ObjectiveTo manage the early immunosuppressant-associated hypertention in liver transplantation patients. MethodsFifty-six liver transplantations were performed from May 2000 to May 2002, their clinical feature (data of blood pressure and treatment) were analysed. ResultThe incidence of hypertension after liver transplantation was 70% in 2 weeks, 66% in one month. The incidence in cyclosporine group and FK506 group was 73% (31/40) and 33%(3/9) respectively(P

BACKGROUND: The structural and functional changes in resistance arteriole of external diameter ＜300 μm is one of the pathological foundations for ischemic cerebrovascular diseases, however there are few quantitative study on the arterioles of various external diameter at different brain area.OBJECTIVE: To probe the difference of arteriolar sclerosis of various external diameter at different brain area after cerebral infarction.DESIGN: Sample investigation.SETTING: Department of Nerve Internal Medicine, General Hospital of Beijing Military Area Command of Chinese PLA.SUBJECTS: Specimen was taken from donated autopsy case in General Hospital of Beijing Military Area Command of Chinese PLA from January 1980 to September 2000. According to the clinical manifestation, brain CT inspection and pathological diagnosis of autopsy, 38 cases were defined as arteriosclerosis cerebral infarction and taken as experimental group, other 15 cases with non-cardiac cerebrovascular disease were taken as controls.METHODS: specimen was obtained in 1-3 days after death from frontal and parietal cerebral cortex and basal gonglion white matters (3 pieces /case) and cut into slices. Five fields of vision were selected from each slice for microscopic observation. Arteriole was divided into ＜ 50 μm group,50-100 μm group and ＞100 μm group according to the arteriole external diameter. (External diameter- internal diameter)/internal diameter was used to assess vascular sclerosis.MAIN OUTCOME MEASURES: [1] Difference of arteriole sclerosis between corresponding external diameter cerebral infarction group and control group. [2] Arteriole sclerosis in various brain region in cerebral infarction group.RESULTS: Totally 38 experimental cases died from arteriosclerosis cerebral infarction and 15 controls died from non-cardiac cerebrovascular disease were enrolled and all data was entered the result analysis. [1] The arteriolar sclerosis index was obviously higher in ＜ 50 μm external diameter cerebral infarction group than in 50-100 μm group and ＞100 μm group[(138.55±76.67)% vs (116.82±58.80)%, (78.07±32.06)%, P ＜ 0.01], while it was approximately the same in the 100 μm external diameter group and control group [(78.07±32.06)% vs (46.38±13.41)%, P=0.174 ]. [2] In ＜ 50 μm external diameter cerebral infarction group, the arteriolar sclerosis index in white matters was significantly higher than that in gray matter [(152.86±87.83)%,(127.97±64.76)%, P ＜ 0.05 ].CONCLUSION: Arteriolar sclerosis degree is correlated with its external diameter and position in patients with cerebral infarction after arteriosclerosis, arteriole of small external diameter or in the white matter has higher arteriolesclerosis liability.

Many kinds of volatile organic compounds(VOCs)exist in the indoor air,the chemical reaction will occur among the pollutants when O3 and NO2 exist simultaneously.This reaction can severely impact the indoor air quality and produce some adverse effects on human health.The main chemical reactions among the indoor air pollutants and the potential health effects associated with inhalation exposure to the products of the chemical reaction in the indoor air were discussed in the present paper.The study of the chemical reactions among indoor VOCs is very important for human health and is helpful for revising the Indoor Air Quality Standard and making the 'Ecologic Label' of building materials.

