Objective To investigate the preventions and managements of hepatic artery reconstructions and its complications. Method Seventy-two patients who underwent the reconstruction of hepatic artery in orthotopic liver transplantation (OLT) and were followed up during recent 3 years after OLT were collected and analyzed retrospectively. Results The overall hepatic artery complications rate was 1.4 % (1/72). A pseudoaneurysm at the side of hepatic artery anastomosis was found by angiography and embolized successfully. The patency of hepatic artery toward donor liver was remained. Postoperative Doppler ultrasonography monitoring showed that no hepatic arterial thrombosis and stenosis occurred during 43 months of follow-up after OLT. Six patients died in the hospital after OLT and 6 patients died during the follow-up period. The overall cumulative 1-, 3-year survival rate was 83.3 % and 83.3 % respectively. No death associated with hepatic artery complications occurred. Conclusion Complete evaluation and prompt management perioperatively of hepatic artery reconstruction and its complications may improve the long-term survival of the recipients and grafts after OLT.

Objective To explore the effects of 7.5% hypertonic saline (HS) and pentoxifylline (PTX) on the pulmonary inflammation in rats with hemorrhagic shock. Method Controlled hemorrhagic shock in rats was induced to 40 mmHg MAP by blood withdrawal and maintained for 60 min. Animals were randomly (random number) divided into 3 groups. In sham shock group ( n = 8), rats underwent cannulation without exsanquination or resuscitation and served as negative controls. In RL-resuscitated animals group ( n = 8), rats received 32 mL/kg RL (Ringers'lactate solution). In HSPTX group, rats received 4 mL/kg of 7.5% NaCl + 25 mg/kg of PTX.PaO2,pH,PaCO2, lung wet/dry weight ratio (W/D) and lung penetrating index were determined, and the percentages of neutrophil in bronchoalveolar lavage fluid (BALF) were detected. The levels of malondialdehyde (MDA) and superoxide dismutase(SOD)were measured. The tumor necrosis factor-α(TNF-α) and interleukin 1β(IL-1β) in BALF supernatant were determined by using ELISA method. Results Compared with RL group, PaO2 and pH of arterial blood more increased and PaCO2 of arterial blood more decreased in HSPTX group ( P ＜ 0. 01).The wet/dry lung weight ratio and the percertages of neutrophil in BALF were reduced in HSPTX group. The level of tumor necrosis factor-αand interleukin 1β in HSPTX group were both more significantly decreased than those in RL group ( P ＜0.01). Conclusions Compared with RL group, the more attenuation of pulmonary inflammation in HSPTX group after shock is associated with less neutrophil activation and decrease in production of the irlammatory cytokines.

Objective To investigate the clinical effects of liver transplantation including living related liver transplantation for Caroli's disease (CD). Methods Seven consecutive patients with diffused type of Caroli's disease had undergone liver transplantation (LT) from September 1999 to February 2007 in our single center. The clinical characteristics and survival of these patients were retrospectively reviewed. Results All 7 patients were diagnosed as Caroli's disease with diffused type which manifested recurrent cholangitis in clinical symptoms. Among them, 4 were female and 3 male.The mean age was 16 years old (ranging from 10 to 31 years old). Six patients were subjected to conservative therapy and only one patient had previously undergone cholecystectomy and T tube drainage before transplantation. In types of surgery, 4 patients accepted split liver transplantation with right liver lobe, two got whole liver transplantation and only one underwent living related liver transplantation. In two patients venovenous bypass was done during the operation. The mean duration of surgery was 9. 1 h. Post-transplant complications included pulmonary infection (3 cases), acute rejection (2 cases), pleural effusion (2 cases) and biliary leakage in the split section of donor liver (1 case). One patient died within 19 days caused by acute renal failure and multiple organs dysfunction.The rest six patients are alive without any signs of recurrence of protopathy and the longest survival time is 7 years. Conclusion Liver transplantation is a valuable treatment to Caroli's disease with diffused type. Due to the organ shortage, living related liver transplantation may own identical effects on LT.

Objective To summarize the experience in hepatic artery reconstruction in adult-to-adult living donor liver transplantation(ALDLT).Methods Fifty patients underwent ALDLT in our hospital from January 2002 to July 2006.All the hepatic a~ery reconstructions were done under surgical microscope.ResultsTwo patients(4%)presented with hepatic artery thrombosis.All the patients were followed up for 2 to 52 months (median,9 months),and no hepatic artery stenosis nor hepatic artery pseudoaneurysm occurred.The 1-year survival rate was 92%(46/50).Conclusions Systematic evaluation of hepatic artery reconstruction and use of microsurgical technique are key to the reduction of complications of hepatic artery reconstruction in ALDLT.

Objective To evaluate the suitability of reported standard liver volume formulae for Chinese adults based on the practice of 216 cases of living donor liver transplantation in our transplantation center. Methods The graft volume was preoperatively estimated in 179 adult-to-adult right liver living donors by two methods: first, the radiological right liver volume by computed tomography (CT) and second,calculated graft volume obtained by reported standard liver volume formula and the percentage of the right liver volume ( given by CT). Both results were compared to the actual graft volume measured during surgery.Results The mean percentage of right liver volume was 55.4% (SD 5.41%). The results of Urata、Heinemann、Vauthey、 Lee、 Yoshizumi formula were significantly larger than the actual right liver volume (P ＜0. 01 ). The result of Sheung-tat Fan was less than the actual right liver volume, there was statistical ESLV =334. 024 + 11. 508 × BW, is most suitable to estimate adult Chinese donor's right liver volume.

