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.

Nonalcoholic fatty liver disease (NAFLD) refers to a syndrome of a series of lesions such as simple fatty liver disease, nonalcoholic steatohepatitis, liver fibrosis, and even liver cirrhosis. With the improvement of living standards, there is an increasing number of children with obesity, and the detection rate of NAFLD also tends to increase. Major treatment methods for children with NAFLD include the changes in diet and lifestyle and medication. The article reviews the advances in the treatment of NAFLD in children in recent years.

Objective To introduce how to improve the operation quality and clinical effect of pancreatoduodenectomy (PD). Methods The morbidity and mortality of 126 patients with pancreatic head cancer or peri ampullary cancer treated by PD of traditional Child method and modified Child method ( pancreatic stump closing style pancrea to jejunum anastomosis) in our department from 1973 to 2002 were analyzed retrospectively. Results In modified Child method group, the morbidity of pancreatic leakage and the mortality of the operation were 2.4% and 4.7% respectively, which were significantly lower than those in the traditional method group(P

OBJECTIVETo explore the risk factors of unplanned reoperation after radical resection for colorectal cancer.

METHODSA retrospective analysis of 60 patients (within 14 to 24 days after the initial surgery) receiving unplanned reoperation after colorectal cancer surgery in the First Affiliated Hospital of Xinjiang Medical University from January 2010 to January 2014 was carried out, comparing with 120 randomly paired patients without reoperation during the same period. Univariate and multivariate Logistic regression analysis was performed to investigate the clinicopathologic characteristics of patients in both groups.

RESULTSUnivariate logistic regression analysis showed that male, massive blood loss, diabetes, high BMI, hypertension and poorer tumor staging were selected as possible risk factors, and surgeon and laparoscopic surgery as conservative factors (all P<0.05). Multivariate logistic regression analysis revealed that massive blood loss (OR=12.935, 95% CI: 2.267 to 73.806, P=0.004), diabetes (OR=1.747, 95% CI: 1.098 to 2.777, P=0.018) and male (OR=1.805, 95% CI: 1.074 to 3.034, P=0.026) were the independent risk factors of unplanned reoperation after radical resection for colorectal cancer.

CONCLUSIONFor heavy bleeding, diabetes and male gender in patients with colorectal cancer, surgeon should pay attention to prevent the risk of postoperative unplanned reoperation.

Case-Control Studies ; Colorectal Neoplasms ; Colorectal Surgery ; Digestive System Surgical Procedures ; Humans ; Laparoscopy ; Male ; Neoplasm Staging ; Postoperative Period ; Reoperation ; Retrospective Studies ; Risk Factors

Objective The aim of this study was to explore the serum 25-(OH) Vitamin D and its correlation with liver function in children who have suffered from non-alcoholic fatty liver disease (NAFLD),and to explore the necessity of vitamin D treatment of NAFLD in children.Methods Forty children with NAFLD diagnosed by imaging were selected from the outpatient of pediatric digestive department of Shengjing Hospital of China Medical University,selected as observation group from July 2017 to August 2019,and 37 healthy children were selected as control group.The clinical data were collected and serum 25-(OH) Vitamin D were detected at the same time.Results There was no significant difference in 25-(OH) Vitamin D among children with NAFLD at different ages and gender (P ＞ 0.05).The level of 25-(OH) Vitamin D in children with NAFLD [(21.30 ±8.77) μg/L]was significantly lower than that in the control group [(28.53 ± 10.18) μg/L] (t =3.343,P ＜ 0.01).The incidence of vitamin D deficiency (＜ 20 μg/L) and insufficiency (＜30 μg/L)in children with NAFLD (35/40 =87.50％) was significantly higher than that in the control group (22/37 =59.46％) (x2 =10.035,P ＜ 0.05).Serum 25-(OH) Vitamin D was negatively correlated with fasting insulin (r =-0.464,P ＜ 0.01) and homeostasis model assessment of insulin resistance (r =-0.444,P ＜0.01),but not correlated with BMI,transaminase level (ALT,AST),uric acid and blood lipid (TG,TC,HDL-C,LDL-C,sd-LDL,Apo-A1,Apo-B).Vitamin D deficiency was the risk factor of NAFLD (OR =1.088,P ＜ 0.01).Conclusion Vitamin D deficiency is common in pediatric NAFLD,which may be a risk factor of NAFLD.The mechanism may be that vitamin D deficiency aggravates insulin resistance and further aggravates liver damage in children with NAFLD.

Programmed death factor-1 (PD-1) is a promising target molecule for clinical tumor immunotherapy in recent years. Recent studies suggest that PD-1 and related signaling pathways (PI3K/AKT, JAK/STAT3, p38MAPK, ERK, etc.) played a key regulatory role in the process of pulmonary fibrosis. Silicosis is a systemic disease caused by inhalation of free silicon dioxide dust, which is mainly characterized by extensive pulmonary nodular fibrosis and seriously endangers the health of patients. Dissecting the role of PD-1 in the pathogenesis of silicosis may be of great significance in the mechanism research and clinical diagnosis and treatment of silicosis. This paper reviews the regulation of PD-1 molecule on related signaling pathways and its role in pulmonary fibrosis, and looks forward to the potential application of these mechanistic studies in silicosis research.