Objective To investigate the impact of preoperative portal vein thrombosis (PPVT) on living donor liver transplantation (LDLT).Methods In this study,99 patients who underwent LDLT by the same surgical team of Tianjin First Centre Hospital from 2007 to 2011 were retrospectively analyzed.According to whether there was a PPVT,all the patients were divided into PPVT group (26 cases) and non-PPVT group (73 cases).The preoperative risk factors and the impact of PPVT on LDLT and outcomes were analyzed.Results Among 26 PPVT patients there were 23 cases in grade Ⅰ and 3 cases in grade Ⅱ.Splenectomy was found to be an independent risk factor for PPVT (x2 =10.211,P =0.001).PPVT prolonged the anhepatic phase (Z =-2.430,P =0.015),but the incidence of surical complications and mortality were no statistical differences between the PVT group and the non-PVT groups.Meanwhile,there was no statistical difference of 1-and 3-year survival rate between the two groups(x2 =0.505,P =0.477).Conclusions With proper intraoperative treatment and postoperative prevention,PPVT does not affect the outcomes of patients suffering from grade Ⅰ or Ⅱ PPVT.However,PPVT added to difficulties of operation,so the detailed preoperative evaluation and careful intraoperative operation is necessary.

Objective To screen the risk factors of liver metastasis in patients with postoperative colorectal cancer and to set up a mathematic model.Methods One hundred and sixty-eight patients received radical surgery were retrospectively analyzed.Logistics model regression was used to identify the risk factors and ROC test to complete a mathematic model.Results The 3 and 5-year incidence rate of liver metastasis was 25.0％ and 33.3％,respectively.The risk factors of liver metastasis were lymph node metastasis (LNM),tumor invasive depth (TID),histological grading (G) and preoperative serum tumor markers (PSMs).The mathematic model was:logit (P) =-0.931 + 0.973 × LNM + 0.302 x TID + 0.637 x G + 0.042 x PSMs.Conclusion The risk factors of liver metastasis were LNM,TID,G and PSMs,and the mathematic model could be set up.

Objective To explore the direct effect of attachment and the indirect effect through coping style and social support on mental health in technical school students. Methods 372 technical school students were assessed by Experiences in Close Relationship' s Inventory ( ECR), Symptom Check Scale List-90 ( SCL90) ,Coping Style Scale For Secondary School Students( CSS)and Perceived Social Support Scale(PSSS). Results ( 1 ) Total score of SCL-90 had significant correlations with all index of attachment anxiety, parents attachment avoidance( r=0. 165 ～0.370, P＜0.01 ) ,with coping style focus on problem ( r=0.291 ～0.552, P＜0. 01 ) and perceived social support( r = -0. 245, P ＜ 0.01 ). (2)Coping style focus on emotion had significant correlations with attachment anxiety( r=0.237 ～0.383, P＜0.01 ) and coping style focus on problem had significant correlations with attachment avoidance( r= -0. 267 ～ -0. 403, P＜0. 01 ). (3) Perceived social support had significant negative correlations with attachment avoidance ( r= - 0. 425 ～ - 0. 459, P ＜ 0.01 ). (4) The coping style focus on emotion had 65.2% mediation effect between attachment anxiety and mental health and perceived social support was moderated by attachment avoidance. Conclusions ( 1 ) Attachment anxiety and attachment avoidance have direct effect on mental health. ( 2 ) The indirect effect of attachment anxiety on mental health is a lot mediating effect performed by the coping style focus on emotion. Attachment avoidance also indirectly influences on mental health by moderating perceived social support.