Objective This study was to detect protein expression of ERK 1,ERK 2,JNK 1,p38 and MEK 1 ,MEK 2 in human hepatocellular carcinoma and adjacent non neoplastic liver tissues.Method Western blot was used to detect the expression of ERK 1,ERK 2, JNK 1,p38 and MEK 1,MEK 2 in the surgically resected hepatocellular carcinoma and para carcinoma tissues in 16 HCC patients.[WT5”HZ] Result The expression of ERK 1,ERK 2,p38 expressed by integral optic density (IOD) in hepatocellular carcinoma was significantly higher than that in para carcinoma respectively: as for ERK 1 it was 300?98 in carcinoma and 98?48 in para carcinoma tissues ( P

[Objective]To evaluate the long-term clinical results of Herbert screw in the treatment of intra-articular fractures by retrospective analysis.[Method]From 1991 to 2006,fifty-five patients of different parts of intra-articular fracture treated with Herbert screw were followed up effectively,including scaphoid fracture group of 19 cases,the radial head fracture group of 25 cases,the femoral head fracture group of 11 cases.[Result]After an average follow-up time of 5 years and 11 months(ranged,1-13 years),the good-to-excellent rates were 94.7%,96%,72.7% according to the modified Mayo score,the Broberg-Morrey score and the Tompson-Epstein score.[Conclusion]The Herbert screw can provide strong fixation and stability in the long-term follow-up.It is an ideal material in treating intra-articular fractures.

Objective To study the causes and management of biliary complications after orthotopic liver transplantation.MethodsClinical data of 38 patients who have underwent orthotopic liver transplantation between May 2000 and January 2002 were studied retrospectively. ResultsPostoperative bililary complications occurred in 9 patients(24%), including simple biliary fistula in 4, stricture of hepatoenterostomy, intrahepatic cholelith, biliary stricture with sludge, biliary stricture with cholelith, and intrahepatic biloma and cholelith in one each. Two patients died of the complication, and seven were cured successfully. ConclusionsThe causes of biliary complications are complicated. Early diagnosis and timely management helps to decrease the mortality. Endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography is a valuable, less traumatic procedure.

Objective To summary the experience of living donor liver transplantation (LDLT) in order to improve therapeutic effect of LDLT. Methods We retrospectively analyzed the clinical data of donors and recipients of 22 LDLT cases, evaluating patients' and donors' preoperative assessment, surgical strategies and postoperative complications. Results Donor's grafts harvested included 2 left lateral lobes, 6 left half livers, 1 extended left half liver, 5 right half livers and 8 extended right half livers. Postoperatively all donors recovered without severe post-transplantation complications. Among 13 adult and 9 child receipients, there were 8 recipients suffering from posttransplantation complications, including intra-abdominal severe infection in one case, delayed liver function recovery complicating incisional infection in one case, intra-abdominal hemorrage complicating thrombogenesis of the hepatic artery in one case. All these 3 patients died. One child recipient of hepatic failure died of heart and respiratory failure after operation. Other non-lethal complications were bile leakage in 2 cases, refractory ascites in one and deep venous thrombosis of the lower limb in one. These complications were cured without laparotomy. Finally 18 recipients were fully recovered and discharged. Late post-operative complications included strictures of biliary tract in 3 cases which were treated with PTCD and indwelling stent, the obstructive jaundice due to achalasia of sphincter of Oddi was treated with endoscopic sphincterotomy. These 4 patients' are on stable condition and the liver function is normal. Conclusions Select proper donor and optimal surgical strategy are extremely helpful to secure donors and recipients during the procedure of LDLT.

