Objective To investigate the indications and results of combined liver-kidney transplantation.Methods From Jan. 2001 to Dec. 2003, 15 patients were subjected to combined liver-kidney transplantation in our department. The underlying diseases included hepatitis B viral cirrhosis complicated by HRS ( n= 8), hepatitis B viral cirrhosis complicated by uremia ( n =2), hepatitis B viral cirrhosis complicated by diabetic nephropathy ( n =1), polycystic liver and kidney disease ( n =2), Caroli's disease and polycystic kidney ( n =1), alcoholic liver cirrhosis complicated by uremia ( n =1). The surgical procedure, perioperative complications, acute and chronic rejection, the recurrence of hepatic viral B hepatitis, and the result of follow-up were analyzed.Results The graft function in 15 cases of combined liver-kidney transplantation was restored well after operation. The 6-month and one-year survival rate was 100%. One patient was supported by respiration machine for 48 days. The complications occurred in 3 patients after operation, including one case of gastroenternal bleeding repeatedly and one case of postoperative wound bleeding subject to non-surgical treatment, and one case of stenosis of biliary anastomosis subject to ERCP. Only one patient experienced a rejection episode of the liver. No acute rejection of the kidney graft occurred. One patient was died from liver graft function failure by recurrence of hepatitis B after 30 months.Conclusions Combined liver-kidney transplantation is only radical treatment method for patients with end-stage liver disease with chronic renal dysfunction or chronic renal failure. In the patients with hepatitis B,lamividine and hepatitis B immunoglobin can prevent the recurrence of hepatitis B.

Objective To evaluate the clinical effect of Ho:YAG laser with flexible ureteroscope on the treatment of renal calculi. Methods Fifty one cases of renal stone burdens were treated with Versa Pulse Select Ho:YAG lithotriptor through flexible ureteroscope. Results The successful rate of stone fragmentation after single session was 90%(45/51).Mean operation duration was 45 min (30～78 min).Mean duration of post operation in hospital was 2.4 days (1～6 days).Stone free time was 3～6 weeks,with a mean of 4 weeks.No ureteral perforations or pyonephrosis occurred. Conclusions Ho:YAG laser lithotripsy through flexible ureteroscope is a safe, effective treatment for renal calculi.

ObjectiveTo compare orthotopic liver transplantation (OLT)and combined liverkidney transplantation (CLKT) in the treatment of severe hepatitis B.MethodsIn this study 52 patients of severe hepatitis B were allocated to OLT (40 cases) or CLKT( 12 cases) at our department from Jan.2001 to Sep.2005.The perioperative complications and the result of follow-up were analyzed.ResultsThe preoperative renal functions in CLKT cases were severer than that in OLT cases.Postoperative severe infection was more common in CLKT cases than that in OLT cases.In OLT group 28 patients (70％)suffered from early posttransplant renal dysfunction,among them 11 patients needed dialysis,whilst there were 2 (16.7％ ) patients who needed dialysis in CLKT group (P ＜0.01 ).The posttransplant mortality in OLT group was 40％ ( n =16),significantly higher than that in CLKT ( 16.7％,n =2) ( P ＜ 0.01 ).In OLT group,9 cases developed severe renal failure and died.No one died of renal failure in CLKT group.ConclusionsThe prognosis is more favorable to perform CLKT in patients who suffered from severe hepatitis B with chronic renal dysfunction before transplantation.

BACKGROUND: Multiwaled carbon nanotubes can accelerate the proliferation and differentiation of osteoblasts, and exert a therapeutic effect on steroid-induced necrosis of femoral head (SNFH). OBJECTIVE:To investigate the function of multiwaled carbon nanotubes in the establishment of a rabbit model of SNFH. METHODS:Thirty-six New Zealand white rabbits were divided randomly into three groups. In treatment group, 16 rabbits were given intraglutealy injection of dexamethasone (2.5 mg/kg) every day and injection of 1 mL liquor of multiwaled carbon nanotubes (0.1 g/L) into the bilateral femur medulary space every week. In model group, 16 rabbits were given intraglutealy injection of dexamethasone (2.5 mg/kg) every day and injection of 1 mL normal saline into the bilateral femur medulary space every week. In control group, four rabbits were given intraglutealy injection of 2 mL normal saline every day and injection of 1 mL normal saline into the bilateral femur medulary space every week. RESULTS AND CONCLUSION: Four weeks after hormone injection, the trabeculae began to exhibit a smal amount of thinner fractures, an accumulation of fatty tissue in the bone marrow were obvious, bone marrow fat cels became bigger and microvascular thrombosis appeared in the model group, while there was no positive histopathological manifestation in the treatment group. This indicates that the multiwaled carbon nanotubes can extenuate pathological damage to the femoral head to a certain extent.

