Objective To investigate the prevention and management of portal vein thrombosis following orthotopic liver transplantation.Methods Between May 1995 to September 2005,clinical data of 137 cases subject to orthotopic liver transplantation were analyzed.Among them,there were 10 cases of portal vein thrombosis(5 cases in gradeⅠ,4 cases in gradeⅡand 1 case in gradeⅢ). All patients received an eversion thromboendovenectomy(ETEV)with occlusion of the portal flow u- sing a Forgarty balloon.Ligation of the collateral circulation,especially spontaneous or surgical sple- norenal shunt,was made as approaches to improve portal flow.Heparin or low-molecule-weight hepa- rin as a prophylactic anticoagulation therapy was maintained during and after operation if prothrombin time was less than 18 s.Follow-up Doppler ultrasonography was used daily in the early postoperative period.Results After a follow-up of 2～66 months,overall incidence of portal vein thrombosis was 2.92%(4/137).Surgical thrombectomy and revascularization was carried out in 1 case.Thromboly- sis,balloon angioplasty and stent placement via hepatic artery were performed on 2 cases.No treat- ment was given in 1 patient without hepatic dysfunction and portal hypertention.Mortality related to portal vein thrombosis was 0.Conclusions Portal vein thrombosis might be avoided by performing a complete thrombectomy as often as possible,by ligation of portosystemic shunt during surgery,and by postoperative anticoagulation.Close follow-up by Doppler ultrasonography may make a prompt di- agnosis and reduce portal vein thrombosis-derived loss of grafts.

BACKGROUND: A new composite scaffold for cartilage tissue engineer ing has been employed to culture chondrocytes and overcome many limits related to traditional scaffolds, such as poor biocompatibility, inferior mechanical property, inappropriate biodegradability, and simplex structure which can not match layered structure of articular cartilage, etc. The new composite scaffolds provided a new approach for the research of cartilage tissue engineering.OBJECTIVE: To evaluate the feasibility and value of layered cylindrical collagen/hydroxyapatite (HA) composite for cartilage tissue engineering by observing how it absorbs chondrocytes and affects its cellular characteristics.DESIGN: Completely randomized design and controlled experimental study.SETTING: Department of Orthopaedics, Third Hospital Affiliated to Sun Yat-sen University, and College of Material Science, South China University of Technology.MATERIALS: The experiment was conducted at the central experimental laboratory of the Third Hospital Affiliated to Sun Yat-sen University from June to November 2004. One two-week-old male healthy New Zealand rabbit,which was bred in 20 ℃ and 40% humidity, was used in this experiment.METHODS: ①Right amount of deionized water was added into HA, collagen I solution was added to disperse HA, then carbodiimide was added in the mixture at a proportion for getting the collagen/HA composite at different ratios. Pour to the certain mould in successive layers. The upper layer was pure collagen and the bottom was pure HA. The prepared layered cylindrical collagen/HA composite was put into the ultra low temperature freezer, lyophilized, and sterilized by ethylene oxide for the following procedures. ② Chondrocytes of juvenal rabbit were isolated and multiplied in vitro, then chondrocytes were seeded onto porous collagen/HA composite scaffold and cultured. The effects of composite scaffold on chondrocytes'morphological changes, proliferation, and function were evaluated through a series of examinations such as inverted phase-contrast microscopy, histological, scanning electron microscopy and immunohistochemistry.MAIN OUTCOME MEASURES: ①Morphology of collagen/HA porousscaffold. ②The characteristics of chondrocytes cultured in vitro. ③ The chondrocytes' compatibility with the collagen/HA porous scaffold.RESULTS: ①Morphology of collagen/HA porous scaffold: Collagen/ HA was a cylindrical three-dimensional porous scaffold in layer structure with certain mechanical strength. The top layer was pure collagen, the bottom was pure HA, and the intermediate layer was collagen and HA composite.Under scanning electron microscope, the scaffold had irregular blowhole structure, the apertures were even and pores were communicated each other. The average pore diameter was about 147 μm. ②The characteristics of chondrocytes cultured in vitro: The chodrocytes that had just been isolated were spherical; rate of living cells was 95%. 24 hours later, the cells were going to attach to the wall, extend to be triangle or polygon. The cytoplasms were abundant with secretary granules inside. The cells kept on growing in monolayer and the multiply rate accelerated after passage, and chondrocytes overspreaded the culture flask in 4 days. After passaged for several times, the multiply rate decreased. In passage Ⅵ, the ability of cell division was decreased obviously, the cytomorphosis was clear. Cellular sizes were larger. Most of cells were shuttle-shape, less refracted with blur edges, which trended to age and dedifferentiate to fibroblast. ③The chondrocytes' compatibility with the collagen/HA porous scaffold: Cylindrical collagen/ HA composite scaffold in layer structure had good hydrophilicity. The chondrocytes adhered to the surface of the scaffold, proliferated and migrated toward the scaffold through the pore. Chondrocytes attached to wall of microholes of the scaffold had largely maintained a rounded morphology and could secrete the extracellular matrix on the porous scaffold.CONCLUSION: Cylindrical collagen/ HA composite scaffold in layer structure has good cellular compatibility.It is stronger in mechanical property than pure collagen, is anideal scaffold for cartilage tissue engineering.

