OBJECTIVE:To establish a method for the simultaneous determination of the contents of Shuanghuanglian freeze-dried powder in placental perfusate. METHODS:HPLC was performed on the column of Agilent Zorbax-C18 with mobile phase of acetonitrile-1%formic acid aqueous solution(gradient elution)at flow rate of 1.0 ml/min,the internal standard was puera-rin,detection wavelength was 280 nm,column temperature was 25 ℃ and sample volume was 10 μl. RESULTS:There was a lin-ear range between linear ranges and peak area of 8 ingredients(r≥0.999 0);RSDs of within-day and inter-day precision tests were no more than 1.9%,repeatability tests was no more than 7.3%;average recoveries were in the range of 92.73%-112.37%(RSD=3.2%-8.2%,n=6);and average matrix effects were 90.33%-105.78%(RSD=3.2%-8.0%,n=6). CONCLUSIONS:The method is rapid,sensitive and specific,and can be used to the simultaneous determination of the contents of 8 ingredients of Shuan-ghuanglian freeze-dried powder in placental perfusate.

Objective To assess the relationship between the HLA gene sharing of couples and gestational diabetes mellitus (GDM). Methods Thirty GDM women and their husbands served as study group, 40 normal pregnant women and their husbands were selected as control group. All pregnant women were primipara with single fetus. 5 ml cubital venous blood were taken. Genomic DNA was extracted using phenol chloroform method. HLA-DRB alleles type were determined with PCR-SSP. Results The sharing of HLA-DRB1 between couples in GDM group were 33.33%, significantly higher than that of normal pregnancy(12.50%)(P0.05). Conclusions The sharing of HLA-DRB1 between couples may inerease the risk of GDM, It suggested that placenta- and-fetus unit may play roles in GDM.

0 05) and incidence rate of postoperative complications (0 vs.0). Postoperative hospital stay in group experiment was longer than that in group control ((2 2?0 4)d vs. (2?0)d, t =2 958, P

Objective To evaluate the effects of different selection criteria on the prognosis of hepatocellular carcinoma(HCC)patients undergoing liver transplantation(LT)and to evaluate a new criterion.Methods A retrospective analysis was performed on 81 consecutive patients with HCC who underwent LT.The survival rates of the patients who met different criteria such as Milan.UCSF(University of California San Francisco UCSF).and Pittsburgh(Pitt)modified TNM criteria were calculated by KaplanMeier method,and the value of different criteria was evaluated.The Long-Rank test and COX proportional hazards regression model were performed to analyze the prognostic factors.the model of criteria was established according the most important prognostic factors.Using the Kaplan-Meier method,the suitable cut-offs of every variable ifl the model were found by comparing the survival and the number of the patients who met the cut-off,and considering the significant difference between the patients who met and exceed the cut-off at the same time.Resuits The 1,2,3-year accumulative survival rates of the 19 patients who met Milan criteria were 87.7%,87.7%,and 52.6%respectively:the 1,2,3-year disease free survival rates of them were 88.9%,72.7%,and 72.7%respectively.The 1,2.3-year accumulative survival rates of the 26 patients who met UCSF criteria were 87.2%,80.5%,and 55.2%respectively;the 1,2,3-year disease free survival rates of them were 84.1%,68.4%,and 68.4%respectively.With our new expanded criterion as of solitary tumor≤8 cm in diameter.or no more than 3 tumors,with the largest≤6 am,and a total tumor diameter≤10 cm.there was no significant difierence in 1,2,3-year sunrival rates and disease free survival rates(89.0%,81.8%,71.8%,and 81.9%,72.4%,72.4%.)as compared with Milan or UCSF criteria.but with this new criterion more patients(a=41)would be eligible for transplantation with a comparable long term survival.and the difference of the accumulative survival rates and disease free survival rates of the patients who met and exceed the new criteria was significant(P＜0.05).Conclusion The new indication is acceptable because the criteria does not adversely impact survival.