BACKGROUNDIn most instances, advanced non-small cell lung cancer (NSCLC) is treated with primary chemotherapy. Many chemotherapy regimens can palliate cancer-related symptoms. Quality of life and modestly improved survival are very important especially for elderly patients. This clinical trial is to compare the efficacy and toxicity of gemcitabine and oxaliplatin (GO) versus gemcitabine and cisplatin (GP) in treatment of advanced NSCLC in elderly patients.

METHODSA total of 42 patients with advanced NSCLC diagnosed pathologically were randomly divided into GO group (gemcitabine 1000mg/m² on days 1, 8; oxaliplatin 65mg/m² on days 1, 8) and GP group (gemcitabine 1000mg/m² on days 1, 8; cisplatin 30mg/m² on days 1-3), 28 days as a cycle. All patients received two cycles of chemotherapy at least.

RESULTSIn GO group, the response rate was 55.0%. Whereas in GP group, the response rate was 40.9%. The difference in response rate was not statistically significant between the two groups (P > 0.05). The median survival duration was 11.2 months in GO group and 11.8 months in GP group. The 1-year survival rate was 45% in GO group and 50% in GP group (P > 0.05). The main toxicities were well tolerated. Leukopenia and nausea/vomiting at grade III+IV, and alopecia and impaired renal function at grade I+II occurred more frequently in GP group than those in GO group (P < 0.05).

CONCLUSIONSBoth of the two regimens are feasible, well-tolerated and effective in treatment of advanced NSCLC in elderly patients. GO regimen may be safer than GP regimen.

Background/Aims: The aim of this study was to analyze the chronological changes in postoperative complications in surgical ulcerative colitis patients over the past decade in China and to investigate the potential parameters that contributed to the changes. Methods: Ulcerative colitis patients who underwent surgery during 2008–2017 were retrospectively enrolled from 13 hospitals in China. Postoperative complications were compared among different operation years. Risk factors for complications were identified by logistic regression analysis. Results: A total of 446 surgical ulcerative colitis patients were analyzed. Fewer short-term complications (24.8% vs. 41.0%, P=0.001) and more laparoscopic surgeries (66.4% vs. 25.0%, P<0.001) were found among patients who received surgery during 2014–2017 than 2008–2013. Logistic regression suggested that independent protective factors against short-term complications were a higher preoperative body mass index (odds ratio [OR], 0.870; 95% confidence interval [CI], 0.785–0.964; P=0.008), laparoscopic surgery (OR, 0.391; 95% CI, 0.217–0.705; P=0.002) and elective surgery (OR, 0.213; 95% CI, 0.067–0.675; P=0.009). The chronological decrease in short-term complications was associated with an increase in laparoscopic surgery. Conclusions Our data revealed a downward trend of short-term postoperative complications among surgical ulcerative colitis patients in China during the past decade, which may be due to the promotion of minimally invasive techniques among Chinese surgeons.

Objective To establish a differential model of phlegm and blood stasis pattern and qi deficiency and blood stasis pattern in stable angina pectoris using radiomics.Methods A total of 91 patients with stable angina pectoris who underwent coronary artery CT angiography in Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 2021 to January 2022 were collected,including 47 cases of phlegm and blood stasis pattern and 44 cases of qi deficiency and blood stasis pattern.The patients were divided into train set(64 cases)and test set(27 cases)according to the ratio of 7∶3 by stratified random sampling method.3D-slicer software was used to extract the radiomics features of pericoronary adipose tissue(PCAT)images.Principal component analysis was used to visualize the distribution of radiomics features of pattern of phlegm and blood stasis and pattern of qi deficiency and blood stasis.The least absolute shrinkage and selection operator regression analysis and support vector machine decreasing feature elimination were used for feature selection.The multinomial logistics regression was used for model construction.The receiver operating characteristic(ROC)curve was used to verify the model in the train set and the test set to evaluate the effectiveness of the radiomics features in differentiating phlegm and blood stasis pattern and qi deficiency and blood stasis pattern.Finally,Spearman coefficient was used to analyze the correlation between the differential features and clinical physicochemical data.Results A total of 837 radiomics features were extracted from PCAT images by 3D-slicer software.In the principal component analysis,PC1 and PC2 explained 77.9%and 8.1%of the total variance,respectively,and there was a relatively obvious separation trend between the two pattern groups.After feature screening,7 radiomics features were used to construct the differential model of phlegm and blood stasis pattern and qi deficiency and blood stasis pattern.The area under the ROC curve(AUC)of the differential model was 0.844 in the train set and 0.834 in the test set.Spearman correlation analysis showed that the differential features were significantly correlated with cTnI,neutrophil,triglyceride,total cholesterol,and leukocyte.Conclusion The CT radiomics model based on PCAT has a high discrimination efficiency for stable angina pectoris with phlegm and blood stasis pattern and qi deficiency and blood stasis pattern.

