Objective To outline the surgical experience of liver transplantation in children receiving left lateral lobe (segments II, III). Methods From March 1 to September. 1, 2004, 11 cases of pediatric liver transplantation were performed in Medical School of Hannover including 10 cases of split liver transplantation and 1 case of living related liver transplantation, and the clinical data of those cases were collected and analyzed. The average age and weight of these patients was 48.6 months (5-82 months) and 14.3 kg (6.9-23.8 kg) respectively, and 8 children had the previous abdominal surgical history. Results The average weight of the left lateral graft procured was 276.2 g (198-373 g), and the average cold ischemia time, anhepatic phase and operation time was 679 min (183-1290 min), 69 min (44-88 min) and 252 min (155-335 min) respectively. Six children received temporal closure of abdominal wall after liver transplantation. One child developed the perforation of stomach 15 days after operation, and compression of hepatic artery due to limited abdominal capacity occurred in 2 children within 24 h postoperatively. No complications including outflow obstruction of hepatic vein, hepatic artery thrombosis, primary graft nonfunction, graft necrosis and bile leakage from the cutting surface happened. Conclusion The left lateral lobe liver transplantation in children has been widely used with promising results. Resection of ill liver under controlling of inferior vena cava, simultaneous reperfusion of hepatic artery and portal vein and application of temporal abdominal wall closure had unique advantage, and thus, would be worth adopting.

BACKGROUND: Currently there are over 1 billion smokers worldwide. While many cessation programs are available to assist smokers in quitting, research suggests that partner involvement may encourage long-term abstinence. The purpose of this review was to determine if an intervention to enhance partner support helps smoking cessation when added as an adjunct to a smoking cessation program. METHODS: The search was performed in Cochrane Tobacco Addiction Group specialized register and 10 other databases. The search terms used were smoking, smoking cessation, and support. The search was also limited to English language. Randomized controlled trials that included a partner support intervention and reported follow-up of 6 months or greater were selected. Abstinence was the primary outcome measure and was analyzed at 2 post-treatment intervals: 6-9 months and >12 months. A fixed-effects model was used to assess the summary effect of the studies. RESULTS: A total of 31 articles were identified for this review. Only 9 studies met the inclusion criteria. The definition of partner varied among the studies. There was limited biochemical validation of abstinence rates. The odds ratio for self report abstinence at 6-9 months was 1.08 (CI 95%, .81, -1.44) and at 12 months post-treatment was 1.0 (CI 95%, 0.75, 1.34). There were no numerical data values for biochemical validation (saliva cotinine/thiocyanate) and carbon monoxide levels at 6-9 months and/or >12 months follow-up. CONCLUSION: We concluded that interventions designed to enhance partner support for smokers in cessation programs did not increase quit rates. Limited data from several of the RCTs suggest that these interventions did not increase partner support either. No conclusions can be made about the impact of partner support on smoking cessation. More systematic intervention to affect partnership significantly should be delivered if partner support were part of an existing cessation program.
Carbon Monoxide ; Follow-Up Studies ; Odds Ratio ; Outcome Assessment (Health Care) ; Self Report ; Smoke* ; Smoking Cessation* ; Smoking* ; Tobacco

Objective To explore the features of recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) and the related factors.Methods 117 cases of LT for HCC were retrospectively analyzed in a single transplantation center,Medical School of Hanover between Nov 1993 and May 2006.The cumulative survival rates were calculated using the Kaplan-Meier method and the differences of the related factors between various groups were analyzed by Log-rank test.Results 63 cases (58.3％) met the Milan criteria,45 cases (41.7％) exceeded the Milan criteria.Those comply with and exceed The University of California,San Francisco (UCSF) criteria were 73 cases (67.6％) and 35 cases (32.4％),respectively.103 cases were cadaveric donor liver transplantation (CDLT) and 14 cases of living donor liver transplantation (LDLT) with no significant difference between the two groups in postoperative survival rate (P =0.911).Age(P =0.048),microvascular invasion(P =0.001),over UCSF criteria(P =0.013),and the grading of tumor differentiation(P =0.015) were major factors of tumor recurrence after transplantation.Conclusion Appropriate selection criteria,perioperative comprehensive treatment and effective control of recurrence are the keys for improving survival rate of liver transplantation recipients for HCC.