Objective To determine the risk factors of biliary complications (BC) after liver transplantation (LT),and to provide a theoretical basis to reduce the rate of postoperative biliary complications.Method A meta-analysis was carried out using Revman 5.1.Results Eighteen studies were identified,including 524 patients in the case study group (BC group) and 3967 patients in the control group (Non-BC group).There were no significant differences in donor age,recipient age,primary disease,warm ischemia time,second warm ischemia time,anhepatic phase time and cytomegalovirus infection.The incidence of biliary complications after liver transplantation was significantly different in male than female patients (OR: 1.40; 95％ CI: 1.09～ 1.79;P=0.008).Child C hepatic function increased the incidence of postoperative biliary complications (OR: 1.95; 95％ CI: 1.02 ～3.76;P=0.04).Using a T-tube for biliary reconstruction significantly increased the incidence of postoperative biliary complications (OR: 2.00 ; 95 ％ CI: 1.30～ 3.08 ; P 0.002).The incidence of biliary complications after liver transplantation was significantly different in patients with rejection than those without (OR: 1.80;95％ CI:1.11～2.93;P 0.02).Patients with hepatic artery complications were associated with a higher incidence of postoperative biliary complications (OR: 3.15;95％ CI: 1.37～7.23 ;P=0.007).Patients in the BC group had a significantly longer cold ischemia time and operative time (P＜0.01).Conclusions A male recipient,Child C hepatic function,T-tube drainage,rejection,hepatic artery complications,prolonged cold ischemia time and prolonged operative time were factors affecting the risk of biliary complications.Biliary complications after liver transplantation had no relationship with donor age,recipient age,primary disease,warm ischemia time,second warm ischemia time,anhepatic phase time,and the presence or absence of cytomegalovirus infection.

The individual variability should be considered in precision medicine-prevention and treatment strategies.Medical research using genomics, proteomics, metabolomics, systems analyses, and other modern tools has made big progress.In 2002, the members of the Complex-Trait Consortium proposed to develop a new mouse genetics resource called the Collaborative Cross (CC).The CC is a genetic reference panel of recombinant inbred lines of mice, designed for the dissection of complex traits and gene networks.It will provide a powerful measure for functional studies of biological networks, which will be essential to understand the intricacies of disease processes.

Objective To explore the related risk factors for diabetic nephropathy(DN) and discuss the value of diabetic dermopathy (DD) screening for DN.Methods A total of 188 patients with type 2 diabetes mellitus (T2DM) were studied,which included 78 patients with DN (DN group) and 110 cases without DN (non-DN group).The sex,age,duration of diabetes mellitus,smoking,DD,body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting blood glucose (FBG),2hours postpradial glucose(2 h PG),triglyceride (TG),total cholesterol (TC),glycosylated hemoglobin A1c (HbA1c),fasting C-peptide(FC-P) were recorded.Multiple factor Logistic regression was applied in patients with DN and non-DN.Results The incidence of DD and DN in T2DM patients was 47.34％(89/188) and 41.49％ (78/188) respectively.The ratio of DD in DN group was 79.49％(62/78),in non-DN group was 24.55％ (27/110),and the difference was significant (P ＜ 0.05).The age,duration of diabetes mellitus,SBP,FBG,2 h PG,HbA1c in DN group was higher than that in non-DN group [(52.83 ± 6.43) years old vs.(50.35 ±6.48) years old,(10.51 ±4.36) years vs.(6.48 ±3.25) years,(137.42 ± 14.17) mmHg(1mmHg =0.133 kPa) vs.(132.57 ± 15.38) mmHg,(11.95 ±2.83) mmol/L vs.(10.28 ± 1.98) mmol/L,(15.07 ± 3.16) mmol/L vs.(13.51 ± 2.75) mmol/L,(9.62±2.17)％ vs.(8.63 ± 2.08) ％],FC-P was lower than that in non-DN group [(1.76 ± 0.89) μ g/L vs.(2.01 ± 0.72) μ g/L],and the difference was significant (P ＜ 0.05).Multiple factor Logistic regression analysis showed that duration of diabetes mellitus,DD and FPG were still related to DN in T2DM (OR =4.841,3.209,3.368,P ＜0.01).Conclusions DD is correlated with DN in T2DM.DN should be screened in T2DM patients with DD.

