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1.
Proc Natl Acad Sci U S A ; 116(28): 13774-13779, 2019 07 09.
Article in English | MEDLINE | ID: mdl-31209044

ABSTRACT

Adhesives are ubiquitous in daily life and industrial applications. They usually fall into one of two classes: strong but irreversible (e.g., superglues) or reversible/reusable but weak (e.g., pressure-sensitive adhesives and biological and biomimetic surfaces). Achieving both superstrong adhesion and reversibility has been challenging. This task is particularly difficult for hydrogels that, because their major constituent is liquid water, typically do not adhere strongly to any material. Here, we report a snail epiphragm-inspired adhesion mechanism where a polymer gel system demonstrates superglue-like adhesion strength (up to 892 N⋅cm-2) that is also reversible. It is applicable to both flat and rough target surfaces. In its hydrated state, the softened gel conformally adapts to the target surface by low-energy deformation, which is locked upon drying as the elastic modulus is raised from hundreds of kilopascals to ∼2.3 GPa, analogous to the action of the epiphragm of snails. We show that in this system adhesion strength is based on the material's intrinsic, especially near-surface, properties and not on any near-surface structure, providing reversibility and ease of scaling up for practical applications.

2.
Langmuir ; 34(13): 3827-3837, 2018 04 03.
Article in English | MEDLINE | ID: mdl-29558142

ABSTRACT

Numerous biomimetic structures made from elastomeric materials have been developed to produce enhancement in properties such as adhesion, static friction, and sliding friction. As a property, one expects adhesion to be represented by an energy per unit area that is usually sensitive to the combination of shear and normal stresses at the crack front but is otherwise dependent only on the two elastic materials that meet at the interface. More specifically, one would expect that adhesion measured by indentation (a popular and convenient technique) could be used to predict adhesion hysteresis in the more practically important rolling geometry. Previously, a structure with a film-terminated fibrillar geometry exhibited dramatic enhancement of adhesion by a crack-trapping mechanism during indentation with a rigid sphere. Roughly isotropic structures such as the fibrillar geometry show a strong correlation between adhesion enhancement in indentation versus adhesion hysteresis in rolling. However, anisotropic structures, such as a film-terminated ridge-channel geometry, surprisingly show a dramatic divergence between adhesion measured by indentation versus rolling. We study this experimentally and theoretically, first comparing the adhesion of the anisotropic ridge-channel structure to the roughly isotropic fibrillar structure during indentation with a rigid sphere, where only the isotropic structure shows adhesion enhancement. Second, we examine in more detail the anomalous anisotropic film-terminated ridge-channel structure during indentation with a rigid sphere versus rolling to show why these structures show a dramatic adhesion enhancement for the rolling case and no adhesion enhancement for indentation.


Subject(s)
Biomimetics/instrumentation , Stress, Mechanical , Anisotropy , Elasticity , Friction
3.
Langmuir ; 33(20): 4942-4947, 2017 05 23.
Article in English | MEDLINE | ID: mdl-28447798

ABSTRACT

Droplet motion arises in many natural phenomena, ranging from the familiar gravity-driven slip and arrest of raindrops on windows to the directed transport of droplets for water harvesting by plants and animals under dry conditions. Deliberate transportation and manipulation of droplets are also important in many technological applications, including droplet-based microfluidic chemical reactors and for thermal management. Droplet motion usually requires gradients of surface energy or temperature or external vibration to overcome contact angle hysteresis. Here, we report a new phenomenon in which a drying droplet placed on a periodically compliant surface undergoes spontaneous, erratic motion in the absence of surface energy gradients and external stimuli such as vibration. By modeling the droplet as a mass-spring system on a substrate with periodically varying compliance, we show that the stability of equilibrium depends on the size of the droplet. Specifically, if the center of mass of the drop lies at a stable equilibrium point of the system, it will stay there until evaporation reduces its size and this fixed point becomes unstable; with any small perturbation, the droplet then moves to one of its neighboring fixed points.