Objective To investigate safety and efficacy of dinoprostone suppositories(0.8 mm) used in cervical ripening and labor induction in women with term premature rupture of the membranes.Methods One hundred women of term monocyesis with premature rupture of the membranes,head presentation,bishop score less than 6(test group)and 180 women with intact fetal membranes(control group)were enrolled into this multicenter,prospective clinical study.The vaginal delivery system was inserted into the posterior foruix,and the patients were recumbent for 2 hours after insertion.The interval time from using dinoprostone suppositories to uterine contraction,to labor and delivery were recorded.The following index were also recorded and compared,including the mean inserted time of dinoprostone suppositories,fetal heart beat,meconium stained amniotic fluid,hyperstimulation of uterus and the other complications,mode of delivery,stage of labor,postpartum hemorrhage,status of neonates.Results Three cases intest group and 23 casesin control group weren't in labor within 24 hours.The rate of labor within 24 hours in test group was significant higher than that in control group(97.0% vs.87.2%,P<0.01).It was observed that 73 cases undergoing vaginal deliveries(75.3%,73/97)and 24 cases undergoing cesarean section dehveries(24.7%,24/97)in test group and 107 cases undergoing vaginal delivery(68.2%,107/157)and 50 cases undergoing cesarean section delivery(31.8%,50/157)in control group,when compared the rate of vaginal or cesarean section deliveries between two group,it didn't reach statistical difference (P >0. 05). It had no significant difference in the interval time from using dinoprostone suppositories to labor starting and the mean inserted time and the total labor time between two groups ( P > 0.05 ). The incidence of uterine tachysystole was 11.3% (11/97) in test group and 19. 1% (30/157) in control group (P>0. 05), which did not reach statistical difference (P>0. 05). There wasn't neonatal asphyxia in both groups. Conclusion It was safe and efficient to use dinoprostone suppositories for cervical ripening and induction of term pregnancy with premature rupture of the membranes, however, monitoring should be intensified.

Objective To look for different expression of proteins between T and B lymphoma cell lines and normal peripheral blood lymphocytes by surface enhanced laser desorption/ionization-time of flightmass spectrometry (SELDI-TOF-MS) technology. Methods T and B lymphoma cells were conventionally cultivated, and logarithmic phase cells were collected for experiment. The normal lymphocytes were separated from peripheral blood of healthy persons. Proteins were extracted from the total protein of various cells, and were detected by SELDI-TOF-MS technology. SPSS 13.0 statistical software was used to statistical analysis and P ＜0.05 was considered as statistically difference. Results There are six differentially expressed proteins between T/B lymphoma cell lines and health human peripheral lymphocyte. There are seven differentially expressed proteins between B and T lymphoma cell lines. Conclusion The levels of proteomics were significantly different among T, B lymphoma cell line and normal lymphocyte. Application of SELDI-TOF-MS technology probably is some benefit on screening molecular markers of lymphoma. Moreover it is possible to lay the preliminary foundation for pathogenesis and targeted treatment of lymphoma.

Objective To investigate the correlation between vertebral artery dominance (VAD) and posterior circulation ischemic stroke (PCIS).Methods The consecutive patients with acute ischemic stroke hospitalized from November 2013 to October 2015 were collected.All patients underwent MRI and magnetic resonance angiography (MRA).The dominant vertebral artery was defined as having the larger diameter if left and right diameter difference ≥0.3 mm or the vertebral artery connected to the basilar artery in a more straight fashion if the diameter difference ＜ 0.3 mm.They were divided into either an anterior circulation ischemia stroke (ACIS) group or a PCIS group according to the classification criteria of Oxfordshire Community Stroke Project (OCSP).A multivariate logistic regression analysis was performed to investigate the correlation between VAD and PCIS.Results A total of 226 patients withacute ischemic stroke were enrolled,including 172 patients (76.1％) in the ACIS group and 54 (23.9％) in the PCIS group.Fifty-four patients (23.9％) had VAD,including 38 (70.3％) on the left and 16 (29.7％) on the right.The proportion of the patients with VAD in the PCIS group was significantly higher than that in the ACIS group (55.6％ vs.14.0％;x2 =39.115,P ＜ 0.001).Multivariate logistic regression analysis showed that VAD was an independent risk factor for patients occurring PCIS (odds ratio,13.60,95％ confidence interval 6.90-27.01;P＜0.001).Conclusions VAD is closely associated with the occurrence of PCIS,and it is an independent risk factor for PCIS.

