Objective To investigate the efficacy of terlipressin in the management of ascites after hepatectomy.Methods Fifty-four patients with hepatic cancer who were admitted to the Union Hospital of Tongji Medical College from January 2010 to January 2011 were randomly divided into the research group (28 patients) and control group (26 patients) according to the random number table.Patients in the research group were treated by the terlipressin and albumin,and patients in the control group were treated by furosemide and albumin.The volume of ascites,urine output,renal function,electrolyte balance,recovery after hepatectomy and complications of the 2 groups were investigated.All data were analyzed by the t test,chi-square test or Fisher exact probability.Results The volume of postoperative maximum drainage was (351 ± 174) ml in the research group,which was significantly lesser than (551 ±233)ml in the control group (t =3.604,P ＜ 0.05).The total urine output of the research group was significantly higher than that of the control group at postoperative day 1 and day 3 (t =5.816,2.722,P ＜ 0.05).All patients had normal renal function except 1 patient was complicated by hepatorenal syndrome in the control group.Electrolyte imbalance was observed in 3 patients (11％) in the research group and 9 patients (35％) in the control group,with a significant difference (x2 =4.456,P ＜ 0.05).The postoperative time of intensive care unit stay and the anal exsufflation time of the research group were (22 ± 12)hours and (68 ±24)hours,which were similar to (23 ± 10)hours and (76 ±28)hours of the control group (t =0.331,1.130,P ＞0.05).The abdominal drainage tube removal time and hospital stay of the research group were (102 ± 42)hours and (15 ±4)days,which were significantly shorter than (140 ±50) hours and (18 ±5)days (t =3.032,2.443,P ＜ 0.05).There were 1 patient in the research group complicated with high blood pressure and 1 patient in the control group with cardiac arrhythmia.The incidences of adverse reaction were 4％ (1/28) in the research group and 4％ (1/26) in the control group,with no significant difference (P ＞ 0.05).Conclusion Terlipressin is effective in the management of ascites after hepatectomy,has less effect on electrolyte balance and is beneficial to quick recovery.

Objective To develop an ion chromatogram method for determination of fluoride in the sea food and meat. Methods Under the acid condition,fluorine could be separated by distillation,then fluorine is absorbed by washing liquid. The electricity lead detection-ion chromatogram with Ionpac AS14 column was employed to determine the content of fluoride,3.5 mmol/L of sodium carbonate-1.0 mmol/L of soda as the washing liquid at 1.2 ml/ min. Results The linear range was 0.05-1.0 mg/L,the relative coefficient (r) was more than 0.999 7 (n=6),the lowest detection limit was 0.3 mg/kg,the relative standard deviation was 1.00%-3.85%,the recovery rates were 88.1%-99.0%. Conclusion This method presents a good effect of pretreatment and fluorine ion seperation and with a satisfactory recovery rate,precision and detection limit.

Objective To evaluate the efficacy and safety of repeated endoscopic sclerotherapy injection(ESI) and endoscopic variceal ligation(EVL) in eradication of esophageal varices among patients who survive an episode of first variceal hemorrhage with a high risk of rehaemorrhagia and death. Methods The correlated literatures were identified from Medline,Embsae,the Library Cochrance,PubMed and CNKI.RevMan 4.2 Software provided by the Library Cochrance was used for data analysis. Results A total of 4 randomized controlled trials were included.It was demonstrated that there was no significant difference in the esophageal varices eradication rate between repeated ESI and EVL(OR=0.75,95%CI: 0.48-1.15;P=0.19).However,the rehaemorrhagia rate of EVL after emergency hemostasis was significantly lower than that of ESI(OR=2.19,95%CI:1.44-3.31;P=0.000 2).Meanwhile,there was no significant difference in mortality between ESI and EVL(OR=1.34,95%CI:0.82-2.17;P=0.24).Little publication bias was found with funnel plot analysis. Conclusion EVL outperforms ESL in prevention of rehaemorrhagia in treatment of esophageal varices,while does no better than ESL in eradication of esophageal varices and mortality.

Objective To investigate the change of inflammatory factor and blood coagulation in patients with laparo?scopic gastric cancer radical surgery. Methods Data of seventy-seven stomach cancer patients hospitalized in our hospital and received the surgical treatment from June 2012 to June 2014 were retrospectively analyzed. Thirty-eight of these pa?tients underwent laparoscopic treatment (laparoscopic group) and 39 cases received laparotomy treatment (laparotomy group). The values of interleukin-6 (IL-6), IL-8 and tumor necrosis factor alpha (TNF-α) were analyzed at the time points of preop?eration and 6 h, 24 h after the surgery in two groups. The levels of activated partial thromboplastin time (APTT), prothrombin time (PT), international standardization ration (INR), fibrinogen (FIB) and D dimer (D-D) were also analyzed at the same time points in two groups. The postoperative thrombosis and tumor recurrence rate were also analyzed in two groups of pa?tients. Results There were no significant differences in the gender, age, the size of tumor, differentiation degree and TNM staging between two groups of patients. The serum levels of IL-6, IL-8 and TNF-αwere significantly increased after surgery in two groups (P < 0.01), and which were significantly higher in laparotomy group than those of laparoscopic group (P<0.01). The levels of APTT, PT and INR were significantly lower after surgery in two groups of patients, and which were signifi?cantly lower in laparoscopic group than those of laparotomy group (P<0.05). The levels of FIB and D-D were significantly increased after operation in two groups of patients (P<0.05), which were significantly higher in laparoscopic group than those of laparotomy group (P<0.05). The postoperative recurrence of cancer was less in laparoscopic group than that of lapa?rotomy group. But, the postoperative thrombosis was more in laparoscopic group than that of laparotomy group. Conclusion There was less release of inflammatory mediators and less effect on the body’s immune function in patients with laparoscopic gastric cancer radical surgery. But, the surgery has a large influence in blood coagulation, we should pay attention to it in the clinical treatment.

