AIM To investigate the expression of endothelial NO synthase (eNOS), inducible NO synthase (iNOS)protein and eNOS mRNA gene in the splanchnic organs of liver cirrhosis and portal hypertensive rats.METHODS In control and CCl4-induced liver cirrhotic rats, the expression of eNOS and iNOS proteins wasdetected by immunohistochemical method, and eNOS mRNA was detected by in situ hybridization.RESULTS The expression of eNOS protein and eNOS mRNA increased in most organs of the cirrhotic rats,including bronchial and alveolar epithelial cells, renal tubular epithelial cells and mesenchyma, endothelialand adventitial cells of aorta and superior mesenteric artery, whereas no significant increase of iNOS proteinwas found. In the hepatic tissue, NOS protein and eNOS mRNA were present in mesenchymal cells and vesseladventitial cells, no difference was observed in the expression between control and cirrhotic rats.CONCLUSION The expression of NOS varied in region. In splanchnic organs and vasculars there was anincreased expression of eNOS which induced aplanchnic vasodilation and increased the inflow of portal vein,while in the liver tissue and blood vessel showed no increased expression, which may be associated withincreased intrahepatic vascular resistance.

作者： 刊期： 2000年第03期

AIM To treat esophageal stricture secondary to the ingestion of corrosive materials in children using theileocolon with ileocecal valve as a substitute for esophagus.METHODS Between 1992 and 1999, isoperistaltic retrosternal ileocolic esophageal replacements wereperformed in 12 patients; 50 cadavers were studied to observe the vascularity in the ileocolic region andmetabolic indexes were measured before and after surgery or between the operative group and the normalcontrols in 20 piglet models.RESULTS A follow-up of 3 years in the 12 cases found no death in intra- and post- operative periodclinically. Cervical ileoesophageal anastomotic leaks occurred in 2 cases. The distribution pattern of venousvessel in the ileocolic region was far more constant than that of the artery. The arrangements of artery in theileocolic segment were classified into 7 types, and there was no interruption of paracolic anastomosis betweenarteries. The resections of 50 cm terminal ileum, cecum and 50 cm ascending colon affected enterohepaticcirculation of bile acid (bile salt) and the fatty metabolism in early period after surgery in piglet models.Shortening of the time and reducing of the area for water absorption after ileocolic resection resulted indiarrhea in piglet models. The loss of “bacterial barrier” role of ileocecal valve led to bacteria immigrationfrom colon to ileum and small intestinal bacterial overgrowth.CONCLUSION The ileocolic esophageal replacement taking advantage of antireflux role of the ileocecalvalve has obtained satisfactory effect. To understand the characteristics of the patterns of arteries and veinsdistribution and physiological functions of the ileocolic segment is useful in guiding clinical practice andpostoperative management and preventing postoperative complications as well.

作者： 刊期： 2000年第03期

AIM To evluate the curative effect of metal clips combining with microwave in treating large, pedicellatedgastrointestinal polyps by endoscopy.METHODS Ten patients with pedicellated gastrointestinal polyps were treated with metal clips (OlympusMD-850) combining with microwave by endoscopy. Among them, gastric polyps were found in 6 cases (6polyps), colonic polyps in 4 cases(4 polyps), 9 polyps were 1.5 cm - 2 cm in size, the other one was morethan 2 cm, the diameter of pedicel was 1 cm to 1.5 cm. All patients were repeatedly examined withendoscopy to observe the curative effect at 5 to 10 days and one month after treatment.RESULTS All the 10 polyps were eradicated, 2- 4 metal clips were placed in one polyp, the succeedingcurative rate was 100%. No hemorrhage, perforation and other complications occurred.CONCLUSION The curative effect of metal clips combining with microwave in treating large, pedicellatedgastrointestinal polyps by endoscopy is reliable and safe.