4.
Langmuir ; 33(1): 75-81, 2017 01 10.
Article in English | MEDLINE | ID: mdl-27997205

ABSTRACT

The Laplace pressure of a droplet placed on one side of an elastic thin film can cause significant deformation in the form of a bulge on its opposite side. Here, we show that this deformation can be detected by other droplets suspended on the opposite side of the film, leading to interaction between droplets separated by the solid (but deformable) film. The interaction is repulsive when the drops have a large overlap and attractive when they have a small overlap. Thus, if two identical droplets are placed right on top of each other (one on either side of the thin film), they tend to repel each other, eventually reaching an equilibrium configuration where there is a small overlap. This observation can be explained by analyzing the energy landscape of the droplets interacting via an elastically deformed film. We further demonstrate this idea by designing a pattern comprising a big central drop with satellite droplets. This phenomenon can lead to techniques for directed motion of droplets confined to one side of a thin elastic membrane by manipulations on the other side.

5.
Langmuir ; 29(51): 15755-61, 2013 Dec 23.
Article in English | MEDLINE | ID: mdl-24313824

ABSTRACT

Template-assisted glancing angle deposition (GLAD) is explored for the fabrication of single and multipatch patchy particles with one or more patches of controlled but asymmetric shape. The template is used to ensure the formation of uniform patchy particles, whereas rotation of the template gives access to a large number of asymmetric patch shapes caused by the shadowing effect of the templating groove and/or the neighboring particle. Careful analysis with a straightforward geometric model reveals the effect of the angle of incidence, rotational angle, groove size, and particle size on the patch shape. Initial magnetic field assembly results are presented to illustrate the removal of patchy particles from their template and accessibility to a large number of patchy particles. Two-patch particles with overlapping patches are also accessible by means of secondary metal vapor deposition. The connectivity of these two patches on each particle and the predictable size of the overlapping section provide access to functional patchy particles. The combination of the template-assisted GLAD method with rotation of the template and secondary evaporation is demonstrated to be a good method for fabricating patchy particles with a variety of asymmetric patch shapes, sizes, and multipatches where every particle of a batch carries exactly the same patch pattern and thereby provides valuable input on experimentally accessible patch shapes for future experimental and computational studies of patchy particles.

6.
Langmuir ; 28(26): 9915-9, 2012 Jul 03.
Article in English | MEDLINE | ID: mdl-22708736

ABSTRACT

Patchy particles with uniform patches of specific shape and size have been predicted to have a rich potential in fabricating new structures; however, an effective method to control the patch shape and size is still missing. In the method presented here, a template is used to assist the fabrication of patchy particles with patches of uniform shape and controlled size by use of the glancing angle deposition method (GLAD). Uniform shadowing effects are caused by the wall of the grooves carved into the surface of a silicon wafer. The ratio of template dimension to particle diameter and the angle of incidence of the metal vapor rays determine the patch shape and size. Mathematical calculations are applied to predict the patch shape and size. Scanning electron microscopy is used to demonstrate the efficiency of the method. Scaling analysis shows that the template-assisted GLAD method leads to a 3100-fold increase in patchy particle fabrication volumes compared to the template-free GLAD method.

7.
Front Surg ; 9: 940376, 2022.
Article in English | MEDLINE | ID: mdl-36684291

ABSTRACT

Objective: To use the fetal pylorus as a reference point to conveniently display the normal fetal duodenum by ultrasound. Methods: This study was designed in cross-section. A total of 450 healthy singleton pregnant women at 19-39 weeks of gestation who underwent prenatal screening at our hospital from January 2019 to February 2020 were selected. They were divided into three groups according to gestational weeks: the 19-23 gestational weeks group, 29-32 gestational weeks group, and 34-39 gestational weeks group. The duodenal bulb was identified. Its movement and course were continuously and dynamically observed. The descending part of the duodenum was identified, and the duodenal course was traced. Results: The fluid-filled in the fetal duodenum was discontinuous. The overall detection rates of the duodenum in the 19-23 gestational weeks group, 29-32 gestational weeks group, and the 34-39 gestational weeks group were 82.2%, 26.2%, and 13.8%, respectively. The detection rates of the bulbar, descending, horizontal, and ascending parts of the duodenum were 94.4%, 58.2%, 58.0%, and 52.0%, respectively. The anatomical structures of the duodenum as a whole and the pancreas were most easily recognized in the 19-23 gestational weeks group; while in the 34-39 gestational weeks group, the bulbar part had a maximum detection rate of 98.8%, and it had the longest filling time and the shortest examination time. Conclusion: The pylorus is an ideal starting point for tracing the fetal duodenum. The overall detection rate of the fetal duodenum decreases with gestational age. The duodenal bulb is the most easily detected site.

