? in the blood. There were three isomeric compounds of DDT in the fat and two in the blood were detectable. Conclusion There was still accumulation of HCH and DDT in human body fat and blood in Xiaogan population although the accumulative levels were significantly lower than that of the allowable residue standard of China.

?-HCH. The average of pp'-DDE in the surface water was the highest, 0.062 ?g/L. In the water in the deep well of 70 meters, organochlorine was still found. Conclusion The residues of organochlorine pesticide in different soil and water of the agricultural products base in Xiaogan have been detected, the contents are under the related national standard limitation, but the potential threat of the accumulation of organic chlorine pesticide should not be underestimated.

Objective To evaluate the therapeutic effects of EN,PN support on postoperative recovery of (patients) with portal hypertension. Methods 135 patients with portal hypertension who underwent (esophagogastric) devasularization were randomly divided into three groups:EN,PN and control group. (Postoperatively), EN and PN nutritional support and routine fluid replacement therapy was respectively given to the 3 groups. Several clinical and laboratory parameters were studied in order to determine the therapeutic effect of the two different forms of nutrition.Results Nutritional status and immunological function of patients were improved in both EN and PN study groups but with no significant difference, while alterations in liver function and incidence of abdominal infection were higher in PN group. Conclusions EN is an optimal form of nutritional support for patients with portal hypertension after operation.

Objective To explore the relapse,therapeutic effect,risk and prognostic factors of the pulmonary invasive fungal disease(IFD)in patients with a history of pulmonary IFD following allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods Fourteen patients with a history of pulmonary IFD received allo-HSCT between March 2005 and October 2006.Before transplantation,10 patients obtained complete remission(CR)and 4 partial remission(PR)after antifungal therapy.Antifungal prophylaxis was initiated on the first day of the conditioning therapy.Logistic regression models were used for multivariable analyses.Results The relapse rate of pulmonary IFD after allo-HSCT was 71.43%(10/14).Of 10 patients in CR,6 relapsed and all four patients in PR relapsed.Seven patients relapsed less than 3 months and 3 relapsed between four and six months after transplantation.Among the 10 patients with a history of IFD who relapsed after transplantation,9 patients received antifungal therapy,4 obtained CR,2 PR again and the other 3 didn't obtain remission.The effective rate of anti-fungal therapy was 66.67% and the pulmonary IFD-related mortality was 35.71%(5/14).There was no significant difference between amphotericin B,itraconazde and voriconazole for antifungal prophylaxis in patients with a history of pulmonary IFD(P=0.122).No risk and prognostic factors of the pulmonary IFD was identified by multivariable analyses.Conclusion Pulmonary was not an absolute contraindication for allo-HSCT,and patients with a history of pulmonary IFD had a higher relapse rate and transplant-related mortality after receiving allo-HSCT.

Objective To study the method of preparation of donor liver in liver transplantation. Methods The methods and skills of donor liver preparation and the anomaly artery reconstruction of graft in 64 cases of orthotopic liver transplantation (OLT) were retrospectively analyzed. Results All allografts had preparation and were suitable for clinical transplantation. Thirteen cases with hepatic artery anatomy variation were found. Among the 13 cases, 5 cases were reconstructed. Splenic artery (3/5) and gastro-duodenal artery (2/5) were typically used for anastomosis of the variant hepatic arteries. No complications resulted from donor liver preparation. Conclusions Correct preparation of the donor hepatic artery and biliary tracts, can decrease the incidence of hepatic artery and biliary tract complications after liver transplantation, and is the key to ensure successful donor liver preparation.

The quality and function of the donor liver is one of the main factors which influence the success and prognosis of liver transplantation.At present,the major source of donor liver for transplantation is Donor of Brain Death (DBD) all over the world,which has unstable circulation.When the brain death occurs,a series of serious physiological function changes will be induced within a few minutes and affect the hemodynamics and homeostasis of the body,which will greatly influence the liver quality and function,and consequently the success and prognosis of liver transplantation,finally leading to the loss of potential donor organs.Therefore,it is necessary to identify the physiological function changes induced by the process of brain death and its injury to liver and take immediate proper protective measures,which can effectively reduce the organ injury,improve liver function and enhance the organ utilization and liver transplantation success.In this paper,the changes and maintenance measures of liver physiological function in DBD will be reviewed.

China donation after citizens' death (CDCD) has already entered a new historical era,and the donation after brain death plus cardiac death (DBCD),which refers to the transition from brain death to cardiac death,is most widely used.The various pathological and physiological changes have an influence on donor organs,which could not be ignored.So the research on the effects of donor brain death for CDCD liver transplantation will be of great significance.Here we discussed the CDCD initiation and its classification,and the necessity and application of establishing a donation after brain death (DBD) animal model to clarify the relationship between DBD and CDCD liver transplantation and thus to enlighten future studies.

