Objective To investigate the difference in biliary composition between cholesterol polyps and cholesterol gallstones patients.Methods Totally 20 patients with cholesterol polyps(CP group),20 cases of cholesterol gallstones(CG group),and 10 adults without hepatobiliary diseases(control) were enrolled in this study.HITACHI-7060 automatic biochemistry analyzer was employed to determine the concentration of total bile acid(TBA),phospholipid(PL),and total cholesterol(TC) of the patients.Glycoprotein was detected by colorimetric method.Free Ca2+ and pH value were anlyzed using ORION-720A ionic acidimeter.And the contents of 8 conjugated bile acids in gallbladder bile were determined by using Agilent-1100 high performance liquid chromatography.Results The conentration of TC,cholesterol saturation index(CSI),and the ratio of(TCA+GCA)/(TCDCA+GCDCA+GDCA+TDCA) of the CP and CG groups were significantly higher than those of the control [TC:(14.0?0.5) mmol/L and(18.6?1.2) mmol/L vs(9.1?0.8)mmol/L,P

ObjectiveTo investigate the clinical features,early diagnosis and therapeutic methods of primary tumor of the duodenum.MethodsThe clinical data of 130 patients of primary tumor of the duodenum who were hospitalized in Peaking University Third Hospital from 1974 to 2010 were summarized.There were 30 cases of benign tumors and 100 cases of malignancy. ResultsMore than 90％ of primary tumors of the duodenum were located at the duodenal bulb and descendent part.59％ of malignant tumors were located in the area of duodenal papilla. The mean diameter of benign tumors was less than 2 cm compared with more than 3 cm in malignancies. Upper abdominal pain,jaundice,black stool,intestinal obstruction and abdominal mass were among the most common clinical manifestations. Jaudice was most common in papilla tumors,and intestinal obstruction and palpable abdominal mass often indicate advanced stage.Duodenofiberscopy combined with air barium double contrast radiography increase the diagnosis rate.Among the 30 benign cases,11 cases underwent simple tumor resection,14 cases received endoscopic tumor resection and 3 cases underwent pancreaticoduodenectomy.Resection rate and the 5-year survival rate was 100％. Of the 100 malignant cases,56 cases underwent standard pancreaticoduodenectomy,3 cases received pylorus preserving pancreaticoduodenectomy,9 cases underwent simple tumor resection and 12 cases received segmental duodenectomy.Resection rate was 84％.The 5-year survival rate was 46％ in 59 cases receiving Whipple's procedure.ConclusionsPrimary tumor of the duodenum lacks specific clinical features. Simple tumor resection and segmental duodenectomy can be done for benign cases, while pancreaticoduodenectomy is the therapy of choice for malignant cases.

Objective To investigate proper indications of endoscopic sphincterotomy (EST). Methods A retrospective review was made on 9 cases of EST with controversial indications from January 2005 to January 2006 in this hospital. There were 1 case of jaundice due to hepatitis and intrahepatic cholestasis, 1 case of intrahepatic and extrahepatic cholelithiasis, 1 case of common bile duct stones, 2 cases of bile duct obstruction due to malignant tumors at upper (1 case) or lower segment (1 case), 2 cases of papillary tumors, 1 case of choledochal cyst, and 1 case of gallstones accompanying common bile duct stones. Results Except for 1 case of jaundice due to hepatitis and intrahepatic cholestasis misdiagnoed as having obstructive jaundice, surgical indications presented in 8 cases. Of the 8 cases, 5 cases were given a surgical operation following EST, 1 case was inoperable because of worse general condition after EST, and a radical operation was given up in 2 cases of end-stage tumors. Conclusions Without complete relief of proximal bile duct obstruction, EST may worsen the patient’s condition instead of curing the biliary diseases. EST may be unnecessary for resectable tumors, especially in young patients.

Objective To investigate the long term result of orthotopic liver transplantation for advanced hepatocellular carcinoma, and to evaluate the predictability of Pittsburg scoring system. Methods 46 patients of advanced hepatocellular carcinoma received orthotopic liver transplantation in our center during October 2000 to December 2004. Data were collected and the 1-year and 3-year survival rates, were evaluated by Kaplan-Meier method. Based on the Pittsburg Scoring System, all cases were divided into 4 groups. The length of survival of each group was observed respectively, and differences were compared with Log-rank test. Results 3-year survival rate and tumor-free rate of all 46 patients were 46.7% and 38.8%, respectively. The mean tumor-free time was 27.7 months, and the mean survival time was 32.5 months. Among the 4 groups, no death or tumor relapse was detected in cases of grade 1 and grade 2 (group I) up to the present, whereas the 1-year tumor-free rate of grade 5(group IV) patients was only 12.5%, and no patient survived over 2 years. The 1-year and 3-year tumor-free rate among grade 3 and 4 (group II and III) patients were both about 65% and 40%, the mean tumor free time was about 32.5 and 24.3 months respectively, and there was no significant difference between 2 groups. In these two groups, the longest tumor free time was 58 months. Conclusions Some of the patients with advanced hepatocellular carcinoma still have the chance to survive tumor-free for a long time after liver transplantation. Pittsburg scoring system has more predictability than Milan criteria, especially in cases of grade 1, 2 and 5, but not so satisfactory in cases of grade 3 and 4.

