Four hundred and eighty two paients suffering from intrahepatic bile duct stone undergoing lobectomy and segmental resection (from 1975 to 1994,9) has reported. 63% of the patient in this group underwent 1-5 operations, including different types of biliary-intestinal anastomosis (21.6%). 482 cases underwent different types of hepatectomy, including left lateral-lobetomy 321 cases (66.6%),left hemihepatectomy 80 cases(16.6%), right hemihepatectomy 19 cases (3.9%), and multiple segmental resections 39 cases (8.1%, including Ⅴ+Ⅷ 11 cases, Ⅵ+Ⅶ 28 cases). Other type hepatectomy combined with guadrate lobectomy 20 cases (4.1%). Postoperative complication rate was 10.2%, including diliary fistula. hemobilia and subdiaphragmatic and resectional surface infectioin, 85% of the patients were followed up with an excellent result of 88%. The authors emphsize that hepatic lobectomy nad segmental resection is the core of treatment and selection of operative methods depends on clinical-patholigic types of the disease.
Objective To observe the retinal toxicity of intravitreal injection of Bevacizumab (Avastin) in albino rabbit eyes at different doses. Methods Sixteen New Zealand albino rabbits，thirty-two eyes were divided into four groups at random. Three groups were prepared for Avastin experiment, named A, B, C. Each group received intravitreal injection of Avastin at dose 1.25 mg/0.05ml，2.5 mg/0.1ml and 6.25 mg/0.25 ml respectively. The other group named D served as a control, and accepted intravitreal injection of 0.9% normal saline 0.1 ml. Then test it by electroretinagram (ERG) after 1, 2 and 4 weeks. In addition, each group was removing two rabbitprime;s eyes to observe the retinal morphology and ultra structure by light microscope and transmission electron microscopy after intravitreal injection avastin 1, 2 and 4 weeks. Results The ERG pattern and amplitude of each group were normal after intravitreal injection Avastin 1, 2 and 4 weeks. （P＞0.05）Between study and control groups, there was no significant difference in retinal morphology which was observed by light microscope at any stage of the study. By electron microscopic observation, retinal ultramicrostructure was no evident retinal toxicity being tested both at group A and B (1.25 mg/0.05 ml and 2.5 mg/0.1 ml). But at group C (6.25 mg/0.25 ml), significant mitochondrial swelling and hydropic changes were seen in the inner segments of photoreceptors. And there was no improvement of the pathological changes in four weeks. Conclusion It is safe that intravitreal injection of Avastin in rabbitprime;s eyes at dose 1.25 mg or 2.5 mg at single time. （Chin J Ocul Fundus Dis，2008，24：193-196）
To investigate the relationship between clinicopathological features and lymph node metastasis in the primary gastric cancer and affer the basis for deciding appropriate extent of lymph node dissection, a total of 192 patients who underwent curative gastrectomy and lymph node dissection for gastric cancer were analyzed retrospectively. Result: The total rate of lymph node metastasis was 60.4%, with 28.9% of the resected lymph nodes involved. The lymph node metastasis of C, M, A region and the whole stomach were 64.6%, 57.7%, 59.1% and 90.9% respectively. The rates of the lymph node metastasis increased successively in carcinoma of early, middle and late stages (Ｐ＜0.05), the rate of the infiltrative tumor (Borr Ⅲ，Ⅳ) being 76.5% which was significantly higher than that of the circumscribed tumor (Borr Ⅰ，Ⅱ) (43.2%)。 Relating with the tumor size ＜4cm in diameter showed lesser rate, while 4-8 cm and ＞8cm in diameter showed increasingly higher metastaticrate (Ｐ＜0.01). As a result, we should decide the appropriate extent of lymph node dissection during the operation on the basis of clinicopathological stages, type of Borrmann’s, site and maximum diameter of gastric cancer along with the state of lymph node metastasis in carcinoma of different region of the stomach.
