Objective To evaluate the effect of endoscopic variceal ligation(EVL) combined with splenectomy for the patients with portal hypertension. Methods Thirty two cases of portal hypertension underwent EVL plus splenectomy from May 1999 to May 2002 in our department. The patients were registered and followed up in the third, sixth and twelfth months after operation respectively. Re ligations were performed in case of relapsed varices. Results Thirty one patients were followed up for ≥2 years.Of them,esophageal varices recrrented in 6.4% of patients during following-up period,but no reblecding, and no death caused by hepatic encehpalopathy or other complications.Conclusions EVL combined with splenectomy has less trauma , less postoperative complications and high eradication rate of esophageal varices, so it can be used safely in the treatment of patients with ruptured esophageal varices.

BACKGROUND:Engineered hepatic tissue is considered a promising strategy for healing acute liver failure. But, there are series of hindrances in the construction of engineered hepatic tissues, including acquisition of vital hepatocytes, choice of scaffolds and culture system, and nutrition supply. OBJECTIVE:To construct three kinds of engineered hepatic tissues in hope to screen the optimal one for transplantation in acute liver failure. METHODS:After purification, amplification, bone marrow mesenchymal stem cells were induced to differentiate into hepatocyte-like cells which were co-cultured with acellular amniotic membrane, DACRON PATCH cardiovascular surgical patch, biological surgical patch, respectively to construct three kinds of engineered hepatic tissues. After 3 days of culture, morphological and functional detections were performed. RESULTS AND CONCLUSION:Rat bone marrow mesenchymal stem cells with higher purity were successful y harvested by using density gradient centrifugation and adherent methods, and then the cells were differentiated into hepatocyte-like cells. In the three kinds of engineered hepatic tissues, hepatocyte-like cells were found to be combined with the biological surgical patch to the maximum extent, and their combination exhibited stronger ability of urea synthesis and albumin secretion, which provides experimental basis for treatment of acute liver failure.

Objective To Study the effect of splenectomy plus endoscopic varices ligation (SEVL) in the treatment of portal hypertension. Methods SEVL was carried out in 38 patients with portal hypertension from January 2000 to June 2002. The authors compared hemodynamic parameters and gastric emptying time before and after the operation. The incidence of upper gastrointestinal bleeding, the disappearance rate of esophageal varicosis, the outcomes of portal hypertensive gastropathy (PHG) and the incidence of complications were recorded at postoperative 3 weeks, 6 months, 12 and 18 months, respectively. Results Postoperatively, the free portal pressure, portal flow volume and velocity were significantly reduced in all the cases ( P 0.05). Portal thrombosis was seen in 6 cases (6/38, 15.8%). Conclusions SEVL has little influence on gastric emptying and PHG, offering a high disappearance rate of varicosis and a low incidence of complications.

Objective To investigate the expression and significance of ?-endorphin in hippocampus after high power microwave (HPM) radiation. Methods 50 male Wistar rats were sacrificed at 6h, 1d, 3d, 7d, 14d, 28 days after exposure to 12mW/cm~2 HPM imitational source radiation. The hippocampus was harvested, the characteristics of injury to the hippocampus and expression of ?-endorphin were evaluated by means of light microscope, EM, immunohistochemistry and image analysis. Results In the neutrons of hippocampus, mitochondrial swelling and myelin sheath confluence and dissociation were observed 6 hours after radiation, and mitochondrial swelling, cavitation, disruption of crista, concentration margining of chromatin, blurring of synaptic cleft, piling or evacuation of vesicles were observed 3 days after HPM radiation. The expression of ?-endorphin in cytoplasm of neurons was up-regulated continuously from 1 to 7 days, peaking at 7 days, restoring to normal level from 14 to 28 days after radiation. Conclusion HPM can produce injury to the hippocampus at histological and ultrastructural levels. The expression of ?-endorphin is up-regulated, and it might play an important role in the pathophysiological process of injury and repair in the hippocampus.

Objective To investigate the distribution and changes of basic fibroblast growth factor (bFGF) and fibroblast growth factor receptor-1 (FGFR-1) in normal heart or heart after myocardial infarction (MI),and to explore beneficial effects of bFGF on heart after MI. Methods Eleven adult minipigs were randomly divided into 2 groups,control (n=5) and MI group (n=6). MI was induced by ligating the left anterior descending coronary artery. Sham-operation was carried out on the animals of control. bFGF-like-immunoreactivity (bFGF-ir) and FGFR-1-like-immunoreactivity (FGFR-1-ir) in heart tissues were detected by immuno-histochemistry and image analysts in 4 weeks after surgery. Results In controls,bFGF-ir and FGFR-1-ir in the atrium showed a considerable high level compared with 2 ventricles (P

