Objective To summarize the experience of emergency orthotopic liver transplantation (EOLT) in fulminant hepatic failure (FHF).Methods The clinical date of 4 cases of FHF successfully subject to EOLT were retrospectively analyzed.Results Four patients’ consciousness completely recovered in 12 to 48 h after operation, no surgical complication occurred; Acute rejection postoperatively occurred in 2 patients and reversed after treatment. Now 4 patients were survived for 38, 17, 11, 7 months respectively with good liver function, and 3 of them went to work again.Conclusion EOLT is an effective means to cure FHF. Choosing appropriate perioperative management and (operative) timing is essential to improve the successful rate of EOLT.

Objective To assess the immune tolerance of allogeneic T cells induced by dendritic cells genetically engineered to express I?B? mutant. Methods DCs were prepared from WF rat bone marrow cells and modified by I?B?M gene wit h adenovirus vector, and then the expression of I?B? and I?B?M was detected by Western-blot. The cell-surface expression of costimulatory molecules (CD80, CD86 and CD40) was detected by flow cytometry, and the production of IL-12 in DCs culture supermatant was determined by ELISA. The ability to stimulate the pr oliferation of Lewis rat T cells was analyzed by mixed leukocyte reactions (MLR) . The antigen-specific T cell hyporesponsiveness was tested by secondary MLR. Results I?B?M suppressed the cell-surface expression of costimulatory molecules and i nhibited the production of IL-12. I?B?M-DC showed reduced ability to stimula te T cells proliferation, and potential to induce antigen-specific T cell hypo responsiveness. Conclusion Immune tolerance of T cells can be induced by dendritic cells genetically engine ered to express I?B? mutant.

Objective To summarize our operational experience in using unusual renal allografts.Methods The plastic operations of 326 unusual renal allografts were retrospectively and the renal transplant outcome was compared with 542 normal renal allografts an the same time. Results All the 326 unusual renal allografts were utilized. There was no significant difference between unusual renal allografts and usual ones in average serum creatinine level, acute tubular necrosis (ATN) and the survival rate of renal allgraft after 1 year. There was no complications related to plastic operation during or after kidney transplantation.Conclusions By making good use of various kinds of plastic operation, abnormal or injuried renal allografts can also be used safely without affecting the outcome after renal transplantation.

Objective To explore the effects of 1,25-(OH) 2-D 3 in combined with DBMC to induce tolerance on heterotopic rat cardiac allografts.Methods After the establishment of a stable rat cervical heterotopic heart transplantation model, inbred male Wistar rat hearts were transplanted to male SD rats. The experimental rats were divided into the following groups: Group A served as experimental control group, group B receiving 1,25-(OH) 2-D 3 5000 ng/kg, group C being treated with 1?10 8 DBMC, group D being treated with 1?10 8 DBMC in combined with 1,25-(OH) 2-D 3 5000 ng/kg and group E being treated with CsA 10?mg/kg. The survival time of donor hearts was observed, meanwhile, the donor specific mixed lymphocyte reaction (MLR) and concentrations of TNF-alpha and ICAM-1 in grafts were measured. HE staining inspected all specimens of heart grafts.Results The mean graft survival time (days) in the groups A, B, C, D and E group was 7.2 ? 1.6 , 10.6 ? 2.3 , 12.4 ? 2.5 , 68.3 ? 9.9 and 17.5 ? 4.4 , respectively. The results showed there were significant differences in graft survival time between the group D and the other groups ( P

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. In ad-dition to genetic alterations, epigenetic inactivation of (tumor suppressor) genes has been recognized as an important and alternative mechanism in tumorigenesis. In recent years, increasing evidence has shown that ep-igenetic silencing of those genes is essential to carcinogenesis and metastasis. Epigenetics include two main forms: histone acetylation and DNA methylation, histone acetylation and DNA hypomethylation can promote gene expression,otherwise, they will inhibit gene expression. It is important to the methylation especially the hypermethylation of the tumor suppressor gene during the hepatocarcinogencsis. The study of epigenetics will be proved valuable for early diagnosis and disease monitoring at hepatocell.

