Hepatitis B recurrence is one of the most frequent complications that will probably result the treat failure of liver transplantation. As many as 80% of patients with HBV are reinfected by this virus after liver transplantation. This has been the most deadly case that threatens patient survival amongst all problems emerging from liver transplantation executed for Hepatitis B ralated hepatocirrhosis. In recent years a great deal of prophylaxis practices have been adopted, which has greatly reduced the possibility of Hepatitis B recurrence. The present paper reviews the causes and treatment of Hepatitis B recurrence after liver transplantation.

Objective To assess the use of medical services by patients with chronic hepatitis B, cirrhosis resulting from hepatitis, or hepatic carcinoma and the composition of the expenses incurred. Methods A survey was made on the use of outpatient and inpatient services as well as the details of medical expenses incurred by 1 395 self-funded patients and patients enjoying social medical insurance in Shanghai. And an analysis was made on the composition of the expenses and direct medical expenses per annum. Results There was no significant difference between the self-funded group and the insurance group in the use of outpatient and inpatient services; in terms of medical expenses, those incurred by the insurance group were 30% to 50% higher than those incurred by the self-funded group; an analysis on the composition of outpatient expenses showed that drug expenses accounted for over 80% and examination and test expenses accounted for over 15%; an analysis on the composition of inpatient expenses showed that drug expenses incurred by the two groups both accounted for 45% to 60% of the total expenses and examination and test expenses accounted for 15% to 25%. Conclusion Social medical insurance reduces the economic burden of individual patients but significantly raises treatment expenses. The key to containing the rise of medical expenses lies in controlling the conversion of hepatitis B to cirrhosis and the irrational growth of inpatient drug expenses and examination and test expenses.

Objective To investigate the related factors of encephalopathy following orthotopic liver transplantation (OLT).Methods The clinical data of 128 patients who underwent liver transplantation consecutively between October 2001 and October 2003 were analyzed retrospectively by SPSS 10.0 . All clinical factors were analyzed by Crosstabs or independent-samples t test. A mutivariative analysis of these significant factors was done by using the Binary Logistic Regression.Results Encephalopathy occurred in 21 cases within the first week after operation, including 19 cases of Child-pugh C and 2 cases of Child-pugh B. There was a higher occurrence in the patients with chronic severe hepatitis or undergoing re-transplantation ( P 0.05 ). In the encephalopathy group the incidence of renal failure after transplantation and infection pre- or postoperation was higher than in control group ( P

[Objective]To investigate the value of double plates in the anterior approach for the treatment of jumping multilevel CSM.[Method]From July 2003 to July 2004,21 cases of jumping multilevel CSM and 7 cases of CSM were operated with single level discectomy/anterior corpectomy and self-iliac bone graft and fixation by double plates.During the 6,9,12 month follow-up,bone fusion were assessed and neurological function、complications were recorded.[Result]All patients were followed up for 16~32 months(24 months on average).Based on JOA evaluation,the average improving rate was 88.5%.And 82.1% fusion was achieved at 6 months,the fusion rate reached 89.3% and 93% at 9 and 12 months accordingly.There were 6 cases with complications in the donor site of grafting.Indications of this approach:the compressing pathology was located anterior to the spinal cord.This included central,broad-based disc herniations and large bridging osteophytes at or adjacent to the level of the disc space.And it was especially indicated for patients with jumping multilevel CSM who did not have a lordotic spine.Complications:complications occurring with this approach could be related to injuries to the soft tissue during dissection or to the neurological elements.In addition,postoperative fusion or hardware failure could occur.[Conclusion]Single level discectomy/anterior corpectomy and self-iliac bone graft and fixation by double plates is an effective treatment to the jumping multilevel CSM.It allows restoration of the spinal canal and neural foramen to normal dimensions to decompress the spinal cord.To the cases of jumping multilevel CSM that have a kyphotic deformity,it allows anterior decompression and reconstruction of the spine to help restore a lordotic curvature.

Objective To explore the method and significance for constructing three-dimensional visual model in bronchial tree of pig lung. Methods A set of pig lung specimen was infused with epoxy resin-lead oxide through the trachea,and then casted. The Mimics 15. 0 was used to construct three-dimensional visual model in bronchial tree of pig lung by utilizing CT data of the cast specimen. Results In the reconstructed three-dimensional visual model of bronchial tree,the three-dimensional effect was realistic. This model not only clearly showed each lobar direction and distribution of bronchial tree,but also allowed three-dimensional arbitrary scaling,shifting or rotating at any angle, and the diameter and distance of each lobar bronchus could be measured with the sofeware. Conclusion The three-dimensional visual model in bronchial tree of pig lung can be successfully reconstructed from the CT dataset by using related sofeware like Mimics,which can bring morphological reference to anatomical teaching and will be helpful to the development of virtual operation.

