Biliary duct injury can arise severe complications,but the proper management can improve patients'prognosis and living quality.So we reviewed the current relevant references and hope it can do some help for clinicians.

Objective To investigate the protective effect of penotoxffylline (PTX) on renal iscbemia-reperfusion injury (IRI) and its mechanisns. Method Seventy-five male SD rats were randomly divided into three groups with 25 rats in each group: the sham operated controls, Iri group and FIX treated group. The rat model of renal IRI was established with occlusion of left and fight kidney pedicle for 45 minutes. Sham rats underwent laparotomy without IR.Treated mrs received FIX 20 mg/kg at 30 minutes before operation through their tail vein,tben PTX 6 mg/(kg·h) IV with pump. SO group and IRI group rots were IV normal saline equivalently. The pathological change of kidney, serum creatinine (sCr) values and the levels of MDA,SOD,TNF-α and ICAM-1 in homogenate of kidney tissue were measured before ischemia, 0, 1, 4, and 24 hours after reperfitsion. Results After IRI, renal tubular epithelial cells manifested swelling, degeneration, necrosis, and inflammatory ceils infiltration. After treated with PTX, the pathological change of the kidney was significantly alleviated, and inflammatory cells infiltration reduced. In FIX group,the kidney tissue pathological change was ameliorated, and the values of serum Cr, the scores of renal tubules were significantly lower than those in IRI group (P<0.05). Compared with IRI group, the levels of TNF-α in bemegenate of kidney in FIX group were significandy lower at 0 h, 1 h,4 h and 24 h after reperfiJsion (P<0.05). Compared with IRI group, the levels of MDA, ICAM-I in homogenate of kidney in FIX group were obviously lower at4 h, 24 h after reperfusion (P<0.05), while the level of SOD in homogenate of kidney was significantly higher (P<0.05). TNF-α correlated with levels of MDA, SOD, ICAM-1 ( r =0.801, -0.895,0.838,and P<0.01). Conclusions PTX had the protective effect on renal IRI by directly inhibited expression of TNF-α in kidney tissue,then decreased expression of MDA, ICAM-1 and ameliorated the inflammatory ceils infiltration in kidney.

ObjectiveTo analyze the systolic function of subendocardial myocardium of the left ventricle in patients with diabetes mellitus (DM) and DM associated hypertension by speckle tracking imaging (STI).Methods The left ventricular ejection fraction(LVEF) and left ventricular mass index (LVMI) of all subjects including 30 patients with diabetes mellitus(DM group),25 patients with DM associated hypertension (DH group) and 30 healthy volunteers (control group) were normal and near.The common parameters of echocardiogram were measured and the peak systolic longitudinal strain of subendocardial myocardium were analyzed from the long-axis view at the levels of mitral annulus,papillary muscle and apex by STI.All above parameters were compared among three groups.ResultsNo significant difference in all parameters was found between the control group and two patient groups,but the ratio of E/A was significantly lower in the two patient groups than that of control group ( P ＜0.01).The peak systolic longitudinal strain of some segments were significantly lower in the two patient groups than that of control group ( P ＜0.01).The peak systolic longitudinal strain of the subendocardial myocardium of all segments in the two patient groups were different decrease compared with the control group( P ＜0.01 or P ＜ 0.001).The peak systolic longitudinal strain of the subendocardial myocardium of the DH group except some segments were decrease compared with the DM group ( P ＜0.01).ConclusionsSTI may be early used to identify the left ventricular systolic function in patients with diabetes mellitus.

