Research advances in congenital extrahepatic portosystemic shunt / 临床肝胆病杂志

Congenital extrahepatic portosystemic shunt (CEPS) is also called Abernethy malformation, with the manifestation of congenital abnormal anastomosis between the portal vein and the inferior vena cava. CEPS is extremely rare in clinical practice and has diverse clinical symptoms, which often leads to missed diagnosis and misdiagnosis. This article reviews the pathogenesis, classification, clinical manifestation, diagnosis, and treatment of CEPS, so as to improve the awareness of this disease and provide a reference for further standardization of its diagnosis and treatment process in the future.

Reoperation of biliary-enteric anastomotic stricture after surgery for congenital choledochal cysts / 中华普通外科杂志

Objective:To analyze the causes of postoperative stricture of biliary-enteric anastomotic for congenital choledochal cysts.Methods:These 28 patients underwent salvage operation on an average 15 years (0.2-25 years) after initial surgeries at the Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital from Jan 2014 to Jun 2018.Results:In 26 patients the biliary-enteric anastomotic stenosis was benign, and in 2 the stricture was caused by cancerration. In 26 cases the Roux-en-Y hepaticojejunostomy was redone,among them 8 cases underwent concurrent hepatectomy for a better exposure of the intrahepatic bile duct. In 2 cases the anastomotic stenosis was found to be caused by canceration with extensive intraabdominal metastasis ,an external drainage was adopted. There were no inhospital deaths, and no serious complications. The postoperative follow-up time was 6-67 months. Two cancerated patients died within half a year, and the remaining patients had no long-term complications.Conclusions:Biliary-enteric anastomotic stenosis is one of the serious complications in postoperative patients for congenital choledochal cysts. Hence a wide, tension free biliary-enteric anastomosis performed by a experienced hand is necessary.

Mechanism and treatment of portal-systemic circulatory imbalance in hepatorenal syndrome / 临床肝胆病杂志

Hepatorenal syndrome (HRS) is a serious complication of end-stage liver disease, and its pathogenesis is associated with the systemic hemodynamic changes such as portal hypertension, arterial vasodilation, reduced cardiac output, reduced effective circulating blood volume, and renal artery contraction, as well as portal-systemic circulatory imbalance. For the treatment of HRS at present, vasoactive agents and interventional treatment are used to change systemic hemodynamics and portal-systemic circulatory imbalance, and early intervention can improve the prognosis of patients.

Research advances in drug-induced liver injury / 临床肝胆病杂志

Drug-induced liver injury (DILI) has a complex pathogenesis and obvious individual difference. Early diagnosis and treatment of DILI may achieve good prognosis, but due to a lack of specific clinical symptoms, most cases cannot be identified in the early stage. If no timely treatment is given, DILI may progress to irreversible liver failure with a high mortality rate, and there are no effective therapies for advanced DILI except liver transplantation. Therefore, early diagnosis and treatment are of great importance for patients with DILI. This article summarizes the recent research advances in DILI, including suspected drugs, risk factors, pathogenesis, pathological features, clinical types and manifestations, diagnostic criteria and evaluation, and network database, in order to provide a basis for early diagnosis, clinical typing, treatment guidance, and prognostic evaluation of DILI.

Role of the OPG/RANKL/RANK signaling pathway in the progression of nonalcoholic fatty liver disease / 临床肝胆病杂志

Nonalcoholic fatty liver disease (NAFLD) has now become the most common liver disease around the world, and there is an urgent need for better diagnosis and treatment of NAFLD. The osteoprotegerin (OPG)/receptor activator of nuclear factor-kappa B ligand (RANKL)/receptor activator of nuclear factor-kappa B (RANK) signaling pathway is an important signaling pathway involved in the balance of bone metabolism. This article introduces the OPG, RANKL, RANK, and OPG/RANKL/RANK systems and elaborates on the current research on the role of the OPG/RANKL/RANK signaling pathway in regulating the production of inflammatory factors and promoting the progression of NAFLD by activating NF-κB. It is pointed out that the OPG/RANKL/RANK system may be used as a potential target for the treatment of NAFLD.

