Objective To investigate the epidemiology and drug resistance associated with fungal infection during early postoperative period after liver transplantation in the purpose of prevention and treatment.Methods A total of 118 cases of liver transplantation admitted from April 2004 to January 2009 in Nanfang Hospital were studied retrospectively,and the fungal infection and drug resistance were identified.Results Fungal infections occurred in 26 cases (22.0%).Totally there were 49 fungi strains isolated,of which mainly Candida albicans (57.1%),followed by Aspergillus (18.4%),Smooth Candida (10.2%),Candida tropicalis (6.1%),Candida parapsilosis (4.1%),and Candida krusei (4.1%).The sensitive rate of voriconazole,itraconazole,amphotericin B,5-fluorouracil,fluconazole were 92.0%,90.0%,75.5%,73.5%,and 55.1% respectively.Conclusion Because of the change of fungi strains and the increase of drug resistance,it’s important to identify the fungi and drug resistance for the purpose of prophylaxis and treatments.

Objective To investigate the clinical outlook of hepatic stem cells and its relations with liver cancer. Methods The literatures of recent years on the studies of hepatic stem cells were reviewed. Results Liver cancer may consist of cells of various differentiation grades and it may result from the perodifferentiated hepatic stem cells or abnormal differentiated cells. Conclusion The hypothesis of hepatic stem cells has been identified extensively. Further study maybe helpful for revealing the origin, carcinogenesis of hepatic cancer, and may also be useful for the understanding of the mechanism of metastasis.

Objective To investigate the effects of phenylephrine and norepinephrine on tissue oxygen metabolism in elderly patients undergoing fluid restriction. Methods Eighty elderly patients who had underwent elective colorectal surgery were selected, with ASA of Ⅰ-Ⅱ grade. The patients were divided into restricted fluid administration combined with phenylephrine group (group Ⅰ) and restricted fluid administration combined with norepinephrine group (groupⅡ) by random digits table with 40 cases each. The compound recipe sodium lactate was given at a rate of 5 ml/(kg · h). Small dose of phenylephrine was infused intravenously at 0.1-0.3μg/(kg · min) simultaneously during the surgery in group Ⅰ, or norepinephrine 0.01-0.03 μg/(kg · min) in group Ⅱ. Mean arterial pressure (MAP) was maintained ≥ 65 mmHg (1 mmHg = 0.133 kPa). The intraoperative blood loss was replaced with the equal volume of 6% hydroxyethyl starch 130/0.4. The blood gas analysis, hemoglobin and so on were determined before the surgery (T0), 1 h after beginning of surgery (T1), 2 h after beginning of surgery (T2) and at the time of leaving operation room (T3). The complications were recorded. Results There were no statistical differences in MAP, central venous pressure (CVP), heart rate, lactic acid, arterial partial pressure of oxygen, central venous oxygen pressure, central venous blood oxygen saturation, oxygen uptake rate, hemoglobin, albumin, blood urea nitrogen, creatinine and incidence of complication between 2 groups (P>0.05). The T1-3 hemoglobin and arterial oxygen content (CaO2), T1 and T3 venous oxygen content (CcvO2) and T2 atrerial venous oxygen content differences (Da-cvO2) in groupⅠwere significantly higher than those in groupⅡ, hemoglobin:(103.8 ± 7.9) g/L vs. (110.8 ± 8.6) g/L, (101.7 ± 7.7) g/L vs. (107.3 ± 7.8) g/L and (101.6 ± 6.9) g/L vs. (106.8 ± 5.6) g/L; CaO2: (140.6 ± 9.7) mmol/L vs. (149.6 ± 10.5) mmol/L, (137.5 ± 9.3) mmol/L vs. (144.9 ± 10.2) mmol/L and (137.2 ± 9.2) mmol/L vs. (143.1 ± 8.9) mmol/L;CcvO2:(119.8 ± 10.2) mmol/L vs. (126.4 ± 10.8) mmol/L and (102.3 ± 8.6) mmol/L vs. (108.5 ± 8.9) mmol/L;Da-cvO2:(19.6 ± 3.9) mmol/L vs. (23.0 ± 4.5) mmol/L, and there were statistical differences (P<0.05). Conclusions Phenylephrine has more effect on tissue oxygen metabolism in the elderly patients undergoing fluid-restricted abdominal surgery.

