Objective:To explore the treatment and effect of ABO-different orthotopic liver transplantation(OLT).Methods:Fifteen cases of ABO-different OLT were analyzed retrospectively.Six cases of ABO-different but compatible OLT were treated routinely.In 9 cases of ABO-incompatible OLT,plasma exchange was done in 1 case before operation,splenectomy was done in 5 cases during operation,the hepatic artery and biliary duct anastomosis were performed by the microvascular technique.The immuno suppressive protocol included a quadruple drug therapy,and anticoagulant therapy were performed postoperation.Results:No complications were found in 6 cases of ABO-different but compatible OLT.Of the 9 cases of ABO-incompatible OLT,4 patients recovered smoothly without complications.Postoperative complications included acute rejection in 3 patients,biliary nonanastomotic stricture in 4 patients,and 3 cases died.Conclusion:The effect of ABO-different but compatible OLT is good.ABO-incompatible OLT can be used when the graft is scarce,but we should manage to decrease the complications.

Objective To describe the impact of administrative penalties for medical disputes on the medical staff, including their perception on the penalty and its impact on their mind and body, professional behavior, career development, etc, and to provide a theoretical basis for health policy making and hospital management. Methods The phenomenological research method was adopted to conduct in-depth interview to 10 hospital staff in Taian who were involved in medical disputes and got punished, and the Giorgi qualitative data analysis was used in the research. Results The interviewees′perception and impacts of the punishment were concluded into five aspects:physiologically, psychologically, cognitively, behaviorally and professional development. Conclusions It is concluded that the current punishment to individuals has caused quite negative effects, and a new mechanism should be established to systematically reconstruct the procedure and reduce the medical disputes to the minimum.

Objective To study the features and risk factors of ischemic leukoaraiosis (LA) progression in elderly patients aged 80 years and over. Methods The 56 elderly patients with ischemic LA confirmed by MRI were enrolled in this study. The characteristics and risk factors of ischemic LA were comparatively analyzed between baseline and 3 years later by single and multi-variable logistic regression analysis. Results Ischemic LA progressed mostly in the subcortical white matter in elderly patients, especially the frontal lobes (progression of white matter lesion was present in 40% in the frontal lobes at baseline and 52% after 3 years), followed by the parietal lobes (35% at baseline and 36% after 3 years); Furthermore, previous high homocysteine (Hcy) and chronic bronchitis were risk factors of ischemic LA progression. Conclusions Ischemic LA progresses mostly in the subcortical white matter in the elderly, especially the frontal lobes; High Hcy and chronic bronchitis are risk factors of ischemic LA progression in elderly patients.

ObjectiveTo investigate the clinical efficacy of vastus medialisoblique enhancement plus electroacupuncture intervention in treating patellar chondromalacia.MethodFifty-two patients meeting the inclusion criteria were randomly allocated to a treatment group of 32 cases and a control group of 20 cases. The treatmentgroup received vastus medialis oblique enhancement plus electroacupuncture intervention and the control group, electroacupuncture intervention alone. Both groups were treated once daily, 10 times as a course, for four consecutive courses. The Visual Analogue Scale (VAS) score was counted in the two groups before and after treatment. The clinical therapeutic effects were evaluated in the two groups.ResultThe VAS score improved significantly in both groups of patients after treatment compared with before(P<0.05). It improved significantly more in the treatment group than in the control group (P<0.05). The cure rate and the total efficacy rate were 37.5% and 96.9%, respectively, in the treatment group, which were higher than a cure rate of 20.0% and a total efficacy rate of 75.0% in the control group, respectively. ConclusionVastus medialis oblique enhancement plus electroacupuncture intervention can improve the clinical symptom of pain more markedly and heighten the clinical therapeutic effect in patients with patellar chondromalacia. Its effect is better than that of electroacupuncture intervention alone.

Objective:To investigate the management in patients with complete portal vein (PV) and superior mesenteric vein (SMV) thrombosis during liver transplantation (LT). Methods:Seven patients with complete PV and SMV thrombosis undergone LT, The reconstruction of PV were the anastomosis PV to varicose coronary vein in 3 cases, PV to varicose vein near hilus of spleen in 2 case, PV to varicose vein in front of common bile duct in 1 case, PV to varicose right gastro-epiploic vein in 1 case. Results:All patients undergone successful LT. One case died 7 days after the transplantation of multi-organic nonfunction, but the PV was patent. One case was found stenosis at the anastomosis 6 months after LT, and he was cured by percutaneous transhepatic portography and stent placement. Other patients were followed-up12~22 months, the PVs were patent, and had sufficient blood supply, and they have normal liver and kidney functions now. Conclusion :The anastomosis between graft portal vein and the splanchnic varicose vein may be a applicable choice for the patients with complete PV and SMV thrombosis during LT.

Objective To explore the treatment of ABO-incompatible orthotopic liver transplantation. Methods Nine cases of ABO-incompatible liver transplantation performed in our hospital were analyzed retrospectively. Plasma exchange was done before the operation in 1 case. Hepatic artery and biliary duct anastomosis were performed by the microvascular technique. Splenectomy was done during operation in 5 cases. The immunosuppressive protocol included a quadruple drug therapy. Blood oxygen saturation was maintained above 95% and anticoagulant therapy was performed after operation.Results Four patients recovered smoothly without complications. Postoperative complications included acute rejection in 3 patients and biliary nonanastomotic stricture in 4. Three patients died. Conclusion ABO-incompatible orthotopic liver transplantation can be used when the graft is scarce, and should manage to decrease the complications.