Artery cannulation is one of the clinical skills that should be mastered by the internships of anesthesiology. In consideration of its invasiveness,teachers should carry out the clinical teaching strictly and patiently,and assist the internships to establish a correct opinion on clinical practice. We should train the internships step by step,improve their success rates on artery cannulation and avoid complications as far as possible.

Objective To evaluate the three-dimensional reconstruction and significance of arterial cast on chronic venous insufficiency of low extremity. Methods A set of specimen on chronic venous insufficiency of left lower extremity amputation residues was infused with epoxy resin-lead oxide through the femoral artery,and then casted. The CT data of the cast specimen was used to reconstruct 3D modal of ar-tery on chronic venous insufficiency of left lower extremity,using the volume rendering(VR) and maximum intensity projection(MIP). Re-sults The cast specimen and 3D reconstruction of chronic venous insufficiency of left lower extremity amputation residues could clearly dis-play distribution and run of lower extremity arteries,blood supply of lesion and local region embolism of small artery ( arteriole) . Conclusion The 3D modal of artery on chronic venous insufficiency of left lower extremity should provide morphological basis of exact etiology and perfect pathogenesis,also has a certain guiding significance of clinical diagnosis and treatment.

Objective:To investigate the curative effect of different restorations for deciduous teeth defect of children.Methods:67 children with teeth defecting seriously and being unable to fill restore were enrolled from January 2011 to January 2015 and randomly divided into three groups,one group of patients accepted metal crown restoration (Group A,n=22),one group adopted ceramic inlay restoration (Group B,n=22),and the last one accepted silver amalgam filling (Group C,n=23),the curative effect and incidence of adverse reactions among three groups in the period follow-up were compared.Results:In the period of 18-month follow-up,6 patients of toothache,5 patients of food impaction and crevices between restorations and teeth,3 cases of gingival congestion,2 cases of secondary caries were observed in group C;3 cases of toothache,1 case of food impaction,gingival congestion,crevices between restorations and teeth and secondary caries were observed in group B;2 cases of toothache and food impaction,1 case of gingival congestion were observed in group A.The incidence of adverse reactions in group A and group B was lower than those in group C (P＜0.05),which was lower in group A than that in group B,but no significant difference was found between group A and group B (P＞0.05).Conclusion:The restoration of metal crown and ceramic inlay deserved popularization had better curative effect and safety for deciduous teeth defect of children than silver amalgam filling.

Objective To investigate the protective effect of a COX inhibitor,flurbiprofen (Flurb) on hepatic ischemia/reperfusion (IR) injury in rats and the action mechanism.Method C57BL/6 mice were randomized into sham,IR and Flurb (4 different doses) groups.The model of segmental (70％) warm hepatic ischemia was established in IR and Flurb groups.Flurbiprofen of different doses (5,7.5,10 and 15 mg/kg) was injected via the tail vein 20 min before ischemia.At different time points after reperfusion,liver cell necrosis and apoptosis were evaluated by HE and TUNEL staining.The COX and inflammatory cytokine gene expression was detected by using realtime PCR.Liver mitochondria were separated and mitochondrial permeability transition (MPT) pore sensitivity was examined by using swelling assay and fluorescence spectrophotometry assay.Result In flurbiprofen groups of different doses,the serum AST and ALT levels were significantly decreased at 6 h after reperfusion as compared with IR group.Moreover,10 mg/kg Flurb pretreatment significantly inhibited the mitochondrial permeability transition (MPT) pore opening,and thus alleviated liver cell damage and prevented mitochondria-related cell death and apoptosis by inhibiting COX-2 and inflammatory factor genes expression such as IL-1β,IL-6 and TNF-α.Conclusion Flurbiprofen protects mice from hepatic I/R injury possibly by inhibiting mitochondrial permeability transition and IL-1β,IL-6 and TNF-α expression,which may provide experimental evidence for clinical use of flurbiprofen to protect liver function in surgical settings other than its conventional use for pain relief.