BACKGROUND: Biliary complications are a common cause of death in patients after liver transplantation, biliary endoscopic minimally invasive technique is gradually becoming an important tool to solve biliary complications following orthotopic liver transplantation.OBJECTIVE: To analyze the literatures on the biliary tract complications after liver transplantation, and to demonstrate a clear role of bile duct endoscopy in biliary complications.METHODS: Using "orthotopic liver transplantation, biliary complications, biliary tract, endoscope technique" in English for the search term, Pubmed database were searched between January 1980 and October 2008; Using "liver transplantation, biliary complications, bile duct cast, cholangioscopy" in Chinese for the search term, Vip Chinese Periodical Database and CNKI database were searched between 1994 and January 2009. Literature language was limited to English and Chinese. The studies related to bile duct injury-caused biliary complications after liver transplantation were included, while other research unrelated to biliary complications after liver transplantation were excluded.RESULTS AND CONCLUSION: A total of 52 literatures were screened out by the primary computer inspection, according to inclusion and exclusion criteria, 30 ones were involved for analysis. Biliary complications and vascular complications are considered as a common cause of death in patients after liver transplantation, particularly in biliary complications has become the major reason limiting the development of liver transplantation. Because of the difficulties on early recognition and treatment, the importance of the treatment for the complications in liver transplant patients is increasingly attracting more and more attention. Endoscopic operation technology and their subsidiary parts are improving, particularly therapeutic endoscopic retrograde cholangiopancreatography and biliary mirror technology are developing and continuously improving, biliary endoscopic minimally invasive technique is gradually becoming a major approach to solve biliary complications after orthotopic liver transplantation, The minimally invasive endoscopic diagnosis and treatment is an intuitive, reliable and credible means for the biliary complications after liver transplantation, serving as the most preferred method for diagnosing and treating biliary complications after liver transplantation.

Objective To evaluate the preventive effect of different portal vein flush solutions in no heart beating donor harvest on biliary cast syndrome (BCS) after orthotopic liver transplantation (OLT), and the application of choledochoscopy in treating BCS. Methods The incidence of biliary complications in 137 consecutive recipients undergoing OLT in our liver transplant center from May. 2002 to Dec. 2003 was retrospectively analyzed. The incidence and risk factors of BCS were compared in 2 groups with different types of portal vein flush solution in no heart beating donor liver harvest: group 1 (n = 65). University of Wisconsin (UW) solution; and group 2 (n = 72), hypertonic citrate adenine ( HCA) solution combined with UW solution. Therapeutic experience and clinical value of choledochoscopy for BCS were summarized. Results Seventeen out of 137 cases (12.4 %) developed BCS in the first three months after operation. In the group 1, the incidence of BCS was 20. 0 % (13/ 65), while that in the group 2 5. 56 % (4/72) with the difference being significant (P

Objective To explore the clinical experience of liver retransplantation in management of biliary complications after liver transplantation.Methods The clinical data of patients receiving liver transplantion in our department between April 2002 and Aug. 2004 were retrospectively analyzed, including 5 patients being subjected to liver retransplantation because of serious biliary complication.Results Three patients were cured with the survival time being 5 months, 6 months and 8 months respectively. Two patients died at 8th and 43rd day: one died of liver non-function combining with lung infection and heart failure, and another died of renal failure. Complications included liver absess, biliary infection, wound infection, hydrops abdominis and lung infection.Conclusions Liver retransplantation is an effective treatment for serious biliary complications after liver transplantation. Surgical procedure, indication, operative opportunity, perioperative monitoring and so on contribute to the increase of the survival rate of the patients receiving liver retransplantation.

Objective To determine whether the anti-proliferation effect of L-arginine is due to inhibiting the expression of cyclin dependent kinase-2 (CDK2)、 CyclinE and proliferation cell nuclear antigen (PCNA) in blood vessel after balloon injury. Methods Rats were randomized into three groups: Group S (sham operation group), Group C (balloon injury control group) and Group L (balloon injury + L-arginine group). After 14 days, blood samples were collected for biochemical studies, and the thoracic aortas were harvested for immunohistochemistry. The expression of CDK2、 CyclinE and PCNA were measured by means of computer image analayzer. Results The levels of plasma nitric oxide (NO) in group C were significantly lower than those in group S. Compared with group C, the levels of plasma NO increased (P