Objective:To investigate the outcome of liver transplantation(LT) for end stage liver disease with portal vein thrombosis(PVT) in different processes.Methods: Data from 308 patients who underwent LT from July 2004 to February 2008 were retrospectively assessed.The processes of varies grades of PVT during LT were analyzed and estimated for whether the outcome of LT was different between patients with or without PVT.Results: There were 46 patients with PVT,including 11 of grade 1,14 of grade 2,18 of grade 3 and 3 of grade 4.LT performed in grade 1 and 2 PVT patients without special intervention.LT was performed in 16 patients with grade 3 PVT after simple thrombectomy or thrombus-extraction.The other 2 patients with grade 3 PVT received the donor superior mesenteric vein to act as a bridge between the donor portal vein and host superior mesenteric vein.Two cases with grade 4 PVT received a cavo-portal hemitransposition,and the other one anastomosis between graft portal vein and varicose coronary vein.The postoperative 1-year survival rates of patients without PVT and patients with PVT were 91.6%(240/262),80.5%(211/262)vs 86.9%(40/46),76.1%(35/46),respectively.The patients with PVT had a recurrence rate of 4.3%(2/46).Conclusion: Most patients suffering from end stage liver disease with PVT can be successfully treated by LT.However,the result of the patients with diffused PVT undergoing LT is relatively poor.

objective To explore a new method of repairing skin defects complicated with fracture and tendon rupture at the middle and distal sections of the second to fifth fingers. Methods The reversed dorsal metacarpal island flap was designed to be pedicled on the digital proper artery-common digital artery-fingerweb artery-dorsal metacarpal artery-cutaneous branch of dorsal metacarpal artery.In repairing digital palmar skin defects,after the flap was dissected,the proximal incision was extended along the direction of dorsal metacarpal nerve to harvest an enough length of the nerve so that the dorsal metacrppal nerve can be anastomosed with the digital proper nerve to restore the sensation of finger pulp.From the June 2003 to March 2009,the flap was used to repair 26 fingers in 24 patients with middle and distal digital skin defects complicated with fracture and tendon rupture.They were 17 men and 7 women,aged from 16 to 63 years (average,37 years).There were 15 cases of palmar skin defect and 9 cases of dorsal skin defect.In the 2 cases of combined tendon defects,a section of the extensor tendon of index(or little) finger was dissected together with the flap to repair the tendon rupture. Results The areas of the flap ranged from 3.1 cm ×1.6 cm to 6.0 cm × 4.0 cm.The flaps survived in all 24 cases without any vascular crisis.Twenty-two patients obtained an average follow-up of 14 months (from 4 to 32 months) but 2 were lost to the follow-up.The flaps were fine in texture,colour and appearance.The finger pulps appeared full and recovered sensations of pain and temperature.The average two-point discrimination was 7.5 mm (from 5 to 9 mm).Sensory function evaluation revealed an outcome of S3 + ～ S4.Tendon adhesion occurred in 4 cases which recovered digital function following secondary lysis 3 to 6 months postoperation. Conclusion Application of the reversed dorsal metacarpal island flap pedicled on the digital proper artery is a good way to repair skin defects complicated with fracture and tendon rupture at the middle and distal sections of the second to fifth fingers.

Objective To investigate the effects of epidural administration of a mixture of betamethasone and lidocaine on nerve root inflammation and epidural space adhesion in rabbits. Methods Twenty-four adult male New Zealand white rabbits weighing 2.0-2.1 kg, were randomly divided into 2 groups ( n = 12 each): control group and treatment group. A catheter was inserted into epidural space at L2,3 interspace. Twenty-four hour after epidural catheter placement, talcum powder 0.5 mg/kg was injected into epidural space to make the model of nerve root inflammation and epidural space adhesion. Three days later a mixture of lidocaine 2.5 mg/kg and betamethasone 0.25 mg/kg was injected via the epidural catheter in treatment group, while the equal volume of normal saline was given in control group. At 21 days after administration of lidocaine and betamethasone, the spinal cord was removed, and dura mater and nerve root were checked with naked eye, light microscope and electron microscope.The neutrophil count in the dura mater was determined. Results There was nerve root inflammation and epidural space adhesion in control group. The nerve root inflammation and epidural space adhesion was not observed in treatment group. The neutrophil count was reduced in treatment group (21 ± 12) compared with control group (250 ±43) ( P < 0.01) . Conclusion Epidural administration of a mixture of betamethasone and lidocaine can alleviate nerve root inflammation and epidural space adhesion.