Liver transplantation is the best treatment for end-stage liver disease.Because of the severe shortage of donor sources,most of the patients died while waiting for liver grafts.Artificial liver support system can improve the liver function in a short time,and help patients to pass the waiting periods.Artificial liver support system takes place of composition,detoxification and metabolism function of liver,stabilizes the physiological and biochemical index of liver,relieves the burden of liver and helps patients to prepare for the liver transplantation.With the wide application of artificial liver support system,new types of the artificial liver support systems gradually conquered the defects of the old types,but they still have their own defects.This review concludes the merits and demerits of artificial liver systems,its clinical application and the problems so as to help the treatment of end-stage liver disease.

Acute liver failure is a culmination of liver diseases which develop in a common pathophysiologic procession.The mortality rate is very high due to complicated etiology and diagnostic difficulties.Presently,the main method for acute liver failure treatment is dialysis,adjuvant therapy,and liver transplantation.We reviewed new research findings for the treatment of this disease and particular attention was given to practical matters for clinicians to consider in approaching patients.

Objective To study correlation between systemic sclerosis(SSc)and plasma D-dimer and to reveal the probably rules of the fibrinolytic systems in SSc.Methods In 2013 January to 2014 January,cellected 32 patients with SSc and 35 with healthy controls to detected level of plasma D-dimer.Logistic and t student test were used for statistical analysis for correlation between SSc and pulmonary artery hypertension.Results When compared to healthy controls (0.28±0.04μg/ml),the level of plasma D-dimer were significantly increased in SSc patient (0.31±0.05μg/ml,t=1.997,P=0.008).After stratifying SSc patients according to disease subset,whereas patients with diffuse subset displayed substantially increased values (0.41±0.06μg/ml,t=2.051,P<0.001).The level of plasma D-dimer was associated with pulmonary artery hyper-tension (OR=4.38,95%CI=2.59~8.91,P=0.008).Conclusion Demonstrated that SSc patients with diffuse subset are characterized by increased plasma D-dimer values,reflecting a potential activation of fibrinolytic cascaded,which might finally predispose these patients to thrombotic complications and pulmonary artery hypertension.

Objective To investigate the effect of cyaniding?3?glucoside (Cy3G) on glucose and lipid metabolism in the APPswe/PS1ΔE9 mouse model of Alzheimer’s disease (AD). Methods Seven?month?old APPswe/PS1ΔE9(PAP) mice were randomly divided into model group (PAP), Cy3G treatment group (PAPCy, 5 mg/kg/d) and negative?control group (nPAP). In addition, age?matched and normal wild?type of C57BL/6J mice were selected and divided into vehicle group (WT), Cy3G intervention group (WTCy, 5 mg/kg/d). Each group containing 12 mice, with equal number of male and female mice. After 8?week Cy3G supplementation, microPET/CT was used to measure cerebral glucose metabolism rate of mice in each group. Biochemical methods were used to detect the liver / kidney function as well as indicators associated with lipid metabolism. After weighting brain tissue, the brain coefficient was tested and pathological examination was used to observe tissues changes. Transmission electron microscope was used to observe neuropathological amyloid plaques deposition. Western?blot was used to determine protein levels of AKT and JNK. Results Compared with the WT group, PAP mice had low levels of 18 F?FDG uptake rates, especially in the regions of the frontal lobe and hippocampus accompanied by the decreased brain coefficient and amyloid plaques deposition in hippocampus. And levels of aspartate transaminase ( AST) and lactic dehydrogenase ( LDH) were also increased in PAP mice, but lipid metabolism index was relatively normal. In addition, the expression of JNK was decreased and AKT was increased in mice of PAP. However, in the PAPCy group, 18 F?FDG uptake rates were obviously increased in the regions of the frontal lobe and hippocampus compared with those in the PAP mice. And the reduction of brain atrophy and amyloid plaques deposition, normal lipid metabolism and no obvious liver/kidney toxicity were also observed. Cy3G also could reverse the changes of JNK and AKT protein. Conclusions Cy3G can improve glucose metabolism disorders instead of lipid metabolism, inhibit the senile plaques deposition in hippocampus and regulate insulin resistance and inflammatory reaction associated with JNK/AKT pathway. Thus, Cy3G has a good safety profile and may be used as an ideal alternative to traditional disease?modifying treatments against AD.

