Objective To summarize the clinical experience in 58 cases of split liver transplantation (SLT).Methods A retrospective analysis was conducted on 58 cases of SLT during June 2006 to January 2011.There were 13 cases performed at the first phase (2006.6-2008.12),and 45 cases at the second phase (2009.1 2011.1). The survival rate of patients,recovery of liver function,re-transplantation rate,incidence of vascular complications and biliary complications were observed,and the causes of death were analyzed.Results The median follow-up time of all the patients was 11.4 months (0-48 months).The 1- and 2-year cumulative survival rate was 77.4％ and 68.3％ respectively,re-transplantation rate was 6.9％,the incidence of vessel complications was 13.8％,and biliary complication rate was 32.1％.Fifteen cases died,including 8 deaths which were related to surgical complications.Conclusion With the donor split technology improvements and refinements in partial liver transplantation, the survival rate of SLT recipients is significantly increased,but selection of recipients is still the key factor that impacts survival rate of recipients receiving SLT.SLT can expand the resource of liver donors,and adequate selection of recipients can obtain better results.

ObjectiveTo determine the incidence,risk factors and measures to prevent biliary complications after ex vivo split liver transplantation (SLT).Method33 ex vivo SLT were performed between June 2006 and September 2010.One patient was excluded from this analysis because of early postoperative death.There were 18 males and 14 females,with a mean age of 33.4 yr (range,6 mo to 65 yr).Biliary reconstruction was carried out by duct-to-duct anastomosis in 20 and Roux-en-Y hepaticojejunostomy in 12 patients.Biliary complication was defined as either bile leak or bile duct stricture which required surgery,interventional radiology or endoscopic treatment.These biliary complications were confirmed by percutaneous tranahepatic cholangiography,endoscopic retrograde cholangiopancreatography,or T-tube cholangiography.ResultThe median follow-up was 13.5 months (3 to 54 mo).Twelve (37.5 ％ ) biliary complications occurred in 11 patients:hepatic parenchymal leak from the transeeted liver surface in 9.3％ (3/32),anastomotic leaks in 12.5％ (4/32),anastomotic strictures in 3.1％ (1/32),stump leaks from the left bile duct in 3.1 ％ (1/32),and ischemic biliary strictures in 9.3％ (3/32).Two patients died of abdominal sepsis in the 8 patients who had biliary leaks.Univariate analysis showed that graft type and biliary reconstruction were not significant risk factors for biliary leaks.ConclusionCompared with whole liver transplantation and living donor liver transplantation,biliary complications of SLT are more common.Prevention and treatment of biliary complications are important factors to improve the result of SLT.

OBJECTIVETo develop a human ovarian carcinoma SKOV3 model in severe combined immunodeficiency (SCID) mouse and to study its biologic characteristics.

METHODSHuman ovarian carcinoma SKOV3 cells were injected intraperitoneally into female SCID mouse to establish a transplantation model of human ovarian carcinoma. The biological characteristics, metastasis and morphology of transplanted tumors were studied.

RESULTAll tumors grew progressively with no sign of regression. The tumor cells spread around the peritoneal cavity and mainly on the diaphragm, mesentery, peritoneum and around the liver, which was confirmed by histopathology. The morphology, growth pattern and CA125 secretion of primary culture of transplanted cells remained as same as those of ovarian carcinoma cell line SKOV3.

CONCLUSIONAn intraperitoneal transplantation model of human ovarian carcinoma SKOV3 in SCID mice has been developed successfully, which can simulate the biological behavior of peritoneal metastasis of human ovarian carcinoma.

Animals ; Disease Models, Animal ; Female ; Humans ; Mice ; Mice, SCID ; Neoplasm Transplantation ; Ovarian Neoplasms ; pathology ; ultrastructure ; Peritoneal Neoplasms ; secondary ; Transplantation, Heterologous

Objective To explore the distribution of water with high level arsenic and prevalence of arsenism along Huai'he River and the surrounding area of Hong'ze lake in Huai'an of Jiangsu. Methods Wate rsamples were collected and tested in 2008 from 18 villages of 6 towns according to history data in 3 counties like Xuyi,Jinhu and Hongze. Samples having arsenic level higher than 0.05 mg/L were investigated by epidemiological method and the patients were diagnosed by Standard of Diagnosis for Endemic Arsenism. Results All 5199 water samples were determined,and 260 water samples were exceeding the national drinking water quality level (0.05 mg/L) in 3 counties,the rates of exceeding diagnosis were 5.6%(247/4454),0.7%(4/597),6.0%(9/148) respectively. Total detected rate of endemic arsenic disease was 5.94%(128/2155). The detected rates of age group of 0 ～ ,20 ～,30 ～ ,40 ～ ,50 ～ ,60 ～ ,70 ～ ,80 ～ were 2.86%(1/35),2.11%(2/95),1.26%(3/239),3.10%(16/516),5.53% (32/579),10.07%(41/407),11.84%(27/228),10.71%(6/56) respectively. The detected rate of male (9.10%,78/857) was higher than that of female(3.85%,50/1298,χ~2 = 25.46,P < 0.01). Conclusions Huai'he River and the surrounding areas of Hong'ze lake like Xuyi,Jinhu and Hongze are identified existing endemic arsenic disease area. The prevention of arsenism should be strengthened in these areas.

