fulminant liver failure(FLF)is a rapid onset life-threatening emerency in which liver dysfunction,liver failure and hepatic encephalopathy occur within 8 weeks in previouslv norillal person.It has been confirmed by available clinical experience and literatures during the past decades that FLF patients are ideal recipients of liver transplantation.However,the prognosis of the FLF patients who accepted liver transplantation differed greatly according to the available reports because of the differences of supportive treatment during waiting period,the criterion for recipient assessment,the determination of operation chance,the use of critical techniques during operation and postoperative management between different transplantation centers.We probe the standardized clinical use of the aspects above mentioned in liver transplantation for FLF,particularly discuss the treatment of complications resulting from coagulopathy,determination of operation chance,significance of standardized etiological treatment and the indication of the use of veno-venous bypass technique during transplantation to provide better treatment strategy and improve the prognosis of FLF patients.

Objective To determinate the content of 2, 3, 5, 4′-stibene glucoside in Xuezhiping Capsules. Method HPLC was performed with Diamosil~(TM)C_(18) column, a mobile phase of acetonitrile-water (20: 80), the detection wavelength at 320nm and the flow rate being 1.0 mL/mL. Results 2, 3, 5, 4′-stilbene glucoside has a good linear within 0.0267～2.6640 ?g and the average recovery was 99.62% with RSD 1.32%. Conclusion This method is convenient and efficient and can be used for the quality control of Xuezhiping Capsules.

Objective To develop Knee Osteoarthritis Self-Care Questionnaire for Elderly (KOSCQE), and test reliability and validity of the scale. Methods Based on self care theory, with reference to International Knee Documentation Committee Subjective Knee Form, combined with literature analysis and through semi-structured interviews, the item pool of the scale was established. A total of 148 elderly were investigated by questionnaire survey. Results KOSCQE extracted 5 common factors with 26 items, and the total variance contribution rate was 68.972%;the item load factor was 0.576 to 1.872, item level content validity index was 0.901-0.928, factor in overall content validity index of 0.916;total Cronbach αcoefficient was 0.898, test-retest reliability was 0.864, and the confirmatory factor analysis showed that:χ2/df=1.09, goodness of fit index =0.942, root mean square error of approximation=0.020, adjusted goodness of fit index=0.964, normed fit index=0.960, comparative fit index=0.948, relative fit index=0.931, incremental fit index=0.918, parsimony goodness of fit index=0.891. Conclusions The reliability and validity of the KOSCQE of the elderly accord with the requirements of the measurement of the scale, it can improve the elderly's awareness of self care and quality of life of the knee osteoarthritis.

Objective To analyze the status quo of and problems inthe allocation and services of pediatric health resources in Huadu District , Guangzhou and to put forward suggestions for improvement .Methods All hospi-tals providing pediatric services in Huadu District were surveyed with questionnaire on health resources allocation and services supply .Results There were only 4 pediatric specialty hospitals in the district with problems such as lack of pediatricians , higher rate of pediatric bed utilization , imbalance in the supply of pediatric outpatient services and heavy work load of pediatricians .Conclusion The rational allocation of pediatric resources and enhanced training for pediatric professionals are effective for solving the problem in the deployment and service supply of pediatric health re -sources .

Objective To summarize the main early complications after pancreatoduodenectomy and analysis of the probable causes.Methods The clinical data of 576 cases who underwent pancreatoduodenectomy(PD) in our department between Feb 1990 and May 2009 were analysed retrospectively.Results There were 92 early postoperative complications occurred in 85 patients(14.8%).Gastrointestinal dysfunction,pancreatic leakage,intra-abdominal infections and hemorrhage were the most of complications,and 7 cases died during perioperative period(mortality 1.22%),among which 3 died of multiple system organ failure,2 died of hemorrhagic shock and 2 died of toxic shock.Preoperative hypoproteinemia and hyperbilirubinemia complicated with a high incidence of postoperative complications on multivariate analysis.Conclusions Meticulous preoperative preparation,delicate intraoperative technigne and close postoperative observation are the key points to decrease early complications and improve the prognosis of the patients who undergo PD.

Objective To understand the actual situation of community‐based diabetes management and analyze common prob‐lems in diabetes management and find the solutions to diabetes management though the objective investigation .Methods The pa‐tient′s data including gender ,age ,education ,medication ,lifestyle information were collected by household face‐to‐face survey and were performed a single factor χ2 analysis of relevant indicators .Results Relative to the patients with middle school education only and is less than 3 000 a month ,the diabetic patients who ere above the junior middle school and family income equal to or greater than 3 000 had good diabetes management on medication ,diet ,exercise ,blood glucose monitoring ,diabetes related knowledge .Con‐clusion Patient′s education and economic level could effect attitudes toward diabetes ,medication ,diet ,exercise ,blood glucose moni‐toring ,diabetes‐related knowledge .

Objective To study molecular adsorbent recycling system (MARS) in the treatment of patients with acute liver failure waiting for liver transplantation. Methods The effects of MARS artificial liver treatments in 16 cases were reviewed. Results There was a remarkable improvement in clinical symptoms and physical signs after MARS treatment, including significant decrease in prothrombin time, total bile acid, level of alanine aminotransferase, aspartate aminotransferase, creatinine, and blood ammonia (P＜0.05＝;There was no statistical change in NO,TNF-α and IL-10(P＞0.05).Sequential organ failure assessment(SOFA)score decreased from 9.91±1.09 to 6.64±1.76 and Glascow coma score increased from 7.29±2.06 to 13.26±2.14.Fourteen patients were tided over to liver transplantation among them 13 patients survived and were successfully discharged from the hospital. The survival rate was 89.5%.Conclusion MARS is a safe and effective assistant device in bridging acute liver failure patients to liver transplantation.