Research advances in high-risk factors for primary biliary cholangitis / 临床肝胆病杂志

Primary biliary cholangitis (PBC) is a multifactorial disease caused by the combined effect of genetic susceptibility and environmental triggers. Among the known risk factors for PBC, environmental factors mainly cause the onset of the disease by disrupting mitochondrial immune tolerance. With the deepening of research, especially the application of genome-wide association study technology, some dangerous genes have been found, such as human leukocyte antigen gene IL and X chromosome monomer. This article reviews the research advances in high-risk factors for PBC.

The association between interleukin-8 and autoimmune liver diseases / 临床肝胆病杂志

Interleukin-8 (IL-8) is an inflammatory cytokine with chemotaxis and there is a significant increase in the expression of IL-8 in autoimmune liver diseases. It participates in disease progression by binding to its receptors CXCR1 and CXCR2, promoting chemotaxis of inflammatory cells, angiogenesis, and fibrosis, and inducing cell proliferation. This article reviews the research advances in the association between IL-8 and autoimmune liver diseases.

Postoperative portal vein thrombosis and the liver function after splenectomy and pericardial devascularization / 中华肝胆外科杂志

Objective To study the impact of splenectomy and pericardial devascularization on the occurrence and development of portal vein thrombosis and the liver function in patients with cirrhosis complicated by portal hypertension.Methods 29 patients with cirrhosis and portal hypertension who underwent splenectomy and pericardial devascularization in the 302 Hospital of PLA from December 2012 to June 2013 were retrospectively studied.The incidences of PVT before and after operation were monitored.The liver function was assessed using the Child-Pugh classification.Results 29 patients with cirrhosis and portal hypertension underwent splenectomy and pericardial devascularization.The incidences of PVT in the preoperative period,12 days,3 months,6 months after operation were 10.3％,89.7％,51.7％,24.1％,respectively.The Child-Pugh scores in the preoperative period,12 days,3 months,6 months after operation were (5.2 ± 0.4),(5.6 ± 0.7),(5.2 ± 0.7),(5.3 ± 0.7),respectively.Conclusions The incidences of postoperative PVT increased after operation,but it decreased on long-term follow-up after operation.The liver function did not change.

Preliminary Study on Serum Metabolites of Primary Biliary Cholangitis by Hydrogen Spectrum Nuclear Magnetic Resonance / 胃肠病学

Hydrogen spectrum nuclear magnetic resonance (1 H-NMR ) is a commonly used method for metabolomics and has been applied in the study of liver cirrhosis and liver cancer,however,study on serum metabolites in patients with primary biliary cholangitis (PBC)is rare.Aims:To investigate the capability of 1 H-NMR for screening serum metabolites of PBC.Methods:Twenty PBC patients,20 HBV-related cirrhosis patients and 20 healthy controls were detected by 1 H-NMR.The 1 H-NMR spectra data were processed by principal component analysis (PCA)and orthogonal partial least squares-discriminant analysis (OPLS-DA)so as to create the diagnostic model.Based on the correlation coefficient P (corr),VIP value and non-paired t test of OPLS-DA model,the differential metabolites between normal group and the two cirrhosis groups were screened.Results:OPLS-DA model could effectively distinguish healthy controls and PBC patients,model interpretation ability and prediction ability were 81.9% and 44.8%,respectively (P=0.0293), glutamine,folic acid,urocanic acid,4-ethylbenzoic acid were differential metabolites.OPLS-DA model could also effectively distinguish healthy controls and HBV-related cirrhosis patients, urocanic acid, 1-methylhistamine, 1-methyladenine,glucose,L-acetylcarnitine were differential metabolites.OPLS-DA model could not effectively distinguish PBC patients and HBV-related cirrhosis patients.Conclusions:Serum glutamine and folic acid may be the potential biomarkers of PBC,which may be closely related to the immune damage mechanism and prognosis of PBC;1 H-NMR combined with OPLS-DA diagnostic model are expected to become a new method for studying liver cirrhosis.

