Objective To determine the optimal volume of plasma that should be used to perfuse through the portal vein (PV) to washout preservation fluid in retrograde reperfusion during liver transplantation.Methods The clinical data of S0 patients who underwent orthotopic liver transplantation (OLT) using retrograde reperfusion via the inferior vena cava (IVC) in our hospital from January 2011 to October 2013 were retrospectively analyzed.The patients were divided into two groups based on the volume of plasma infused via the PV to flush out the preservation fluid.Group 1:27 patients who received 400 ml,and Group 2:23 patients who received 1 200 ml.The preoperative and intraoperative data of the two groups were compared and analyzed.The serum concentrations of K+,Na+,Ca2+,mean arterial pressure (MAP) and pH were continuously monitored in the transplant recipients at different time points during liver transplantation.In addition,for patients in Group 2,the serum K +,Na + and Ca2 + concentrations in the samples of effluent fluid from the liver grafts were collected via the anastomotic stoma of the infrahepatic IVC and measured after infusion of 200 ml,400 ml,600 ml,800 ml,1 000 ml,or 1 200 ml of plasma.Results There were no significant differences in the preoperative and intraoperative data between the two groups.The plasma concentration of K + in Group 1 was significantly higher than that of Group 2 at 1 min after PV revascularization (T3) [(4.31 ± 0.54) mmol/L vs (3.96 ± 0.58) mmol/L,P ＜ 0.05],while the pH was significantly lower in Group 1 than that of in Group 2 (7.26 ± 0.02 vs 7.30 ± 0.04,P ＜ 0.05).The plasma Na + and Ca2 +concentrations,as well as the MAP,were not significantly different between the two groups at this time point.In group 2,no significant changes were observed in Ca2+ concentration in IVC blood following perfusion of 200 ml plasma.The insignificant changes in Na + after perfusion of 400 ml of plasma and for K + after 800 ml of plasma (P ＞ 0.05).Conclusions The electrolyte concentrations,blood pressure and arterial blood pH were fairly normal after resuming flow with PV revascularization after a perfusion volume of 800 ml of plasma.This volume was the most appropriate perfusion volume,balancing its effectiveness with economy to wash out any UW solution during OLT using retrograde reperfusion.

ObjectiveTo investigate the correlation between single nucleotide polymorphism (SNP)of complement factor H (CFH) gene and exudative age-related macular degeneration (AMD) susceptibility.MethodsThis is a retrospective case control study. 136 exudative AMD patients (AMD group) and 140age and sex-matched normal subjects (control group) were enrolled in this study. The peripheral blood was collected,polymorphism genotypes and frequency of CFH Y402H(rs1061170),CFH-257C ＞ T (rs3753394) and CFH IVS15 (rs1329428)were measured by polymerase chain reaction (PCR) and allelespecific restriction endonuclease digestion. The SHEsis software was performed on haplotype construction to analyze the frequency.ResultsThere are TT, TC, CC genotypes and T, C allele in CFH Y402H (rs1061170); CC, CT, TT genotypes and C, T allele in CFH-257C＞T (rs3753394); AA, AG, GG genotypes and A, G allele in CFH IVS15 (rs1329428). The differences of genotypes and allele frequency between 2 groups were statistically significant (P＜0. 05). The TC genotype in CFH Y402H, TT genotype in CFH-257C＞T (rs3753394) and GG genotype in CFH IVS15 (rs1329428) were associated with exudative AMD susceptibility (OR=4. 11,2. 55,3.11;P＜0.05). The T, C and G allele were the risk alleles (OR=3.14,1.72,1.79;P＜0. 05). The differences of frequency between TCG, CTG and CTA haplotype were statistically significant(X2 =10.53,6.60, 32.82;P＜0.05). ConclusionThere is correlation between SNPs of CFH gene and exudative AMD susceptibility.

