ObjectiveTo manage the early immunosuppressant-associated hypertention in liver transplantation patients. MethodsFifty-six liver transplantations were performed from May 2000 to May 2002, their clinical feature (data of blood pressure and treatment) were analysed. ResultThe incidence of hypertension after liver transplantation was 70% in 2 weeks, 66% in one month. The incidence in cyclosporine group and FK506 group was 73% (31/40) and 33%(3/9) respectively(P

BACKGROUND: The structural and functional changes in resistance arteriole of external diameter ＜300 μm is one of the pathological foundations for ischemic cerebrovascular diseases, however there are few quantitative study on the arterioles of various external diameter at different brain area.OBJECTIVE: To probe the difference of arteriolar sclerosis of various external diameter at different brain area after cerebral infarction.DESIGN: Sample investigation.SETTING: Department of Nerve Internal Medicine, General Hospital of Beijing Military Area Command of Chinese PLA.SUBJECTS: Specimen was taken from donated autopsy case in General Hospital of Beijing Military Area Command of Chinese PLA from January 1980 to September 2000. According to the clinical manifestation, brain CT inspection and pathological diagnosis of autopsy, 38 cases were defined as arteriosclerosis cerebral infarction and taken as experimental group, other 15 cases with non-cardiac cerebrovascular disease were taken as controls.METHODS: specimen was obtained in 1-3 days after death from frontal and parietal cerebral cortex and basal gonglion white matters (3 pieces /case) and cut into slices. Five fields of vision were selected from each slice for microscopic observation. Arteriole was divided into ＜ 50 μm group,50-100 μm group and ＞100 μm group according to the arteriole external diameter. (External diameter- internal diameter)/internal diameter was used to assess vascular sclerosis.MAIN OUTCOME MEASURES: [1] Difference of arteriole sclerosis between corresponding external diameter cerebral infarction group and control group. [2] Arteriole sclerosis in various brain region in cerebral infarction group.RESULTS: Totally 38 experimental cases died from arteriosclerosis cerebral infarction and 15 controls died from non-cardiac cerebrovascular disease were enrolled and all data was entered the result analysis. [1] The arteriolar sclerosis index was obviously higher in ＜ 50 μm external diameter cerebral infarction group than in 50-100 μm group and ＞100 μm group[(138.55±76.67)% vs (116.82±58.80)%, (78.07±32.06)%, P ＜ 0.01], while it was approximately the same in the 100 μm external diameter group and control group [(78.07±32.06)% vs (46.38±13.41)%, P=0.174 ]. [2] In ＜ 50 μm external diameter cerebral infarction group, the arteriolar sclerosis index in white matters was significantly higher than that in gray matter [(152.86±87.83)%,(127.97±64.76)%, P ＜ 0.05 ].CONCLUSION: Arteriolar sclerosis degree is correlated with its external diameter and position in patients with cerebral infarction after arteriosclerosis, arteriole of small external diameter or in the white matter has higher arteriolesclerosis liability.

Many kinds of volatile organic compounds(VOCs)exist in the indoor air,the chemical reaction will occur among the pollutants when O3 and NO2 exist simultaneously.This reaction can severely impact the indoor air quality and produce some adverse effects on human health.The main chemical reactions among the indoor air pollutants and the potential health effects associated with inhalation exposure to the products of the chemical reaction in the indoor air were discussed in the present paper.The study of the chemical reactions among indoor VOCs is very important for human health and is helpful for revising the Indoor Air Quality Standard and making the 'Ecologic Label' of building materials.

[Objective]To evaluate the long-term clinical results of Herbert screw in the treatment of intra-articular fractures by retrospective analysis.[Method]From 1991 to 2006,fifty-five patients of different parts of intra-articular fracture treated with Herbert screw were followed up effectively,including scaphoid fracture group of 19 cases,the radial head fracture group of 25 cases,the femoral head fracture group of 11 cases.[Result]After an average follow-up time of 5 years and 11 months(ranged,1-13 years),the good-to-excellent rates were 94.7%,96%,72.7% according to the modified Mayo score,the Broberg-Morrey score and the Tompson-Epstein score.[Conclusion]The Herbert screw can provide strong fixation and stability in the long-term follow-up.It is an ideal material in treating intra-articular fractures.

Objective This study was to detect protein expression of ERK 1,ERK 2,JNK 1,p38 and MEK 1 ,MEK 2 in human hepatocellular carcinoma and adjacent non neoplastic liver tissues.Method Western blot was used to detect the expression of ERK 1,ERK 2, JNK 1,p38 and MEK 1,MEK 2 in the surgically resected hepatocellular carcinoma and para carcinoma tissues in 16 HCC patients.[WT5”HZ] Result The expression of ERK 1,ERK 2,p38 expressed by integral optic density (IOD) in hepatocellular carcinoma was significantly higher than that in para carcinoma respectively: as for ERK 1 it was 300?98 in carcinoma and 98?48 in para carcinoma tissues ( P

Objective To study the causes and management of biliary complications after orthotopic liver transplantation.MethodsClinical data of 38 patients who have underwent orthotopic liver transplantation between May 2000 and January 2002 were studied retrospectively. ResultsPostoperative bililary complications occurred in 9 patients(24%), including simple biliary fistula in 4, stricture of hepatoenterostomy, intrahepatic cholelith, biliary stricture with sludge, biliary stricture with cholelith, and intrahepatic biloma and cholelith in one each. Two patients died of the complication, and seven were cured successfully. ConclusionsThe causes of biliary complications are complicated. Early diagnosis and timely management helps to decrease the mortality. Endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography is a valuable, less traumatic procedure.

