Objective　To report the experience in diagnosis and treatment of inferior vena cava stenosis (IVCS) after orthotopic liver transplantation (OLT). Methods　The clnical data of 3 patients with IVCS out of 51 OLT patients were analysed retrospectively. Results　The incidence of IVCS after OLT was 5.8% (3/51) in our hospital. In the 3 cases, IVCS of the posteriorhepatic IVC segment occurred within the first postoperative month. IVCS was identified by color duplex ultrasonography and confirmed by angiography. Percutaenous transluminal angioplasty (PTA) or metallic stent replacement were used in the 3 cases resulting in restoration of normal venous flow and elimination of legs edema. The first patient died of cerebral hemorrhage 14 days after transplantation during anti-coagulative therapy. The other two recovered smoothly with good liver function, abdominal ultrasonography demonstrated patency of the IVC. The 2 cases were alive for 18 and 4 months respectively. Conclusions　The venacavographic balloon angioplasty and metallic stent replacement are safe and useful for post-OLT IVCS. The short-term result is excellent.

Objective To investigate the effects of inhaled low dose nitric oxide(NO)on lung ischemia-reperfusion injury during flush and delayed 10 min after reperfusion.Methods Sixty health a- dult male Sprague-Dawley rats were randomly allocated to the control and the NO group.Before the donor lung was harvested,the right hilus was clipped for 5 min(clipping test),then blood sample was collected from carotid artery for arterial blood gas analysis as baseline.Lung transplantation was per- formed in a“cuff-like”vessel anastomosis technique.Dynamic compliance(Cdyn)and resistance of airway(Raw)were monitored before operation(baseline)and after 2-h reperfusion.The graft's gas exchange and oxygenation were assessed by“clipping test”after 2-h reperfusion.The lung graft was harvested for measuring wet/dry weight ratio(W/D),the activity of myeloperoxidase(MPO)and in- ducible nitric oxide synthase(iNOS),the content of malonyldialdehyde(MDA),and the expression of iNOS gene and protein.Results After 2-h reperfusion,compared to the control group,PaO_2/FiO_2, OI,and Qs/Qt were improved significantly in the NO group(277?91 vs.157?47,P＜0.01;2.67?0.89 vs.4.72?1.48,P＜0.01;21.1?4.57 vs.27.1?2.37,P＜0.01,respectively).The activi- ties of MPO were significantly reduced in NO group(1.80?0.46 vs 3.08?0.65 U/g tissue,P＜0.01).The content of MDA in the lung tissue of NO group was significantly higher than that of the control group(34.8?7.9 vs.20.0?11.2 nmol/mg protein,P＜0.05).Inflammatory cell infiltration was also significantly reduced(P＜0.05).The expression of iNOS gene and protein in the lung tissue of NO group was significantly lower than that of the control group.The activities of iNOS were also significantly reduced in NO group(10.6?10.2 vs 97.8?82.2 nmol?g~(-1)?min~(-1),P＜0.05).The im- munohistochemical positive staining of iNOS was localized in the alveolar epithelial cells and the in- flammatory cells infiltrated in the alveolar spaces and mesenchymal tissue.But there were no signifi- cant differences between two groups in Cdyn,Raw and W/D ratio.Conclusion Inhaled low dose NO might mitigate the intrapulmonary shunt,prevent neutrophil sequestration,inhibit the expression of iNOS gene and protein in isograft,thereby ameliorate ischemia-reperfusion injury and improve the ox- ygenation of the graft.