Objective: To develop a resiliency scale for university students. Methods: Based on reference research and some similar foreign scales, the resiliency scale for university students, including 6 factors and 31 items, has been developed and its reliabilities and validities has been studied. Results: The ? coefficients of the total and 6 subscales was 0.6383-0.8594; the split-half reliability of the the total and 6 subscales was 0.6334-0.8600. A good construct validity was found by some indexes(?2/df=2.27,RMSEA=0.048,GFI=0.8991,IFI=0.9006) demonstrated by confirmatory factor analysis. The scores of this scale had significant correlations with SCL-90 scale. Conclusion: A good psychometric feature of the scale has been demonstrated.

Objective To explore a better method for establishing rat model of simultaneous (liver)-kidney transplantation and the prevention of complications after transplantation.Methods In the donor operation, the liver and the right kidney were flushed with 0-4 ℃ sodium lactate Ringer’s (injection) through aorta, and en bloc resection of organs of right kidney, liver, pancreas, intestines, and spleen were done. Preparation was performed in the preservation solution. During the recipient (operation), all the blood vessels were reconstructed with cuff methods. The bile duct was anastomosed using a simple inside bracket. Operation of connecting ureter attached part of bladder with the bladder was conducted.Results One hundred and ten simultaneous liver-kidney transplantations including 50 (preliminary) experiments were carried out. Eighteen recipient rats died in the preliminary experiments. Five recipient rats died in the formal experiments and all the remaining had survived for more than 30 days. The successful rate of formal transplantations was 91.7 %.Conclusion This kind of rat model of simultaneous liver-kidney transplantation is simple. The time for blood vessel anastomosis and (anhepatic) stage was reduced. Complications such as stenosis were avoided. Preparation before operation, manipulation after operation and management after operation can affect the establishment of the model.

Object To study the effects of chronic prenatal exposure to cocaine on hepar in the newborn rabbit at birth. Methods The pregnant Japan long ear white rabbits were divided randomly into cocaine group( N =12) and normal control( N =12). Pregnant rabbits were treated with cocaine hydrochloride 5 mg/kg or normal saline 1 ml/kg intravenously, one time daily from day 15 of pregnancy until day 30 respectively. Serum aspartate aminotransferase(AST), albumin(ALB), total bilirubin(T BIL), hepatic glutathione(GSH) were examined. Results (1)The levels of serum AST, T-BIL were significantly higher in the cocaine group than that in the control group( P

OBJECTIVE To discuss the clinic presentation,imaging characteristics and surgical management of the external auditory canal cholesteatoma (EACC) with invasion of the tympaniccavity and the mastoid. METHODS This was a retrospective study including the clinical data of 14 cases of EACC invading tympanic cavity and mastoid from 1998 to 2003 . RESULTS All 14 cases showed different bone erosion in the four walls of external auditory canal with extention to the mastoid . Pars flaccida perforation were found in 4 cases with invasion of the cholesteatoma into the tympanic cavity, the ossicular chains were compressed or destroyed. The bony mastoid segment of facial canal was destroyed in 3 cases . Cerebral plate destruction and congenital stenosis of external auditory canal were found in one case respectively. According to the extent of disease, modified radical mastoidectomy was performed in 8 cases and radical mastoidectomy in 5 cases , meatoplasty in one case. The post-operative hearing of 10 cases with intact ossicula chains were normal.One case with compression,shift of ossicules also got normal audition after the operation. The hearing threshold of the air condition in 3 cases with ossicular disruptions got 15 to 20dB of improvement among the language frequency after reconstruction of ossicular chain. The 14 cases were followed-up from 18 months to 5 years and no recurrences were found. CONCLUSION The exact etiology of EACC still remains unclear. There is some difficulty in diagnosing external auditory canal cholesteatoma (EACC) invading the tympanic cavity and the mastoid because of its untypical clinic presentation . High-resolution temporal bone CT scan could help to find out the primary lesion and determine the range of the pathological changes, and choose the proper surgical approach.

