Objective To summarize experience of selection of donors of living related liver transplantation (LRLT) for Wilson’s Disease.Methods Twenty-nine cases of Wilson’s disease were subjected to LRLT in our center. A retrospective data analysis was carried on 70 potential donors. Results Twenty-three of the 70 potential donors were excluded. The causes were as follows: family and traditional background (n=10, 43.5 % ), copper metabolism abnormality, serum ceruloplasmin 100 ?g (n=6, 26.1 % ), hepatic steatosis (n=4, 17.4 % ) and hepatitis B (n=3, 13 %). The grafts were right liver (n=10) and left liver (n=19). Graft-recipient weight ratio was ( 1.38 ? 0.44 ) %. All donors recovered completely. Perioperative surgical complications occurred in 3 donors and were cured without reoperation, temporary biliary leakages (n=2) as well as postoperative bleeding from the wound of liver (n=1). Conclusions Major impact on living relative donors for Wilson’s Disease is traditional background, copper metabolism abnormalities, hepatitis B and hepatic steatosis. Comprehensive preoperative evaluation of potential donors and harvesting liver surgery innovation ensure the donor safety and graft quality.

Objective To evaluate the effect of cold ischemia on the expression of tumor necrosis factor alpha (TNF-?) and interleukin-10 (IL-10) and hepatic regeneration in liver grafts.Methods Partial liver transplantation model in rats was developed. The rats were divided into 3 groups: control group receiving 50 % liver resection,experimental group 1 receiving partial liver transplantation 30 min after cold ischemia and experimental group 2 receiving partial liver transplantation 10 hr after cold ischemia. The expression of the proliferative cell nuclear antigen (PCNA),TNF-? and IL-10 in liver tissues obtained on the postoperative day 1,2 and 4 in rats was detected by using immunohistochemical method. Correlation analysis was performed on the liver proliferation and regeneration,and the expression of TNF-? and IL-10.Results The survival rate in control group,experimental group 1 and experimental group 2 was 100 % , 79 % and 29 % respectively. In the experimental group 2,the expression of PCNA,TNF-? was significantly decreased,while the expression of IL-10 increased as compared with that in experimental group 1 (both P

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Neural Conduction ; physiology ; Paraplegia ; diagnosis ; physiopathology ; Sural Nerve ; physiopathology

Objective To investigate the feasibility of qualitative diagnosis of small pulmonary nodules (≤1 cm) using multi‐plane reconstruction (MPR) and volume rendering (VR) techniques based on spiral CT scan .Methods The CT images of 190 patients with small pulmonary nodules (≤1 cm) were analyzed retrospectively ,and compared the detection rates of several imaging features among different pathological types of nodules .Results In these 190 patients who were diagnosed as malignance by CT ,168 were confirmed by pathology with an accuracy rate of 88 .4% .The imaging features such as ground glass nodule ,vascular convergence in the benign group were significantly lower than those in the malignant group ,however the solid nodule was observed more frequently in the malignant group (P<0 .05) .The significant differences in other imaging features were not found (P>0 .05) .Except air bronchogram and vascular convergence ,some imaging features (pure ground glass nodule ,part solid ground glass nodule ,solid nodule) showed a decreasing trend ,whereas some others (speculation ,lobulation ,vacuole sign and pleural tag ) were increased among different pathological types of malignant nodules .The linear trend passed the significant test at 0 .017 level .Conclusion CT multi‐plane reconstruction (MPR) and volume rendering (VR) techniques can sufficiently demonstrate the malignant signs in small pulmonary nodules (≤1 cm ) ,can improve to identify different pathological types of such small pulmonary lesions .

