Objective To explore the risk factors for chronic gastritis in Yuhang district,Hangzhou.Methods All cases came from the population involved in screening for upper gastrointestinal tract diseases in 2002 and were diagnosed by histopathology.The controls were chosen in residents of the same village who had no stomach disease history and dyspeptic symptoms.All subjects were investigated with a questionnaire by interviewers on their lifestyle and health condition.Results The odds ratios of smoking,the family history of chronic gastritis,drinking,sleep quality,oral debris,regular dining,drinking tea and the intake of beans & bean products were 3.012,2.343,1.438,1.384,1.283,0.418,0.603 and 0.809,respectively.Foods taste also took significant effect on chronic gastritis.The odds ratios of sour foods,spicy foods,salty foods and sweet foods were 2.72,2.33,2.22 and 2.06,respectively.Conclusions The risk factors for chronic gastritis were smoking,family history of chronic gastritis,heavy drinking,sleep quality,oral debris,foods flavor.While regularly dining,properly drinking tea and intake of beans and bean products were protective factors.

20 yrs in Yuhang is high.We should further screen for MS among adults older than 40 yrs and make some effective measures against MS in the high-risk population.

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.

Patients who suffer from HBV-related endstage liver disease are the majority of liver transplantation (LT) recipients,and hence HBV recurrence post-LT is the key for the treatment success.HBIG was no longer solely used in clinical practice because of high cost and unavoidable drug-resistance.Nowadays,the standard prophylaxis regimen is the combination of low-dose HBIG and nucleoside analogues (NAs).Recently,the necessity of HBIG usage has been often questioned,and the novel prophylaxis of HBIG-withdrawn and HBIG-free regimen have been carried out in several transplant centers with encouraging results.In this review,we summarized the application of HBIG in the prophylaxis of HBV recurrence,and then evaluated the prospect of the prophylaxis of HBIG-withdrawn and HBIG-free regimen.

Chinese donation after citizen's death (CDCD) is an important way to solve the donor shortage problem,but if we can't effectively control warm ischemia time of CDCD donor,it's easy to cause grafts primary nonfunction,early grafts dysfunction and biliary complications.Nowadays,with the development of surgical techniques,the definition of warm ischemia continues has been continuously updated.The understanding on different definitions may lay the foundation for improving the survival rate of liver and kidney and effectively protect liver and kidney function after transplantation.This paper overviewed the significance of different definitions of warm ischemia and its effect on liver and renal function,which could provide a reference for further experimental study and clinical practice.

Liver transplantation has become the most effective treatment option for end-stage liver diseases.The liver donation after cardiac death (DCD) had been increasingly used in clinical practice.Nevertheless,the DCD donated livers inevitably exposed to long-term ischemia and hypoxia makes the implanted organs with decreased function and more postoperative complications.Different from the conventional static cold storage,machine perfusion (MP) can be continuously used in vitro liver perfusion,which could simulate the in vivo liver status.Through the observation of ischemia injury status,we could evaluate the quality of donated liver,and thus reduce ischemia related complications.This review provides an overview and evaluation on the markers that have been investigated for the assessment of graft quality and viability testing during different types of MP.

Objective To explore the application of steatosis liver donor (SLD) in piggyback liver transplantation (PBLT). Methods Sixty-four cases of SLD were subjected to PBLT and classified into light steatosis liver (S1,22 cases),moderate steatosis liver (S2,25 cases),and severe steatosis liver (S3,17 cases) groups.Eighty cases of non fatty liver selected randomly in the same period served as controls. The liver and renal function at the day of surgery,postoperative liver function recovery,complications one month after surgery,and the death of recipients were recorded.Results There was no significant difference in the liver and renal function between steatosis liver groups and control group at the day of surgery (P＞0.05). At 21st day after surgery,the liver function of 95％ recipients in control group returned to the normal level,and the liver function recovery rate in S1,S2 and S3 groups was 90.9％,80.0％,and 70.6％ respectively.Graft primary nonfunction occurred in 2 cases (11.8％) of S3 group. The incidence of complications such as bleeding,infection,hepatic artery thrombosis,ascites,sepsis in S1,S2 and S3 groups was higher than in control group (P＜0.05).One year after operation,there were two deaths in control group,one in S1 group,one in S2 group,and 5 in S3 group,respectively.Conclusion SLD can be used for transplantation,but for the transplantation with severe steatosis liver,it should be carried out carefully.

Objective To investigate the repair function of extracorporeal membrane oxygenation (ECMO) in vivo for the liver after cardiac death with warm ischemia injury for 30 min from cardiac death swinc.Method Ten landraces,30 to 40 kg,randomized to experimental group and control group,were used to make 30-min cardiac death models through clamping trachea after deep anesthesia.An intravenous cannula was placed through right iliac arteries and veins,and connected to ECMO extracorporeal circulation pipes in experimental group.The balloon catheter was placed to diaphragm plane through left femoral artery.The ECMO was performed to infuse abdominal organs,and pH and electrolyte were adjusted.The circulation flow rate,intraperitoneal organ perfusion pressure,venous blood gas,electrolyte,transaminase,and bile product,etc.were monitored and recorded.The livers of control group were retrieved after 30-min cardiac arrest and stored in cold UW for 4 h.Pathological tissue was sliced and stained by HE.Result After 30-min cardiac arrest,the liver showed obvious congestion appearance; pathologically,there were hepatic sinus expansion,blood cells clog,and erythrocyte aggregation.Circulating blood gas analysis revealed severe acidosis.After the ECMO recirculation started,circulation flow rate maintained to 1 L/min,the liver gradually restored bright red,pathological biopsy showed that hepatic sinus expansion disappeared,and clogged blood cells dispelled.AST was markedly increased to (226.0 ± 28.0) U/L after 30-min cardiac arrest and reduced to (150.0 ± 30.0) U/L 4 h after the ECMO recirculation.Average bile production was 7.75 ml/h.Conclusion ECMO recirculation in vivo can repair the injured livers from cardiac death donor with 30-min cardiac arrest.

Vascular complications after liver transplantation can seriously threaten the survival of patients.In the preoperative assessment and postoperative monitoring of patients' vascular conditions,although the digital subtraction angiography (DSA) is the golden standard for vascular lesion diagnosis,but not the first choice due to traumatic lesions.In some clinical circumstances,DSA can only be used when Doppler ultrasound,spiral CT,and MRI are not applicable,and in most cases DSA is used for treatment rather than diagnosis.This article reviewed the current interventional treatment of vascular complications to stress the important role of DSA in diagnosis and treatment of related complications after liver transplantation.

Since Shaw et al,first reported the first case successfully treated by veno-venous bypass (VVB),there has been great controversy on the routine application of VVB during conventional liver transplantation and piggyback liver transplantation in recent decades.With the improvements on the surgical skills,surgical techniques and anesthesiology,only a small portion of patients have the indications for VVB in liver transplantation routinely.This article reviews the current publications in this topic,which may provide new insight into the liver transplantation in clinical practice.