Objective To summarize the experience of reconstruction of Ⅴ and Ⅷ hepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation. Methods The clinical data of 55 cases of living donor liver transplantation of right lobe without middle hepatic vein were analyzed, and Ⅴ and Ⅷ hepatic veins were reconstructed. All donors underwent evaluation on the basis of vascular anatomy, GRWR and graft volume/ESLV. Fifty-one grafts underwent reconstruction of Ⅴ and Ⅷ hepatic veins with cold-storage cadaveric iliac veins. Great saphenous vein, varicose umbilical veins, recipient intrahepatic portal veins and recipient intrahepatic veins were used respectively in the remaining 4 cases. Results One recipient died of obstruction of out-flow on the postoperative day 43. One recipient was converted to cadaver donor liver transplantation at the 7th day after operation, because of acute liver function failure. The remaining 53 cases recovered successfully. Conclusion Reconstruction of Ⅴ and Ⅷ hepatic veins with proper materials in right lobe (without middle hepatic vein) living donor liver transplantation is feasible, and the effect is satisfactory.

ObjectiveTo observe the virological and immunological items in peripheral blood of Chinese-origin Rhesus macaques infected with SIVmac251.The normal levels of WBC and CD4+T cell ratio for healthy Chinese-origin Rhesus macaques that suitable for simian AIDS modeling also investigated.MethodsThirty-six Chinese-origin Rhesus macaques were intravenously infected with SIVmac251.Blood samples were collected at 10 time points respectively include 1 day before SIV infection,every week within 1-8th week and then in tenth week post infection.Blood routine,peripheral blood T lymphocyte subsets,plasma viral load were tested.ResultsThe most significant changes of the tested items were appeared in 1 or 2 weeks post SIV infection,while the WBC counts didn't show marked changes in all the time points tested.WBC counts ranged from 4×106/ml to 10×106/ml and the CD4+T cells ratio high than 25％ are the suitable levels for simian AIDS modeling.ConclusionThis research provides necessary and beneficial informations to the usage of Chinese-origin Rhesus macaques in AIDS research.

Objective To summarize our experience of harvesting and using the organs of donors after cardiac death.MethodsForm March 2010 to October 2011,56 potential donors were diagnosed with cardiac death,who conformed to the classification of Maastricht Ⅲ criteria.There were 40 failure cases whose family refused to donate,and one failure case who suffered from serious infection.Finally,the success ratio of donation after cardiac death was 26.8％ (15/56).Twelve livers and 22 kidneys were transplanted into 12 and 20 recipients respectively.ResultsTwelve cases of liver transplantations had acceptable outcomes. The grafts of 4 cases out of 20 cases of kidney transplantations were removed after transplantation,and other recipients had acceptable outcomes.ConclusionCitizens organ donation after cardiac death can expand the number of suitable organs,but we need to strictly control the criteria for potential donors.

Objective The purpose of this article was to investigate the diagnostic value of CT and MRI in preoperative local staging for rectal cancer patients. Methods Forty rectal cancer patients were enrolled,and their preoperative CT and MRI staging and pathological staging in T and N were compared. Results The total diagnostic accordance rate of CT staging in T was 57.5%(31/40),among which the accordance rate of T1-2,T3 and T4 was 87.5%(35/40),83.25%(33/40) and 70%(28/40),respectively. The total diagnostic accordance rate of MRI staging in T was 77.5%(31/40), among which the accordance rate of T1-2, T3 and T4 was 92.5%(37/40), 77.5%(31/40) and 85%(34/40),respectively. The differences were tested by Chi-square test,and there were no significant differences between the two groups in T staging. The sensitivity of T staging by CT was 77.78%(7/9) for T1-2, 75% (12/16) for T3 and 93.33% (14/15) for T4. Compared with CT, the sensitivity of MRI was 66.67%(6/9) for T1-2, 81.25%(13/16) for T3 and 80%(12/15) for T4, and there were no significant differences between the two groups. The specificity of T staging by CT was 90.32% (28/31) for T1-2, 45.83%(11/24) for T3 and 96%(24/25) for T4. Compared with CT, the specificity of MRI was 100% (31/31) for T1-2, 75% (18/24) for T3 and 88%(22/25) for T4, and there was a significant difference in T3 specificity ( <0.05) . The total diagnostic accordance rate of CT staging in N was 82.5% (33/40),among which the rate of N- and N+was 82.5%(33/40) and 82.5%(33/40), respectively. The total diagnostic accordance rate of MRI staging in N was 62.5%(25/40),among which the rate of N- and N+was 62.5% (25/40) and 62.5%(25/40), respectively. There were significant differences between the two groups in pelvic N staging ( < 0.05) . The sensitivity of N staging by CT was 75.00%for N- (18/24) and 81.25%(13/16) for N+. Compared with CT,the sensitivity of MRI was 75.00%(18/24) for N- and 43.75%(7/16) for N+,and there were significant differences between the two groups ( <0.05) . The specificity of N staging by CT was 81.25% (13/16) for N- and 83.33%(20/24) for N+. Compared with CT, the specificity of MRI was 43.75% (7/16) for N- and 75.00%(18/24) for N+, and there were significant differences between the two groups ( <0.05) . Conclusion MRI has a high reliability in diagnosing rectal cancer with penetrating through the muscularis propria into the placenta percreta or not, but CT is superior in diagnosing the lymphonodus metastasis.