Clinical characteristics of 31 cases of patients with TIPS and literature review / 重庆医学

Objective To explore the clinical characteristics of patients with transjugular intrahepatic portosystemic shunt (TIPS) and literature review in patients with clinical features ,and provide clinical reference for carrying out the TIPS .Methods Totally 31 patients in our hospital from January 2009 to May 2014 who received TIPS treatment and strict follow‐up were retro‐spectively analyzed ,the preoperative basic situation ,laboratory index ,the incidence of postoperative bleeding again ,surgical compli‐cations ,the use of anticoagulant drugs and thrombosis ,dissolved ,etc .were statistical analyzed .Results In all patients with TIPS in the diagnosis of cirrhosis and portal hypertension ,hepatitis B ,hepatitis C cirrhosis and portal hypertension ,alcoholic liver cirrhosis and portal hypertension ,unknown cause of liver cirrhosis and portal hypertension ,Budd Chiari syndrome ,hepatitis B and hepatitis C cirrhosis and portal hypertension ,primary biliary cirrhosis and portal hypertension in proportion of 45 .16% ,16 .13% ,12 .90% , 12 .90% ,6 .45% ,3 .22% ,3 .22% respectively ;the incidence of postoperative bleeding again within six months was 9 .68% ;the Child‐Puhg score of preoperative and postoperative 1 week and 3 months ,6 months was (8 .35 ± 2 .52) ,(8 .32 ± 1 .76) ,(9 .29 ± 2 .55) ,(8 .10 ± 1 .85) respectively .Statistical results showed in postoperative 1 week and 3 months ,6 months ,there was no statisti‐cally significant difference compared with preoperative respectively (P>0 .05) ,postoperative 3 months liver function score of Child‐Puhg was higher than that of postoperative 1 week and 6 months (P<0 .05) operation;the rate of abdominal hemorrhage ,hepatic encephalopathy ,stent stenosis were 3 .22% ,22 .58% ,12 .90% ;the proportion of no postoperative taking anticoagulants ,taking as‐pirin ,clopidogrel ,and warfarin were 9 .68% ,38 .71% ,41 .94% ,9 .68% ,respectively ;the formation of portal vein thrombosis (inclu‐ding thrombosis increased) rate was 12 .90% ,thrombus dissolution rate was 100% .Conclusion In China ,liver cirrhosis and portal hypertension is the main source of TIPS and hepatitis B is a major cause of liver cirrhosis ;TIPS have no effect on liver function in Child‐Puhg score;hepatic encephalopathy ,stent restenosis is still the main postoperative complications of TIPS ;rules taking antico‐agulant drugs can dissolve thrombus of the portal vein and prevent thrombosis .

Effect of bone marrow mesenchymal stem cells transplantation on expression of high mobility group box 1 protein in rats with acute liver failure / 中华器官移植杂志