8.
Int J Hyperthermia ; 27(2): 116-23, 2011.
Article in English | MEDLINE | ID: mdl-21090915

ABSTRACT

PURPOSE: The heat-sink effect produced by rapid blood flow through large vessels (diameter (D) ≥ 5 mm) is an important factor that influences ablation zone size after radiofrequency ablation (RFA). Currently, however, the interactions between hepatic RFA lesions and large vessels are not well understood. The purpose of this study was to examine the effects of RFA lesions occurring near large vessels (D ≥ 5 mm) in the canine liver. MATERIALS AND METHODS: Thirty healthy adult mongrel dogs were used, with 15 dogs randomly assigned to groups I and II. In group I, the closest distance from the tip of the RFA electrode to the large vessel (D ≥ 5 mm) was more than 20 mm; in group II, this distance to the wall of the inferior vena cava (IVC) was no more than 5 mm. RFA was performed on the liver of each dog according to standard procedures. The blood flow velocity of the IVC, the computerised tomography (CT), the pathological characteristics of the RFA lesions and procedure-related complications were examined. RESULTS: No death or complications occurred in any dogs. Vascular walls were not affected, except for when the tips of the electrode stuck to the IVC. The coagulative necrosis region was decreased, and its shape was fusiform close to the IVC. Some normal hepatic cells were found in the necrotic region near the IVC. CONCLUSIONS: It is both safe and feasible to perform RFA near the IVC. The shape and size of the coagulation zone should be considered when electrodes are placed in this area. Near the IVC, the size of the coagulation zone was decreased, and it was incompletely formed.


Subject(s)
Catheter Ablation/methods , Liver/surgery , Vena Cava, Inferior/surgery , Animals , Dogs , Female , Liver/pathology , Liver/physiology , Male , Regional Blood Flow
9.
J R Soc Interface ; 18(175): 20200940, 2021 02.
Article in English | MEDLINE | ID: mdl-33530861

ABSTRACT

The interface between two surfaces patterned with complementary shapes such as arrays of ridge-channel structures or pillars accommodates relative misorientation and lattice mismatch by spontaneous production of dislocation arrays. Here, we show that the relative sliding of such an interface is accomplished by dislocation glide on the interfacial plane. An exception is the singular case where the lattices are perfectly matched across the sample dimension, in which case sliding is accompanied by motion of edge-nucleated defects. These are meso-scale analogues of molecular sliding friction mechanisms between crystalline interfaces. The dislocations, in addition to the long-range elastic energy associated with their Burgers vectors, also cause significant out-of-plane dilation, which props open the interface locally. For this reason, the sliding friction is strongly pressure dependent; it also depends on the relative orientation of the patterns. Sliding friction can be strongly enhanced compared with a control, showing that shape-complementary interfaces can be engineered for strongly enhanced pressure- and orientation-dependent frictional properties in soft solids.


Subject(s)
Friction , Motion , Surface Properties
10.
Zhonghua Yi Xue Za Zhi ; 90(12): 822-5, 2010 Mar 30.
Article in Zh | MEDLINE | ID: mdl-20450621