AIM:To investigate morphologic and functional changes of small intestinal mucosa and proliferating cell nuclear antigen in postoperative portal hypertension patients with single or combined administration of Gln and rhGH.METHODS:Twenty-nine portal hypertension patients with surgical treatment were prospectively randomized to four groups as follows:① Gln group(n=6);② rhGH group(n=8);③ Gln+rhGH group(n=7)and ④ control group(n=8).A standard solution for TPN was given three days after operation for a week.The concentration ratio of urinary lactulose and mannitol(L/M),the villus height and crypt depth and PCNA index of small intestinal mucosa were compared.RESULTS:A week after TPN postoperation,the increased ratios of L/M in Gln+rhGH group were less than those in control group(P0.05).CONCLUSION:This study suggest that Gln together with rhGH reduce the intestinal permeability and protect the mucosa integrality in postoperative portal hypertension patients,but not in single treatment.

Objective To evaluate the effect and safety of combined treatment by laparoscopic cholecystectomy and subsequent ablation in patients with HCC adjacent to the gallbladder. Methods From June 2005 to June 2009,13 patients with HCC nodules( less than 3 cm) adjacent to the gallbladder were treated by ablation after laparoscopic cholecystectomy. The rate of complete necrosis as well as postoperative complications were also analyzed. Results All the patients showed complete necrosis of their tumor lesions after treatment by ablation subsequence of laparoscopic cholecystectomy. During the follow-up period( nearly 2 years), recurrent nodules appeared in other subsegments but not at the original site treated by ablation. Of note, no fatal complications were observed in all the ablation treated patients. Conclusion Combined treatment by laparoscopic cholecystectomy and subsequent PMCT was an effective and safe method for patients with small HCC which was adjacent to gallhladder.

Objective To construct the bioartificial liver by bone mesenchymal stem cell (BMSC) and alginate scaffold. Method Alginate scaffold was used as the cell carrier for the cultivation of BMSC and the differentiation from BMSC into hepatic like cells was induced by the cell factors of HGF, EGF and FGF-4 in the scaffold in vitro. The compatibility of the cells and the scaffold was observed by microscopy and the function of the differentiatd cells was tested. The gene of AFP and ALB was detected by RT-PCR. The secretion of ALB and the urea synthesis of the cells were tested by ALB kit and urea kit respectively. The glycogen synthesis and the CK-18 was tested by the glycogen stanning method and the immunofluorescence test. Results BMSC was able to attach, grow and proliferate well in the alginate scaffold, the well compatibility was observed by microscopy. ALB and urea were detected in the cultivating medium, the gene of ALB and AFP was identified by RT-PCR. The glycogen synthesis ability and the expression of CK-18 were induced during the differentiation. Conclusion The three dimensional atginate scaffold exhibited well compatibility with BMSC, BMSC could be differentiated into the hepatic like cell in the scaffold. BMSC and the alginate scaffold could be used to construct the bioartificial liver for the hepatic tissue engineering.

Objective To evaluate the effect of combination splenectomy and endoscopic varices ligation in comparison with Hassab procedure in the treatment of portal hypertension. A prospective, controlled study was carried out on Splenectomy with EVL in comparision with portoazygous disconnection--the Hassab procedure to assess whether SEVL can achieve better results in the treatment of portal hypertension. Methods From Jan 1999 to June 2002, 103 cirrhotic patients with portal hypertension were admitted. These patients were randomized into two groups. Group A were treated by splenectomy combined with EVL(53 cases) , and group B were treated with Hassab procedure(50 cases). Results In both groups, there was a significant postoperative decrease in free portal pressure, the velocity and volume of portal flow (all P0.05). Portal vein thrombosis developed in 7 cases (13%) in group A, and in 14 cases (28%) in group B, P

AIM: To investigate the protective effect and mechanisms of di-ao-xin-xue-kang (DK) on myocardial ischemia-reperfusion. METHODS: Models of myocardial ischemia-reperfusion were constructed with sixteen mongrel dogs. The left ventricular pressure (LVSP), the marximal/minimum rate of LVSP (?dp/dt max) and the serum aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), malondialdehyde (MDA) were determined before and 90 minutes after occlusion, 120 and 240 minutes after reperfusion, and the MDA content in myocardial cell membrane prepared at 240 minutes after reperfusion was determined. The oxygen free radical was assayed with electron spin resonace spectroscopy (ESR) technique. RESULTS: ① LVSP and ?dp/dt max in the normal saline control (NS) group decreased with the time progress of occlusion-reperfusion, and it was the same in DK group, but the levels were significantly higher than that in NS group (P