Objective To investigate the effect of bone marrow mesenchymal stem cells (BMSCs) transplantation on expression of high mobility group box 1 protein (HMGB1) in rats with acute liver failure (ALF).Method SD rats were randomly divided into three groups:control group,ALF group and BMSCs transplantation group.Specimens were harvested in each group at 12 h,24 h and 72 h after ALF induction.Serum ALT and AST concentrations were determined,liver pathological changes were observed by HE staining,serum HMGB1 concentration detected by ELISA,and HMGB1 mRNA and protein in liver tissues examined by RT-PCR and immunohistochemistry respectively.Result The ALF models were successfully induced by D-GalN (900 rng/kg) and LPS (10 μg/kg) injection.Serum levels of ALT and AST in the ALF group were gradually increased with progression of the disease.As compared with the ALF group,significant improvement of liver function parameters and histological findings was observed in the transplantation group 72 h after transplantation (P＜0.01).The serum HMGB1 concentrations,the HMGB1 mRNA expression and the HMGB1 protein expression in liver tissue of control group were lowered at all time points,and they increased with time in the ALF group.After BMSCs transplantation,the serum HMGB1 concentrations,the HMGB1 mRNA and protein expression decreased with time.All the differences between ALF group and BMSCs transplantation group at 24 h and 72 h after transplantation were statistically significant (P＜0.01).At 24th h after transplantation,mortality rates of control group,ALF group,BMSC transplantation group were 0 (0/24),33.3％ (8/24) and 16.7％ (4/24) respectively with the difference being statistically significant (x2 =21.098,P＜ 0.01).Conclusion BMSCs transplantation can improve the liver function and pathological changes in rats with ALF,and decrease the expression of HMGB1.

Expression of NKG2D/MIC in natural killer cell subsets of patients with primary biliary cirrhosis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To compare frequencies of natural killer (NK) cell subsets and their surface expression of the NKG2D receptor in patients with primary biliary cirrhosis (PBC), and to determine the correlation between expression of MICA on monocytes and function-associated receptors on the NK cells of PBC patients.</p><p><b>METHODS</b>Twenty patients with PBC and 18 healthy donors were included in the study. Peripheral blood samples anticoagulated with heparin were labeled with the following antibody combinations: anti-CD45/anti-CD14/anti-MICA, antiCD3/anti-CD56/anti-CD16/anti-NKG2D. Frequencies of MICA-positive monocytes, NK cell subsets, and NK cells with surface expression of NKG2D were measured with flow cytometry. Correlation of MICA expression on monocytes with NKG2D expreesion on NK cells was assessed through linear correlation and regression analysis.</p><p><b>RESULTS</b>The PBC patients had significantly lower percentages of NK cells than the healthy donors (6.8%+/-2.9% vs.16.4%+/-3.4%, P =0.000<0.05). In the PBC patients, the percentage of CD56-positive NK ceils was significantly higher than that of CD16-positive NK cells (4.2%+/-2.8% vs.1.4%+/-0.7%, P=0.003<0.05). The PBC patients also had significantly higher percentage of NKG2D surface expressing CD56-positive NK cells than the healthy donors (79.4%+/-10.2% vs.64.8%+/-10.7%, P=0.000<0.05). The PBC patients and healthy donors showed no statistically significant differences in percentages of NKG2D surface expressing CDl6-positive NK (70.1%+/-12.9% vs.61.1%+/-5.9%, P=0.078>0.05). MICA was seldom detected on normal monocytes (2.6%+/-1.9%), but present for 51.6%+/-16.2% of monoeytes from the PBC patients (P =0.000<0.05). There was a significant difference in frequency of CD14/MICA double-positive monocytes between the healthy donors and PBC patients. No correlation of MICA expression on monocytes with NKG2D expression on NK cells was found.</p><p><b>CONCLUSION</b>PBC patients have lower levels of NK cells in peripheral blood than their healthy counterparts. PBC patients also have higher levels of the CD56+ NK cell subset and cells with surface expression of the activated NKG2D receptor. It appears that PBC patients have a greater level of CD14+MICA+ peripheral blood mononuclear cells. NK cells may be affected by the PBC-related monocytes and participate in disease pathogenesis through immune regulation.</p>

Correlation and differences in proto oncogene protein of patients with OLK and OSCC / 中国生化药物杂志

Objective To analyse the significance of proto oncogene protein in oral squamous cell carcinoma and oral leukoplakia.Methods 40 patients who were diagnosed with oral leukoplakia (OLK),40 patients who were diagnosed with oral squamous cell carcinoma(OSCC),and at the same time, 40 healthy volunteers as control group were collected.the lesions and normal oral mucosa were taken as samples, left supernatant after grinding, MDM2 protein, p53 protein and Ki-67 protein were detected by ELISA in three groups,and analyse the correlation between three groups.Results Among three groups,MDM2, p53 expression:OSCC group>OLK group>control group (POLK group>control group (P<0.05).MDM2, p53, Ki-67 expression had a positive correlation in OSCC group and OLK group (P<0.05), but there was no obvious correlation in control group.Conclusion When oral leukoplakia developes into oral squamous cell carcinoma, MDM2, p53, Ki-67 shows high expression, and there is a positive correlation between MDM2, p53, Ki-67.

