《内经》形脏神脏“器”的概念相互关系及解剖结构

目的:形脏、神脏、"器"的概念和解剖。方法:研究《内经》中三者的概念及它们之间的关系,对比体内类似"器"的解剖结构。结论:形脏(四),就是指心、肺、肝、肾四脏的实体;《内经》里有一个被命名为"器"的人体解剖的概念,其结构就是以经肝门静脉回流静脉血的器官为主体,合并尿液的排出通道而构成的器官组合体。在四形脏和"器"内,各存在着一个由毛细血管网组成的微观结构,这种结构就是神脏(五)。据此认为,《内经》对脏腑,在实体认识的基础上,还存在一个基于微循环的微观认识:神脏(腑)。

形一神

最早的中国绘画是不是就提出了不取形似?我想在千余年的中国画的进展和流变中,我们的古代先辈最早一定还是把形放在一个比较重要的地位的,不取形似应该是后来人提出的。我想一开始他们还是会相当重视形的描写,只不过这个"形"和我们今天所理解的"形"是有差别的。中国古代绘画,和西方绘画的展开从一开始就是分歧的,中国的绘画方式最早就是以线条来描写事物,以线状物。比如说它勾勒肖像。

父亲的孔雀石

每次回到家,院子里那片绿色的平滩都会不经意地从眼前闪过。不管工作多繁忙,时间多紧张,我都想在那停留一会儿。这个时候.父亲那温暖慈祥的音容总能在脑海中浮现……我的家乡在青海省都兰县一个名叫宗加的小村子,爷爷奶奶都是河南来的下乡知青。爷爷是村子里的警察,奶奶是队里的生产队长。父亲就出生在这样一个在当时令人羡慕的家庭里,可父亲连小学都没读完,放羊、放牛、种地、除草成了他少年生活的全部。虽然向往外面的世界。

医案聊斋续篇 发热案

师兄：古代《当家诗》云：＂想你当家不当家,及至当家乱如麻。早起开门七件事,柴米油盐酱醋茶。＂师弟：其实是两件事——能源及利用能源加工的食品。师兄：由此可见柴之重要,七件事占其一半。古代农村人多自砍自烧,城里人到柴行买着烧。师弟：这柴行就相当于现代之煤厂、煤气公司之类。师兄：

Prenatal diagnosis of congenital fetal heart abnormalities and clinical analysis

Objective: To study the value of detecting fetal congenital heart disease (CHD) using the five transverse planes technique of fetal echocardiography. Methods: Nine hundred and eighty-two high-risk pregnancies for fetal CHD were included in this study, the fetal heart was scanned with the five transverse planes technique of fetal echocardiography described by Yagel, autopsy was conducted when pregnancy was terminated. Blood from fetal heart was collected for fetal chromosome analysis. A close follow-up was given for normal fetal heart pregnancies and neonatal echocardiography was performed to check the accuracy of prenatal diagnosis. Results: (1) Forty-six cases (4.68%) were found to have fetal heart abnormalities in this study, 69.56% of them were diagnosed by single four-chamber view, another 30.43% fetal CHD were found by combining other views; (2) Forty-one parents of prenatal fetuses with CHD chose to terminate pregnancy, thirty-two of them gave consent to conduct autopsy, 93.75% of which yielded unanimous conclusion between prenatal fetal echocardiography and autopsy; (3) Thirty-two of 46 cases underwent fetal chromosome analysis, 8 cases (25%) were found to have abnormal chromosome; (4) Five cases were found to have right ventricle and atrium a little bigger than those on the left side, with the unequal condition being the same after birth, but there were no clinical manifestations and they are healthy for the time being; (5) Nine hundred and thirty-six cases were not found with abnormality in this study, but one case was diagnosed with ventricular septal defect after birth, one case was diagnosed with patent ductus arteriosus, one case had atrial septal defect after birth. Conclusions: (1) The detected CHD rate was 4.68% by screening fetal heart with five transverse planes according to Yagel’s description of high risk population basis for CHD. The coinciding rate of prenatal diagnosis and autopsy was 93.75%; (2) The sensitivity of detecting fetal heart abnormality is 92%, the specificity is 99.6% using the five transverse planes technique of fetal echocardiography; (3) Fetuses with mild or moderate disproportion of right and left side in the heart are potentially healthy babies.

