Objective To further probe and investigate the etiopathogenisis of acute lung injury(ALI)after in situ liver transplantation,and to search for an effective treatment.Methods ALI was final diagnosed as the oxygen saturation index(OSI)was less than 200.The arterial blood gas analysis and others clinical examinations were timely monitored to 189 of 211 patients undergone liver transplantation in situ.The other 22 cases died of other causes at the early stage after liver transplantation.The occurring of ALI was analyzed correlatively with protopathy.All the patients were given with the therapies of oxygen,antibiotics,immunosuppressant,drugs of liver protection,nutrition,diuretics,and vasodilators,and some criteria were measured continuously.The oxygen concentration and circulation volume were adjusted accordingly with blood gas analysis and central venous pressure respectively.Results ALI occurred within 146 of 189 patients(77.5%)at the early stage after liver transplantation in situ.All the cases were treated systemically and recovered to normal.The liver function kept unvaried during the period of treatment.By analyzing the patients' data,the occurrence of ALI showed a definite relation to the hepatic decompensation of patients' primary disease,the blood loss during operation,and to the liquid intake/output postoperation.Conclusion For the purpose of preventing or reducing the incidence of ALI,It is important to pay attention to the primary disease,keep stability of the blood dynamics of the patients during or after operation.Besides the oxygen therapy,systemic general treatment is also necessary for those patients who received in situ liver transplantation.

Objective To discuss and prevent hepatic artery thrombosis (HAT ) or stenosis (HAS) after orthotopic liver transplantation (OLT). Methods In harvesting the donor's liver, the hepatic artery should be obtained together with its origin from the celiac artery as a whole. Damage to the hepatic artery should be avoided during dissection, the endothelium should not be injured, especially that of its branches. When the portal veins of the donor and the recipient were opened, the matching arteries were anastomosed end to end. If the diameter of the anastomosing artery was less than 5 mm, a branching section of the artery was selected, the bifurcation septum was divided so that the arterial end was enlarged to ensure a good anastomosis. The endothelium of the artery should be kept intact during the procedure. Results In 36 patients with OLT, no patients suffered from HAT or HAS. Conclusion The important procedures to prevent HAT or HAS in OLT are harvest of a complete donor's arteries, suitable selection of hepatic artery for anastomosis, precise technique of vascular anastomosis, and appropriate use of anticoagulant.

Objective: To study the correlation between radionuclide pulmonary perfusion imaging (PPI) data and quantitative analyzed data of lung biopsy specimens in congenital heart defects with left to right shunt associate with severe pulmonary hypertension in young children. Methods: 52 data of PPI were collected from 43 young children with severe pulmonary hypertension caused by congenital heart defects. Lung biopsies were performed in 26 cases and the specimens were quantitative analyzed. The correlation between PPI and lung biopsy was studied. Results: The percentage of wall thickness (%MT) and percentage of wall area (%MS) were significantly increased in cases with right upper to lower count ratio (RULR)≥0.70 (P

OBJECTIVETo explore protective effects of acupuncture at "Zusanli" (ST 36) on cerebral tissue in rats with sepsis.

METHODSCecal ligation and puncture (CLP) was applied to duplicate the rat model of sepsis. According to random number table, thirty SD rats were divided into a sepsis model group (group A), a sepsis model plus electroacupuncture (EA) group (group B), and a sepsis model plus non-acupoint EA group (group C), ten rats in each one. EA with the same frequency and intensity at "Zusanli" (ST 36) and non-acupoint (0.5 cm laterally to "Zusanli") for 30 min was applied in the group B and group C, respectively. No treatment was given in the goup A. 6 hours after CLP, blood was acquired from abdominal aorta to measure the levels of neuron specific enolase (NSE). Then the rats were sacrificed by abdominal aorta exsanguination to take their cerebral tissue for measuring the levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6).

RESULTSSix hours after CLP, the level of NSE was (3.51 +/- 0.39) ng/mL in group B, which was significantly lower than (7.72 +/- 0.64) ng/mL in group A (P<0.05). The level of NSE was (8.02 +/- 0.72) ng/mL in the group C, which had no statistical significance with group A (P>0.05). The levels of TNF-alpha, IL-6 in cerebral tissue in group B were significantly lower than that of group A and C (all P>0.05).