Analysis of risk factors of hepatic encephalopathy after TIPS / 重庆医学

Objective To investigate the risk factors of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt (TIPS) .Methods 181 cases of patients after TIPS diagnosed in this department from January 2009 to December 2013 were reviewed .The patients were divided into two groups:42 cases with hepatic encephalopathy (HE group)and 139 cases without he-patic encephalopathy(control group) .To evaluate the possible risk factors such as age ,sex ,pathogeny of cirrhosis ,complications [(Child-Pugh score ,portal pressure gradient (PPG ) ,Child-Pugh grading ,fibrinogen ,hemoglobin ,serum natrium ] were recorded and analyzed .Unconditional logistic regression model(W ald test)was used to screen the independent risk factors .Receiver operating characteristic curve was plotted and the area under it was calculated to evaluate the diagnose performance .Results There was no significant statistical difference between HE group and control group about age ,sex and pathogeny of cirrhosis(P>0 .05) .Analysis of unconditional logistic regression model indicated that Child-Pugh score ,PPG ,Child-Pugh grading ,were single risk factors of HE after operation(OR=1 .29 ,1 .06 ,1 .22) ,while fibrinogen ,hemoglobin and serum natrium were protective factors .ROC curve was plotted and the AUC was calculated to evaluate the diagnose performance ,which indicated the sequence was that ,Child-Pugh score> PPG>Child-Pugh grading>hemoglobin>fibrinogen>serum natrium .Conclusion Child-Pugh score ,PPG ,Child-Pugh grading , fibrinogen ,hemoglobin and serum natrium were single hazard factors of HE after operation .

The evaluation value of the concentration of serum cholinesterase combined with acute physiology and chronic health evaluation Ⅲ in predicting the condition and prognosis of patients with severe acute pancreatitis / 中国医师进修杂志

ObJective To explore the value of acute physiology and chronic health evaluation Ⅲ(APACHE Ⅲ ) score and the concentration of serum cholinesterase (ChE) in predicting the condition and prognosis of patients with severe acute pancreatitis (SAP) within 24 hours afar hospitalization.Methods Sixty-two SAP patients were enrolled and APACHE Ⅲ score was assessed and the concentration of serum ChE was detected within 24 hours after hospitalization.The correlation between the concentration of serum ChE,APACHE Ⅲ score and the condition and prognosis was analyzed.Results There were 44 survivalcases and 18 dead cases.The APACHE Ⅲ score of the surval patients was significantly lower than that of the dead patients [(52.16 ± 13.76) scores vs.(97.10 ± 15.85) scores] (P＜0.01).The concentration of serum ChE of survival patients was significantly higher than that of the dead patients [ (3685 ± 466) U/L vs.(2109 ± 345) U/L] (P＜ 0.01 ).The higher APACHE Ⅲ score was,the lower the serum ChE concentration was,and the higher the mortality rate was.APACHE Ⅲ score and the concontration of serum ChE both had statistical significances compared with the prognosis in the Logistic regression analysis (P =0.0043,0.0075);APACHE Ⅲ score (95％ CI 1.0306-1.1507),the concentration of serum ChE (95％ CI0.9986-1.0125 ).ROC areas under curve (AUC) of APACHE Ⅲ score,serum ChE concentration with the prognosis were 0.936 and 0.882,respectively.There was no significant difference (P=0.0820).In combined prediction of APACHE Ⅲ score and serum ChE concentration,AUC was 0.952,and its predicting accuracy was higher than either APACHE Ⅲ score or serum ChE concentration (P=0.0016,0.0027).Conclusions APACHE Ⅲ score and the concentration of serum ChE both are significantly correlated with the condition and prognosis of SAP patients.Their combined detection can significantly improve the accuracy of prognosis judgement and provide some clinical guidances for treatment.