Congenital left ventricular aneurysms and diverticula： an entity in search of an identity

Congenital left ventricular aneurysm or diverticulum are rare cardiac malformations described in 809 cases since the first description in 1816, being associated with other cardiac, vascular or thoraco-abdominal abnormalities in about 70%. It appears to be a developmental anomaly, starting in the 4th embryonic week. In an experimental study, targeted knockdown of cardiac troponin T in the chick was performed at day 3, after the heart tube has formed. Morpholino treatment of gene TNNT2 at this stage led to the development of left ventricular diver- ticula （LVD） in the primitive left ventricular wall. Diagnosis of left ventricular aneurysms （LVA）/LVD can be made after exclusion of coro- nary artery disease, local or systemic inflammation or traumatic causes as well as cardiomyopathies. Clinically, most of LVA and LVD are asymptomatic or may cause systemic embolization, congestive heart failure, valvular regurgitation, ventricular wall rupture, ventricular tachycardia or sudden cardiac death. Diagnosis is established by imaging studies （echocardiography, magnetic resonance imaging or left ventricular angiography） visualizing the structural changes and accompanying abnormalities. Mode of treatment has to be individually tai- lored and depends on clinical presentation, accompanying abnormalities and possible complications, options include surgical resection （espe- cially in symptomatic patients）, anticoagulation after systemic embolization, radiofrequency ablation or implantation of an implantable car- dioverter defibrillator （ICD） in case of symptomatic ventricular tachycardias, and occasionally combined with class I- or III-antiarrhythmic drugs. Cardiac death occurs usually in childhood, is significantly more frequent in LVA patients and caused by congestive heart failure in most of the cases, whereas patients diagnosed with LVD died more frequently from rupture of the LVD.

Effects of interleukin-10 on activation and apoptosis of hepatic stellate cells in fibrotic rat liver

AIM： TO study the effects of interleukin-10 （IL-10） on the expression of o-smooth muscle actin （α-SMA）, nuclear factor-κB（NF-κB） and Fas/Fas ligand （FasL） in hepatic stellate cells of experimental rats with hepatic fibrosis. METHODS： Sixty clean SD rats were randomly divided into control group （group N）, liver fibrotic group （group C） and IL-10 treatment group （group I）. Control group received intraperitoneal injection of saline （2ml·kg^-1）, twice a week. Fibrotic group was injected intraperitoneally with 50% carbon tetrachloride （CCh） （2 ml·kg^-1）, twice a week. IL-10 treatment group was given IL-10 at a dose of 4 pg·kg^-1 20 minutes before CCl4 administration from the third week. Hepatic stellate cells （HSCs） were isolated from these rats at the seventh and eleventh weeks during the course of liver fibrosis, respectively. The expression of α-SMA and NF-κB in HSCs was measured by S-P immunohistochemistry. The expression of Fas and FasL mRNA was measured by RT-PCR. Furthermore, liver tissues were harvested from three groups at the same time. RESULTS： The CCh- induced experimental rat hepatic fibrosis model was established successfully. The purity of extracted hepatic stellate cells was about 95% and the yield of hepatic stellate cells was 1.2-2.3×10^6/g liver tissue averagely. The positive expression of α-SMA and NF-κB was 36.5% and 28.5% respectively in group N. The positive levels of α-SMA and NF-κB were increased significantly in group C compared to group N （P〈0.01）. The positive signals decreased significantly （P〈0.05） in group I. In the 11^th week, the HSCs of group I became round with visible pyknotic nuclei. The expression of NF-κB in group C was significantly increased in a timedependentmanner （P〈0.01）, but there was no difference in the α-SMA expression （P〉0.05）. The mRNA of Fas and FasL in group C was significantly increased in a timedependent manner compared to that in control group. After treated with IL-10, the expression level of Fas and FasL was higher in group I than in group C. CONCLUSION： The positive expression of α-SMA and NF-κB in hepatic stellate cells is decreased by ectogenic IL-10 in liver fibrosis induced by CCh. The expression of Fas and FasL is increased in the course of liver fibrosis, and is further increased by IL-10. IL-10 could inhibit the activation of HSCs and cause apoptosis of activated HSCs.