Objective To investigate the expression of E26 transformation-specific-1 (E26ts-1),matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in choroidal melanoma and the correlation with the tumor′s infiltration and metastasis. Methods Immunohistochemistry was used to detect the expression of E26ts-1,MMP-1and TIMP-1 in 78 cases of choroidal melanoma who were divided into shuttle-cells,paraepithelial-cells and mixed-cells type according to the configuration of tumor cells.The patients were followed up and their average existing time was calculated.The results were statistically computed with statistic SPSS 10.0 package. Results In the 78 cases,shuttle-cells type was found in 21,paraepithelial-cells type in 34,and mixed-cells type in 23. Expression of TIMP-1was low in uveal melanoma,while expression of E26ts-1 and MMP-1 was obviously found in the three types of choroidal melanoma;the sequence of expression intensity was shuttle-cells,mixed-cells and paraepithelial-cells type.Among 37 cases who had been followed up,the shuttle-cells type was in 18 with the average existing time of (78.33?24.69) months,the mixed-cells type was in 10 with the average existing time of (61.44?20.46) months,and the paraepithelial-cells type was in 9 with the average existing time of (36.76?12.19) months.The existing time was negative correlated with the intensity of expresion of E26ts-1 and MMP-1. Conclusion The high expression of E26ts-1 and MMP-1and low expression of TIMP-1may relate to the choroidal melanoma′s infiltration and metastasis.

Objective To explore the possibility of gelatin sponge as supporter of central nervous tissue engineering. Methods Primary NSCs were isolated from forebrain of neonatal Sprague Dawley rats and cuhured in serum-free medium for long-term survival in vitro. Neural stem cells were divided into absorbable gelatin sponge group and control group.Observe their morphology and proliferation.Immunofluorescence technique were used to test the results of differentiation of two groups of neural stem cells. Resultes NSCs in absorbable gelatin sponge group and control group survived and there was no conspicuous change in shape and quality. The rates of survival cell were 91.6％ and 92.8％ respectively, which was no significant difference between them.NSCs could adherented to the surface of the gelatin sponge and well-grown.After induced differentiation,NSCs started to shrink and stretch,axons grown and connected with each other,till form network structure.The expression of neuroglia cell marker GFAP and neuron cell marker NSE could be detected by immunofluorescence assay. Couclusion Neural stem cells and gelatin sponge can mixed and cultivating together in vitro.NSCs is no conspicuous change.It is suggested that absorbable gelatin sponge can serve as the carrier of the tissue engineering of central nervous system.

Objective: To study the relationship between Framingham risk score for coronary artery disease (CAD) and cognitive function in healthy community elders.
Methods: A total of 276 healthy community elders were evaluated by Framingham score to predict the risk for suffering from CAD in 10 years. The subjects were divided into 3 groups. High risk group (the risk > 20%), n=46, Mid risk group (the risk at 10%-20%), n=76 and Low risk group (the risk < 10%), n=154. The cognitive function was measured by mini-mental state examination (MMSE) and China adult intelligence scale (CISA). The differences of cognitive function levels to 3 CAD risk groups were studied.
Results: With the increased CAD incidence from Low risk, Mid risk to High risk groups, the MMSE score reduced accordingly (26.9 ± 1.45) vs (24.3 ± 1.53) vs (22.2 ± 1.43), P=0.014. Pearson analysis presented that MMSE score was negatively related to Framingham risk score (r=-0.213, P<0.001). There were several elements of cognitive function related to Framingham risk score including MMSE score, question answering, grid filling, oral arithmetic and word distinguishing (r=-0.247), (r=-0.167), (r=-0.132), (r=-0.152) and (r-0.256), all P<0.05.
Conclusion: CAD risk level was negatively related to cognitive function, the higher Framingham risk score resulted in the lower cognitive function in healthy community elder subjects.

