Objective To investigate the causes of biliary tract complications after liver transplantation, and to put forward effective measures of prevention, diagnosis and treatment. Methods The literatures of recent years were reviewed and summarized. Results The causes of biliary tract complications after liver transplantation are very complex, and there are no standard preventive measures. Treatment differs according to causes. Conclusion One of the most important causes leading to biliary complications is preservative and ischemic injury. Poorly operative techniques and blood supply to biliary tract are also disastrous. Improving T tube placement can reduce the incidence of biliary complications related with T tube. To prevent biliary complications, it is crucial to completely wash the biliary tract, avoid damaging the blood supply to donor biliary tract and manage perfect biliary mucosa-to-mucosa anastomosis without tension. T tube cholangiography combined with noninvasive MRCP enables accurate depiction of the biliary tree and diagnosis of biliary complications. Doppler ultrosonography should be routinely applied postoperatively. Timely application of interventional radiological technique is a valuable nonoperative procedure for treatment of biliary complications. Meanwhile, biliary sludge or cholestasis and mixed infections of biliary tract should be handled actively and properly.

Tie2 expressing monocytes (TEMs) only present in human circulating blood and tumor organs,and have an important role in tumor angiogenesis and progression.TEMs are effectively recruited to tumors by angiopoietin 2 (Ang2) and hypoxia and then differentiate into macrophages,which promote the angiogenesis in experimental tumor models by providing paracrine support to nascent blood vessels.Studies show that TEMs are up-regulated in hepatocellular carcinoma,colorectal cancer,breast cancer,malignant glioma and other human cancers,which suggests that TEMs are conducive to diagnosis and prognosis of tumors.With the further research,TEMs are applied to deliver drugs which can obtain significant anti-tumor responses and inhibit metastasis with the ability of tumor-homing.Meanwhile,TEMs may also be a potential target for the anticancer drugs.However,the present researches indicate that the effects of TEMs in tumor microvessel density,clinical stage and prognosis are still questionable.Current works that aim at describing and predicting the concrete function of TEMs have attracted significant attention from researchers.

POEMS syndrome is a rare clonal plasma cell disease characterized by polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes. Significant advances have been made in the diagnosis and treatment of POEMS syndrome over the last decade. In this study, we reviewed the diagnostic criteria and characteristic features of POEMS syndrome. We also focused on the role of the characteristic features of POEMS syndrome in early diagnosis. Autologous peripheral blood stem cell transplantation has become the first-line treatment for younger patients with normal organ function because it has resulted in a high response rate and durable remission. Melphalan and dexamethasone is an effective and well-tolerated treatment for older patients and those with organ dysfunction. Patients with poor performance status or renal function can benefit from novel agents that can also improve transplantation eligibility.

OBJECTIVE To investigate the infection status and antibiotic susceptibility of Mycoplasma in our area,so as to instruct the rational use of antibiotics.METHODS Genitourinary secretions were collected with swabs.They were cultured with the diagnostic kit of Mycoplasma(Biomerieux Company).Meanwhile the susceptibility of Mycoplasma against 9 antimicrobial agents was tested with the same kit.According to the instrnction of the kit,the results were read.The data were statistically analyzed.RESULTS A total of 382 samples were collected,and the positive rate was 44.8%.which were composed by Uu 69.6%,Mh2.9%,and Uu+Mh infection 8.8% and low titer Uu+Mh infection 18.7%.The result of drug sensitivity showed that sensitivity of Mycoplasma to pristinamycin PRI,86.5% was the highest,then was to JOS(84.8%)and CIP(26.3%).CONCLUSIONS Ureaplasma urealyticum is the major cause of infection in genitourinary system.It shows serious resistance to commonly used antibiotics.Sensitive antibiotics should be selected based on the results of bacterial culture and drug sensitivity tests so as to raise the clinical curative effects.