Effects of pharmacological serum from normal and liver fibrotic rats on HSCs

AIM: To make drug sera of Salvia miltiorrhiza and Yigankang, both of which are Chinese herbs that activate bleeding and eliminate stasis, in normal rats and those with liver fibrosis, respectively. To investigate and compare the effects of the two different drug sera on the proliferation and activation of hepatic stellate cells (HSCs). METHODS: Some rats were induced with liver fibrosis: 40% carbon tetrachloride (CCI4) subcutaneous injection, twice a week for 9 wk. Salvia miltiorrhiza, Yigankang, colchicines and normal saline were administered into the stomachs of normal rats and those with liver fibrosis. Drug sera were extracted 5 d later. HSCs in vitro were cultivated in different drug sera for 24 h. The rates of proliferation and expression of a-smooth muscle actin (α-SMA) were detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and immunocyt-ochemistry stain, respectively. RESULTS: The drug sera from normal and liver fibrotic rats could be used to cultivate HSCs and to observe the effects of the corresponding components of herbs on HSCs. Salvia miltiorrhiza and Yigankang had better inhibitory effects on HSCs than colchicines (MTT: normal drug serum: Salvia miltiorrhiza 0.42 ±0.08, Yigankang 0.32±0.10 vs colchicines 0.45±0.12 pathological drug serum: Salvia miltiorrhiza 0.33±0.02, Yigankang 0.26±0.01 vs colchicines 0.41±0.09. P<0.05). The drug sera of Salvia miltiorrhiza, Yigankang from liver fibrotic rats had a stronger inhibitory effect than the same ones from normal rats (MTT: Salvia miltiorrhiza: normal drug serum 0.42±0.08 vs pathological drug serum 0.33±0.02. Yigankang: normal drug serum 0.32±0.10 vs pathological drug serum 0.26±0.01. P<0.05) CONCLUSION: Salvia miltiorrhiza and Yigankang could inhibit the expression of a-SMA and the proliferation of HSCs. The drug sera from normal and liver fibrotic rats had different effects on HSCs, probably due to different metabolic processes, effective components and different quantities of drug contents in drug sera from rats with different states of liver.

Effects of adrenomedullin gene overexpression on biological behavior of hepatic stellate cells

AIM: To investigate the effects of adrenomedullin (AM) gene overexpression on the biological characteristics of human hepatic stellate cells (hHSCs) by stable transfection.METHODS: hHSCs which express low basal levels of AM were stably transfected with an expression construct containing rat AM gene or with an empty expression vector. Expression of AM in hHSCs was determined by reverse transcription (RT)-polymerase chain reaction (PCR) and radioimmunoassay (RIA). Cell proliferation was evaluated by 5-bromo-2'-deoxyuridine (BrdU) incorporation and immunocytochemistry. RT-PCR and Western blot were used to test the expression of procollagen types Ⅰ and Ⅲ. Protein expressions of interstitial collagenase (MMP-1), gelatinase (MMP-2) and tissue inhibitors of matrix metalloproteinases-2 (TIMP-2) were assessed by Western blot.RESULTS: Two cell clones (A-2, A-8) transfected withthe AM gene expressed higher levels of AM mRNA (nontransfected group: 0.86±0.11, empty vector group: 1.01±0.11, A-2 clone group: 1.44±0.08 and A-8 clone group: 1.36±0.05) and protein (12.31±0.17, 12.35±0.12,12.56±0.06 and 12.62±0.07) (P＜0.05). AM geneoverexpression had inhibitory effects on cell proliferation of hHSCs (29.6%, 30.9%, 18.9% and 21.8%, respectively. P＜0.05) and expression of procollagen type Ⅰ (0.58±0.1,0.48±0.11, 0.3±0.06 and 0.31±0.07 at mRNA level)(0.27±0.07, 0.3±0.06, 0.14±0.05 and 0.13±0.05 at protein level) (P＜0.05) and procollagen type Ⅲ (0.17±0.04, 0.15±0.03, 0.1±0.02 and 0.09±0.02 at mRNA level) (0.22±0.04, 0.2±0.03, 0.11±0.04 and 0.13±0.03 at protein level) (P＜0.05). Compared with cells non-transfected (TIMp2: 2.77±0.03, MMP-2: 0.5±0.04, MMP-1: 0.49±0.07) and transfected with empty vector (TIMP2: 2.79±0.04,MMP-2: 0.48±0.03, MMP-1: 0.45±0.09), these two clones had lower expression levels of TIMP2(A-2 clone group: 2.7±0.02 and A-8 clone group: 2.71±0.02) (P＜0.05) and MMP-2(A-2 clone group: 0.15±0.05 and A-8 clone group: 0.13±0.04) (P＜0.05) but displayed a higher expression level of MMP-1(A-2 clone group: 0.68±0.06 and A-8 clone group: 0.81±0.09) (P＜0.05).CONCLUSION: AM gene exerts negative influence to some extent on hHSCs by inhibiting proliferation and production of extracellular matrix (ECM) in addition to inducing MMP-1 expression.