Objective To compare the role of Gd-EOB-DTPA dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with multi-detector row computed tomography (MDCT),and to determine the sensitivity,specificity and accuracy in focal hepatic lesions.Methods A retrospective analysis was conducted on 32 patients with focal hepatic lesions who had undergone MRI and MDCT examinations.These patients were divided into two groups:the CT group and the MRI group.The results were analysed using receiver operating characteristic (ROC) curves.Result There were 185 focal hepatic lesions.The sensitivity,specificity and the area under the ROC curve (AUC) were 86.5％,90.9％,0.855,respectively for the MRI group and they were significantly higher than the CT group (63.6％,54.5％,0.532).For detection of lesions ＜1 cm,the sensitivity,specificity and the area under the ROC curve (AUC) for the MRI group were 90％,86.6％,0.886,respectively,which were also significantly higher than the CT group (50.5％,45.5％,0.500).When combined with pathological findings and follow-up,the diagnostic accuracy was 40.6％ using Gd-EOB-DTPA DCE-MRI.Conclusion Gd-EOB-DTPA DCE-MRI has a higher detection rate,better accuracy and diagnostic value for focal liver lesions (＜1 cm) than MDCT.

Objective To investigate the met ho ds of isolation,culturing and passaging of neural stem cells originated from ra t embryonic brains.Methods The neural stem cells were obtained from the brain tissue of rat embryos.They were cultured and passaged with serum-free medium.T hey were identified with Nestin and stained with NF68,GFAP,and GalC after diff erentiation.Results We cultured the neural stem cells through several passages .With the help of serum,they differentiated to neurons,astrocytes and oligode ndrocytes.Conclusion The neural stem cells derived from rat embryonic brains a re able to proliferate and multiplepotent for differentiation.

Objective By comparing the change of expression of AQP1 in vitro lung preserved by the continuous infusion of a heart‐lung machine ,continuous pressure perfusion and single low temperature ,to explore the best method of vitro lung preserva‐tion .Methods Thirty Mongrel dogs were randomly divided into 3 groups ,and both lungs were completely resected under the condi‐tion of keeping mechanical ventilation .The vitro lungs were preserved by the way of the continuous infusion of a heart‐lung ma‐chine ,continuous pressure perfusion and single low temperature ,and collecting specimens according to the time point .HE staining was used to observe the morphological changes of vitro lung tissue .Immunohistochemistry and Western blot were used to detect the expression of AQP1 in vitro lung .Results HE staining found that as the time went by alveolar structure gradually collapsed ,in‐flammatory cells increased ,alveolar interval also gradually broadened and exudation could be seen in the alveolar cavity ;at the same time point ,organization structure of extracorporeal circulation group changed lighter than pressure perfusion group and low‐temper‐ature preservation group .In each experimental group ,the expression of AQP1 showed a trend of decline;at each time point ,the ex‐pression of AQP1 in extracorporeal circulation group was higher than pressure perfusion group ,and pressure infusion group was higher than that of low‐temperature preservation group .Conclusion The protective effect of the continuous infusion of a heart‐lung machine on vitro lung was better than continuous pressure perfusion and single low temperature .

Objective To study the values of quantitative parameters of DCE-MRI in diagnosis of benign and malignant liver tumors and to explore its diagnostic efficacy.Methods Consecutive 25 patients with benign or malignant liver tumors underwent plain scanning and dynamic contrast-enhanced MRI,and total 28 lesions were confirmed by pathology or follow-up.The DCE-MRI quantitative parameters (Ktrans ,Kep ,Ve and iAUC)of the lesions and the surrounding normal liver tissue were acquired.The inde-pendent sample t test was used to compare the quantitative parameters between different tumors.The optimal parameters values of benign and malignant liver tumors were determined by plotting ROC curves.Results The mean quantitative parameters of HCC and benign lesions were larger than those of the surrounding normal liver tissue.Ktrans ,Kep and iAUC between HCC and surrounding nor-mal liver tissue had significant differences (P <0.05),Ktrans and iAUC between benign lesions and surrounding normal liver tissue had a significant difference (P <0.05).Ktrans ,Kep and iAUC between HCC and benign lesions had significant differences (P <0.05). The diagnostic effectiveness of Ktrans = 0.21 5 min-1 ,with sensitivity of 81.3% and specificity of 66.7%,was greater than that of Kep =0.477 and iAUC=24.706.Conclusion The DCE-MRI quantitative analysis can provide a reference for the differential diagnosis of HCC from benign liver tumors.