0.05); while in nuclear positive group, the positive rate of p53 was significantly higher than that in nuclear negative one (P

Objective To seek an effective and safe therapy for acute variceal hemorrhage of patients with Child class C cirrhosis. Methods One hundred and nine Child class C cirrhotic patients with an acute hemorrhage from esophageal varices were reviewed. Sixty - one patients received medical therapy;29 patients were underwent sur- gical operations and 19 patients received TIPSS. Results The surgical group had a higher mortality rate during hos- pitalization(65. 5 % ) than either of the other groups(36. 1 % and 26. 3 % respectively ). The rebleeding rates during hospitalization were 24. 1 %, 36. 1 % and 15. 8 % respectively in the surgical group, medical group and TIPSS group. Rebleeding rate during following- up period were 33. 0%, 36. 1 % and 21 .4% respectively. The rebleeding rate was significantly higher in the medical group than that in either of the other groups during the two phases. Kaplan - Meier survival analysis didn' t show significant difference among the three groups. Conclusions The results showed that TIPSS is a good alternative to surgical or medical therapy for patients with Child class C cirrhosis and acute vericeal bleeding.

Objective To investigate the feasibility and practicability of the precondition using high-dose of Tacrolimus (FK506) before the bone marrow transplantation (BMT) for macrochimerism specific tolerance. Methods One hundred male C57BL/6 mice and 60 female BALB/C mice were respectively used as donors and recipients of skin transplantation, and another 15 male ICR mice were used as the third germ line to detect the specificity of tolerance. Sixty recipient mice were divided randomly into 5 groups: blank control group, FK506 group, BMT group, experimental group (FK506+BMT) and third party donor control group, with 12 mice in each group. Before the skin transplantation, high-dose abdominal injection of FK506 (3 mg/kg?2 d) was performed in recipient mice. On the transplantation day a bonus of 2?10 7 bone marrow cells were injected through the tail vein. Then a short period of low-dose FK506 (0.5 mg/kg?7 d) was administrated for maintenance treatment. The survival time of skin grafts, reject reaction against the third party skin, and mixed lymphocyte culture (MLC) were observed. The polymerase chain reaction (PCR) was employed for the detection of macrochimerism. Results Routine dose of bone marrow cells infusion or short period of FK506 administration led to neither prolonged survival time of grafts nor the formation of macrochimerism. The skin graft survival time was significantly prolonged in the experimental group (24 0?1 5 d), as compared with the blank control group (9 6?1 1 d), the FK506 group (10 5?1 6 d), the BMT group (10 3?1 5 d), and the third party donor control group (9 8?1 1 d), respectively ( P

Objective To investigate the effect of liver transplantation on hepatitis B associated diseases and the efficiency of prevention and treatment on the re-infection of hepatitis B.Methods The data of 17 patients undergoing liver transplantation were analyzed after treatment of lamivudine and hepatitis B immune globulin (HBIg). Results Of the 17 cases of hepatitis B pretransplantation, 2 cases were positive for HBsAg. Liver function was normal in all patients.Conclusions Liver transplantation is an effective therapy for hepatitis B. Lamivudine and HBIg could effectively prevent and treat the re-infection of hepatitis B after liver transplantation.

Objective To investigate the relationship between dose and trough blood concentration of tacrolimus after orthotopic liver transplantation and the changes of time-dependent concentration. Methods The doses and trough blood concentrations of tacrolimus from 20 patients who survived longer than 1 year were summarized retrospectively.Results The initial oral doses of 0.15 mg?kg -1?d -1 as suggested by most surgeons led to 53.4 % of the measured whole blood concentrations in the first postoperative week were higher than 15 ?g/L, 23.3 % of them within 10 ?g/L to 15 ?g/L and 23.3 % of them lower than 10 ?g/L. The ratio of trough concentration/dose was increased gradually after transplantation and reached its peak at the second postoperative month, which was higher than those in the following month 3, 4, 5, 6, 7, 8 and 11 significantly (all P

Objective To establish a non-irradiated precondition strategy for successful donor specific transplantation tolerance induced by bone marrow transplantation which may be introduced to clinical application by a murine model.Methods Male C57BL/6 and female BALB/c mice were used as skin transplant donors and recipients respectively. In all, 11 groups were studied: group 1, control mice with skin graft and without any other treatment; group 2, mice receiving only donor bone marrow transplantation (DBMT) before skin transplantation; groups 3～5, mice administrated by only high dose FK506, CsA or CTX respectively and then skin transplantation; groups 6～8, mice receiving DBMT preconditioned by high dose FK506, CsA or CTX respectively and followed by skin transplantation. Both skin and bone marrow donors were male C57BL/6 mice in above 8 groups. Mice in groups 9～11 were treated almost equally to groups 6～8 except that skin grafts were from the third party ICR donors to prove specificity of tolerance. Every group included 6 recipients. Survival time of skin graft was recorded. Macrochimerism were examined by PCR method.Results Neither standard dose DBMT nor high dose immnodepressants alone could prolong skin graft survival, and macrochimerism was not detected, either. But skin graft survival time was significantly prolonged and macrochimerism was also detected in mice of 6～8 groups. Survival time of skin graft from the third party mice was not prolonged. Conclusions Bone marrow transplantation preconditioned with high dose immunosuppressants and without irradiation can induce donor specific transplantation tolerance and prolong murine skin graft survival. It may work through the mechanism of establishment of macrochimerism.