Along with the fast development of medical technology,the theory of holistic medical care is infiltrated into every aspect of clinical medical practices.In this paper,though the treatment of surgical hepatobiliary diseases under the direction of holistic medical care ,we emphasize the significance of holistic medical care in diagnosis and treatment ,recommend and canonize the usage of holistic medical care into the clinical practices.

BACKGROUND:Transplantation of autologous stem cells for treatment of liver cirrhosis has been widely reported.But up to now,there exist some concerns for clinical physicians,including relationship between stem cells and post-transplantation prognosis/turnover of liver cirrhosis,directed differentiation of stem cells in the impaired liver,and malignant phenotype.OBJECTIVE:To dynamically monitor the serum levels of alpha-fetoprotein(AFP)and AFP variants(AFP-L3)in decompensated cirrhosis patients following intrahepatic transplantation of peripheral blood stem calls via portal vein and evaluate the safety of this treatment method.METHODS:A total of 44 decompensated cirrhosis patients who underwent intrahepatic transplantation of peripheral blood stem cells via portal vein in the 309 Hospital of Chinese PLA in April 2007 were included in this study.Prior to and after surgery,serum levels of AFP and AFP-L3 were detected by chemiluminescence.Through the use of a positive criterion for liver cirrhosis,i.e.,the proportion of AFP-L3 in AFP[AFP-L3(%)]≥10%,and the relationship between decompensated cirrhosis treatment using stem cells transplantation and the malignant phenotype of liver cancer were analyzed.RESULTS AND CONCLUSION:At 2 months after surgery,serum level of AFP showed a transient increase.There was no significant difference in AFP-L3(%)between prior to and after surgery(P>0.05).No significant difference in AFP-L3-positve rate,as well as AFP-L3(%),existed among patients with different serum level of AFP.These findings indicate that clinical symptoms and liver function of decompensated cirrhosis patients recovered to some extent after transplantation of peripheral blood stem cells via portal vein.Results regarding serum level of AFP-L3,a serological marker of liver cancer,did not demonstrate the appearance of malignant biological phenotype.

Objective To evaluate the safety and clinical effect of ABO-incompatible (ILT) pediatric living donor liver transplantation.Method We analyzed 169 pediatric living donor liver transplantation recipients from Sept.20,2006 to Dec.31,2014.There were 16 ABO-incompatible liver transplantation cases.The median age was 6 months.The blood agglutitin titer was monitored.The titer was controlled lower or equal to 1 ∶ 16.The method to decrease blood agglutitin titer included IVIG and plasma exchange.The patients were treated with Tacrolimus combined with methylprednisolone.Basiliximab for injection was used.The patients were followed-up for 9-26months.The survival rate,acute rejection,vascular and biliary tract complications,and infection were monitored.Result All the patients survived.There was once case of acute rejection,1 case of bile duct dilatation,2 cases of portal vein stenosis,8 cases of EBV viremia,5 cases of CMV viremia,and 6 cases of lung infection.The liver functions of all the 16 recipients were recovered within 3 weeks.Conclusion ABO-incompatible liver grafts can be used safely in pediatric patients.

Objective To evaluate the value of whole genome amplification (WGA) combined with array comparative genomic hybridization (aCGH) in prenatal diagnosis. Methods Array CGH were performed by the DNA of 18 prenatal specimens , which were amplified by WGA because of the low DNA yield. Result 3 of the 18 fetuses were 45, X0 and 9 of 15 fetuses with normal aCGH results showed healthy outcome. Conclusion It’ s feasible for prenatal diagnosis using WGA combined with aCGH which not only can shorten the reporting time but also keep the sensitivity and accuracy of detection.

Objective To analyze the incidence and risk factors of de novo hepatitis B virus (HBV) infection from anti-HBc-positive donors in pediatric living donor liver transplantation and to explore the diagnosis and treatment.Method A retrospective analysis was conducted on 105 cases of pediatric living donor liver transplantaions (LT) perfomed during September 2006 to December 2013.HBV markers,including hepatitis B surface antigen (HBsAg) and antibody (anti-HBs),anti-HBc,hepatitis B e antigen (HBeAg) and antibody (anti-HBe) were determined in both donors and recipients before LT and in recipients after LT.HBV DNA titer was measured if the recipients were strongly suspected of de novo HBV infection.Result After 4 perioperative deaths were excluded,101 cases were studied.The median follow-up period of all the patients was 20.5 months (2.7-97.7 months).de novo HBV infection occurred in 6 of 101 recipients (5.9％) 3.5 18 months after LT.Forty-four (43.6％) of the children received HBcAb-positive allografts,and 11.4％ (5/44) of the children were had de novo hepatitis B infection.All five of the HBV-infected children received HBcAb-positive allografts without preventive treatment in 11 cases (5/11,45.5 ％),57 (56.4％) of the children received HBcAb-negtive allografts,and 1.7％ (1/57) of the children had de novo hepatitis B infection.Conclusion Anti-HBc-positive donors can significantly increase the incidence of de novo HBV infection in HBsAg-negative recipients without preventive treatment.with the appropriate treatment strategy,HBcAb allografts can safely used in pediatric recipients.

Objective To investigate the expression and significance of adaptor protein containing PH domain,PTB domain,and leucine zipper motif 1 (APPL1) in gastric cancers.Methods Expressions of APPL1 protein and mRNA were detected with immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR) in 47 surgical specimens of gastric carcinomas (GC) and 27 normal gastric tissue specimens,respectively.Results The expression rate of APPL1 protein was 59.6％ (28/47) in GCs,and 26.1％ (6/23) in normal gastric tissues,with a statistically significant difference between two groups (P ＜0.05).The relative expression of mRNA was 0.821 ±0.141 in GCs,and 0.731 ±0.112 in normal gastric tissues,with a statistically significant difference between two groups (P ＜ 0.05).Conclusions The expressions of APPL1 protein and mRNA are increased in GCs,with a close relationship between GC and APPL1.

