Objective To introduce the birth and development of model of end-stage liver disease(MELD) and evaluate its effect on liver transplantation(LT) as a new scoring system.Methods Literatures of MELD applied in LT were analyzed retrospectively.Results MELD scoring system was used for predicting the prognosis of patients with end-stage liver disease and the death risk of candidates on waiting LT extensively and the order of organ sharing was determined by its predicable results.Conclusion MELD has been had a successful initial implementation for predicting the short-term survival probability and mortality in patients with end-stage liver disease,and meeting the goal of providing a system of allocation that emphasizes the urgency of the candidate while diminishing the reliance on waiting time,which has been proven to be a powerful tool for auditing the liver allocation system.

Objective To explore the status and perioperative management of liver transplantation in treatment of portal hypertension. Methods Clinical data of 56 patients with portal hypertension who underwent (orthotropic) liver transplantation (OLT) from February 2000 to April 2004 were studied retrospectively.(Incidence) of complications,and in-hospital mortality and survival rate were analyzed. Platelet count after OLT was measured and liver blood flow was monitored by Doppler. Results Among the 56 OLT patients, 6 cases(10.7%) underwent simultaneous splenectomy. Incidence of complications was 40.3%,and in-hospital mortality and 1-,2-,and 3- year survival rate after OLT were 12.5% and 87.46%,85.19% and 81.58% respectively. Platelet count reached a nadir at post-transplant day 3. Conclusions OLT is an (effective) method for radical treatment of portal hypertension. Perioperative management is of vital importance for success of the operation and patient′s prognosis.

Objective To study the diagnosis and therapy of recurrent cholelithiasis caused by peripapillary duodenal diverticulum.Methods The clinical data of 40 patients with repeated formation of bile duct stones caused by peripapillary duodenal diverticulum were retrospectively reviewed,and the data on surgical treatment were analyzed.Results All the patients underwent duodenal diverticulum operation and subtotal gastrectomy (Billroth Ⅱ).Twenty-one patients in addition underwent R-Y cholangiojejunostomy,14 patients and 5 patients underwent choledochotomy with T-tube drainage and duodenotomy with Oddi sphincterotomy,respectively.In forty patients,three patients presented temporarily biliary fistula,two patients lost touch,three-eighty fully recover from an illness in three years.Conclusion Recurrence of bile duct stones caused by peripapillary diverticulum may be cured by duodenal diverticulum operation combined with bile duct surgery,which is a feasible and efficacious treatment.

The urinary continence mechanism in the fetal and neonatal periods is the foundation of the development of continence function in the lower urinary tract (LUT).At present,it is rarely reported what is the fetus and newborns' LUT continence,and the domestic reviews about these knowledge is blank.The authors searched all the research reports about LUT continence and its mechanism in the fetal and neonatal period both in the human and animals,and reviewed the urinary continence of the fetus and newborns at first time at home,to fill the domestic blank of this field.

Objective To observe the effect of supervised rehabilitation on functional recovery in hemiplegia patients after stroke.Methods 65 patients with acute stroke were divided into supervised rehabilitation group and no-supervised rehabilitation group. They were assessed with Ueda Test and Barthel Index before and after treatment. Results The scores of the Barthel Index in supervised rehabilitation group were significantly superior to those of the not supervised rehabilitation group (P <0.05), while the scores of Ueda Test between these two groups were not significantly different (P>0.05). Conclusion Supervised rehabilitation can improve the function recovery, especially in activities of daily living.

Objective To investigate changes in craniomaxillofacial soft and hard tissues following orthodontic treatment by MBT edgewise technique with fix appliance in patients with Angle classⅡdivisionⅠmalocclusion. Methods Fifty patients with Angle classⅡdivisionⅠmalocclusion were selected in this study. All patients were treated with MBT edgewise technique. Cephalometrics tracings were performed before treatment and after treatment. Cephalometrics measurements were statistically analysed by t-test. Results After the orthodontic treatment, the main changes were the reduction of maxillary and mandibular prominence and the increasement of the Pg′B′-FH and Pog-Pog′and upper-lower prominence as well. The appearance of uncovered teeth by their lips was obviously improved. The changes of soft issue profile are the increment of nasolabial angle and the changes among UL-U1, LL-L1 and the E-line. Conclusion Patients with Angle classⅡdivisionⅠmalocclusion have normal overjet and overbite, and also have a better appearance of soft tissue after the extraction treatment.

