The lack of organ donors is a major obstacle against the application of liver transplantation.Recently,how to expand the source of liver donors has become a focus of transplantation research.The use of marginal donor may help solve current dilemma between the increasing waiting recipients and the relatively few donors.However,marginal donors always comes with elevated risk of primary nonfunction,initial poor function,delayed graft function loss and infection.Research on risk factors and complication preventing strategies of marginal donor transplantation is important in improving our understanding of liver transplantation.In the present article,we summarized recent progress in the research of marginal donors.And based on the experience from our center,we believe that the use of marginal donors in liver transplantation may help improve the situation of donor shortage,and isehemia-reperfusion injury remains the core topic of marginal donor transplantation and represents the direction of future study.

Liver failure is a dreaded and often fatal complication that sometimes follows partial hepatectomy.This article reviews the pathophysiology, risk factors and treatment of post-resectional liver failure (PLF). An inadequate quantity or quality of residual liver mass are the key event in its pathogenesis. The major risk factors are small remnant liver volume (RLV), excessive blood loss or transfusion, ICGR15 of greater than 20%, and F4/F3 liver cirrhosis. It is essential to identify these risk factors during the pre-operative assessment. Preventive measures should be applied whenever possible as options of curative treatment for PLF are limited. Artificial liver and/or liver transplantation are the important treatment alternatives for hepatic failure after hepatectomy.

The hypothesis that tumor comes from stem cells has been demonstrated in various human tumors.Cancer is not only a genetic disease but also a stem cell disease. It is a key to regeneration, mutations and recurrence of tumors that gene mutations affect stem cells, and then stem cells mutate to cancer stem cells. In an effort to review the evidence that liver cancer stem cells exist, two fundamental questions must be addressed. First, do hepatocellular carcinomas(HCC)arise from liver stem cells? Second, do HCCs contain cells that possess properties of cancer stem cells?More recently, there is a hypothesis that HCC arise from maturation arrest of liver stem cells. Analysis of the cells in HCC supports the presence of cells with stem-cell properties(ie, immortality, transplantability, and resistance to therapy). However, definitive markers for these putative cancer stem cells have not yet been found and a liver cancer stem cell has not been isolated.

Objective To study the expression of gastrin receptor in 4 HCC cell lines and tis-sues and their relation to clinieopathological features. Methods Immunohistochemical staining of GR was performed for the 4 HCC cell lines and the paraffin sections of 25 HCC cases. The relationship be-tween the GR expression in HCC sections and the clinicopatho[ogical parameters were analyzed. Results Positive staining for GR in the 3 HCC SMMC-7721>HepG2>QGY-7701 cell lines and HCC tissues was observed. The expression rate of gastrin receptor was 56 % (14/25). However, there was no association between expression of GR and elinieopathologieal features such as age, gender and clini-cal stage etc except for tumor thrombosis. Concision GR exists in the HCC. Futher study is needed to identify whether GR is a applicable target for endocrine therapy in HCC.

Objective To investigate the significance of metastasis associated lung adenocarcinoma transcript 1 (MALAT1) in the occurrence and development of non-small cell lung cancer(NSCLC).Methods Eighty-six NSCLC lung tissue samples and 86 corresponding adjacent tissues were collected.Real-time quantitative polymerase chain reaction (RT-PCR) was used to detect MALAT1 mRNA expression.The correlation analysis of the gender,age,carcinoma embryonic antigen (CEA),clinical stage,and the degree of differentiation was performed.Results MALAT1 expression levels showed an average 2.16-fold increase in NSCLC lung tissues(87.23 ±9.72) when compared with adjacent tissues(40.38 ± 5.49),the difference was statistically significant (t =7.894,P ＜ 0.01).There was no significant difference between gender,age,histological type,tumor diameter,CEA level in terms of MALAT1 expression (P ＞ 0.05).There was significant differences between pathological stage (Ⅰ stage =52.38％ (11/21),Ⅱ stage =76.00％ (19/25),Ⅲ stage =97.50％ (39/40),x2 =11.839,P =0.042),tumor differentiation (High differentiated =39.13％ (9/23),moderately differentiated =74.47％ (35/47),low differentiated =100％ (16/16),x2 =15.383,P =0.032)and lymph node metastasis (with =97.22％ (35/36),no =46.00％ (23/50),x2 =23.947,P =0.030).Conclusion MALAT1 might be involved in the development of NSCLC,and could be an auxiliary diagnosis marker.

As an essential technique involved in complicated liver surgery,portal vein reconstruction results in eradication of macro- or microscopic tumor residual on surgical margins when combined with precise hepatectomy,improving both the living quality and the survival rate of patients.The application of this reconstruction technique needs precise evaluation of pre-operational image data,clearly dissection of portal vessels and tremendous amount of collaborative effort by the surgery team. Other techniques performed during the surgical procedure include intra-operative ultrasound scan,revitalizing the cryopreserved vessels,and angioplasty.

BACKGROUND:The traditional orthopedic fixation by C-arm positioning surface is completed, but the large C-arm injury on the human body and the long fixed time increase the suffering of patients. OBJECTIVE:To investigate the X-ray fixed in position within the orthopedic implants, navigation and effect. METHODS:Twenty-six New Zealand white rabbits were randomly divided into C-arm machine group and X-ray group, with 13 in each group. Rabbits in both groups were used to simulate soft tissue foreign body localization, intramedul ary nail implantation at distal fracture end and spinal pedicle screw entry point position. In the C-arm machine group, positioning navigation was conducted with C-arm machine. In the X-ray group, X-ray positioning navigation was used. The positioning and navigation effects were compared between the two groups. RESULTS AND CONCLUSION:(1) Compared with the C-arm machine group, the time required for navigation in the X-ray group targeting soft tissue foreign body localization, fracture distal locking intramedul ary nail implantation and pedicle screw spinal needle point location was significantly shorter (P<0.05);navigation displacement and deviation produced were significantly less (P<0.05). (2) These findings suggested that the X-ray positioning for orthopedic fixation method is relatively simple, with high availability, and can obtain a high performance-price ratio. Meanwhile, the X-ray localization can improve accuracy and shorten the fixed time.