Background and purpose:The most serious aspect of cancer is the emergence of metastases in organs distant from the primary tumor, since most deaths from cancer are due to metastases. In recent years, a series of studies has been undertaken both in vitro and in vivo, and demonstrated that the CD133+ hematopoietic stem cell is effective in increasing mice tumor cell metastases, but the efficacy of CD133+ stem cells is not well studied for human cancer.We investigated the effects of CD133+ stem cells on the proliferation, adhesion and migration in human colorectal neoplasm cell line SW480.Methods:CD133+ cells were separated from fresh cord blood mononuclear cells(MNC) by Ficoll density gradient centrifugation and magnetic activated cell-sorting system(MACS).The treatment group was the co-culture of CD133+ cells and SW480, the control group used the same culture medium without CD133+ cells. The effect of CD133+ cells on proliferation in SW480 cell was measured by MTT assay, the migration abilities of SW480 cell were assayed in Transwell cell culture, Cell adhesion assay was carried out in a 96 microplate well precoated with fibronection.Results:CD133+ cells could significantly improve the growth ability of SW480 cell, not only the ability of proliferation, but also the morphology. The morphology of the cells was remarkably changed. Irregular nucleus, double nucleus and polymorphic nucleus appeared in the treatment group, and the cells were shaped as polygon-like and leptosomatic. In the cell adhesion assay, A 490 of the treatment group was 0.11?0.01, A 490 of the control group was 0.05?0.01(P﹤0.05).Conclusions:Our results indicate that the CD133+ cell is effective in increasing tumor cell proliferation and invasion. Hematopoietic stem cell may play an important role in the invasion and metastasis of colorectal neoplasm.

Objective:To investigate the effect of enteral nutrition support one week before surgery and postoperative periods on the postoperative immune function and nutritional status in old patients with gastric cancer. Methods:A retrospective analysis was con-ducted on 77 stomach cancer patients who were admitted and received surgical treatment in our hospital. Among the patients, 38 re-ceived enteral nutrition support one week before surgery and early period of postoperation, and were labeled as the experimental group. The remaining 39 patients did not receive enteral nutrition support one week before surgery and early period of postoperation, and were named as the control group. The levels of prealbumin, albumin, transferrin, CD4+T (%), CD8+T (%), and CD4+/CD8+cells were also an-alyzed before surgery and 1 d and 8 d after surgery. Results:No statistical differences in the gender, age, site of tumor, TNM staging, and differentiated degree were found between the two groups. All operations were successful and the patients recovered well after sur-gery. In the nutritional status, the levels of prealbumin, albumin, and transferrin in the patients of the two groups had no significant dif-ference (P>0.05). On the first day after the surgery, the levels of prealbumin, albumin, and transferrin were significantly low in both groups;the control group had lower levels than the experimental group (P<0.05). No differences in the levels of CD4+T (%), CD8+T (%), and CD4+T/CD8+T cells were found between the two groups (P>0.05). On the first day after surgery, the levels of CD4+T (%), CD8+T (%), and CD4+T/CD8+T cells were significantly low in both groups;the control group had lower levels than the experimental group (P<0.05). Conclusion:Elderly patients with gastric cancer who receive appropriate enteral nutrition support one week before sur-gery would have better immune function and nutritional status after surgery than those who did not, and the recovery of old patients im-proved.

refer to the cases with pression caused by both posterior and anterior matters, the posterior-anterior surgery is better.

Objective To compare of the effect of portaazygous devascularization(PADV) and combination operation(splenorenal shunt plus portaazygous devascularization)on the treatment of esophageal variceal bleeding(EVB).Methods 28 cases of EVB admitted from October 1995 to October 2000 were divided randomly into two groups:(1)PADV group (14 cases);(2) combination operation(14 patients).The free portal pressure(FPP) and portal veinous flow(PVF)were measured intraoperatively; and pre and post-operative barium meal and therapeutic effect between 2 groups were compared.Results The average value of FPP of PADV group and combination operation group reduced (4.81?7.26)cmH 2O and (10.03?2.66)cmH 2O respectively after operation, there were significant difference (both P

Objective To analysis the clinical characteristics, pathogenesis, diagnosis and treatment of acute acalculous cholecystitis.Methods Seventy-nine cases of acute acalculous cholecystitis from January 1996 to January 2003 were retrospectively reviewed.Results Of those 79 cases, 13 cases were treated non-operatively and 66 cases were treated operatively. Twenty-three cases were suppurative, 43 cases were gangrenous with perforation in 18 cases,which were proved by postoperative pathology. Seventy-six cases were cured and 3 cases were dead. Conclusion Keeping vigilant alert, observing dynamically as well as appropriate operative intervention are effective to improve the prognosis of acute acalculous cholecystitis.

Objective To analyze the incidence, clinical feature and late complications, and treatment for diabetes ketoacidosis (DKA) in children with type 1 diabetes mellitus.Methods Ninty children with type 1 diabetes mellitus within 10 years were retrospectively reviewed.The onset situation,clinical feature and long-term complication,and treatment of DKA were analized.Results High morbidity was found in 10 to 16 years old children.DKA was often caused by infection; late complications of diabetes mellitus was resulted from interrupted injection of insulin.Conclusions Emergency treatment for DKA may involve the injection of small dose insulin,correction of the disorder of water and electrolysis and regulation of acid-base.The education of patients and parents about diabetes mellitus and long-term injection of insulin are of importance in preventing the complications.