Objective To analyze the actions of transforming growth factor ? 1 (TGF-? 1) and tumor necrosis factor ?(TNF-?) in the liver fibrosis formation in chronic viral hepatitis patients and liver cirrhosis patients.Methods Serum levels of TGF-? 1 and TNF-? were measured by ELISA in 107 patients with chronic liver diseases,liver biopsy was performed in 23 patients in order to identify pathological stages under optic microscope.Results The serum levels of TGF-? 1(?g/L) in mild,middle and severe groups of chronic viral hepatitis and liver cirrhosis group were 14 2?5 9,20 1?7 0,30 2?6 7 and 32 6?7 5 respectively.The serum levels of TNF-? (pg/L) were 6 1?3 2,29 8?18 6,57 3?22 5 and 96 7?38 2 respectively.The serum levels of above two markers increased with hepatitis progression.The results of liver biopsy revealed that the changes in these two markers were related to liver cirrhosis degree.Conclusions TGF-? 1 and TNF-? are related to liver cirrhosis formation.

Objective To compare the analgesic effects of flurbiprofen axetil combined with sufentil and sufentil alone used through intravenous postoperatively.Methods 40 cases under general anesthesia were randomly divided into the group A and group B with 20 cases in each group.The analgesia methods were flurbiprofen axetil 100 mg plus sufentanil 100 μg(diluted to 100 ml with normal saline) in the group A,and sufentanil 200 μg(diluted to 100 ml with normal saline) in the group B.The scores of Visual Analogue Scale(VAS) for pain and the incidence of side effects within postoperative 48 hours were recorded.Results The VAS scores of two groups were not significantly different(P>0.05).The incidence of side effects of the group A was significantly lower than that of the group B(P<0.05).Conclusion Flurbiprofen axetil combined with sufentanil has a good analgesic effect used through intravenous postoperatively,and can clearly reduce the dose of sufentanil and the incidence of side effects.

Objective To observe the effect of arthroscopic meniscectomy to tr eat discoid lateral meniscus tear. Methods From July 1999 to June 2003, arthrosc opic meniscectomy was conducted for 49 menisci of 45 patients with discoid later al meniscus tear. 41 patients had unilateral injury, and 4 bilateral. 32 knees w ere complete injury and 17 incomplete. The discoid lateral meniscus tear account ed for nearly one third of the patients with meniscus tear who received arthrosc opic meniscectomy at the same time. Arthroscopic partial meniscectomy was done f or 44 knees, total meniscectomy for 5 knees and meniscus suture for 3 knees. Aft er operation the rehabilitation training programs, including straight-leg-rais ing exercise and range-of-motion exercise, were carried out. Results The opera tions for the 45 cases were successful and there was no complication. 40 patient s were followed up. Before operation, the mean Lysholm -Ⅱscore was 55 points ( 40 to 71 points). After a mean follow-up period of 39 months, the mean Lysholm -Ⅱscore was 88 points (60 to 100 points). The excellent and good results were obtained in 85.3%of the patients. Conclusions Arthroscopic meniscectomy should be a preferred method for discoid lateral menisci tear, due to its minimal invas ion, possibility of early mobilization, a lower complication rate, and preservat ion of more meniscus structure and function. If the operation is combined with s tandard rehabilitation training, the effects can be enhanced.

The study of isolated coronay heart disease (iCHD) (n=17) and CHD+T2DM (n=17) showed that the serum level of vascular cell adhesion molecule-1 (VCAM-1) and CHD scores increased in CHD+T2DM group than in iCHD grup, and was positively correlated with CHD scores in CHD population (all P<0.01).

OBJECTIVE To analyze the characteristic of vancomycin-resistant Enterococcus(VRE) infection after orthotopic liver transplantation, and provide a basis to improve prophylaxis and therapy. METHODS A retrospective survey in 136 patients who underwent orthotopic liver transplantation was carried out to define the incidence, clinical feature and therapeutic outcome of VRE infection. RESULTS Eleven patients were infected by VRE in this study and the incidence of infection by VRE was 8.1% following liver transplantation. Totally 31 of the VRE isolates were isolated, including 26 Enterococcus faecium strains and 5 E. faecalis strains. Sites of VRE infection included abdomen(n=4), blood(n=2), and respiratory tract(n=2). In the other 3 patients, VRE was cultured from multiple sites. Among 11 patients with VRE infection, 4 were sensitive to teicoplanin, and 7 resistant to teicoplanin. So 4 patients received antibiotics with teicoplanin and 7 patients with linezolid. In this study, 10 patients were cured and 1 patient died of sepsis. CONCLUSIONS VRE has become an nosocomial pathogen of increasing importance in liver transplantation patients. The risk factor of VRE infection should be paid attention. Infection prophylaxis of VRE should be emphasized.

