Objective To evaluate the clinical value of minimally invasive methods for non-anastomotic biliary stricture (NABS) after orthotopic liver transplantation.Methods The clinical data of 403 patients who underwent liver transplantation during recent 10 years in Liver Transplantation Center at General Hospital of Guangzhou Military Commanmol were analyzed retrospectively,and 13 patients with NABS were selected.The outcomes of 3 types of NABS patients treated by endoscopic retrograde cholangiopancreatography(ERCP) or percutaneous transhepatic cholangial drainage(PTCD) were compared and the indication for re-transplantation was identified.Results PTCD treatments of 4 patients were proved ineffective.The shortterm curative rate of minimally invasive treatments was 8/13.Five patients eventually required surgical treatments (re-transplantation in 4,Roux-en-Y anastomosis in 1).According to cholangiography results,NABS were divided into 3 types,namely hepatic bile duct strictures (n =4,type Ⅰ),multiple extra-hepatic and intrahepatic biliary strictures (n =7,type Ⅱ),intrahepatic biliary strictures (n =2,type Ⅲ).The success rates of minimally invasive treatment in 3 types of NABS were 3/4,4/7 and 1/2,respectively.Nearly half of type Ⅱ and type Ⅲ patients needed re-transplantation,which was more likely for those patients with hepatic artery stenosis (2/3).Conclusion NABS treated with minimally invasive methods are preferred.Based on the appearance of biliary stricture,type Ⅰ patients had the best prognosis.For those type Ⅱ and type Ⅲ patients who failed minimally invasive treatment,especially combined with hepatic arterial stenosis,surgical treatment should be timely,so as not to lose a chance for re-transplantation.

To study the electrophysiological mechanism of atrial fibrillation induced by acetylcholine(Ach). The results showed that:①Ach decreased ERP of four atrial sites.When the concentration of Ach was incseased, ERP of 4 sites became shorter but COVERP became bigger.②As the concentration of Ach was increased, the percent of AF induced by Ach and AF was increased with the duration prolonged( P 0 05).③There was a significant correlation between atrial vulnerability with ERP and COVERP( P

BACKGROUND: Radiofrequency catheter ablation (RFCA) in dog triggers myocardial nerve sprouting and sympathetic hyperinnevation. It is possible that RFCA in humans has the same effect. Nerve growth factor (NGF) is a neurons nurture that supports the survival and differentiation of sympathetic neurons and enhances target innervation. Therefore, it is hypothetic that RFCA can increases plasma NGF concentration in humans.OBJECTIVE: To test the hypothesis that RFCA increases plasma NGF concentration in humans.DESIGN: Self-control experiment.SETTING: Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University of Chinese PLA.PARTICIPANTS: Forty-three patients were selected from the Cardiological Department of Tangdu Hospital, the Fourth Military Medical University of Chinese PLA from January to June 2005, including atrioventricular nodal reentrant tachycardia (AVNRT) (n=18), right-sided accessory pathways (RSAP) (n=13) and left-sided accessory pathways (LSAP) (n=12), 20 males and 23 females, ages 28-65 years, all agreed to participate in the study voluntarily.METHODS: Blood samples were obtained from the peripheral veins before ablation and at 6 hours, 1, 3, 5, 7 days after ablation. The plasma concentration of NGF was determined with enzyme-linked immunosorbent assay (ELISA).MAIN OUTCOME MEASURES: The plasma concentration of NGF was determined with ELISA before RFCA and at 6 hours, 1, 3, 5, 7 days after RFCA in each patient.RESULTS: Total 43 patients who were referred for ablation therapy for AVNRT, RSAP and LSAP were involved in the result analysis without loss. Plasma NGF increased at 6 hours after RFCA. Increased NGF continued to 7 days in the RFCA treated patients. The plasma NGF concentrations at 6 hours, 1, 3, 5, 7 days after RFCA in AVNRT, RSAP and LSAP ablations treated patients were (29.72±7.04), (30.94±5.68),(31.39 ±4.92), (31.06 ±4.56), (29.11 ±4.59), (31.77 ±6.25), (30.69 ±5.10),(31.46±4.96), (30.15±4.01), (30.43±3.14), (31.42±6.75), (31.00±5.20),(32.08±4.62), (30.67±3.71), (29.27±2.75) μg/L, respectively, and all more than that before RFCA [(14.89±2.84), (15.00±2.71), (15.51±2.75) μg/L, P ＜ 0.01]. However, there were no significant differences in the NGF levels at 6 hours, 1, 3, 5 and 7 days after RFCA (P ＞ 0.05). The plasma NGF concentration was not significant different among AVNRT, RSAP and LSAP ablation patients at any given time (P ＞ 0.05). The number of RFCA applications, the procedure time and the total energy have no correlation with NGF concentration at any given time instance.CONCLUSION: RFCA increases plasma NGF concentration in humans and lasts for at least 7 days. The number of RFCA applications, the procedure time and the total energy have no correlation with NGF concentration at any given time instance.

