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 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.

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.

CD40 Ligand ; pharmacology ; HL-60 Cells ; drug effects ; Humans ; fas Receptor ; metabolism

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 observe the effect of cluster needling at scalp acupoints plus paraffin therapy on motor function in cerebral palsy patients.Method Forty eligible patients with spastic cerebral palsy were randomized into a control group and an experimental group, 20 cases in each group. The control group was intervened by cluster needling with long-time retaining of the needles plus Uyeda's approach and conventional rehabilitation trainings specifically for spastic cerebral palsy; the experimental group was intervened by paraffin therapy in addition to the treatment given to the control group. The interventions were conducted once a day, for a total of 8 weeks. The Gross Motor Function Measure-88 (GMFM-88) and Modified Ashworth Scale (MAS) were adopted to evaluate the motor function before and after the treatment.Result The GMFM-88 scores were significantly changed after the treatment in both groups (P<0.05), and there was a significant difference in comparing the GMFM-88 score between the two groups after the intervention (P<0.05). The MAS score was significantly changed after the intervention in the experimental group (P<0.05), while the score wasn't significantly changed in the control group (P>0.05); there was a significant difference in comparing the MAS score between the two groups after the intervention (P<0.05).Conclusion On the basis of conventional rehabilitation trainings, cluster needling at scalp acupoints plus paraffin therapy can produce a significant efficacy in improving the muscular tension and motor function, and benefit the development of cerebral palsy patients.

Objective To evaluate the clinical usefulness of 99m Tc MIBI imaging for the diagnosis of breast malignancy.Methods 195 patients with a total of 204 breast lesions were divided into three groups to undergo 99m Tc MIBI imaging and the results were compared with pathology.20 cases with normal breast served as control.Abnormal density showed by 99m Tc MIBI imaging in the breast(10% higher than surrounding structure) was regarded as positive.Results Of 100 breast cancer lesions,positive feature appeared in 92.Twelve out of 70 benign breast lesions showed positive imaging.Six out of 34 breast occult lesions were with positive imaging, among them 3 were finally found with carcinoma.No positive imaging was found in the control group.The diagnostic accuracy,sensitivity,specificity,positive predictive value,negative predictive value of 99m Tc MIBI was 92 0%,91 8%,92%,86%, and 92%,respectively.Conclusions[WT5”BZ] 99m Tc MIBI imaging has high sensitivity and accuracy in the diagnosis of breast cancer and in the differentiation between benign and malignant breast lesions.

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.