Objective To provide possible evidences for the medical reform by analyzing the survey data of medical insurance and key cardiovascular diseases among rural residents in Tongnan, Chongqing City. Methods The survey data, collected in Tongnan, Chongqing from Chinese important cardiovascular disease prevalence survey and key technology research which was a multi-stage stratified random sampling questionnaire survey research, was selected to discover the status of medical insurance, cardiovascular dis-eases and medical care among local residents through inputting the data by the Excel 2007 software and through generally descriptively analyzing the data by SPSS 17.0 statistical software. Results Of 1 035 resi-dents, male 534, female 501, total average age was (61.25 ±13.74) years old, the coverage rate of new rural cooper-ative medical insurance was 93.91% and commercial medical insurance was 0.39%; the total morbidity rate of hypertension or diabetes and both was 26.67% (276 patients). Within one year, 94.57%of the 276 patients were not hospitalized but were covered by the medical care and were followed up in the primary health institutions. And only the rest 15 ones (5.43%) were under hospitalization, among which 7 were in primary, 5 were in secondary and 3 were in tertiary medical care institutions; the average hospital-ization frequency was 2.93 times in one year and 6.53 days for each time. The average hospitalization cost was 4 362 yuan each time for each patient after insurance reimbursement. Conclusion It was recommended to continue to implement the new rural cooperative medical insurance in rural areas, to promote the commer-cial medical insurance appropriately, to set up and carry out the hierarchical medical system and the first medical care in community, to adjust medical insurance reimbursement proportions and patterns, to strengthen the cultivation of general practitioners, to establish hospital supports and dual referral system.

Objective To investigate the feasibility and primary therapeutic effect of inverted Y-shaped self-expandable metal stent for complex airway stenosis.Methods On the standpoint of the peculiar anatomic structure and the pathological changes of complex airway stenosis,we designed the inverted Y-shaped self- expandable metal stent.Under the fluoroscopic guidance,7 stents were implanted in 7 cases of airway complex stenosis.Results The inverted Y-shaped self-expandable metal stents were placed seccussfully,with instantaneous relief of dyspnea and improvement of living quality.Conclusion The placement of inverted Y- shaped self-expandable metal stent is feasible and safe for treating airway complex stenosis.(J Intervent Radiol, 2007,16:92-94)

Objective To explore the clinical significance of preoperative ultrasound-assisted drawings in location of thyroid micronodule resection .Methods A total of 88 patients ( 137 nodules ) who underwent thyroid micro-nodule resection were enrolled in the prospective randomized controlled study .All patients were randomly divided into two groups:46 patients (68 micronodules) in experimental group and 42 patients (69 micronodules) in control group.Inclusion criteria:the maximum diameter of nodule≤1.0 cm. Preoperative thyroid ultrasound was conducted .Patients in experimental group also underwent ultrasound-assisted location of thyroid micronodule .Results The diagnostic accuracy rate of US was 81.82%(69/88) in all patients .With the help of ultrasound-assisted location , all nodules in experimental group were found quickly and accurately.The resection rate of experimental group was 100%(46/46).Whereas 4 nodules (in 4 patients ) were missed in control group with a resection rate of 90.5% (38/42).The postoperative US examinations after 3 months showed that all nodules were completely removed in experimental group while 4 nodules retained in control group .Conclusions Preoperative ultrasound-assisted drawings in location of thyroid micronodule plays an important role in thyroid nodule resection .It is great value of clinical application .

0.05),while the level of IL-8,TNF-? and endotoxin changed significantly during CRRT(Pa