Ubiquitin-like proteins are structurally similar to ubiquitin. These proteins are processed, activated, conjugated, and re-leased from conjugates by enzymatic steps that are similar to the corresponding mechanisms for ubiquitin. Ubiquitin-like proteins regu-late a wide array of cellular processes through modification processes, such as nuclear-cytosolic transport, transcriptional regulation, protein stability, response to stress, and progression through the cell cycle. A large number of recent studies have found dysfunctional ubiquitin-like proteins in hepatocellular carcinoma. These proteins are important in tumorigenesis, cell proliferation, apoptosis, and an-giogenesis. Anticancer drug studies revealed that regulating protein modification by using ubiquitin-like proteins may alter the anti-tu-mor effects of chemotherapy and thus influence the chemosensitivity of hepatocellular carcinoma. Results indicate that ubiquitin-like proteins may become a new target for cancer therapy. The mechanism of ubiquitin-like proteins in tumorigenesis and hepatocellular car-cinoma progression is of great significance in the diagnosis and treatment of hepatocellular carcinoma.

Objective To evaluate the therapeutic effects of pingyangmycin in treatment of body surface hemangioma in children.Methods The clinical data of 1 658 children patients with hemangioma on body surface in which pingyangmycin was injected between January 1997 and January 2008 were analyzed retrospectively.Results All 1 658 patients were observed for 6-12 months,with average of 10.83 months.The total effective rate was 97.09%.Compared among different types of hemangioma,total effective rate had significant difference(?2=203.12,P

Biliary atresia (BA) is a kind of disease of unknown etiology, characterized by progressive inflammation and fibrosis of obstructive biliary diseases. Kasai portoenterostomy is the only method to treat BA. However, about 80% of the patients treated by Kasai operation still need liver transplantation in the future. Many factors affect the survival of autologous liver in children with BA after Kasai operation, including the types of BA, laparoscopic Kasai surgery or traditional open surgery, patient’s age at surgery, condition of liver function, occurrence of cholangitis, jaundice clearance, using steroids and central hospitalization. This article reviews the factors that affect the survival of autologous liver in patients with BA after Kasai surgery.

Objective To investigate the influence factors of left ventricular hypertrophy ( LVH) in incipient systemic lupus erythe-matosus (SLE) patients with lupus nephritis (LN).Methods A total of 210 LN patients in the authors′centre were enrolled in this cross-section study .General information , laboratory measurements , examinations of left ventricular hypertrophy by ultrasonography were col -lected.Patients were divided into two groups according to left ventricular mass index (LVMI):left ventricle thickening (LVT) group (n=89) and left ventricle normal group (n=121).General information and laboratory results of two groups were statistically analyzed .In-fluence factors of the patients were analyzed with Spearman rank correlation and multiple linear regression .Results Serum uric acid and hyper-sensitive C-reactive protein (hs-CRP) were higher in left ventricular thickening (LVT)group, as compared with those in left ventricle normal group .Hemoglobin and estimated glomerular filtration rate ( eGFR) in LVT group were significantly lower than those in left ventricle normal group (P<0.05).Spearman rank correction indicated that LVH was positively correlated with serum uric acid and hs-CRP (r=0.283、0.327, all P<0.05).LVH was negatively correlated with hemoglobin and eGFR (r=-0.232, -0.186, all P<0.05).Multiple linear regression showed hs -CRP and hemoglobin correlated with LVH (β=0.235、-0.206, all P<0.05).Conclu-sion Inflammatory state and anemia were risk factors of LVH in LN patients .

