There is a complicated association between the liver and diabetes mellitus.Diabetes mellitus may cause various forms of liver damage,such as nonalcoholic fatty liver disease (NAFLD),hepatic cirrhosis,hepatocellular carcinoma,liver abscess,and liver transplant complications.With the growing epidemic of diabetes mellitus,this review investigates diabetes mellitus induced liver damage.

BACKGROUND:Studies have found that a variety of biological materials can be used for preparing corneal stroma scaffolds that have good biocompatibility, but research on preparation and biocompatibility of the acel ular porcine corneal stroma scaffold is little. OBJECTIVE:To explore the preparation and biocompatibility of the acel ular porcine corneal stroma scaffold. METHODS:Acel ular porcine corneal stroma scaffold and its extract were prepared. Wel-grown human corneal stromal cel s were selected and cultured in the extract of acel ular porcine corneal stroma scaffold (experimental group) or in the complete medium (control group), respectively. After 1, 2 and 3 days of culture, the proliferation ability of human corneal stromal cel s was detected by MTT assay. In the meanwhile, human corneal cel s were directly seeded onto the acel ular porcine corneal stroma scaffold, and then the cel growth on the scaffold was detected using immunochemical method. RESULTS AND CONCLUSION:The number of human corneal stromal cel s was in a rise with time in the two groups, and absorbance values had no significant difference between two groups at different time points of culture. Human corneal stromal cel s grew wel on the scaffold, and were positive for cel integrinβ1, vimentin, aldehyde dehydrogenase 3A1, as wel as CD34, CDK2 and K-Ras. These results show that the acel ular porcine corneal stroma scaffold has no cytotoxicity, and has good biocompatibility.

Objective Hepatocellular carcinoma with bile duct tumor thrombus (BDTT) is rare,and surgical treatment is currently considered as the most effective treatment.Whether resectional surgery should be carried out on these patients remains controversial.Therefore,this Meta-analysis aimed to find out the long-term survival after resectional surgical treatment.Methods We conducted a literature search on PubMed,Embase and Web of Science from inception to September 2016.11 studies were included which involved 5295 patients.Each study was evaluated using the Newcastle-Ottawa Scale.The pooled effect was calculated and the associations between BDTT and overall survival (OS) or disease-free survival (DFS)were reevaluated using Meta-analysis with hazard ratio (HR) and 95％ confidence interval (CI).Results The HR for OS and DFS was 2.34 and 1.81,the 95％ CI were 1.26 ～ 4.36 and 1.17 ～ 2.78,respectively.Conclusion HCC patients with BDTT had a bad prognosis after hepatic resection or liver transplantation.

In recent years,exciting research progress has been made on hepatic Kupffer cells.For inflammation,the study of Kupffer cells focused on its mechanism of whether and how Kupffer cells play a role in regulating inflammatory reaction,especially molecular mechanisms.For fatty liver,researchers are exploring the role of Kupffer cells in the development of fatty liver,as well as potential treatments.For the treatment of ischemia-reperfusion injury,latest protocols were based on Kupffer cells.In the area of liver transplantation,the study of Kupffer cells centered on immune tolerance and graft versus host disease (GVHD).As for tumor,current studies focused on regulatory mechanism of Kupffer cells on growth and metastasis of tumor.This article will present a review on the latest progress.

Objective To study the effect of UHRF1 expression inhibition by RNA interference on the radiosensitivity of esophageal cancer cell line TE-1 and its mechanism.Methods Short hairpin RNA (shRNA) targeting UHRF1 gene was introduced into TE-1 cells by lentivector-mediated transfer.The cells were divided into three groups:non-transfected group,negative control (NC)-shRNA-transfected group,and UHRF1-shRNA-transfected group.The mRNA and protein expression levels of UHRF1 in TE-1 cells were measured by RT-PCR and Western blot before and after transfection.After transfection and X-ray radiation,the radiosensitivity of TE-1 cells was evaluated by colony formation assay; the cell cycle and cell apoptosis were determined by flow cytometry; the γ-H2AX (as a marker of DNA damage) level was measured by Western blot.Results After transfection with UHRF1-shRNA,the mRNA and protein expression levels of UHRF1 were significantly decreased in TE-1 cells,as compared with those in the NC-shRNA-transfected group and non-transfected group (0.11 vs 0.96 and 0.98,F =124.21,P =0.000;0.10 vs 0.89 and 0.94,F =125.25,P =0.000).The UHRF1-shRNA-transfected group had sensitization enhancement ratios of 1.53 (D0 ratio) and 1.95 (Dq ratio).X-ray radiation could cause G2/M arrest and increase apoptotic rate and γ-H2AX expression in TE-1 cells.Compared with the two control groups,the UHRF1-shRNA-transfected group showed significantly less G2/M arrest (F =500.15,P =0.000),a significantly higher apoptotic rate (F =100.10,P =0.000),and significantly higher residual γ-H2AX expression (F =61.00,P =0.000) at 24 hours after X-ray radiation.Conclusions RNA interference can effectively inhibit the UHRF1 expression and enhance the radiosensitivity of TE-1 cells.The mechanism may be related to cell cycle regulation,cell apoptosis,and DNA damage repair.

