Objective To explore the liver transplantation in end stage liver disease with portal vein thrombosis (PVT). Methods Computer Tomography and color Doppler examinations were performed on the recipients to be subject to liver transplantation. Four male cases were found having PVT, received orthotopic liver transplantation and thrombectomy. Cell Saver auto transfusion blood and venous by-pass was also conventionally used. By reason of one case with residual thrombosis, a catheter with heparin cap was inserted into the branch of superior mesentery vein, followed by perfusion of urokinase for thrombus dissolution. Anti-coagulation treatments with low molecule heparin and Prostaglandtin E1 after operation were carried on in all of the patients. Results Surgical management of PVT were successful only one time in 3 patients. One patient with PVT extending over the entrance of spleen vein and left and right portal vein branches had portal vein residual thrombosis postoperation. After dissolution and anti-coagulation for 28 days, the residual thrombus disappeared. One cured patient with PVT died 48 days after operation from lung infection due to multiocular effusion resulting from chest cavity bleeding after pleuracentesis, and other 3 patients were cured in 2 months. Conclusion The PVT is not an absolute contraindication to liver transplantation; Thrombectomy combined with thrombus dissolution and anticoagulation can cure PVT; Prevention of bleedings in the patients with PVT is very importance postoperation.

AIM: To study the effect of nasal mucosal tolerance to E-selectin on cerebral ischemia-reperfusion injury.METHODS: Two different doses(single and booster) of E-selectin or PBS were dropped into membrana mucosa nasi of rats.The middle cerebral artery occlusion(MCAO) model referring to Zea Longa method with modifications was performed 48 h after the last dose of E-selectin or PBS.After 2 h ischemia and 22 h reperfusion,the numbers of CD3+CD4+T-lymphocyte and CD3+CD8+T lymphocyte subgroup in the blood were examined with flow cytometry.Rats were killed,then part of the animals was used to measure the cerebral infarction volume by TTC staining.mRNA expressions of E-selectin,ICAM-1 and lymphocyte function-associated antigen-1(LFA-1) were determined by RT-PCR and activity of SOD was determined by xanthinoxidanse method in ischemic cortex of the other part of animals.RESULTS: The ratio of the numbers of CD3+CD4+T-lymphocytes and CD3+CD8+T-lymphocytes increased in E-selectin single pretreatment group(P

OBJECTIVE:To study invalid medical order warned by Prescription automatic screening system (PASS),and to improve rational drug use monitoring. METHODS:The infusion medical order warned with black light,red light and orange light by PASS were extracted from Pharmacy intravenous admixture services(PIVAS)of our hospital during Oct. to Dec. 2014. Invalid warning items were analyzed statistically in respect of warning level,problem types and reasons. RESULTS & CONCLUSIONS:There are 3 392 warnings items,468 were invalid (13.80%) which include 10 items by black light,219 items by red light and 239 items by orange light;by problem types,there are 218 items of overdose and 136 items of repeated treatment,etc. The main causes of invalid warning include 191 items caused by wrong system prompt,126 items by incomplete system information,143 items by insufficient auditing standards,etc. There are still some defects of invalid warning in practical application of PASS. It is suggested that user and developer add the function of self-defined drug list or user-defined system data by,and unify auditing stan-dards of rational drug use,etc.,so as to timely update the system information,and improve the accuracy of software system moni-toring and warning function.

AIM: To investigate the relationship between basic fibroblast growth factor (bFGF) and the development of silicosis in mice. METHODS: MTT test was utilized to examine the effects of bFGF-neutralizing antibody and the bronchoalveolar lavage fluid (BALF) of the mice exposed to silica on lung fibroblast cell growth. RESULTS: BALF from mice treated intrabronchially with silica promoted the growth of lung fibroblasts and anti-bFGF antibody inhibited the effect of BALF dramatically. CONCLUSION: These results indicates that bFGF secretion increases in lung in a mice silicosis model and participates in the development of silicosis.