Objective: To study the surgical strategy of portal vein organized thrombosis ( PVOT ) during liver transplantation ( LT ) . Methods: The clinical data of 41 patients with PVOT performed LT from January 2005 to June 2006 ( 359 cases ) in our institute was retrospectively analyzed . The reconstruction of portal vein ( PV ) were removing thrombosis in 22 cases , throm- boendovenectomy in 10 cases , PV to splanchnic varicose vein in 8 cases , cavoportal hemitranspo- sition in 1 case . Results: 1 case died of multiple organ failure , 1 case died of hepatic artery bleeding . Retransplantation and portosystemic shunt vein ligation were performed in 1 case 14 days after LT because of its insufficient PV flow 2 cases were found anastomotic stenosis and they were cured by balloon angioplasty and stent placement via hepatic vein . Other patients were followed up 6 to 20 months , all of them had normal PV flow . Conclusion: Thromboen- dovenectomy or removing thrombosis is applicable to manage PVOT during LT .

Background Blepharitis caused by Demodex infestation is very common in clinical practice.There are various methods mentioned in the study of Demodex infestation in China,but a unified introduction and evaluation of the operating procedures is lacked.A quick and accurate clinical diagnostic method for Demodex infestation needs to be further studied.Objective This study aimed to establish operation procedures for the clinical examination of eyelid Demodex infestation,which were applied to evaluate the conditions of eyelid Demodex infestation in ocular patients with discomfort.Methods One thousand and fifty-two patients with eye dryness,eye itchiness or other symptoms were selected for slit lamp examination and photographing of the eyelid margin area.Three eyelashes with associated scurf from each superior eyelid were plucked out for examination of Demodex under the microscope.Positive findings included observation of Demodex mites or eggs.Their amounts were recorded individually for all eyelash samples.Results A procedure for observing,recording and reporting eyelid Demodex infestations in patients was successfully established.By using this procedure,1 052 patients were investigated for the examination of Demodex infestations.Demodex mites or eggs were found in 582 cases (55.3％).The positive rate of Demodex infestation increased with age,and the population over 60 years group had the highest positive rate,showing a significant difference among the different age groups (x2=10.547,P=0.001).There was no significant difference in positive rate between male patients and female patients (P =0.352).The test turnaround time (TAT) for one examination was (11.4±5.2) seconds.Conclusions The operational procedure for examining the palpebral margin Demodex infestation by the slit-lamp,optical microscope,photographing and laboratory reports is established.It is simple and quick in the appliation for the clinical diagnosis of eyelid Demodex infestation.

Objective To investigate the clinical pathological features and imaging findings of primary pulmonary sarcomatoid carcinoma. Methods Fifteen patients with a pathologically verified primary pulmonary sarcomatoid carcinoma were reviewed retrospectively. Fourteen patients had CT examinations and I0 of them had contrast-enhanced CT scan. Nine patients had chest plain films. Results Of 15 patients, 14 were peripheral and 1 was central, diameters ranging from 2.5 cm to 9.5 cm. Five located in the upper, 3 in the middle and 4 in the lower lobe of the right lung. The other 3 located in the upper left lobe. All cases presented with a spheroid solid lung mass on chest plain film and CT examinations. Three had irregular eccentric cavities. Six were well demarcated, 2 were ill defined, 4 were lobulated and 3 were speculated. The central case had obstructive pneumonia and showed ill defined. Ten showed irregular peripheral heterogeneous contrast enhancement. The center part of the tumor showed no enhancement or inhomogeneous enhancement. Seven had thoracic wall or pleural invasion, 4 had hilar or mediastinal lymphopathy and 2 had metastasis. Histopathologically, 8 were pleomorphic carcinoma, 2 were spindle cell carcinoma, 3 were giant cell carcinoma and 3 were pulmonary blastomas. Conclusion The X-ray and CT findings of the primary pulmonary sarcomatoid carcinoma are not specific. The clinicopathologic features were the evidence of diagnosis.

[Objective] To learn about the genetic diversity,we studied the five X-chromosomal STR (X-STR) loci in Guangdong Han Nationality Groups.[Methods] The five Loci (DXS6803,DXS981,DXS6809,DXS6789,and DXS7132) were amplified in a pentaplex PCR reaction.PCR products were analyzed using capillary electrophoresis and ABI prism 3100 Genetic Analyzer,with GeneMapper ID 3.1 Analysis Software.[Results] A total of 363 individuals (181 unrelated male and 182 unrelated female) from Guangdong Han population were tested,54 alleles were observed for these loci.Polymorphism information content is 0.6935 ～ 0.8177.Power of discrimination in females was 0.8976 ～ 0.9562.Mean exclusion chance for X-STR in standard trios with daughters was 0.7805 ～ 0.8467.[Conclusion] The five loci in the multiplex system provide high polymorphism information for forensic identification and paternity testing,particularly for difficult paternity deficiency cases.