Objective To investigate the clinical features of patients with superinfection of HEV and HBV related acute on chro-nic liver failure(ACLF) .Methods Clinical data of 35 patients diagnosed with superinfection of HEV and HBV related ACLF and 37 patients diagnosed with HBV related ACLF were collected for this retrospective study .The liver and kidney function ,HBV DNA level ,blood platelet count(BPC) ,coagulation function ,model for end-stage liver disease(MELD)score and mortality at 24 weeks were analyzed .Furthermore ,comparison of the clinical data between the survival patients and died patients in superinfection group was made .Unconditioned binary response logistic regression model was used to determine the corresponding risk factors .Results The level of total bilirubin(TBIL) ,MELD score ,incidence rate of hepatic encephalopathy and mortality at 24 weeks were signifi-cantly higher and prothrombin activity(PTA)was significantly lower in superinfection patients(P<0 .05) .The level of serum creat-inine(Cr) ,MELD score and incidence rate of hepatic encephalopathy were significantly higher and PTA was significantly lower in died patients than that of superinfection group(P< 0 .05) .Logistic regression analysis identified TBIL(P= 0 .024 ,OR= 1 .006) , BPC(P=0 .019 ,OR=0 .983) ,PTA(P=0 .001 ,OR=0 .795) ,MELD score(P=0 .005 ,OR=1 .497)and hepatic encephalopathy(P=0 .001 ,OR=4 .147)as prognostic factors for patients with superinfection of HEV and HBV related ACLF .Conclusion The clini-cal features of patients with superinfection of HEV and HBV related ACLF were more serious .The higher level of TBIL ,MELD score and hepatic encephalopathy and the lower level of BPC and PTA ,the worse prognosis .

Diagnosis, Differential ; Fibroadenoma ; metabolism ; pathology ; surgery ; Humans ; Keratins ; metabolism ; Lipoma ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Thymoma ; metabolism ; pathology ; surgery ; Thymus Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

The effects of ginsenosides on the actions of morphine are summarized. It mainly focuses on the antagonistic effects of ginsenosides on morphine-induced changes of animal behaviors, neural system functions and cell signaling transduction.
Animals ; Behavior, Animal ; drug effects ; Body Weight ; drug effects ; Ginsenosides ; pharmacology ; Mice ; Morphine ; antagonists & inhibitors ; pharmacology ; Morphine Dependence ; Neurotransmitter Agents ; metabolism ; Rats ; Signal Transduction ; drug effects

Anemia, Hemolytic ; etiology ; Child ; Female ; Humans ; Insecticides ; poisoning ; Trichlorfon ; poisoning

