ObjectiveTo study the impact of allocation of organ arteries and their reconstruction for donor livers on arterial complications after liver transplantation from organ clusters obtained by combined liver,kidney,pancreas and duodenum harvesting.The aim is to guide future use of donor organs more safely and rationally with a decrease in postoperative complications.MethodWe studied 11 patients.ResultsThere was no hepatic artery anomaly.A Carrol artery patch was obtained at the bifurcation of the proper hepatic artery and the gastroduodenal artery in these donor livers.In one patient,an arterial graft was used because of inadequate arterial length,and arterial thrombosis developed which required re-transplantation.The hepatic arterial reconstruction was successful for the remaining 10 patients.One patient died of pulmonary infection 5 months post transplantation.ConclusionWhen combined liver,kidney,pancreas and duodenum harvesting was used,enough arterial length of the recipient must be preserved.There should be adequate and prompt communication between the teams carrying out the donor operation and the recipient operation.A Carrol arterial patch of the proper hepatic artery and the gastroduodenal artery for the donor liver,and the use of microsurgical vascular anastomosis in the operation are the keys to prevent hepatic arterial complications after liver transplantation.Multi-organ harvesting can be used for obtaining donor livers in liver transplantation.

Sperm-mediated gene transfer (SMGT) is one of the most methods in the transgenic animal research and the efficiency of spermatozoa binding and internalization exogenous DNA after sperm/DNA co-culture is important to a successful SMGT.In this study,the influencing factors of exogenous DNA uptake by spermatozoa were detected using DIG labeled EGFP as exogenous gene.The results demonstrated that porcine spermatozoa could spontaneously take up exogenous DNA which mainly binding occurs on the sub-acrosomal and nuclei region of the sperm head.The rate of spermatozoa binding exogenous DNA increased with the extending action of time.At 37℃ and 39℃,the rate of spermatozoa uptake exogenous DNA would not increase after 60 min incubation,and the similar result was observed on 90 min at 17℃.Binding rates and internalization rates of washed ejaculated sperm cells from the 15 boars varied between 6.57%-35.81% and 2.990%-24.66%,respectively.The binding rate and intemalization rate were mostly inhibited by seminal plasma.The binding rates were significantly increased by liposome and DMSO,respectively.Dead-spermatozoa could bind exogenous DNA,the intermalization process could not be completed.Furthermore,the highest binding rate was found in membrane broken spermatozoa as a result of freeze-thawing and this was independent of the sperm donors.

Objective:To characterize tibial plateau fractures using a computed-tomography-based "four-column and nine-segment" classification.Methods:A retrospective analysis was conducted of the 698 adult patients with tibial plateau fracture (704 knees) who had been admitted to Department of Orthopedics, The Affiliated People's Hospital of Jiangsu University from December 2007 to May 2018. They were 377 males and 321 females with an average age of 51.6 years. The left knee was affected in 371 cases (53.2%), the right knee in 321 cases (46.0%) and bilateral knees in 6 cases (0.9%). According to the differentiated morphological characteristics, the tibial plateau and proximal fibula were divided into 4 columns, which were subdivided into 9 segments. Tibial plateau injury index (TPII) was innovatively introduced to represent the extent of injury. Fracture mapping was retrospectively analyzed according to the "four-column and nine-segment" classification based on the CT imaging.Results:The rates of one-column, two-column, three-column and four-column injuries were 30.5% (215/704), 31.5% (222/704), 28.0% (197/704), and 9.9% (70/704), respectively. On average, 2.2 columns ± 1.0 columns and 3.6 segments ± 2.1 segments were affected in each case. The mean TPII was 5.7±3.0. The rates of mild, moderate and severe comminuted fractures were 50.0% (352/704), 37.5% (264/704), and 12.5% (88/704). The columns most frequently affected were the lateral column (572, 81.3%) and the intermedial column (524, 74.4%) while the less frequently involved ones the medial column (219, 31.1%) and the fibular column (218, 31.0%). The sequence of the segments affected was the posterolateral segment (465, 66.1%), the anterolateral segment (453, 64.3%), the posteromedian segment (379, 53.8%) and the tubercle segment (85, 12.1%).Conclusions:The novel "four-column and nine-segment" classification may be a beneficial system for clinical diagnosis, statistical analysis and prognostic judgment of tibial plateau fractures.

Objective:To explore potential predictors of refractory Mycoplasma pneumoniae pneumonia (RMPP) in early stage. Methods:The prospective multicenter study was conducted in Zhejiang, China from May 1 st, 2019 to January 31 st, 2020. A total of 1 428 patients with fever >48 hours to <120 hours were studied. Their clinical data and oral pharyngeal swab samples were collected; Mycoplasma pneumoniae DNA in pharyngeal swab specimens was detected. Patients with positive Mycoplasma pneumoniae DNA results underwent a series of tests, including chest X-ray, complete blood count, C-reactive protein, lactate dehydrogenase (LDH), and procalcitonin. According to the occurrence of RMPP, the patients were divided into two groups, RMPP group and general Mycoplasma pneumoniae pneumonia (GMPP) group. Measurement data between the 2 groups were compared using Mann-Whitney U test. Logistic regression analyses were used to examine the associations between clinical data and RMPP. Receiver operating characteristic (ROC) curves were used to analyse the power of the markers for predicting RMPP. Results:A total of 1 428 patients finished the study, with 801 boys and 627 girls, aged 4.3 (2.7, 6.3) years. Mycoplasma pneumoniae DNA was positive in 534 cases (37.4%), of whom 446 cases (83.5%) were diagnosed with Mycoplasma pneumoniae pneumonia, including 251 boys and 195 girls, aged 5.2 (3.3, 6.9) years. Macrolides-resistant variation was positive in 410 cases (91.9%). Fifty-five cases were with RMPP, 391 cases with GMPP. The peak body temperature before the first visit and LDH levels in RMPP patients were higher than that in GMPP patients (39.6 (39.1, 40.0) vs. 39.2 (38.9, 39.7) ℃, 333 (279, 392) vs. 311 (259, 359) U/L, both P<0.05). Logistic regression showed the prediction probability π=exp (-29.7+0.667×Peak body temperature (℃)+0.004×LDH (U/L))/(1+exp (-29.7+0.667×Peak body temperature (℃)+0.004 × LDH (U/L))), the cut-off value to predict RMPP was 0.12, with a consensus of probability forecast of 0.89, sensitivity of 0.89, and specificity of 0.67; and the area under ROC curve was 0.682 (95% CI 0.593-0.771, P<0.01). Conclusion:In MPP patients with fever over 48 to <120 hours, a prediction probability π of RMPP can be calculated based on the peak body temperature and LDH level before the first visit, which can facilitate early identification of RMPP.