CONCLUSIONEA at "Zusanli" (ST 36) has certain protective effect on septic rat's brain, which has some relationship with decreasing levels of cerebral tissue proinflammatory cytokine and plasma NSE. EA at non-acupoint has no the same action.

Acupuncture Points ; Acupuncture Therapy ; Animals ; Humans ; Interleukin-6 ; immunology ; Male ; Phosphopyruvate Hydratase ; immunology ; Rats ; Rats, Sprague-Dawley ; Sepsis ; enzymology ; immunology ; therapy ; Tumor Necrosis Factor-alpha ; immunology

Objective To introduce and evaluate the hand assisted transperitoneal laparoscopic technique for living donor nephrectomy. Methods Five cases treated by using the technique of the hand assisted transperitoneal laparoscopic living donor nephrectomy (HLDN) were summaried.The procedure utilized a hand assisted device for laparoscopic technique to increase safety and control of the laparoscopic technique. Results In these 5 cases,only left side nephrectomy were performed.Mean operating time was 116 min,with mean warm ischemia time being 2.8 min.Mean length of renal arteries and renal vein was 1.8 cm and 2.7 cm,respectively.There were no intra or post operative complications. Conclusions HLDN is easier than traditional laparoscopic donor nephrectomy (LDN) for the surgeons,so it can minimize the lear ning curve.HLDN can reduce warm ischemia and operating time,and also facilitate trocar placement.In addition,it can improve the prevention of torsion of the kidney,control of potential bleeding,and in the final stages of vascular stapling and kidney removal.HLDN is a promising new method for living donor nephrectomy.

Objective : To explore the mediating effect of sleep quality on mobile phone dependence and loneliness in university students, so as to provide evidence for prevention and intervention of mobile phone dependence. Methods : A survey was conducted from December 2019 and January 2020 among the students of Guangzhou Medical University. The general information questionnaire, mobile phone dependence index scale, UCLA loneliness scale and Pittsburgh sleep quality index scale were used to analyze the mediating effects of sleep quality on mobile phone dependence and loneliness. Results : A total of 575 questionnaires were distributed and 573 valid ones were collected, with an efficiency of 99.65%. The detection rate of 115 students with mobile phone dependence was 20.07%, and that of 203 students with sleep quality problems was 35.43%. The students scored ( 48.03±6.07 ) points in loneliness, and 405 of them had high level. Mobile phone dependence was positively correlated with loneliness and sleep quality ( r=0.299, 0.385, both P<0.05 ); loneliness was positively correlated with sleep quality ( r=0.553, P<0.05 ). Mobile phone dependence and sleep quality both could positively predict loneliness, mobile phone dependence could positively predict sleep quality, and sleep quality and gender had a significant interaction effect on loneliness ( all P<0.05 ). The mediating effect value of sleep quality on mobile phone dependence and loneliness was 0.290 ( 95%CI: 0.186-0.400 ) in males and 0.131 ( 95%CI: 0.084-0.187 ) in females. Conclusion Sleep quality has a mediating effect on mobile phone dependence and loneliness among university students. Male students are susceptible to the negative effects of mobile phone dependence.

Objective To evaluate extended criteria donor liver in adult cadaveric liver transplant.Methods 126 liver transplantations were performed from January 2003 to June 2009,of them,74 patients received standard criteria donor livers,52 patients received extended criteria donor livers.These 52 donor livers could be divided into two groups:E1 group (a graft with 1 to 2 risk factors) and E2 group(a graft with 3 to 4 risk factors).Results There was no significant difference in half a year and 1 year survival rates between patients received E1 group extended criteria donor livers and those received standard criteria donor livers(respectively x2 =2.55,3.64,all P ＞0.05).But 2 year survival rate of patients received E1 group extended criteria donor livers was lower than those receiving standard criteria donor livers (x2 =4.9,P ＜0.05).Half a year,1 year and 2 year survival rates in patients receiving E2 group extended criteria donor livers were less than those receiving standard criteria donor livers (respectively x2 =3.91,8.67,11.34,all P ＜ 0.05).The half a year,1 year,and 2 year survival rates of patients received extended criteria donor livers with MELD score more than 20 was less than those with MELD score ＜ 20 (respectively x2 =0.16,0.16,0.07,all P ＜ 0.05).Conclusions Extended criteria donor livers can be used safely if the risk factor of donor liver was less than 3,or when recipient's MELD score was ＜20.