ABSTRACT

OBJECTIVE: To study the effects of carbon tetrachloride (CCl4)/ethanol induction upon experimental liver fibrosis and hepatic carcinogenesis of HBV transgenic mice. METHODS: The wild-type mice, p21-HBx transgenic mice with integration of p21 locus by HBx gene and p21-HBsAg transgenic mice with integration of p21 locus by HBsAg gene were induced separately by CCl4/ethanol twice weekly for 20 weeks. The investigators observed the development of liver fibrosis and hepatic carcinogenesis in three groups and detected the gene expressions of HBx and HBsAg by RT-PCR. RESULTS: The expression of HBx or HBsAg mRNA existed in both control and induced transgenic mice, but in none of wild-type mice. Comparing with wild-type mice, p21 genes was not expressed in livers of transgenic mice. After induction by CCl4/ethanol, the fibrotic degrees of liver were not significantly different among wild-type mice, p21-HBx transgenic mice and p21-HBsAg transgenic mice, as well as between male and female mice. Reversely, the incidence rates of hepatic carcinogenesis of two HBV gene knock-in transgenic mouse lines (p21-HBx & p21-HBsAg) were higher than that of wild-type mice. And the incidence rate of hepatic carcinogenesis in males was also markedly higher than that in females. Induction by CCl4/ethanol markedly promoted and accelerated hepatic carcinogenesis in transgenic mice. CONCLUSIONS: Integration of HBsAg and HBx genes into the murine p21 locus can significantly promote the progression of hepatic carcinogenesis, but failed to promote the progression of liver fibrosis. The male mouse is more likely to develop experimental hepatocellular carcinoma than the female mouse. Experimental hepatocellular carcinoma induced by CCl4/ethanol in p21-HBx and p21-HBsAg transgenic mice is a feasible animal model.


Subject(s)
Hepatitis B Surface Antigens/genetics , Liver Cirrhosis, Experimental , Liver Neoplasms, Experimental , Trans-Activators/genetics , Animals , Carbon Tetrachloride/adverse effects , Disease Models, Animal , Ethanol/adverse effects , Female , Gene Knock-In Techniques , Hepatitis B virus/genetics , Liver Cirrhosis, Experimental/chemically induced , Liver Cirrhosis, Experimental/virology , Liver Neoplasms, Experimental/chemically induced , Liver Neoplasms, Experimental/virology , Male , Mice , Mice, Transgenic , Viral Regulatory and Accessory Proteins
11.
Zhonghua Gan Zang Bing Za Zhi ; 18(2): 119-23, 2010 Feb.
Article in Zh | MEDLINE | ID: mdl-20196951

ABSTRACT

To study the effects of Smad4 on liver fibrosis and hepatocarcinogenesis in mice treated with CCl(4)/ethanol. The wild-type mice (Smad4 +/+) and the Smad4 knockout mice (Smad4 +/-) were injected subcutaneously with carbon tetrachloride(CCl(4))/ethanol twice a week for twenty weeks. The expression of Smad4, TGFbeta1, Smad2, Smad3, Smad6, TIMP1, MMP2 and MMP9 was detected by RT-PCR. In the cirrhotic liver, the expression of Smad4 mRNA was significantly higher than that in the normal liver. Comparing with wild-type mice (Smad4 +/+), the TGFbeta1-Smad4 signaling was markedly attenuated in the Smad4 knockout mice (Smad4 +/-). After induction by CCl(4)/ethanol, the hepatic fibrosis in the Smad4 knockout mice (Smad4 +/-) was obviously alleviated compared with the wild-type mice (Smad4 +/+), and the incidence rate of hepatocarcinogenesis of the former was also lower than that of the latter(32.0% vs 41.9%). These results indicate that knocking out Smad4 can delay the progression of liver fibrosis and liver cancer.


Subject(s)
Liver Cirrhosis, Experimental/pathology , Liver Neoplasms, Experimental/pathology , Signal Transduction , Smad4 Protein/genetics , Transforming Growth Factor beta1/metabolism , Animals , Carbon Tetrachloride/administration & dosage , Disease Models, Animal , Ethanol/administration & dosage , Female , Liver Cirrhosis, Experimental/chemically induced , Liver Cirrhosis, Experimental/metabolism , Liver Neoplasms, Experimental/chemically induced , Liver Neoplasms, Experimental/metabolism , Male , Mice , Mice, Knockout , RNA, Messenger/genetics , RNA, Messenger/metabolism , Reverse Transcriptase Polymerase Chain Reaction , Smad Proteins/genetics , Smad Proteins/metabolism , Smad4 Protein/metabolism , Tissue Inhibitor of Metalloproteinase-1/genetics , Tissue Inhibitor of Metalloproteinase-1/metabolism , Transforming Growth Factor beta1/genetics
12.
Zhonghua Wai Ke Za Zhi ; 47(15): 1151-4, 2009 Aug 01.
Article in Zh | MEDLINE | ID: mdl-20021906