Objective To study the genetic diversity in Fujian Sanming Sarcandra Glabra from different geographical provenances;To construct genetic relationship diagram.Methods DNA in leaves was extracted by CTAB. Analysis and evaluation of DNA molecular level of 45 samples of different geographical provenances were conducted by ISSR method. POPgen32 software was used to calculate the genetic diversity and establish gene trees. NTSYS software was used to carry out cluster analysis.Results Six ISSR primers amplified 630 bands. Genetic diversity analysis showed that the average effective number of alleles of 45 varieties was 1.620 2;the average Nei's genetic diversity index was 0.364 5;the average Shannon information index was 0.543 2. Each point had different levels of genetic diversity. Nei's genetic diversity index of the maximum value was 0.497 2, and the minimum value was 0.107 8;Maximum Shannon information index was 0.690 3, and the minimum value was 0.219 2. Cluster analysis results showed that 45 varieties and 14 loci band data were the primitive matrix. 630 genetic similarity coefficients between two different species were obtained. The maximum similarity coefficient among different groups was 1.0, and the minimum was 0.516.Conclusion Different varieties of Fujian Sanming Sarcandra Glabra exist abundant genetic variation and has the molecular basis of abundant species. Using 0.610 as the threshold value can divide Sarcandra Glabra from 45 different geographical provenances into 6 groups. The genetic distance and geographical distance was not related.

Purpose Dual-energy coronary artery CT angiography (CTA) is a very promising one-stop examine, but the radiation dose is too high to hinder the development of the technology. The aim of this article is to explore the feasibility of low tube current combined with sonogram-affirmed iterative reconstruction (SAFIRE) technology in dual energy coronary artery CTA scan. Materials and Methods One hundred and twenty patients were randomly divided into four groups according to the tube current of A ball:conventional group (180 mAs) and low-dose groups (150 mAs, 120 mAs, 90 mAs). The SAFIRE 3 reconstruction method was used in the low-dose groups. The differences of mean CT values, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), image quality score and effective dose (ED) of the four groups were compared. Results The coronary artery segment display and the mean CT value of the four groups showed no statistic difference (P>0.05), while the image quality score, noise, SNR, and CNR showed statistic difference (P<0.05). The image quality score, SNR, and CNR was highest in the 150 mAs group, but noise was the lowest. There were no statistic difference of the image quality score, SNR, and CNR between the 180 mAs group and 90 mAs group (P>0.05). The ED was (5.50±1.47) mSv, (4.55±1.16) mSv, (3.41±0.77) mSv and (2.44±0.67) mSv, respectively for the four groups, and there was statistical difference (P<0.05). ED of 90 mAs group decreased 55.62% than that of 180 mAs group. Conclusion Coronary artery CTA using 90 mAs combined with SAFIRE can significantly reduce the radiation dose without losing image quality, thus it has a good prospect of clinical application.

