Classical piggyback liver transplantation (CPBLT) is an advanced technique based on standard orthotopic liver transplantation (SOLT),which has more advantages compared to the SOLT.However,there are still some problems with CPBLT to be solved,such as complicated surgical procedures,postoperative hepatic venous outflow obstruction and thrombosis.Recently,in order to solve these problems,modifications have been made,being named ameliorated piggyback liver transplantation (APBLT).The APBLT solved above-mentioned problems,and expanded the application of PBLT.Therefore,this article describes the technique of these ameliorations,and discusses their individual characteristics.

Objective To discuss role of double intramedullary nail in the treatment of floating knee injuries under minimally invasive surgery.Methods From July 2006 to July 2010,23 patients with floating knee injuries ( Fraser type Ⅰ ) were fixed with tibial intramedullary nail and femoral retrograde intramedullary nail assisted by minimally invasive method such as portable bracket,AO large distractor and Schanz screw.The postoperative continuous passive motion (CPM) was performed for functional exercises of the knee.Results The operation lasted for average 95 minutes ( range,70-160 minutes),with average blood loss of 260 ml ( range,100-600 ml).All patients were followed up for average 11 months (range,7-35 months).According to assessment systems of Karlstrom and Olerud,the clinical results were excellent in 17 patients,good in 4 and fair in 2,with excellence rate of 91％.Conclusions Combined with the methods of portable bracket of lower limb,AO large distractor and Schanz screw,the intramedullary nail is much convenient and minimally invasive for the floating knee injuries.

Objective To screen out the bioactive sulfate saccharides interacted with granulocyte colony-stimulating factor (G-CSF) and provide some scientific data on their pharmacology. Methods The interactions between G-CSF and 15 sulfate saccharides with various chain lengths and extent of sulfation were studied by capillary electrophoresis. Furthermore, the effects of these G-CSF binding saccharides on the proliferation and differentiation of leukemia cell line and NFS-60 were also investigated. Results Except for the hepatosaccharide, degradable carrageenan, Dextran sulfate (DexS) with a low molecular mass the nonsulfated sancharide and alkaline chitosan oligosaccharide, the rest of saccharides had interact with G-CSF.DexS500, λ carrageenan, ι carrageenan, κ carrageenan and low molecular weight heparin-1(LMWH-1)with anticoagulant activity could inhibit the NFS-60 growth. Compared with the absorbency of the control group (100.00±3.00) after these saccharides interacted with the NPS-60 cells, their relative absorbencies were 31.33±2.08,37.67±2.08,45.00±1.20,43.00±2.65 and 74.67±1.52, respectively. Their differences had a statistical significance(t=27.94,26.71,26.42,26.61,10.54,P<0.01). The morphological analytic results showed that the LMWH and lambda carrageenan as well as DexS with a molecular mass of 500 000 induce effectively promyclocyte to transit metamyelocyte. Flow cytometry results showed enhanced expressions of CD11b, CD18 and CD45 after treatment with the LMWH, lambda carrageenan and DexS500,respectively. Cell cycle analysis indicated that the S phase population decreased after treatment with these saccharides. Conclusions Capillary electrophoresis is an effective medicine-screening technique that is used to screen some of these saccharides which could bind to G-CSF. And it is found that the interactions are correlated with the chain length, the extent and the position of sulfation of these saccharides.

This paper summarizes 6 cases with multi-fracture of dental instruments in tooth root canal treated in our hospital from June 2011 to July 2013,the creation of a straight pathway,establishment of collateral bypass ,ultrasonic vibration,prevention of root perforation and secondary instrument fracture were emphasized,a reference in dealing with similar situations was provided.

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.

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.

Liver transplantation,a unique effective treatment for end-stage liver diseases,has already been applied in clinical practice for more than half a century.But the shortage of donor liver source has been the bottleneck limiting its development.How to determine the tiny minority donor liver quality to guarantee the prognosis of transplant patients becomes a hot focus for current research.Brain death causes patho-physiological changes of body organs,including liver.How to carry out related pathological and serologic tests to determine the safety of the donor liver is a very important issue.In this paper,the articles published in recent years were overviewed and analyzed to summarize the evaluation index of donating organ quality.We hope this paper may benefit the treatment through ensuring an effective evaluation on the donor liver in the future.