Objective To explore the relationship between immune functions of patients with acute leukemia (AL) and invasive fungat infection (IFI). Methods T lymphocyte subpopulations and natural killer (NK) cells in 61 AL patients complicated with IFI at first visit, AL remission, the time of IFI onset and 4 weeks after antifungal treatment were measured by flow cytometry. Meanwhile,levels of IgG, IgM and IgA were detected by immunoturbidimetry. The statistical analysis was done using ANOVA, t test and chi-square test. Results CD3+ , CD3+ CD4+ , CD8+ CD28+ T lymphocyte as well as CD4+/CD8+ ratio at the time of IFI onset in AL patients were all lower than those at first visit, AL remission and 4 weeks after antifungal treatment (F= 25.6,26.6,13. 1,167.9; all P＜0.05), while CD8+ CD28- T lymphocyte were higher than those at first visit, AL remission and 4 weeks after antifungal treatment (F= 220.2,P＜0.01). CD3+ , CD3+ CD4+ and CD4 + /CD8+ ratio of patients who responded effectively to antifungal treatment were all higher than those of non-responders (t=3.75,8. 61,3.17; all P＜0.05). The serum levels of IgG, Igm and IgA at first visit, ALremission, the time of IFI onset and 4 weeks after treatment were similar (F=0.78,0.72,0.81; all P ＞0.05). The effect rate of antifungal therapy in AL remission group was higher than that in nonremission group (87% vs 53%,x2 = 7.62, P＜0.05). Conclusions The cellular immune functions are impaired severely in AL patients complicated with IFI, while the levels of IgG, IgM and IgA are similar during IFI. Therefore, the efficacy of antifungal therapy may partly depend on the recovery of cellular immune functions and remission of AL.

Objective:To identify the polymorphisms of cytochrome P450 3A5 gene (CYP3A5) and multidrug resistance gene 1 (MDR-1) and their distributions in Hans renal transplant recipients in Hunan province, we analyzed the difference of the gene polymorphisms and distributions between Hunan province and 11 other provinces of China.
Methods:We collected 598 Hans renal transplant recipients who had operation or follow-up examination in 3rd Xiangya Hospital from Hunan province. We examined the gene polymorphisms of CYP3A5 and MDR-1 and compared their distributions with the data from 11 other provinces of China by chi-square test.
Results:hTere were CYP3A5*1/*1 genotype in 58 cases (9.7%), CYP3A5*1/*3 genotype in 251 cases (42.0%), CYP3A5*3/*3 genotype in 289 cases (48.3%);MDR-1 3435CC genotype in 238 cases (39.8%), MDR-1 3435CT genotype in 263 cases (44.0%), MDR-1 3435TT genotype in 97 cases (16.2%). Frequency of CYP3A5*1/*1 and*1/*3 genotypes of Hunan province was higher than the that from the 11 other provinces of China and the frequency of mutator*3 was lower. Frequency of MDR-1 3435CC and 3435CT genotypes of Hunan province was higher and the frequency of mutator T was lower than that from the 11 other provinces of China.
Conclusions:There were significant difference in gene polymorphisms and distributions of CYP3A5 and MDR-1 between Hunan province and the 11 other provinces of China. It may be a guideline for us to use calcineurin inhibitor drugs in the early stage atfer renal transplantation.

Objective To deepen the understanding of chronic disseminated candidiasis(CDC)in patients with acute leukemia(AL).Methods CDC was investigated in 119 AL patients who received induction chemotherapy from August 2004 to May 2005.Clinical manifestations,laboratory tests,imaging modalities,diagnosis and treatment were investigated retrospectively.Results Three patients(2.5%) were identified to be suffering from CDC.All the three patients had an absolute neutrophil count (ANC)＜0.5 × 109/L for more than 15 days.Two patients had normal ANC when they were diagnosed to have CDC.The common manifestations in these three patients were persistent fever,splenohepatomegalia and percussion pain in hepatic region.Meanwhile,2 of them were accompanied with cough,expectoration and dyspnoea.The abnormal laboratory test observed during the course of infection in two of them was increase of alkaline phosphatase.Computed tomography scan showed multiple hypodense lesions in the liver and spleen in all the three patients:two of them showed multiple nodular patchy shadOW$in lungs.Nuclear magnetic resonance imaging showed multiple abnormal signal in liver,spleen and kidneys in one of the patients.Two patients had positive bleed fungal cultures and histologic examination in one of the patients were positive for Candida tropicalis.Two patients received amphotericin B therapy empirically,but it was replaced by amphotericin B colloid dispersion (ABCD) later in one and combined with voficonazole in another because of unresponsiveness to the drug.One patient took a favorable turn after receiving ABCD therapy for 45 d,which was replaced by voriconazole because of the emergence of fever after disconfinuation of ABCD.All the three patients received further chemotherapy smoothly after the diagnosis of CDC.Conclusion The diagnosis of CDC remains difficult.Fungal blood cultares and histologic examination have been considered in many studies as the golden standard for the diagnosis of CDC.Amphotericin B is the cornerstone of treatment in patients with CDC and lipid formulations of amphotericin B can be used in CDC patients who are intolerant of or refractory to conventional amphotericin B.Voriconazole has a favorable response for refrectory/relapse patients and could be used for second line trectment.The development of CDC in patients with acute leukemia does not preclude further chemotherapy.