Biliary complications are a serious problem in patients after liver transplantation, which often results in graft loss, the causes of bile duct stricture are complex. This paper reviewed the mechanism of bile duet stricture after liver transplantation. This complication maybe related with various factors such as liver arterial thrombosis, loss of blood supply of bile duct, warm iscbemia/preservation injury, chronic ductopenic rejection, cytomegalovirus infection, ABO incompatibility, and recurrence of primary sclerosing cholangitis.

Cadmium is one of the important heavy metal pollutants with strong toxicity and wide distribution. It poses a threat to human health and invertebrates,especially to insects. It has been demonstrated that cadmium can infiltrate into insects through respiration ,food intake and so on. It can affect their development,and even induce apoptosis via oxidative damage. Insects can gradually develop defense mechanisms against cadmium with the help of metallothionein,antioxidant enzymes, excretion and heat shock protein. Toxicity effect varies among different species. This paper reviewsed the effect of cadmium on development,cell apoptosis mechanism and defense mechanism in insects.

Objective To compare the characteristics of coronary artery lesions and ventricular systolic, diastolic and synchronous function of non-ST-segment elevation (NSTEMI) with those of ST-segment elevation myocardial infarction (STEMI) in Chinese. Methods One hundred and sixty-eight consecutive patients with NSTEMI 116 and STEMI 52 were enrolled into this study. Coronary angiography (CAG) was performed within 72 hours in all patients, while the parameters of left ventricular function were measured by equilibrium radionuclide angiography (ERNA) with ventricular phase analysis (PA) within 1 week after acute myocardial infarction. Results (1) The incidences of patients associated with diabetes and old myocardial infarction in NSTEMI group were higher than those in STEMI group (30.77% vs 10.34%; 34.62% P

Objective To explore the role of choledochofiberscopy in the diagnosis and treatment of biliary complication after orthotopic liver transplantation.Methods The patients with continuous biliary infection and obstructive jaundice in 6 cases subject to orthotopic liver transplantation were treated by choledochofiberscopy through T tube sinus tract. The findings from choledochofiberscope at different periods after operation were recorded.Results Three to five months after operation, there were a lot of flocs in the bile duct cavity under the choledochofiberscopy, and mucous membrane of bile duct was pale or coarse. On the postoperative month 6, 11 and 18, choledochofiberscopy revealed there were funicular, columned and brown biliary stones in bile duct cavity which mostly located in porta hepatis, and there existed stenosis in anastomotic stoma of bile duct to varying degrees; the wall of bile duct was coarse, with congestion of the mucous membrane. The flocs and stones could be extracted conveniently by the choledochofiberscope.Conclusion We can observe the transplanted liver’s bile duct through the T tube sinus tract by the choledochofiberscopy and treat the biliary complications conveniently.

Objective To investigate the curative effect of arthroscopic treatment for lateral dis-cord meniscus tear in children. Methods The study involved 229 child patients with lateral discord meniscal tear treated arthroscopically from March 1996 to March 2008. There were 133 males and 96 fe-males, at age of (9±3.5) years (range 4-14 years). The treatment methods included meniscus-plasty in 219 patients (including two children with postoperative recurrence), meniscus-plasty-suture in eight and partial meniscectomy in two. The function of the knees was assessed pre-operationally and post-operation-ally by using Lysholm score. Results Of all, 221 patients were followed up for a period of (65±48.9) months (range 5-144 months). The pain and swelling were alleviated, with obvious improvement in range of motion and knee function in all patients six months after operation. There were no complica-tions including intra-articular infection, iatrogenic injury, fibroarthritis or loss of range of motion. Ly-sholm score was (61.85±7.65) points (range 45-73) before operation, which was improved to (95.30±3.50) points (range 87-100 points) six months after operation (t= 26.778, P < 0.01). Conclusion Treatment of lateral discord meniscus tear under arthroscopic guidance in children has the advantages of minor trauma, satisfactory results, can maintain good shape of the meniscus and good func-tion of knee and reduce incidence rate of osteoarthritis.

