Objective To analyze the incidence and risk factors of de novo hepatitis B virus (HBV) infection from anti-HBc-positive donors in pediatric living donor liver transplantation and to explore the diagnosis and treatment.Method A retrospective analysis was conducted on 105 cases of pediatric living donor liver transplantaions (LT) perfomed during September 2006 to December 2013.HBV markers,including hepatitis B surface antigen (HBsAg) and antibody (anti-HBs),anti-HBc,hepatitis B e antigen (HBeAg) and antibody (anti-HBe) were determined in both donors and recipients before LT and in recipients after LT.HBV DNA titer was measured if the recipients were strongly suspected of de novo HBV infection.Result After 4 perioperative deaths were excluded,101 cases were studied.The median follow-up period of all the patients was 20.5 months (2.7-97.7 months).de novo HBV infection occurred in 6 of 101 recipients (5.9％) 3.5 18 months after LT.Forty-four (43.6％) of the children received HBcAb-positive allografts,and 11.4％ (5/44) of the children were had de novo hepatitis B infection.All five of the HBV-infected children received HBcAb-positive allografts without preventive treatment in 11 cases (5/11,45.5 ％),57 (56.4％) of the children received HBcAb-negtive allografts,and 1.7％ (1/57) of the children had de novo hepatitis B infection.Conclusion Anti-HBc-positive donors can significantly increase the incidence of de novo HBV infection in HBsAg-negative recipients without preventive treatment.with the appropriate treatment strategy,HBcAb allografts can safely used in pediatric recipients.

Objective To evaluate the safety and clinical effect of ABO-incompatible (ILT) pediatric living donor liver transplantation.Method We analyzed 169 pediatric living donor liver transplantation recipients from Sept.20,2006 to Dec.31,2014.There were 16 ABO-incompatible liver transplantation cases.The median age was 6 months.The blood agglutitin titer was monitored.The titer was controlled lower or equal to 1 ∶ 16.The method to decrease blood agglutitin titer included IVIG and plasma exchange.The patients were treated with Tacrolimus combined with methylprednisolone.Basiliximab for injection was used.The patients were followed-up for 9-26months.The survival rate,acute rejection,vascular and biliary tract complications,and infection were monitored.Result All the patients survived.There was once case of acute rejection,1 case of bile duct dilatation,2 cases of portal vein stenosis,8 cases of EBV viremia,5 cases of CMV viremia,and 6 cases of lung infection.The liver functions of all the 16 recipients were recovered within 3 weeks.Conclusion ABO-incompatible liver grafts can be used safely in pediatric patients.

Objective To identify the long-term survival of patients with hepatic carcinoma who received hepatitis B surface antigen (HBsAg) positive donor livers.Method A total of 195 patients were enrolled in the study.They were all diagnosed as having hepatic carcinoma with malignant thrombus in portal vein pre-operation and received liver transplantations between 1999 and 2014.The long-term survival between the patients who received HBsAg positive grafts and those who received HBsAg negative grafts was compared.Result There were no differences in ages,preoperative tumor stages and postoperative mortality between the two groups.There was significant difference in survival time between the two groups (Z=-2.038,P =0.042),with the median survival time of 8.83 months (2.50-24.80 months) in HBsAg positive graft group and 13.12 months (6.50-27.65 months) in HBsAg negative graft group,respectively.The long-term survival rate in HBsAg positive graft group was 48％ and that in HBsAg negative graft group was 34.7％ (P =0.740,x2 =0.110).However,the proportion of deaths due to recurrence of tumor was high to 75.8％ in all causes.Conclusion To prolong the survival time,it is safe and feasible to receive HBsAg positive donor livers in patients with hepatic carcinoma in late stage.However,tumor recurrence was still the main causes of deaths in patients post-operation because of the advanced tumor conditions pre-operation.

BACKGROUND:It remains controversial about the clinical outcomes of bone fil ing mesh containers (BFMCs) and percutaneous kyphoplasty (PKP) in pain relief, kyphosis correction, vertebral height restoration and reduction of cement leakage. OBJECTIVE:To compare the clinical outcomes of BFMCs and PKP for osteoporotic vertebral compressive fracture. METHODS:A total of 90 patients with osteoporotic vertebral compressive fracture were equivalently randomized into two groups, fol owed by treated with BFMCs or PKP, respectively. During a more than 3-month fol ow-up, pain relief, kyphotic angle, the vertebral height and cement leakage were observed in the two groups to assess the therapeutic effects. RESULTS AND CONCLUSION:Pain in al patients was relieved at 24 hours after operation. There was no significant difference in pain relief between two groups (P>0.05). PKP was more effective to restore the vertebral height (P<0.05), while BMCFs significantly reduced the leakage rate of bone cement (P<0.05). These results suggest that BFMCs and PKP have their own advantages in the treatment of osteoporotic vertebral compressive fracture, but both exert analgesic effects.