Objective To study how to decrease the hospital cost of liver transplants. Methods Fifty-four(patients) who underwent liver transplantation at our hospital within 2 years were analyzed retrospectively. The hospital costs of the patients with different liver function before operation, the costs of the(ICU-dependent), as well as the costs of the non-survival group with the survival group were analyzed and compared. Results The average hospital cost of all the patients was about 340 000 yuan. The cost of(pharmacy), anesthesia,(disposable)(materials), transfusion and laboratory tests accounted for 86.9 percent. The(average) cost of Child grade C(patients) was about 410 000 yuan, was 130 000 yuan higher than that of grade A or B patients. The cost of the ICU-dependent was 240 000 yuan greater than that of the(ICU-independent). The(non-survival) group incurred an average cost of 130 000 yuan higher than the(survival) group. Conclusions For decreasing the hospital cost of liver transplants significantly,it is best to encouraging the patients to receive(liver)(transplants) under good conditions.

OBJECTIVE To evaluate the embryo toxicity of Shuanghuanglian (SHL) by the combination of a human placental barrier model and embryonic stem (ES) cell test model.METHODS A human placental barrier model was set up by placenta slice culture and Ussing chamber.SHL 0.2,0.4,0.8,1.6,3.2,6.4 and 12.8 g· L-1 was added into the maternal side of the human placental model,respectively.All the media was collected respectively from the matemal side and fetal side 60 min later and taken as the SHL containing medium.ES cells (D3 line) and embryonic fibroblast cells (BALB/c 3T3) were cultured with the SHL containing medium respectively from the maternal side and the fetal side for 10 d.Cell viability was detected by MTT assay,and 50％ survival inhibitory ratio of ES and 3T3 cells by SHL was calculated.ES cells were incubated with the SHL containing medium from the matemal side or fetal side when they differentiated to cardiac myoblasts using hanging drop-suspension-attachment method.Messenger RNA of myosin heavy chain genes (β-MHC) was detected by Q-PCR for differentiation ratio,and 50％ differentiation inhibitory ratio of ES cells by SHL was calculated.A statistics formula was used for prediction of SHL embryotoxicity potential.RESULTS The IC50 of SHL in the matemal side of the human placental model for 3T3 cell survival,ES cell survival and ES differentiation was 1.97,0.84 and 0.48 g· L-1,respectively.According to the criteria for embryo toxicity evaluation,SHL had weak embryo toxicity.However,the IC50 of SHL in the fetal side of the human placental model for 3T3 cell survival,ES cell survival and ES differentiation was 3.19,2.57 and 0.95 g· L-1,respectively.According to the criteria for embryo toxicity evaluation,the supernatant containing SHL that went through the placental barrier had no embryo toxicity.CONCLUSION SHL is safe in the test concentration range during pregnancy.It is more scientific to evaluate embryo toxicity of drugs by ES cell test with the samples obtained through the placental barrier during pregnancy.

Objective:To investigate the common reasons,clinical features and the strategy of management with postoperative bleeding in thorax and abdominal cavity in orthotopic liver transplantation(OLT).Methods:Data based on the 12 cases undergoing OLT in our hospital from August 2000 to January 2002 were collected and analyzed.Results:The most common reason for bleeding post OLT was staxis in abdominal cavity(n=5),then was as followed:the abdominal bleeding caused by hepatic artery thrombolytic therapy(n=3),liver biopsy(n=2),Tipps(n=1),surgical technical reason(n=1).In all 12 cases,re operation of laparotomy was needed in 6 because of the massive bleeding.Acute renal failure happened in 5,and 3 needed hemodialysis.Four patients died postoperatively from massive abdominal bleeding,and 3 caused directly by the acute renal failure.Conclusion:Bleeding in the thorax and abdominal cavity happens frequently after OLT,and staxis in abdominal is the most common reason.The correct management for bleeding is the key thing to prevent complications.It is important to pay close attention to perioperative improvement of coagulative capacity,control of massive bleeding and prevention of renal failure.

