct ligation(CBDL).In group C SM(5ml/kg?d) was given through abdominal cavity for 21 days.The rats were executed at 7th,14th,and 21th day after operation respectively.The contents of serum BIL,Cr,BUN and the contents of renal mitochondria MDA and cholesterol were determined respectively,and the changes of renal histopathology were observed.Results:The contents of renal mitochondria MDA and cholesterol in group B and group C were markedly higher than group A(P