Objective To explore the role of monitoring the cellular immune function in preventing and treating the fungal infection in the recipients of liver transplantation. Methods 679 cadaveric liver transplantations (from Jan. 2004 to Jan. 2010) were retrospectively studied. All the cases were divided into 3 groups according to different treatments and preventing regimens. The patients in groups A, B, C were treated based on the clinical experiences (394 cases), T lymphocyte subsets counting (151 cases), and combination of ATP values of CD4+ T cell and T lymphocyte subsets counting (134 cases), respectively. The infection, mortality and acute rejection rate were analyzed. The relationship between fungal infection and cellular immune function was investigated.Results The fungal infection rate in groups A, B, and C was 28. 9 %, 21.2 %, and 19. 4 % (P<0. 05), the morbidity rate was 16. 7 %, 12. 5%, and 3. 8% (P>0. 05), and the acute rejection rate was 28. 4 %, 17. 2 %, and 13. 4 % (P<0. 01), respectively. The CD4+ T lymphocyte counting in all cases of fungal infection was (147±43)×106/L. The morbidity could reach 50. 0 % when the CD4+ T lymphocyte counting < 100 ×106/L, while it was 2. 4 % when the counting was between (100-200) ×106/L (P<0. 01). The CD4+ T lymphocyte counting had no linear relation with the ATP value.The ATP value in fungal infection cases was (117 ± 61)μg/L. Conclusion The cellular immune function test could be quantitatively evaluated according to the T lymphocyte subsets and ATP value of CD4+ T lymphocyte. And individualized immunosuppressive therapy could be adjusted accordingly.Therefore, cellular immune function could be instructive in preventing and treating the fungal infection after liver transplantation.

Objective To evaluate the efficiency and safety of hair removal with Lightsheer 800 nm diode laser. Methods Lightsheer, 800 nm diode laser, was used to remove hairs from different areas, including hairlines, lips, whiskers, armpit, chest, back, limbs and bikinis area, in 432 patients. Results At least twice treatments, the maximum 29 times, were needed to achieve satisfactory results. Total effective rate increased with the treatment times but depended on the different area:63.4 % of hairlines, 67.7 % of lips, 71.9 % of whiskers, 100 % of armpit, 100 % of chest, 100 %of back, 82.6 % of limbs and 100 % of bikinis area, respectively. The adverse effect was observed with temporal hypopigmentation in 4 patients and hyperpigmentation in 9 patients, without any scar formation. Conclusions Lightsheer 800 nm diode laser is a safe and efficient method of laser hair removal.

Objective To analyze related perioperative risk factors of acute respiratory distress syndrome (ARDS) early after orthotopic liver transplantation (OLT).Methods The cases from the recipients having undergoing OLT,aged from 15 to 65 years and having no chronic respiratory diseases and hyoxemia were collected.The exclusive criteria were as follows:(1) the patients dead or automatic discharging at the day after the OLT or during the OLT; (2) the patients suffered from severe surgical technic complications; (3) initial poor graft function occurred; (4) marginal donor; (5) pulmonary wedge pressure (PAWP)＞ 2.394kPa.251 patients were enrolled in this analysis,who were grouped according to whether they developed ARDS (group B) or not (group A) in the first postoperative day.The analyzed factors were as follows:(1) the sex,age and weight of the recipients; (2) preoperative variables of recipients:Child-Pugh and Model for end-stage liver disease (MELD) score,left vent ricular ejection fractions,oxygenation index,the serum levels of creatinine,BUN,TB,albumin,prealbumin,fibrinogen and hemoglobin,white blood cells (WBC),platelet count and international normalized ratio (INR) ; (3) the variables of donator:age,the time of warm and cold ischemia; (4) the intraoperative variables:operative time,anhepatic phase,the volumes of hemorrhage and blood-transfusion (red cell suspension and plasma),transfusion volume; (5) postoperative variables of recipients:the serum levels of creatinine,blood urea nitrogen (BUN),total bilirubin (TB),albumin,alanine aminotransferase (ALT),sodium and potassium,fibrinogen and hemoglobin,WBC,platelet count and INR.Results The mild ARDS incidence early after OLT was 25.5 ％ (65/251) and the moderate or severe was 4.8％ (12/265).Single factor analysis showed that the factors having significant difference between group A and group B were as follows:the age of the recipients,preoperative variables (Child-Pugh and MELD score,the preoperative serum levels of BUN,TB,prealbumin,fibrinogen and hemoglobin,WBC,platelet count and INR),the intraoperative variables (the volumes of hemorrhage and blood-transfusion including red cell suspension and plasma) and the postoperative variables (the serum levels of BUN,TB,sodium,fibrinogen and hemoglobin,WBC,platelet count and INR).The significant factors were put to the analysis of LOGISTIC regression,and the results showed that the age of recipients,preoperative Child-Pugh score,BUN and INR,intraoperative hemorrhage volume,postoperative serum level of sodium were the independent risks contributing to ARDS.Conclusion The mild ARDS incidence early after OLT was high but the the moderate or severe incidence was low.The age of recipients,preoperative Child-Pugh score,BUN and INR,intraoperative hemorrhage volume and postoperative serum level of sodium may be the main risk factors to lung injury after OLT.

