Objective To evaluate liver transplantation for patients with hepatocellular carcinoma (HCC).Methods From Feb,1999 to Mar,2002 a total of 95 cases underwent liver transplantation(LTX) in our centre, among them there were 23 cases of HCC.SPSS 10 0 software was used to evaluate the risk factors on the tumor recurrence after LTX.Results The tumor recurrence rate was 65% during the period of follow up. The patients' tumor free survival rate at 6 and 12 months was 75 0% and 58 3%, respectively. Multi variants analysis revealed that there was a statistical relationship between pretransplant tumor size and tumor recurrence( P =0 024).Statistical relations between preoperative demograplaic, clinical features and post LTX recurrence were not found.Conclusion Large hepatocellular carcinoma is a relative contraindication for LTX.

ObjectiveTo sum up the clinical experience in recent 10 years in our organ transplantation center. Methods We retrospectively reviewed clinical data of 120 patients receiving liver transplantation from April 1993 to October 2002. The patients′ clinical characteristics, surgical techniques, complications and survival rates were compared between the periods of 1993～1997 (phase Ⅰ), 1999 (phase Ⅱ), and 2000～2002 (phase Ⅲ). ResultsMalignant liver diseases were major indications for liver transplantation in phase Ⅰ (100%) and Ⅱ (53%), and phase Ⅲ (34%), respectively. The survival rate of recipients with benign liver diseases in phase Ⅲ significantly improved with the 3-month, 6-month and 1-year survival rates of 86%, 85% and 83.1%, respectively. For patients with malignant liver diseases, the 3-month, 6-month and 1-year survival rates were 87%, 81% and 46%, respectively. The recurrence of hepatitis B was 24% in 12 months after transplantation. The incidence of postransplantation vascular complications decreased significantly (from 29% in phase Ⅰ and Ⅱ to 4.9% in phase Ⅲ).Biliary complications remained one of the major problems for long-term survival. No veno-venous bypass was applied in phase Ⅲ. ConclusionStrict selection of candidate recipients, technical refinement, appropriate management of vascular and biliary complications, and prevention of recurrence of hepatitis B and malignant liver diseases are important for long-term survival.

Objective To compare the effect of two different fluid infusion models in the non-operative management of spleen rupture .Methods The clinical data of 46 cases of spleen rupture with non-operative management from 1995 to 2001 were analyzed retrospectively. Results In the non-operative management of spleen rupture, patients received continuous but rather slow fluid infusion had higher successful treatment rate(95.24%) and less intra- abdominal bleeding than those in patients received rapid fluid infusion (91.02%) . Conclusions In the non- opeative management of spleen rupture, continuous but rather slow fluid infusion model is superior to traditional rapid fluid infusion.

ObjectiveTo verify the effect of comprehensive therapy for primary liver cancer (PLC). MethodsThe clinical data of 420 cases admitted to our hospital from Jan. 1994 to Jun. 2000 was analyzed retrospectively. Patients received hepatectomy and transarterial chemoembolization (TACE), drug delivery system (DDS) on case-to-case basis.Results Three hundred and twenty-seven patients were followed-up from 3 days to 81 months. The overall 1-, 3-, 5-year survival rates were 40.9%、19.1%、12.4%, respectively. 75.9%,47.3%,40.1% for patients undergoing radical resection and 39.6%,22.1%,17.5% in patients with palliative resection. TACE or DDS implantation after palliative resection was effective to enhance the survival rate. Conclusion The rational and scientific combination of multiple modality is important to prolong survival time of the patients with PLC.