objective To analyze the risk factors of sepsis,and to elucidate the efficacy of high-flux hemofihration(HVHF)in the treatment of sepsis and the initiate opportunity of HVHF treatment on sepsis complicated with acute kidney injury(AKI). Methods Clinical data of 152patients with sepsis undergoing HVHF treatment were retrospectively analyzed.APACHE Ⅱ,APACHE Ⅲ and SAPS Ⅱ score evaluation before treatment and 24 h,48 h.72 h after treatment were performed.According to 28-day survival,patients were divided into survival group and death group.Clinical indicators before and 24 h,48 h,72 h after treatment were compared between groups.Risk factors influencing prognosis of patients were examined by multivariate regression analysis.Influence of AKI stages on prognosis of patients was studied. Resalts Lung and alimentary tract were the most frequent infection sites of sepsis.Twenty-eight days after HVHF treatment,74 patients (48.68%)survived,seventy-eight patients (51.32%)died among 152patients,and 4 patients(2.63%)needed sequent renal replacement therapy.Twenty-eight-day mortality was significantly lower than the mortality 88.78%±17.72%predicted by APACHE Ⅲ.APACHE Ⅱ,APACHE Ⅲ and SAPS Ⅱ Sscores decreased remarkably (P＜0.01) 24 hours after treatment.Age,number of dysfunctional organ,APACHE Ⅱ,APACHE Ⅲ,SAPS Ⅱ scores,undedying diseases,shock,AKI,severe acute pancreatitis,alimentary tract hemorrhage,cataphora and pressor agent were correlated with 28-d survival rate.Underlving diseases and APACHE Ⅲ were independent risk factors.Renal function recovery rate in AKI stage 1 was higher than that in AKI stage 2,3(P＜0.05).Twenty-eight-day mortality of patients without AKI was lower compared to AKI stage 1,2,3(P＜0.05),but 28-day mortality was not significantly different among AKI stage 1,2,3. Conclusions Prognosis of patients with sepsis is poor.HVHF can improve biochemical indicators and prognosis of patients effectively,and increase survival rate.Underlying diseases and APACHE Ⅲ are independent risk factors of 28-day mortality of sepsis patients.Twenty-eight-day mortality of non-AKI patients is obviously lower compared to AKI stage 1,2,3patients.AKI stage is correlated with 28-day renal function recovery rate,but not obviously correlated with 28-day mortality.

Objective To compare the infection free and overall survival between first and subsequent tunneled cuffed hemodialysis catheters in geriatric patients.Methods The study involved57 geriatric patients [32 male,25 female; mean age (72.4 ± 6.7) years]undergoing maintenance hemodialysis in our blood purfication unit over a period of 72 months.Among a total of 131 catheters and 2686 catheter months including 57 first catheters and 74 consecutive catheters,48 wire guided exchange (WGE) and 26 removal and replacement (RAR),55/131 (42.0％) catheters were exchanged because of catheter-related bacteremia (CRB),37131 (28.2％) exchanged because of malfunction or cuff extrusion,39 /131 (29.9％)catheters were removed electively or was still functional at the end of the study period.Results One-year survival rates for first and consecutive catheters were 35.8％ and 28.4％,respectively.There was no difference in the overall survival between first catheters group and subsequent catheters group [(29.8±7.9)months vs.(28.7±6.0)months,t=0.711,P=0.443].However,infection free survival of first catheters group was significantly prolonged in comparison with that of subsequent catheters group [(13.1 ± 3.5) months vs.(11.6±2.7) months,t =2.415,P=0.018].The overall and infection-free survival in WGE group were not different with those of RAR group [(28.2 ± 7.2 ) months vs.( 28.5 ± 5.8 ) months,(11.1±3.1)months vs.(12.2±2.1)months,t=-0.163,0.103,P＞0.05].The infection free survival of first catheters group and WGE group was prolonged in comparison with that of in situ group[(13.1±3.5)months and (11.1±3.1)months vs.(8.2±2.1)months,t =7.602,5.601,P＜0.05].Conclusions WGE is safe and effective in the elderly patients if the tunnel and the exit site are not infected and has the potential benefit of preserving the vascular access site.

Objective To summarize our operational experience in using unusual renal allografts.Methods The plastic operations of 326 unusual renal allografts were retrospectively and the renal transplant outcome was compared with 542 normal renal allografts an the same time. Results All the 326 unusual renal allografts were utilized. There was no significant difference between unusual renal allografts and usual ones in average serum creatinine level, acute tubular necrosis (ATN) and the survival rate of renal allgraft after 1 year. There was no complications related to plastic operation during or after kidney transplantation.Conclusions By making good use of various kinds of plastic operation, abnormal or injuried renal allografts can also be used safely without affecting the outcome after renal transplantation.