Longitudinal Mechanical Properties of Small-Diameter Polyurethane Vascular Graft Reinforced by Tubular Knitted Fabric

The vascular graft with 4 mm diameter was prepared by casting one layer of polyurethane (PU) film onto the knitting tubular fabric as the reinforced support. The effects of different PU content and wall thickness on the longitudinal mechanical properties of vascular graft were investigated. The breaking elongation, breaking force, initial modulus and breaking work were studied. The results showed that the longitudinal mechanical properties of vascular graft were enhanced as the content of polyurethane increased, which resulted from the combination of PU excellent elasticity and fabric preferable strength.

Construction of a hepatic stellate cells subtracted cDNA library of differentially expressed genes in normal mice and mice with Schistosomiasis japonica

To construct a hepatic stellate cells (HSCs) subtracted cDNA library to find differentially expressed genes in normal mice and mice infected with Schistosoma japonicum (S. japonicum). Suppression subtractive hybridization (SSH) was used. The cDNA fragments of normal mouse were compared to those of schistosoma-infected mice to find differentially expressed genes. Then differentially expressed cDNA fragments were directly inserted into T/A cloning vector to set up the subtractive library. Amplification of the library was carried out with transformation of DH5α. The amplified library contained more than 400 positive bacterial clones, which were then hybridized with forward and backward subtracted probes for differential screening. One hundred positive bacterial clones were randomly selected for sequencing and BLAST analysis. Finally, virtual Northern Blot confirmed such differential expression. The subtracted cDNA library of differentially expressed genes of HSCs was constructed successfully, the library is efficient and lays foundation for screening and cloning new and specific genes of schistosomiasis.

Risk factors of thrombosis in abdominal veins

AIM: To estimate the prevalence of inherited and acquired thrombophilic risk factors in patients with abdominal venous thrombosis and to compare the risk factor profiles between Budd-Chiari syndromes (BCS) and splanchnic vein thrombosis (SVT). METHODS: In this retrospective study, 36 patients with abdominal venous thrombosis were studied. The patients were divided into Budd-Chiari group (hepatic vein, IVC thrombosis) and splanchnic venous thrombosis group (portal, splenic, superior mesenteric veins) based on the veins involved. Hereditary and acquired thrombophilic risk factors were evaluated in all patients. RESULTS: Twenty patients had SVT, 14 had BCS, and 2 had mixed venous thrombosis. Ten patients (28%) had hereditary and 10 patients (28%) acquired thrombophilic risk factors. The acquired risk factors were significantly more common in the SVT group (SVT vs BCS: 45% vs 7%, χ2 = 5.7, P = 0.02) while hereditary risk factors did not show significant differences between the two groups (SVT vs BCS: 25% vs 36%, χ2 = 0.46, P = 0.7). Multiple risk factors were present in one (7%) patient with BCS and in 3 patients (15%) with SVT. No risk factors were identified in 57% of patients with BCS and in 45% of patients with SVT. CONCLUSION: Hereditary and acquired risk factors play an important role in the etiopathogenesis of abdominal venous thrombosis. Acquired risk factorsare significantly more common in SVT patients while hereditary factors are similar in both groups.

