Pediatric liver transplantation has long been developed in the western world.Currently,favorable outcomes after liver transplantation have been achieved in pediatric recipients and the postoperative 5-year survival rate reached 80％ in western transplantation centers.In the mainland China,pediatric liver transplantation started quite recently and there is still a big gap compared with western centers.In addition,there is unbalanced development between adult and pediatric recipients due to surgical difficulties and undesirable outcomes following pediatric liver transplantation.The operation methods of pediatric liver transplantation include whole liver transplantation,reduced-size liver transplantation,living donor liver transplantation and split liver transplantation.Perioperative complications of pediatric liver transplantation mainly include portal vein thrombosis,hepatic artery thrombosis,intra-abdominal bleeding,infections,rejection,bile leakage and biliary strictures.While the long-term complications are infections,post-transplantation lymphoproliferative disorders,acute and chronic rejections caused by poor compliance with immunosuppressive therapy.Perioperative complications have been reduced recently thanks to improvement of surgical techniques.With the highly-prolonged survival period,long-term postoperative complications have been playing a significant role in recipients' survival rates.Management of long-term follow-up and compliance has been the next focus of pediatric liver transplantation.

AIM: To examine whether reactive oxygen species (ROS) is involved in the neuroprotection by mitochondrial ATP- sensitive potassium channel (mitoKATp) in rat hippocampal slices during hypoxia. METHODS: The technique of elec-trophysiology was used, and the latency to hypoxic depolarization (HD) and the amplitude of population spike (PS) in the stratum pyramidale of the CA1 region were measured. RESULTS: Pretreatment of the slices with diazoxide (DIA, a mitoKATP opener, at concentration of 300 ?mol/L) , prolonged the latency to HD, delayed the onset of PS disappearance and improved the recovery of PS after reoxygenation. The effects induced by DIA were attenuated by 5 - hydroxydecanoic acid (a mitoKATP blocker, at concentration of 200 ?mol/L). Pretreatment with N - 2 - mercaptopropionyl glycine (MPG, a ROS scavenger, at concentration of 500 ?mol/L), also abrogated the effects induced by DIA, while treatment of MPG alone had no effect on PS and HD. CONCLUSION: ROS participates in neuroprotection offered by mitoKATp opener during hypoxia.

Objective To investigate the clinical and pathological features of children malignant lymphoma.Method A retrospective study was carried out to analyse the clinical,laboratory and pathological data in 65 patients with malignant lymphoma.Results In the chidren malignant lymphoma,the incidence of nonHodgkin′s lymphoma(NHL) was more than that of Hodgkin′s disease(HL),the ratio of NHL to HL was 2.25∶1.The peak incidence of age was among 6 to 9 years old,the ratio of male to female is about(3.5∶1.)NHL of our children was mostly consised of lymphoblastic lymphoma,anaplastic large-cell lymphoma,diffuse large B-cell lymphoma and Burkitt′s lymphoma.The clinical manifestations were predominantly presented with peripheral nodes intumescing,mediastinal tumeur,abdominal tumeur,bone marrow infiltration.In patients with Hodgkin′s disease,mixed cellularity was the most common pathological category,and cervical painless lymphadenectasis was usually the initial signs in most patients,sometimes accompanied with infiltration of celiac lymph nodes,spleen and bone marrow.Conclusions NHL of our children differs from that of adult in the clinical feature and pathology,while HL of our patients is similar to adults.Since the prognosis of the malignant lymphoma is determined by its pathology,immunohistochemistry plays an important role in the diagnosis and differential diagnosis.J Appl Clin Pediatr,2006,21(3):160-161

Cholangiocarcinoma (CCA) is a malignant neoplasm derived from cholangiocytes. The incidence of CCA is only lower than that of hepatocellular carcinoma and ranked the second in liver malignant cancers. The prognosis of CCA patients is poor and most patients will die within a few months after diagnosis. CCA is related to various risk factors, including primary sclerosing cholangitis, cirrhosis, certain chemical agents and liver fluke. Establishment of proper animal models of CCA can not only be helpful for understanding the mechanisms of incidence and development, but also lay a solid foundation for developing novel treatment strategies. Common animal models of CCA include carcinogen-induced models, implantation models, operation models, and genetically engineered models.

