[Application effect of pericardial devascularization plus gastric fundus transaction in advanced schistosomiasis].

OBJECTIVE: To discuss the effect of pericardial devascularization plus gastric fundus transaction in advance schistosomiasis patients with portal hypertension. METHODS: Thirty-six advanced schistosomiasis patients with portal hypertension treated with devascularization plus gastric fundus transaction (a portal hypertension group), as well as 10 patients treated with modified Sugiura operation (a modified Sugiura operation group) in the Third People's Hospital of Yangxin County since 2006 were chosen as the observation objects, and the clinical effects of the two groups were observed and compared. RESULTS: The operation time, indwelling time of stomach tube, time to taking food after operation, drainage tube removal time of the portal hypertension group were all shorten than those of the modified Sugiura operation group (all P＜0.05). The hospitalization expenses of the two groups were (25 466.00 ± 2 888.48) Yuan and (34 517.10 ± 4 948.39) Yuan respectively, and the difference was also statistically significant (P＜0.05). The incidence rates of portal thrombosis of the portal hypertension group and modified Sugiura operation group were 33.33% (12/36) and 40.00% (4/10), respectively, and the incidence rates of rehaemorrhagia of the two groups 12 months after the operation were 16.67% (6/36) and 10.00% (1/10), respectively, but the differences had no statistically significance (both P ＞ 0.05). In addition, 1 case with delayed gastric emptying and 1 case with stomal leak of esophagus happened in the modified Sugiura operation group, while no corresponding complications happened in the portal hypertension group. CONCLUSIONS: Pericardial devascularization plus gastric fundus is a relatively easy procedure which has a good short-term clinical effect, and therefore it is suitable for application in primary hospitals. However, its long-term effect still needs further observation.

Significances of gene differential expression patterns in hepatocirrhosis and non-hepatocirrhosis tissues within different ischemic time / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the gene differential expression patterns in hepatocirrhosis and non-hepatocirrhosis tissues within different ischemic time.</p><p><b>METHODS</b>The liver tissues were divided into two groups: Group A (non-hepatocirrhosis), Group B (hepatocirrhosis), each of which consisted of 3 groups with different ischemic time: 15, 30 and 45 minutes. The gene differential expression patterns in the two groups within different ischemic time were detected and compared with those in normal liver tissues by using 4000 points gene microarray.</p><p><b>RESULTS</b>In non-hepatocirrhosis tissues, the homeostatic maintenance genes expressed highly during hepatic ischemia for 15 minutes, and no apoptotic gene was expressed; but in hepatocirrhosis tissues, many apoptotic genes expressed highly. As for 30 minutes, in both two groups liver tissue genes expressed to the peak, and the genes related to cell death, oxidative stress and nuclear factors expressed highly. The difference lies in the facts that in Group B pro-apoptosis genes expressed more than those in Group A, and the Ratio values were higher than those in Group A. Many genes of heat shock protein family and antioxidant proteins expressed highly simultaneously in Group A, but comparatively low in Group B. As for 45 minutes, genes of heat shock proteins and antioxidant proteins expressed lowly in Group B.</p><p><b>CONCLUSIONS</b>It suggests that the safe time limit of hepatic ischemia for cell survive is 30 minutes or so. Non-hepatocirrhosis tissues could endure 30 minutes of ischemia and even longer, but it should be restricted within 30 minutes in hepatocirrhosis tissues.</p>