Objective To study the risk factors of hepatitis B virus re-infection after liver transplantation. Methods We retrospectively analyze the data of 285 patients who underwent liver transplantation for hepatitis B related diseases basing on data collected during a follow-up of at least 6 months. Results The postoperative follow-up ranges from 6 to 59 months of all the 285 cases after liver transplantation. There were 10 patients diagnosed as hepatitis B virus re-infection after liver transplantation leading to a 3.5% re-infection rate. There were 9 patients being diagnosed as HCC recurrence before HBV re-infection was identified. Patients with HCC recurrence suffered from higher HBV re-infection rate than other patients, and HBsAg and HBcAg was detected in one of the 13 metastatic HCC specimens.Conclusions HBIg combined with nucleotide analogue can effectively prevent HBV re-infention. HCCrecurrence is an important risk factor to HBV re-infection after liver transplantation.

Objective To evaluate the recovery of normal splenic function of hyperplenism in patients of liver transplantation. Methods In this study,93 liver transplant patients(all with pretransplant hypersplenism)were divided into group in which the platelet count become normal and the group in which the platelet count failed to recover. Results Hypersplenism disappeared after transplantation in 60 patients(64.5%),hypersplenism after transplantation persisted in 33 patients (35.5%);the portal vein pressure in new liver period,the splenic veinous blood flow after transplantation and the size of spleen were all significantly different between the two groups.The platelet count on three months after operation significantly correlates with pretransplant platelet count,the size of the spleen,the portal vein pressure in new liver phase and the posttransplant size of spleen.Conclusions The persistence of hypersplenism after liver transplantation is common,in may correlate with an unsatisfactory fall in portal pressure after transplantation,characteristics of splenomegaly and poor splenic venous blood flow.

Objective To analyze the role of continuous renal replacement therapy(CRRT) in the prevention of renal failure in perioperative patients undergoing orthotopic liver transplantation. Methods The clinical data of renal function were reviewed in 21 liver transplantation patients receiving CRRT during perioperative period. Results Serum Cr level decreased after CRRT in all 21 patients; The overall mortality in this group was 38.1%. The mortality rate was 8.3% in the 12 cases in whom the renal function recovered, and that was 77.8% in the 9 cases in whom the renal function did not recover (?~2=5.838,P

Objective To evaluate the role of CT in quantitative assessment for hepatic steatosis.Methods We retrospectively assessed 215 liver grafts used in orthotopic liver transplantation (LT) from January 2006 to December 2009.Pathology and CT data were reviewed.The correlation between liver steatosis level and CT value of the liver were analyzed.The ratio of liver-spleen,liver-descending aorta,liver-inferior vena cava were calculated. Results There were 52 steatosis grafts diagnosed by pathologist and the steatosis level was from 2.78％ to 56.8％.The CT value of the liver,the ratio of liver-spleen,liverdescending aorta,liver-inferior vena cava was 41.3 ± 7.5 HU,0.89 ± 0.16,1.02 ± 0.16,1.04 ± 0.15,respectively.There were significant linear negative correlation between the steatosis level and the CT value,the ratio of liver-spleen,liver-descending aorta and liver-inferior vena cava. The correlation index was -0.881,-0.817,-0.951 and -0.948,respectively. Conclusions The CT value of the liver,the ratio of liver-spleen,liver-descending aorta and liver-inferior vena cava could be used to quantitatively evaluate liver steatosis.The ratio of liver-descending aorta was the most sensitive index.

Objective To optimize the process conditions of one-step pelletization of Rouganbao Granules. Methods The factors influencing the pelletization of Rouganbao Granules were investigated by L9(34)orthogonal test, with the indexes of forming rate and fluidity. Results The spraying speed had the greatest effect on one-step pelletization, followed by atomization pressure and material temperature, and wind temperature had the smallest effect. At last, the best process parameters were relative density 1.15 (60 ℃), spray speed 55 mL/min, atomization pressure 0.25 MPa, wind temperature 75 ℃, material temperature 55 ℃, and critical relative humidity was 63%. Conclusion One-step pelletization technology can improve the preparation level and product quality, which can be used for the industrial production of Rouganbao Granules.

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

OBJECTIVETo study the risk factors of renal failure in the early post-liver transplantation period.

METHODS92 consecutive liver transplantation cases were reviewed and a multi-factor analysis of presumed risk factors of early post-transplantation period renal failure was conducted. The factors analyzed were total bilirubin level, prothrombin activity, onset of structural renal disease, onset of gastrointestinal hemorrhage, whether the patient underwent large-volume paracentesis, or underwent plasmapheresis therapy, needed renal replacement therapy, the operation method used, the bleeding volume during operation and the immunosuppressive agents used.

RESULTSOf the 92 patients, 29 (31.5%) developed acute renal failure (ARF) in the early postoperative period. Multi-factor analysis revealed a high pre-transplantation serum creatinine level and low prothrombin activity as risk factors for development of ARF.

CONCLUSIONARF is a frequent medical complication after liver transplantation. A high pre-transplantation serum creatinine level and low prothrombin activity are risk factors of its development.

