Objective: To discuss the predictive value of liver and spleen stiffness detected by transientelasticity imaging technology on esophageal varices bleeding (EVB) of patients with hepatitis B cirrhosis. Methods: 100 patients with hepatitis B cirrhosis (18 cases were no EV, 30 cases were mild EV, 28 cases were moderate EV and 24 cases were severe EV) were selected. In these patients, 52 cases were no bleeding, 28 cases were single hemorrhage and 20 cases were multiple hemorrhage. As the Child-Pugh grading, there were 34 cases were A grade, 30 cases were B grade and 36 cases were C grade. All of the liver and spleen stiffness of these patients were detected by instantaneous elasticity imaging technology, and to compare different Child-Pugh grading of patients, different EV degree, and liver and spleen stiffness on different EVB situation. Results: The liver and spleen stiffness of patients in Child-Pugh C stage were significantly higher than that in Child-Pugh A stage and B stage, respectively (t=21.13, t=12.04, t=11.24, t=9.741; P<0.05). With the aggravating of the severe degree of EV, the liver and spleen stiffness were significant increasing, and there were significant differences between different EV degree patients for liver stiffness and spleen stiffness, respectively (F=7.494, F=8.129, P<0.05). The liver and spleen stiffness of multiple hemorrhage group were significant higher than that of no-hemorrhage group and single hemorrhage group, respectively (t=13.13, t=18.14, t=12.15, t=17.46; P<0.05). Conclusion: By using instantaneous elasticity imaging technology to detect liver and spleen stiffness can predict EVB of patient with hepatitis B cirrhosis and it has higher clinical value, therefore, it is a sophisticated noninvasive examination with simple operation and better repeatability.

Correspondence analysis was used for determining the important factors from the six factors influencing analysis of cephalosporin in reversed phase-high performance liquid chromatography (RP-HPLC). Experiments were planed by U7（76）, then the synthetical correspondence between a series of optimizations and the factors was calculated. Result indicated that that proportion of organic solvent, pH and concentration of buffer were three most important factors. It showed that the correspondence analysis was a better method to determining the important factors in RP-HPLC

OBJECTIVETo perform an analysis and comparative study of the clinical data for patients with cirrhosis and type 1 hepatorenal syndrome (HRS) who received treatment with terlipressin using high-or low-dose regimens.

METHODSA total of 56 patients with cirrhosis and type 1 HRS who presented for treatment to the Wuhan Medical Treatment Center and Taizhou Central Hospital between March 2010 and October 2012 were enrolled in the study. The patients were randomly assigned to the terlipressin treatment groups for receipt of the high-dose regimen (1 mg/6-8 h;n =27) or low-dose regimen (1 mg/12 h;n =29). All patients were assessed for 24-hour urine volume, serum blood urea nitrogen (BUN) and creatinine (Cr) levels, therapeutic effect and prognosis, and adverse reactions. Measurements were made before and after the treatment, and on post-treatment days 3, 7 and 14. Inter-group differences were assessed by statistical analyses.

RESULTSThe high-dose group showed an increase in 24-hour urine volumes from post-treatment day 3 (1112 ± 262 ml) to day 7 (1938 ± 312 ml), and the volumes on both days were significantly better than those of the low-dose group (day 3:986 ± 162 ml and day 7:1760 ± 300 ml, t =1.500, 1.830, P=0.038, 0.041). The high-dose group also showed a significantly better decreases in serum BUN levels (35.1 ± 8.6 to 30.2 ± 6.3 mmol/L vs.low-dose group: 43.2 ± 10.9 to 35.1 ± 7.6 mmol/L, t =3.200, 5.901, P =0.043, 0.047) and in serum Cr values (219.0 ± 35.1 to 128.2 ± 41.6 vs.low-dose group: 230.3 ± 82.1 to 151.5 ± 38.7, t =2.997, 5.765, P =0.036, 0.046).On post-treatment day 14 the 24-hour urine volume of patients in the high-dose group decreased (to 720+/-136 ml), but the difference from that of the low-dose group was not significant (vs. 620 ± 164 ml, t =1.855, P =0.069). The serum BUN level increased in the high-dose group (to 54.4 ± 15.0 mmol/L), which was statistically different from that in the low-dose group (vs .57.7 ± 17.3 mmol/L, t=5.166, P =0.022); the same trend was seen for the serum Cr value (397.8 ± 127.4 mumol/L vs. 480.3 ± 179.8 mumol/L, t =5.638, P =0.047). No statistically significant differences were observed for the groups in regard to significant efficiency, efficiency or 2-week survival rate (x2 =2.314, 1.767, 0.678, P =0.128, 0.128, 0.410 respectively), but the total efficiency was significantly different between the two groups (x² =5.793, P =0.016). In addition, no serious adverse reactions (including precordial pain, myocardial infarction or intestinal necrosis) were observed in either group.

CONCLUSIONTerlipressin therapy at both high and low dosages can lead to significant beneficial effects within as little as 3 days after the treatment; however, the high-dose appears to produce a better lasting efficacy (at day 14 after the treatment). The difference in doses does not appear to markedly affect significant efficiency, efficiency, nor the 2-week survival rate.

Adolescent ; Adult ; Aged ; Dose-Response Relationship, Drug ; Female ; Hepatorenal Syndrome ; drug therapy ; etiology ; Humans ; Liver Cirrhosis ; complications ; drug therapy ; Lypressin ; administration & dosage ; analogs & derivatives ; therapeutic use ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective:To investigate the pahtogengesis and pathology of delayed xenograft rejection (DXR) after pig to rhesus monkey heart xenotransplantation.Methods:Heterotopic xenogeneic heart transplantation in the abdominal cavity was performed using piglet as donors.4 monkeys were used as recipients.Complete complement depletion was achieve in the recipients treated with repetitive doses of a high activity cobra venom factor (Y CVF).The recipients were immunosuppressed with a combination of cyclosporine A,cyclophosphamide and steroids.Sera were analyzed for C3,C4 levels and complement activity and anti pig endotheliocyte xenoantibody.The graft were examined histopathologically and immunohistochemically for C3,C4,C5b 9,IgM,IgG,necrosis factor alpha (TNF alpha),intercellular adhesion molecule 1 (ICAM 1),CD57 (NK cells),CD68 (macrophages),CD4 and CD8.Results:The xenografts survived 8,10,13,13 days respectively and all grafts occoured DXR.Venular thrombosis was outstanding feature within DXR xenografts,complicated with interstitial edma,local hemorrhage and myocardial necrosis,with mild to moderate cellular infiltration.The serum C3 levels and complement activity almost decreased to 0 from the day of transplantation due to Y CVF,the C4 level began to decrease 2 4 days before the cardic xenografts losing their function.The anti pig endotheliocyte xenoantibody also decreased after transplantation,and slightly increased during DXR,all rejected xenografts showed C3,C4,C5b 9,IgG and IgM deposits in different degree.Large numbers of macrophages (50% of total leukocytes) were found infiltrating the entire xenograft,a few natural killer cells (8%～10%),some of CD4+T cells (15%) and CD8+T cells (25%) were detcted also,up regulation of ICAM 1 on the graft endothelial cells and TNF alpha in the interstitial were demonstrated in the rejected heart.Conclusion:Both Humor and cell mediated immunologic reaction may play an important role in pahtogengesis of DXR. [