作者： 刊期： 2000年第03期

AIM To determine NO, NO synthase (NOS) and NOSmRNA of the esophageal carcinoma cells (SHEEC1)in apoptotic process induced by As2O3 and to explore the relationship between NO and apoptosis.METHODS The apoptosis of the cell line (SHEEC1) was induced by arsenite (As2O3, 5 μmol/L and10 μmol/L). In the process, at 2 h, 4 h, 8 h, 16 h and 24 h after administration of As2O3, NO production incultural medium was detected quantitatively by spectrophotometry; NOS Ⅱ was detected byimmunohistochemistry and NOS mRNA by in situ hybridization (ISH). The cells at endpoint of theexperiment were examined under transmitted electron microscope (TEM) for apoptosis.RESULTS The amount of NO released from SHEEC1 were increased from the basal condition (0.68×10-2μmol/L) up to the high level (2.38×10-2μmol/L) at h 16. The increment of NOS Ⅱ was found afteradministration of As2O3; the intracytoplasmic ISH signals of NOSmRNA in small size was found firstly at4 h, and then became highly predominant. Apoptotic changes of SHEEC1 occurred at 24 h under TEM.CONCLUSION After administration of As2O3, NO released from cultured SHEEC1 cells was detected withincreasing amount up to 16 h. The expression of NOS H and transcription of NOSmRNA are upregulated.The present findings suggest a concept that the NO may be a mediated and effective factor in apoptosisinduced by As2O3,

作者： 刊期： 2000年第03期

AIM To substantiate the therapeutic effects of carbonate buffer mixture on naturally occurringgastrointestinal atony in cattle.METHODS Therapeutic effects of carbonate buffer mixture (Na2CO350 g, NaHCO3420 g, KCI 20 g, NaC1100 g, water 10 L) were observed in 120 cases of gastrointestinal atony including forestomach atony, rumenimpaction, rumen acidosis, omasum impaction and intestinal constipation. Judgement of curative effects ascure: after treated, the cases become clinically normal in general conditions, appetite, rumination, ruminalperistalsis and defecation; uncure: after giving two doses, the gasto-intestinal atony has not been eliminated.RESULTS Average cure rate of carbonate buffer mixture on above-mentioned diseases were 95%, andaverage dose was 1.4±0.5.CONCLUSION Being a new approach for treatment of gastrointestinal atony in ruminants, the carbonatebuffer mixture can eliminate the gastrointestinal atony originated from the over acidity in gastrointestinalcanal.

作者： 刊期： 2000年第03期

AIM Endoscopic ultrasonography (EUS) guided pancreatic pseudocysts drainage is an ideal therapeuticprocedure. We perform it in just one step by using the self-made drainage stent.ETHODS We made an aperture at the tip of the needle outer sheath, and tied the outer sheath with theself-made stent by suture. EUS-guided pancreatic pseudocysts drainage was performed in five patients. Nopatient had visible endosmotic bulge on the gastrointestinal wall. Mean pseudocyst diameter was 4.5 cm(pancreatic head 1, body 2, tail 4). We determined the optimal site for puncture and advanced the needlyand stent into cyst. Taking out the needle made the stent separated from the sheath.RESULTS No hemorrhage happened among these patients. One patient suffering from fever up to 40℃recovered within two days after operation. All the cysts diminished insige after 7 days and resolvedcompletely after 6.8 weeks in average. Cyst resolution was accompanied by symptomatic improvement in allpatients. During a follow-up of 6 months no cyst recurred.CONCLUSION EUS-guided drainage of pseudocysts is a safe and effective procedure, which performs thejust in one process and diminishes the patients' distness.

作者： 刊期： 2000年第03期

AIM To examine hepatitis C in hepatocellular carcinoma in most endemic area, Guangxi, China.METHODS Immunochemistry was performed on formalin fixed, paraffin embedded tissue sections. A total202 specimens were analysed from the high, intermediate and low HCC prevalent regions of Guangxi.RESULTS The distribution of positive hepatitis C cases from high, intermediate and low regions wasrespectively 24/63 (38%), 23/62 (37%) and 30/77 (39%), with a total of 77/202 (38.12%).CONCLUSION Hepatitis C virus is an important risk factor in the development of hepatocellularcarcinoma, but the regional difference in prevalence of this cancer is more likely influenced by hepatitis Bviral infection and aflatoxin B1 exposure. In Guangxi, infection of hepatitis B and C virus in thedevelopment of hepatocellular carcinoma may be greatly enhanced by exposure to aflatoxin.