Objective To investigate the influence of Smac to the chemosensitivity of cyclophosphamide (CTX) and doxorubicin (DOX) in MCF-7 cells.Methods MCF-7 cells were exposed to CTX,DOX and the combination of both.3-(4,5-dimethyl-2-thiazoly)-2,5-diphenyl-2 H-tetrazolium bromide (MTT) assay was used to estimate the cell viability.Apoptosis was measured by acridine orange staining and Ho.33342/PI dou-ble staining.The mRNA and protein expressions of Smac were determined by RT-PCR and Western blotting.The study also analyzed the changes of pro-apoptotic proteins active caspase-3 and active caspase-9.Results CTX,DOX and the combination of both drugs reduced the cell survival rates in a concentration-dependent manner.The cell viability after being treated with 4.0 μg/ml CTX or 0.2 μg/ml DOX or 2.0 μg/ml CTX and 0.1 μg/ml DOX for 48 hours was (52.90 ± 8.78) ％,(53.35 ± 6.29) ％ and (34.19 ± 5.43) ％,respectively.The drug combination developed a stronger inhibitory effect compared to the single drugs (t =9.051,P=0.014;t =9.074,P =0.014).The Smac mRNA and protein levels in 2.0 μg/ml CTX and 0.1 μg/ml DOX group were 7.47 ± 0.82 and 4.13 ± 0.36,which were higher than those in 4.0 μg/ml CTX group (3.27 ± 0.40 and 2.28 ± 0.27;t =-50.120,P =0.000;t =-42.588,P =0.000) and 0.2 μg/ml DOXgroup (3.34±0.62and2.45±0.40;t=-46.233,P=0.000;t=-39.541,P=0.000).Furthermore,pro-apoptotic proteins active caspase-3 and active caspase-9 increased activity was confirmed by Western blotting.Conclusion Smac plays a vital role in enhancing the sensitivity of chemotherapeutic drugs CTX and DOX in MCF-7 cell line.

Objective To explore the relationship between snoring and hypertension in the elderly.Methods A total of 375 subjects who were ≥40 years without stroke and myocardial infarction accepted questionnaire survey on snoring.Non conditional Logistic regression analysis was used to analyze the factors of hypertension.Results In 375 subjects,non-snore was in 169 subjects,occasionally snore was in 86 subjects and regular snore was in 120 subjects,the prevalence of hypertension in them were 33.7％(57/169),39.5％(34/86) and 49.2％ (59/120),respectively,there was significant difference among them.Non conditional Logistic regression analysis showed:after correcting other factors,regular snore was still risk factor of hypertension,the OR value was 2.124 (95％ CI 1.189-3.796).According to gender stratification,regular snore was still risk factor of hypertension in female,the OR value was 3.993 (95％ CI 1.259-12.663),rather than risk factor in male.Condusion Regular snore is relevant to the increased prevalence of hypertension,and it is a risk factor of hypertension.

ObjectiveTo investigate prophylaxis and treatment of bile leakage from hepatic duct anomalies after liver transplantation.MethodsWe retrospectively analyzed 3 patients with bile leakage from hepatic duct anomalies after liver transplantation in our institute.The graft procurements were combined liver-kidney harvesting.The reconstruction of the bile ducts was end-to-end anastomoses.ResultsIn the first patient with a right accessory duct joining the cystic duct,leakage of bile came from the stump of the cystic duct after anastomosis of the bile ducts.The original anastomosis was taken down,and reanastomosis was performed after plasty of the bile ducts.The patient recovered uneventfully.In the second patient with a Luschka bile duct,the biliary fistula closed spontaneously after percutaneous drainage.However,re-transplantation was performed for severe infection 7 month after the primary transplantation.In the third patient with an accessory hepatic duct from the right posterior sector joining the common bile duct,the bile duct stump which we missed leaked bile.Re-transplantation was performed because of severe complications.Conclusion Understanding the anatomy of intra- and extra-hepatic bile ducts and their common anomalies identifying the structures in the porta hepatis during preparation of the liver grafts,and looking for possible accessory hepatic ducts and aberrant bile ducts are important steps to prevent bile leakage in liver transplantation.

ObjectiveTo study the impact of allocation of organ arteries and their reconstruction for donor livers on arterial complications after liver transplantation from organ clusters obtained by combined liver,kidney,pancreas and duodenum harvesting.The aim is to guide future use of donor organs more safely and rationally with a decrease in postoperative complications.MethodWe studied 11 patients.ResultsThere was no hepatic artery anomaly.A Carrol artery patch was obtained at the bifurcation of the proper hepatic artery and the gastroduodenal artery in these donor livers.In one patient,an arterial graft was used because of inadequate arterial length,and arterial thrombosis developed which required re-transplantation.The hepatic arterial reconstruction was successful for the remaining 10 patients.One patient died of pulmonary infection 5 months post transplantation.ConclusionWhen combined liver,kidney,pancreas and duodenum harvesting was used,enough arterial length of the recipient must be preserved.There should be adequate and prompt communication between the teams carrying out the donor operation and the recipient operation.A Carrol arterial patch of the proper hepatic artery and the gastroduodenal artery for the donor liver,and the use of microsurgical vascular anastomosis in the operation are the keys to prevent hepatic arterial complications after liver transplantation.Multi-organ harvesting can be used for obtaining donor livers in liver transplantation.