Objective To observe the protective effect of?-asarone,the active components from Rhizoma Acori Tarinowii,on human umbilical venous endothelial cell strain ECV304 injury induced by oxidized low-density lipoprotein(ox-LDL)and to investigate its influence on proliferation of vascular smooth muscle cells(VSMC). Methods The well-grown ECV304 cells were randomized into 5 groups:normal group,control group,high-, middle-and low-dose?-asarone groups.Except the normal group,ECV in the other groups were co-cultured with ox-LDL 25?g/mL,and the?-asarone groups were additionally with?-asarone 30,15 and 7.5?g/mL added respectively.Flow cytometry was used to detect the cell apoptotic rate and the mitochondrial membrane potential (MMP)of ECV304 as well as the proliferation index and the DNA content in different cell phases of VSMC. Results In the model group,the apoptotic rate of ECV was increased,MMP was decreased,and VSMC proliferation was promoted(P

Hepatectomy is the treatment of choice for huge ( ＞ 10 cm) hepatocellular carcinoma.However,the resection is more difficult and risky due to a huge space occupied by the tumor and vascular invasion.Precise hepatectomy is a new concept of liver surgery in the 21st century.The goal of which is the least invasive,most parenchymal preserving and optimal recovery.A male patient with a huge hepatocellular carcinoma (diameter =22.5 cm) received precise hepatectomy in the Department of Hepatobiliary Surgery of Fuzhou General Hospital of Nanjing Military Area.By using the digital medical technology and procedure of liver surgery planning system,the tumor and the whole structure of the liver were three dimensionally reconstructed,and the planning of resection was made.During surgery,the right liver artery and the right.porta hepatis were ligated and the right hemihepatic vessels were occluded.We accomplished right hepatectomy by accurate resection according the precisely planned preoperation,with less bleeding or no bleeding surgical field and rapid recovery.

Objective To study the methods of three dimensional reconstruction of digitized virtual breast invasive ductal carcionma and sterical characteristic of tumor growth.Methods The specimens were sliced into 0.2 mm continuous sections on transversal plane with the computerized miller,and photographs were taken with digital camera.3DDOCTOR software was used to make three dimensional block diagram and the thin sectional and three dimentional characteristics of breast invasive ductal carcionma were observed.Results Every structure of breast in thin section was clear.Stereo image of breast solid could be shown satisfactorily.Every shape of stereo image and the structure of breast could be shown by revolving the three dimensional image in different direction,beneficial to us in understanding the dimensional growth pattern of tumor.Conclusion The sliced image of breast invasive ductal carcionma database was exact.The image of three dimentional reconstruction was clear,which could reflect the structural feature and growth pattern of breast carcinoma in the breast exactly and be conducive to the evaluation of tumor margin in breast conservation therapy.

Objective To investigate the diagnostic value of heart-type fatty acid binding protein (H-FABP) versus cardiac trofonin I (cTnI) and creatinekinase-MB (CK-MB) in early diagnosis of acute myocardial infarction (AMI) in elderly patients.Methods 67 patients with acute chest pain were selceted sequentially and divided into AMI group (n＝30) and non-AMI group (n=37).Plasma H-FABP level was rapidly detected by using colloidal gold reagent plate and solid phase immunochromatographic assay for qualitative determination within and after 6 hours of AMI onset.Plasma levels of cTnI and CK-MB were determined within and after 6 hours of onset.The diagnositic value of H-FABP,cTnI and CK-MB in AMI was compared within and after 6 hours of onset.Results The sensitivity of H-FABP was better than that of cTnI and CK-MB within 6 hours of onset (93.3％ vs.46.6％,23.3％,both P＜0.05).The negative predictive value of H-FABP was better than that of cTnI and CK-MB within 6 hours of onset (94.7％ vs.69.8％,61.1％,both P＜ 0.05) While,positive predictive value and specificity were basically the same between H-FABP,versus cTnI and CK-MB.H-FABP and cTnI levels had significant differences between AMI and non AMI group after 6 hours of onset (all P＜0.05).Plasma levels of cTnl and CK-MB were higher after 6 hours than within6 hours [cTnI (4.10±1.79) mg/L vs.(1.45±1.31) mg/L,CK MB(180.52± 158.70) U/L vs.(20.02± 7.97) U/L,both P＜0.05].Conclusions As compared with cTnI and CK-MB,within 6 hours after AMI onset,H-FABP as a new myocardial necrosis marker has higher sensitivity,specificity,positive and negative predictive values in the diagnosis of AMI.While,after 6 hours of AMI onset,H-FABP has the same diagnostic value as cTnI and CK-MB.