Objective To approach the efficacy of urgent liver transplantation for acute liver failure.Methods The clinical data of 22 patients with acute liver failure undergoing urgent liver transplantation in our hospital from January 2003 to January 2009 were retrospectively analyzed.The prognosis,survival rate and complication were summarized.Results Among 22 patients,there were 14 cases of hepatitis B-induced acute liver failure,and 8 cases of drug-induced acute liver failure.The mean waiting time was 2.3 days.Three patients died perioperatively.Retransplantation was done in 1 patient.Complications after urgent liver transplantation included:abdominal cavity hemorrhage (2 cases),biliary complications (2 cases).There were no vascular complications.Renal dysfunction of different degrees occurred in all patients.Psychiatric symptom occurred in 17 cases,epilepsy in 1 patient,pulmonary infection in 11 patients,and acute cell rejection in 3 patients.The 1-,2-and 3-year recipient survival rate was 81.8 ％,81.8 ％,81.8 ％,respectively,and the 1-,2- and 3-year graft survival rate was 81.8 ％, 77.3 ％, 77.3 ％, respectively.ConclusionUrgent liver transplantation has a good efficacy for acute liver failure.Reasonable preoperative evaluation,length of waiting for graft,and effective treatment of various kinds of complications are the key point to improve the prognosis of patients with acute liver failure undergoing urgent liver transplantation.

AIM: To explore the characters of fibroblast-like (F-L) cells cultured from granunocyte clony stimunating factor (G-CSF)-mobilized peripheral blood cell (PBC) harvests. METHODS: The adherent cells in the PBC harvests were cultured for 2 week in the mediums of RPMI-1640/L-DMEM/G-CSF or interleukin-3 (IL-3) plus RPMI-1640, the cultured F-L cells were analyzed by flow cytometry (FC). RESULTS: The adherent non-confluent F-L cells obtained from the four groups were similar in their phenotypes: CD33+, CD11c+, CD64+, CD14+, CD45+, HLA-DR+, CD86+, CD34-, CD38-, CD3-, CD19-, CD56-, CD29-, CD44-, CD105-. The F-L cells are similar to monocytes except CD38-and were distinct from dendritic cells (DC) or mesenchymal stem cells (MSC). CONCLUSION: The cultured F-L cells are macrophages rather than DC or MSC. G-CSF, rhIL-3 enhances their numbers.

Objective To construct a recombinant adenovirus vector of Hairpin RNA specific for MRP1 gene and study its inhibition of MRP1 gene expression in K562/AS2 cell line resistant to AS_2O_3 (ATO). Methods A MRP1-specific hairpin RNA recombinant adenovirus vector was constructed and used to infected K562/AS2 cells. Expression level of MRP1 mRNA detected by real-time fluorescent quantitative PCR. MRP1 protein detected by flow cytometry. MTT method was used to detected the cytotoxicity of ATO and etoposide. Results MRP1 mRNA and protein expression level in K562/AS2 cells before and after the pAd-MRPl-shRNA adenovirus infection was (34.70±0.28 vs 4.19±0.03, P <0.05) and (26.40±0.16 vs 10.85±0.37, P<0.05), respectively. RR of K562/AS2 to arsenic trioxide and etoposide was (11.4078±0.3183 fold vs 1.6126±0.3015 fold, P<0.05) and (5.9141 ±0.0149 fold vs 1.7664±0.1038 fold, P <0.05), respectively. The reversal fold of ATO and etoposide was (7.2409±1.3668) and (3.3555±0.1886), respectively. Conclusion Successfully constructed pAd-EGFP-U6-shRNA-MRPl adenovirus vector, the vector of infection K562/SA2 cells can inhibit MRP1 gene expression and reverse the resistance of the ATO and etoposide.