Objective To investigate the reversal of the multidrug resistant gene mdr1 in vivo by antisense oligodeoxynucleotide (ASODN) on the basis of study in vitro. Methods The cultured drug-resistant human hepatocellular carcinoma cells were injected under the skin of axilla to establish the tumor model of nude mice. mdr1 ASODN accompanied by Lipofectamine were injected locally and ADM was injected intraperitoneally. Control 1 and control 2 were locally injected by Lipofectamine and normal saline separately, and ADM was also injected intraperitoneally. Results As time went on the tumor size increased and from the 5th day on alterations were marked, tumor size in different time phase showed marked difference to the prior time phase with significant difference (P 0.05). The results suggested that SODN and Lipofectamine showed no marked effect on tumor growth of nude mice and ASODN had marked inhibition effect on tumor growth.Conclusion mdr1 ASODN can also reverse multidrug resistance of drug-resistant human hepatocellular carcinoma cells in vivo. After the treatment the tumor’s growth in nude mice will slow down in a range of time.

Objective To investigate the effect of APE1 on differentiation of peripheral blood mononuclear cells into osteoclast-like cells(OCL) which induced by macrophage colony stimulating factor (RANKL) and macrophage colony stimulating factor (M-CSF) .Methods Human peripheral blood mononuclear cells (PBMCs) were collected by density gradient separation ;Constructed APE1 siRNA expression vector Ad5v-APE1 siRNA was used to transfect PBMCs .Tartrate-resistant acid phosphatase (TRAP) method was conducted to identify the cells ,the expression level of APE1 was detected by Western blot ,the mRNA expression levels of Cathepsin K(CK) and V-ATPase were detected by RT-PCR .Results PBMCs transfected with APE1 siRNA had significantly lower protein expression of APE1 than untransfected cells (P< 0 .05) ;PBMCs could differentiate into OCL under the stimulation of RANKL and M-CSF ,the mRNA expression levels of CK and V-ATPase increased ;After APE1 siRNA treatment ,the number of OCL was reduced and the levels of CK and V-ATPase mRNA decreased .Conclusion PBMCs can differentiate into a large number of OCL induced by RANKL and M-CSF ,APE1 siRNA significantly inhibited differentiation of PBMCs into osteoclast-like cells , APE1 may be involved in the regulation of osteoclast-like differentiation process .

Objective To evaluate the reproducibility of ADC measurements at 1.5 vs 3.0 T and at 1.5 T of different scanners in liver,spleen and pancreas of healthy volunteers.Methods Abdominal DWI were performed on 33 healthy volunteers by using GE 1.5 T,Siemens 1.5 T and Philips 3.0 T MR scanners.The mean ADC values of liver,spleen,pancreatic head,body,and tail were calculated.The ADC data were analyzed by using paired-sample t tests.Results The mean ADC of liver at GE 1.5 T,Siemens 1.5T and Philips 3.0 T were (1.56 ±0.10) ×10-3,(1.67 ±0.15) ×10-3 and(1.35 ±0.12) ×10-3 mm2/s,spleen were (0.96±0.10) × 10 3,(0.98 ±0.11) ×10-3and(0.81 ±0.14) × 10-3 mm2/s,pancreatic head were (2.09 ± 0.27) × 10-3,(2.20 ± 0.21) × 10-3 and (2.05 ± 0.27) × 10-3 mm2/s,pancreatic body were (2.03 ± 0.27) × 10-3,(2.09 ± 0.30) × 10-3 and (1.76 ± 0.25) × 10-3 mm2/s,pancreatic tail were (1.88 ± 0.28) × 10-3,(1.88 ± 0.27) × 10-3 and (1.56 ± 0.27) × 10-3 mm2/s,respectively.From the aspect of different field strength MR scanners,there were significant differences in mean ADC of liver (t =11.073,P ＜0.01 in GE 1.5 T vs Philips 3.0 T; t =12.795,P ＜0.01 in Siemens 1.5 T vs Philips 3.0 T),spleen (t =4.143,P ＜ 0.01 in GE 1.5 T vs Philips 3.0 T; t =5.376,P ＜ 0.01 in Siemens 1.5 T vs Philips 3.0 T),pancreatic body (t =4.677,P ＜ 0.01 in GE 1.5 T vs Philips 3.0 T; t =5.174,P ＜0.01 in Siemens 1.5 T vs Philips 3.0 T) and tail (t =5.356,P ＜0.01 in GE 1.5 T vs Philips 3.0 T; t =4.648,P ＜0.01 in Siemens 1.5 T vs Philips 3.0 T),but there were no significant differences in mean ADC of pancreatic head (t =0.340,P ＞ 0.05 in GE 1.5 T vs Philips 3.0 T; t =1.349,P ＞ 0.05 in Siemens 1.5 T vs Philips3.0 T).From the aspect of different 1.5 T MR scanners,there were significant differences in mean ADC of liver (t =-4.563,P ＜ 0.01),but there were no significant differences in mean ADC of spleen (t =-0.732,P ＞ 0.05),pancreatic head (t =-0.879,P ＞ 0.05),body (t =-1.020,P ＞0.05) and tail (t =0.054,P ＞ 0.05).Conclusion Between 1.5 T and 3.0 T MR scanners,there were significant differences in mean ADC of liver,spleen,pancreatic body and tail,but there were no significant differences in mean ADC of pancreatic head.At different 1.5 T MR scanners,there were significant differences in mean ADC of liver,but there were no significant differences in mean ADC of spleen,pancreatic head,body and tail.

