Objective To evaluate the therapeutic results of percutaneous transhepatic stent angioplasty for portal vein stenosis following liver transplant.Methods From 2005 to 2007,7 patients developed portal vein stenosis following liver transplant.Percutaneous transhepatic stent angioplasty of the portal vein was performed in all patients.The therapeutic results were monitored by clinical follow-up and imaging examination.Results In seven patients,the percutaneous transhepatic stents were placed successfully.The follow up period ranged from 3 months to 34 months.Portal venous patency Was maintained in six patients(one patient died due to hepatic arterial thrombosis and ischemic insult to bile duct at three months following the stent placement).No complications due to stent angioplasty occurred.Conclusion Percutaneous transhepatic stent angioplasty is an effective and safe method for treatment of portal vein stenosis following liver transplant.

OBJECTIVETo evaluate the therapeutic effect of Danning Tablet (DNT) on patients with non-alcoholic fatty liver (NAFL) of damp-heat Syndrome type.

METHODSMulti-center randomized double-blinded positive medicine parallel controlled method was adopted. One hundred and two patients were treated with DNT and 33 patients treated with Ursodeoxycholic acid (UDCA) as control. Indexes including body mass index (MBI), principal symptom, liver function, blood lipids, iconographic parameters and comprehensive efficacy were measured before and after treatment in the two groups respectively.

RESULTSDNT and UDCA had the effect in improving BMI, distress in hepatic region, fatigue, anorexia, liver function, blood lipids and iconographic parameters, etc. DNT showed effects in improving BMI and distress in hepatic region better than those of UDCA. Histological examination also showed that DNT had good therapeutic effect.

CONCLUSIONDNT is an effective medicine for NAFL patients of damp-heat Syndrome type, and its efficacy is better than that of UDCA.

Adult ; Diagnosis, Differential ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Fatty Liver ; classification ; drug therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Tablets ; Treatment Outcome

OBJECTIVETo determine the current radiographic practices of root canal treatment (RCT) undertaken by endodontists, general dentist practitioners (GDPs) and interns, and to analyze the relationship between the usage of periapical films and the quality of RCT.

METHODSThe patients who had received RCT treatment in West China College of Stomatology were investigated at random and were divided into three groups: Endodontists treating group, GDPs treating group and interns treating group according treating physician. The usage status of periapical film were investigated by the well designed questionnaires. The obturation quality of postoperative films were evaluated. Chi-square analysis was used to compare usage rates of periapical films of three groups. Mann-Whitney test was used to determine the relationship between the usage of periapical films and the quality of RCT.

RESULTS571 teeth of 412 patients were investigated. In endodontists treating group, GDPs treating group and interns treating group, the usage rates of preoperative films were 95.3%, 89.5% and 92.1% respectively. The usage rates of working length films were 5.2%, 1.1% and 5.8% respectively. The usage of master point films was 94.8%, 72.1% and 97.4% respectively. The usage of postoperative films was 97.9%, 76.3% and 95.3% respectively. There were statistically significant differences among the working length films, master point films and postoperative films of three groups (P<0.05). The periapical films of adequate quality RCT and inadequate quality RCT were 3.14+/-0.639 and 2.84+/-0.736 respectively. There was statistically significant difference between periapical films of adequate quality RCT and inadequate quality RCT (P<0.05).

CONCLUSIONRadiographic practices of endodontists and interns are more standardized than GDPs. Quality RCT is related to radiographic practices. Standard radiographic practices would be benefit to RCT.

Dental Pulp Cavity ; Humans ; Root Canal Therapy

In Taiwan, the first human-infecting H6N1 avian influenza virus was isolated in 2013. To better understand the origin, evolutionary relationship and pathogenesis of the H6N1 virus, we studied the adaptive evolution and evolutionary dynamics of the hemagglutinin (HA) genes of the H6N1 virus in Taiwan. We felt that such studies woud contribute to the further study and control of the virus. Datasets were gained from the Flu and Global Initiative on Sharing All Influenza Data (GISAID) databases. Then, phylogenetic trees and evolutionary dynamics were reconstructed. The evolutionary rate and characterization of adaptive evolution were analyzed by bioinformatic methods. Results indicated that the HA genes of H6N1 in Taiwan were divided into at least five types, and that the new types that the infected human H6N1 belonged to could be local advantage type at present. Evolutionary dynamics revealed the viral population expanded first at the end of 1971, reduced sharply in 2008, and then increased slightly. Three sites were identified under positive selection, suggesting that various sites might increase the adaptive ability of the virus. Eighty-nine sites were under negative selection, revealing that these sites might play an important role in the replication and epidemiology of the virus. Interestingly, site 329 upstream from the cleavage site was also under negative selection, suggesting that this site might be associated with the virulence of H6N1. These data suggest that the HA genes of the Taiwanese H6N1 virus have been undergoing adaptive evolution, and that an outbreak may occur again. Hence, more attention should be paid to the identified sites, to enable timely monitoring and control of a future epidemic.
Animals ; Birds ; Evolution, Molecular ; Hemagglutinin Glycoproteins, Influenza Virus ; genetics ; Influenza A virus ; genetics ; Influenza in Birds ; virology ; Taiwan