Objective To explore the effect of perioperative risk factors on post-liver transplantation acute renal failure ( ARF). Methods Clinical data of 89 cases undergoing liver transplantation between 1999 and 2002 in our centre were retrospectively analyzed. Univariate logistic regression analysis was used to determine relative risk factors leading to post-liver transplantation ARF. Significant factors were then entered into a multivariate logistic regression to identiy factors independently associated with post-liver transplantation ARF. Result In univariate analysis, intraoprative volume of blood transfusion (P - 0. 041) and duration of operation (P = 0. 005) are with statistical significance. ARF is associated with a poor prognosis ( P

Objective:To investigate the protective effect of salidroside on acute lung injury or acute respiratory distress syndrome (ALI/ARDS) in rats. Methods:A total of 50 rats were randomly divided into five groups:the normal control group,the model group, salidroside high,medium and low (8.0,4.0,2.0 mg·kg-1) dose groups with 10 ones in each. ALI/ARDS model was prepared by tail vein injection of oleic acid (0.1 ml·kg-1). The administration route was intraperitoneal injection, once daily for continuous 3 days. At 24 h after the model preparation was successful,1.0 ml blood samples were collected through carotid artery for the blood gas analysis. The lung wet/dry weight ratio,arterial oxygen partial pressure and HE staining lung tissue pathology were detected and the expression of HMGB1 and KRT-14 in the blood of rats was detected after the drug was administered for 3 days. Results:The expres-sion of HMGB1 and KRT-14 in each salidroside was lower than that in the model group,and the differences were statistically significant between the medium and high dose groups and the model group(P<0.05). The dose and efficacy of salidroside were positively corre-lated,and the differences were statistically significant between the medium and high dose groups and the low dose group(P<0.05). The oxygen partial pressure of each salidroside group was higher than that of the model group, and the lung wet/dry weight ratio was lower than that of the model group,and the difference was statistically significant between the medium and high dose groups and the model group(P<0.05). The dose and efficacy of salidroside were positively correlated,and the difference was statistically significant between the medium and high dose groups and the low dose group(P<0.05). Compared with the model group,the lung pathological changes of each salidroside group were improved. Conclusion:Salidroside can reduce the expression of inflammatory factors HMGB1 and KRT-14 in blood,reduce pulmonary edema and increase oxygen partial pressure in ALI/ARDS rats, which shows obvious thera-peutic effect on ALI/ARDS.

Objective To evaluate the outcome of liver transplantation in patients with recurrent liver cancer after resection.Methods Data of 23 patients underwent liver transplantation for recurrent liver cancer from April 2001 to March 2008 were retrospectively collected and analyzed.Results Previous history of liver resection had little negative effect in subsequent liver transplantation in technical aspect.Liver function recovered uneventfully after transplantation in all cases.Alpha fetoprotein(AFP) recovered to normal value in 13 of 17 cases with elevated AFP before transplantation within one month after operation.Five cases(21.74%) had postoperative complications.Nineteen cases(82.61%) were followed up,average follow-up duration were 610 days.There were 5 cases(26.32%) of cancer recurrence and 6 deaths during follow-up,survival rate was 68.42%.Conclusion Liver transplantation is a reasonable treatment for recurrent liver cancer after resection.

Objective To explore the indications for liver transplantation among patients with hepatolithiasis.Methods Data from 1 431 consecutive patients with hepatolithiasis who underwent surgical treatment from January 2000 to December 2006 were retrospectively collected for analysis.Surgical procedures included T-tube insertion combined with intraoperative cholangioscopic removal of intrahepatic stones,hepatectomy,cholangiojejunostomy,and liver transplantation.Results Nine hundred and sixty-one patients who had a stone located in the left or right intrahepatic duct underwent hepatectomy or T-tube insertion combined with intraoperative cholangioscopic removal of intrahepatic stones.The rate of residual stones was 7.5%(72/961).Four hundred and seventy patients who had a stone located in the bilateral intrahepatic ducts underwent surgical procedures other than liver transplantation;the rate of residual stones was 21.7%(102/470).Only 15 patients with hepatolithiasis underwent liver transplantation;they all survived.According to the degree of biliary cirrhosis,recipients were divided into 2 groups: a group with biliary decompensated cirrhosis(n=7),or group with biliary compensated cirrhosis or noncirrhosis group(n=8).There were significant differences in operative times,transfusion volumes and blood losses between 2 groups(P

From 1987 to 2017, cardiovascular disease (CVD) had been ranking the first cause of death in Suzhou, and the mortality rate showed an upward trend annual percentage changes (APC=0.62%, P=0.001), while the standardized mortality rate showed a downward trend (APC=-2.65%, P<0.001). The probability of premature death of CVD declined consistently from 7.06% in 1987 to 2.00% in 2017 (APC=-4.45%, P<0.001). When the life expectancy was set at 70, the potential years of life lost rate (PYLLR) decreased from 6.35‰ in 1987 to 3.30‰ in 2017, and the standardized PYLLR decreased from 7.30‰ to 2.68‰. When the life expectancy was set at 75, the PYLLR decreased from 10.12‰ to 5.19‰, and the standardized PYLLR decreased from 11.44‰ to 3.88‰. With the increase of years, all PYLLR and standardized PYLLR showed a significantly downward trend (APC=-2.51%--3.89%, P<0.001).