在以往的時日里，對于肝硬變門靜脈高壓癥的治療常常爭論于是以內科治療為主還是外科治療為主; 若進行外科治療，是以斷流還是分流手術為首選，抑或聯合手術； 若選定了某種術式，是行預防性干預還是不得已而為之的急診干預，凡此種種，尚可舉之。但是時至今日，該領域在觀念和技術上已經有了很大的變革與進步。對此，我們的關注及思考也隨之發生變化，現不揣冒昧，敞開所想，予以探討……
Objective To determine the effectiveness of sodium hyaluronate (SHA) in preventing intraperitoneal (IP) adhesion. Methods Thirty-eight rats were randomly divided into A,B,C groups, normal saline, 6% Dextran-40 or SHA were applied on the present serosal injury respectively, during operation. Biopsy was taken on the 14th postoperative day.Results There were statistically significant differences in the extent of adhesion among three groups (Ｐ＜0.01). Mild inflammatory changes and less fibrous proliferation were found in group C by microscopy and decreased production of collagen (by fibroblast) and active mesothelial cells proliferation were observed in group C under electron microscope. Conclusion SHA appeares to reduce the extent of postoperative IP adhesion, which is more satisfactory than Dextran-40.
Objective To investigate the relation between gaseous signal molecule hydrogen sulfide (H2S) and diseases. Methods Literatures about the advancement of H2S were reviewed and analyzed. Results H2S is recognized as a novel gaseous signal molecule. By acting specially on ＫATPchannels, H2S can relax smooth muscle cells to regulate blood pressure.It even plays an important roles in pulmonary hypertension, ischemia/reperfusion injury, neurotransmission， apoptosis and inflammatory reaction. Conclusion H2S has been regarded as the third gaseous signal molecule， which exerts many physiological and pathological effects on mammals, and will pave way for development of new drugs and provide therapeutic intervention for various diseases.
Objective To summarize the clinical significance of endoscopic treatment for obstructive jaundice. Methods The recently published literatures in domestic and abroad about endoscopic treatment for obstructive jaundice were reviewed. Results The results of endoscopic treatment for bile duct stones and bile duct surgery for biliary stricture had the same outcome. The endoscopic treatment could identify bile duct and duodenal periampullary tumors and lesions. Conclusion Endoscopic treatment for obstructive jaundice is a safe and effective method.
Objective To investigate the risk factors, prevention and therapy of hepatic artery thrombosis after liver transplantation. Methods The literatures on the risk factors, prevention and therapy of hepatic artery thrombosis after liver transplantation in recent years were collected and reviewed. Results The risk factors include factor Ⅴ Leiden, metabolic liver diseases of recipients, recipient sex, the use of Roux-en-Y biliary reconstructions, virus infection and so on. The measures of prevention and therapy include early diagnosis, detection of activated protein C resistance, postoperative anti-coagulation therapy, liver arteries reconstructions measures, hyperbaric oxygen therapy, continuous transcatheter arterial thrombolysis, liver retransplantation and so on. Conclusion The study of risk factors, prevention and therapy will promote the process of improving the prognosis of patients with liver transplantation.
Objective To investigate the expression of tumor suppressor gene Lumican mRNA in gastric cancer and its role in the development of gastric cancer. Methods The expressions of Lumican mRNA in gastric cancer tissues, tissues near tumor and normal tissues were detected by using reverse transcription polymerase chain reaction (RT-PCR), clinical pathology for those tissues was studied as well. Results The expression absence rates of Lumican mRNA were 42.4% (28/66), 15.2% (10/66) and 0 in gastric cancer tissues, tissues near tumor and normal tissues respectively. The expression absence rate of Lumican mRNA in patients with lymph node metastasis was 61.1%, which was significantly higher than that of the patients without lymph node metastasis (20.0%, χ2=11.323, P=0.001). The expression absence rate of Lumican mRNA in the gastric cancer at the advanced stages (stages Ⅲ, Ⅳ) was 61.5%, which was significantly higher than that in the gastric cancer at the early stages (stages Ⅰ, Ⅱ, 30.0%, χ2=6.417， P=0.011). The expression absence rates of Lumican mRNA in the high, moderate and poor differentiation tumors were 38.5% (10/26), 38.5% (10/26) and 57.1% (8/14) respectively, the expression absence rate of Lumican mRNA was no significant association with the differentiation degree (χ2=1.576, P=0.455). Conclusion The expression absence of tumor suppressor gene Lumican mRNA may play an important role in the tumorgenesis and influences the prognosis of gastric cancer.
Objective To improve the diagnosis and treatment of complications following spleen transplantation. Methods Five cases of spleen transplantation performed to treat severe hemophilia A were analyzed retrospectively .Results Hemorrhage was found in 2 cases that one was from small vessels of spleen porta and the other one was retroperitoneal hemorrhage. Acute rejection was diagnosed in early stage to all in which it happened to 1 case within 5 days, happened to 3 cases from the fifth day to the tenth postoperative day and happened to 1 cases after the tenth day. Infection was found in 2 patientsone with incision infection and the other with infection retroperitoneal infection. All but one who died from hydrocephalus recovered as a result of timely diagnosis and treatment.Conclusion It is of great significance to the recipients with transplanted spleen that the complications are detected comprehensively and treated in time.