Objective:To investigate the risk and prognosis of orthotopic liver transplantation (OLT)for patients with advanced hepatocellular carcinoma(HCC)and those without liver tumor.Methods:The risk and prognosis of 21 cases of orthotopic liver transplantation for patients with HCC were retrospectively reviewed and the comparison was made between such patients and 19 others with non tumor caused end stage failures whose OLT procedures have been done at the same period.Results:Compared with the non tumor OLT recipients,the HCC patients have a better preoperative coagulation function.In accordance with this,the blood lose,the required transfusion and the total infusion during the operation were also less than those of non tumor OLT patients.The duration of hypotension induced by bleeding in HCC patients were also shorter than that in non tumor patients.There were more patients in HCC group with uneventful postoperative course than that in non tumor group.The perioperative mortality was also lower in HCC group.Although the recurrence of malignance affected the long term survival of HCC patients,the whole survival rate was similar to that of non tumor OLT patients.Conclusion:OLT remains an effective alternative for the advanced HCC patients for whom there was no other better choice.It is possible that some patients can get a long term survival and are free of the recurrence of the HCC after OLT treatment.

Objective To summarize the experience in the diagnosis and treatment of elastofibroma dorsi,focusing on the clinical features,the specific radiological characteristics,and the typical pathological alterations.Methods Clinical data of 10 cases of pathologically confirmed elastofibroma dorsi from January 1997 to April 2008 were retrospectively reviewed.Results Most patients were female(8/10)in this series.All the lesions were located within the muscles in the subscapular region.There were 13 lesions in 10 cases(3 cases with bilateral involvement).Seven patients complained of pain and feeling of foreign body,and three were asymptomatic.The size of the masses was between 4 centimeters to 12 centimeters,averaging at(7.46 ±2.70)centimeters.Except for the early 3 cases,accurate diagnosis was made in all the other 7 cases before the histological exams solely based on the physical examination and imaging findings.Marginal excision was done for all the cases under general anesthesia.Fluid accumulation,as the only kind of complication was found in 3 cases which was resolved by repeated paracentesis.No recurrence was found during the follow-up period(4 months to 125 months,median 11 months).Conclusion Elastofibroma dorsi is a rare,pseudotumoral lesion usually found in elderly women.It is a very special type of soft tissue tumors that its diagnosis can usually be made solely on the basis of unique imaging characteristics and physical examination before the histological exam.Surgical marginal excision is the choice of treatment with good short-term and long-term results.

Objective To summarize the initial experience in application of mesohepatectomy for the treatment of central liver tumors while focusing on its indication, short-term and long-term prognosis and especially outlining its technical details. Methods The clinical data of 3 patients receiving mesohepatectomy from December 2007 to March 2009 in our hospital were retrospectively analyzed.The imaging characteristics were summarized to convey the indication details. The technique details of the operation were outlined so as to reduce blood loss or other complications during and after the operation. The post-operative course and follow-up data were also collected and analyzed. Results Two patients suffered from primary hepatocellular carcinoma with liver cirrhosis and the other from giant hemangioma. The tumors were located in Couinaud yegment Ⅳ and/or Ⅷ. The average blood loss and operative duration were 800 ml and 7 h, respectively. Blood liver function tests returned to normal within 7 days postoperatively and the patients were discharged after that. No complications occurred. The follow-up for 7-15 months showed that there was no recurrence. Conclusion Mesohepatectomy is the principal choice of treatment for centrally located liver tumors. For the safety and avoidance of complications, the doctor should abide by the concept of segment-oriented hepatectomy and apply the updated techniques such as CUSA (Cavitron ultrasonic surgical aspirator). For patients with compromised liver function, mesohepatectomy might be superior to extended bepatectomy. Thus, the application of mesohepatectomy should be expanded. Meanwhile, further investigation is needed for its full evaluation.