Objective To improve the level of early detection and treatment of pyonephrosis. Methods This study included 41 cases(17 men and 24 women;mean age,49 years)of pyonephrosis.A variety of examinations,including urinary analysis,blood analysis,kidney nuclear medicine scan,ultrasonog- raphy,intravenous urography(IVU),and CT were used for the early diagnosis of pyonephrosis.Pereutaneous nephrostomy(PCN)drainage was done for the interim management of pyonephrosis,then phase 2 operation was performed in 28 cases.The double-J tube was placed in ureter by ureteroscope for drainage,and then phase 2 operation was done in 2 cases.Emergency operation was done in 10 cases.The remaining 1 case un- derwent ESWL after anti-infective therapy.Results Definite diagnosis of pyonephrosis before operation was made by invasive examinations in 31 cases(75.6%),and by percutaneous drainage in 4 cases;the other 6 cases were detected during operation.Only 6 cases(14.6%)underwent nephrectomy;the other 35 cases (85.4%)underwent kidney-sparing operation.Follow-up of 3 months to 9 years was available in 37 cases. No nephrectomy was needed in 33 cases with spared kidney.Serum creatinine was normal in the 4 cases un- dergoing nephrectomy.Conclusions The key to the treatment of pyonephrosis by kidney-sparing surgery is early diagnosis,timely drainage and relief of obstruction.Ultrasonography plays an important role in the early diagnosis of pyonephrosis,and CT has a high sensibility in the diagnosis.Pereutaneons nephrolithotomy (PCNL)secondary to drainage through pereutaneous nephrostomy was beneficial to the patients with kidney stones or upper ureter stones.

The purpose of this study was to explore the expressions of midkine (MK) and vascular endothelial growth factor (VEGF) in multiple myeloma (MM), and to evaluate their relation with angiogenesis and prognosis. The expression levels of MK and VEGF in bone marrow mononuclear cells of 31 MM patients in different stages and 20 controls were detected by real-time fluorescent quantitative RT-PCR. The results showed that the MM patients had significantly higher MK and VEGF expression level than control group (p < 0.05, p < 0.01), and there was a linear relationship between MK and VEGF (r = 0.692, p < 0.01); The expression levels of MK and VEGF in stage III was significantly higher than those in stage I and stage II (p < 0.05, p < 0.01), but there was no difference between stage I and stage II (p > 0.05); MK and VEGF levels were significantly decreased in MM patients after treatment than those before treatment (p < 0.05, p < 0.01). It is concluded that the high expression of MK and VEGF is correlated with angiogenesis and prognosis of MM, and there is synergistic effect between MK and VEGF. It is supposed that the monitoring MK and VEGF expression levels may contribute to guide the treatment and estimate prognosis for MM.
Adolescent ; Adult ; Aged ; Bone Marrow ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; diagnosis ; metabolism ; pathology ; Neoplasm Staging ; Nerve Growth Factors ; metabolism ; Prognosis ; Vascular Endothelial Growth Factor A ; metabolism ; Young Adult

OBJECTIVETo investigate the variations type of hepatic artery and discuss the method of how to protect hepatic artery from injury during the quick harvest of the donor liver.

METHODSA retrospective review of the variations of hepatic arteries of the donor livers and the course of excision and reconstruction of 200 donor livers was performed, and the aberrance and reconstruction method of hepatic arteries were summarized.

RESULTS37 out of 200 hepatic arteries varied and 2 patients suffered biliary complications because of improper preservation of aberrant hepatic arteries.

CONCLUSIONSMost aberrant liver arteries come from superior mesenteric artery or left gastric artery. Proper quick harvest of multiple organs is the basis of the integrity of hepatic arteries, and all the aberrance must be reconstructed.