BACKGROUND:In esophageal cancer chemotherapy, inhibiting proliferation of tumor cels and tumor stem cels can be effectively improved by using appropriate sensitive agents.
OBJECTIVE:To explore the effect of molybdenum on ECA-109 cel chemosensitivity and p75NTR cel inhibition in esophageal carcinoma cels.
METHODS:ECA-109 cels at logarithmic phase were selected and randomly divided into blank control group, cisplatin group, molybdenum group and molybdenum+cisplatin group (combination group). Molybdenum and cisplatin at different concentrations were used in the three groups. MTT assay was used to detect ECA-109 cel proliferation and growth; flow cytometry was used to detect the proportion of P75NTR cels.
RESULTS AND CONCLUSION:Cisplatin at different concentrations showed a certain inhibitory role in ECA-109 cels, which had an increasing kiling effect on esophageal carcinoma stem cels at dose- and time-dependent manner. Molybdenum alone had no remarkable kiling effects on inhibiting ECA-109 proliferation and esophageal carcinoma stem cels. Combination of molybdenum and cisplatin was found to have an enhanced effect to inhibit ECA-109 cels and to kil esophageal carcinoma stem cels in a dose- and time-dependent manner, which was significantly different from the cisplatin group and blank control group (P < 0.05). These findings indicate that molybdenum can promote and enhance the inhibitory effect of cisplatin on ECA-109 and p75NTR cels, which can be used as a chemosensitizer.

OBJECTIVE To clarify the long-term toxicity to the respiratory system in a rat model of acute lung injury (ALI) induced by a single low-dose of perfluoroisobutylene(PFIB) inhalation expo?sure,and observe the possible beneficial effect of early intervention via Qingkailing(QKL) injection. METHODS Totally 224 male Wistar rats were randomly divided into 4 groups:normal control group in which air exposure was followed by a saline 10 mL · kg-1(ip),QKL control group in which QKL 10 mL · kg-1 was ip given after air exposure,PFIB exposure group in which rats were exposed to PFIB 280 mg·m-3 for 5 min only,and QKL treatment group in which QKL 10 mL·kg-1 was given ip at 1 h after PFIB exposure. Lung functions of rats were measured at 24 h,3,6,12,24,36 and 48 weeks after exposure. The arterial blood gas,lung coefficient,protein content in bronchoalveolar lavage fluid(BALF),hydroxy?proline(HYP) content in lung tissue and plasma,and other indicators were detected or analyzed. RESULTS Within 24 h after PFIB exposure,the lung coefficient and protein content in BALF were increased significantly(P<0.01),whereas the PaO2(P<0.01) and SaO2(P<0.05) indices in arterial blood decreased significantly in PFIB group compared with normal control. The inhalation time , exhalation time,tidal volume(TV),expired volume(EV)and relaxed time were reduced significantly (P<0.01). However,all the above indicators returned to normal in 3 weeks,but TV,EV and peak expiratory flow were significantly lower than in normal group at 48 weeks(P<0.05). HYP contents in lung tissues,compared with normal control(P<0.05),were reduced significantly within 24 h after PFIB exposure,increased significantly in 6 weeks(P<0.05),then returned to normal in 12 weeks. HYP contents in plasma increased significantly compared with normal control(P<0.05) within 24 h after PFIB exposure but returned to normal in 3 weeks. The protein contents in BALF of QKL treatment group were significantly lower than those in PFIB group(P<0.01) within 24 h after PFIB exposure. From 24 h to 24 weeks after PFIB exposure,changes of pulmonary functions were similar to those in PFIB group. At 48 weeks,TV and EV in QKL treatment group were more significantly increased than those in PFIB group(P<0.05). CONCLUSION Rats with ALI induced by a single low dose of PFIB exposure undergo compensatory repair except for pulmonary capacity and pulmonary ventilation functions. Early treatment with QKL reduces protein content of BALF and alleviates pulmonary edema,and has some beneficial effect on lung function recovery later.

Objective: To establish and implement a smartphone-based school syndromic surveillance system, and to provide references for school communicable disease control and prevention. Methods: A smartphone-based school syndromic surveillance system was constructed and applied. A list of seven symptoms including fever, cough, vomit, diarrhea, rash, red eye and parotid swelling was classified as targeted indicators. Spatio-temporal permutation scanning was applied to automatic early warning. Results: A total of 1 973 school joined the syndromic surveillance system. System usage rate was 54.13%, no significant differences were found among different types of schools(χ2=1.58, P=0.67), whereas significant differences were observed among counties（χ2=726.78, P<0.01). Totally, 852 036 pieces of symptoms data were reported during September 2018 to March 2019, the primary symptoms included cough (35.17%) and fever (21.11%). Time trends in different symptoms varied with time, with fever and cough highest in January, vomit and diarrhea in November. Thirteen pieces of early warning were confirmed as school communicable diseases by field investigation, the average number of the infected students were four. Conclusion The smartphone-based school syndromic surveillance system is generally acceptable. Characteristic seasonal distributions of school communicable diseases are reflected accurately by surveillance system which plays an active role in prevention and control of school communicable diseases.