作者： 刊期： 2000年第03期

AIM To study the effects of ATRA on experimental liver metastasis of gastric cancer cells.METHODS MGc80-3 and SGC-7901 cells were injectied into spleen subcapsule of nude mice, who weresubsequently administrated with ATRA every other day. Food-intake and body weight of mice were measuredweekly. After six weeks, the nude mice were executed, tumors in spleen and liver were examinedpathologically, microtumor vessel density (MVD) was accounted by immunohistochemical method and serumCEA was measured by radioimmunoassay.RESULTS Nude mice administrated with ATRA, the growth of spleen tumor and its metastatic ability toliver were inhibited, the metastatic rate was decreased by 33.3% (MGc80-3) and 50.0% (SGC-7901). SpleenMVD and liver MVD were reduced by 28.6% and 22.9% (MGc80-3), 23.7% and 37.6% (SGC-7901),respectively. The serum CEA was lowered by 43.4% (MGc80-3).CONCLUSION ATRA can effectively inhibit the experimental liver metastasis of gastric cancer cells,which is relavant with the decrease of MVD and CEA.

作者： 刊期： 2000年第03期

AIM To search for a new surgical method which accords with physiologico-anatomical principles, reducethe incidence rate of some postoperative complications in conventional Billroth I (CB1) gastrectomy andraise the life quality of patients after surgery.METHODS Using the blood vessels and innervation of the remaining stomach and duodenum, we designeda new pyloric sphincter reconstruction (PSR) in Billroth I gastrectomy, in which the end of the duodenumremnant is surrounded by the seromuscular valve of 2 cm wide in the end of the greater curvature, thickenedthe muscle of the stoma and reconstructed a similar pylorus with the sphincteric function.RESULTS Eleven patients were treated, 8 males and 3 females, 6 malignant and 5 benign and 1accompanied by mould infection, aged from 33 to 73 years, with 1 to 29 years of gastric disease history(average 7.9 years). The function of gastric emptying was shown to be essentially normal by barium mealstudy with video record one month after the operation. The pyloric-like control effect was present in thereconstructive pylorus. PSR vs CB1 vs NES (P >0.01); PSR vs CB1 (P < 0.01); PSR vs NSE (P >0.05).CONCLUSION The new method of pyloric reconstruction is safer, simpler and more effective thanconventional procedures. This method can be applied to all patients for whom Billroth 1 anastomosis can beperformed regardless of benign or malignant lesion.

作者： 刊期： 2000年第03期

AIM To observe the clinical effect of self-made Jinhuang Pingan Decoction (JHPAD) in treating intestinaladhesion.METHODS Among 580 cases of intestinal adhesion, 492 cases were treated with oral JHPAD alone; 88cases with incomplete intestinal obstruction were treated by gastrointestinal decompression, then givingconcentrated JHPAD through the GI tube as well as fluid replacement and anti-inflammation therapy.RESULTS Among 580 cases, 302 cases were cured, 232 cases, improved and 46 cases had no change, thetotal effective rate was 92.1%. In 492 patients treated with JHPAD alone, 264 cases had obvious effect, 202cases were improved and 26 cases had no effect, the total effective rate was 94.7%, and the corresponingresults in 88 cases treated with JHPAD and gastrointestinal decompression were 39 cases, 29 cases, 20 casesand 77.3% respectively. In addition, there was close relationship between the therapeutic efficacy anddisease course, and had significant statistical difference in therapeutic efficacy with the disease course of lessthan 30 d or over 12 m (x2=87.32, P<0.0001).CONCLUSION JHPAD has the effect of clearing heat, detoxication, anti-inflammation, relieving edema,analgesia, hemostasis and anti-adhesion in the treatment of intestinal adhesion. It has a satisfactory efficacyand no toxic reaction, so it is worthy to popularize in clinical practice.

作者： 刊期： 2000年第03期

AIM To clarify the surgical strategy for patients with stage Ⅳa primary hepatic carcinoma (PHC).METHODS Twenty-seven patients with stage Ⅳ a PHC were retrospectively studied in 1989 - 1998,including resected group (19 cases) whose all tumor nodes were resected and cytoreductive group (8 cases)whose most tumor nodules were resected and remnant nodules treated by ethanol injection. B-ultrosoundshould be used intraoperation in order to prevent from missing any tumor nodule. All the tumor nodules inthe liver should be removed, and residual nodules should be treated by ethanol injection during operation ifall the tumor nodules can not be removed. Multidisciphinary therapies were undertaken perioperatively.RESULTS The 1-, 2- and 3-year survival rates were 71.4%, 55.6% and 7.7% respectively. The 1-, 2- and3-year survival rates of the resected and cytoreductive groups were 73.3%, 53.3%, 10.0% and 66.7%,50.0%, 0% (P>0.05) respectively. The rate of complications was 22.0%, without operative and in-hospital mortality.CONCLUSION The surgical treatment included resected or cytoreductive operation plus supplementarytherapy considered to be both useful and the first choise for stage Ⅳa PHC.

