Liver transplantation is currently the only treatment option for end-stage liver disease,but it is limited by the lack of high quality donor livers.The ongoing liver donor shortage could be alleviated by the consequent expansion of do-nor criteria to include the use of livers that would once have been discarded as unsuitable,marginal livers.Static cold storage,the current gold standard of organ preservation,is incapable of reversing the ischemic damage these organs have sustained.In hepatic transplantation,the limitations of cold storage are reflected in the significantly higher rates of early al]ograft dysfunction,primary non-function,and local ischemic cholangiopathy,especially seen with older,steatotic and donation after cardiac death (DCD) grafts.The existing cold storage technology has restricted the use of this kind of organs and machine perfusion preservation technology becomes an alternative choice.In this paper,we review the research progress on machine perfusion preservation of livers,and introduce the normothermic machine perfusion.

Objectives: To investigate the distribution of common pathogens and their antibiotic resistance from patiens with catheter related sepsis (CRS).Methods: Catheter bacteria cultrure and antibiotic sensitivity test were performed from 69 patiens with CRS.Results: The common pathogens in CRS were fungi (41.1%),Gram-positive cocci (35.6%)and Gram-negtive bacilli (23.3%). Non-C. albicans species were major pathogen (19/30 stranins).The most strains were staphylococcus epidermidis in Gram-positive cocci and the most of them were Methicillin resistant.No vancomycin resistant strains were found. The Gram negative bacilli were often resistant to third generation cephalosporens.Conclusions: The dorminant pathogens of CRS are fungi and gram positive cocci and we should pay more attention to pathogens of resistence to antibiotics. In order to control CRS, CVC must be used reasonably and shorten the duration of retention.

Objective To explore the repair of the open compound wounds in lower extremities caused by multiple factors. Methotis Transplantation of cutaneous.musculo-cutaneous or greater omentum flaps were applied to 155 patients of open compound lower extremity wounds. Results The wound healing rate following first operation was 50% and that following two operations was 14.8%.While the wounds were healed in 7.7% of patients after three operations. Conclusion Transplantations of cutaneous,musculo-cutaneous or greater omentum flaps ale effective to repair and reconstruct the open compound lower extremity wounds.

Objective:To compare the laparoscopic and open surgery in the treatment of Mirizzi syndrome (MS).Methods:The clinical data of 125 patients with MS undergoing surgery in Tianjin Nankai Hospital from May 2013 to April 2020 were retrospectively analyzed, including 59 males and 66 females, aged (57.7±13.6) years old. Patients were divided into the laparoscopic group ( n=84) and open group ( n=41). General data, operation time, intraoperative blood loss, postoperative complications, postoperative and total hospital were compared between the groups. Patients were followed up and screened for biliary stone recurrence or biliary stenosis by phone or Wechat. Results:The postoperative hospital stay [8.00(5.25, 12.00) d vs. 13.00(10.00, 17.50) d, P<0.001] and total hospital stay [15.00 (10.25, 22.75) d vs. 22.00 (16.00, 27.50) d, P<0.001] were shorter in laparoscopic group. The conversion rate of laparoscopic group was 15.5% (13/84). No perioperative death occurred in either group. The incidence of postoperative complications were comparable between the groups [9.5%(8/84) vs. 7.3%(3/41), P>0.05]. In laparoscopic group, 64 patients were followed up [76.2% (64/84)]. During follow-up, there were two deaths, five cases of bile duct stones recurrence and one case of bile duct stenosis. In open group, 37 patients were followed up [90.2% (37/41)]. During follow-up, there were four deaths, four cases of bile duct stones recurrence. All deaths during follow-ups were non-MS-related. Conclusion:Compared to open surgery, laparoscopic surgery could shorten the total/postoperative hospital stay while does not increase the morbidity and mortality, which could be safe and feasible in the treatment of MS.

In the process of radical resection of abdominal malignant tumors, large blood vessels are often invaded, which not only increases the difficulty of operation, but also directly affects the curative effect and prognosis. As the concept of expanded radical surgery combined with vascular resection and reconstruction and related techniques have been gradually recognized, surgeons have begun to use autologous, allogeneic or artificial vessels to repair the defective blood vessels during surgery, so as to achieve the effect of radical surgery. However, due to the short comings of these materials, scholars have been looking for better alternatives. In view of the fact that the mesothelial cells of the peritoneum and the endothelial cells of the blood vessels have many similarities in embryology, histology and physiology, and peritoneum is also easier to obtain than autologous, allogeneic or artificial vessels. To make the autologous peritoneum into a patch for repairing the defective blood vessels is feasible in theoretical and technical. In this paper, we review the current research progress of autologous peritoneal patch to repair blood vessels of defect.

Objective:To analyze the expression levels of microRNA-203(miR-203)and fibroblast growth factor-2(FGF-2)in hemangiomas of infancy(HOI)and to explore their clinical significance.Methods:A total of 55 patients with HOI admitted to our hospital from March 2016 to August 2017 were selected as HOI group and divided into proliferative phase(31 cases)and regressive phase(24 cases), normal tissue specimens were taken as control group(34 cases). Real time fluorescence quantitative PCR(qRT-PCR)was used to detect the expression levels of miR-203 and FGF-2 mRNA in HOI tissues.Immunohistochemistry was used to detect the expression of FGF-2 protein in HOI tissues.Clinical indicators of HOI patients included angiogenin(ANG), vascular endothelial growth factor(VEGF), basic fibroblast growth factor(bFGF), glucocorticoid receptor alpha(GRα), glucocorticoid receptor beta(GRβ). Pearson method was used to compare and analyze the correlation between various indicators in children with HOI group.Logistic multivariate regression analysis was used to analyze the related influencing factors of HOI.Results:Compared with the control group(1.01±0.15), the expression level of miR-203 in HOI group(0.73±0.24)decreased significantly( P<0.05), and the proliferative phase(0.72±0.21)was significantly higher than the regression phase(0.59±0.19)( P<0.05); the expression levels of FGF-2 mRNA and protein in HOI group(2.38±0.74)were significantly higher than those in control group(1.02±0.14)( P<0.05), and the regression phase(2.37±0.79)was significantly higher than the proliferative stage(2.03±0.68)( P<0.05); Pearson analysis showed that miR-203 was negatively correlated with FGF-2, ANG, VEGF and bFGF( P<0.05), while FGF-2 was positively correlated with them( P<0.05); Logistic analysis showed that the expression levels of miR-203 and FGF-2 were both influencing factors of HOI. Conclusion:MiR-203 is low expressed in HOI, while FGF-2 is highly expressed.There is a significant difference in the expression changes of the two in HOI stages and it is important for clinical diagnosis of HOI and treatment.

Cholangiocarcinoma originates from bile duct epithelial cells and is a highly heterogeneous and aggressive malignant tumour. A deep understanding of the biological characteristics of the tumor can help to make progress in the treatment of cholangiocarcinoma. There are many types of animal models of cholangiocarcinoma, and different models can be induced according to different research purposes, including chemotoxic agent models, cholestatic models, implantation models, genetically engineered models, etc. This paper summarises the existing animal models of cholangiocarcinoma, compares their advantages and disadvantages as well as the application scenarios, and provides a reference for subsequent studies.