Objective Misdiagnosis of benign hepatic mass as malignancy is not infrequent. This study was to improve the clinical diagnosis by reviewing our clinical data for space occupying hepatic lesions. Methods In this study 545 patients undergoing hepatic resection for suspected malignant hepatic lesions were retrospectively studied from Jan 1998 to Jun 2004. All patients were pre-operatively assessed with plasma tumor makers, ultrasonography, computed tomography or magnetic resornance imaging. Percutaneous liver biopsy was employed in selected patients. Final pathological data was reviewed to evaluate preoperative diagnosis. Results Twenty-four out of 545 patients were pathologically diagnosed as with benign lesion. Preoperative misdiagnosis involved atypical radiological characteristics, incomprehensive clinical data and inexperienced recognition for liver lesions. Two of 24 cases suffered from minor post-operative complications, and there was no mortality. No recurrence was found by a mean follow-up of 3 years and 1 month. Conclusions Some benign hepatic lesions are easily misdiagnosed as malignant tumor. Appropriate use of multimodality examination in combination with correct algorithm of diagnostic protocol could improve diagnostic accuracy in cases of benign solid space occupying lesions of the liver.

OBJECTIVE To analyze the cause of failure of bacteria-killing by autoclave.METHODS Under the process of using the fast-reading bio-indicator to take a routine inspect for the autoclave,while the pressure,the temperature and the time for the bacteria-killing were up to the standard,and the result of the inspection was respectively negative and positive.RESULTS For the sudden malfunction of the exhaust valve,the cold air mass was left in the experimental parcel.Therefore,the result was respectively negative and positive.CONCLUSIONS The more strict examination should be taken for the bacteria-killing tank and the advanced B-D process inquiry-device and the bacteria-killing process inquiry device in the world should be adopted to ensure that the process of bacteria-killing is qualified at all times.

OBJECTIVE To effectively control the quantum of bacteria existing in the air of the cleaning section in the disinfecting supply division. METHODS The standards and methods set in the Hospital Disinfecting Sanitation Standard(GB15982-1995) were used. RESULTS Scientific,effective and strict control measures should be implemented to make the quantum of bacteria existing in the air to meet the Environment Standard Type Ⅱ. CONCLUSIONS This article provides the credible data for boosting the pureness of the air of the cleaning section of disinfecting supply division.

OBJECTIVE To observe the effect of the quickread bioindicator. METHODS According to the GB15981-1995 The Measures and the Standards of the Assessment of Disinfection and Sterilization,to control conventionally the(7 high-pressure) steam sterilization cabinets by the quickread-bioindicators. RESULTS Using the effective control method shortened the waiting time by 45 hours,and in-time provided the qualified disinfected supply. CONCLUSIONS The effect of using the quickread-bioindicator resolves the problem of delay of the control result.This is an ideal,scientific,and practical method for effective control of the high pressure steam sterilization.

OBJECTIVE To explore the management methods of sterilization and supply department for the control of hospital infection. METHODS Since 2005, strict infection management system in all aspects by the sterilization and supply department has been taken including renewable medical equipment from recycle to distribution, sterile disposable medical equipment from acceptance to distribution, and the district environment and self-protection of its own staff in the sterilization and supply department and so on. RESULTS Hospital infections had not occurred as a result of sterilized supply for three years. CONCLUSIONS Since strict control and management system is carrying out, measures are effective, and good results have been achieved, which provide important guarantees for effectively controlling infection and medical safety.

Objective For prevention and early diagnosis of the complications following liver transplantation.Methods Complications and treatment following liver transplantation in 26 cases were retrospectively analyzed. Results The transplantation was successful in all 26 cases. Complications included intraabdominal bleeding in 5 cases,outflow stenosis of suprahepatic IVC in 1,kinking of posthepatic IVC in 1,stenosis of portal vein in 1, stricture of intrahepatic duct and common hepatic duct in 2,acute rejection in 7,chronic rejection in 1,hepatitis B recurrence in 4, recurrent carcinoma in 4 and lung metastasis in 2,intracerebral hematoma in 5,acute renal function failure in 6 and infection in 20. Conclusions Prevention of complications is extremely important for successful liver transplantation. Early diagnosis and correct management depend upon the knowledge of time and symptoms of corresponding complications following liver transplantation.