OBJECTIVE: To investigate the clinical and pathological characteristics of sinonasal neoplasms. METHOD: A cohort of 333 patients with sinonasal neoplasm, which were confirmed by surgical pathology, were enrolled in this study. The clinicopathological characteristics, in terms of age, sex, location, and disease constituent ratio were retrospectively reviewed. RESULT: (1) In this series of patients, there were 200 males and 133 females, aged from 2 to 84 years, with a median of 54 years. The benign to malignant ratio was 1.1:1. As for their origination, 144 tumors arose from the nasal cavity, while, 191 tumors derived from sinus, including 90 from maxillary sinus, 31 from frontal sinus, 46 from ethmoid sinus, and 24 from sphenoidal sinus. (2) Disease constituent ratio decreased in order of epithelial tissue, soft tissue, lymphohematopoietic tissue, bone and cartilaginous tissue, ectopic intracranial tumors. The five most frequent malignant tumors were squamous carcinoma, lymphoma, adenoid cystic carcinoma, malignant melanoma and esthesioneuroblastoma, while, benign tumors ranked in the top five were papilloma, fibroma, osteoma, angioma and ectopic intracranial tumors,respectively. (3) Of 200 cases arising from epithelium, 118 were benign, 82 were malignant, and the benign to malignant ratio was 1.4:1. Of 68 cases from soft tissue, 37 were benign and 31 were malignant tumors (ratio, 1.2:1). Among the 22 cases from bone and cartilaginous tissue, 17 were benign and 5 were malignant (ratio, 3.4:1). With respect to the 29 cases from lymphohematopoietic tissue, the majority of tumors were malignant (28 cases), with only one benign case. In addition, ectopic intracranial tumors were also observed. Besides the above all, 12 cases of other types were found in this work. CONCLUSION Neoplasms from different parts of nasal cavity and paranasal sinus have specific clinical characteristics. The pathological types of these tumors may be highly diverged. The diagnosis and differential diagnosis depend mainly on pathological examination. Comprehensive treatment, which employs surgery in combination with other modalities, is the main strategy for these tumors.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; diagnosis ; pathology ; surgery ; Papilloma, Inverted ; diagnosis ; pathology ; surgery ; Paranasal Sinus Neoplasms ; diagnosis ; pathology ; surgery ; Retrospective Studies ; Young Adult

OBJECTIVESTo summarize the results of liver transplantation for various end-stage liver diseases at the Sun Yat-Sen University of Medical Sciences (SUMS), define the role of liver transplantation in the treatment of hepatocellular carcinoma and fulminant hepatitis B, and assess the efficiency of lamivudine on preventing HBV recurrence.

METHODSSeventy liver transplants performed at the SUMS between April 1993 and December 2000 were retrospectively analyzed. The main indications for liver transplant were hepatocellular carcinoma (26 cases), liver cirrhosis (21 cases), fulminant hepatitis B (12 cases), sclerosing cholangitis (4 cases) and other terminal liver diseases (7 cases). Lamivudine was used in twelve patients suffering from fulminant hepatitis B. Logistic multivariate regression analysis was applied to determine the risk factors predicting liver transplantation outcomes.

RESULTSFifty-four patients survived for more than one month, and 16 patients died within 30 days after orthotopic liver transplantation (OLT). The overall hospital survival rate was 77.1%. The hospital survival rates in the Child's A and B patients were 87.5% and 83.3%, respectively. Those rates were superior to those of the Child's C patients (P < 0.05). The outcome of patients with small hepatocellular carcinoma (HCC) was superior to that of patients with large HCC. Preoperative APACE III scores, the severity of ascites and serum creatine level had independent influence on outcome. Of the patients with fulminant HBV infection, 9 recipients survived for a follow-up period of 2 - 24 months. Treatment with lamivudine monotherapy was both well tolerated and efficacious in patients with fulminant hepatitis B.

CONCLUSIONSThe results indicate that orthotopic liver transplantation could provide long-term cure and palliation for patients with HCC, and that patient selection is extremely important in predicting outcome. The results support the continued application of liver transplantation as a therapeutic modality for various end-stage liver diseases and that lamivudine is an effective and safe monotherapy in OLT for patients with HBV infection.