Objective:To investigate the effect of phacoemulsification using different corneal micro-incision sizes on the postoperative corneal healing.Methods:A non-random controlled study was performed.Seventy-six patients (76 eyes) with age-related cataract who underwent phacoemulsification and cataract extraction combined with intraocular lens (IOL) implantation in Yanbian University Hospital from May 2016 to May 2017 were enrolled.The subjects were divided into 2.2 mm incision group (37 eyes) and 1.8 mm incision group (39 eyes) according to corneal incision size.The intraoperative cumulative dissipated energy (CDE) and ultrasound time of the two groups were measured and compared.The corneal incision structure and corneal thickness of operative eyes were measured by anterior segment optical coherence tomography before surgery and at postoperative 1 day, 1 week and 1 month.The corneal endothelial cells count, the central corneal thickness (CCT), and the corneal volume in the central corneal diameters of 3.0 mm (CV3) and 10.0 mm (CV10) were measured by Pentacam.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Yanbian University Hospital (No.2015153), and written informed consent was obtained from all subjects before surgery.Results:There were statistically significant differences in the corneal endothelial cells count, CCT, CV3, CV10, and corneal thickness at epithelial side of the incision between pre-operation and post-operation in each group ( Ftime=17.717, 67.356, 17.577, 13.559, 80.076; all at P<0.01).But there was no statistically significant difference in the indexes between the two groups ( Fgroup=0.788, 0.706, 3.692, 4.341, 4.182; all at P>0.05).The number of corneal endothelial cells in the two groups was gradually decreased after surgery, and was significantly reduced at one month after surgery in comparison with the pre-operation, and the differences were statistically significant (both at P<0.05).At 1 day after surgery, the CCT, CV3, CV10, and corneal thickness at epithelial side of the incision in the two groups were increased significantly in comparison with the pre-operation and the differences were statistically significant (all at P<0.05), and the differences were not statistically significant between preoperative and postoperative 1 week or 1 month (all at P>0.05).With time going by, the indexes were back to normal gradually.The incidence of endothelial gaping and dislocation at the corneal incision in the 1.8 mm incision group was 12.8% (5/39) and 5.1% (2/39), which were significantly higher than 0.0% (0/37) and 2.7% (1/37) in the 2.2 mm incision group, and the differences were statistically significant ( χ2=5.078, P=0.024; χ2=0.295, P=0.590).At 1 day after surgery, corneal thickness at the endothelial side in the 1.8 mm incision group was significantly thicker than that in the 2.2 mm incision group, and the difference was statistically significant ( P=0.042), and the corneal thickness at endothelial side of the incision was positively correlated with CDE in the two groups ( r=0.231, P=0.025; r=0.347, P=0.003). Conclusions:Compared with 2.2 mm incision, 1.8 mm corneal incision results in higher incidence of endothelial gaping and dislocation at the corneal incision, greater corneal thickness at endothelial side of the incision and slower recovery.

Objective To evaluate the effect of GTV volume on response of esophageal carcinoma.Methods From Jan.2004 to Dec.2008,72 cases newly diagnosed N0 stage thoracic esophageal carcinomas were included in this retrospective study.All treatment plans were set up and designed by CT simulator and 3D TPS.They received dose 56-70 Gy/27-33F/6-7w with 6MV X-ray.The GTV,the tumor length and maximum diameters were measured on the treatment planning system with the X-ray.RECIST standard was applied to evaluate the radiotherapy response of esophageal carcinoma.The effectiveness of related prognostic factors on survival was evaluated by univariate analyses.Results The short-term response with CR were 79％ with length ＜ 5 cm,48％ with 5-7 cm and 26％ with length ＞7 cm(P =0.003).The 1-,2-,3-and 5-year survival rates were 93％,79％,69％,69％ ; 91％,61％,46％,46％ and 80％,46％,28％,22％ (P =0.037).The short-term response with CR were 56％ with maximum diameters ≤3 cm and 33％ with maximum diameters ＞ 3 cm(P =0.033).The 1-,2-,3-and 5-year survival rates were 91％,72％,55％,37％ and 80％,45％,30％,30％ (P =0.037).The short-term response with CR were 52％ with GTV volume≤40 cm3 and 30％ with GTV volume ＞40 cm3(P =0.059).The 1-,2-,3-and 5-year survival rates were 91％,67％,51％,41％ and 80％,43％,27％,27％ (P =0.047).In the multivariate analysis,the length of GTV was likely to be the most important factor for the short-term response(P =0.005,0.014).Conclusions GTV volume,the tumor length and maximum diameters are factors for short-term response of N0 stage esophageal carcinoma.The GTV length is independent prognostic factor.The GTV length is the worse the prognosis will be.

