Gastroesophageal varices hemorrhage is a common complication of portal hypertension. Drug and endoscopic therapy have become the basic treatments for varices. Transjugular intrahepatic portal venous shunt is recommended for the management of refractory or recurrent variceal hemorrhage. Liver transplantation will be considered when variceal hemorrhage becomes fatal and traditional therapies are with high risk, contraindicated, or have unsatisfactory results. Patients who received traditional treatments can achieve short-term efficacy and even stabilize the disease for a long time. However, if these treatments lead to complications such as portal vein thrombosis and hepatorenal syndrome, it may increase the risk of liver transplantation complications and affect the patient’s prognosis. Elevated portal venous pressure has a variety of adverse effects on systemic circulation, which can cause hepatopulmonary syndrome, portal pulmonary hypertension, refractory ascites, etc. In these cases, liver transplantation should be performed as early as possible. Conventional treatments are unsatisfactory. In addition, frailty may be worsened after traditional treatment, which will significantly increase the risk of liver transplantation. With the increase of model for end-stage liver disease, the requirement for donor liver volume will also has been increased, which will also affect the implementation of living donor liver transplantation. Some patients with portal hypertension may have poor quality of life and it may also become a clinical indication for liver transplantation. These liver transplant-related issues should be evaluated when administering traditional therapies. Traditional therapies aimed at improving the patient's condition, delaying or controlling complications should not interfere with the consequent implementation of liver transplantation. Improving the long-term overall survival rate and quality of life of patients with portal hypertension is the ultimate standard of all treatments.

0.05). Conclusion Combined inplantation of different types of DES is safe and does not increase the incidence of MACE.

OBJECTIVE: To study the constituents of the subaerial of Saussuare deltoidea (DC.)C. B. Clarke. METHODS: The constituents were separated by column chromatography on silica gel and the structures were elucidated by spectroscopic means. RESULTS: Eight constituents were identified to be Luteolin(Ⅰ), Quercetin(Ⅱ), Quercetin 3 0 ? L rhamnopyranoside(Ⅲ), rutin(Ⅳ), Lupeol acetate(Ⅴ), Lupeol(Ⅵ), ? sitosterol (Ⅶ), and Daucosterol(Ⅷ).CONCLUSION: Compounds Ⅰ Ⅷ were obtained from S.deltoidea for the first time.

BACKGROUND: Results from clinical trials suggested that clopidogrel and ticlopidine had side effects of granulopenia, and aspirin could inhibit endothelial progenitor cell proliferation. There is no report of effects of these drugs on human bone marrow mesenchymal stem cells (hBMSCs) in stem cell transplantation. OBJECTIVE: To investigate the effects of antiplatelet drugs including clopidogrel, ticlopidine and aspirin on hBMSC proliferation and secretion. DESIGN, TIME AND SETTING: The cytology in vitro observation was performed at the Laboratory of Toxicology, Shanghai Municipal Center for Disease Control and Prevention from March to December 2006.MATERIALS: The second passage of hBMSCs was kindly donated from Shanghai Tissue Engineering Research & Development Center, Shanghai Ninth People's Hospital. Clopidogrel (Lot number J20040006) and ticlopidine (Lot number H19980186) were obtained from Hangzhou Sanofi-Synthelabo Minsheng Pharmaceutical CO., Ltd. Aspirin (Lot number 20050059) was obtained from Bayer Vital GmbH. METHODS: The standard culture medium consisted of DMEM-LG, 10% heat-inactivated FBS, 100 U/mL penicillin and 100 μg/mL streptomycin. After being cultured in vitro expanded out to passage 6, hBMSCs were treated with antiplatelet drugs of different concentrations and compared with control group. MAIN OUTCOME MEASURES: Cell proliferation was assessed by 3- (4, 5-dimethylthiazol -2-yl)-2,5-diphenyltetrazolium bromide (MTT) colorimetric assay, level of vascular endothelial growth factor (VEGF) of culture medium was detected by enzyme-linked immunoadsordent assay (ELISA), and surface antigens of hBMSCs were analyzed by the flow cytometry. RESULTS: A570 values of hBMSCs treated by clopidogrel or ticlopidine of 0.02,0.1,0.4,2,10,40 μmol/L were higher than control group (P < 0.01), while A570 values of aspirin group of 60, 600, 2 000 μmol/L were lower than control group(P < 0.05). Antiplatelet drugs had no obvious effect on cell surface antigens(CD34, CD105, CD106)expressed by hBMSCs. Treated by high dose clopidogrel or ticlopidine (40 μmol/L), VEGF level from hMSCs was lower than that of control group(P < 0.01), but VEGF level of low dose (0.02 μmol/L) ticlopidine group was higher than control group(P < 0.01), and there was no significantly difference of VEGF level among low dose clopidogrel group (0.02 μmol/L), aspirin group (5, 2 000 μmol/L), and control group(P > 0.05). CONCLUSION: Clopidogrel and ticlopidine improve proliferation of hBMSCs, but aspirin inhibits proliferation of hBMSCs. High dose of clopidogrel and ticlopidine suppress VEGF secretion of hBMSCs, while low dose of ticlopidine promote it. Antiplatelet drugs have no obvious effect on hBMSCs differentiation.