Objective To evaluate the therapeutic effects of liver transplantation (LT) for cholangiocarcinoma(CC)and analyze the prognostic factors.Methods From December 2001 to December 2006,234 patients receiving LT for hepatic carcinoma in our institute were enrolled as a basis of comparative study for 6 CC patients undergoing LT during the same period.Results These 6 patients were followed-up from 1 to 56 months.Five patients died and one recurred.The 0.5-,1-and 2-year patient cumulative survival rates were 4/6,3/6 and 1/6,respectively.The 0.5-,1-and 2-year tumor-free survival rates were 3/6,2/6 and 1/6,respectively.The average patient or tumor-free survival time were both(14±4) months.Conclusion The prognosis of cholangioearcinoma patients after LT iS poor.

Objective To investigate the surgical options for the management of portal vein thrombosis (PVT) during liver transplantation and its impact on the outcome of patients. Methods 773 cases of liver transplantation were analyzed retrospectively. PVT occurred in 107 patients, inclu-ding 59 of grade Ⅰ ,33 of grade Ⅱ, 12 of grade Ⅲ and 3 of grade Ⅳ. Simple thrombectomy or thrombus-extraction was performed in grade Ⅰ and Ⅱ. 12 patients with grade Ⅲ received thrombus-extraction or using the donor iliac vein to act as a bridge between the donor portal vein and host superior mesenteric vein. Two cases of grade Ⅳ received a modified cavo-portal hemitransposition and one case received portal-vena coronaria varication anastomosis. Results Liver function had a good recover and the perio-perative mortality is 4. 3% in grade Ⅰ and Ⅱ. In grade Ⅲ , 5 cases received thrombus-extraction had a normal liver function after transplantation and had no died. 2 cases among the other 7 cases using por-tal vein reconstruction had bad liver function and died. The liver function recovered well after trans-plantation and there was no died in grade Ⅳ. Conclusions PVT is not a contraindication for liver transplantation. Good results can be obtained by applying reasonable operative procedures individually.

Adult ; China ; epidemiology ; Chronic Disease ; epidemiology ; Dyslipidemias ; epidemiology ; Female ; Health Status ; Humans ; Hypertension ; epidemiology ; Male ; Middle Aged ; Obesity ; epidemiology ; Smoking ; epidemiology

Objective To investigate the prevention and treatment of acute renal failure (ARF) following orthotopic liver transplantation(OLT).MethodsClinical data of 51 patients who underwent liver transplantion consecutively between October 2001 and April 2003 were analyzed retrospectively. Results Preoperatively 9 out of 51 patients had suffered renal dysfunction (Cr≥132 ?mol/L or BUN≥18 ?mol/L), ARF developed in 7 cases within one week postoperatively. Kidney function recovered to normal in 6 cases in 3 to 6 days after administration of vasoactive drugs (dopamine) and daclizumab (Zenapax). One patient failing to response needed hemodialysis for 11 days before his kidney finally functioned. Conclusions The etiology of ARF following OLT is multifactorial, with preoperative, intraoperative and postoperative factors being involved. Individually applied immunosuppressant, improving renal perfusion, and hemodialysis were important for the recovery of kidney function.