作者： 刊期： 2000年第03期

AIM To study the safety and the traumatic degree of D4 approach by retrospective analysis of the para-operative data from the para-aortic lymph nodes excision in comparison with those from standard radicalresection in advanced gastric cancer (AGC).METHODS Several para-operative data including the resectability, the mortality, the complicatedmorbidity, the amount of transfused blood, and the hospitalized days relating to the operation were analyzedstatistically between D4(n = 30) and D2 lymph nodes excision (n = 34) groups. The data expressed as means±SD was analyzed statistically by Student t test. Percentage of the data was analyzed by x2 test statistically.It was taken as significant difference if P value was less than 0.05.RESULTS The percentage of palliated resection in D4 group was significantly lower than that in D2 group(16.67% vs 47.06%, P<0.05). This D4 radical resection would indeed prolong the drainage time (7.35±0.98 days vs 14.78±2.16 days, P < 0.01). The amount of transfused blood during operation (774.32±112.09mL) and the operative consuming time in D4 group (7.14±0.39h) increased significantly toocompared with those in D2 group (538.67±59.87mL, P < 0.05; 4.12±0.18h, P < 0.05), suggesting that thedraumatic degree of D4 operation was severer than that of D2 operation. But the mortality, the morbidity ofcomplication and the hospitalized time after D4 operation did not increase significantly, indicating that D4lymph nodes excision as a choice of the surgical treatment of AGC was safe and feasible.CONCLUSION D4 lymph nodes excision for AGC is safe, reasonable and feasible.

作者： 刊期： 2000年第03期

AIM To study the comprehensive prevention and treatment of gastric cancer among high-risk population inthe high risk areas.METHODS A gastrocarcinoma mass screening was performed in 16 villages of Zhuanghe region. About50 000 population were involved and 3033 cases aged above 35 suffering from gastric diseases, and/or hadfamily history of gastric cancer were screened. Clinical epidemiological investigation, double-contrast X-ray,serum pepsinogen monitor, gastroscopic biopsies and histopathologic examinations were adopted in thescreening.RESULTS The ratio of the examined patients with gastric disorder reached up to 82% and 32 patients withgastric cancer were detected (1.06%) and 18 cases were early gastric cancer (56.25%). Patients with gastriccancer were treated successively. Aside from gastric cancer, several gastric lesions were also detected, whichlaid a good foundation for further interventional treatment. It was also found in the examination that93.97% of the local residents were addicted to salted pork and more than 60% of the residents had Hpinfection.CONCLUSION Gastric diseases, Hp infection of gastric mucosa and eating salted pork are very common inZhuanghe region. These are very dangerous factors causing gastric cancer. It is feasible to quit eating saltedpork and eradicate Hp infection and cure precancerous diseases.

作者： 刊期： 2000年第03期

AIM To search for a simple and safe method to avoid reoperation, reduce complications and mortality,shorten hospital stay and lower the medical cost.METHODS Based on the characteristic of pathology and anatomy of biliary fistula and pancreatic fistula,modified endoscopic nasobiliary drainage or endoscopic nasopancreas drainage with negative pressure wereused to drain the bile and pancreatic juice to the duodenum and in vitro to facilitate fistulous tract close.RESULTS In seven patients with biliary fistulas with conservative treatment who were not yet recoveredafter 6 - 110 days, the leakage was blocked after 6 - 17 days treatment, and in 6 patients with pancreaticfistulas with conservative treatment who were not recovered after 90 - 720 days, the leakage was blockedafter treatment for 12- 28 days.CONCLUSION The advantages of this modefied method are: retain the function of the Oddi sphincter; the anatomy of the pancreatic duct and bile duct and the position of fistulas can be seen clearly withcontrast examination; the drainage effect was defieate, safe and with less complications; the leakageblock can be promoted with the drainage of negative pressure; and hospital stay is shortened and medicalcost is reduced.