Objective To explore the relation between thyroid nodular and thyroid calcification .Methods The clinical data of 430 cases with nodular goiter admitted from January 2011 to December 2013 were reviewed.All cases were performed ultrasonography and pathologic examination .Results Of 430 cases,there was thyroid carcinoma in 49 cases(11.4%),including microcalcification in 30 cases(61.2%) and macrocalcification in 3 cases(6.1%);benign lesion in 381 cases(88.6%),including microcalcification in 24 cases(6.3%) and macrocalcification in 39 cases(10.2%).The difference was remarkable (P=0.000).There was remarkable difference in malignant calci-fied nodules ratio between the patients with microcalcification and macrocalcification (55.6%vs 7.1%,P=0.000), between the patients aged 45 years below and above(48.8%vs 22.6%,P=0.007),between the patients with solita-ry and multiple nodules(45.0%vs 16.7%,P=0.005).But there was no statistic difference in malignant calcified nodules ratio between the male and female groups (24.2% vs.39.7%,P=0.130).Conclusion Microcalcification is a highly specific sign to predict thyroid carcinoma in ultrasonography exam .Positive intervention will be performed immediately when calcification appears in thyroid nodules .

Humans ; Hypertension, Pulmonary ; metabolism ; Inhibitor of Apoptosis Proteins ; Microtubule-Associated Proteins ; metabolism

Objective To summarize the experience of the simple neuroendoscopic endonasal transsphenoidal surgery for the large pituitary adenoma and discuss it's application value.Methods Seventy-eight cases of the large pituitary adenoma treated by simple neuroendoscopic endonasal transsphenoidal surgery from July,2011 to May,2014 were analyzed retrospectively.Tumors were resected using 0 and 30 degree endoscope after opening the same side of the anterior wall of the sphenoidal sinus and sellar bone using the abrasive drilling during operation.Results The tumor removal was total in 62 (79.49％),subtotal in 12 (15.38％),major in 3(3.85％) and part in 1 (1.28％).Seventy-one cases were followed up for 2 months to 2 years after operation and no recurrence was founded,the symptoms of headache disappeared in 49 cases;The vision of patients was improved in 47 cases,menstruation resumed in 12 cases;The acromegaly of patients reduced in 21 cases.Hormone level review of PRL returned to normal in 32 cases,GH returned to normal in 21 cases,ACTH returned to normal in 2 cases.Conclusion The endoscopic transsphenoidal surgery for large pituitary tumors is the safely,minimally invasive surgical techniques.With the development of endoscopic equipment constantly updated and the operational flexibility and comfort is improved ceaselessly,endoscopic transsphenoidal surgery for the sellar tumor will be carried out more widely.

BACKGROUND:Airway epithelial regeneration can effectively inhibit submucosal hyperblastosis and the occurrence of obliteration. Studies demonstrated that ventilation could accelerate the regeneration of airway epithelium. OBJECTIVE:To establish and improve an orthotopic tracheal transplantation model and to further observe the effects of ventilation on trachea in alogeneic mice. METHODS:C57BL/6 mouse's tracheal served as donor, and BALB/c mouse's tracheal as recipient. This experiment contained two groups. In the experimental group, the membranous part of trachea was longitudinaly dissected in two donors and sutured into an enlarged trachea, which was implanted in the recipient. In the control group, donor's trachea was implanted into the recipient in situ. Samples were obtained and detected at 28 days after surgery. RESULTS AND CONCLUSION: Hematoxylin-eosin staining results demonstrated that compared with the control group, wel-differentiated ciliated epithelium was visible in the epithelial lamina of tracheal lumen, accompanying a few non-ciliated single or stratified squamous epithelium, mild submucosal fibrosis and inflammatory cel infiltration. Morphological analysis revealed that ciliated epithelial proportion in the experimental group was higher than in the control group (P < 0.05). The ratio of lamina propria to the tracheal cartilage, submucous fibrous tissuearea and the degree of lymphocyte infiltration were lower in the experimental group than in the control group (P < 0.05). Immunohistochemical staining demonstrated that the transplanted tracheal epithelium in both groups was recipient epithelial phenotype. Results verified that a modified orthotopic tracheal transplantation model was successfuly established. The increased ventilation of the tracheal alografts can accelerate the differentiation of tracheal epithelium. The wel-differentiated airway epithelium inhibited the proliferation of fibroblast.