PurposeTo explore the significance of dual energy CT in differential diagnosis of squamous cell carcinoma metastatic lymph nodes and lymph node tuberculosis in the neck.Material and Methods Twenty-five patients with a total of 62 cervical enlarged lymph nodes confirmed with squamous cell carcinoma metastasis or lymph node tuberculosis by pathology underwent dual energy enhanced CT scan. Iodine coverage value of two different kinds of pathological properties of lymph nodes was measured. The trend of the spectrum curve was observed and the energy spectrum curve slope of two kinds of lymph nodes were compared. The sensitivity, specificity and accuracy of energy spectrum curve slope in differential diagnosis were analyzed. Results Of all 62 lymph nodes, there were 32 squamous cell carcinoma metastatic lymph nodes and 30 lymph node tuberculosis. There were statistic significance in the iodine coverage between the squamous cell carcinoma metastatic lymph nodes and lymph node tuberculosis (t=3.806 and 3.698,P<0.05). In the range from 60 keV to 180 keV, CT value of the two kinds of lymph nodes decreased with increase of keV value. It showed the higher the keV value the less CT value decreased, with the energy spectrum curve of drop type. The area of the iodine coverage was 0.756 with the differential diagnostic sensitivity of 56% and the specificity of 80%. The area of energy spectrum curve slope was 0.898 with the differential diagnostic sensitivity of 76% and the specificity of 85%.Conclusion The iodine coverage value and the energy spectrum curve slope have significance in differential diagnosis of the cervical squamous cell carcinoma metastatic lymph nodes and lymph node tuberculosis. The energy spectrum curve slope is superior to the iodine coverage value in differential diagnosis.

Objective To study the diagnostic value of contrast-enhanced CT scan with split bolus for the ureleropelvic junction obstruction(UPJO) caused by aberrant vessel of kidney.Methods 52 patients with UPJO underwent contrast-enhanced CT scan with split bolus.The aberrant vessels and its origin as well as the relationship between aberrant vessels and UPJO were observed comparatively with the results of surgery.Results In 52 cases,CT showed UPJO caused by aberrant vessl of kidney in 14 cases,including accessory renal arteries in 10,ovarian artery originated from left renal artery in one,right accessory renal artery in one and gonad veins in 2.CT findings were corresponded to operations in all these 14 cases.The sensitivity and specificity of CT in evaluating UPJO were 100% respectively.Conclusion The UPJO caused by aberrant vessel of kidney can be diagnosed accurately by contrast-enhanced CT scan with split bolus,which can be offered for surgical treatment for UPJO.The patient's CT dose can be decreased with split bolus.

Objective To evaluate the indications and results of liver transplantation ior benign liver tumors.Methods From Jan 2001 to Dec 2014,16 patients of inoperable severely symptomatic benign liver tumors underwent liver transplantation in our department.There were 10 cases of polycystic liver disease,2 cases of hepatic epithelioid hemangioendothelioma,1 case of hepatic cavernous hemangioma,1case of liver mesenchymal hamartoma,1 case of hilar bile duct mucinous cystadenoma,1 case of hepatic adenoma.Results 3 cases were dead in the perioperative period.The remaining patients were alive and discharged with normal perioperative liver and kidney function.One case of polycystic liver lost to follow-up,the remaining 12 patients were all alive at the end of a follow-up of 17 to 161 months,with fully active life style.Conclusions Liver transplantation is an effective and sometimes the only treatment option for unresectable and symptomatic benign liver lesion.

ObjectiveTo determine the incidence,risk factors and measures to prevent biliary complications after ex vivo split liver transplantation (SLT).Method33 ex vivo SLT were performed between June 2006 and September 2010.One patient was excluded from this analysis because of early postoperative death.There were 18 males and 14 females,with a mean age of 33.4 yr (range,6 mo to 65 yr).Biliary reconstruction was carried out by duct-to-duct anastomosis in 20 and Roux-en-Y hepaticojejunostomy in 12 patients.Biliary complication was defined as either bile leak or bile duct stricture which required surgery,interventional radiology or endoscopic treatment.These biliary complications were confirmed by percutaneous tranahepatic cholangiography,endoscopic retrograde cholangiopancreatography,or T-tube cholangiography.ResultThe median follow-up was 13.5 months (3 to 54 mo).Twelve (37.5 ％ ) biliary complications occurred in 11 patients:hepatic parenchymal leak from the transeeted liver surface in 9.3％ (3/32),anastomotic leaks in 12.5％ (4/32),anastomotic strictures in 3.1％ (1/32),stump leaks from the left bile duct in 3.1 ％ (1/32),and ischemic biliary strictures in 9.3％ (3/32).Two patients died of abdominal sepsis in the 8 patients who had biliary leaks.Univariate analysis showed that graft type and biliary reconstruction were not significant risk factors for biliary leaks.ConclusionCompared with whole liver transplantation and living donor liver transplantation,biliary complications of SLT are more common.Prevention and treatment of biliary complications are important factors to improve the result of SLT.