BACKGROUND: Complications, caused by bile duct injury after liver transplantation, are difficult for diagnosis and treatmerit and the bottlenecks for the development of liver transplantation. OBJECTIVE: To observe and record bile duct injury and do biopsy in parallel with treating biliary complications following liver transplantation successfully with choledochoscope, and to analyze the relationships between various bile duct injuries, histopathological types and biliary complications following liver transplantation. DESIGN, TIME AND SETTING: Case analysis was carried out at Dalian Institute of Hepatobiliary Surgery, Department of Hepatobiliary Surgery. Dalian Friendship Hospital between July 2001 and October 2005. PARTICIPANTS: Nineteen patients after liver transplantation were divided into three groups according to the occurrence of biliary complications: four cases for normal group, twelve cases for bile duct injury group, three cases for hepatic artery miury group. METHODS: They were observed. diagnosed and recorded respectively and take biopsy for pathological analysis through the choledochoscope. With regard to the cases without T-tube. Choledochoscope combined duodenoscope were used to take biopsies. MAIN OUTCOME MEASURES: Choledochoscope was used to observe T-tube cholangiography, the appearances and pathological changes of intemal and external bile duct mucous membrane. healing of the donor-receptor bile duct stoma. Patients in the bile duct injury group were done examinations described above after endoscopic stone extraction and stenosis expansion. RESULTS: The intemal and extemal bile duct anatomy of the patients in the normal group were normal, without bile ductstenosis and scar, their bile duct mucous membrane lookcd good, and the anastomosis of the donor-receptor bile duct healed well. Restored mucous tissue coating with intact epithelium was found by pathological examination. Various kinds of bile duct stones, simple, multiple and casting mould stones, were found in patients of the bile duct injury group. Bile duct mucous membranes were injured at different degrees and repaired after removing stones and relieving obstruction by endoscope. Contrast examination demonstrated that bile duct tree regained normal. In hepatic artery injury group, patients had bile duct wall ischemic necrosis and lost bile duct normal structure, congestion was obvious, biliary sludge and stones completely filled in the bile duct tree. Interrupted bile duct structure were found in Ⅲ grade bile ducts.Pathological examination revealed extensive bile duct wall necrosis,indistinct strcture,more bile infiltration,proliferative granulation tissue and suppuration focus.CONCLUSION:Bile ducts are injured at different degrees in orthotopic liver transplantation;cold preservation/repeffusion injury is the most important initiating agent leading to bile duct tree injuries;the vessel plexus damage and microcirculatory disturbance surrounding the bile ducts maybe one of the mechanisms of the bile duct injury.

A new minimally invasive gallbladder-preserving operation has emerged for the treatment of gallbladder stones,but fundamentally it is a replica of the previous gallbladder preservation method.The gallbladder aids in digestion but is not essential for life.Its function should not be exaggerated and should not instigate trivial reasons for its preservation.Most patients undergoing cholecystectomy maintain a good quality of life.The causes,mechanisms,and prevention of gallstone formation remains mysterious,so a high recurrence rate after gallbladder-preserving operation is difficult to avoid.A full cholecystectomy can avoid recurrence complications and the benefits outweigh the risks.A discussion of the benefits and complications must be initiated to evaluate both treatment modalities for gallstones.

BACKGROUND:The correlation of zinc with Stro-1+cells and bone morphogenetic protein 7 surrounding the prosthesis may affect the bone fusion and survival rate in hip prosthesis. ＜br> OBJECTIVE:To analyze the correlation of zinc content with Stro-1+cells and bone morphogenetic protein 7 in proximal femur. ＜br> METHODS:Bone samples were obtained from the discarded metaphysis region of the proximal femur in 24 patients with primary total hip replacement. Bone marrow mesenchymal stem cells were cultured in vitro. At 14 days after culture, Stro-1+cells in bone marrow mesenchymal stem cells were detected using flow cytometry. Bone morphogenetic protein 7 expression in cellsupernatant was detected using enzyme-linked immunosorbent assay. Zinc content in supernatant was measured using radio-immunity assay. ＜br> RESULTS AND CONCLUSION:No significant difference in the zinc content was detected in different age groups and different gender groups. Zinc content was positively associated with Stro-1+cells and bone morphogenetic protein 7 expression. The further study of the trace element zinc in proximal femur can predict and intervene the longevity of hip prosthesis.

BACKGROUND:The prosthesis fusion rate after total hip replacement is closely related to the reconstruction process of bone,which is affected by the factors around the implant of patient.Trace elements are strongly associated with the ossification.Thus,the content of trace elements in proximal femur may affect the bone fusion and survival rate of the prosthesis.OBJECTIVE:To analyze the correlation of trace elements and bone fusion surrounding the prosthesis in proximal femur.METHODS: Bone samples were obtained from the discarded metaphysis region of the proximal femur in 24 patients with primary total hip replacement.Trace element (calcium,magnesium,zinc,parathyroid hormone,activated vitamin D3) contents were detected aftervitro cel culture.Bone mineral density was tested surrounding the prosthesis at 1 week,3 and 6 months after replacement by dual energy X-ray absorption method with a bone density meter.The difference in trace elements was compared in patients at different ages and different genders.The correlation between above five kinds of trace elements and bone mineral density was analyzed.RESULTS AND CONCLUSION:No significant difference in trace element contents was detected in different age groups and different gender groups (P＞ 0.05).Zinc content was positively correlated with parathyroid hormone and magnesium contents (P＜ 0.05).Zinc was positively associated with bone mineral density in the region 7 (P＜ 0.05).The further studies concerning the trace elements in proximal femur can be used to predict and intervene in the longevity of hip prosthesis.

BACKGROUND: The reason for the short of cornea donator is the olden donating conception or the limit knowledge of cornea transplantation remains poorly understood. OBJECTIVE: To explore the awareness level of the medical staff to corneal transplantation and corneal donation. METHODS: The study consisted of 820 medical staff from different departments of 5 hospitals, including doctor, nurse, technician, and administrator. Awareness level was evaluated with an interviewer-study. RESULTS AND CONCLUSION: Totally 805 interviewer-studies were effect. The correct answer fill rate in department of ophthalmology was higher than other departments. Different measures should be taken to teach the medical staff to improve the awareness level of the transplantation and corneal donation.