Objective To optimize static pressurized liquid extraction(PLE) method for the extraction of aristolochic acids Ⅰ and Ⅱ(AAⅠ and AAⅡ) from Fructus Aristolochiae and study the influences of related factors.Methods The univariate design was introduced.The operational parameters,such as the type of solvent,particle size of the sample powder,extraction temperature,pressure,static time,flush volume,the number of cycles,and the amount of sample were optimized.Results The optimized result employed methanol as extraction solvent,particle size of 100—120 meshes,extraction temperature of 120 ℃,extraction pressure of 10.3 MPa,static time of 10 min,flush volume of 40%,1 cycle,and sample amount of 1.00 g.The method was applied for four species of traditional Chinese medicinal materials including Fructus Aristolochiae,Caulis Aristolochiae Manshuriensis,Radix Aristolochiae,and Radix Arsitolochiae Fangchi.Conclusion This method can be used to completely extract AAⅠ and AAⅡ from Fructus Aristolochiae in once extraction.The comparison shows that this static PLE method is better than ultrasonication and Soxhlet methods with higher extraction efficiency and less time-consuming.It is also better than the dynamic one in the extraction of AAs from Radix Aristolochiae.

Objective To analyze the effects and the complications of partial splenic artery embolization(PSE)and splenectomy offering a feasible way to choose different therapeutic methods for hypersplenism. Methods Forty-six patients treated with PSE and thirty-three undergone splenectomy were compared for their effectivenesses and complications in treating hypersplenism. Results Thrombocyte and leucocyte counts increased markedly after the two kinds of treatment(P 0.05). The complication rate of the PSE was far more than that of the splenectomy(P

Objective To study the possible different effects on primary liver cancer of various types of blood supply demonstrated by DSA via hepatic artery radioimmunotherapy with 131Ⅰ-HAb18F(ab')2.Methods Under thyroid protection and negative dermal sensitivity test,46 times of intraarterial injection with a 0.75 mCi/kg dose of 131Ⅰ labeled murine HCC monoclonal antibody fragment [HAb18F(ab')2] were performed in 30 patients of PLC using the Seldinger technique.The shrinkage rates of tumor volume were analyzed according to hyper,moderate and hypo vascular three types provided by DSA.Results The volume shrinkage rates of hyper and moderate vascular HCC were 60% and 37.5% respectively,while that of 2 cases of hypovascular HCC showed significantly reduction.Conclusion 131Ⅰ-HAb18F(ab')2 internal radioimmunotherapy prossesses certain signification volume shrinkage efficacy on different blood supplies provided by DSA.(J Intervent Radiol,2007,16:243-245)

Objective To analyze the clinical effects of 131I-HAb18F(ab')2 radioimmunotherapy via hepatic artery on PLC with portal vein tumor emboli. Methods Under the condition of thyroid protection and negative dermal sensitivity test, 12 times of intraarterial injection with 131I labeled murine HCC monoclonal antibody fragment HAb18F(ab')2 were performed in 8 patients of PLC complicated with portal vein tumor emboli. A 0.75 mCi/kg dose of 131I was administrated individually into certain target vessel after hepatic artery angiography using Seldinger technique. Results 3 of 7 patients with symptoms of pains showed remission with simultaneous improvement and stabilization in Karnofsky score in 3 and 4 patients respectively. AFP levels decreased about 50%(3/6)in 3 cases among those 6 positives and the values of I.B. and ALT changed within a very narrow range to a certain extent after the treatment. The overall rate of CR + PR was 28.6% and similar better result was obtained in a non-symptomatic diffuse PLC patient.1 year survival rate was 12.5%. Conclusion 131I-HAb18F(ab')2 radioimmunotreating drug(0.75 mCi/kg)with hypotoxicity to liver-function can be used as an acceptable method for unresectable PLC with portal vein tumor emboli, especially for those without tumor emboli in the main trunk.