Adolescent ; Adult ; Carcinoma, Hepatocellular ; mortality ; surgery ; Child ; Child, Preschool ; China ; Cholangitis, Sclerosing ; mortality ; surgery ; Female ; Follow-Up Studies ; Hepatitis B ; mortality ; surgery ; Humans ; Infant ; Liver ; pathology ; surgery ; Liver Cirrhosis ; mortality ; surgery ; Liver Neoplasms ; mortality ; surgery ; Liver Transplantation ; Male ; Middle Aged ; Schools, Medical ; Survival Rate ; Treatment Outcome

Objective To understand the epidemiologic characteristics on newly reported HIV cases and those recently infected HIV-1 cases in the past few years in Beijing so as to find out their correlates.Methods All the qualified newly reported HIV serum samples from both the first quarters of 2009,2010 and the second quarter of 2011 in Beijing,were tested using the BED HIV-1 incidence capture enzyme immunoassay (BED-CEIA) to identify those recent HIV-1 infection (BED positive) samples and related socio-demographic characteristics.The proportions of BED positives were determined and the correlates analyzed by SPSS software.Results The Annual qualified newly reported HIV serum samples of each year from Beijing were 274,236 and 356,with BED positive rate among them as 35.0％,31.8％ and 33.7％,respectively.The majority of newly reported HIV cases of each year were males (89.1％,88.6％,91.9％),range of age as 20-39 years (77.4％,75.8％,82.0％),Han nationality (77.7％,88.6％,85.7％),and most of them were not permanent residents of Beijing (74.1％,80.5％,2011 data missed).The proportions of patients through sexual transmission showed upward trend(67.5％,76.2％,86.8％).Especially in the ‘man having sex with man’ (MSM) group,it showed a significantly increase (44.9％,45.3％,62.6％).The proportions of injection drug users (15.3％,8.1％,9.0％) declined to some extent during this period.Data from statistics indicated that the proportions of BED positives among newly reported HIV cases of each year were significantly correlated to factors as patients' sex,transmission route and source of samples,but not significantly correlated to patents' age or marital status.Male cases accounted for 96.9％ and MSM accounted for 73.5％ of all the BED-positives during 2009-2011.Conclusion MSM accounted for both large portion of newly reported HIV cases and recent HIV-1 infections which suggested an increasing trend in 2009-2011.It seemed that the characteristic and changing trends of HIV epidemic in Beijing was oriented by MSM population in the last years.

OBJECTIVE: To develop a digital breast tomosynthesis (DBT) imaging system with optimizes imaging chain. METHODS: Based on 3D tomography and DBT imaging scanning, we analyzed the methods for projection data correction, geometric correction, projection enhancement, filter modulation, and image reconstruction, and established a hardware testing platform. In the experiment, the standard ACR phantom and high-resolution phantom were used to evaluate the system stability and noise level. The patient projection data of commercial equipment was used to test the effect of the imaging algorithm. RESULTS: In the high-resolution phantom study, the line pairs were clear without confusing artifacts in the images reconstructed with the geometric correction parameters. In ACR phantom study, the calcified foci, cysts, and fibrous structures were more clearly defined in the reconstructed images after filtering and modulation. The patient data study showed a high contrast between tissues, and the lesions were more clearly displayed in the reconstructed image. CONCLUSIONS This DBT imaging system can be used for mammary tomography with an image quality comparable to that of commercial DBT systems to facilitate imaging diagnosis of breast diseases.
Algorithms ; Artifacts ; Breast ; diagnostic imaging ; Female ; Humans ; Mammography ; methods ; Phantoms, Imaging ; Radiographic Image Enhancement ; methods

Resection is crucial for treating non-small cell lung cancer. Routine follow-up after surgery is an effective method for early detection and treatment of tumor recurrence and metastasis or the second primary tumor, which can improve the quality of life of patients and their prognosis. This consensus aims to provide a reference for colleagues responsible for postoperative follow-up of non-small cell lung cancer patients in China, and further improve the standardization of lung cancer diagnosis and treatment.