作者： 刊期： 2000年第03期

AIM To study the development of D (somatostatin-secreting) and P (bombesin-secreting) cells ofproventriculus from Shao ducks at different ages.METHODS Ninety Shao ducks were divided into nine groups, 10 ducks per group. The ducks were slayedgroupby group at the nine time points of week 0 (after hatching), 1, 2, 4, 6, 10, 14, 18 and 22.Proventriculus samples from each duck were collected, fixed by Bouin solution and embedded with paraffin.gections were made and stained with an avidin-biotin-peroxidase complex kit (Dako Co., Ltd. ) to visualizeD and P cells of each proventriculus. Thirty glandular lobes per duck were observed for enumeration of Dand P cells.RESULTS ① Both D and P cells were mostly oval or polygonal shape with dumpy cytoplasmic processesand located in the inner and central area of the glandular lobe. ② The D and P cells peaked at wk 18 and 6respectively. ③ There was no apparent correlation between D cells and the body weight until wk 4. Negativecorrelation was observed from wk 6 and reached a marked level at 18wk (r = -0.829, P<0.05).Individuals with maximum body weight had less D cells than those with minimum body weight from wk 10-wk 18.CONCLUSION The morphology and distribution of D and P cells in the proventriculus of Shao ducks weresimilar to Peking ducks, gooses and chickens. Both D and P cells had continuing development during thepostnatal period, though the rates of their development were different. If appeared that beyond a definitenumber of D cells, they were negatively correlated with the body weight.

作者： 刊期： 2000年第03期

AIM To investigate DNA methylation status in gastric cancer and its relationship with folate metabolism.METHODS Serum before operation, the gastric mucosa from the lesion, and the surrounding area inpatients with gastric cancer and the remote normal-appearing mucosa of the resected stomach were collectedrespectively. The serum folate, mucosal tissue folate, S-adenosylmethionine ( SAM ), S-adenosylhomocysteine (SAH), and the DNA methylation levels were determined.RESULTS The tissue folate was significantly lower than that in ulcers, especially in the surrounding andnormal mucosa (0.38±0.13, 0.50±0.17 vs 0.53±0.50, 0.79±0.82ng/mg protein, P < 0.01), and itdecreased gradually in the lesion areas. The DNA methylation status showed similar decreasing trend incancers compared with the methylation increasing trend in ulcers. The SAM level ascended in the lesion areaswith a higher. concentration in cancer mueosa (63.5±43.0 vs 25.9±11.9nmol/g tissue, P < 0.01 ). Theaccumulation of SAH in the surrounding and normal mucosa of cancers was observed (17.3±24.6, 15.5±8.6vs 14.6±4.2, 10.0±1.9nmol/g tissue, P < 0.05 - 0.01). There were significantly negative correlationsbetween tissue folate and the SAM and SAH levels in the three areas.CONCLUSION Patients with gastric cancer have the regional folate deficiency in the stomach mucosa,although the serum folate level remains normal. This disturbs the local SAM and SAH metabolism withaccumulation of SAH and DNA hypomethylation which has been known as an important molecularmechanism for carcinogenesis. Folic acid can modulate DNA methylation status by its effect in one-carbongroup metabolism and thus affect the process of the carcinogenesis. Therefore, this may be an access for theprevention of gastric cancer.

作者： 刊期： 2000年第03期

AIM To probe into the effect of abnormal protection on coronary artery disease (CAD) in patients withliver cirrhosis (LC).METHODS Fifty-two cases of LC associated with diabetes mellitus (DM) and 63 cases of simple DM werecompared prospectively. Blood biochemistry, blood viscosity and ECG were examined carefully every threemonths, and the three-year morbidities CAD in both groups were monitored dynamically.RESULTS There were significant decreases in blood biochemistry and viscosity in LC group as comparedwith those in control (P<0.05 or 0.01), and there was a more significant decrease in ST-T abnormality ratein LC group than in the simple DM group (P<0.05). As a result, the three-year morbidity of CAD in LCgroup was 64% lower than in the control 1group.CONCLUSION There is truly an abnormal protection against CAD in patients with LC.