Objective To observe the therapeutic effect of curculioside on rats with ulcerative colitis(UC),and to explore its regulatory effect on the protein extracellular regulated kinases(PERK)/activated transcription factor 4(ATF4)/enhancer-binding protein(C/EBP)homologous protein(CHOP)pathway.Methods Sixty-one SD rats were induced by trinitrobenzene sulfonic acid(TNBS)to establish UC model.According to the random number table,they were divided into low,medium and high dose curculioside groups(25,50 and 100 mg/kg citronelioside dissolved in normal saline),mesalazine group(500 mg/kg mesalazine dissolved in normal saline),PERK inhibitor group(GSK2606414 1.0 mg/kg dissolved in normal saline),and model group(normal saline),and another 10 healthy SD rats were recorded as the normal group(normal saline),and the volume of normal saline was 1ml/100g the body weight of rats,gavaged once a day for 10 consecutive days.On the day after the end of administration,disease activity index(DAI)was evaluated.The ratio of lactulose(L)to mannitol(M)excretion rate(L/M)in the 5-hour urine of two groups of rats was determined by Gas chromatography(GC).Double antibody sandwich method was used to measure serum glucocorticoid concentration,and enzyme-linked immunosorbent assay was used to detect serum interleukin-6(IL-6),interferon-γ(IFN-γ),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)levels.Hematoxylin eosin(HE)staining was used to observe the pathological changes of the intestinal mucosa.Real time reverse transcription fluorescence quantitative polymerase chain reaction(RT-qPCR)was used to detect the expression of PERK,ATF4,CHOP,Bcl2 associated X protein(Bax),B lymphoblastoma 2(Bcl-2)messenger RNA(mRNA)in intestinal mucosa.Immunoblotting(WB)was used to detect the expression of PERK,ATF4,CHOP,Bax,and Bcl-2 proteins in intestinal mucosal tissue,as well as the levels of phosphorylated PERK(p-PERK).Results Visual and HE staining observations confirmed successful modeling.Compared with the normal group,the model group had L/M,DAI and intestinal mucosal pathological score,serum glucocorticoid concentration,and serum IL-6,IFN-γ,IL-8 and TNF-α levels,mRNA and protein expressions of PERK,ATF4,CHOP,Bax,and p-PERK increased(P＜0.05),while the mRNA and protein expressions of Bcl-2 decreased(P＜0.05).Compared with the model group,the L/M,DAI and intestinal mucosal pathological scores,serum glucocorticoid concentration,and serum IL-6,IFN-γ,IL-8 and TNF-αlevels,mRNA and protein expressions of PERK,ATF4,CHOP,Bax,and p-PERK of the three dose curculioside groups,mesalazine group,and PERK inhibitor group decreased(P＜0.05),while the mRNA and protein expressions of Bcl-2 increased(P＜0.05).There were no significant differences in glucocorticoid concentration,PERK,ATF4,CHOP,Bax,Bcl-2 mRNA and protein expressions,p-PERK levels between the low dose curculioside group and the mesalazine group,between the medium dose curculioside group and the PERK inhibitor group(P＞0.05),and there were significant differences between each other two groups(P＜0.05).The pathological changes of colonic mucosa in the model group were serious.The low dose curculioside group was relieved,the medium dose curculioside group,the Mesalazine group and the PERK inhibitor group were significantly relieved,and the high-dose group of citronelloside was significantly relieved.Conclusion Curculioside can improve intestinal mucosal barrier function,control disease activity,and alleviate pathological changes in UC rats,which is speculated to be related to the inhibition of the PERK/ATF4/CHOP pathway.

Objective To evaluate the effects of portoenterostomy (Kasai surgery) on living donor liver transplantation (LDLT) for children with biliary atresia (BA). Methods A total of 150 children with BA, who were treated with LDLT in our center from September 2006 to September 2014, were retrospectively analysed. The children were categorized into Kasai group (90 cases, 60%) and non-Kasai (60 cases, 40%) group, based on whether they had previously undergone Kasai procedure pre-LDLT. Clinical data, incidence of complications and accumulated survival rates were compared between two groups. Results The ages of pediatric patients were 4.9-87.0 months. The patient age and height were significantly higher in Kasai group than those of non-Kasai group (P<0.05). The serum bilirubin level was lower before surgery in Kasai group than that of non-Kasai group (P<0.05). There were no significant differences in body weight, pediatric end stage of liver disease (PELD) score, graft to recipient body weight ratio (GRWR), operation time and blood loss between two groups ( P>0.05). Similarly, there were no significant differences in pulmonary infection, acute rejection, portal vein thrombosis, hepatic artery occlusion and biliary complications between the two groups (P>0.05). The overall complication rate of post-LDLT was 61.1%in Kasai group, which was higher than that in non-Kasai group (43.3%,χ2=4.580, P=0.032). Totally, there were 7 cases (4.7%) died on post-LDLT, in which there were 6 cases (4.0%) in Kasai group including 5 cases of multiple organ
failure and 1 case of severe pulmonary infection, and 1 case (0.7%) in non-Kasai group, who died of multiple organ failure due to preoperative gastrointestinal bleeding for emergency surgery. There were no serious complications and death in donors. The overall cumulative survival rates were 98.6%, 96.6%, 94.9%and 92.7%in 1 month, 1 year, 3 years and 5 years after LDLT, respectively. And there were no significant differences in survival rates in 1 month, 1 year, 3 years and 5 years between two groups (χ2=1.490, P=0.222) with the rates of 98.9%, 96.5%, 93.8%, 91.3%in Kasai group and 98.3%, 96.6%, 96.4%, 95.5% in non-Kasai group. Conclusion Performing Kasai procedure can acquire satisfied results to pediatric patients with BA pre-LDLT, without increasing the incidence of major complications and mortality post-LDLT. And the accumulated survival rate is not different in pediatric patients received Kasai surgery compared with that in non-Kasai patient. Besides that, Kasai surgery might postpone the time of receiving LDLT, benefit to the growth of children and reduce the jaundice of pre-LDLT.