To prepare the hawthorn leaves flavonoids self-microemulsifying membrane controlled-release coated drop pill, and to study its release rate in vitro and pharmacokinetics study in vivo. In order to improve the dissolution of hawthorn leaves flavonoids, self-microemulsifying technology was used to prepare the hawthorn leaves flavonoids self-microemulsion. Hawthorn leaves flavonoids self-microemulsifying drop pill was prepared with the PEG 6000. Studies were made on the in vitro release of flavonoids from hawthorn leaves self-micro-emulsifying membrane-moderated coated drop pills and the in vivo pharmacokinetic in rats. The prescription of flavonoids from hawthorn leaves self-micro-emulsifying drop pills was 0.25 g of flavonoids from hawthorn leaves, 0.25 g of iodophenyl maleimide, 0.375 g of polyethylene glycol 400, 0.375 g of cremophor RH 40 and 2 g of polyethylene glycol 6000. The optimized prescription was 4 g of ethyl cellulose 20, 0.64 g of polyethylene glycol 400, 1.8 g of diethyl phthalate, and the weight of coating materials increased by 3.5%. Flavonoids from hawthorn leaves self-micro-emulsifying membrane-moderated coated drop pills complied with the design of sustained-release in 12 h in terms of in vitro release and in vivo pharmacokinetic parameters in rats, and its bioavailability was 2.47 times of quick-release drop pills. Slightly soluble flavonoids from hawthorn leaves could be made into sustained-release preparations by the self-micro-emulsifying and coating technology.
Animals ; Chemistry, Pharmaceutical ; Crataegus ; chemistry ; Delayed-Action Preparations ; chemistry ; pharmacokinetics ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; Flavonoids ; chemistry ; pharmacokinetics ; Male ; Plant Leaves ; chemistry ; Rats ; Rats, Sprague-Dawley

AIMTo study the chemical constituents of Paeonia lactiflora.

METHODSThe constituents of P. lactiflora were separated by using various kinds of modern chromatography and was identified its structure on the basis of spectral analysis.

RESULTSA monoterpene glucoside named albiflorin R1 was isolated from the roots of Paeonia lactiflora Pall. In the structure of albiflorin R1, the aglycone connected with a glucose at its 2-OH while the hemiacetal hydroxyl in glucose moiety was free.

CONCLUSIONAlbiflorin R1 is a new monoterpene glycoside.

Glucosides ; chemistry ; isolation & purification ; Heterocyclic Compounds, 3-Ring ; chemistry ; isolation & purification ; Molecular Conformation ; Molecular Structure ; Paeonia ; chemistry ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry

Objective To explore the potential mechanisms of carcinogenesis for human eukaryotic translation elongation factor 1 alpha 2(EEF1A2).Methods Specific inhibition of EEF1A2 with siRNA was achieved in human pancreatic cancer cell line,BxPC-3,which usually expresses high level of EEF1A2.The changes of EEF1A2 expression were determined by Western blot.The effect of siRNA in suppressing the proliferation of BxPC-3 cells was determined by MTT assay,and its role in inducing BxPC-3 cell apoptosis evaluated by flow cytometry,TUNEL and transmission electron micro- scope.Results The sequence-specific siRNA effectively suppressed the expression of both EEF1A2 mRNA and protein.Specific inhibition of EEF1A2 with siRNA in pancreatic cancer cell line BxPC-3 could suppress proliferation and induce apoptosis.Conclusion The oncogenicity of EEF1A2 may be related to its role in suppressing the apoptosis and promoting the growth of pancreatic cancer cells.