Objective To explore the efficacy of liver retransplantation for hepatocellular carcinoma (HCC) patients with or without HCC recurrence.Method 131 cases of retransplantation performed between 2003 and 2012 were analyzed retrospectively.Their first and second liver transplantations were both performed in our hospital.Diagnoses of their primary diseases before transplantations were confirmed pathologically after the first transplantation.Patients were divided into two groups in terms of benign causes and HCC.Results Sixty cases were fallen into benign disease group and 65 cases into HCC group.The proportions of main causes of retransplantation were similar between two groups.The graft survival rate of early retransplantation (retransplantation performed within 30 days after the first transplantation) and late retransplantation (retransplantation performed beyond 30 days after the first transplantation) was calculated and compared respectively due a great difference in survival rate between the two phrases.The deaths of HCC patients with HCC recurrence before retransplantation were more than those without HCC recurrence (P＜0.01) and benign disease group.The 5-year cumulated survival rate was close between HCC patients without recurrence before retransplantation (51.0％) and benign disease group (51.8％).Conclusion The retransplantation after HCC recurrence has an unacceptable prognosis.The survival rate was similar between patients without HCC recurrence and patients with benign diseases.HCC patients without recurrence should not be restrained from retransplantation just for the HCC history.

Objective To evaluate the effect of carbon fiber couch on dose distribution of radiotherapy planning and verification pass rate.Methods Establishing the carbon fiber treatment couch model in Pinnacle8.0m Treatment Planning system (TPS),and then this model was used to correct dose calculations of oblique fields in the treatment plans of 10 cases of nasopharyngeal carcinoma,10 cases of breast cancer and 10 cases of lung cancer and evaluate the effect of carbon fiber couch on the whole dose distribution of the plans.Then these plans were measured by three-dimensional dose verification equipment Delta4 to confirm the improvement extent of Gamma pass rate after considering the carbon fiber treatment couch.Results For the majority of plans,when the carbon fiber couch was taken into consideration,the target doses was significantly reduced (4772 cGy-7266 cGy vs.4859 cGy-7347 cGy,P=0.000-0.002) and the relative deviation of D95 was 1％ to 3％.Measurement results of Delta4 showed that Gamma pass rate (3 mm/3％ criteria) increased in all plans (96.4％-98.8％ vs.93.4％-97.3％,P =0.000),some of that were up to 5 percentage when the couch model was applied.Conclusions Target doses will be overestimated if the treatment couch is ignored in TPS measurement.,However it should arouse enough attention when the disease with smaller doses corresponding gradient.