PULMONARY BLOOD DISTRIBUTION AFTER TOTAL CAVOPULMONARY CONNECTION OF DIFFERENT TYPES

Objective.To assess the feature of pulmonary blood flow distribution after total cavopulmonary connection(TCPC)of different types,and to provide the selection of the best type.Methods. Thirty-two consecutive survival patients after TCPC underwent radionuclide lung perfusion imaging. According to the radionuclide counts in the left and right lungs,analyses of the distribution of blood flow from superior venous cava(SVC) and inferior venous cava(IVC)and the whole pulmonary blood flow in both lungs were made. All patients were divided into 4 groups by the the anastomosis between IVC and pulmonary artery.Results. GroupⅠ:The flow ratio of the IVC to left lung was greater than that to the right lung,P≤0.01;the flow ratio of the SVC to right lung was greater than that to the left lung,P≤0.01;and the whole pulmonary blood flow went dominantly to the left lung,P≤0.05,which is not in line with physiological distribution. GroupⅡ:the flows from the SVC and IVC were mixed in the middle of the junction and ran evenly into the right and left lungs,the whole pulmonary blood flow went to both lungs,P≥0.05. Group Ⅲ:the flow ratio of the SVC to both lungs were the same,P≥0.05,and major part from IVC went to the right lung,P≤0.01;the pulmonary blood flow go dominantly to the right lung,P≤0.05,which is in accord with physiological distribution. Group Ⅳ:the flows from the right SVC went to right lung by 100%,P≤0.01,and that from the left SVC went to left lung by 100% too,P≤0.01;the flows from IVC went dominantly to the left lung,with little part to the right lung ,P≤0.05.Conclusions. Different types of TCPC can result in different pulmonary blood distributions. The best flow distribution between the left and right lungs can be obtained by an offset of the IVC anastomosis toward the RPA with widening anastomosis for the patients without persist left superior venous cava(PLSVC).

RELATIONSHIP BETWEEN SOMATOSTATIN RECEPTORS AND ACTIVATION OF HEPATIC STELLATE CELL

Objective To investigate the relationship between expression of somatostatin receptors(SSTRs) and activation of rat hepatic stellate cell (HSC). Methods HSCs were isolated from rats by in situ perfusion and single-step density gradient centrifugation, and then SSTR1-5 mRNA levels in the differentiated first passage HSCs were detected by means of reverse transcription polymerase chain reaction. On the other hand, hepatic fibrosis was induced in adult male Sprague-Dawley rats by carbon tetrachloride intoxication, and the expression of SSTR1-5 in normal as well as fibrotic liver was measured by immunohistochemical staining. Results SSTR mR-NA and SSTR could not be found in freshly isolated rat HSCs and normal rat liver. But SSTR1-3 mRNA appeared as HSCs became wholly activated, and SSTR1-3 could also be identified on the membrane of activated HSCs in the peri-sinusoid space, fibrous septa, etc. Conclusion The expression of SSTR1-3 in the rat HSC is closely related to its activation. This may reflect one of the main negative regulation mechanisms in the course of HSC activation.

Multi-modality liver image registration based on multilevel B-splines free-form deformation and L-BFGS optimal algorithm

A new coarse-to-fine strategy was proposed for nonrigid registration of computed tomography(CT) and magnetic resonance(MR) images of a liver.This hierarchical framework consisted of an affine transformation and a B-splines free-form deformation(FFD).The affine transformation performed a rough registration targeting the mismatch between the CT and MR images.The B-splines FFD transformation performed a finer registration by correcting local motion deformation.In the registration algorithm,the normalized mutual information(NMI) was used as similarity measure,and the limited memory Broyden-Fletcher- Goldfarb-Shannon(L-BFGS) optimization method was applied for optimization process.The algorithm was applied to the fully automated registration of liver CT and MR images in three subjects.The results demonstrate that the proposed method not only significantly improves the registration accuracy but also reduces the running time,which is effective and efficient for nonrigid registration.

Renal mucinous tubular and spindle cell carcinoma: two cases report and review of the literature

We reported the clinical and pathologic features of two different types of renal mucinous tubular and spindle cell carcinoma (MTSCC). The first patient was incidentally discovered by health examination, with lower nuclear grade, no part and distant metastasis. The second patient presented with persistence hyperpyrexia, part and distant metastasis, and high nuclear grade. Surgery were both performed successfully. The first patient had no recurrences and no distant metastases. The second patient died of multiple organ failure 3 months postoperatively. Although MTSCC is usually a low potential malignancy carcinoma, high malignancy may occur and lead to a fatal course. So it needs a proper management and prognostication.

Fatal thrombotic complications of hepatic cystic compression of the inferior vena: A case report

Of 5% of patients who develop liver cysts, only 10-15%of them come for medical attention, typically because of dull right upper quadrant pain, abdominal bloating or early satiety. We treated a 77-year-old female with a rare complication of inferior vena cava thrombosis. The patient expired due to septic shock and multiple organ failure.

