Objective:To improve the surgical technique to establish the arterialized orthotopic liver transplantion in rat.Methods:On the basis of two-cuff technique of Kamada,we improved the techniques of separaring,perfusing donor liver,the anastomosis of the suprahepatic inferior vena cava,and so on.And used the modified "stent" method to reestablish the hepatic artery.Results:80 cases of operation were completed.The time of donor operation,recipient operation and anhepatic time were(40?3) min,(50?5)min,and(16?2)min,respectively.The time of reestablishing suprahepatic inferior vena cava and hepatic artery were(6~9) min,(2~3) min,respectively.The survival rate at 48 h,1 week and 1 month were 96.3%,93.7%,and 87.5%,respectively.Conclusion:The modified method can enhance the stability and survival rate,which is an ideal method for establishing the arterialized orthotopic liver transplantation model in rat.

Objective To evaluate Caspofungin for the treatment of fungous infection liver transplant patients. Methods From 2003 to 2008 clinical data of 27 cases of liver transplant patients with fungal infections were reviewed retrospectively. Before 2005 (control group) fungal infections were treated with amphotericin B or Fluconazole in 13 cases. After 2005, the infection was treated with Caspofungin (observation group) in 14 cases. Liver function (AST, ALT, TBIL) and renal function (BUN, Scr) were evaluated at one and two weeks respectively. Result of treatment was evaluated 7 ～ 14 d after the treatment as for the clinical cure rate, with or without acute rejection. Result The liver function of the observation group compared with that of the control group at one week was as AST(t =8. 03 ,P <0. 01), ALT(t =9. 09, P<0.01), TBIL(t =6.01,P<0.01), and at 2 week as AST(t=5.59,P<0.01), ALT(t =6.60,P< 0. 01), TBIL(t = 8.45,P <0. 01). The renal function of the observation group compared with that of the control group after one week as for BUN(t =6. 51 ,P <0. 01), Scr(t =5.66,P <0. 01). At 2 week,as BUN (t =7.61,P <0.01), Scr(t =6.91,P <0.01). The clinical cure rate of the control group was 7/13 (53%), that of the observation group was 12/14(86%) ; Two cases in the observation group and one in the control group had acute rejection which was successfully managed by methylprednisolone pulse therapy. Conclusion Caspofungin is an ideal alternative therapy for fungal infection after fiver transplantation.

Objective To explore the modified of methods and techniques to establish a rat model of or thotopic liver transplantion effectively by a single operator, and improve the stability. Methods On the basis of two-cuff technique of Kamada, we improved the techniques of perfusing, shearing, triming donor liver, the suturation of the superior and inferior eaval veins, and so on. Operation was performed in 80 rats with modified techniques (experiment group) and conventional techniques (control group), respectively, compare the survival rates of 48 h, 1 week, lmonth were compared between the two groups. Results In contrast to conventional teehniques, the modified techniques reduced the average time of donor operation, recipient operation and anhepatie phase (P < 0. 05), elevated 1-week, 1-month survival rates, remarkably (P < 0. 05 ).Between the Iwo groups, the survival rate of 48 hour had no statistical significance (P > 0. 05). Conclusions The modified techniques may reduce the operation time of donor and receptor effectively raise the quality of donor liver, elevated the survival rate of receptor. II is a stable, reliable and effective method to establish the rat urthotopic liver transplantation model.

Ideal ecological condition for the growth of Ophiopogon japonicus(L. f) Ker-Gawl. is a warm and moist environment. It is generally planted along the banks of Fujing River,460～520m above sea level. The best soil will be brown and sandy with complicated parent material,rich in mineral,calcium and organic matters,neutral and vivid with bacterial activity. It has a deep soil horizon,shallow water level,loosely composed on the surface while tightly beneath,good permeation for both air and water. Such a concert among soil,water,air,heat and manure will result in a high yield of the plant to satisfy the demand of high quality product.

Objective To improve the method of orthotopic liver transplantation model in mice.Methods On the basis of "Qian SG" mothod,the techniques of perfusion,harvesting,and trimming of donor's liver,as well as the anastomosis of superior and inferior caval veins were improved.Operations were performed in 70 mice with improved technique(experiment group) and in 70 mice with conventional technique(control group),respectively.The operation time in both donors and recipients,and the survival rates of 48h,1 week and 1 month after operation were compared between the two groups.Results The operation time for both donors and recipients and the time of anhepatic phase were 37?2min,45?2min and 16?2min,respectively in experiment group,while they were 45?2min,54?2min and 23?2min,respectively,in control group,so that the average time for each procedure was significantly shorter(P0.05).Conclusions The improved technique may shorten the operation time and raise the survival rate,and is an ideal method for the establishment of orthotopic liver transplantation model in mice.

OBJECTIVE To investigate the distribution of 2916 strains and analyze the antimicrobial susceptibility of major pathogens and to provide evidences for clinical therapy.METHODS The distribution,and the antimicrobial susceptibility of pathogens,which were collected and isolated from all of the clinical specimens from Jan 2007 to Oct 2008 in our hospital,were studied restrospectively.RESULTS Totally 2916 strains(except fungi) of pathogens were isolated from patients,among which 1857 strains were Gram-negative bacteria(63.7%) and 1056 strains were Gram-positive cocci(36.2%).The five common bacteria isolated from the specimens were Escherichia coli(14.3%),Klebsiella pneumoniae(11.8%),Pseudomonas aeruginosa(10.7%),Staphylococcus aureus(10.5%),and Acinetobacter baumanii(8.7%).The ESBLs producing E.coli and K.pneumoniae accounted for 31.4% and 33.7%,respectively;meticillin-resistant S.aureus(MRSA) accounted for 53.3% and meticillin-resistant coagulase-negative staphylococci(MRCNS) accounted for 49.6%;vancomycin-resistant S.aureus was not isolated Gram-negative bacilli had the lowest resistance to carbapenems,and then to piperacillin/tazobactam(TZP) and cefoperazone/sulbactam(CFS),showing multi-resistantce.Gram-positive cocci were more sensitive to vancomycin,rifampicin,nitrofurantoin than to other antibacterials.CONCLUSIONS The drug resistance of the isolated bacteria is common.It is very important to monitor the drug resistance of the bacteria regularly,for guiding the clinic use of antibiotics rationally,and infection control.