Objective To study genotyping and molecular epidemiology distribution of GBS pathogenic strains of GBS positive pregnant women in Guangzhou,for GBS pathogenic strains of rapid molecular diagnosis and epidemiological surveillance pro-vide certain theoretical basis and method.Methods In the Guangzhou area,used multi stage stratified sampling method col-lecting GBS positive pregnant women’s reproductive tract specimens from January to December 2015,drug sensitivity quality control standard strains:Streptococcus pneumoniae (ATCC49619)and Staphylococcus aureus (ATCC25923),took culture of bacterial,strain,identification,DNA extraction,PCR,gene detection method,through the relevant software for data analy-sis,analyzed GBS strains of gene and molecular epidemiology.Results In the study,collected 2 812 samples of secretions,af-ter identification of strains isolated from 178 strains of pathogenic GBS strains,the detection rate was 6.33%.GBS patho-genic strains to linezolid vancomycin,penicillin,nitrfurantion and other antimicrobial drug resistance rate was 0,GBS parho-genic strains to ampicillin,ciprfloxacin moxifloxacin and levofloxacintesistant parts,the restance rates were 1.1%,16.9%, 18.0% and 22.5%,but GBS pathogenic strains to erythromycin,clindamycin tetracydine antibiotics showed a high resistance rate,the resistance rates were 50.6%,47.8%(of which 20 cases of erythromycin induced clindamycin resistance accouted for 23.5%)and 73.0%.Among them,65 strains of GBS detected the mreA gene,56 strains of GBS detected the ermB gene,36 strains of GBS detected the mefA gene,28 strains of GBS detected the mefE gene,5 strains of GBS detected the ermA gene, ermC gene was not detected in the gene.Among them,carried five multidrug resistance gene of 3 strains (1.6 9%)and 4 kinds of resistant gene carried with 15 strains (8.43%),carried three resistance genes of 19 strains (10.67%),2 kinds of resistant gene carrying a 25 strains (14.04%),carried the resistance gene of 5 strains (2.81%),did not carry resistance gene of 1 strain (0.56%).The nucleotide sequences of the five drug resistance genes were 100%,and no gene mutation oc-curred.Conclusion The main GBS disease resistant gene was mreA,ermA,ermB,mrfA,mefE and its nucleotide sequence homology was 100%.The clinical need to strengthen the detection of resistant gene and molecular level and guide clinical more scientific and rational drug use.

Objective To explore the main pathogenic bacteria and antibiotic resistance patterns in children with bacterial diar‐rhea from Guangzhou region .Methods Regular bacterial culture of stool samples from children with suspicious bacterial diarrhea was performed to isolate the pathogen during 2011 to 2012 ,followed by the analysis of its composition and serum type ,ward distri‐bution characteristics and drug resistance to 12 antimicrobacterial drugs .Results 416 strains of pathogenic bacteria were isolated from diarrhea children during 2011-2012 ,in which salmonella ,enteropathogenic E .coli ,Campylobacter jejuni and Candida albicans isolates accounted for 53 .61% ,37 .98% ,5 .29% and 1 .68% respectively .Drug resistance rate of the main strains to 12 antimicrobi‐al agents was 85 .25% to ampicillin ,54 .28% to compound sulfamethoxazole ,44 .70% to cefotaxime ,42 .53% to ceftriaxone , 40 .66% to chloramphenicol ,23 .55% to ceftazidime ,23 .36% to aztreonam ,14 .88% to ciprofloxacin ,8 .07% to cefepime ,7 .99% to cefperazone/sulbactam ,7 .42% to piperacillin/tazobactam respectively ,and no resistance to imipenem was detected .Conclusion The pathogenic bacteria causing diarrhea mainly includes salmonella ,pathogenic e .coli ,campylobacter jejuni in children from guang‐zhou region ,the top five sensitive antimicrobial reagents for the main strains includes imipenem ,piperacillin/tazobactam ,cefpera‐zone/sulbactam ,cefepime and ciprofloxacin .

A stable HMG-CoA reductase (HMGR) reaction in vitro was developed by a sensitive, selective and precise liquid chromatography–tandem mass spectrometry (LC–MS/MS) method. The optimized enzyme reac-tion condition contained 1.5μg of HMGR, 20 nM of NADPH with 50 min of reaction time. The method was validated by several intra-and inter-day assays. The production transitions of m/z 147.0/59.1 and m/z 154.0/59.1 were used to detect and quantify mevalonolactone (MVAL) and MVAL-D7, respectively. The accuracy and precision of the method were evaluated over the concentration range of 0.005–1.000μg/mL for MVAL and 0.010–0.500μg/mL for lovastatin acid in three validation batch runs. The lower limit of quantitation was found to be 0.005μg/mL for MVAL and 0.010μg/mL for lovastatin acid. Intra-day and inter-day precision ranged from 0.95%to 2.39%and 2.26%to 3.38%for MVAL, 1.46%to 3.89%and 0.57% to 5.10% for lovastatin acid, respectively. The results showed that the active ingredients in Xuezhikang capsules were 12.2 and 14.5 mg/g, respectively. This assay method could be successfully applied to the quality control study of Xuezhikang capsule for the first time.