Objective To investigate the role of deferoxamine pretreatment for hepatic ischemia reperfusion injury in liver auto-transplantation in rats. Method Murine liver auto-transplantation model was established. Ninety six male Sprague-Dawley rats were randomly divided into three groups: 32 rats in deferoxamine pretreatment group (D), 32 rats in control group with aqua pro injection pretreatment(C) and 32 rats in sham-operation group (S). The animals were killed at 30 min, 2 h, 6 h, 24 h after operation respectively. ALT and AST level, superoxide dismutase (SOD) and malondialdehyde (MDA), liver histological change(HE), the protein expression of HIF-1α、TNF-α and IL-1 were measured. Results At 30 min, 2 h, 6 h, 24 h after operation, the levels of ALT,AST,MDA and the expression of IL-1 protein and TNF-α protein were higher in group C than group D significantly,while the expression of HIF-1α and SOD were higher in group D [SOD(411±70; 384±53; 379±46)、H1F-1α(0.0413±0.0040; 0.0684± 0.0032; 0.0583±0.0032; 0.0491±0.0026)] than group C significantly (P<0.01) [SOD(341±21; 323±25; 303±25)、HIF-1α (0.0254±0.0024; 0.0312±0.0022; 0.0381±0.0022; 0.0257± 0.0015)] (F>59.881;P<0.01). Conclusion The up-regulated expression of HIF-1α, decreased liver lipid peroxidation injury and TNF-α and IL-1 levels, may be involved in the mechanism hy which deferoxamine pretreatment protects liver from ischemia reperfusion injury in rats' liver auto-transplantation.

Objective To investigate the ultrasonic characteristics of invasive micropapillary carcinoma(IMPC) of breast and the metastatic lymph nodes,and to evaluate the value of ultrasonography for preoperative TNM staging.Methods The ultrasonic characteristics of 16 IMPC and 81 invasive ductal carcinoma (IDC) confirmed by pathology,as well as the metastatic lymph nodes were analyzed retrospectively.The TNM-staging for IMPC by preoperative ultrasonography was evaluated according to pathology.Results Compared with IDC group,the masses showed higher A/T ratio (＜ 0.7),larger maximum diameter,more calcification,unclear border and lymph node metastasis rate,while less acoustic halo in IMPC group.Meanwhile,similar ultrasonic characteristics,such as irregular shape,uneven internal echo,spiculate margin,posterior acoustic attenuation and internal blood flow were seen in IMPC and IDC groups (P ＞0.05).According to pathology,the ultrasonic coincidence rate for T staging was 56.3 ％,and T2-staging was 85.7％.The sensitivity,specificity,positive predictive value and negative predictive value of ultrasonic diagnosis on lymph node metastases was 70.0％,83.3％,87.5％ and 62.5％,respectively.Conclusions Ultrasonography displayed more typical malignant signs,higher lymph node metastasis rate and diagnosis accuracy for IMPC,which possessed certain value for preoperative TNM staging.

Objective To investigate the functions of microRNA-1 43 (miR-1 43)in esophageal cancer cell line ECA1 09.Methods ECA1 09 cells were transfected with negative control (NC),miR-1 43 mimics or miR-1 43 inhibitors.3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT)assay was per-formed to evaluate the growth of ECA1 09 cells after transfection.Annexin V-FITC /PI apoptosis test kit was used to detect early apoptosis rate in ECA1 09 cells.Transwell migration and invasion assays were conducted to compare the migration and invasion capacity of ECA1 09 among different groups.Real-time PCR and Western blotting were used to analyze the mRNA and protein alteration after transfection.Results Three and four days after transfection,compared with NC (absorbance value:0.90 ±0.02 and 1 .09 ±0.07),miR-1 43 mimics inhibited ECA1 09 cell proliferation (absorbance value:0.66 ±0.05 and 0.80 ±0.04),while miR-1 43 inhibi-tors promoted cell proliferation (absorbance value:1 .1 3 ±0.09 and 1 .51 ±0.08),with statistical signifi-cances (F =49.1 6,P =0.000;F =1 00.34,P =0.000).Early-stage apoptosis rates of ECA1 09 transfected with NC,miR-1 43 mimics and miR-1 43 inhibitors were 3.42% ±0.72%,1 1 .63% ±1 .1 5% and 0.94% ± 0.1 0%,respectively,with statistical significance (F =1 51 .61 ,P =0.000).Meanwhile,compared with NC (migration cell number:336 ±1 3,invasion cell number:1 47 ±1 6),miR-1 43 mimics inhibited cell migration (1 48 ±1 6)and invasion (75 ±1 0),while miR-1 43 inhibitors promoted cell migration (51 0 ±1 4)and inva-sion (238 ±1 6),with statistical significances (F =470.99,P =0.000;F =90.04,P =0.000).Compared with NC (1 .00 ±0.00),miR-1 43 mimics down-regulated mRNA (relative expression level 0.22 ±0.08)and protein expression (relative expression level 0.46 ±0.08)of K-ras,whereas miR-1 43 inhibitors up-regulated mRNA (1 .55 ±0.1 2)and protein expression (1 .33 ±0.05)of K-ras (F =1 31 .36,P =0.000;F =88.1 7, P =0.000).Conclusion miR-1 43 functions as a tumor suppressor in esophageal cancer cell line ECA1 09, probably by down-regulating K-ras expression.