Objective To investigate calcium-sensing receptor (CaSR) expression level in osteoarthritis (OA) carti-lage,and the relationship with OA pathogenesis thereof. Methods The degenerated human cartilage of distal femur and proximal tibia came from 5 patients with OA underwent total knee replacement surgery. The tissue specimens were stained by HE. According to the Collins histological grading standards, articular cartilage degeneration was classificated in speci-mens. Eight HE slices of Collins grade 0 were used as normal cartilage group. Eight HE slices of Collins gradeⅡwere used as degeneration cartilage group. The CaSR expression levels detected by immunohistochemical staining technique were com-pared between two groups. Results Expression of CaSR was detected in osteoarthritis cartilage. The expression intensity of CaSR was significantly lower in normal cartilage group than that of degeneration of cartilage group (score:1.63±0.95 vs 3.52± 0.78,t=8.99,P<0.05). Conclusion The activation of CaSR is associated with the degeneration of articular cartilage.

Objective:To analyze the awareness rate of obesity risk factors among children and adoles-cents, and to provide the basis for preventing their obesity. Methods: The students selected by using stratified cluster sampling method, were measured for the body height, weight, and waist circumference, and were surveyed for the awareness rate of obesity risk factors by using the questionnaire. The distribu-tion characteristics of awareness on obesity risk factors were analyzed. Results: The awareness rate of obesity risk factors was 74 . 1%, and there was no significant difference on the awareness rate of obesity risk factors between the males [71. 2% (247/347)] and females [77. 2% (257/333)], the abdominal obesity students [73. 5% (202/275)] and non-abdominal obesity students [74. 6% (302/405)], the overall obesity students [74. 3% (185/249)] and non-overall obesity students [74. 0% (319/431)], re-spectively. However, the awareness rate of obesity risk factors among the primary school students was 81. 9% (272/332) that was higher than that of the middle school students [66. 7% (232/348)] (P<0. 05). Compared with the primary school students, the non-awareness risk of obesity risk factors would in-crease among the middle school students (OR=2. 23, P<0. 05). Conclusion:The overall awareness rate of obesity risk factors is not high among children and adolescents, especially among middle school students.

Objective To explore the monitoring and the individualized adjustment of cellular immunology function in the recipients infected with pan-drug resistant Acinetobacter baumannii(PDR-Ab)after liver transplantation.Methods We retrospectively summarized the infection and the prognosis of PDR-Ab in 299 cases of liver transplantation performed from Jan.2008 to May 2010.The absolute number of T lymphocytes and ATP level within CD4+ T cells were monitored,and T cell immunology function(TCIFS)was scored.According to different immunology adjusting proposals,14 cases of PDR-Ab infection were divided into 2 groups:(1)traditional group,routine anti-infective therapy;(2)individualized group.Individualized immunology adjustment was made according to the score of TCIFS besides routine therapy.Results There was no significant difference in age,MELD and Child-pugh score between two groups.The peri-operative bleeding volume in individualized group was more than that in traditional group(P<0.01).There was no significant difference in TCIFS score between two groups at 1st week after transplantation and the onset of the PDR-Ab infection.However,the score in individualized group was apparently higher than that in traditional group when anti-infection therapy ended(P<0.05).The difference in the recovery rate between two groups was significant(P<0.05).No rejection happened in two groups.Conclusion It is an effective way to decrease the mortality of PDR-Ab infection after liver transplantation that the individualized adjustment of immunosuppression protocols is guided by grading quantitatively the cellular immunology function according to the absolute number of T lymphocytes and ATP level within CD4+ T cells.