Objective To summarize the experience in hepatic artery reconstruction in adult-to-adult living donor liver transplantation(ALDLT).Methods Fifty patients underwent ALDLT in our hospital from January 2002 to July 2006.All the hepatic a~ery reconstructions were done under surgical microscope.ResultsTwo patients(4%)presented with hepatic artery thrombosis.All the patients were followed up for 2 to 52 months (median,9 months),and no hepatic artery stenosis nor hepatic artery pseudoaneurysm occurred.The 1-year survival rate was 92%(46/50).Conclusions Systematic evaluation of hepatic artery reconstruction and use of microsurgical technique are key to the reduction of complications of hepatic artery reconstruction in ALDLT.

Objective To investigate the clinical effects of liver transplantation including living related liver transplantation for Caroli's disease (CD). Methods Seven consecutive patients with diffused type of Caroli's disease had undergone liver transplantation (LT) from September 1999 to February 2007 in our single center. The clinical characteristics and survival of these patients were retrospectively reviewed. Results All 7 patients were diagnosed as Caroli's disease with diffused type which manifested recurrent cholangitis in clinical symptoms. Among them, 4 were female and 3 male.The mean age was 16 years old (ranging from 10 to 31 years old). Six patients were subjected to conservative therapy and only one patient had previously undergone cholecystectomy and T tube drainage before transplantation. In types of surgery, 4 patients accepted split liver transplantation with right liver lobe, two got whole liver transplantation and only one underwent living related liver transplantation. In two patients venovenous bypass was done during the operation. The mean duration of surgery was 9. 1 h. Post-transplant complications included pulmonary infection (3 cases), acute rejection (2 cases), pleural effusion (2 cases) and biliary leakage in the split section of donor liver (1 case). One patient died within 19 days caused by acute renal failure and multiple organs dysfunction.The rest six patients are alive without any signs of recurrence of protopathy and the longest survival time is 7 years. Conclusion Liver transplantation is a valuable treatment to Caroli's disease with diffused type. Due to the organ shortage, living related liver transplantation may own identical effects on LT.

Objective To discuss the influence of anatomical variations of the cystic duct on preoperative diagnosis and operational scheme for cholecystectomy. Methods A 47-year-old woman was admitted to our hospital with diagnosis of cholecystolithiasis. Ultrasonography suggested minimal intra- and extrahepatic ductal dilatation. Laboratory tests showed that serum levels of alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase were 189 IU/L, 366 IU/L and 144 IU/L, respectively. In order to make a certain diagnosis, the patient received both magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP). Results MRCP showed the bile duct slightly dilated with a shuttle shape figure and a lower signal with a strip form in it. MRCP could not confirm the quality of this signal and was doubtful of choledochus diaphragma. Subsequently, ERCP was applied to demonstrate that the cystic duct was collateral with the common hepatic duct when arriving into its left side and converged into the bile duct with a lower position, which was the reason for why MRCP misjudged the formation of choledochus diaphragma in the bile duct. Finally, the patient underwent open cholecystectomy. Conclusion There are some kinds of variations in the cystic duct including course, appearance and location of confluence. Combing MRCP with ERCP can significantly elevate the diagnostic accuracy of the cystic duct before operation, especially in those patients with doubtful diagnosis upon admission. To avoid biliary injury as much as possible, open cholecystectomy is superior to the laparoscopic cholecystectomy (LC)with regard to the patients suffering from cholecystolithiasis complicated with variation of the cystic duct.