Objective To investigate the mechanism by which Ginkgo biloba extract reduces myocardial injury in rats with myocardial infarction(MI).Methods Bioinformatics was used to identify key targets of Ginkgo biloba extract in the treatment of MI in rats.An MI rat model was established via coronary artery ligation.Rats were randomly assigned to the model group,Betaloc ZOK group(2.5 mg/kg),and low-,medium-,and high-dose Ginkgo biloba extract groups(50,100,and 200 mg/kg,respectively).A sham-operation group was included for comparison.Following six weeks of gavage administration,myocardial tissues were examined using hematoxylin-eosin and Sirius red staining to assess pathological changes.Wheat germ agglutinin staining was used to observe cardiomyocyte hypertrophy.Western blotting was performed to evaluate changes in the expression of MCODE core targets,including HIF1α,MAPK14,MMP9,and CXCR4.Results Compared to the sham-operation group,the model group exhibited irregular arrangement of cardiomyocytes,significant inflam-matory infiltration,and a marked increase in type Ⅰ and Ⅲ collagen fibers in the myocardial tissue(P＜0.05).Additionally,significant upregulation in the expression of MCODE core target proteins(P＜0.05)was observed.In contrast,compared to the model group,low-,medium-,and high-dose Ginkgo biloba extract groups displayed more orderly arrangement of cardiomyocytes,reduced inflammatory infil-tration,significantly decreased levels of type Ⅰ and Ⅲ collagen fibers(P＜0.05),notable downregulation in the expression of p-MAPK14,MMP9,and CXCR4 proteins(P＜0.05),and significantly increased expression of HIF1α protein(P＜0.05).Conclusion Ginkgo biloba extract may exert protective effects on myocardial cells following MI by inhibiting the formation of neutrophil extracellular traps.

OBJECTIVE: To study the expression and significance of hMSH2 protein in laryngeal squamous cell carcinoma. METHOD: The expression of hMSH2 protein were detected by immunohistochemistry SP method in 51 cases of laryngeal squamous cell carcinoma, the control group included 30 cases of atypical hyperplasia tissue of vocal fold and 16 cases of normal laryngeal tissue. RESULT: The expression rates of hMSH2 in laryngeal squamous cell carcinoma, atypical hyperplasia tissue of vocal fold and normal laryngeal tissue were 58.8%, 73.3%, 87.5% respectively. There was significant difference among them (P < 0. 05). The expression of hMSH2 in laryngeal carcinoma was not associated with location and T stage (P > 0.05), but the expression was related with metastasis of lymph node and differentiation level (P < 0.05). CONCLUSION The deletion of hMSH2 maybe participate the early occurrence of laryngeal carcinoma; hMSH2 protein maybe delay and suppress oncogenesis and development of laryngeal carcinoma.
Carcinoma, Squamous Cell ; metabolism ; pathology ; Case-Control Studies ; Head and Neck Neoplasms ; metabolism ; pathology ; Humans ; Hyperplasia ; Immunohistochemistry ; Laryngeal Neoplasms ; metabolism ; pathology ; MutS Homolog 2 Protein ; metabolism ; Squamous Cell Carcinoma of Head and Neck

Biliary stent has been widely used in the treatment of biliary stricture and obstruction, it can relieve the pain of patients effectively, but bacterial infection and stent obstruction are still troublesome after surgery. We introduce the mechanism of infection and stent blockage caused by bacterial invasion after biliary stent implantation, and expound the formation mechanism of bacterial biofilm and bile sludge in this review. Antibacterial biliary stent is an effective way to inhibit biliary tract infection, the literatures on antibacterial modification of biliary stent with different antibacterial methods in domestic and abroad are reviewed, and the research prospect of antibacterial biliary stent is summarized and prospected.
Anti-Bacterial Agents/pharmacology* ; Bile ; Biliary Tract ; Cholestasis ; Humans ; Stents