Objective To evaluate the application value of ultrasound in extracorporeal membrane oxygenation (ECMO)for protecting the liver donation after brain-cardiac death (DBCD).Methods Forty patients with brain death or irreversible brain injury,admitted to Guangzhou General Hospital of Guangzhou Military Command from April 2006 to November 201 4,were eligible for liver donation.The hepatic artery blood flow (QHA),portal vein blood flow (QPV)and ECMO-induced ECMO flow of hepatic artery (VE)of the donor liver were monitored by ultrasound before,5 min after the initiation of ECMO and immediately after ECMO.The changes of total bilirubin (TB),alanine transaminase (ALT)and lactic acid were observed at corresponding time points.Hepatic recovery was subsequently evaluated within 3 months after liver transplantation.Results The mean time of ECMO was (1 .0 ±0.2)h.There was no significant difference in QHA and QPV before and after ECMO (both in P >0.05).And there was no significant difference in liver function parameters before and after ECMO (all in P >0.05).At different time points within postoperative 3 months,the results of ultrasound evaluation and liver function test revealed that the transplant liver function was well recovered in 40 recipients.Conclusions Through monitoring QHA by ultrasound,the best ECMO flow should be chosen,which protects DBCD liver and averts perfusion injury and hypoperfusion.

Hereditary hemochromatosis(HH) is relatively rare in the Chinese population, and the disease can involve multiple systems. It is easy to be missed and misdiagnosed due to nonspecific clinical manifestations. We report on a case with diabetes as the first diagnosis and being confirmed HH later. In addition to abnormal liver function, this patient also developed a variety of endocrine and metabolic diseases such as hypogonadism and osteoporosis. Included with this case report is a literature based discussion of clinical features, management of HH along with its relationship with endocrine dysfunction to improve disease understanding.

Objective To explore the clinical value of noninvasive left ventricular pressure-strain loop(LV-PSL)technique in evaluating myocardial work and left ventricular remodeling before and after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods Seventy patients with AMI admitted to our hospital(coronary heart disease group)and 50 healthy adults(control group)who underwent physical examination during the same period were selected,The conventional echocardiographic indexes,left ven-tricular global longitudinal strain(GLS)and left ventricular myocardial work indexes,[global work index(GWI),global work efficiency(GWE),global constructive work(GCW),global wasted work(GWW)]were examined before and 7 days after operation in control group and coronary heart disease group.The differences of the above indexes between the coronary heart disease group and control groups were compared.According to the results of coronary angiography,AMI patients were further divided into a coronary heart disease single-branch group(34 cases)and a coronary heart disease multi-branch group(36 cases),and the differences of the above indexes between the two groups were compared.Analyze the correlation between left ventricular myocardial work indexes and GLS,conventional echocardiographic indexes.Result Left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV)and GWW were higher incoronary heart disease group than in control group before and 7 days after surgery,while left ventricular ejection fraction(LVEF),GWI,GWE,GCW and GLS were lower than control group,with statistical significance(all P<0.05).At 7 days after surgery,LVESV,LVEDV and GWW in the coronary heart disease group were lower than those before surgery,while LVEF,GWI,GWE,GCW and GLS were higher than those before surgery,with statistical significance(all P<0.05).LVESV,LVEDV and GWW at 7 days before and after surgery in the coronary heart disease multi-branch group were higher than those in the coronary heart disease single-branch group,while LVEF,GWI,GWE,GCW and GLS were lower than those in the coronary heart disease single-branch group,with statistical significance(all P<0.05).Correlation analysis showed that GWW was negatively correlated with GLS and LVEF,while GWE,GCW and GWI were positively correlated with GLS and LVEF(all P<0.001).Conclusion LV-PSL technique has good application value in evaluating left ventricular function and left ventricular remodeling in AMI patients before and after PCI,and provides a new non-invasive method for clinical practice.