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Objective To describe the interpositional omentum and demonstrate its clinical significance.MethodsCT and clinical data of the cases whose suprahepatic gaps widen were reviewed and the contrast of CT was adjusted to observe further.ResultsIn 1 916 cases with upper abdominal CT data,suprahepatic gap was widen in all 152 cases,and 119 cases showed fat density(6.21％ ).There were 3 cases of trauma and 3 cases of acute abdomen in the 119 cases CT in the 119 cases displayed free gas under diaphragma,but displayed fat density after contrast adjusted.There were 11 cases undergoing operations,1 for sigmoid rupture 4 liver cirrhosis and portal hypertension,3 gastric cancer,and 1 acute cholecystitis,1 bile duct carcinoma and Ⅰ case congenital cystic dilatation of common bile duct.The other 108 cases did not undergo surgical operation.ConclusionsInterpositional omentum is a clinical phenomenon that the omentum was shift in suprahepatic gap covering the liver surface.It is not rarely,the incidence rate being 6.21％ ( 119/1 916) in our study.The occurrence mechanism may be similar to that of Chilaiditi syndrome.It is difficult to differentiate interpositional omentum from free gas under diaphragms on CT plain scan picture,but it is easy after contrast adjusted of CT.Free gas under diaphragma should not be identify incorrecdied and patients should not undergo unnecessary surgical procedure.
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ObjectiveTo summarize the experience of gastric D2 operation and evaluate the feasibility and safety of peripheral vascular choroid of lymph node dissection.Methods A retrospective study was adopted to analyze the redical D2 operation procedure and operation results 24 advanced gastric cancer cases,summarizing the experience of D2 radical gastrectomy operation for gastric cancer.The number of resected lymph nodes,operation bleeding volume,postoperative complications were analyzed to evaluate the feasibility and safety of operation.Results All 24 cases undergoing D2 radical gastrectomy operation of advanced gastric cancer were successful,and got the R0 resection.A total of 634 lymph nodes were excised in all the cases,averaged 26.42.A totle of 206 metastatic lymph nodes were found,metastasis rate being 32.49％.Operation bleeding volume was averaged 264.58 mL.The postoperative complication rate was 25％,anastomotic bleeding in 1 case,input loop jejunum fistula of esophageal jejunum anastomosis in 1 case,hyperamylasemia and 2 cases reflux esophagitis in 2 cases respectively.Conclusions D2 radical gastrectomy operation of gastric cancer is safe and feasible on the basis of mastering perigastric anatomy and master of lymph node excision technology and anatomical hierarchy separation.
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AIM: To investigate the change of adrenocorticotropic hormone (ACTH) cells and thyroid- stimulating hormone(wn) cells of pars distalls of pituitary gland of morphine dependent dependent rats and its restoration after withdrawal. METHODS: Morphine dependent model of male rats was made by subcutaneous injection of mor- phine and the adstinent model was made after withdrawal. Changes of ACTH cells and TSH cells of pars distails of pituitary gland were detected by immunohistochemistoy survey and image analysis. RESULTS: The intensity of positive staining and the numerical density of ACTH and TSH immunoreactive cells were weakened (P＜ 0.01), after withdrawal from morphine for a short time the changes would exist continuously. CONCLUSION: Morphine may give rise to disorder of endocrine of pituitary gland of male rats, which may incompletely restore after withdrawal for a short time.