Objective To evaluate the clinical application of Helix water-jet dissector in complex hepatectomy. Methods Clinical data were retrospectively analyzed in 47 patients who received complex hepatectomy using Helix water-jet dissector for the parenchymal division. It was evaluated for the intraoperative blood loss, operation time, postoperative hepatic function and complications in these patients.Results Forty seven patients including 10 cases of hepatic giant cavernous hemangioma, 34 cases of hepatocellular carcinoma, and 3 cases of miscellaneous liver tumors. Among these patients, caudate lobe resection was performed in 6 cases, hepatic segment Ⅵ + Ⅷ resection in 19 cases, segment Ⅳ + Ⅴ + Ⅷresection in 9 cases, segment Ⅷ resection in 5 cases and right hepatic trisegmentectomy in 8 cases. The operation time was (240 ±85) min, intraoperative blood loss was (950 +650) ml, 13 out of 47patients (27.7%) received heterologous packed red blood cell (PRBC) transfusion for more than 2 units per case.Length of stay in hospital was ( 12. 5 ±4. 7) days. Post-operative complications included ascites in 6 cases,hydrothorax in 4 cases, atelectasis in 2 cases and pulmonary infection in 4 cases. No severe complications and death occurred in this group. Conclusion Water-jet dissector may increase operation accuracy,decrease massive blood loss and postoperative complications, therefore, it should be widely used in complex hepatectomy.

Objectives To determine the incidence of de novo neoplasms after liver transplantation and methods of prevention.Methods The clinical data of 605 patients after liver transplantation carried out from May 2000 to December 2010 in our centre were analysed.The patient's gender,age,primary disease and the clinical characteristics of post-transplantation de novo neoplasms were analysed.Results The incidence of de novo post-transplantation neoplasms was 1.80％.There was one case of post-transplantation lymphoproliferative disorders (PTLD),one case of pulmonary blastoma,one case of acute myelogenous leukemia,one case of bladder tumor,one case of gastric carcinoma,one case of sigmoid colon carcinoma,one case of carcinoma of rectum,one case of renal clear cell carcinoma and two cases of hepatocellular carcinoma.Conclusion There was a low incidence of de novo posttransplantation neoplasm in our centre than that reported in the West,probably because of variations in patient selection,immunosuppression regimens used,patients' age and different patient ethnic groups.Early diagnosis and treatment of de novo neplasm helped to improve prognosis.

objective To explore a new method of repairing skin defects complicated with fracture and tendon rupture at the middle and distal sections of the second to fifth fingers. Methods The reversed dorsal metacarpal island flap was designed to be pedicled on the digital proper artery-common digital artery-fingerweb artery-dorsal metacarpal artery-cutaneous branch of dorsal metacarpal artery.In repairing digital palmar skin defects,after the flap was dissected,the proximal incision was extended along the direction of dorsal metacarpal nerve to harvest an enough length of the nerve so that the dorsal metacrppal nerve can be anastomosed with the digital proper nerve to restore the sensation of finger pulp.From the June 2003 to March 2009,the flap was used to repair 26 fingers in 24 patients with middle and distal digital skin defects complicated with fracture and tendon rupture.They were 17 men and 7 women,aged from 16 to 63 years (average,37 years).There were 15 cases of palmar skin defect and 9 cases of dorsal skin defect.In the 2 cases of combined tendon defects,a section of the extensor tendon of index(or little) finger was dissected together with the flap to repair the tendon rupture. Results The areas of the flap ranged from 3.1 cm ×1.6 cm to 6.0 cm × 4.0 cm.The flaps survived in all 24 cases without any vascular crisis.Twenty-two patients obtained an average follow-up of 14 months (from 4 to 32 months) but 2 were lost to the follow-up.The flaps were fine in texture,colour and appearance.The finger pulps appeared full and recovered sensations of pain and temperature.The average two-point discrimination was 7.5 mm (from 5 to 9 mm).Sensory function evaluation revealed an outcome of S3 + ～ S4.Tendon adhesion occurred in 4 cases which recovered digital function following secondary lysis 3 to 6 months postoperation. Conclusion Application of the reversed dorsal metacarpal island flap pedicled on the digital proper artery is a good way to repair skin defects complicated with fracture and tendon rupture at the middle and distal sections of the second to fifth fingers.

Objective To analyze clinical features,surgical treatment efficacy and prognostic factors of bone metastasis patients after liver transplantation for hepatocellular carcinoma.Methods A retrospective clinical data of 20 bone metastasis patients after liver transplantation for hepatocellular carcinoma from July 2000 to January 2010 were received.The effect of surgery aimed at bone metastasis was evaluated.Univariate and multivariate prognostic risk factors were analyzed.Results The median survival time of these patients was 7.5 months and 1-year survival rate was only 20％.Surgical treatment could relieve pain and promote patients' peformance status significantly.Univariate and multivariate analysis found that tumor microvascular invasion within the removed recipient liver was the only prognostic risk factor.Conclusions Patients of bone metastasis after liver transplantation for HCC had poor prognosis.Surgical treatment helps improve patient's quality of life.Tumor microvascular invasion is the risk factor of surgical prognosis.