Objective To evaluate the treatment and prevention measure for intrahepatie diffuse biliary stricture after orthotopic liver transplantation. Methods The clinical data of 21 patients with intrahepatic diffuse biliary stricture after orthotopic liver transplantation from January 2002 to December 2007 in Beijing Center for Organ Transplantation were retrospectively analyzed. A prospective clinic study was launched in order to prevent microthrombosis in the microcireulation of bile duct during warm and cold iscbemia in non-heart-beating donor since January 2006. Urokinase perfusion of the artery system was conducted during graft harvesting and reperfusion at the end of graft trimming to reduce the incidence of intrahepatic diffuse biliary stricture. Results Among 21 patients with intrahepatie diffuse and mixed type biliary stricture, 16 patients underwent liver retransplantation, and the other 5 patients died of primary graft failure while waiting for retransplantation. The incidence of intrahepatic diffuse biiiary stricture was 5.9% in non-urokinase perfusion group. On the contrary, the incidence rate of intrahepatie diffuse biliary stricture was 1.4% in urokinase perfusian group (x2 = 5.98, P < 0. 05). Conclusions Liver retransplantation is effective for refractory biliary stricture in liver transplant recipients. The incidence of intrahepatic diffuse biliary stricture is reduced in non-heart-beating donor by using urokinase perfusian.

Objective To summarize the experience of emergency orthotopic liver transplantation (EOLT) in fulminant hepatic failure (FHF).Methods The clinical date of 4 cases of FHF successfully subject to EOLT were retrospectively analyzed.Results Four patients’ consciousness completely recovered in 12 to 48 h after operation, no surgical complication occurred; Acute rejection postoperatively occurred in 2 patients and reversed after treatment. Now 4 patients were survived for 38, 17, 11, 7 months respectively with good liver function, and 3 of them went to work again.Conclusion EOLT is an effective means to cure FHF. Choosing appropriate perioperative management and (operative) timing is essential to improve the successful rate of EOLT.

[Objective]To evaluate the feasibility of repairing cartilage defect with tissue-engineered cartilage ,which was made of chondrocytes and osteoblast seeded onto a biodegradable porous bioceramic ?-tricalcium phosphate (?-TCP).[Method] A porous bioceramic template of ?-TCP was created in the shape of a circular cylinder. Chondrocytes and osteoblasts induced from dog bone marrow stem cells were seeded onto the ?-TCP and then kept them growing together for 1 week prior to transplantation into the cartilage defects. After 12 , 16 weeks ,the specimens were harvested and examined macroscopically, histologically and immunohistochemically. [Result] Gross morphological and histological analysis of the specimens from the ?-TCP complex demonstrated new cartilage construction. The result was better than that in control group. [Conclusion] These findings suggest that porous bioceramic (?-TCP) is a good "matrix" for chondrocytes and osteoblasts, and can be used for cartilage engineering.

Objective To investigate effect of monosialotetrahexosy-1 ganglioside (GM1) on the autophagic neuronal death induced by spinal cord injury.Methods Ninety SD rats were randomly divided into sham group,isotonic saline group and GM1 group,with 30 rats per group.Spinal cord injury at T10 segment was induced by Allen method in the isotonic saline group and GM1 group.Expression of endogenous LC3 was detected by florescence microscope.Ratio of LC3-Ⅱ and LC3-Ⅰ,and expression of Beclin-1 were detected by Western blot.Results LC3 was significantly up-regulated in the isotonic saline group,as compared to the sham group (P ＜0.05).Also,an up-regulation of LC3 and a decline of autophagic body formation were observed in GM1 group,as compared to isotonic saline group (P ＜0.05).Expressions of LC3-Ⅱ and Beclin-1 and ratio of LC3-Ⅱ to LC3-Ⅰ were significantly increased in the isotonic saline group,as compared to the sham group (P ＜ 0.05).Expressions of LC3-Ⅱ and Beclin1 and ratio of LC3-Ⅱ to LC3-Ⅰ significantly were decreased in the GM1 group,when compared to the isotonic saline group (P ＜ 0.05).Conclusion GM1 inhibits autophagic neuronal death after spinal cord injury and hence exerts protective effect on the neurons.

Objective To explore the feasibility and reliability of thoracoscopic surgery in the treatment of esophageal leiomyoma.Methods According to the tumor site selection of incision,7 patients with esophageal leiomyoma were taken myomectomy by thoracoscopic surgery.Results All cases were cured,and there was no death and serious complication.The patients were followed up for 3 to 24 months.There was no recurrence.Conclusion The myomectomy by thoracoscopic surgery would be an alternative to open surgery for patients with esophageal leiomyomas,which is safe and effective.