Objective To explore the diagnosis and surgical treatment experience of vascular ring in infants and children.Methods Fourteen cases (9 boys and 5 girls,aged 2 months to 6 years,weighted 4.5 - 15.0 kg) with vascular ring were diagnosed and treated surgically in Children's Hospital of Chongqing Medical University from Sep.2009 to Dec.2010.All children underwent X-ray,echocardiography and spiral computed tomography examination preoperatively.Bronchoscopy and barium swallow was performed in 5 cases respectively.The pathological types of vascular rings included double aortic arch in 1 ( 7.1％ ),pulmonary artery sling in 7 (50.0％),right aortic arch with left patent ductus arteriosus or persistent left ligament in 6 (42.9％).Associated cardiac anomalies were present in 7 (50.0％) patients.Tracheal stenosis of different length ( 12％ -62％ ) and severity (45％ -74％ cross-sectional luminal narrowing) was observed in the group.Barium swallow in 5cases showed localized compression of the esophagus.12 cases underwent repair of vascular ring with cardiopulmonary bypass (CPB),and the associated congenital heart defects were repaired simultaneously.2 cases of right aortic arch with left patent ductus arteriosus or persistent left ligament underwent surgery without CPB.Results The median duration of CPB in 12 cases and aortic cross-clamp time in 7 patients were 77.5 minutes ( range:55 - 186 minutes) and 36 minutes ( range:22 - 110 minutes) respectively.The median duration of postoperative ventilation and ICU stay were 21 hours (range:7 -308 hours) and 79.5 hours (range:16-314 hours) respectively.One baby with pulmonary artery sling died on the postoperative 12th day ( in-hospital mortality 7.1％ ).Of the 13 cases discharged from the hospital,1 case were lost to follow up.In the follow-up ( 1- 15 months) of 12 cases,digestive symptoms were disappeared.Development,exercise tolerance and symptoms showed obvious improvement,although 5 (41.7％) patients had residual respiratory problems.Conclusion Prolonged or recurrent aerodigestive issues in children should alert the pediatrician to the possibility of a vascular ring.Multislice spiral CT scanning is the best imaging modality.All vascular rings should be surgically corrected,and the associated long-segment severe tracheal stenosis needs.The short to midterm outcomes of surgical division are excellent.

Objective To investigate the expression and clinical significance of augmenter of liver regeneration (ALR) in patients with HBV related acute on chronic liver failure (ACLF) .Methods The serum and clinical data of patients with ACLF (ACLF group ,n=214) ,patients with mild chronic hepatitis B (mild chronic hepatitis B group ,n=196) were collected from outpatient and inpatient in the hospital ,and control group(n=200) people were the blood transfusion healthy blood donors .The level of ALR was measured by ELISA method .The correlation between ALR and MELD score of patients with ACLF were analyzed by linear regres-sion analysis .Unconditioned binary response logistic regression model was used to determine the correlation between ALR and mor-tality at 24 weeks of patients with ACLF .Results Serum ALR level was higher in ACLF group than in mild chronic hepatitis B group and control group(P<0 .05) .There were negative correlations between the serum ALR level and MELD score of patients with ACLF(r2 = -0 .249 ,F=13 .955 ,P<0 .01) .Serum ALR level of patients with ACLF was more significant in survival group than in dead group(P=0 .004) .Logistic regression analysis identified that high serum ALR level was related to the good prognosis (P=0 .012 ,OR=0 .807) .Conclusion The serum ALR level was significantly increased in patients with HBV related ACLF which played an important role in liver regeneration and improve the prognosis of patients .

Objective To review the experience of modified sternal elevation in management of pectus excavatum deformities. Methods A retrospective study was carried out on 268 children with pectus excavatum deformities from January 2002 to December 2005.Of these patients,213 were boys and 55 were girls.Their age ranged from 2 to 16 years and 2 months[mean,(4.48?2.74) years)].Among then,69 cases were aged from 2 to 3 years,130 cases from 3 to 6 years and 69 cases over 6 years.268 patients with PE underwent modified sternal elevation and fixation with the home made stainless steel strut.The lung cysts,esophageal hatal hernia and congenital heart diseases were surgical treated simultaneously.Results There was no death postoperative.Postoperative compli- cations included pneumonia in 1 case,subcutaneous fluid in 2.the foUow-up period was 1-5 years.One patient was found having light notch in sternum.All patients had satisfactory results.In 165 cases stainless steel strut have been taken off postoperatively and no recurrence occurred.Conclusion The modified sternal elevation procedure for pectus excavatum results in an excellent cosmetic outcome.

Objective Analysis the influence risk factors of infants and young children tetralogy of Fallot for radical treatment , and explore the perioperative treatment methods .Methods 195 cases(include death group and survival group)of hospitalized data of TOF resection in this hospital were collected in January 2003 to November 2012 ,then statistical analysis was done .Results Uni-variate analysis of variance showed ,age ,weight ,McGoon ratio ,cardiopulmonary bypass time and aortic clamping time were statisti-cally significant in two groups ,Multivariate Logistic regression analysis showed McGoon ratio <1 .0 ,cardiopulmonary bypass time>90 min ,aortic clamping time>70 min ,age<3 months were related to the postoperative death of TOF radical operation .Conclu-sion It is safe and reliable of radical surgery in infants and young children ,McGoon ratio ,cardiopulmonary bypass time and aortic clamping time ,age are the risk factors of the postoperative death of TOF radical operation .