BACKGROUND: Dental porcelain crown containing Ni-Cr alloy has been widely used in modern dentistry. The dispute of its safety is limited in oral cavity and neighbor tissues, however, the relevance between Ni-Cr alloy and systemic disease, such as nephridium toxicosis, are poorly understood. OBJECTIVE: To analyze the possibility of Ni-Cr porcelain crown resulted nephropathy and to explore its long-term clinical safety.METHODS: Databases of VIP, CNKI, Wanfang, CBMdisc, Biosis Previews and BioOne were researched by computer with key words of "nickle chromium alloy, porcelain crown, nephridium toxicosis" both in Chinese and English. Literatures concerning Ni-Cr porcelain crown and toxicity of related metal ion were included, repetitive research was excluded. RESULTS AND CONCLUSION: By consulting literatures, the possibility of erosion and release of heavy metal ion lead to nephridium toxicosis were analyzed with following aspects: effects of Ni-Cr alloy corrosivity and its accumulation on oral cavity or systemic disease; direct toxicity of released metal ions from Ni-Cr alloy and susceptivity of nephridium toxicosis; and the possible ways for renal damage resulted by Ni-Cr ion. This study can provide a basis for the further research concerning security of dental porcelain crown containing Ni-Cr alloy.

Animals ; Cardiomegaly ; Constriction ; Heart ; Mice

Objective To analyze the imaging features and to enhance the understanding of pancreatic and renal involvement in yon Hippel-Lindau disease (VHLD). Methods CT and MRI appearances and clinical data of six patients with pancreatic and renal involvement in VHLD were studied retrospectively.Six patients underwent CT scanning, and two of them also had MRI.Results Pancreatic cysts found in all six patients varied from several small cysts to cystic replacement of the entire gland.Calcifications were detected in four patients. Multiple bilateral renal lesions were detected in six patients.The renal lesions were classified as cystic, cystic with solid components and solid.Multiple combined renal lesions were found in five patients, and multiple simple cysts in one patient.Unilateral nephrectomy was performed in two patients, and the renal masses were diagnosed as clear cell carcinoma by pathology.Bile carcinoid was found in one patient, and retroperitoneal metastasis in another.Conclusion Multiple pancreatic cysts and/or multiple and bilateral combined renal lesions are highly suggestive of VHLD.

Objective To explore the application of body mass index(BMI)and the increased value of postpradial 2h C peptide [2hCP minus fasting C-peptide(FCP), ΔCP]as indexes to adjust the antidiabetic plan after intensive blood glucose control in poorly controlled patients with type 2 diabetes mellitus(T2DM).Methods The insulin intensive therapy with injections of insulin four times a day was applied to 156 type 2 diabetic in-patients with poorly glycemic control.Islet function was evaluated after glucostasis in all patients.According to FCP≥1 ng/ml, addition of basal insulin to oral antidiabetic drugs was applied(as plan A, A group).The insulin intensive therapy was continued if FCP<1ng/ml(as plan B,B group).The treatment plan was adjusted from plan A to B when plasma glucose was poorly controlled after a week(as B group).The baseline data of sex, age, diabetes duration, BMI, fasting plasma glucose(FPG), 2 hours postpradial plasma glucose(2hPG), HbA1C, triglyceride(TG), total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, FCP, 2hCP, 2hCP/FCP, and ΔCP were analyzed.Insulin dose, the incidence of hypoglycemia, and the targeted rate of glucose control were compared between two groups before grouping and one month after treatment.Results The results showed that BMI, TG, FCP, 2hCP, 2hCP/FCP, and ΔCP in A group were higher than those in B group(P<0.01), while FPG, 2hPG and HbA1C were lower(P<0.01).There were no differences in insulin dose, the incidence of hypoglycemia, the targeted rate of FPG and 2hPG between two groups when grouping.After one-month treatment, insulin dose and the incidence of hypoglycemia in group A were lower than those in group B, while the targeted rates of FPG and 2hPG in group A were better than group B(P<0.05 or P<0.01).The results of binary logistic regression analysis showed that BMI and ΔCP were independent factors for choosing antidiabetic plan A(β=0.26, 0.90,P<0.01).The areas under receiver operator characteristic curve of BMI and ΔCP were 0.72 and 0.84, respectively(P<0.01), and their cut-off points to choose antidiabetic plan A were 23.14 kg/m2 and 1.32 ng/ml.Conclusions BMI and ΔCP can be used as the predictive indexes for choosing an antidiabetic plan for poorly controlled type 2 diabetic patients.