Primary gastric teratoma on the cardiac orifice in an adult

Gastric teratoma (GT) is a seldom seen congenital abnormality. GT always occurs in children. The greater curvature and posterior wall of the stomach are the most common sites involving GT. We diagnosed a case of GT located on the inferior wall of the cardiac orifice in a 20-year-old man. To the best of our knowledge, this is the first case of GT located on the wall of the cardiac orifice in an adult in the English literature. We report this unusual case as an addition to this rare disease usually found in children. Computed tomography combined with endoscopic ultrasonography can be selected to diagnose GT.

Balloon aortic valvuloplasty as a bridge-to-decision in high risk patients with aortic stenosis： a new paradigm for the heart team decision making

Background Whilst the majority of the patients with severe aortic stenosis can be directly addressed to surgical aortic valve replace- ment （AVR） or transcatheter aortic valve implantation （TAVI）, in some instances additional information may be needed to complete the diagnostic workout. We evaluated the role of balloon aortic valvuloplasty （BAV） as a bridge-to-decision （BTD） in selected high-risk patients. Methods Between 2007 and 2012, the heart team in our Institution required BTD BAV in 202 patients. Very low left ventricular ejection fraction, mitral regurgitation grade 〉 3, frailty, hemodynamic instability, serious comorbidity, or a combination of these factors were the main drivers for this strategy. We evaluated how BAV influenced the final treatment strategy in the whole patient group and in each specific subgroup. Results Mean logistic European System for Cardiac Operative Risk Evaluation （EuroSCORE） was 23.5%±15.3%, age 81 ± 7 years. In-hospital mortality was 4.5%, cerebrovascular accident 1% and overall vascular complications 4% （0.5% major; 3.5% minor）. Of the 193 patients with BTD BAV who survived and received a second heart team evaluation, 72.6% were finally deemed eligible for definitive treatment （25.4% for AVR; 47.2% for TAVI）： 96.7% of patients with left ventricular ejection fraction recovery; 70.5% of patients with mitral regurgitation reduction; 75.7% of patients who underwent BAV in clinical hemodynamic instability; 69.2% of frail patients and 68% of patients who presented serious comorbidities. Conclusions Balloon aortic valvuloplasty can be considered as bridge-to- decision in high-risk patients with severe aortic stenosis who cannot be immediate candidates for definitive transcatheter or surgical treatment.

Preoperative predictors of portal vein thrombosis after splenectomy with periesophagogastric devascularization

AIM:To evaluate the predictive value of preoperative predictors for portal vein thrombosis(PVT)after splenectomy with periesophagogastric devascularization.METHODS:In this prospective study,69 continuous patients with portal hypertension caused by hepatitis B cirrhosis underwent splenectomy with periesophagogastric devascularization in West China Hospital of Sichuan University from January 2007 to August 2010.The portal vein flow velocity and the diameter of portal vein were measured by Doppler sonography.The hepatic congestion index and the ratio of velocity and diameter were calculated before operation.The prothrombin time(PT)and platelet(PLT)levels were measured before and after operation.The patients'spleens were weighed postoperatively.RESULTS:The diameter of portal vein was negatively correlated with the portal vein flow velocity(P<0.05).Thirty-three cases(47.83%)suffered from postoperative PVT.There was no statistically significant difference in the Child-Pugh score,the spleen weights,the PT,or PLT levels between patients with PVT and without PVT.Receiver operating characteristic curves showed four variables(portal vein flow velocity,the ratio of velocity and diameter,hepatic congestion index and diameter of portal vein)could be used as preoperative predictors of postoperative portal vein thrombosis.The respective values of the area under the curve were 0.865,0.893,0.884 and 0.742,and the respective cut-off values(24.45 cm/s,19.4333/s,0.1138 cm/s-1 and 13.5 mm) were of diagnostically efficient,generating sensitivity values of 87.9%,93.9%,87.9%and 81.8%,respectively,specificities of 75%,77.8%,86.1%and 63.9%,respectively.CONCLUSION:The ratio of velocity and diameter was the most accurate preoperative predictor of portal vein thrombosis after splenectomy with periesophagogastric devascularization in hepatitis B cirrhosis-related portal hypertension.