Objective To investigate the clinical characteristics and risk factors of non-premature STEMI patients underwentprimaryPCI with multivessel disease.Methods Data of clinic and coronary angiographic features were retrospectively compared between group of 371 younger STEMI patients (male age ＜ 55 years,female ＜ 65 years) and group of 662 older STEMI patients.All patients were admitted to hospital from January 2005 to January 2015 and treated with primary PCI.The patients' gender,smoking history,family history of coronary heart disease (CHD),hypertension,type 2 diabetes mellitus,previous myocardial infarction and revascularization,stroke history,serum uric acid,lipids etc.were documented.The comparison of coronary artery disease characteristics and the incidence of adverse events during hospitalization were also carried out between two groups.Results (1) Prevalence of males (88.4％ vs.76.9％),smokers (74.9％ vs.51.5％),family history of CHD (21.0％ vs.9.7％) and levels of diastolic blood pressure,total cholesterol,low density lipoprotein cholesterol (LDL-c),triglycefides,and low cholesterol were significantly higher in the non-prematuregroup than in the premature group (all P ＜ 0.01),while high density lipoprotein cholesterol (HDL-c) was lower in non-prematuregroup (P ＜ 0.01).(2) The incidence of in-hospital events in both groups were low.There was less ventricular tachycardia in the non-premature group (1.5％ vs.0.3％) (P＜0.05).(3) There were no statistically significant differences in the number of infarct vessels,site ofinfarctbetween two groups.(4) Logistic regression analysis showed that smoking (OR =2.22,95％ CI:1.588-3.108) (P ＜ 0.05),family history of CHD (OR=2.12,95％CI:1.431-3.140) (P＜0.05),triglyceride concentration (OR=1.971,95％CI:1.475-2.635) (P＜0.05),LDL-c (OR=1.193,95％CI:1.008-1.413) (P=0.04) were independent risk factors fornon-premature STEMI withmultivessel disease.Conclusion Smoking,family history of CHD,triglyceride concentration,LDL are main risk factors of younger age STEMI patients with multiple vessel disease;Compared with younger age patients,older age patients during hospitalization are more likely to occur ventricular tachycardia.Regardless of age difference,the characteristics of coronary artery lesions show no significant difference.

AIM: To examine the inhibition of matrix metalloproteinase (MMP) activity by doxycycline (Doxy) and its effect on vascular smooth muscle cells (SMCs) proliferation, neointimal hyperplasia and vascular remodeling. METHODS: The model of rat common carotid artery injury was established by balloon-dilatation. Doxy was administered to the animals of treatment group at dose of 30 mg?kg -1?d -1. The activity of MMPs in the tissue of injured carotid arteries was measured by gelatin zymography. The thickness and area of neointimal, lumen area and the proliferation of SMCs were measured by histological and morphometric analysis. RESULTS: 1. After Doxy treatment, the activity of MMP-9 in the carotid arteries was reduced by 26.3% and 34.5% compared to that in rats without Doxy treatment at 24 hours and 3 days after balloon injury, respectively (P

Objective To study the diagnosis and treatment of non-anastomotic biliary stricture (NABS) after liver transplantation.Methods The clinical data of 403 patients who underwent liver transplantation in the past 10 years in our department were analyzed retrospectively,compared different methods to find out the most appropriate method in the diagnosis and management of NABS.Results NABS occurred in 13 out of 403 patients (3.2％),almost the same incidence as in patients who received DCD donor livers (4.16％,2/48).The clinical signs of NABS were frequent cholangitis and high TBil,r-GT and AKP (P ＜0.01).All these cases were finally diagnosed by cholangiography and they could be classified into 3 types:hepatic bile duct stricture (4 patients,type Ⅰ),multiple extrahepatic and intrahepatic biliary strictures (7 patients,type Ⅱ),intrahepatic biliary strictures (2 patients,type Ⅲ).NABS were mainly treated by interventional therapy,Roux-en-Y anastomosis and retransplantation in our centre.All type Ⅰ patients were successfully managed with interventional therapy/ERCP and Roux-en-Y anastomosis,but 44.4％ (4/9) of type Ⅱ and Ⅲ patients required retransplantation.The TBIL,r-GT and AKP decreased significantly in 12 patients (P ＜ 0.05) and the total curative rate of NABS was 92.3％ (12/13) with one patient who died after retransplantation.Conclusions Cholangiography was an effective way to diagnose NABS which is common among patients after liver transplantation.Interventional therapy/ERCP,Roux-en-Y anastomosis and retransplantation were our 3 ways to treat this problem.We proceeded from easy to difficult and chose a suitable way to deal with NABS according to the different types of biliary stricture from cholangiography.Type Ⅰ patients had much better prognosis than Type Ⅱ and Ⅲ patients who should receive retransplantation if interventional therapy/ERCP failed.