AIM: To established a method for determinating emodin and berberine hydrochloride in Wangshi baochi (Pills Radix et Rhizoma Rhei,Rhizoma Coptidis,etc.) by HPLC. METHODS : The separation was performed on Lichrospher C_ 18 column,using methanol-0.1% H_3PO_4(90∶10) and acetonitrile-0.05mol?L -1 KH_2PO_4 (35∶65) as mobile phase,respectively. The detection wavelength was at 290nm and 345nm,respectively. The flow rate was at 1.0mL?min -1 ,the column temperature was room temperature. RESULTS : The linear range of emodin was in the range of 0.1966～0.9830 ?g,r =0.9997, the average recovery was 98.81% and RSD was 1.41%,respectively. The linear range of berberine hydrochloride was 0.1644～0.8220 ?g,r =0.9996,the average recovery was 98.47% and RSD was 2.08%. CONCLUSION : This method is rapid,sensitive and accurate. It can be used for quality control of Wangshi baochi Pills.

After half a century of development,liver transplantation has become an important means to solve the problem of end-stage liver diseases and has greatly improved the prognosis of the patients.This article reviewed and summarized the post-operation intensive care management and treatment of complication in children with liver transplantation.

Objective To ascertain the optimum condition for extracting Rhizoma polygoni cuspidati and Radix angelicae sinensis with alcohol. Method With extract yield and the amount of polydatin as index,the primary factors of affecting the extraction were optimized. Result The optimum extraction condition was as follows:taking 60% alcohol as solvent,the meterials were refluxed and extracted two times with 10 and 8 times volume of alcohol for 1.5 h and 1.0 h,respectively. Conclusion The optimum extraction process provides an experimental basis for industrial production.

Objective To summarize clinical results of 29 cases of multi-vessel coronary disease treated by hybrid revascularization.Methods A total of 29 consecutive patients(all male,aged 62.8?9.7 years) with coronary artery disease(two-vessel,n=10;three-vessel,n=19) were treated with minimally invasive direct coronary artery bypass(MIDCAB)(left internal mammary artery to left anterior descending artery,LIMA-to-LAD) and percutaneous coronary intervention(PCI) between January 2000 and April 2005.The left ventricular ejection fraction(LVEF) was 0.576?0.108.Concomitant diseases included hypertension in 23 patients,insulin-dependent diabetes mellitus in 5 patients,chronic obstructive pulmonary disease in 2 patients,and old myocardial infarction in 14 patients.Results The 29 patients received 33 grafts(LIMA: 27 grafts;great saphenous vein: 6 grafts).Balloon angioplasty was carried out in 41 coronary lesions,usually following surgery.The mean number of revascularization was 2.5 per patient.There was no surgery-related complications and mortality.The blood flow in the LIMA was 45?14 ml/min.The chest drainage volume was 274?197 ml.Blood transfusion was required in 2 patients(6.9%).The length of ICU stay was 1.9?0.1 d and the length of hospital stay was 4~11 d(mean,7.5 d).Follow-up for 2.2?0.9 years showed no late death and myocardial infarction.Postoperative New York Heart Association(NYHA) Classification showed Class Ⅰ in 25 patients and Class Ⅱ in 4 patients.Repeated angiography was conducted in 4 patients,which found great saphenous vein graft occluded in 1 patient and stent re-stenosis in 2 patients.Conclusions The midterm results of hybrid techniques for coronary artery disease are satisfactory.Hybrid procedure is beneficial to high-risk patients.The long-term results need further investigation.

Objective To study the effect of mini percutaneous nephrolithotripsy (MPCNL) for non-nephredema kidney calculi. Methods A total of 47 patients with non-nephredema kidney calculi were enrolled in this study. Physiological saline solution was infused into the kidney through a ureteral catheter to induce hydronephrosis. C-arm X-ray machine was employed in percutaneous puncture and Wolf EMS was used to smash the calculi. Results The mean operation time was (120?35) min.The calculi were removed through one passage in 38 cases,through two passages in 6, and three passages in 3. Among the 47 patients, the MPCNL was performed once in 35, and twice in 12. The stone-free rate was 83.0% (39/47) and final stone-free rate was 93.6% (44/47). No complications were noted in all the patients. Conclusions Highly skilled technique is necessary in MPCNL for non-nephredema kidney calculi. The MPCNL is a safe, minimally invasive, and effective method. By using MPCNL, patients have less trauma, lower rate of calculi remaining, and quick recovery. As long as the surgeons are familiar with the technique of MPCNL and the anatomy of non-nephredema kidney, the therapeutic outcome can be as good as that in the patients with nephredema renal calculi.