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Objective To investigate the causes of peripheral cytopenia in patients with posthepatitic cirrhosis and portal hypertensive splenomegaly.Methods The clinical data of 183 patients with hepatitic cirrhosis and portal hypertensive splenomegaly complicated by peripheral cytopenia who were operated in our hospital in the past 17 years were retrospectively studied.Results All these patients underwent splenectomy.Before operation,all these patients had one or more types of peripheral cytopenia (cumulative cytopenia:390 patient-times).After splenectomy,blood counts in 79.2％ returned to normal;in 15.9％ increased but failed to reach normal levels;and in 4.9％ became lower than before operation.5 patients died soon after operation.Conclusion Hypersplenism is the main cause for the peripheral cytopenia most cirrhotic portal hypertension patients.Splenectormy is an effective method to treat hypersplenism.
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Objective Todiscuss the diagnosis and therapy of the pancreatoblastoma(PB).Methods The data of 2 cases of PB were analyzed retrospectively and related literatures were reviewed.Results Both cases were males,11 years old and 8 years old respectively.The 2 cases both had solid mass located in the tail of the pancreas.Alpha-fetal protein(AFP) was normal in case 1 and 2 903 ng/ml in case 2.The 2 cases underwent resection of the pancreas tail,and the postoperative pathological examination confirmed the diagnosis of PB.Followup of 26 months in case 1 and 10 months in case 2 showed that the survival was good.Conclusions PB is an extremely rare tumor of exocrine pancreas and often occurs in male children.The solid mass located in the pancreas with elevated AFP can be considered as PB.Our experience showed a pancreatic mass with normal AFP can also be PB.Surgery is the best management of PB.
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Objective To investigate the effects of α-lipoic acid on mitochondrial energy metabolism of liver in the rat with obstructive jaundice. Methods Seventy-two male SD rats were randomly divided into groups of sham operation and bile duct-ligation + normal soldium( BDL + NS) and bileduct-ligation + α-lipoic acid( BDL + LA). Malondialdehyde(MDA) , superoxide dismutase(SOD) and ATP, ADP, AMP in rat liver's mitochondrion were examined on days 7,14,21 after operation. Results MDA contents, ADP contents and AMP contents of liver' s mitochondrion were significantly increased at each time point in BDL + NS-group,while SOD contents and ATP contents of liver' s mitochondrion decreased remarkably on the 7th, 14th days; MDA content of liver' s mitochondrion in BDL + LA group was more lower than that in BDL + NS group (P ＜ 0. 01 )on the 21st day; MDA content was further increased in BDL + NS group and in BDL + LA group but there was no difference in their comparisons. On the 7th, 14th days, SOD contents and ATP contents in BDL + LA group were significantly higher than that in BDL + NS group( 7th days,P ＜ 0. 01; 14th days,P ＜ 0.05 ), On the 21 st day SOD contents in BDL + NS group had no difference with that in BDL + LA group (P ＞ 0. 05). Conclusions LA has a protective effect on energy metabolism of liver' s mitochondrion in the initial ,metaphase stage of obstructive jaundice.
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Objective To investigate the diagnosis and treatment of rectal carcinoid. Methods Clinical data of 16 patients of rectal carcinoids in our hospital from January 2000 to December 2009 were analyzed retrospectively. Related literatures were reviewed. Results Among the patients included, 11 cases(68.8%)suffered from hypogastralgia, 3 cases(18.8%)bloody stool, 3 cases(18.8%)defecation number increase. All the patients underwent enteroscopy. The average size in diameter of all the tumors was 8.8 mm. 81.3% of the tumors ≤10 mm in diameter. The average distance from tumor to anus was 6.8 cm and 87.5% of the tumors ≤8 cm in distance, Only 25% of all the cases were diagnosed preoperatively, most cases were diagnosed as other diseases and definitely diagnosed by postoperative pathology. 14 cases underwent operation as radical resection of rectal carcinoma, and 2 cases endoscopic removal. There was no operative death and postoperative five-year survival rate is 69.2%. Conclusions Preoperative diagnosis rectal carcinoid is difficult.Misdiagnosis rate is high. The key point of improving diagnosis of this disease is annal digital examination. Enteroscopy and pathology, operation is the first choice to treat rectal carcinoid.
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Objective To investigate the therapeutic effects of latarjet nerve and pylous preserved pancreaticoduo-denectomy (LPPPD). Methods Clinical data and postoperative follow-up of Latarjet nerve and Pylous Preserved Pancreaticoduodenectomy since1996 of 32 cases were analyzed retrospectively, and 36 cases being carried out con-temporaneous Pylous Preserved Pancreaticeduodenectomy(PPPD) were compared with. Results The recovery time of postoperative gastrointestinal function recory time is five days of LPPPD group on average; but the time is eight days of PPPD group on average, and significantly slower than LPPPD group ( t = 3.01, P < 0.05 ) ; the occurrence of abdominal distenal, retention of gastric juice and enterogastric recurrent flow are significantly slower in LPPPD group than that in PPPD group( P < 0.05 ). Conclusion The postoperative gastrointestinal function recovered fas-ter, and the postoperative complications were less in LPPPD group than that in PPPD group.
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Objective To investigate the peripheral blood cytopenias in patients with portal hypertension complicated with splenomegaly. Methods The clinical data of 309 patients with portal hypertension who had been admitted to our department from January 1991 to December 2006 were retrospeetively analyzed. Results Of all patients, 278 showed peripheral blood cytopenia, ineluding 71 with paneytopenia, 48 with leukocyte and platelet decrease, 25 with erythroeyte and platelet decrease, 33 with leukocyte and erythroeyte decrease, 28 with platelet decrease, 26 with leukocyte decrease, and 47 with erythrocyte deerease. The number of blood cells increased significantly after splenectomy ( t=6.53, P<0.01). The whole blood cells of the remaining 31 patients without hematocytopenia were normal. Conclusions Patients with portal hypertension eomplieated with splenomegaly do not always accompany peripheral blood eytopenia. Peripheral blood cytopenia is one of the complications of splenomegaly, hut it dose not always appear. Splenectomy is effective in the treatment of hematocytopenia. The reason for some patients do not have peripheral blood cytopenia may be related to the slight pathological changes of spleen and severe hyperplasia of bone marrow.