Objective: To summarize the research status of the changes in local microenvironment of acupoints caused by acupuncture, provide theoretical guidance for the initiation mechanisms of local acupuncture effect at acupoints. Methods: Using acupuncture, acupoint as key words to search China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), PubMed and other databases, the representative articles were selected for review. Results: Acupuncture could excite afferent nerves, activate cells, and promote the release of chemical substances like neuropeptide, hormone, cytokines, etc. in the local site of acupoints. Besides, it may cause mechanical deformation of connective tissues, and change chemical ions as well as ion channels. Conclusion: The microenvironment changes around acupoints are crucial to acupuncture effect; the concept of 'acupoints network' can be used to objectively describe the local changes around the acupoints after acupuncture.

Antibiotics, Antineoplastic ; pharmacology ; Breast Neoplasms ; enzymology ; pathology ; Cell Line, Tumor ; Doxorubicin ; pharmacology ; Drug Resistance, Multiple ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Female ; Glucosyltransferases ; biosynthesis ; genetics ; Humans ; Oligodeoxyribonucleotides, Antisense ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; Transfection

ObjectiveTo explore the normal range of the volume of internal capsules in Chinese adults of the Han nationality and its relationship with age,body habitus,and craniocerebral volume.Methods One thousand healthy volunteers (age range =18 to 80 years) were divided into 5 groups according to their age;Group A ( 18 to 30 years old),group B (31 to 40 years),group C (41 to 50 years),group D (51 to 60 years),and group E (61 to 80 years).Each group consisted of 100 males and 100 females.MR imaging was performed in all of the volunteers using T1 weighted three-dimensional nagnetization prepared rapid acquisition gradient echo sequence. After three dimension data reconstruction,the volumes of bilateral internal capsules were manually measured. The volumes of bilateral internal capsules were compared by paired sample t test.The internal capsule volumes were compared between male and female by independent sample t test,and the differences among 5 age groups were compared by one-way ANOVA.The relationship between the volumes of internal capsule and age,body habitus or cerebral volume were analyzed using bivariate correlation.ResultsThe left and right internal capsule volumes were (2809 ± 393) and (2677 ± 343 ) mm3 respectively.The left internal capsule volumes were significantly larger than that of right (t =12.078,P ＜ 0.05 ).The left and right side of internal capsule volumes in male were (2863 ± 396) and (2744 ±358) mm3 respectively,and (2754 ±385) and (2609 ±314) mm3 in female.The left and right internal capsule volumes were larger in males than in female (t =1.982,2.851 ;P ＜ 0.05 ).The left internal capsule volume of the 5 age groups were ( 3273 ± 361 ),( 2943 ± 299 ),( 2777 ± 255 ),( 2607 ± 199 ),(2444 ±213) mm3,and the right were (2993 ± 361 ),(2814 ± 270),(2682 ± 239),(2543 ± 219),(2351 ±210) mm3.There were significant differences among 5 age groups between left and right internal capsule volume ( F =55.244,34.493 ; P ＜ 0.05 ).There was significant negative correlation between the volume of left and right internal capsule and age ( r =- 0.718,- 0.637 ; P ＜ 0.05 ).Conclusions1.5 T MR scanner can be used to accurately measure the internal capsule volumes.There is a significant negative correlation between age and internal capsule volumes.

OBJECTIVETo study the expression level and significance of glucose transporter 1 (Glut-1) in normal breast tissue, adenosis, adenoma and breast carcinoma.

METHODSA total of 147 cases of female breast tissue samples, including 92 cases of invasive ductal carcinoma, 26 cases of breast fibroadenoma, 24 cases of breast adenosis and 5 cases of normal breast tissues, were collected for quantitative detection of the expression of Glut-1 protein by immunohistochemistry (EnVision method) and Western blot, and its mRNA by reverse transcriptase-polymerase chain reaction (RT-PCR).

RESULTSIn normal breast tissue and benign lesions of the breast, Glut-1 was undetectable or only weakly detectable in cytoplasm of ductal and acinar epithelia. In contrast, the intensity of Glut-1 staining was significantly higher in invasive ductal carcinomas (P = 0.0002) with protein expression predominantly in cellular membrane and lesser in cytoplasm. Western blot and RT-PCR analyses showed that the expression of Glut-1 protein and mRNA were significantly increased in invasive ductal carcinoma than fibroadenoma (P =0.001 for protein; P <0.05 for mRNA) and adenosis (P =0.001 for protein; P < 0.05 for mRNA). There was a significant difference among groups (P = 0.0002 for protein; P = 0.0001 for mRNA).

CONCLUSIONSGlucose transport activity, as indicated by Glut-1 protein and its mRNA expression, significantly increases in breast carcinoma than non-cancerous lesions. The over-expression of Glut-1 in breast carcinoma is tightly coupled with tumor cell proliferation, invasion and metastasis, implying that Glut-1 may serve as a new marker in the early diagnosis and prognostication of breast malignancy as well as a new therapeutic target.

Breast Neoplasms ; metabolism ; Carcinoma, Ductal, Breast ; metabolism ; Female ; Gene Expression Regulation, Neoplastic ; Glucose ; physiology ; Glucose Transport Proteins, Facilitative ; genetics ; metabolism ; Glucose Transporter Type 1 ; genetics ; metabolism ; Humans ; Prognosis