Objective:The aim of this study was to investigate the prognostic value of vitamin B12 as the non-invasive biomarker to predict long-term rebleeding rate in cirrhotic patients with esophagogastric varices.Methods:From Dec 1, 2016 to Dec 31, 2017, cirrhotic patients with esophagogastric varices who had been admitted to Zhongshan Hospital affiliated to Fudan University were enrolled. All these patients received endoscopic treatment to prevent variceal rebleeding. The serum vitamin B12 and folic acid levels were measured in all of them. The receiver operating characteristic (ROC) analysis, Kaplan-Meier analysis, univariate and multivariate cox regression analysis were conducted to explore the value of vitamin B12 in predicting 3-year variceal rebleeding in cirrhotic patients with esophagogastric varices after endoscopic treatment.Results:115 patients were included. The ROC curve analysis indicated that the optimal cutoff value of vitamin B12 for 3-year variceal rebleeding was 567.25 pg/ml. According to the cut-off value, the patients were divided into high-level vitamin B12 group ( n=49) and low-level vitamin B12 group ( n=66). Compared with the low vitamin B12 group, the high vitamin B12 group had lower albumin level, less male (63.3% vs 80.3%), and higher 3-year rebleeding rate ( P<0.05). Cox analysis showed that vitamin B12 and platelet were independent prognostic factors for 3-year rebleeding in patients with variceal bleeding. Conclusions:Elevated peripheral blood vitamin B12 predicts a higher risk of long-term rebleeding in patients with liver cirrhosis and esophagogastric varices.

OBJECTIVE To find the infla mmation bio markers induced by coke oven e missions (COE),we investigated the changes of T helper 17 (Th17 )cytokines in hu man bronchial epithelial (16HBE)cells.METHODS 16HBE cells were exposed to organic extracts of COE collected fro m co-king plant at the concentrations of 5,10 and 20 mg·L -1 for 24 h or 5 d to establish short-term and long-term cell models,respectively.Cell viability was measured by MTT assay and infla mmatory da mage was assessed by lactate dehydrogenase assay (LDH).The cytokines in culture supernatant sa mples was detected by co mmercial hu man Th17 cytokine panel kit.RESULTS COE Can induce infla mmation in COE 20 mg·L -1 group and no expression on IL-17 F and IL-1 β.The concentration of IL-10 was 1 .25 ± 0.54,1 .39 ±0.13 and (1 .90 ±0.73)pg·mL -1 in COE 5,10 and 20 mg·L -1 group showing good con-centration-effect relationship (r=0.98,P <0.05 ).IL-23 expression was found only higher at 10 and 20 mg·L -1 and the concentrations were 3.38 ±3.90 and (1 .74 ±2.00 )pg·mL -1 ,respectively.In 16HBE cells treated by COE for 5 d,elevated expression of IL-17A was found in COE 5 and 10 mg·L -1 group,and there was statistically sigificant difference between COE 10 mg·L -1 and DMSO group (P<0.05).Elevated concentration of IL-17F of 10.2 ±1 1 .78 and (6.79 ±7.84)pg·mL -1 was found in COE 5 and 10 mg·L -1 group.The concentration of IL-10 was 1 .71 ±0.02,1 .49 ±0.25 and (2.82 ± 0.33)pg·mL -1 in COE 5,10 and 20 mg·L -1 group,respectively.We found increased IL-1 βexpression with concentration of 2.72 ±0.62,2.25 ±0.33 and (0.93 ±0.21 )pg·mL -1 in COE 5,10 and 20 mg·L -1 group with negative dose-response relationship.We also found more elevated TNF-αlevels in the 5 d than in the 24 h model with no COE specific relationship.CONCLUSION COE induces expression changes of Th17 cytokines profile in 16HBE cells,including IL-23 and IL-1 βfor early and long-term infla mmation,respectively.IL-10 may be a candidate marker for population study on COE induced infla mmatory injury.

A high throughput screening method based on QuEChERS purification and stable isotope dilution-liquid chromatography coupled to high resolution time-of-flight mass spectrometry was developed for the simultaneous rapid determination of 86 kinds of glucocorticoids (GCs) in cosmetics.The analytes were extracted by acetonitrile, and then the extracts were purified using an improved QuEChERS method.The chromatographic separation was performed on a novel multiple chromatographic retention mechanisms column of Poroshell 120 PFP (100 mm × 2.1 mm, 2.7 μm) with gradient elution using 0.2% (V/V) acetic acid and acetonitrile as mobile phase.The accurate mass database of parent ions and mass spectra library of fragment ions of 86 GCs were established under positive ionization mode with electrospray ionization source.Based on the method described above, the qualitative identifications of the 86 GCs were accomplished without the contrast of standard substances.The results demonstrated that the linear range of this method was from 2 μg/L to 200 μg/L with good correlation coefficients of R2>0.99.The average recoveries of the 86 GCs ranged from 66.2% to 112.8%, and the relative standard deviation (RSDs) was 4.6%-13.9% at three different spiked levels.The limit of detection (LOD) and quantification (LOQ) were 0.006-0.015 mg/kg and 0.02-0.05 mg/kg, respectively.The method is simple, efficient, reliable and accurate, and is suitable for high throughput screening of 86 GCs added illegally in cosmetics.