Objective To evaluate the treatment and prevention measure for intrahepatie diffuse biliary stricture after orthotopic liver transplantation. Methods The clinical data of 21 patients with intrahepatic diffuse biliary stricture after orthotopic liver transplantation from January 2002 to December 2007 in Beijing Center for Organ Transplantation were retrospectively analyzed. A prospective clinic study was launched in order to prevent microthrombosis in the microcireulation of bile duct during warm and cold iscbemia in non-heart-beating donor since January 2006. Urokinase perfusion of the artery system was conducted during graft harvesting and reperfusion at the end of graft trimming to reduce the incidence of intrahepatic diffuse biliary stricture. Results Among 21 patients with intrahepatie diffuse and mixed type biliary stricture, 16 patients underwent liver retransplantation, and the other 5 patients died of primary graft failure while waiting for retransplantation. The incidence of intrahepatic diffuse biiiary stricture was 5.9% in non-urokinase perfusion group. On the contrary, the incidence rate of intrahepatie diffuse biliary stricture was 1.4% in urokinase perfusian group (x2 = 5.98, P < 0. 05). Conclusions Liver retransplantation is effective for refractory biliary stricture in liver transplant recipients. The incidence of intrahepatic diffuse biliary stricture is reduced in non-heart-beating donor by using urokinase perfusian.

Objective To study 3D imaging and pelvic angiography for multiple pelvic fracture. Methods 30 cases suspected with multiple pelvic fracture with vascular injury were performed with 3D imaging and pelvic angiography, whose dada were analyzed retrospectively. Results 30 cases had multiple pelvic fracture to different extents, of which 25 ones had no abnormality at lower part of abdominal aorta, left & right common iliac artery, left & right iliac artery, external iliac artery and upper part of left & right femoral artery, and 1 case, complicated with local hematoma, had a raptured left external iliac artery at the middle piece of the ilium, and another two cases, also complicated with local hematoma, had a raptured left iliac artery due to the comminuted fracture of the sacrum and a raptured right anterior femoral artery due to the fracture of light femur respectively. Conclusion 16-slice CT has to be involved in when the patient with multiple pelvic fracture is suspected with vasculaer injury.

Objective To evaluate the second generation micro-endoscopic discectomy (MED) system in the treatment of lumbar disc herniation. Methods Eighty-five patients with single or double level lumbar disc herniation were treated with MED under epidural anesthesia from May 2000 to October 2001.Single disc herniation was in 72 cases, double disc herniation in 13 cases; lateral recess stenosis in 15 cases. Results The average following-up period was 14 months and the successful therapeutic results achieved 92 9%(79/85). the patients were allowed to walk 3 d and discharged 3～5 d after operation. The length of incision was only 1.6 cm. Conclusions MED has short-term satisfactory therapeutic efficacy in the treatment of lumbar disc herniation. The suitable indication and precise technique are the key for the operation.

Objective To analyze the current situation of voluntary counseling and testing(VCT) and improve HIV/AIDS prevention and control in Jiangxi province.Method VCT services in the province were analyzed using descriptive methodology.Result The province is in shortage of full time VCT workers.Of the individuals receiving pre-testing counseling,those receiving post-testing counseling and receiving referral counseling accounted for 5.22% and 1.39%,respectively.The individuals receiving tests mostly were aged 20-29 years,and a little less were aged 30-39 years.Higher positive rates of HIV screening tests were found in Pingxiang and Nanchang cities,accounting for 39.13% and 26.09%,respectively.Conclusion To improve VCT service and contain the spread of HIV/AIDS in this province,it is necessary to establish VCT networks,upgrade quality of counseling service and publicize VCT and its outreach activities among target population.

OBJECTIVE To analyze the characteristic of vancomycin-resistant Enterococcus(VRE) infection after orthotopic liver transplantation, and provide a basis to improve prophylaxis and therapy. METHODS A retrospective survey in 136 patients who underwent orthotopic liver transplantation was carried out to define the incidence, clinical feature and therapeutic outcome of VRE infection. RESULTS Eleven patients were infected by VRE in this study and the incidence of infection by VRE was 8.1% following liver transplantation. Totally 31 of the VRE isolates were isolated, including 26 Enterococcus faecium strains and 5 E. faecalis strains. Sites of VRE infection included abdomen(n=4), blood(n=2), and respiratory tract(n=2). In the other 3 patients, VRE was cultured from multiple sites. Among 11 patients with VRE infection, 4 were sensitive to teicoplanin, and 7 resistant to teicoplanin. So 4 patients received antibiotics with teicoplanin and 7 patients with linezolid. In this study, 10 patients were cured and 1 patient died of sepsis. CONCLUSIONS VRE has become an nosocomial pathogen of increasing importance in liver transplantation patients. The risk factor of VRE infection should be paid attention. Infection prophylaxis of VRE should be emphasized.