BACKGROUNDEstrogen might play an important role in type 2 diabetes mellitus pathogenesis. A number of polymorphisms have been reported in the estrogen receptor alpha (ERalpha) gene (also named ESR1), including the XbaI and PvuII restriction enzyme polymorphisms of ESR1, which may be involved in disease pathogenesis. The aim of this study was to determine whether ERX gene polymorphisms are associated with type 2 diabetes mellitus and serum lipid level.

METHODSTwo hundred and ninety-nine patients with type 2 diabetes mellitus were compared with three hundred and forty-one health controls of Guangzhou in China, both were male and postmenopausal female residents at 51 - 70 years. ESR1 genotyping was performed using polymerase chain reaction (PCR) and PvuII and XbaI restriction fragment length polymorphism (PCR-RFLP) analysis.

RESULTSESR1 allelic frequencies of P, p and X, x alleles were 0.408, 0.592; 0.360, 0.640 in the type 2 diabetes mellitus group and 0.318, 0.682; 0.328, 0.672 in the control group, respectively. In case-control study, there was significant difference in PvuII, but not XbaI, allele frequency between the type 2 diabetes mellitus and control groups (P = 0.001 and P = 0.122). When the group was separated into men and women, the difference was significant in women (P < 0.001) but not in men (P = 0.854) with the PvuII genotype, and the effect of PvuII variant on the development of type 2 diabetes mellitus was improved with aging. In addition, PvuII genotype was associated with blood glucose [fasting blood glucose (FBG), postprandial blood glucose (PBG)] and serum lipid [total cholesterol (TC) and low density lipoprotein (LDL)-c] concentration in healthy women.

CONCLUSIONSPvuII polymorphism of ESR1 increases susceptibility to type 2 diabetes mellitus in Chinese Guangzhou women. ESR1 variants may also impact serum lipid metabolism, which might provide a mechanism connecting ESR1 to type 2 diabetes.

Aged ; Blood Glucose ; analysis ; Cholesterol, LDL ; blood ; Diabetes Mellitus, Type 2 ; blood ; genetics ; Estrogen Receptor alpha ; genetics ; Female ; Genotype ; Humans ; Lipids ; blood ; Logistic Models ; Middle Aged ; Polymorphism, Genetic

Whole-cell patch clamp and cell volume measurement techniques were used to investigate the ATP-activated chloride current and the ATP effect on cell volume in nasopharyngeal carcinoma cells. Extracellular application of ATP in micromolar concentrations activated a current with the properties of modest outward rectification and negligible time-dependent inactivation in a dose-dependent manner. The current reversed at a potential [(-0.05+/-0.03) mV] close to the Cl- equilibrium potential (-0.9 mV). Substitution of Cl- with gluconate in the extracellular solution decreased the ATP-activated current and shifted the reversal potential positively. NPPB, one of the chloride channel blockers, inhibited the current by (81.03+/-9.36)%. The current was also depressed by the P2Y purinoceptor antagonist, reactive blue 2, by (67.39+/-5.06)%. ATP (50 micromol/L) decreased the cell volume under the isotonic condition. Depletion of extracellular and intracellular Cl- abolished the ATP effect on cell volume. The results suggest that extracellular ATP of micromolar scales can induce a chloride current associated with cell volume regulation by activation of chloride channel through binding to purinoceptor P2Y.
Adenosine Triphosphate ; physiology ; Cell Size ; drug effects ; Chloride Channels ; antagonists & inhibitors ; metabolism ; physiology ; Humans ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Nitrobenzoates ; pharmacology ; Patch-Clamp Techniques ; Tumor Cells, Cultured

The transwell chamber migration assay and the patch-clamp technique were used to investigate the volume-activated Cl(-) current (I(Cl.vol)) in migrated nasopharyngeal carcinoma cells (CNE-2Z). 47% hypotonic solution activated a ICl.vol in the migrated CNE-2Z cells. Compared with the control cells (non-migrated), the properties of this current and the sensitivity to Cl(-) channel blockers were changed. The current density in migrated CNE-2Z cells was higher than that in non-migrated cells. The current was almost completely inhibited by extracellular application of adenosine-5'-triphosphate (ATP, 10 mmol/L), 5-nitro-2-3-phenylpropylamino benzoic acid (NPPB, 100 mmol/L) and tamoxifen (30 mmol/L) in all voltage steps applied. The inhibition of NPPB and tamoxifen on the current was stronger in migrated cells than that in non-migrated cells. The permeability sequence of the four anions was Br(-)>Cl(-)> I (-)>Gluconate. The sequence was different from that of the non-migrated cells (I(-)> Br(-)> Cl(-)> Gluconate). The results suggest that volume-activated chloride channels may be involved in the CNE-2Z cell migration.
Carcinoma ; drug therapy ; metabolism ; pathology ; Cell Cycle ; drug effects ; physiology ; Cell Division ; drug effects ; Cell Movement ; drug effects ; Cell Size ; drug effects ; Chloride Channels ; antagonists & inhibitors ; metabolism ; physiology ; Chlorides ; metabolism ; Humans ; Nasopharyngeal Neoplasms ; drug therapy ; metabolism ; pathology ; Nitrobenzoates ; pharmacology ; Patch-Clamp Techniques ; Tamoxifen ; pharmacology ; Tumor Cells, Cultured

OBJECTIVESTo analyze the survival rate of orthotopic liver retransplantation (Re-OLT) and identify the variables predicting the outcome.