Objective To evaluate the effects of portoenterostomy (Kasai surgery) on living donor liver transplantation (LDLT) for children with biliary atresia (BA). Methods A total of 150 children with BA, who were treated with LDLT in our center from September 2006 to September 2014, were retrospectively analysed. The children were categorized into Kasai group (90 cases, 60%) and non-Kasai (60 cases, 40%) group, based on whether they had previously undergone Kasai procedure pre-LDLT. Clinical data, incidence of complications and accumulated survival rates were compared between two groups. Results The ages of pediatric patients were 4.9-87.0 months. The patient age and height were significantly higher in Kasai group than those of non-Kasai group (P<0.05). The serum bilirubin level was lower before surgery in Kasai group than that of non-Kasai group (P<0.05). There were no significant differences in body weight, pediatric end stage of liver disease (PELD) score, graft to recipient body weight ratio (GRWR), operation time and blood loss between two groups ( P>0.05). Similarly, there were no significant differences in pulmonary infection, acute rejection, portal vein thrombosis, hepatic artery occlusion and biliary complications between the two groups (P>0.05). The overall complication rate of post-LDLT was 61.1%in Kasai group, which was higher than that in non-Kasai group (43.3%,χ2=4.580, P=0.032). Totally, there were 7 cases (4.7%) died on post-LDLT, in which there were 6 cases (4.0%) in Kasai group including 5 cases of multiple organ
failure and 1 case of severe pulmonary infection, and 1 case (0.7%) in non-Kasai group, who died of multiple organ failure due to preoperative gastrointestinal bleeding for emergency surgery. There were no serious complications and death in donors. The overall cumulative survival rates were 98.6%, 96.6%, 94.9%and 92.7%in 1 month, 1 year, 3 years and 5 years after LDLT, respectively. And there were no significant differences in survival rates in 1 month, 1 year, 3 years and 5 years between two groups (χ2=1.490, P=0.222) with the rates of 98.9%, 96.5%, 93.8%, 91.3%in Kasai group and 98.3%, 96.6%, 96.4%, 95.5% in non-Kasai group. Conclusion Performing Kasai procedure can acquire satisfied results to pediatric patients with BA pre-LDLT, without increasing the incidence of major complications and mortality post-LDLT. And the accumulated survival rate is not different in pediatric patients received Kasai surgery compared with that in non-Kasai patient. Besides that, Kasai surgery might postpone the time of receiving LDLT, benefit to the growth of children and reduce the jaundice of pre-LDLT.

Objective To summarize the clinical experience in pediatric split liver transplantation (SLT) recipients.Methods A retrospective analysis was conducted on 38 cases of pediatric recipients using split donors during February 2007 to December 2015.The ex situ splitting technique was used for 22 grafts and in situ splitting technique was used for the rest 16 grafts.The survival rate of patients,recovery of liver function,re-transplantation rate,incidence of vascular complications and biliary complications were Observed,and the causes of death were analyzed.Results The median follow-up time of all the patients was 30.65 months (0.1-96.6 months).The 1-and 3-year cumulative survival rate was 81.6％ and 76.3％ respectively.The re-transplantation rate was 13.16％,the incidence of vessel complications was 31.58％,and biliary complication rate was 31.58％.There were 9 deaths,including 5 deaths which were related to surgical complications.Conclusion SLT can expand the resource of 1iver donors for pediatric recipients.Comparing to ex situ split liver grafts,in situ split liver grafts can reduce morbidity and mortality of children after liver transplantation.

Objective To summarize the clinical features,natural history and causes of death of mitochondrial encephalomyopathy,lactic acidosis and stroke-like episodes (MELAS).Methods We retrospectively evaluated the clinical findings of 64 patients diagnosed as MELAS more than 3 years (death cases excluded) in Huashan Hospital from January 2005 to March 2017 and analyzed the natural course and the causes of death of the disease.Results Among 64 patients,the male-to-female ratio was 1.3 ∶ 1.Median onset age was 20.5 (16.8) years.The peak of incidence age was from 14 to 22 years.The most common features of MELAS in acute phase were seizures (48/64,75.0％),headache (41/64,64.1％),blurred vision (37/64,57.8％),nausea and vomiting (27/64,42.1％),fever (25/64,39.1％),mental and behavioral disorder (24/64,37.5％).Lactate dehydrogenase (31/60,51.6％),resting blood lactic acid (43/58,74.1％) and cerebral spinal fluid lactic acid (9/9) were elevated.Abnormal findings in electroencephalogram (36/40,90.0％),electrocardiogram (37/47,78.7％),electromyography (25/41,61.0％) were detected.In this cohort,20 patients (20/64,31.3％) with MELAS were dead.A Kaplan-Meier survival curve showed the estimated overall median survival time was 12 years.The median survival time of the group onset before sex maturity (≤ 14 years) was 8 years and that in the group onset after sex maturity (＞ 14 years) was 21 years.The causes of death were cardiogenic incidence (4/20,20.0％),pulmonary infection (4/20,20.0％),lactic acidosis (2/20,10.0％) and status epilepticus (2/20,10.0％).Conclusions MELAS is usually presented in young people associated with high mortality rate.The leading causes of death are cardiogenic,pulmonary infection and lactic acidosis.