Purpose　The aim is to obtain the cDNA sequence of encoding extramembrane human FL gene with high level expression in E.coli. Methods　The primers were designed based on the known FL cDNA sequence. The total RNA was isolated from fetal liver cells , and then RT-PCR was performed. The fragment was cloned into pUC-18T vector, and further sequenced by automatic sequence analyzer. The gene was inserted into GST fusion expression vector between BamH Ⅰ and EcoR Ⅰ sites. The recombinant plasmid was transformed into E.coli strain DH5 α and induced with 1mmol/L IPTG.Results　The 546bp DNA fragment was amplified by RT-PCR method from fetal liver cells and its sequence was identical to the published sequence encoding human FL. The expressed fusion protein, with molecular weight of about 22kD, was about 10% of the total bacteria protein by SDS-PAGE and densitometry analysis.Conclusion　cDNA was cloned successfully. This study provided a basis for the further fundamental research and clinical application of FL.

Objective To investigate the development status of tumor radiotherapy in Guangxi Zhuang autonomous region in order to provide reference for the decision-making of the competent administrative departments for public health.Methods A questionnaire survey was conducted by the aid of on-site inspection and telephone or Email investigation among the medical institutions in Guangxi to know the current status of radiotherapy units and settings,human resources,allocation of radiotherapy facilities,and standardization of medical practices.Results Up to the end of August 2014,radiotherapy was carried out in 39 hospitals,with other 5 hospitals under preparation for construction.Among these 40 hospitals were three-dimensional conformal radiotherapy in 38,intensity modulated radiation therapy (IMRT) in 23,and image guided radiation therapy (IGRT) in 5.There were 48 linear accelerators,15 afterloading therapy apparatus,and 4 γ-knife or X-knife in Guangxi.There were 647 professional personnel (except nurses),including 322 radiation oncologists,100 radiotherapy physicists,213 radiotherapy technologists and 12 professional engineers.There were 2 000 to 2 500 hospital beds and 20 000 cancer patients had received radiotherapy in 2013.1 600 to 2 000 people received treatment on average every day.Conclusions The present radiotherapy resources in Guangxi are insufficient and the input to radiotherapy equipment is deficient,with low proportion of cancer patients treated with radiotherapy.Because of the uneven radiotherapy quality among different hospitals,the reasonable planned development and unified diagnostic and treatment practices are required to improve radiotherapy level in Guangxi.For shortage of medical staff and high-quality physical and technical personnel,the improvements are needed by fostering and introduction of personnel.Compared with developed regions in China,the introduction of new technology is largely needed.

The authors of this paper confirm the goal, factors and principles in arrangement of clinical practice, design a transplacement algorithm to solve the model, and after estimating the capacity to interns of affiliated hospital, make the schedule by that algorithm so as to relieve the relative short supply of good clinical education resourses.

OBJECTIVE: To evaluate therapeutic effect and safety of poly DL-lactic bio-absorbable screws in the treatment of Pipkin fractures.METHODS: A total of 13 Patients of Pipkin fractures received treatment at the Department of Orthopaedics, Third People's Hospital of Wujiang City and Department of Orthopaedics, First Affiliated Hospital of Soochow University from March 2003 to October 2007 were selected, including 10 males and 3 females, mean aged 30.5 years. Six of them had a Pipkin type Ⅰ fracture,4 had a Pipkin type Ⅱ fracture, and 3 patients had a Pipkin type Ⅳ fracture. In all the operative procedures, a dorsolateral Kocher-Langenbeck approach was used.RESULTS: After an average duration of 47.9 months follow-up, all fractures achieved complete bony healing. One patient had femoral head avascular necrosis and 1 had persistent hip pain, but no heterotopic ossification was observed. According to Harris hip score: Pipkin type I 85 points, type Ⅱ 90 points and type Ⅳ 77 points. According to the Thompson-Epstein hip scale, 3 patients were rated as excellent, 8 good, 1 fair, and 1 poor; the excellent and good rate was 84.6%.CONCLUSION: Poly DL-lactic bio-absorbable screw fixations are safe and effective in treating Pipkin fractures.