Humans ; Multiple Myeloma ; therapy

Humans ; POEMS Syndrome ; diagnosis ; therapy

Objective To establish a method for detection of RhD(+) red blood cells mixed in D-negative blood by flow cytometry(FCM).Method RhD(+) and RhD(-) RBCs were mixed according to predefined ratios.Cells were indirectly labeled,with IgG anti-D labeled as the first antibody,and FITC-anti-IgG F(ab')2 as the second antibody.The percentage of RhD(+) RBCs was determined by FCM,and the best dosage of IgG anti-D was also defined.The ratio of red cells in the two groups,measured by FCM,was compared with the actual ratio.The consistency of method was also evaluated.Results The effective dosage of IgG anti-D was 1∶4,and 50?l/1?106 cells.When the actual percentages of RhD(+) cell among RhD(-) cells were 2.5%-0.312%,the correlation coefficient between the percentages measured by FCM and the actual percentages was 0.987.The same tubes,containing 10% and 2.5% RhD(+) RBCs,were each tested for 10 times,and their coefficient of variation were 3.4%,and 4.9%,respectively.Conclusion The method of quantifying the RhD(+) RBCs in D-negative blood by FCM is feasible and repeatable,which deserves a further clinical application.

[Objective]To evaluate therapeutics for lumbar tuberculosis. [Method]Data from 65 patients treated with five different therapeutics were retrospectively reviewed.Group A(n=14) was treated with focal debridement.Group B(n=15) with focal debridement and bone grafting fusion.Group C(n=9) with posterior focal debridement plus bone grafting fusion and internal fixation.Group D(n=12) with posterior fixation and anterior focal debridement plus,bone grafting fhsion.Group E(n=15) with anterior focal debridement plus bone grafting fusion and anterior internal fixation.Patients all received routine support and anti-tuberculosis therapy before and after operation.Follow-up, erythrocyte sedimentation rate was studied,and bone fusion and kyphosis correction with X-ray plain film and 3D-CT reconstruction were evaluated.[Result]There were not damages occurring in the great vessels,nerves or ureters.No recurrence was found during the follow-up of 12~16 months(average 13 months).Grafting bone were all fused after 4~6 months with an average time of 3.8 months.There was no missing of angel of kyphosis correction,complications of looseness or break of internal fixation.[Conclusion]Efficient anti-tuberculosis therapy and the debridement is the key for treatment of tuberculosis.The selection of fusion or internal fixation is depended on the severity of tuberculosis.Reasonable selection may improve the therapeutic effect of lumbar tuberculosis.

Aged ; Amyloidosis ; complications ; Factor X Deficiency ; complications ; Humans ; Immunoglobulin Light-chain Amyloidosis ; Male

BACKGROUND:Schatzker V, VI fracture often causes the injuries to cruciate ligament, col ateral ligaments and meniscus. Moreover, the col apse and shifting were severe. The locking plate on one side cannot support the weight or obtain satisfactory reduction. OBJECTIVE:To compare the effects and stability of the dual-incision double-plate fixation and knee midline incision locking plate fixation in the treatment of Schatzker V, VI tibial plateau fracture. METHODS:A total of 76 patients with Schatzker V, VI tibial plateau fracture were respectively treated with locking plate fixation (n=38) and dual-incision double-plate fixation (n=38). Fracture reduction and healing were assessed using anteroposterior and lateral radiographs. Varus angle and medial caster angle of tibial plateau received biomechanical measurement. RESULTS AND CONCLUSION:Hospital stay and postoperative load time were significantly less in the dual-incision double-plate fixation group than in the locking plate fixation group (P<0.05). No significant difference in healing time was detected between locking plate fixation and dual-incision double-plate fixation groups (P>0.05). The number of complications, such as ankylosis, fracture delayed union, pin tract infection, delayed union, varus deformity, was significantly fewer in the dual-incision double-plate fixation group than in the locking plate fixation group (P<0.05). There were no significant differences in the fracture of loosening, knee instability, wound infection, skin necrosis, bone necrosis and nonunion between the dual-incision double-plate fixation and locking plate fixation groups (P>0.05). Postoperative Rasmussen classification was significantly better in the dual-incision double-plate fixation group than in the locking plate fixation group (P<0.05). Experimental results indicated that the clinical efficacy of the dual-incision double-plate fixation is superior to that of the anterior cruciate midline incision locking plate fixation in the treatment of Schatzker V, VI type tibial plateau fractures. The dual-incision double-plate fixation has more biomechanical stability.