Acute Kidney Injury ; epidemiology ; etiology ; Adolescent ; Adult ; China ; epidemiology ; Creatinine ; blood ; Female ; Humans ; Liver Cirrhosis ; surgery ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Prothrombin ; metabolism ; Risk Factors

The functional hemocompatibility between fibrinogen (FIG) and a novel vascular stent material (Ti-O film fixed with albumin and heparin) was investigated as follows: (1) Preparing the new biologic material (Ti-O) film; (2) Coating albumin and heparin on the Ti-O film; (3) Testing platelets (PL) adsorption; (4) Determining FIG adhesion number by use of enzyme linked immunoassay (ELISA); (5) Implanting the films from the test group of Ti-O film and from the comparison group of stainless steel (SS) film into the left and right femoral arteries respectively in 4 dogs. It was proved that albumin and heparin were fixed on Ti-O film. After 6 months, the femoral arteries of the dogs were resected. In the test group of Ti-O film coated with albumin and heparin, few PL adhered to the coat, their form did not change, and no thrombus was found by scanning electron microscopy; the result was better than that of plain Ti-O film, and was much better than that of SS film. Ti-O maintained normal transformation condition of FIG, and no C terminal of gamma chain in FIG was revealed. As it is known whether the hemocompatibility of a biomaterial is good depends upon its adsorption of FIG, and Ti-O has excellent reaction on albumin and heparin by chemical processes. In this study, the Ti-O film coated with albumin and heparin further reduced the absorption of FIG and PL when compared against the plain Ti-O film. So the Ti-O film coated with albumin and heparin has the insistent and permanent anticoagulant character.
Albumins ; chemistry ; Animals ; Coated Materials, Biocompatible ; pharmacology ; Dogs ; Fibrinogen ; chemistry ; Heparin ; chemistry ; Materials Testing ; methods ; Prosthesis Design ; Stents ; Surface Properties ; Titanium ; chemistry

OBJECTIVEAnalyze the epidemiology character of the residual paralysis(RP) of acute flaccid paralysis (AFP) in Guangdong during 1994-2007.

METHODSThe viruses isolated from the excrement of RP cases were identified and typed in Guangdong from 1994 to 2007. Statistics analysis was performed to reveal the relationship among the immunization history,age,gender and the distribution of the etiology.

RESULTSA total of 503 RP cases were reported. 150 of which were isolated with PV and 59 were isolated with NPEV. From 1994 to 2007, The PV isolating rate ranged from 18.92% to 47.06% and was higher in winter and spring, while the NPEV isolating rate ranged from 4.17% to 25.00%. and was higher in summer and autumn. The PV isolating rate decreased as the age increased,and its isolating rate (61.11%) was highest in "0" year group. The PV isolating rate of the population of < or =2 times OPV was far higher than 3 times. The PV and NPEV isolating rate of the RP cases was higher than without RP.

CONCLUSIONThe case with RP caused by wild poliovirus wasn't found from 1994 to 2007 in Guangdong, but the relationship of RP case was observed between < or =2 years group and < or =1 time OPV, and NPEVs probably are the potential etiological agent that cause children RP.

Acute Disease ; Adolescent ; Child ; Enterovirus ; classification ; isolation & purification ; Enterovirus Infections ; epidemiology ; immunology ; physiopathology ; prevention & control ; Humans ; Immunization Programs ; Infant ; Infant, Newborn ; Male ; Paralysis ; virology ; Paraplegia ; complications ; epidemiology ; Poliovirus ; isolation & purification ; Population Surveillance ; Risk Assessment ; Serotyping ; Vaccination

BACKGROUND:The outcome of cardiopulmonary resuscitation (CPR) may depend on a variety of factors related to patient status or resuscitation management. To evaluate the factors influencing the outcome of CPR after cardiac arrest (CA) will be conducive to improve the effectiveness of resuscitation. Therefore, a study was designed to assess these factors in the emergency department (ED) of a city hospital.METHODS:A CPR registry conforming to the Utstein-style template was conducted in the ED of the First Affiliated Hospital of Wenzhou Medical College from January 2005 to December 2011. The outcomes of CPR were compared in various factors groups. The primary outcomes were rated to return of spontaneous circulation (ROSC), 24-hour survival, survival to discharge and discharge with favorable neurological outcomes. Univariate analysis and multivariable logistic regression analysis were performed to evaluate factors associated with survival.RESULTS:A total of 725 patients were analyzed in the study. Of these patients, 187 (25.8％) had ROSC, 100 (13.8％) survived for 24 hours, 48 (6.6％) survived to discharge, and 23 (3.2％) survived to discharge with favorable neurologic outcomes. A logistic regression analysis demonstrated that the independent predictors of ROSC included traumatic etiology, first monitored rhythms, CPR duration, and total adrenaline dose. The independent predictors of 24-hour survival included traumatic etiology, cardiac etiology, first monitored rhythm and CPR duration. Previous status, cardiac etiology, first monitored rhythms and CPR duration were included in independent predictors of survival to discharge and neurologically favorable survival to discharge.CONCLUSIONS:Shockable rhythms, CPR duration ≤15 minutes and total adrenaline dose ≤5 mg were favorable predictors of ROSC, whereas traumatic etiology was unfavorable. Cardiac etiology, shockable rhythms and CPR duration ≤15 minutes were favorable predictors of 24-hour survival, whereas traumatic etiology was unfavorable. Cardiac etiology, shockable rhythms, CPR duration ≤15 minutes were favorable predictors of survival to discharge and neurologically favorable survival to discharge, but previous terminal illness or multiple organ failure (MOF) was unfavorable.