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.

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 effect of the genotypic analysis of donor from cardiac death donation on the initial dose of Tac for liver transplant recipients and provide individualized administration for the early use of Tac in liver transplantation patients.Method Thirty recipients with a different genotype of CYP3A5 from cardiac death donors were collected from March 2010 to February 2013.The matched recipients were randomly divided into experiment group and control group.There was an adjustment of initial doses of Tac according to the donors' different CYP3A5 genotypes in experiment group but not in control group.Result In experiment and control groups,the average Tac blood concentrations at the 7th day after operation were (7.47 ± 1.83) and (8.68 ± 5.14) ng/mL,and the percent of recipeints reaching the optimal Tac concentrations was 72.2％ and 38.9％,respectively (P＜0.05).In experiment and control groups,22.2％ and 55.6％ recipients needed adjustments of Tac concentrations respectively (P＜0.05).Conclusion Individualized adjustment of Tac initial doses of recipients according to cardiac death donors' different CYP3A5 genotypes was benefit for reaching optimal concentrations as soon as possible and could decrease the rate of rejection,and reduce the side effects of Tac.

Objective To explore the differential proteins between livers of control and brain dead grups,and to provide an experimental basis for the assessment of liver quality in brain dead rabbits.Methods 60 healthy male New Zealand rabbits were divided into two groups.The brain dead group (n=30) contained rabbits 2 hours (B1),6 hours (B2),and 8 hours(B3) after brain death.The sham group (n=30) contained groups of 2 hours (C1),6 hours (C2),and 8 hours (C3).At the end of the relevant experiments,blood samples and liver tissues were collected.The level of ALT and AST were determined by an automatic biochemistry analyzer and the morphologic changes of the livers were detected by HE staining.The differentially expressed proteins were screened and identified by two-dimensional gel electrophoresis,PDQuest software,matrix-assisted laser desorption ionization time of flight mass spectrometry,and the NCBI database.Results In 8 hour brain dead group,the level of ALT increased comparing with 6 h (P＜0.05),but there was no significant statistical difference in the other groups.Under real time observation with the light microscope,the livers of the brain dead groups had increased edema and infiltration of lymphocytes in the portal area,especially in the 8 hour group.However,infiltration of neutrophils also appeared in the 8 hour control group and all groups had no damage in the liver cell.There were 10 kinds of differentially expressed proteins through the two-dimensional gel electrophoresis,mass spectrometry analysis,and database query.One protein of interest was ALDH2,which showed a gradually decreasing expression in the liver when the braid dead time increased.Conclusion Brain death could lead to no damage of liver function and little damage to liver morphology.The identified protein ALDH2 may be related with liver injury after brain death and could be a new indicator in the assessment of liver quality in brain dead rabbits.

Objective To explore the way to establish the brain death model for rabbits and pathophysiological changes before and after brain death.Methods 80 healthy male New Zealand rabbits were divided into brain death group (n =60) and sham operation group (n =20),The 60 brain death rabbits were established by increasing intracranial pressure in a modified,slow,and intermittent way.The sham operation rabbits were only maintained with anesthesia.Results The 56 brain death rabbits were established successfully and maintained for 10 h with the respiration and circulation supports.2 rabbits died due to anesthetic accident,the other 2 died because of improper pressure.The surgical success rate is 93.3％ (56/60).The changes of mean artery pressure (MAP) and heart rate (HR) in brain death group were more significant than in sham operation group:MAP and HR fluctuated and showed the increased tendency.The mean MAP and HR during increasing intracranial pressure were (400.24±18.36) mm Hg (1 mm Hg=0.133 kPa) and (258.00 ± 25.70) beats/min respectively,which was significantly higher than before and after increasing intracranial pressure (P＜0.05).Conclusions The brain death model for rabbits could be established by increasing intracranial pressure in a modified,slow,and intermittent way successfully and maintained 10 h.the MAP and HR before and after brain death showed characteristic changes.The model is helpful to the further observation of organ changes in brain dead state.

Liver transplantation is the most effective treatment for end-stage liver diseases.To expand the donor source,the Ministry of Health (MOH) initiated a new national program called Donation of Citizen's Deceased (DCD) to address the need for organ transplantation in 2010.However,it has been proven that DCD liver transplantation has the poorer graft function in short-and long-term outcome compared to live donor liver transplantation.In order to improve the effect of DCD liver transplantation,the preconditioning of DCD liver,as an effective measure,is gaining more and more attention.This review summarizes the recent research progress on the application of preconditioning in DCD liver transplantation during perioperative period.

With the increasing demand for liver transplantation,some previously abandoned donors,called marginal donor,started to be involved in clinical liver transplantation,which raises higher requirement on the organ preservation methods.Normothermic perfusion is regarded to be superior to the currently adopted hypothermic perfusion,and plays an important role in the organ preservation of marginal donors.This review will summarize the clinical applications of liver normothermic perfusion in transplantation and repair,as well as its roles in basic research.

Hypoxia-inducible factors 1α (HIF-1α) is the key cellular oxygen-sensitive transcription factors that could activate diverse pathways in regulating cellular metabolism,angiogenesis,proliferation and migration,enabling a cell to generate adaptive responses to a low oxygen or hypoxic environment.HIF-1 α has been shown to play an important role in the pathogenesis of multiple liver diseases.This review explores the impact of HIF1α on liver ischemia-reperfusion injury and liver transplantation as well as its mechanism.