Female ; Hepatic Artery ; anatomy & histology ; surgery ; Humans ; Kidney Transplantation ; Liver Transplantation ; methods ; Male ; Retrospective Studies ; Tissue and Organ Harvesting ; methods ; Transplantation, Homologous

OBJECTIVESTo summarize hemodynamic and metabolic changes during bypass, and to evaluate the bypass in liver transplantation.

METHODSFifty-four patients underwent orthotopic liver transplantation with venovenous bypass from May 2000 to May 2002. Their clinical features were analysed.

RESULTSSHR, MAP, CVP, CO, PaO(2), PaCO(2), serum K(+), Na(+), Ca(2+), BUN values were not significantly changed during bypass. Compared to the pre-bypass stage, pH was decreased in the post-bypass stage (P < 0.05), serum lactic acid value was increased in the bypass and post-bypass stage (P < 0.05), active clotting time was increased in the bypass stage (P < 0.05), serum creatinine value was increased on first postoperative day (P < 0.05).

CONCLUSIONSVenovenous bypass could improve hemodynamic and metabolic stability in the anhepatic phase, but it also could increase operation duration, liver ischemic time and cost.

Adolescent ; Adult ; Aged ; Female ; Hemodynamics ; Humans ; Kidney ; physiopathology ; Liver Transplantation ; methods ; Male ; Middle Aged ; Portal Vein ; surgery ; Postoperative Complications ; etiology

OBJECTIVETo explore the effect of intestinal ischemia/reperfusion (I/R) injury on leptin and orexin-A levels in peripheral blood and central secretory tissues, and investigate the roles of leptin and orexin-A in acute inflammatory responses.

METHODSAn intestinal I/R injury rat model was established, and the rats were grouped according to duration of the reperfusion time following a 60-min ischemia. Radioimmunoassay was used to examine the protein levels of leptin in the serum and adipose tissue, and the protein levels of orexin-A in the plasma and hypothalamus. Reverse transcriptase-polymerase chain reaction was also performed to detect the mRNA expressions of adipose leptin and hypothalamus orexin-A.

RESULTSCompared with that before injury, serum leptin level of 60-min ischemia with 30-min reperfusion (I60'R30') group decreased significantly and that of I60'R360' increased significantly. Compared with the sham-operation group (sham) after injury, serum leptin level of I60'R360' group increased significantly, and adipose leptin protein levels of I60'R30' and I60'R90' groups decreased significantly, whereas that of I60'R360' group increased obviously. Compared with sham group after injury, adipose leptin mRNA expressions of I60'R30', I60'R240' and I60'R360' groups all increased significantly, while that of I60'R150' showed significant decrease. No significant changes were noted in the protein levels of orexin-A either in the plasma or hypothalamus after I/R injury. In comparison with sham group after injury, hypothalamus orexin-A mRNA expressions of I60'R30' and I60'R90' groups showed gradual but significant decrease, and till 150 min of reperfusion, the expression reached its lowest, followed then by slow recovery at 240 and 360 min, though still remaining significantly lower than that of sham group.

CONCLUSIONLeptin and orexin-A have a time-dependent response to intestinal I/R injury, but the former appears to exhibit a faster response, and they may play a certain role in the metabolic disorders of acute inflammation.

Animals ; Female ; Inflammation ; blood ; genetics ; physiopathology ; Intestine, Small ; blood supply ; metabolism ; Intracellular Signaling Peptides and Proteins ; blood ; genetics ; Leptin ; blood ; genetics ; Male ; Neuropeptides ; blood ; genetics ; Orexins ; RNA, Messenger ; biosynthesis ; genetics ; Rabbits ; Radioimmunoassay ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; blood ; genetics ; physiopathology ; Reverse Transcriptase Polymerase Chain Reaction

OBJECTIVETo explore the expression of MICA/B in human esophageal cancer, and to analyze its correlation with clinicopathological features.

METHODSThe expression of MICA/B in 40 cases of esophagus carcinoma and corresponding normal esophageal mucosa tissues were examined by immunohistochemistry.

RESULTSThe positive rate of expression of MICA/B protein in the esophageal carcinoma was 75.0% (30/40), and that in the corresponding normal esophageal mucosa was 0 (0/40). Up-regulation of MICA/B expression was found in the esophageal carcinomas. The expression of MICA/B was related with histological grade of the esophageal carcinoma (P = 0.012).

CONCLUSIONMICA/B protein plays an important role in the esophageal carcinogenesis, and my become a useful molecular marker for the diagnosis of esophageal carcinoma.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; metabolism ; Esophageal Neoplasms ; diagnosis ; metabolism ; pathology ; Female ; Histocompatibility Antigens Class I ; metabolism ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neoplasm Grading ; Up-Regulation