Role of Janus kinase 2/signal transducer and activator of transcription 3 signaling pathway in attenuation of myocardial ischemia-reperfusion injury by teramethylpyrazine in rats / 中华麻醉学杂志

ObjectiveTo evaluate the role of Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) signaling pathway in attenuation of myocardial ischemia-reperfusion (I/R) injury by tetramethylpyrazine in rats.MethodsSixty-four healthy male Wistar rats weighing 250-300 g were randomly divided into 4 groups( n ＝ 16 each):sham operation group (group S),myocardial I/R group(group I/R),teramethylpyrazine group (group T) and AG,490( a JAK2 inhibitor) group (group AG).Myocardial I/R was induced by 30 min occlusion of left anterior desecending coronary artery (LAD) followed by 120 min reperfusion in groups I/R,T and A.In groups T and A teramethylpyrazine 20 mg/kg was injected iv 20 min before LAD occlusion.In group A AG490 3 tμg/g was injected iv at 5 min before reperfusion.Blood samples were then taken from inferior vena cava at 120 min of reperfusion for measurement of serum creatine phosphokinase (CK) and lactose dehydrogenase (LDH) activities.Myocardial infarct size was then measured and myocardial tissue was obtained for microscopic examination.ResultsSerum CK and LDH activities were significantly higher in group I/R than in group S.Pretreatment with tetramethylpyrazine significantly decreased myocardial infarct size and I/R-induced increase in serum CK and LDH activities and histologic damage.The protective effect of tetramethylpyrazine against myocardial 1/R injury was attenuated by postconditioning with AG490.ConclusionJAK2/STAT3 signaling pathway is involved in attenuation of myocardial I/R injury by tetramethyl pyrazine in rats.

Surgical experience in the treatment of refractory cholelithiasis / 中华消化外科杂志

Objective To investigate the operative techniques for refractory cholelithiasis. Methods The clinical data of 521 patients with refractory cholelithiasis who had been admitted to People's Hospital of Hunan Province from January 1990 to December 2007 were retrospectively analyzed. Results All patients received surgery. After the operation, 3 patients died of liver and kidney failure, the remaining 518 patients were cured without severe complications. The results of B ultrasound and computed tomography showed residual stones in 78 patients (15.1%). Four hundred and twenty-three patients (81.7%) were followed up for 5 months to 17 years (mean, 7.5 years), and the rate of positive effect was 90.1% (381/423). Conclusions Most of the refractory cholelithiasis can be cured radically. Individualized surgical planning, fine and standard surgical procedure are key to the treatment effect.

Analysis of clinical features and liver histopathology of autoimmune liver diseases: an analysis of 109cases / 中华消化杂志