Objective To evaluate the efficacy of discriminant function analysis for pericolic infiltration in colorectal cancer on enhanced 64-slice spiral CT and to improve the diagnostic accuracy and specificity of pericolic infiltration. Methods Dynamic enhanced 64-slice spiral CT was performed in 49 colorectal cancer patients (49 masses in total) before surgery. One or two slices were selected for each mass, with a total of 96 slices. The 96 slices were classified into two groups (pericolic infiltration or nonpericolic infiltration group) according to pathological data. Discriminant analysis was performed on the CT values between the mass and the corresponding pericolic tissue 5 mm from the mass at different time points as follows; 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, and 75 s. The discriminant function was calculated, and the pericolic infiltration determined by discriminant function and CT morphology were compared with the pathological results. The CT values in pericolic and non-pericolic infiltration groups at different enhancement time points were assessed using analysis of variance. Results The mean CT values ranged from (43. 6 ±7. 8) HU to (52. 3 ±0. 8) HU in the pericolic infiltration group, and ranged from (100.4±20.3)HU to(116.2±21.4)HU in the non.perieolic infiltration group.At 20 s and 40 s,the mean CT vshle8 were(43.6±27.8)HU and(50.9±27.8)HU in the perleolic infiltration group, (102.0±16.9)HU and(116.2 ±21.4)HU in the non-perieolic infiltration group,respectively.The mean CT value in the pericolic infiltration group was significantly lower than that in the non-pericolic infiltration group at all contrast enhancement time points(F=6.278,P<0.01).A diseriminant function Was obtained as follows:D=-3.450+0.023Xl±0.017X2-0.00lX12-0.001X22+0.002X1×X2. Based on the CT morphology of colorectal cancer,69 slices were identified correctly and 27 slices were fulsely interpreted.the sensitivity.speeificity and accuracy for perieolic infiltration determination were 82.5%,64.3%and 71.9%.respectively.Based on diseriminant function,85 slices were identified correctly and 11 slices were falsely interpreted.the sensitivity,specificity and accuracy were 85.0%.91.1%and 88.5%,respectively.Conclusion The discriminant function with dynamic enhanced 64-slice spiral CT can improve the diagnostic accuracy and specificity of perieolic infiltration in eolorectal cancer patients.

[Summary] A total of 165 type 2 diabetic patients were divided into two groups with pigmented pretibial pathes(PPP group) and no PPP( NPPP group). 50 subjects with normal glucose regulation were used as a control group(NGR group). The records of sex, age, diabetes duration, body mass index( BMI), systolic blood pressure (SBP), diastolic blood pressure, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, fasting blood glucose(FBG), 2 h postpradial plasma glucose(2hPG), triglyceride(TG), total cholesterol, HbA1C , retinol binding protein 4(RBP4), cystatin C(Cys C)were analyzed. The results showed that BMI,FBG, 2hPG, TG, and Cys C levels in NPPP group were higher than those in NGR group(all P<0. 01). The levels of BMI, SBP, FBG, 2hPG, TG, Cys C, and RBP4 in PPP group were higher than those in NGR group(P<0. 01 or P<0. 05), while diabetes duration, FBG, 2hPG, HbA1C , Cys C, and RBP4 in PPP group were higher than those in NPPP group ( P <0. 01). Pearson correlation analysis revealed that serum RBP4 and Cys C were in linear positive correlation(r=0. 77, P< 0. 01). The areas under receiver operating characteristic curve of RBP4 and Cys C were 0. 81 and 0. 78, respectively(P<0. 01). The results of binary logistic regression analysis showed that diabetes duration, HbA1C , RBP4 were related to PPP(r=0. 37, 0. 26, 0. 22, P<0. 05 or P<0. 01).

Objective To determine the effect of NEL-like type 1 gene (NELL-1) transfection in vivo in the repair of traumatic femoral head necrosis.Methods Twenty-four SD rats were randomly divided into three groups (8 rats per group) according to the lottery method,ie,sham group (served as normal control),NELL-1 treatment group (injected NELL-1 gene by recombinant adenovirus vectors around the hip one week after osteonecrosis model induced surgically) and placebo group (given an equal volume of saline solution at the same time after the induction of osteonecrosis).Femurs were taken from the animals 5 weeks after surgery.Gross observation was performed for morphology changes,X-ray assessment for femoral head height and length ratio (H/L),Micro-CT measure for bone parameters of femoral head including total volume (TV),bone volume (BV),total mineralized content (TMC),trabecular thickness (Tb.Th) and trabecular space (Tb.SP),and histological study for osteocytes,osteoblasts and osteoclasts.Results Preserved femoral head shape was noted in NELL-1 treatment group compared to the obvious flattening of the femoral head in placebo group.No heterotopic osteogenesis was observed in any group.Femoral head H/L ratio for 0.753 2 ± 0.040 2 in NELL-1 treatment group was higher than 0.598 4 ± 0.037 0 in placebo group (P ＜ 0.05),but lower than 0.920 2 ± 0.037 0 in sham group (P＜0.05).TV,BV,TMC and BMD between NELL-1 treatment and sham groups did not differ significantly (P ＞ 0.05),but all were increased compared to placebo group (P ＜ 0.05).There was no significant differences in Tb.Th and Tb.SP among three groups (P ＞ 0.05).Most osteocytes were alive in NELL-1 treatment group.More active osteoblasts and osteoclasts were noted in NELL-1 treatment group than those in placebo group.Conclusion NELL-1 gene transfection can preserve femoral head shape and bone content,promote osteoblast activity and neovascularization and hence is an effective treatment for rat traumatic osteonecrosis.However,the activity of osteoclasts is stimulated simultaneously.