BACKGROUND: There are so many experimental and clinical researches on levels of nitrogen monoxide (NO) in serum and endothelins in plasma of patients with stroke; however, ratio and significance between them are still unclear.OBJECTIVE: To observe dynamic changes of levels of NO in serum and endothelins in plasma of patients with stroke.DESIGN: Case-controlled observation.SETTING: Neurological Department and Clinical Neurological Laboratory of the Second Hospital affiliated to Suzhou University.PARTICIPANTS: A total of 216 patients with acute cerebral infarction including 133 males and 83 females and 112 cases with cerebral hemorrhage including 68 males and 44 females were selected from Neurological Department of the Second Hospital affiliated to Suzhou University from September 1999 to December 2001. Another 106 subjects including 63males and 43 females were regarded as healthy control group.METHODS: Contents of NO in serum and endothelins in plasma were measured on 328 patients with stroke and 106 healthy subjects in the courses of 1-3 days, 1, 2, 4, 8 and 12 weeks with nitrate reductase and radio-immunity methods, respectively.MAIN OUTCOME MEASURES: Contents of NO in serum and endothelins in plasma; ratio between NO in serum and endothelins in plasma (NO/endothelins).RESULTS: ① As compared with those in the control group, content of NO in serum of patients with cerebral infarction and cerebral hemorrhage was decreased and reached the lowest value during acute period (within 1-3 days), and then increased gradually and closed to the normal level at about 4 weeks. In addition, content of endothelins in plasma was increased obviously during acute period, reached the peak at 2 weeks, and then decreased gradually. The level was still high at stage of recovery and closed to normal value within 4-8 weeks. ② As compared with that in the control group, NO/endothelins was decreased in cerebral infarction group at the courses of 1-3 days (P ＜ 0.05), reached the lowest value at 1 week (P ＜ 0.001), and increased to the normal level at 2 weeks. Moreover,NO/endothelins was remarkably decreased in cerebral hemorrhage group at the courses of 1-3 days (P ＜ 0.001), reached the lowest value at 1week (P ＜ 0.001), and increased gradually. The changes of course were great and the level reached above normal value at 8 weeks. There was significant difference of dynamic changes of NO/endothelins between cerebral hemorrhage group and cerebral infarction group (P ＜ 0.05).CONCLUSION: NO and endothelins play an important role in onset and development of ischemic cerebrovascular disease and hemorrhagic cerebrovascular disease, and their contents are related to prognosis.

Objective To investigate the diagnostic value of T-SPOT.TB in patients with fever.Methods T-SPOT.TB was carried out in 456 febrile patients who had no determined reason for fever or who could not be excluded from infection with Mycobacterium tuberculosis.These patients were followed up for their final clinical diagnosis and the diagnostic value of T-SPOT.TB was evaluated using the receiver operating characteristic (ROC) curve.Results In the present study,85 patients were clinically diagnosed with tuberculosis (TB) (including 34 cases of pulmonary TB,24 cases of TB infection defined as T-SPOT.TB positive without TB lesion,but effective with anti-TB treatment,10 cases of tuberculous pleurisy and 17 cases of other extrapulmonary TB) and 371 patients had no definite evidence of Mycobacterium tuberculosis infection (including 42 cases of suspected TB and 329 cases of other diseases).T-SPOT.TB had a high sensitivity of 84.3％ in TB patients and a high negative predictive value of 94.2 ％,but the specificity was 68.1％ and the positive predictive value was 41.4 ％.The Kappa value was 0.380 and the area under ROC curve was 0.762 (95％CI:0.707-0.817).T-SPOT.TB had a higher sensitivity in extrapulmonary TB than in pulmonary TB (88.2 ％ vs 78.1 ％),with the negative predictive values of 95.3 ％ and 92.6 ％,Kappa values of 0.438 and 0.299,and the areas under ROC of 0.791 (95 ％ CI:0.724-0.857) and 0.719 (95％CI:0.623-0.815),respectively.Ninety-nine cases were T-SPOT.TB positive out of 329 patients diagnosed with other diseases.Conclusions T-SPOT.TB test can be used as a method for TB diagnosis in patients without obvious TB lesions.Due to its relatively high negative predictive value,T-SPOT.TB can be used to rule out infection with Mycobacterium tuberculosis.