Objectives： To identify the peptide sequence of a epitope and study its three dimensional structure on molecule of cyclophilin A.　Methods： Using anti oyelophilin A (CyPA) monoclonal antibody (McAb D4) as the capture antibody, the library displayed random heptapeptides was screened by biopanning. The phage clones with high affinity for McAb D4 were chosen and their inserts were sequenced and then the antibody binding site was searched for on three dimensional structure of CyPA with RasMol software.　Results：After 3 rounds of biopanning, 7 phage clones with high affinity for McAb D4 were sequenced and 3 different species were obtained, five of seven clones shared a predominant consensus sequence, WSLQSFL. The amino acid sequences of the inserts were compared with that of human CyPA.No homologous sequence was found in the primary structure of CyPA. With the data from PDB database and RasMol software, we found that W121,S99,L98,Q111,S110,F112 and L122 constructed a hydrophobic pocket which may be the epitope for McAb D4.　 Conclusions： W121,S99,L98,Q111,S110,F112 and L122 may form a conformational epitope of cyclophilin A.

Objective To assess the role of dynamic-enhanced MR angiography (MRA) by comparing with DSA and CT arterial portography (CTAP).Methods Sixteen patients with liver diseases (mainly HCC) were included in the study. All patients underwent dynamic MRI of the liver using SENSE, digital subtraction angiography (DSA) and CTAP within two-week. MRA was reconstructed from raw data. The arterial phase of the modified MRA was compared with DSA for the evaluation of hepatic arteries and the portal phase compared with CTAP. In dynamic MRI, a fixed dosage (20 ml) of contrast medium and scan timing were used. Results The main branches and variations of the hepatic arterial system were well displayed on the dynamic-enhanced MRA, although the distant intrahepatic branches were showed poorly. Portal veins on MRV were showed as well as or even superiorly to CTAP. In addition, the inferior vena cava (IVC) was well demonstrated on MRV in most cases. MRV revealed 1 vascular variation which was not found on DSA and CTAP.Conclusion The dynamic-enhanced MRA using SENSE was a effective modality in demonstrating the hepatic vascular system. It may be a first choice modality in preoperative evaluation of orthotopic liver transplantation.

Objective To investigate the characteristics of pulmonary infection and susceptible factors following orthotopic liver transplantation (OLT). Methods Clinical data of 128 patients who underwent OLT from Feb. 1999 to Dec. 2004 were studied retrospectively in order to analyze primary pathogens, infectious time and susceptible factors.Results Forty-eight ( 37.5 %) of 128 patients had pulmonary infections and 27 ( 56.3 %) of them developed within postoperative 7 days. Thirty-four ( 70.8 %) cases suffered from mixed infection and 6 ( 12.5 %) died in the hospital after OLT. The primary pathogenic germs included Pseudomonas aeruginosa, Acinetobacter baumannii/haenolyticus, Golden staphylococcus, Aspergilosis and so on.Conclusion Pulmonary infection can be caused by various pathogens and associated with patients' constitution, mechanical ventilation, immunosuppressive drugs and so on.

Objective To compare the effect of three different analgesic techniques on hyperglycemia and stress response to cholecystotomy so as to select a more reasonable analgesic modelMethods Thirty patients after cholecystotomy ,were randomly divided into three groups using three different analgesic techniques:postoperative intravenous morphine patient-controlled analgesia(PCA)(group M),postopetative epidural PCA(group E),and pre-emptive clonidine combined with postoperative epidurral PCA(group P)Blood glucose,plasma levels of stress hormones such as cotisol,insulin,glucagon,epinephrine and norepinephrine were measured at various timesResults All three analgesic techniques produced satisfactory pain reliefHyperglycemiawas inhibited more efficiently in group E and P than in group MThe secretions of stress hormoneswere less suppressed in group M than in other two groupsThe epidural analgesics requirement in group P was lower than in group E(P