METHODSA retrospective analysis of 74 Re-OLT patients from January 1999 to December 2005 was performed. The univariate analysis of Kaplan-Meier model was used to investigate the relativity between the factors and survival rate, and COX regression model was used in multivariate analysis to identify the prognostic factors for survival.

RESULTSThe total incidence rate of Re-OLT was 5.7%, and overall patient survival rates at 1 month, 3 month, 1 year and 2 year were 82.4%, 73.8%, 71.9% and 68.5%, respectively. There were 10 factors might influence the survival rate by Kaplan-Meier model, such as the period of Re-OLT, stage of hepatic encephalopathy, prothrombin time, total bilirubin, warm ischemia time, operative surgical procedure, quantity of blood lost during operation, days staying in the intensive care unit (ICU), infection and complications after Re-OLT. And three factors among them were identified as independent prognostic factors for survival by multivariate model: operative surgical procedure, days staying in the ICU and complications after Re-OLT.

CONCLUSIONThe surgical procedure, duration in ICU and complications after Re-OLT are strong predictors for survival after Re-OLT.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Liver Transplantation ; mortality ; statistics & numerical data ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Reoperation ; mortality ; statistics & numerical data ; Retrospective Studies ; Risk Factors ; Survival Rate

BACKGROUNDBivalirudin was widely used as an anticoagulant during coronary interventional procedure in western countries. However, it was not available in China before this clinical trial was designed. This randomized, single-blind and multicenter clinical trial aimed to evaluate the efficacy and the safety of domestic bivalirudin during percutaneous coronary intervention (PCI).

METHODSA randomized, single-blind, multicenter trial was designed. Elective PCI candidates in five centers were randomized into a bivalirudin group and a heparin group, which were treated with domestic bivalirudin and non-fractional heparin during the PCI procedure. The efficacy was evaluated by comparing the activated coagulation time (ACT), the procedural success rate (residual stenosis < 20% in target lesions without any coronary artery related adverse events within 24 hours after PCI), and the survival rate without major adverse cardiac events at 30 days after PCI between the two groups. Safety was evaluated by the major/minor bleeding rate.

RESULTSA total of 218 elective PCI patients were randomized into a bivalirudin group (n = 110) and heparin group (n = 108). Except for two patients needing additional dosing in the heparin group, the ACT values of all other patients in both groups were longer than 225 seconds at 5 minutes after the first intravenous bolus. Procedural success rates were respectively 100.0% and 98.2% in the bivalirudin group and heparin group (P > 0.05). Survival rates without major adverse cardiac events at 30 days after PCI were 100.0% in the bivalirudin group and 98.2% in the heparin group (P > 0.05). Mild bleeding rates were 0.9% and 6.9% (P < 0.05) at 24 hours, and 1.9% and 8.8% (P < 0.05) at 30 days after PCI in the bivalirudin group and heparin group respectively. There was one severe gastrointestinal bleeding case in the heparin group.

CONCLUSIONSDomestic bivalirudin is an effective and safe anticoagulant during elective PCI procedures. The efficacy is not inferior to heparin, but the safety is superior to heparin.

Aged ; Antithrombins ; adverse effects ; therapeutic use ; Female ; Heparin ; therapeutic use ; Hirudins ; adverse effects ; Humans ; Male ; Middle Aged ; Peptide Fragments ; adverse effects ; therapeutic use ; Percutaneous Coronary Intervention ; Recombinant Proteins ; adverse effects ; therapeutic use ; Single-Blind Method ; Survival Rate ; Whole Blood Coagulation Time

OBJECTIVETo investigate estrogen receptor (ER) expression and the effects of anti-estrogen therapy on the prognosis of colorectal carcinoma.

METHODSER was measured in fresh colorectal cancer tissues by Dextran-coated charcoal (DCC) assay. The relationships between ER expression and clinicopathological parameters in colorectal cancer were analyzed. Tamoxifen was administrated postoperatively as adjuvant treatment.

RESULTSThe positive rate of ER in colorectal tumor tissues was 37.0%. The 5-year survival rates of tamoxifen group and control group were 66.7% and 72.5% respectively, and there was no significant difference between the two groups. The distant metastasis rate of Tamoxifen group was significantly lower than that of control group (3% versus 20%).

CONCLUSIONSome colorectal carcinomas are hormone-dependent tumors, and anti-estrogen therapy has no effect on them.

Adult ; Aged ; Chemotherapy, Adjuvant ; Colorectal Neoplasms ; drug therapy ; pathology ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Period ; Prognosis ; Receptors, Estrogen ; metabolism ; Survival Rate ; Tamoxifen ; therapeutic use ; Treatment Outcome ; Young Adult