ABSTRACT

OBJECTIVE: To investigate the surgical treatment for hilar cholangiocarcinoma(HCCA) of Bismuth-Corlette type IV. METHODS: The clinical data of 73 HCCA patients admitted in Southwest Hospital, the Third Military Medical University from January 2002 to December 2008 were analyzed retrospectively. There were 41 males and 32 females, aged from 30 to 84 years old (averaged, 56.8 years old). All patients were diagnosed as hilar mass with hilar biliary obstruction by B-ultrasound, CT, magnetic resonance imaging, endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography or percutaneous transhepatic cholangiography, and confirmed by pathological examination in intra-operation and post-operation. Diagnosis of all patients were according to Bismuth-Corlette type IV. RESULTS: Fifteen cases underwent percutaneous transhepatic cholangial drainage, stents were implanted in 8 patients. Simple internal drainage was performed on 25 of the 73 patients and 4 with palliative resection. Radical resection was performed on 19 patients. The radical resection rate of HCCA were 26.0%. The 1, 3 years of survival rates were 36.8%, 10.5% respectively. The 1 year survival rate was 6.3% in drainage group. CONCLUSION: Radical resection is the potentially curative treatment for HCCA, a sufficient, reasonable use of internal and external drainage would improve the patient's quality of life.


Subject(s)
Bile Duct Neoplasms/surgery , Bile Ducts, Intrahepatic , Cholangiocarcinoma/surgery , Adult , Aged , Aged, 80 and over , Bile Duct Neoplasms/diagnosis , Cholangiocarcinoma/diagnosis , Drainage , Female , Follow-Up Studies , Hepatectomy , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Treatment Outcome
13.
Hepatol Res ; 36(4): 259-64, 2006 Dec.
Article in English | MEDLINE | ID: mdl-16997622

ABSTRACT

It is acknowledged that autonomic nerves play an important role on liver function. Sympathetic nerve is the main component of them. This study is to evaluate the effects of sympathetic denervation of the liver on liver function in the normal and chemically injured liver, and its influence on liver regeneration. Eighty healthy male Wistar rats were divided randomly into four groups: Sham group, carbon tetrachloride group (CCL4), 6-hydroxydopamine group (6-OHDA), and CCL4+6-OHDA group. Chemical denervation model was made by injection of 6-OHDA (2ml, 100mg/l) through the mesenteric vein of jejunum loop. Acute liver injury model was established by using CCL4. Blood chemistry, ATP, arterial ketone body ratio (AKBR) and indocyanine green (ICG(15)) were measured in each group after administration of sympathetic denervation or/and acute liver injury. Liver regeneration was assessed with hepatic mass index (HMI), rate of liver regeneration (RLR), mitotic index (MI) and the rates of DNA synthesis under sympathetic denervation. Chemical denervation resulted in significant changes of liver function tests under acute liver injury, and had beneficial effects on protein anabolism, metabolism of bilirubin and energy, and ICG excretion, meanwhile, alleviated low potassium in serum. However, sympathetic denervation only had no effects on liver function tests. It decreased significantly in sympathetic denervation group for HMI, RLR, MI and the rate of DNA synthesis with 3H-TdR (P<0.01). It is concluded that sympathetic denervation can alleviate liver injury by CCL4, impair liver regeneration, but has no effects on liver function tests under normal.

