Humans ; Liver Cirrhosis, Biliary ; diagnosis ; etiology ; therapy

Objective To investigate the factors in association with colorectal disorders in adult recipients of liver allograft. Methods A retrospective cohort study was carried out with clinical, microbiological and management data regarding diarrhea in 218 adult recipients of liver allograft from Jan. 2003 to Dec. 2006. Results Of the 218 patients, 68(31.2%) of them, who did not history of ulcerative colitis, were found to have diarrhea after orthotopic liver transplantation. Among these 68 patients, diarrhea was probably caused by administration of immunosuppressive agents in 35 cases (51.4%), in 12 cases (17.6%) diarrhea was antibiotics associated, and in 5 cases (7.4%) it was due to intraperitoneal infection. The other pathogenic factors included fungal infection in 3 cases (4.4%), cytomegalovirus infection in 3 cases (4.4%), Roux-en-Y choledochojejunostomy in 8 cases (11.8%) and some other unknown problem related in 2 cases (2.9%). Diarrhea occurred soon after transplantation in most cases. Of the 68 patients, the symptom of diarrhea occurred in the first 2 months in 45 cases (66.2%), and in the next 4 months in 23 cases (33.8%), i.e. the symptoms occurred 5-180 days after transplantation. Conclusion Immunosuppressive agents, antibiotics, fungal infection and cytomegalovirus infection are the top four common causes of diarrhea after orthotopic liver transplantation. The outcome is good with appropriate conservative management.

Objective: To construct a replicating adenovirus vector CNHK600-p53 carrying p53 gene and investigate its effect on the chemosensitivity of hepatocarcinoma cell line. Methods: Chemotherapy of hepatocarcinoma cel ls BEL-7404 were carried out using Fluorouracil, Mitomycin, Epirubicin, CNHK600-p53, CNHK600-p53 + Fluorouracil, CNHK600-p53 + Mitomycin, and CNHK600-p53 + Epirubicin, separately. MTT assay was used to evaluate the killing effects after therapy. Results: The inhibition rate on BEL-7404 cells was(47±3)% whe n using 100 μg/ml 5-Fu, was (20±4)% when using 1 μg/ml MMC, and was (73±2)% when using 2.5 μg/ml EPI. The inhibition rates of BEL-740 cells in CNHK600-p53 (MOI=10) + Fluorouracil (100 μg/ml), CNHK600-p53 (MOI=10) + Mitomycin (1 μg/ml), and CNHK600-p53 (MOI=10) + Epirubicin (2.5 μg/ml) groups were (59±4)%, (44±4)% and (86±2)%, respectively (P<0.01). Conclusion: Adenovirus CNHK600-p53 carrying p53 gene can enhance chemosensitivity of BEL7404 hepatocarcinoma cell line. Gene therapy using adenovirus CNHK600-p53 in combination with chemotherapy may be a new strategy for hepatocarcinoma treatment.

The growth and invasion of ectopic endometrium in endometriosis depends on hormone which will work in combination with its receptors.This review introduces the construction,function,gene,subtypes of estrogen receptor and progesterone receptor and their expressions in eutopic and ectopic endometrium,and explores their significance in the genesis,development,treatment and prognosis of endometriosis.

Objective To evaluate the value of magnetic resonance black-blood thrombus imaging (BTI) of the stage of disease in intracranial venous and sinus thrombosis(CVT).Methods From June 2015 to October 2016,37 patients with CVT diagnosed with routine imaging examinations in Beijing Xuanwu Hospital,Capital Medical University were enrolled prospectively,and they also underwent BTI examination.The patients were randomly divided into either a acute group (≤14 d,n=23) or a chronic group (>15 d,n=14) according to the time from the onset of symptoms to BTI.Signal to noise ratio(SNR) and contrast to noise ratio(CNR) difference between acute and chronic CVT groups were compared.The magnetic resonance venography (MRV) examination was used as a reference to calculate the accuracy of BTI on per-segment level.Results (1) The SNR and CNR of thrombosis in the acute group and chronic group were 206±97 and 94±41,201±96 and 86±40,respectively.There was significant difference between two groups (t=4.9 and 5.0 respectively;all P<0.01).(2) In 37 patients with CVT,the thrombi in 159 cerebral veins and venous sinus segments were detected with MRV.BTI identified the thrombi accurately in 152 vascular segments,and the thrombi in 352 vascular segments were eliminated.The diagnostic sensitivity and specificity were 95.6% (152/159) and 98.0% (352/359) respectively.Conclusion Achieving direct angiography of cerebral venous thrombosis,BTI technique can accurately differentiate acute or chronic thrombus.It has higher accuracy.

Objective To compare the impacts of sustained and intermittent gradient pressure on perfusion disorders and myofiber injuries and to explore the mechanism by which intermittent gradient pressure helps treat deep tissue injury (DTI). MethodsTwenty Sprague-Dawley rats 10-12 weeks old were randomly divided into an experimental group and a control group.The tibialis anterior muscles of the experimental group received intermittent fluctuating pressure at 8.0-21.3 kPa while the control group received sustained pressure at 13.3 kPa.The contralateral notpressed muscles served as healthy controls.The experiment was terminated after 3 cycles of compression where each cycle involved 2 h of compression and 30 min of conpression release.The general condition of the rats'skin and muscles in the compressed region were observed and laser doppler perfusion imaging was used to detect blood perfusion of the skin of the compressed leg after 3 cycles of compression.Any pathomorphological changes in the tibialis anterior muscles of the compressed region were observed by phosphotungstic acid hematoxylin (PTAH) staining. Results Blood perfusion of the skin and muscle in the control group was significantly less than in the experimental group after compression,and blood flow velocity increased with time in both groups.However,perfusion was significantly more extensive in the experimental group.PTAH staining showed that muscle injury in the experimental group was significantly less severe than in the control group. ConclusionCompared to the sustained pressure,intermittent pressure cause significantly less severe DTI by reducing compression-induced ischemia and hypoxia.