Objective To analyze the clinical characteristics of autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) and AIH/PSC or/PBC overlap syndrome in order to further understand the autoimmune liver diseases (AILD). Methods One hundred and nine patients with AILDs confirmed pathologically were collected between Jan. 2004 and June 2006. Of 109 patients, AIH was found in 27 eases, PBC in 67 cases, PSC in 4 eases, AIH-PSC overlap syndrome in 1 case and AIH-PBC overlap syndrome in 10 cases. The clinical and laboratory data of all patients were assessed retrospectively. Results The AILD was predominantly found in middle-aged women (73.3% ,80/109), and the main clinical manifestations were jaundice, malaise, anorexia and pruritus. The age distribution of patients with AIH showed a single peak at 50 years. Elevated serum gamma globulin and IgG were found in patients with AIH, of whom 62.9% (17/27) were positive for anti-nuclear antibody (ANA) and 3 were positive for liver-kidney microsomes type 1 antibody. The main histological changes in severe AIH cases included interface hepatitis (77.7 %) and bridging necrosis. Most of the PBC patients were presented with elevated serum alkaline phosphatase, glutamyl transpeptidase and IgM. Fifty patients (74.6%) were positive for anti-mitochondrial antibody (AMA) and AMA-M2. The pathological examination showed that 28. 3% of the cases were in Ⅰ or Ⅱ stage and 71.7% in Ⅲ or Ⅳ stage in patients with PBC who received liver biopsy. The pathologic change of reduction or even disappearing of bile ducts was found in 62. 6% patients with PBC. The clinical and pathological manifestations in patients with AIH-PBC overlap syndrome had both characteristics of PBC and AIH. Three out of 10 patients with AIH-PBC overlap syndrome were positive for ANA and AMA/AMA-M2. Conclusion Since AILD is not rare in Chinese, its diagnosis should be based on the clinical presentation, biochemical, immunological and histologic changes.

Use of immunohistochemical staining and ethylaldehyde acid-induced biomonoamine fluorescence for determining the distribution of sympathetic nerve terminals in human cervical capsule tissues / 中国微创外科杂志

Objective By using immunohistochemical staining of neuropeptide Y (NPY) and fluorescence of ethylaldehyde acid-induced biomonoamine mediators, to observe the distribution of sympathetic nerve terminals in human cervical capsule tissues, and to compare the two methods for further improvement. Methods Surgically removed joint capsule tissues from C 3~7 vertebrae of 17 cases were treated by paraffin imbedding with NPY immunohistochemical staining and frozen-section with fluorescence staining of ethylaldehyde acid-induced biomonoamine mediators. Slides were preconditioned by 1% KMnO4 and sections 15~20 ?m in thickness were made. The staining was conducted at 100 ℃ for 5 min firstly, and then at 80 ℃ for 2 min. We utilized adrenal glands of rats as positive control. The samples were observed under fluorescence microscope at 380~420 nm excitation wavelengths from a high-voltage mercury light source. Results NPY immunostaining findings indicated bulky positive materials in some arteriolar walls and nerve tracts of the joint capsules; biomonoamine mediators gave off fluorescence in green-yellow color under the induction of ethylaldehyde acid, which presented mostly as reticular or radial finely-broken fibers in vascular walls, basal laminae of the synovial membrane and dense connective tissues. The positive rates of NPY immunohistochemical staining were 70.6% (12/17) at C 3~4 intervertebral segment, 42.9% (6/14) at C 4~5 , 57.1% (8/14) at C 5~6 , and 50.0% (5/10) at C 6~7 , respectively, the total positive rate being 56.4% (31/55). When using the ethylaldehyde acid-induced biomonoamine fluorescence, the positive rates were 70.6% (12/17) at C 3~4 intervertebral segment, 93.8% (15/16) at C 4~5 , 66.7% (10/15) at C 5~6 , and 80.0% (8/10) at C 6~7 , respectively, the total positive rate being 77.6% (45/58). The positive rate was remarkably higher in ethylaldehyde acid-induced biomonoamine fluorescence than in NPY immunohistochemical staining, with statistically significant difference (?2=5.774,P=0016), especially at C 4~5 intervertebral segment (P=0.004). Conclusions Both the two methods can demonstrate the distribution of sympathetic nerve terminals, suggesting the presence of the terminals in human cervical capsule tissues. Modified ethylaldehyde acid-induced biomonoamine fluorescence offers a greater specificity.

The value of computed tomograph score in predicting the resectability of pancreatic cancer / 中国普通外科杂志

9scores). Results Fifty-five of fifty-seven cases with CT between 0～6 scores,which considered to be resected,underwent tumor resection . The accuracy of prediction of CT was 96.5%. Conclusions Preoperative CT scord could accurately predict the resectability and difficulty of pancreatic cancer.