14.
Zhonghua Gan Zang Bing Za Zhi ; 14(4): 250-4, 2006 Apr.
Article in Zh | MEDLINE | ID: mdl-16635290

ABSTRACT

OBJECTIVE: To investigate the tolerance time limits from warm ischemia to cold preservation of liver grafts. METHODS: Orthotopic liver transplantations (OLTs) were performed on Bama miniature swine. Morphological and functional changes of the liver grafts and biliary tracts after 10 minutes of warm ischemia followed by different durations of cold preservation and its reversibility were investigated. RESULTS: When the grafts were subjected to 10 minutes of warm ischemia followed by less than 16 hours of cold preservation, all animals could survive 1 week and there was no animal death from biliary necrosis. However, when the cold preservation time exceeded 16 hours, the incidence of biliary necrosis was significantly increased (P<0.05), and recipient death from bile leaks occurred. With further prolongation of the cold preservation time, primary graft nonfunction and intraoperative or early postoperative deaths occurred and the living animals all developed biliary necrosis. When compared with the less than 16 hours cold preservation group, the morphological scores and apoptosis index of the epithelial cells of bile ducts in grafts after reperfusion were significantly elevated in the more than 16 hours cold preservation group (P<0.05) and the activity of Na+-K+-ATPase and Ca2+-ATPase of bile ducts in grafts were also significantly reduced (P<0.05). Liver function tests showed that the recoveries of AST, AST, GGT and ALP were quicker in the 16 hours cold preservation group then those over 16 hour preservation ones. Correlation analysis revealed that the incidence of biliary necrosis was significantly correlated with the morphological score (r = 0.972) and with the apoptosis index of the epithelial cells of bile ducts in grafts after reperfusion (r = 0.931) and also correlated negatively (P<0.01) with the activity of Na+-K+-ATPase (r = -0.973) and Ca2+-ATPase (r = -0.973). CONCLUSIONS: It is concluded that with 10 minutes of warm ischemia, cold preservation of the grafts should not be longer than 16 hours in order to avoid early biliary necrosis, and the corresponding tolerance time limit of the livers to the cold preservation was less than 20 hours.


Subject(s)
Cryopreservation , Liver Transplantation/methods , Liver , Warm Ischemia , Animals , Bile Ducts/pathology , Cold Ischemia , Female , Graft Survival/physiology , Male , Necrosis , Organ Preservation , Swine , Swine, Miniature , Time Factors
15.
Sci Rep ; 6: 26867, 2016 05 26.
Article in English | MEDLINE | ID: mdl-27226233

ABSTRACT

Natural contacting surfaces have remarkable surface mechanical properties, which has led to the development of bioinspired surface structures using rubbery materials with strongly enhanced adhesion and static friction. However, sliding friction of structured rubbery surfaces is almost always significantly lower than that of a flat control, often due to significant loss of contact. Here we show that a film-terminated ridge-channel structure can strongly enhance sliding friction. We show that with properly chosen materials and geometrical parameters the near surface structure undergoes mechanical instabilities along with complex folding and sliding of internal interfaces, which is responsible for the enhancement of sliding friction. Because this structure shows no enhancement of adhesion under normal indentation by a sphere, it breaks the connection between energy loss during normal and shear loading. This makes it potentially interesting in many applications, for instance in tires, where one wishes to minimize rolling resistance (normal loading) while maximizing sliding friction (shear loading).

16.
J Gastrointest Surg ; 9(5): 648-57, 2005.
Article in English | MEDLINE | ID: mdl-15862259

ABSTRACT

Radiofrequency ablation is a relatively new technique used for local ablation of unresectable tumors. We investigated the feasibility and efficacy of radiofrequency ablation for hypersplenism and its effect on liver function in patients with liver cirrhosis and portal hypertension. Nine consecutive patients with hypersplenism due to cirrhotic portal hypertension underwent radiofrequency ablation in enlarged spleens. The ablation was performed either intraoperatively or percutaneously. Patients are followed up for over 12 months. After treatment, between 20% and 43% of spleen volume was ablated, and spleen volume increased by 4%-10.2%. White blood cell count, platelet count, liver function, and hepatic artery blood flow showed significant improvement after 1-year follow-up. Splenic vein and portal vein blood flow were significantly reduced. Only minor complications including hydrothorax (three of nine patients) and mild abdominal pain (four of nine patients) were observed. No mortality or other morbidity occurred. Radiofrequency ablation is a safe, effective, and minimally invasive approach for the management of splenomegaly and hypersplenism in patients with liver cirrhosis and portal hypertension. Increased hepatic artery blood flow may be responsible for sustained improvement of liver condition. Radiofrequency ablation may be used as a bridging therapy for cirrhotic patients waiting for liver transplantation.