ObjectiveTo explore the diagnostic and predictive value of troponin Ⅰ,lactic acid and hypersensitive C-reactive protein(hs-CRP) in viral myocarditis.MethodsTroponin Ⅰ,hs-CRP,lactic acid blood levels in different time were measured in 88 patients with acute viral myocarditis(54 cases) or acute upper respiratory infections (34 cases).Troponin Ⅰ leyel in patients with severe 39 cases and mild VMC 15 cases were compared.ResultsTroponin Ⅰ level of VMC group was (0.59 ±0.10) ng/L,and significantly higher than that of acute upper respiratory infection group [ (0.10 ± 0.08 ) ng/L ] ( t =2.79,P ＜ 0.05 ).And higher lactic acid and hs-CRP level were observed at different period ( t =2.71,2.48,all P ＜ 0.05).ConclusionTroponin I could help diagnose VMC predict the severity of myocarditis to some extent.Lactic acid and hs-CRP could also reflect imflammation injury of VMC.

Objective To investigate the significance of orthotopic liver transplantation in the management of primary hepatocellular carcinoma (PHC) ; To evaluate the survival and prognostic factors of liver transplantation for PHC.Method The clinical data from 194 consecutive PHC patients who underwent OLT were retrospectively analyzed.Result The 1-,3-and 5-year cumulative survival rate of the 194 patients was 92.78％,78.07％ and 76.80％ respectively.There were 37 cases of recurrence or metastasis of the tumor with the incidence rate being 19.1％ (37/194).The tumor TNM stage (P=0.026 667),tumor diameter (P =0.0045),tumor number (P =0.0318),vascular invasion (P =0.006 059),and AFP level before transplantation (P =0.003 426) were significantly related with tumor recurrence.Multivariate analysis revealed that tumor diameter (P =0.0081,OR =0.789,95％ CI:2.1233-6.124),vascular invasion (P＜0.001,OR =5.928,95 ％ CI:1.173-86.789),and AFP level before transplantation (P =0.019,OR =2.601,95％ CI:2.196-5.658) were independent risk factors for tumor recurrence.There was statistically significant difference in survival rate and tumor-free survival rate between Milan criteria group and beyond-UCSF criteria group (P＜0.01),and between UCSF criteria group and beyond-UCSF criteria group (P＜0.01).There was no significant difference in survival rate and tumor-free survival rate between Milan criteria group and UCSF criteria group (P ＞0.05).Conclusion Liver transplantation is an effective treatment for PHC.The tumor diameter ＞8 cm,vascular invasion and AFP level significantly affect the survival of PHC patients.

Objective To investigate the expressions and clinicopathological significance of 3q27-3q29-related p63 protein in diffuse large B-cell lymphoma (DLBCL). Methods An immunohistochemical Envision~(TM) method was used to detect the expressions of p53 and 3q27-3q29-related p63 protein in 102 cases of DLBCL and 15 cases of reactive hyperplasia of lymph node (RHL). Results The tumor cell expressions of p53(62 %) and p63(56 %) in DLBCL were significantly higher than that in RHL (0 and 13 % P < 0.05). The expressions of p53 and p63 were significantly different (1) between stage Ⅰ + Ⅱ (the positive rate 48.3 % and 41.4 %, respectively) and stage Ⅲ+Ⅳ(the positive rate 79.5 % and 75 %, respectively; P <0.05), (2) between GCB type (the positive rate 28 % and 28 %, respectively) and non-GCB type(the positive rate 72.7 % and 64.9 %, respectively; P <0.05). The expressions of p53 and p63 had no relationship to gender, age, B symptoms and locations. The expression of p53 was positively correlated with that of p63 in DLBCL (P <0.05, Cp=0.629). p53 and p63 protein expression in negative group the 5-year overall survival rate is higher than that in positive group (38 % and 6 %, 51% and 4 %, respectively), the difference was statistically significant (P <0.05). Conclusion It was likely that p63, as the oncogene, participated in the occurrence and development of DLBCL together with p53. Also, p63 and p53 might play a synergistic role in the occurrence DLBCL. Combined detection of 3q27-3q29-related 1963 protein and p53 protein in DLBCL, might be one of the indicators to the prognosis of DLBCL.