Objective To study the surgical technique of construction of orthopic liver transplantation model in mice by a single operator.Methods On the basis of two-cuff technique,running suture was used to reestablish the suprahepatic vena cava(SHVC),"two-cuff"technology to reestablish the portal vein(PV)and infrahepatic vena cava(IHVC),and"stent"to reestablish the bile duct.Operation was performed in 70 mice,the 24 h,1 week,1M postoperative survival rate were noted,and hepatic function and pathological change were observed.Results The 24 h,1 week and 1M survival rate was 95.7%,90.9%,85.1%,respectively.The ALT increased gradually in the first postoperative week,and dropped to normal level in the first month.Pathology showed the structure of liver tissue was fine.Conclusions The method is an ideal mothod to establish the orthotopic liver transplantation model in mice,because it has high survival rate,good stability and is easily replicated.

Objective To investigate the incidence of pancreatic cancer-related depression in Guangzhou,China.Methods A multicenter,prospective survey was conducted,50 patients with pancreatic cancer,60 with liver cancer,50 with esophageal cancer,50 with gastric cancer,52 with colorectal cancer were enrolled from 4 hospitals in Guangzhou between June 2007 and June 2009.Hamilton Rating Scale for Depression-24 (HAMD-24) questionnaire was used to assess the degree of depression.Results The incidence of depression in pancreatic cancer patients was 78% (39/50),which was significantly higher than that among liver cancer patients (60% ,36/60),gastric cancer patients (36%,18/50),esophageal cancer patients(24%,12/50),and colorectal cancer patients(19.2%,10/52,P＜0.05 ).Twelve of 50 patients in pancreatic cancer were reported to have severe depression (24%),which was significantly more than that in liver cancer (10%,6/60),gastric cancer (4%,2/50),esophageal and colorectal cancer (0,P ＜0.05).In pancreatic cancer patients,the incidence of depression was significantly higher in patients with advanced stage (94.3%) than that in early stage (46.7%,P＜0.05).Patients who underwent chemotherapy had high incidence of depression(92.3%)than that of patients who underwent operation (62.5%,P＜0.05 ).Conclusions Compared with other cancers of digestive tract,the incidence of pancreatic cancer-related depression was higher,and its degree was more severe than that of other cancers.

Objective To investigate the prevalence and the clinical features of pancreatic cancer pain in a Chinese patient population.Methods The study was carried out in 415 cages of pancreatic cancer which were admitted to the First Municipal people's Hospital of Guangzhou Medical college and the Second Affiliated Hospital of Sun Yat-sen University from 1999 to 2007.The prevalence,clinical features of pancreatic cancer pain and its correlations with the cancer site and the clinical staging were analyzed.Results Of the 415 patients.the prevalence of pain wag 65.1%and 60.5%of all the patients presented pain as the initial symptom;the incidence of pain in pancreatic body/tail cancer patients was 80.7%.while it was 71.4%in total pancreatic cancer patients.and the incidence was 58.2%in pancreatic head cancer patients;the incidence between pancreatic body/tail cancer and pancreatic head cancer patients was statistically different (P＜0.05).The incidence of pain in patients with stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ was 28.6%,58.1%,66.2%and 78.6%.and the difference was statistically significant(P＜0.01).The incidence of moderate to severe degree of pain in patients with stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ was 18.8%,44.4%,53.1%and 68.2%,and the differenee was statistically significant(P＜0.01).Conclusions Pain was very common in patients with advanced pancreatic cancer.The incidence and severity of pain increased with the progression of pancreatic cancer.

Objective To investigate the feasibility and superiority of local anaesthesia video-assisted thoracoscopic surgery (LA-VATS) in diagnosis and treatment of open thoracic trauma (OTT).Methods Seventy-eight patients with OTT emergently admitted from February 2007 and June 2012 were randomized into LA-VATS group (n =37) and conventional treatment group (n =41) by the toss of a coin.In the LA-VATS group,further treatment was determined following LA-VATS.Volume of chest tube drainage,duration of chest tube placement,average length of hospital stay,and postoperative complications were measured and compared between groups.Results In the LA-VATS group,23 patients completed LA-VATS and 14 were transferred for simple VATS-assisted mini-thoracotomy under general anesthesia.In the conventional treatment group,24 cases completed debridement and chest drainage and 17 cases were transferred for thoracotomy under general anesthesia.Volume of chest tube drainage [(195.0 ± 150.8) ml/d∶ (480.0 ±212.3)ml/d] (t =-2.675,P ＜0.05),duration of chest tube placement [(2.6 ± 1.4) d∶ (3.8 ± 1.9) d] (t =-2.318,P ＜ 0.05),average length of hospital stay [(6.4 ±2.3) d ∶ (10.9 ± 3.3) d] (t =-2.471,P ＜ 0.05),and incidence rate of postoperative complications (10.8％ ∶22.0％) (x2 =4.132,P ＜0.05) were all significantly different between LA-VATS and conventional treatment groups.Conclusion LA-VATS is safe and feasible for diagnostic exploration and simple treatment of OTT.