Subject(s)
Catheter Ablation/methods , Hypersplenism/etiology , Hypersplenism/surgery , Hypertension, Portal/complications , Liver Cirrhosis/complications , Adult , Diagnostic Imaging/methods , Female , Follow-Up Studies , Humans , Hypersplenism/diagnosis , Hypertension, Portal/pathology , Liver Cirrhosis/pathology , Male , Middle Aged , Minimally Invasive Surgical Procedures/methods , Pilot Projects , Prospective Studies , Regional Blood Flow , Risk Assessment , Severity of Illness Index , Tomography, X-Ray Computed/methods , Treatment Outcome , Ultrasonography, Doppler
17.
World J Gastroenterol ; 11(29): 4552-9, 2005 Aug 07.
Article in English | MEDLINE | ID: mdl-16052687

ABSTRACT

AIM: To review the experience in surgery for 508 patients with portal hypertension and to explore the selection of reasonable operation under different conditions. METHODS: The data of 508 patients with portal hypertension treated surgically in 1991-2001 in our centers were analyzed. Of the 508 patients, 256 were treated with portaazygous devascularization (PAD), 167 with portasystemic shunt (PSS), 62 with selective shunt (SS), 11 with combined portasystemic shunt and portaazygous devascularization (PSS+PAD), 9 with liver transplantation (LT), 3 with union operation for hepatic carcinoma and portal hypertension (HCC+PH). RESULTS: In the 167 patients treated with PSS, free portal pressure (FPP) was significantly higher in the patients with a longer diameter of the anastomotic stoma than in those with a shorter diameter before the operation (P < 0.01). After the operation, FPP in the former patients markedly decreased compared to the latter ones (P < 0.01). The incidence rate of hemorrhage in patients treated with PAD, PSS, SS, PSS+PAD, and HCC+PH was 21.09% (54/256), 13.77 (23/167), 11.29 (7/62), 36.36% (4/11), and 100% (3/3), respectively. The incidence rate of hepatic encephalopathy was 3.91% (10/256), 9.58% (16/167), 4.84% (3/62), 9.09% (1/11), and 100% (3/3), respectively while the operative mortality was 5.49% (15/256), 4.22% (7/167), 4.84% (3/62), 9.09% (1/11), and 66.67% (2/3) respectively. The operative mortality of liver transplantation was 22.22% (2/9). CONCLUSION: Five kinds of operation in surgical treatment of portal hypertension have their advantages and disadvantages. Therefore, the selection of operation should be based on the actual needs of the patients.


Subject(s)
Hypertension, Portal/mortality , Hypertension, Portal/surgery , Portasystemic Shunt, Surgical/mortality , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Hemorrhage/mortality , Hemorrhage/surgery , Humans , Liver Neoplasms/mortality , Liver Neoplasms/surgery , Liver Transplantation/mortality , Male , Middle Aged , Postoperative Complications/mortality , Retrospective Studies
18.
Zhonghua Yi Xue Za Zhi ; 85(15): 1031-4, 2005 Apr 20.
Article in Zh | MEDLINE | ID: mdl-16029544

ABSTRACT

OBJECTIVE: To investigate the feasibility, efficacy and clinical prospects of radiofrequency ablation (RFA) for hypersplenism in patients with liver cirrhosis and portal hypertension. METHODS: The laboratory and radiologic data over one-year period of patients undergone splenic RFA were analyzed. RESULTS: Nine patients undergone splenic RFA has closely followed-up over 1 year. During hospitalization, no procedure-related complications occurred, only minor complications including hydrothorax (3/9 patients) and mild abdominal pain (4/9 patients) were observed. After treatment, average 30.7% (20%-43%) of spleen volume was ablated, and the platelet count reached peak on 14th post-procedure day. White blood cell and platelet counts, liver function, and hepatic artery blood flow had gained significant improvements comparing with those before RFA procedures. Hyperplasia/regeneration was also occurred in cirrhotic liver after splenic RFA. CONCLUSION: Radiofrequency ablation is a safe, effective and minimally invasive approach for the management of hypersplenism in patients with liver cirrhosis and portal hypertension. Increased hepatic artery blood flow can contribute to significant improvement of liver function, and maybe potentially stimulate liver regeneration in cirrhotic liver.