Objective To investigate the local-regional recurrence in thoracic esophageal cancer after radical surgery including two-field lymph node dissection and provide evidence for postoperative radiotherapy. Methods We reviewed local-regional recurrence for 134 cases with esophageal squamous cell carcinoma after radical surgery from 2004 to 2009. Results In 134 cases, lymph node metastasis rate,anastomosis recurrence rate and tumor bed recurrence rate was 94. 0%, 9. 7% and 3.7%, respectively. As to the 126 cases with lymph node metastasis, significant difference was detected between mediastinal metastasis, supraclavicular metastasis and abdominal lymph node metastasis (80. 2%, 43.7% and 13.5%,respectively, χ2= 113. 15, P = 0. 000). Furthermore, the relative metastasis rate in upper mediastinum,middle mediastinum and the lower mediastinum was 73.8%, 39.7% and 1.6%, respectively, the difference was statistically significant ( χ2 = 139. 11, P = 0. 000 ). Significant difference was identified between right and left supraclavicular lymph node metastasis (31.7% vs 16. 7%, χ2= 7. 81, P = 0. 005 ).To confirm the analysis above,lymph node metastasis rate of left recurrent laryngeal nerve nodes, (including region 1L, 2L, 4L and 5) ,right recurrent laryngeal nerve nodes, azygos nodes, subcarinal nodes, and 2R region was 38.9%, 43.7%, 15.1%, 34.1% and 25.4%, respectively. Conclusions The main characteristics of local-regional recurrence may be lymph node metastasis for esophageal squamous cell carcinoma after radical surgery. On the contrary, tumor bed recurrence is rare. Dangerous regions include supraclavicular nodes, recurrent laryngeal nerve nodes, azygos nodes as well as subcarinal nodes.

ObjectiveTo evaluate correlation factors of cervical lymph nodes metastasis in thoracic esophageal carcinoma.MethodsLocal-regional metastasis of lymph node for 126 cases with esophageal squamous cell cancer after surgery from 2004 to 2009 were reviewed.Risk factors of cervical lymph nodes metastasis were examined by multiple Logistic regression analysis.ResultsIn 126 cases,supraclavicular lymph node metastasis rate was 43.7％ (55/126).By logistic regression,none of the primary site,T stage,N stage,histological grade,lymph node metastasis rate,lymph node metastasis degree and number of lymph nodes metastatic field was not the high risk of cervical lymph nodes metastasis.In addition,multivariate analysis found that lymph node metastasis in mediastinum region 1 was high risk factor for lymph node metastasis of region 1 ( x2 =12.14,9.27,P =0.000,0.002),lymph node metastasis in region Ⅲ and region 2 were high risk factors for lymph node metastasis of region Ⅱa ( x2 =14.56,8.27,8.02,3.93,P =0.000,0.004,0.005,0.047 ).ConclusionMediastinal para-recurrent nerve lymph node metastasis is a significant predictor for cervical lymph nodes metastasis.

OBJECTIVE:To improve high-alert medication management in our hospital. METHODS:According to assessment criteria of JCI,referring to the problems of high-alert medication management in our hospital,PDCA(plan,do,check,action)cy-cle method,reverse fishbone diagram and other methods were adopted to formulate and implement relevant countermeasures. Com-pliance rate of 29 departments was evaluated within 12 months after the implementation of countermeasures. RESULTS:Relevant emergency measures were formulated for 2 negative factors by reverse fishbone diagram;whole-course and orderly quality control of high-alert medication was conducted through establishing high-alert medication management institutions,formulating high-alert medication management system and quality measurement criteria,strengthening staff training and education,improving hospital in-formation system,etc. The compliance rate of departments increased from 53% in Jan. to 100% in Jun.(P<0.05),and kept sta-ble until Dec. CONCLUSIONS:PDCA cycle improves the systemization and standardization of high-alert medication management and multiple department cooperation,and contributes to the safety of drug use.