作者： 刊期： 2000年第03期

AIM To investigate the protective effects and mechanism of Diltiazem (Dil) on liver, pancreas and smallintestine in hemorrhagic-shock canine.METHODS The canines were bled to a mean arterial pressure (MAP) of 5.33kPa-6.67kPa for 30min toestablish the shock model. During the shock state, the dogs received either water-soluble calcium blocker Dilor saline solution. The MAP was kept at this level for 90min, then the total blood which was bled previouslywas reperfused. The total observation time of the experiment was 240min.RESULTS Dil could significantly increase MAP from 150min to 240min (P<0.01) and the activity ofsuperoxide dismutase (SOD) of pancreas tissue (P<0.01), and it could also decrease the content ofmalondialdehyde (MDA) in liver, pancreas and small intestine tissues (P< 0.01) and the activity of SOD ofthe liver and small intestinal tissues (P<0.01) in the canines. Electron microscopic data indicated that theultrastructures of liver, pancreas and small intestine tissues were normal in Dil group.CONCLUSION Dil can protect the structure and function of the liver, pancreas and small intestinal inhemorrhagic-shock canine.

作者： 刊期： 2000年第03期

AIM To investigate the effects of low dosage of nitric oxide synthesis (NOS) inhibitor NG-nitro-L-argininemethyl ester (L-NAME) in long-term treatment on hyperdynamic circulatory state in rats with cirrhosis.METHODS Cirrhosis model was induced in male SD rats by injection of 60% CC14 oily solutionsubcutaneously. Cirrhotic rats were treated with L-NAME (0.5 mg·kg-1·d-1) by gavage for two weeks. Meanarterial pressure (MAP), cardiac output (CO), cardiac index (CI), splanchnic vascular resistance (SVR),splanchnic blood flow (SBF) and serum NO levels were determinded in L-NAME-treated, L-NAME-untreated cirrhotic rats and controls by using 57Co-Labled microsphere technique and a fluorometric assay,respectively.RESULTS Untreated cirrhotic rats had significantly lower MAP, SVR and higher PP, CO, CI, SBF andNO concentration than controls ( 14.42±0,47 kPa vs 17.05±0.34 kPa, 2.974±0.186 kPa·mL-1·min-1 vs4.234±0.118 kPa·mL-1·min-1, 1.665±0.067 kPa vs 1.123±0.096 kPa, 189.99±9.26 mL/min vs 135.5±3.55 mL/min, 55.89±1.82 mL-1·min-1·100g-1 BW vs 39.68±1.64 mL-1·min-1·100g-1 BW, 4.60±1.25μmol/L vs 0.53±0.26 μmol/L, P<0.01, respectively). In treated cirrhotic rats, L-NAME significantlyattenuated the increase of CO, CI, SBF, NO concentration and the decrease of MAP and SVR. In treatedcirrhotic rats, L-NAME induced a marked decrement of NO concentration than untreated cirrhotic rats(1.471 ±0.907 μmol/L vs 4.204±1.253 μmol/L, P<0.01).CONCLUSION The endogenous NO may play an important role in the changes of hemodynamics pattern incirrhosis,and hyperdynamic circulatory state in rats with cirrhosis can be ameliorated by long-term low doseL-NAME treatment.

作者： 刊期： 2000年第03期

AIM To summarize the experience of surgical treatment of hilar cholangiocarcinoma and the results of aseries of experiments.METHODS AND RESULTS Personal perspectives of surgical treatment of hilar cholangiocarcinoma werebased on the experience of a series of patients with hilar bile duct cancer treated in the General Hospital ofPLA, Beijing from 1986 to 1999. A total of 157 cases were treated surgically, with 106 (67.5%) resections ofthe tumor , 37.6% of the resections was proved to be radical. The 1-, 2-, 3-, and 5-year survival rate of theradical resection group was 96.7%, 40.0%, 23.3% and 13.3%, respectively. No patient of the palliativeresection group lived beyond 3 years postoperatively. The recent trends of surgical management of hilar bileduct cancer were discussed. Experiments were carried out for cooperative clinicopathological study toevaluate the perineural space involvement, the neural cell adhesion molecule expression, p16 geneexpression, and the 3-dimensional reconstruction of the bile duct cancer specimens. The pathogeneticrelationship of HBV and HCV with extrahepatic cholangiocarcinoma was evaluated by histochemical and IS-PCR methods. And an inquiry into the possibility of gene therapy was made.CONCLUSION Hilar bile duct cancer rarely runs a “benign” course. It is a regional disease rather than alocal affection and may be related to HBV and HCV infection in China. It possesses the metastasing abilityalong the perineural space by a “jumping” fashion, therefore, in most cases, conventional surgical excision isbound to be unradical in the region of the porta hepatis for anatomical reasons.

作者： 刊期： 2000年第03期