Subject(s)
Catheter Ablation , Hypersplenism/etiology , Hypersplenism/surgery , Hypertension, Portal/complications , Adult , Feasibility Studies , Female , Follow-Up Studies , Humans , Male , Middle Aged
19.
Zhonghua Gan Zang Bing Za Zhi ; 13(2): 113-6, 2005 Feb.
Article in Zh | MEDLINE | ID: mdl-15727697

ABSTRACT

OBJECTIVE: To evaluate the effects of portaazygous disconnection (PAD), portacaval shunt (PCS) and distal splenocaval shunt (DSCS) on the portosytemic shunting (PSS), hepatic function (HF), hepatic mitochondrial respiratory function (HMRF), oral glucose tolerance test (OGTT) and arterial ketone body ratio (KBR) in order to provide a sound basis for selecting suitable operations for patients. METHODS: Using a cirrhotic portal hypertensive model induced by CCl4/ethanol in Wistar rats, the PSS, HF, HMRF, OGTT and KBR were determined three weeks after PCS, DSCS and PAD. RESULTS: It was revealed that: (1) In the cirrhotic portal hypertension rats, the PSS increased significantly, HMRF and hepatic reserve function (HRF) decreased significantly when compared with the control rats. (2) At the time of first postoperative week, the mean blood glucose value in the 120-minute OGTT in each PAD, PCS and DSCS groups had significant differences compared with the cirrhotic control group. But during the second and third postoperative weeks, the mean blood glucose values in the 120-minute OGTT in both PAD and DSCS groups had no significant differences compared with the cirrhotic control group except for the PCS group. The values of KBR in the three operative groups decreased significantly compared with the cirrhotic control group during the two postoperative weeks. In the third postoperative week, only the values of KBR in the PCS group had a significant difference compared with the cirrhotic control group. (3) After PCS, the PSS was further increased; HF and HMRF were significantly decreased. Little improvement was found in the third postoperative week. (4) After DSCS and PAD, the above mentioned indices were less influenced, and they were restored more quickly than those in the PCS group. CONCLUSION: We found that PAD and DSCS are more desirable than PCS.


Subject(s)
Hypertension, Portal/surgery , Liver Cirrhosis, Experimental/surgery , Portacaval Shunt, Surgical , Portasystemic Shunt, Surgical/methods , Animals , Hypertension, Portal/etiology , Liver Cirrhosis, Experimental/complications , Rats , Rats, Wistar
20.
BMC Gastroenterol ; 3: 1, 2003 Jan 10.
Article in English | MEDLINE | ID: mdl-12521381

ABSTRACT

BACKGROUND: The incidence of pancreatic tuberculosis is extremely rare, and it frequently misdiagnosed as pancreatic neoplasms. The nonsurgical diagnosis of this entity continues to be a challenge. CASE PRESENTATION: A 33 year old male with six-month history of intermittent right epigastric vague pain and weight lost had found a solitary pancreatic cystic mass and diagnosed as pancreatic cystadenocarcinoma. The chest X-ray film and physical examination revealed no abnormalities. Abdominal ultrasound (US) examination showed an irregular hypoechoic lesion of 6.6 cm x 4.4 cm in the head of pancreas, and color Doppler flow imaging did not demonstrate blood stream in the mass. The attempts to obtain pathological evidence of the lesion by US-guided percutaneous fine needle aspiration failed, an exploratory laparotomy and incisional biopsy revealed a caseous abscess of the head of pancreas without typical changes of tuberculous granuloma, but acid-fast stain was positive. CONCLUSIONS: Pancreatic tuberculosis should be considered in the differential diagnosis of focal pancreatic lesions, especially for young people in developing countries.


Subject(s)
Abscess/diagnosis , Cystadenocarcinoma/diagnosis , Pancreatic Diseases/diagnosis , Pancreatic Neoplasms/diagnosis , Tuberculosis, Endocrine/diagnosis , Adult , Diagnosis, Differential , Humans , Male
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