Objective To observe the effect of high glucose on the expression of activating transcription factor 4 (ATF4) in cultured retinal Muuml;ller glia cells. Methods The retinal tissue of Sprague-Dawley (SD) rats was collected, and Muuml;ller cells were isolated and cultured. The glial fibrillary acidic protein (GFAP) and glutamine synthetase (GS) of Muuml;ller cells were identified by streptavidin-biotin-peroxidase complex. Cultured rat Muuml;ller cells were divided into control group (5.5 mmol/L glucose), group A (20 mmol/L glucose), group B (30 mmol/L glucose) and group C (40 mmol/L glucose). ATF4 protein expressions in Muuml;ller cells of four groups were measured by Western blot four days after cultured. Results GFAP and GS expressed in more than 95% of Muuml;ller cells. Over 95% of Muuml;ller cells of group A, B and C were positive for GFAP and GS. Western blots indicated that ATF4 protein in group A, B and C increased obviously compared with the control group (q=0.293, 0.754,0.484;P＜0.05). Conclusion High glucose can increase the expression of ATF4 protein and cause endoplasmic reticulum stress in retinal Muuml;ller glia cells in vitro.
【Abstract】Objective To evaluate the pathological diagnosis of liver allograft rejection. Methods Literatures about diagnosis of liver transplantation rejection in recent ten years were reviewed.Results Humoral rejection was rare. The main features were graft blood vessel thrombosis and liver damage and necrosis about some days or one week after transplantation. The humoral rejection of liver graft occurred later than that of kidney and heart transplantation. The diagnosis of acute liver graft rejection was based on Banff Schema. During chronic rejection intrahepatic bile ducts among hepatic lobules in portal area disappeared, and inflammation, fibrosis and stricture of hepatic arteries and veins were found, but the morbidity was less than that of kidney， heart, lung and pancreas grafting. Conclusion Banff standard is the most important base of diagnosing liver graft rejection.
Objective To investigate the clinical features, etiological classification and staging of epiretinal macular membrane(MEM)． Methods Clinical materials of 194 cases of MEM diagnosed by fundus fluorescein angiography in outpatient department of eye clinic in this hospital from 1983 to 2000 were retrospectively analyzed． Results There were typical clinical symptoms and signs of MEM in all of this 222 eyes of 194 patients． Etiological classification revealed that 4 cases were congenital(2．12%), 22 cases were secondary(11．34%), and 168 cases were idio pathic(86．60%)． Staging of course of disease indicated that 119 eyes were in early stage(53．60%), 72 eyes were in middle stage(32．43%), and 31 eyes were in late stage(13．96%)． Conclusion MEM may be classified as congenital, secondary and idiopathic type according to its pathogenesis , as early, middle and late stage according to the clinical course of disease．This can be helpful in treating the disease． (Chin J Ocul Fundus Dis, 2001,17:210-213)
0bjective To explore the effect of endothelin(ET)、nitrioxide (NO) in plasma on retinopathv in the pregnancy-induced hypertension(PIH)． Methods The 1evel of ET and NO in plasma of 75 cases of in-patient women with PIH and 20 cases of women with the full terms and normal pregnancy before and after delivery was determined by radioimmunoassay．The retinopathy of the patients with FIH before and after delivery was detected by appointed doctor．The levels of ET and N0 in both groups were compared and the relationship between ET and N0 in plasma and the retinopathy before and after the delivery was detected.Results The levels of ET[(145．oo±54.41)ng／L] in serious PIH patients were much higher than that in the control[(81．50±43．80)ng／L]，the minor[(85.30±33.33)ng／L]and middling PIH group[(90．20±39．25)ng／L]．The levels of ET in plasma before and after pregnancy were not changed in PIH patients [(118．70±33．44)ng／L]，but were higher than that in the control group. The levels of plasma NO in serious[(87．56±35．58)ng／L]and middling[(78.11±28.96)ng／L] PIH group were both higher than that in the control group[(46．70±32.64)ng/L]，and the levels in minor(52．56±28．35)ng／L]and middling PIH group were lower than that in the serious PIH group.The level of N0 in plasma of PIH patients after the delivery was much lower than that before the delivery，while higher than that in the control．The positive correlation between levels of ET and NO and retinopathy was found in PIH patients.Conclusions The 1evels of plasma ET and N0 in PIH patients are related to the extent of the disease，and the level of ET in plasma is highly related to the retinopathy in PIH patients, ET and NO might be played an important role in pathogenesis of retinopathy and ET might be a good index in reflecting the rank of retinopathy in PIH.(Chin J Ocul Fundus Dis，2004，20：12-15)