Objective: To investigate the impact of stroke unit (SU) on the compliance of secondary prevention in patients with stroke at 12 months after stroke. Methods: Research subjects were stroke patients who were treated in SU (n = 500) and in general ward (GW) (n =445) using a design of retrospective study. The patients in the SU group were followed up by hospital, telephone and home interviews for 12 months, and the patients in the GW group were followed up by telephone interview for 12 months. The main outcome measures were the rate of using antithrombotics, the rate of smoking cessation, and the rates of awareness of early stroke symptom and stroke risk factors of patients. Results: he rate of using antithrombotics was 92.76% in the SU group, and it was significantly higher than 51.49% in the GW group (P ＜0.01); the rate of smoking cessation, and the rates of awareness of early stroke symptom and stroke risk factors of patients were 82.33%, 91.04%, and 94.03% respectively in the SU group, and they were significantly higher than 54.75%, 6.53%, and 70.37% in the GW group(P all ＜ 0.01 ). Conclusions: SU attaches importance to the secondary stroke prevention and emphasizes standardized treatment, and the compliance of the secondary stroke prevention in patient with stroke is improved significantly.

Objective To evaluate the effects and safety of uterine artery embolization for uterine leiomyoma. Methods Total of 185 patients with uterine leiomyoma were treated by UAE. They were followed for one to 6 years to observe the changes of leiomyoma size and improvement in clinical symptoms. Ovarian function was evaluated in 44 cases. Results Bilateral embolization of uterine arteries was performed in 185 patients. Follow-up of 1 ～6 years for 292 leiomyoma indicated that one to 9 months after embolization, shrinkage of leiomyoma size was the most significant factor. One year after embolization, leiomyoma sizes decreased a little. Shrinkage of submucous leiomyoma was more significant than that of intratumoral one, and the latter was more significant than subserous one. Shrinkage of leiomyoma with large size ( volume ≥ 150cm~3) was less than that of small one. Menorrhagia, anemia and pressure symptoms were all resolved. There was no significant difference between pre- and post embolization ovarian hormone level. Conclusions The significant reduction in leiomyoma volume and resolution of clinical symptoms confirmed that the treatment validity of symptomatic leiomyomas by UAE. UAE is an effective therapeutic procedure which has no adverse effect on the ovarian function.

Objective To investigate the different distribution and expression of mammalian target of rapamycin complex (mTORC) in the kidney of diabetic nephropathy (DN) mice.Methods Fourteen eight-week-old male C57BL/6 mice were assigned to 2 groups: the control group ( n=7 ) and the streptozotocin ( STZ )-induced DN group ( n=7 ) . Blood and urinary variables including glucose , albumin, creatinine and albumin/creatinine ratio were assessed 2 weeks after STZ injection.Hematoxylin-eosin staining was performed for renal pathological analyses .The distributions of mTOR , phosph-ser2448-mTOR(p-mTOR), mTORC1(Raptor), mTORC2(Rictor) and phosph-ser240/244-S6K1 (p-S6K1) were determined by immunofluorescence.The expression levels of mTOR, p-mTOR, mTORC1(Raptor), mTORC2(Rictor), S6K1 and p-S6K1 were detected by Western blotting .Results Two weeks after STZ injection , the diabetic mice developed albuminuria (P<0.01) and renal hypertrophy (P<0.05).The immunofluorescence positive staining for mTOR , Raptor, and Rictor was distributed in the epithelial cells of proximal tubules , glomerular mesangium and capillary loops as well as the medullary collecting ducts of the control mouse kidney .These positive signals increased in the DN mouse kidney ( P<0.05).However, pS6K1 was not detected in the inner medulla of control mouse and p-mTOR was not found in the glomeruli of both control and DN mice .Conclusion mTORC is widely expessed in the mouse kidney and participates in the development of DN , whereas the 2448 serine phosphorylation of mTOR may be not implicated in the hyperglycemia mediated glomerular injury .

Objective To investigate the effect of fish oil parenteral supplementation on monocyte function in gastrointestinal cancer patients.Methods Sixty-four gastrointestinal cancer volunteers were equally randomized into study group and control group.Both groups received conventional lipid emulsion,and the study group was added with fish oil parenteral supplementation for 5 days.Blood samples were collected on the 1st,3rd,and 6th post-operative days to detect the interleukin (IL)-1β,IL-10,IL-6,tumor necrosis factor-α,and human leukocyte antigen-DR.Results After 5 days of continuous management,the IL-1β,IL-6,and tumor necrosis factor-o levels in the study group became significantly lower than those in the control group [(1 818 ± 213)pg/Lvs (2292 ±289)pg/L,P=0.027; (415 ±71)pg/Lvs (791±163)pg/L,P=0.001; (2 194± 350) pg/L vs (2 509 ± 507)pg/L,P =0.036,respectively),whereas the level of IL-10 by mononuclear leukocytes in two groups showed no significant difference.The expression of human leukocyte antigen-DR was significantly increased in both groups,but was significantly higher in the study group than in the control group [(76.6±15.2)％ vs (62.3±16.8)％,P=0.029].Conclusion Fish oil helps improve postoperative monocyte function in patients with gastrointestinal tumor.